Background: Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a high mortality rate. Although CCHF has been widely investigated over the past decade, a review of the literature indicated no data on the prognostic capacity of the mean platelet volume-to-platelet count ratio (MPVPCR) and the red cell distribution width-to-platelet count ratio (RDWPCR) for the systemic inflammatory response in patients with CCHF. This study aimed to evaluate the prognostic ability of MPVPCR and RDWPCR on mortality in patients with CCHF.
Methods: A total of 807 patients that were admitted to the Cumhuriyet University Hospital’s Emergency Department from January 2010 to December 2018 were involved. The RDWPCR and MPVPCR were separately calculated via absolute blood red cell and platelet counts at the time of admission. Before performing receiver-operating characteristic (ROC) curve analysis to define the optimum cut-off values of MPVPCR and RDWPCR stepwise logistic regression analysis was used to determine the predictive factors related to mortality in CCHF patients.
Results: Values of both MPVPCR and RDWPCR were significantly lower in survivors than in non-survivors (MPVPCR: 0.20±0.23 versus 0.55±0.55, P<0.001; RDWPCR: 0.27±0.32 versus 0.77±0.77, P<0.001, respectively). The MPVPCR (odds ratio [OR], 5.95; P=0.048) was an independent predictor for the prognosis of mortality in CCHF patients. The area under the curve in the ROC curve analysis for MPVPCR was 0.876 with a cut-off of 0.21 (sensitivity 87%, specificity 76%).
Conclusion: At the time of admission, MPVPCR might be a useful predictor of mortality in patients with CCHF.
To the Editor:
I have followed, with great interest, the passionate debate held between Lichtman, and Ashkenazi and Olsha in Rambam Maimonides Medical Journal. Lichtman put forward a curious and enlightening proposal to offer a fractional value to each author, depending on the value of their relative contribution, with the total amounting to 1, as a way to reduce authorship abuses, such as gift or guest authorship, which are two very prevalent forms of authorship abuses in academic publishing today.
The outbreak of coronavirus disease 2019 (COVID-19) in Italy, the first Western country hit by the pandemic, seriously impacted the Italian healthcare system and social and economic environment. This perspective piece focuses on the main challenges faced by Italian hospital managements: hospital overcrowding; the need for urgent reorganization of the country’s healthcare systems; the lack of data regarding COVID-19 diagnostics, clinical course, and effective treatment; individual and collective consequences of the crisis; and the importance of disease containment measures and early treatment strategies.
Objective: Idiopathic eosinophilic vasculitis has been described in previous case series as a possible manifestation of hypereosinophilic syndrome (HES) in asthma-free patients. A rare disease, it can be classified as an eosinophilic-rich, necrotizing, systemic form of vasculitis that affects vessels of various sizes in these patients. This report shares our experience with the treatment of a patient with eosinophilic vasculitis.
Case Presentation: We present the case of a 45-year-old man who suffered from idiopathic HES manifesting as digital ulcers and peripheral ischemia of both the upper and lower limbs without the involvement of other systems. Diagnosis was made after excluding the primary and secondary causes of eosinophilia. The patient responded well to both corticosteroids and mepolizumab, an interleukin-5 inhibitor, as a corticosteroid-sparing therapy.
Conclusion: Our case of HES-associated vasculitis in an asthma-free patient supports previous reports describing this rare diagnosis of idiopathic eosinophilic vasculitis in recent years. We describe a good response to mepolizumab (interleukin-5 inhibitor) in our patient.
Background and Aims: Irritable bowel syndrome (IBS) poses a significant healthcare challenge, characterized by chronic gastrointestinal and extraintestinal symptoms impacting individuals’ well-being. Treatment preferences may vary among patients from different ethnic groups, such as Arab and Jewish Israelis, necessitating tailored approaches.
Methods: A bilingual (Hebrew/Arabic) questionnaire assessing patients’ preferences regarding treatment goals was developed. It was administered online in Israeli IBS Facebook groups, as well as in two hospital gastroenterology clinics.
Results: The study included 267 IBS patients (91 Arabs and 176 Jews). Demographic analysis revealed a higher proportion of females in both groups, with a significantly greater percentage among Jews compared to Arabs (84% versus 64.8%, respectively, P<0.001). The median age was 32 years for both Arabs and Jews (interquartile ranges of 26–42 and 24–62, respectively). Arabs exhibited higher rates of mixed-type IBS and constipation, while Jews had a higher prevalence of predominant diarrhea IBS. Arabs reported more bloating, higher rates of IBS-related comorbidities, and more medication usage. When asked to rate the importance of treatment goals, both populations preferred improvement in abdominal pain, bloating, and regular defecation, while assigning lower importance to improving difficulty in mental and/or physical aspects of intercourse, as well as arthralgia and myalgia. Arab patients assigned lower importance scores to various symptoms compared to their Jewish counterparts.
Conclusion: This study highlights the impact of ethnicity on patients’ treatment goals. Understanding patients’ preferences will enable tailoring an individual approach to each IBS patient.
The recently published paper “US Medical Schools’ 2024 Commencements and Antisemitism: Addressing Unprofessional Behavior” discusses antisemitism expressions and unprofessional behavior in US medical schools’ 2024 commencement ceremony. While we share the authors’ concerns regarding rising antisemitic, anti-Palestinian and anti-Muslim bias, alongside hateful behavior toward minorities and immigrants in the US in general and in medical schools in particular, we are also concerned about the significant bias informing this paper. The authors mistakenly conflate antisemitism with harsh criticism of Israeli government and the actions of its military, and legitimate acts of solidarity with people under oppression. This fallacy is further aggravated by serious concerns (mentioned by the authors themselves) involving the paper’s methodological and statistical shortcomings. Ultimately, the paper lacks scientific rigor and appears to be ideologically motivated rather than a contribution to objective research. Scholars worldwide, Jews and Israelis amongst them, have demonstrated that these are legitimate protests, and the interpretation of their messaging as antisemitic is just another way to silence Palestinian voices calling for freedom and liberation, and delegitimizing critique on the Israeli government. This paper aims to provide the reader with currently published evidence and scientific controversy regarding this issue, that the discussed paper failed to mention.
