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Background: The causative agents and antibiotic resistances causing neonatal sepsis can vary according to the units. In this study, we aimed to analyze infants diagnosed with culture-confirmed late-onset neonatal sepsis in terms of frequency, etiologic factors, causative microorganisms and antibiotic resistance. Materials and Methods: The data of the patients monitored in the Neonatal Intensive Care Unit of Şanlıurfa Training and Research Hospital between 2018 and 2023 were obtained from infection control committee records, patient files, and the hospital data system. Among 1641 hospitalized cases during the specified period, 218 cases diagnosed with culture-confirmed late-onset neonatal sepsis were included in the study. Results: 218 cases that were detected late-onset neonatal sepsis out of 1641 blood cultures examined for sepsis suspicion were included during the study period. 76.1 % of the cases were receiving invasive mechanical ventilator support. 23.9 % had picc lines, 55.5% had umbilical catheters, and 68.8 % had total parenteral nutrition. Among the isolates obtained from blood cultures taken after the third day of the study, 67 % were gram-negative agents. Among the gram negative agents, 43.1% were Klebsiella pneumoniae. Mortality rates were significantly higher in female cases and those receiving central venous catheters and invasive mechanical ventilator support. When the causative agents of sepsis were analyzed, mortality rates were significantly higher in cases with gram-negative agents (p < 0.05). For Klebsiella pneumoniae and Escherichia coli, the resistance rates were found to be, respectively: 96.6% and 40% for Ampicillin, 83.1% and 55% for Gentamicin, 72.9% and 75% for Ceftazidime, 25.4% and 10% for Amikacin, 16.9% and 10% for Imipenem/Meropenem, 6.8% and 0% for Colistin, and 5.1% and 15.8% for Levofloxacin. Conclusions: The microorganisms detected in neonatal intensive care units and antibiotic resistance of these microorganisms may be variable. It is known that sepsis-related mortality rates can be reduced with appropriate empirical treatment, in early recognized late-onset neonatal sepsis cases. Therefore, each unit is recommended to formulate its treatment strategy as the sepsis agents and antibiotic resistances may differ among neonatal units. [ABSTRACT FROM AUTHOR]

Background: Chylothorax following congenital heart surgery is a potentially serious complication that requires early diagnosis and treatment. The aim of this study is to review our experience with the treatment of chylothorax occurring in the early period after congenital heart surgery. Materials and Methods: The records of patients who developed postoperative chylothorax among 1215 patients who underwent surgery for congenital heart disease in our hospital between March 2017 and February 2023 were retrospectively reviewed. Results: Seventeen patients, 11 of whom were male, who developed postoperative chylothorax were included in the study. The median age was 7.5 months, and the median body weight was 6.4 kilograms. Surgical procedures were aortic coarctation repair (five), Glenn operation (four), Tetralogy of Fallot repair (two), Fontan operation (one), atrioventricular canal defect repair (one), ventricular septal defect closure (one), vascular ring repair (one), patent ductus arteriosus ligation (one), and right modified Blalock-Taussig shunt in one patient. The median amount of lymphatic drainage was 4.6 ml/kg/day (2.3 to 8.1 ml/kg/day) and the median lymphatic drainage time was 16.5 days (5 to 38 days). After the chylous fluid drained, total parenteral nutrition and enteral medium-chain triglyceride diet were given. Octreotide was used additionally in 82.4% of the patients. After the chylous fluid drainage stopped, the patients were given a medium chain triglyceride diet for 6 weeks. One patient died due to sepsis. Conclusions: Chylothorax is a complication that causes morbidity after cardiac surgery. Morbidity can be reduced if a correct algorithm determined by the clinic is followed. [ABSTRACT FROM AUTHOR]

Objective: In our study, we analyzed the most cited 101 articles on nutrition from the intensive care literature. Materials and Methods: Using an advanced mode of the Web of Science (WOS), the keys “WC = Critical Care Medicine and TS = nutr* or WC = Critical Care Medicine and TI = nutr* or WC = Nutrition & Dietetics and TS = intensive care or WC = Nutrition & Dietetics and TI = intensive care or WC = Nutrition & Dietetics and TS = critical care or WC = Nutrition & Dietetics and TI = critical care” were used to identify the articles on June 2021. Results: From 1975 to the present a total of 7,093 articles related to nutrition of critical care were published in the WOS. The most cited article received 1,011 citations; the least cited articles received 166 citations. The average number of citations was determined as 287.77±178.57. The mean annual citation number was 21.86±35.46. The most cited article was by McClave, Stephen et al. “Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.” The three most cited areas of critical care nutrition articles focused on “Enteral Nutrition,” “Immune-nutrition,” and “Outcomes of the Nutrition” and were conducted in 20.8%, 20.8%, and 17.8% studies, respectively. The three most frequently journals in the top 101 position were Critical Care Medicine (43.6%), Intensive Care Medicine (10.9%), Clinical Nutrition (7.9%), and the Journal of Parenteral and Enteral Nutrition (7.9%) happened. The USA (38.6%), Canada (%12.9), and England (7.9%) took the top three places for authors. A total of 36.6% of the authors were from the European continent and 63.4% were from outside the European continent. No significant difference was found between the continent of authors, the journal’s index, the total number of citations and the annual average number of citations. A significant relationship was found between the year of publication of the article, the journal in which it was published, the country of the journal in which it was published, continent of the journal, type of the study, the subject area, number of citations per year, and between the type of study and the total number of citations of the article (p<0.05). Conclusion: This is the first study to search for the most citations articles in the field of nutrition in the intensive care literature. The most frequently cited articles in the field of nutrition in the intensive care, included “Enteral Nutrition” and “Immunonutrition” topics. It is noteworthy that the articles published after 2015 and the guidelines and articles on the enteral and parenteral nutrition received more citations in our study. [ABSTRACT FROM AUTHOR]

Objective: Klebsiella pneumoniae infections have been a problem in intensive care units (ICU) in recent years due to multi-drug resistance. In this study, it was aimed to analyze K. pneumoniae infections in ICU, determine distribution of carbapenem resistance rates and risk factors. Methods: Nosocomial infections (NI) with K. pneumoniae between January 2017-January 2020 were evaluated retrospectively. In cases with recurrent K. pneumoniae infection, only the first episode was included. Results: K. pneumoniae infections were developed in a total of 78 patients. Bloodstream infections (BSI) were the most common (51.3%), followed by pneumonia (41%) and urinary tract infections (7.7%). Among BSI cases, 52.5% were associated with central venous catheter (CVC) and 81.2% of pneumonia cases were ventilator-associated pneumonia (VIP). It was observed that while the proportion of BSI was gradually decreasing in years, pneumonia rates have increased. Among BSI, it was observed that the rate of CVC-related BSI was increased from 33.3% in 2017 to 62.5% in 2019. Carbapenem resistance was 52.6% and colistin resistance was 17.9% in K. pneumoniae isolates and both increased over 3 years. When carbapenem-resistant K. pneumoniae infections were compared with carbapenem-sensitive K. pneumoniae infections, the independent risk factors associated with carbapenem resistance were found to be carbapenem use (p=0.008, OR: 8.45, 95% CI: 1.76-40.64), prior NI developing with different microorganism (p=0.005, OR: 8.70, 95% CI: 1.91-39.65) and total parenteral nutrition (TPN) use (p=0.04, OR: 4.2, 95% CI: 1.06-16.67). Conclusions: Carbapenem-resistant K. pneumoniae infections are gradually increasing in ICUs, and colistin resistance has started to be observed recently. Our study showed that carbapenems are independent risk factors in carbapenem resistance and suggested that carbapenem use should be restricted in our unit. It is important for each center to reveal its own data of frequency and resistance, in order to decrease infection rates with the infection control measures and determine the antibiotic using policies. [ABSTRACT FROM AUTHOR]

Copyright of Eurasian Journal of Veterinary Sciences is the property of Eurasian Journal of Veterinary Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: Initiation of high protein, especially on the first day, was reported to positively affect growth and neuromotor development in premature infants. However the effect of high protein content on metabolic and biochemical parameters is unknown. The aim of this study was to investigate the effects of low and high dose protein administration on biochemical parameters in premature infants. METHODS: Premature infants born ≤34 gestational weeks were included in this retrospective study. The infants were divided into two groups as low protein (LP; first day of 1 g/kg/day, daily 1g increments up to max. 3 g/kg/day) and high protein (HP; first day 3 g/kg/day, max. 3,5-4 g/kg/day) and both groups were compared in terms of antenatal and postanatal characteristics, biochemical results, and growth. RESULTS: A total of 364 infants, 264 in HP and 100 in LP groups, were included in this study. When the groups were compared in terms of biochemical markers; blood urea nitrogen levels showed an increase in HP group in correlation with protein intake, however, no deterioration in renal functions occurred. No electrolyte impairment was observed between two groups. Compared with HP group, more number of infants in LP group had weight, height, and head circumference of <3 percentile at the time of hospital discharge DISCUSSION and CONCLUSION: This study showed that high dose protein administration is safe and effective. Furthermore, when considering the positive effects on postnatal growth, it was observed that the main goal of the feeding was achieved. [ABSTRACT FROM AUTHOR]

Vitamin B12 is found in animal foods acts as cofactor in two enzyme systems in human body. Vitamin B12 shows the majority of its physiological effects via to its contribution to the homocysteine methionine cycle. Vitamin B12 deficiency is mostly caused by disorders related to absorption mechanisms and is associated with many diseases primarily neurological and hematological diseases. Due to increasing measurement uncertainty, serum vitamin B12 levels should be determined as well as homocysteine levels. Finally, parenteral treatment approaches is accepted as a more accurate method with vitamin B12 deficiency. [ABSTRACT FROM AUTHOR]

Objective: Home care services (HCS) is delivery of the healthcare and attendant care service to the patients living with their families by healthcare professionals in accordance with physicians' recommendations so as to meet their medical needs including rehabilitation, physiotherapy, psychological therapy. In our study, it was aimed to evaluate the infections developing in the patients followed by HCS. Methods: Follow-up forms of 361 patients visited by the staff of the HCS unit between January 20-11 and January 2013 were evaluated retrospectively. Results: 143 (39.6%) of the patients followed up by HCS unit were male and the mean age was 69.2±17.8 years. In terms of underlying diseases, 201 (55.7%) of patients had cerebrovascular disease, 187 (51.8%) had ischemic heart disease, 165 (45.7%) had hypertension, 65 (18%) had diabetes mellitus and 67 (18.6%) had solid organ malignancy. 153 (42.4%) patients were completely bedridden. 53 (14.7%) of them had an indwelling urinary catheter. 53 (14.4%) patients had decubitus ulcer. 18 (5%) of the patients were feeding with parenteral nutrition, 13 (3.6%) were feeding via a nasogastric tube and 10 (2.8%) were feeding via a jejunal tube. 88 episodes of infection were identified in 68 (18.8%) of 361 patients followed up throughout the study period. Urinary system infections (41%) and lower respiratory tract infections (26%) were the most common infections in patients. Conclusions: In our study, urinary system infections and lower respiratory tract infections are most commonly observed among patients receiving HCS. Being completely bedridden is a risk factor for developing infection among the patients receiving HCS. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Our aim is to examine the clinical characteristics of patients in a palliative care center and to investigate the factors associated with long-term hospitalization and hospital discharge status. Methods: The study is described as a cross-sectional-retrospective study. The files of who applicate patients were examined between August 1, 2015 and July 30, 2017 term in palliative care center. Demographic characteristics, comorbid conditions, numbers of medication, complaints of hospitalization, nutritional, pressure sore, and pain status at first hospitalization were evaluated for whole patients. Variables were analyzed using Spearman's correlation test that factors associated with long-term hospitalization (≥15 days) and discharge status (go home, referred to advance intensive care unit, and ex). Results: The mean age of 319 patients (55% male, 45% females) was 71±15.8 and mean duration of hospitalization was 15.4±15.7 days. The most common comorbid diseases were malnutrition (59%), malignancy (44%), and infectious disease (33%). The most frequent admission complaints were oral intake impairment (35%), general condition impairment (15%), and fever (17%). Positive factors associated with long-term hospitalization were advanced stage pressure sore (r=0,366; p<0,001), cerebrovascular disease (r=0,175; p=0,002), hypertension (r=0,158; p=0,005), and diabetes mellitus (r=0,129; p=0,021). Positive factors related to discharge status (referred to intensive care unit and/or ex) were malignancy (r=0,234; p<0,001), using opioid (r=0,204; p<0,001), parenteral nutrition (r=0, 20; p<0.001) and weakness-fatigue symptoms (r=0.115, p=0.041). Conclusion: Advanced stage pressure sore are the most important factor that prolongs the length of hospital stay. The most effective factors for patients with discharge status are malignancy, using opioid, parenteral nutrition and the symptoms of weakness-fatigue. [ABSTRACT FROM AUTHOR]

Type B lactic acidosis is an under-recognized clinical entity that must be distinguished from type A (hypoxic) lactic acidosis. A 56-year-old female with a history of colon carci- noma with liver metastasis underwent right hemicolectomy, ileocolic anastomosis, and liver metastasectomy. Two days later, she presented to the general surgical intensive care unit with fever, hypotension, and tachycardia. Arterial blood gas analysis revealed a pH of 7.35, a PaCO2 of 44.8 mm Hg, an HCO3- level of 22.1 mEq/L, a base deficit of -3.3 mmol/L, and a lactate level of 4.3 mEq/L. Liver functions were moderately elevated (AST: 647 U/L, ALT: 153 U/L) on admission. Wound culture revealed the presence of Escherichia coli, and piperacillin-tazobactam was prescribed. She received adequate fluid resuscitation with normal saline, antibiotics for treating septic shock, and norepinephrine for maintaining appropriate blood pressure. Despite achieving blood pressure appropriate for her age and improved tissue perfusion, the patient's lactate level increased to 23 mEq/L. Abdominal computed tomography with angiography showing vascular structures was concerned for possible anastomosis leakage, given the rise in lactate levels with concern for intra-abdominal pathology. There were no signs of perforation and ischemia. Because of a high suspicion that the patient's hyperlactatemia was not due to tissue hypoxia, we used the patient's blood sample to measure the vitamin B1 (thiamine) level. We did not immediately perform thiamine replacement because hyperlactatemia did not accompany acidosis. Her thiamine level was 10 µg/L (range, 25--75 µg/L). Then, 100 mg/day of intravenous thiamine was administered. Within 3 days, her lactate level fell to 2.5 mmol/L; within 24 h, it fell to 1.9 mmol/L. Additional history revealed that she had been taking very little nutrition by mouth before admission and that she was primarily dependent on total parenteral nutrition (TPN). There were no vitamins in her TPN; thus, she was likely to be thiamine deficient during her initial presentation. [ABSTRACT FROM AUTHOR]

Objective: To detect the effects of care bundle that is prepared depending on guidelines for central line associated infections. Material and Method: Patients in a tertiary medical intensive care unit were followed up during one year period in terms of catheter infections. The care bundle that was prepared depending on guidelines was performed for all central catheter placements. Catheters were evaluated in terms of local or systemic bloodstream infections everyday. Data obtained were compared with the previous year's data. Results: We concluded that age, gender or weight characteristics have no effect on central venous catheter related infections but we detected higher infection rates at patients who had higher APACHE 2 scores. Bloodstream infection rates related with central catheter were similar between catheters inserted at operation rooms or intensive care units but catheters inserted at out services had higher infections rates. It was shown that prolonged catheter duration is related with high infection levels but anatomic place of catheter has no relationship with infection rates. No relationship was found between clothing type and infection rate. Total parenteral nutrition, blood or blood product administration via central catheter has increased infection rates. Conclusion: Performing care bundles decreases central venous catheter utilization rates central line associated bloodstream infection rates. [ABSTRACT FROM AUTHOR]

Objective: Malnutrition is a common clinical condition that leads to an increase in morbidity and mortality of critically ill patients. Good nutritional support treatment is essential for the reduction or prevention of malnutrition. In this study, by examining nutritional support therapy in a medical intensive care unit (ICU), we aimed to determine the methods, problems, efficiency, and impact of this therapy on mortality. Material and Methods: Patients hospitalized for more than 72 hours in a medical ICU of a university hospital between January 01, 2010 and June 30, 2010 were included into the study. In this retrospective study, 159 patients were accepted. Patient demographics and nutrition-related data were extracted from hospital and ICU databases, patient files, and records of nursing care. SPSS for Windows, version 15.0 was used to analyze the data. Results: In the study population, the median age was 66 years, and 51% of the patients were men. The median Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II score was 24, and the median nutritional risk screening (NRS) 2002 score was 5. Based on NRS 2002, 99.4% of the patients had malnutrition and needed nutrition support therapy. There was occasional oral intake in 46.0% of the patients. As it was insufficient, enteral nutrition (EN) was delivered in 45%, whereas parenteral nutrition (PN) nutrition was delivered in 88% of the patients. Patients received only 50% of the targeted amount of calories, and only 36% of the targeted amount of proteins on day 3 of nutritional support therapy. The targeted amount of calories was achieved in only 31.4%, while the targeted amount of proteins was achieved in only 33.3% of the patients. In the multivariate analysis, it was demonstrated that mortality was increased by high APACHE II and NRS 2002 scores and modification or interruption of EN and PN, whereas mortality was decreased by oral feeding. Conclusion: It was demonstrated that severe nutritional support was needed in patients admitted to a medical ICU in a university hospital during the first 6 months of 2010 and that the targeted amount of calories and proteins was achieved in a minority of patients, despite the combined use of EN and PN. It was also demonstrated that mortality was increased by high APACHE II and NRS 2002 scores and modification or interruption of EN and PN. [ABSTRACT FROM AUTHOR]

In our study we investigated the effects of parenteral nutrition (PN) solutions on Coagulase negative staphylococci (CoNS) biofilm production. [ABSTRACT FROM AUTHOR]

We aimed to investigate impact of insertion site, indication of catheterization and other clinical feature on complications and success rate in our study. 699 patients who underwent central venous catheterization in Cardiology and Cardiovascular Surgery Units between March 2008 To May 2010 were included in our study. Age, sex, insertion site, indication of catheterization, units, complications and level of prosperity-success. 699 patients were included the study which mean age 56.6±19.5. Most commonly used sites were internal juguler vein, the subclavian vein, and the femoral vein (71.5%, 25.7%, 2.8%; respectively). According to indications of catheterization, primary success rates were 93.2%in central venous pressure measurement group, 89.1%in dialysis group,%87.1 in liquid-drug infusion group and 69%in total parenteral nutrition group. The total complication rate, in all patients who underwent catheterization was found 6.15%. The most frequent complication was catheter dysfunction in all patient%2.15, (n=15). In terms of catheterisation endication, the highest complication risk group was detected in total parenteral nutrition group (10.3%), and the lowest risk group was liquid-drug infusion group (4.6%). There was higher complication rate in suclavian vein group than internal juguler vein group. (8.8%and 4.6%, p=0.001). Our study showed that most confidence way in terms of complications and primary success is internal juguler vein. Indications of catheterization also affect the success and complication rates. [ABSTRACT FROM AUTHOR]

Iron intoxication typically occurs in children who accidentally ingest iron pills as candy, and it can be lethal. Iron intoxication due to parenteral iron in the childhood period has not been reported previously. In this article, we report a 16-year-old boy who presented symptoms indicating iron intoxication after one-month parenteral iron administration. The total dose was 1500 mg elemental iron. He was admitted following 15 days of pallor, headache, weakness, and nausea. Laboratory investigations revealed hemolytic anemia, elevation in hepatic enzymes, and highly elevated serum iron and ferritin levels. The patient was diagnosed as iron intoxication, and treatment with intravenous deferoxamine was started. [ABSTRACT FROM AUTHOR]