To evaluate the etiology and characteristics of vertebral osteomyelitis cases in our country, patients with vertebral osteomyelitis between January 2000 and December 2007 were included in this study. Clinical and laboratory data of the patients were collected from the medical records retrospectively. Of these 100 patients, 44 had pyogenic, 24 had brucellar, and 32 had tuberculous spondylodiscitis. The age of the patients ranged from 13 to 82 years, with a mean of (SD±) 55 ± 15.6 years. Within the pyogenic group, 10 (22.7%) patients had a spinal surgery history, and in 18 patients of the pyogenic group, an etiological agent was isolated. Ten (56%) of these 18 were methicillin-sensitive Staphylococcus aureus. While all of the patients included in this study suffered from pain, 49 of these had fever. Sixty-nine percent of the patients had lumbar involvement. The etiological distribution may differ according to geographical areas. Although brucella and tuberculosis (TB) are endemic in our country, pyogenic vertebral osteomyelitis was more frequent. The most common involved area in our patients was the lumbar vertebrae. Although thoracic involvement may be more predominant in tuberculous vertebral osteomyelitis, it does not strongly suggest TB. Magnetic resonance imaging may exclude some disorders mimicking vertebral osteomyelitis and may delineate the degree of the involvement. Microbiological and/or histopathological examination of computerized tomography-guided fine-needle aspiration biopsies are the mainstays for the diagnosis. Suspicion and early diagnosis seem critical for preventing sequelae development.

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Background It is known that inflammatory responses play an important role in the pathophysiology of COVID‐19. Aims In this study, we aimed to examine the role of kynurenine (KYN) metabolism on the severity of COVID‐19 disease AQ5. Materials & Methods Seventy COVID‐19 patients of varying severity and 30 controls were included in the study. In addition to the classical laboratory parameters, KYN, tryptophan (TRP), kynurenic acid (KYNA), 3 hydroxykynurenine (3OHKYN), quinolinic acid (QA), and picolinic acid (PA) were measured with mass spectrometry. Results TRP, KYN, KYN:TRP ratio, KYNA, 3OHKYN, PA, and QA results were found to be significantly different in COVID‐19 patients (p < 0.001 for all). The KYN:TRP ratio and PA of severe COVID‐19 patients was statistically higher than that of mild‐moderate COVID‐19 patients (p < 0.001 for all). When results were examined, statistically significant correlations with KYN:TRP ratio, IL‐6, ferritin, and procalcitonin were only found in COVID‐19 patients. ROC analysis indicated that highest AUC values were obtained by KYN:TRP ratio and PA (0.751 vs 0.742). In determining the severity of COVID‐19 disease, the odd ratios (and confidence intervals) of KYN:TRP ratio and PA levels that were adjusted according to age, gender, and comorbidity were determined to be 1.44 (1.1–1.87, p = 0.008) and 1.06 (1.02–1.11, p = 0.006), respectively. Discussion & Conclusion According to the results of this study, KYN metabolites play a role in the pathophysiology of COVID‐19, especially KYN:TRP ratio and PA could be markers for identification of severe COVID‐19 cases.

Aim. The use of erythrocyte sedimentation rate (ESR) in coronavirus disease 2019 (COVID-19) to determine disease severity and prognosis is limited. This study aimed to interrogate the diagnostic and prognostic role of ESR compared to other acute-phase reactants. Method. This retrospective cross-sectional study included 493 confirmed and hospitalized adult COVID-19 patients. Pneumonia, radiological severity, oxygen, intensive care requirements, mortality, ESR, and other acute-phase reactant values were recorded. Logistic regression and ROC analysis identified the effect of ESR on mortality and the sensitivity and specificity of the optimal cutoff values of ESR for the prediction of pneumonia, intensive care needs, and mortality and compared these with values for CRP. Results. Of patients, 346 (70.2%) had pneumonia, 98 (19.9%) required intensive care, 183 (37.1%) required oxygen support, and 62 (12.6%) died. ESR data were obtained for 278 patients. Among patients, 80.2% had ESR above 20 mm/h, with a median value of 53 (interquartile range: 49). ESR was higher among those with pneumonia ( p < 0.001 ), requiring oxygen ( p < 0.001 ), and requiring intensive care ( p = 0.003 ) compared to those without these, and in exitus patients ( p = 0.043 ) compared to survivors. Logistic regression analysis identified that ESR did not impact mortality. ROC analysis found the AUC, cutoff, sensitivity, and specificity results of ESR for pneumonia were 0.827, 37 mm/h, 77%, and 78%; for intensive care were 0.625, 50 mm/h, 74%, and 52; and for mortality were 0.606, 51 mm/h, 71%, and 49%, respectively. However, ROC analysis values for CRP were superior to ESR for all these categories. Conclusion. ESR increased in COVID-19 patients in the presence of pneumonia and severe disease; however, it was not prognostic. Sensitivity and specificity values for pneumonia, intensive care requirements, and mortality were lower than those for CRP.

Malaria is a condition that threatens millions of people in many countries in spite of precautions. Sporadic cases have not been observed in our country since 2010, but imported malaria cases are still to be seen because of migration. In this study, two malaria cases are presented that appeared in a non-endemic region within 1 week. Complaints appeared 20 days later after leaving Ivory Coast in the first case and one week after returning from Ghana in the second case. With this two import cases which have a travel story about two different countries and non taking regular chemoprophylaxis; it is aimed to call attention that malaria is a question of common concern and a protozoon which needs to be struggled worldwide.