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Coronavirus Disease-19 (COVID-19) is a highly contagious infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The development of rapid antigen tests has contributed to easing the burden on healthcare and lifting restrictions by detecting infected individuals to help prevent further transmission of the virus. We developed a state-of-art rapid antigen testing system, named DIAGNOVIR, based on immune-fluorescence analysis, which can process and give the results in a minute. In our study, we assessed the performance of the DIAGNOVIR and compared the results with those of the qRT-PCR test. Our results demonstrated that the sensitivity and specificity of the DIAGNOVIR were 94% and 99.2%, respectively, with a 100% sensitivity and 96.97% specificity, among asymptomatic patients. In addition, DIAGNOVIR can detect SARS‑CoV‑2 with 100% sensitivity up to 5 days after symptom onset. We observed that the DIAGNOVIR Rapid Antigen Test’s limit of detection (LoD) was not significantly affected by the SARS‑CoV‑2 variants including Wuhan, alpha (B1.1.7), beta (B.1.351), delta (B.1.617.2) and omicron (B.1.1.529) variants, and LoD was calculated as 8 × 102, 6.81 × 101.5, 3.2 × 101.5, 1 × 103, and 1 × 103.5 TCID50/mL, respectively. Our results indicated that DIAGNOVIR can detect all SARS-CoV-2 variants in just seconds with higher sensitivity and specificity lower testing costs and decreased turnover time.

Objective: Appendicitis is a common surgical emergency among children. The coronavirus pandemic affected the system of hospitals more than any other field, and great amount of people were concerned about visiting the hospitals for any reason. In this study, it was aimed to evaluate the profile of appendicitis by emphasizing perforated and acute appendicitis in the pandemic period and to compare the rates with previous three years. Material and Methods: Charts of the children who underwent laparoscopic appendectomy due to appendicitis between March 11-September 30 between 2017-2020 were retrospectively analyzed in terms of demographic data, duration of symptoms, duration between hospital admission and surgery, radiologic imaging and perioperative outcomes. Results: This study includes 467 children who underwent laparoscopic appendectomy. There were 97 procedures in 2020, 111 in 2019, 146 in 2018 and 113 in 2017. Multiple comparison tests revealed that age did not show difference; but onset of symptoms in admission (p= 0.004), hospitalization time before surgery (p< 0.001), total hospitalization time (< 0.001) showed statistically significant difference between years. Pairwise comparisons showed that these parameters were increased in 2020 compared to other years. Perforated appendicitis rate was significantly increased in 2020 when compared to previous years. Conclusion: Although there is no direct relation between appendicitis and COVID-19 infection in the current knowledge, perforated appendicitis was found to be increased in children during the COVID pandemic. Reason of the higher rate of perforated appendicitis may be multifactorial; however, the pandemic appears to have a role in increased morbidity in children with appendicitis indirectly due to delay of hospital admissions.

Coronavirus Disease 2019 (COVID-19) is a viral infection first seen in Wuhan, China, in December 2019 and then affected the whole world by causing a pandemic. The disease may be asymptomatic, and symptoms such as fever, cough, shortness of breath, weakness, headache, and sore throat can be seen. Various bacterial infections may accompany the process in some COVID-19 patients. In this case, accompanying Fusobacterium nucleatum bacteremia in a patient diagnosed with COVID-19 was examined.

Amaç: Hepatit B virüs (HBV) enfeksiyonu halen tüm dünyada önde gelen sağlık sorunlarından biridir. Karaciğer, vitamin D (Vit-D)’nin metabolizması ve depolanmasında önemli bir organdır. Vit-D’nin hücre farklılaşması, çoğalması ve bağışıklık modülasyon inhibisyonu da dâhil olmak üzere çok önemli bir biyolojik etkiye sahip olduğu bilinmektedir. Son zamanlarda, Vit-D düzeylerinin HBV enfeksiyonu gibi viral enfeksiyonlara karşı immün sistem ve konak yanıtını etkileyebileceği düşünülmektedir. Bu çalışmamızda amaç HBV ile enfekte bireyler ve HBV ile enfekte olmayan bireylerde Vit-D düzeyini karşılaştırıp Vit-D düzeyinin HBV replikasyonu ve hastalığın progresyonu ile ilişkisini saptamaktır.Materyal ve Metod: Çalışmamız retrospektif olarak gerçekleştirilen tanımlayıcı bir çalışma olarak tasarlanmıştır. Dicle üniversitesi Tıp Fakültesi Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniğine Ocak 2014 - Aralık 2015 tarihleri arasında başvuran HBsAg pozitif ve HBV DNA’sı negatif 29 hasta, HBsAg pozitif ve HBV DNA‘sı 2000-20000 IU/ml olan 30 hasta, HBsAg pozitif ve HBV DNA’sı >20000 IU/ml olan 31 hasta ile HBsAg negatif ve komorbiditesi olmayan ancak halsizlik, yorgunluk şikâyeti ile polikliniğimize başvurup vitamin-D düzeyleri bakılmış olan 45 hasta kontrol grubu olarak çalışmamızda değerlendirmeye alınmıştır. Hastaların başlangıç, 6. ay ve 12. ay 25 (OH) D düzeyleri incelenmiştir. Bu çalışmada kullanılan kit için üretici firmanın belirlediği 25 (OH) D referans aralıkları; eksik (, Giriş ve Amaç: Hepatit B virüs (HBV) enfeksiyonu halen tüm dünyada önde gelen sağlık sorunlarından biridir. Karaciğer, vitamin D’nin metabolizması ve depolanmasında önemli bir organdır. Vitamin D’nin, hücre farklılaşması, çoğalması ve bağışıklık modülasyon inhibisyonu da dâhil olmak üzere çok önemli bir biyolojik etkiye sahip olduğu bilinmektedir. Son zamanlarda, vitamin D düzeylerinin HBV enfeksiyonu gibi viral enfeksiyonlara karşı immün sistem ve konak yanıtını etkileyebileceği düşünülmektedir. Bu çalışmamızda amaç HBV ile enfekte bireyler ve HBV ile enfekte olmayan bireylerde vitamin D düzeyini karşılaştırıp vitamin D düzeyinin HBV replikasyonu ve hastalığın progresyonu ile ilişkisini saptamaktır. Gereç ve Yöntem: Çalışmamız retrospektif olarak gerçekleştirilen tanımlayıcı bir çalışma olarak tasarlanmıştır. Dicle üniversitesi Tıp Fakültesi Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniğine Ocak 2014 - Aralık 2015 tarihleri arasında başvuran HBsAg pozitif ve HBV DNA’sı negatif 29 hasta, HBsAg pozitif ve HBV DNA‘sı 2000-20000 IU/ml olan 30 hasta, HBsAg pozitif ve HBV DNA’sı >20000 IU/ml olan 31 hasta ile HBsAg negatif ve komorbiditesi olmayan; ancak halsizlik, yorgunluk şikâyeti ile polikliniğimize başvurup vitamin-D düzeyleri bakılmış olan 45 hasta kontrol grubu olarak çalışmamızda değerlendirmeye alınmıştır. Hastaların başlangıç, 6. ay ve 12. ay 25 (OH) D düzeyleri incelenmiştir. Bu çalışmada kullanılan kit için üretici firmanın belirlediği 25 (OH) D referans aralıkları; eksik(

Background/aim Most of the hospitalized patients are on a number of drugs for comorbidities and/or to prevent nosocomial infections. This necessitates a careful consideration of drug interactions not only to avoid possible toxicities but also to reach the highest efficiency with drug treatment. We aimed to investigate drug interactions related to systemic antibiotic use and compare three different databases to check for drug interactions while characterizing the main differences between medical and surgical departments. Materials and methods This point prevalence study covered data on 927 orders for patients hospitalized between June 3 and 10, 2018 in Ankara University Hospitals. Systemic antibiotic use and related drug interactions were documented using UptoDate, Drugs, and Medscape and comparisons between the departments of medical and surgical sciences were made. Results The number of orders, or the number of drugs or antibiotics per order were not different between the medical and surgical sciences departments. A total of 1335 antibiotic-related drug interactions of all levels were reported by one, two, or all three databases. UptoDate reported all common and major interactions. Pantoprazole was the most commonly prescribed drug and appeared in 63% of all orders. Among 75 different molecules, ceftriaxone and meropenem were the two most prescribed antibiotics by the surgical and medical departments, respectively. Conclusion A dramatic variance existed amongst antibiotics prescribed by different departments. This indicated the requirement for a centralized role of an infectious diseases specialist. Especially for the hospitalized patient, prophylactic coverage with at least one antibiotic brought about a number of drug interactions. A precise evaluation of orders in terms of drug interactions by a clinical pharmacist (currently none on duty) will reduce possible drug-related hazards.

Gender is the attitudes and behaviors expected of men and women as a result of cultural codes and stereotypes adopted by society. As a concept, it began to be used more after the 1960s. With the feminist movement coinciding with the same period, it started to occupy the agenda of society and gained recognition. It is still an issue that remains up-to-date today. This study is aimed to examine how artists from past to present have addressed the concept of woman and womanhood in their artworks, by emphasizing which subjects, and how they associate it with textiles. It is aimed to explain what the changes/immutables in this field are and how the perception of women in the minds manifests in the production of artworks. The development of the concept of gender in the field of art and the forms of expression are explained with examples by making a literature review on the subject. In this context, the artworks produced using textile material within the framework of the concept of women and womanhood of artists who have been accepted in the field of national and international contemporary art are included in the study. As a result of the research, it was seen that the artists used bodily contents and objects identified with women intensely in their artworks. On the other hand, textiles offered metaphorical expression to the artists according to the way of expression in the artworks.

WOS:000605350300001 Objectives: Hepatitis B virus (HBV) affects a significant part of society and is characterized by high mortality and morbidity. Hepatitis B affects approximately 350 million people worldwide, many of whom are chronic patients. Especially being under immunosuppressive therapy is a risk factor for the reactivation of the disease. The aim of this study was to investigate the seroprevalence of HB in oncology patients. Materials and Methods: In this study, the seroprevalences of hepatitis B surface antigen (HBsAg), anti-hepatitis C virus, anti-HBs, and anti-hepatitis B core antibody (anti-HBc) immunoglobulin G (IgG) were retrospectively evaluated from the medical records of 84 patients who were diagnosed of cancer, and were admitted to the outpatient clinic of medical oncology in the Batman State Hospital within a period of one year (between January and December 2017). Results: Anti-HBc IgG was positive in 44 patients (52.2%),16 (36.4%) have received treatment for the prevention of HBV reactivation six of these patients were HBsAg positive No reactivation and no side effects occur in patients who received prophylactic antiretroviral treatment. Conclusion: In our study, both the proportion of patients with HBsAg positivity and the proportion of patients with natural immunity were found to be slightly higher than those in Turkey and worldwide. No patients with HB reactivation is important evidence of necessity effectiveness of prophylactic antiviral treatment Amaç: Hepatit B virüsü (HBV) toplumun önemli bir bölümünü etkiler ve yüksek mortalite ve morbidite ile karakterizedir. HB, çoğu kronik hasta olan dünya çapında yaklaşık 350 milyon kişiyi etkilemektedir. Özellikle immünosüpresif tedavi altında olmak, hastalığın yeniden aktivasyonu için bir risk faktörüdür. Bu çalışmanın amacı, onkoloji hastalarında HB seroprevalansını araştırmaktır. Gereç ve Yöntemler: Bu çalışma retrospektif nitelikte tanımlayıcı bir çalışma olarak gerçekleştirilmiştir. 1 Ocak-2017 ila 31 Aralık 2017 dönemi boyunca Batman Bölge Devlet Hastanesi, Onkoloji Bölümü’ne başvuran 84 hasta çalışmaya dahil edilmiştir. Bu hastaların hepatit serolojileri kayıt altına alınarak hastalar aktif HBV enfeksiyonu, geçirilmiş HBV enfeksiyonu, almış oldukları profilaksiler ve reaktivasyon açısından değerlendirmiştir. Bulgular: Hastaların 6’sı hepatit B yüzey antijeni (HBsAg) pozitif olarak saptanmış olup, 44 hasta (%52,2) ise anti-HBc immünoglobulin G (IgG) pozitif olarak saptanmıştır. Bu 44 hastadan 28 hasta (63.6%) düşük riskli bir kemoterapotik ajan almaları nedeniyle profilaksi almamıştır, diğer hastalar ise profilaksi almıştır. HBsAg poztif olan hastalardan bir hasta dışında tüm hastalar tedavi almıştır. Tüm pozitif hastalar değerlendirdiğinde takipte hiçbir hastada reaktivasyon gelişmemiştir. Sonuç: Kapsamlı HB serolojisi onkolojik tedavi planı olan tüm hastalara bilinmeli ve eğer endikasyonu varsa hastalar tedavi veya profilaksi için değerlendirmelidir. Bu değerlendirmelerde kılavuz önerileri esas alınması reaktivasyon gelişme ihtimalini en aza indirecektir.

Objective: Influenza is a systemic infectious disease. It is recommended that all pregnant women receive the influenza vaccine because the mortality of the disease is high during pregnancy. However, the rates of influenza vaccination in pregnant women are low. This study aims to estimate the rate at which Turkish gynecologists and obstetricians (GOs) recommend the influenza vaccine to their pregnant patients.. Materials and Methods: This study was designed as a cross-sectional survey. The sample size was calculated to be 364 based on 95% confidence interval and 5% margin of error. The data were collected through a questionnaire consisting of 17 questions, which was distributed through social media. The final study group included in the research consisted of 384 GOs. Results:The mean age of the GOs that participated in the study was 39.7 years (SD = 10.2). 43.5% of the GOs reported that they recommended the influenza vaccine to pregnant women who had consulted with them, while 62.8% reported that at least 50% of the pregnant women they had recommended the vaccine rejected it. According to multivariate logistic regression analysis, three factors increased the rate of GOs’ not to recommend influenza vaccination: the GOs’ age, not receiving influenza vaccination themselves, and not knowing the social insurance reimbursement for the vaccine. Conclusion: Vaccination of pregnant women is necessary because of the increased mortality risk of influenza during pregnancy. Even though GOs are not in charge of vaccinating their patients during their routine pregnancy follow-up, they can contribute to vaccination rates by recommending the vaccine. Physicians’ application of scientific knowledge and transferring it to their patients can contribute to increased adult immunization rates. Conclusion: Influenza, Influenza Vaccine, Pregnancy, Vaccination, Viral Infections

It is known that there is an increase in the frequency of psychiatric disturbances in the acute and post-illness phase of coronavirus disease (COVID-19). Comorbid psychiatric symptoms complicate the management of patients and negatively affect the prognosis, but there is no clear evidence of their progress. We aimed to determine psychiatric comorbidity in inpatients and outpatients with COVID-19 and recognize the factors that predict psychiatric comorbidity. For this purpose, we evaluated patients on the first admission and after 4 weeks. We investigated psychiatric symptoms in outpatients (n = 106) and inpatients (n = 128) diagnosed with COVID-19. In the first 7 days after diagnosis (first phase), sociodemographic and clinic data were collected, a symptom checklist was constructed, and the Hospital Anxiety and Depression Scale (HADS) and the Severity of Acute Stress Symptoms Scale (SASSS) were applied. After 30-35 days following the diagnosis, the SASSS and the HADS were repeated. In the first phase, the frequency of depression and anxiety were 55% and 20% in inpatients, and 39% and 18% in outpatients, respectively. In the second phase, depression scores are significantly decreased in both groups whereas anxiety scores were decreased only in inpatients. The frequencies of patients reporting sleep and attention problems, irritability, and suicide ideas decreased after 1 month. Patients with loss of smell and taste exhibit higher anxiety and depression scores in both stages. Our results revealed that the rate of psychiatric symptoms in COVID-19 patients improves within 1 month. Inpatients have a more significant decrease in both depression and anxiety frequency than do outpatients. The main factor affecting anxiety and depression was the treatment modality. Considering that all patients who were hospitalized were discharged at the end of the first month, this difference may be due to the elimination of the stress caused by hospitalization.

Diagnosis of COVID19 is based on reverse transcription-polymerase chain reaction (RT-PCR) testing of nasopharyngeal swab (NPS) samples. As NPS sampling is a discomforting invasive procedure, studies were conducted to investigate the performance of saliva and mouthwash (MW) samples in RT-PCR. There is limited data about MW samples. We have developed a new method for concentrating gargle and mouthwash (GMW) samples to be used in RT-PCR. In our study, we aimed to investigate the performance of concentration of GMW samples in detection of SARS-CoV-2. A paired sample of NPS and GMW samples were collected from patients in 11 centers in Turkey. MW samples were concentrated using MyMagiCon-RW100® (Bio-T, Istanbul, Turkey). NPS, GMW and concentrated GMW samples were tested by RT-PCR for the presence of SARS-CoV2 and the results were compared. The viral RNA was detected in 47.5% of NPS samples, in 28.8% of GMW before concentration and in 37.5% GMW samples after concentration. Concentration of samples increased the number of samples in which SARS-CoV2 RNA was detected by 16.6%. The RT-PCR of concentrated GMW samples yielded better results than the RT-PCR of NPS samples in two centers. Concentrated GMW sampling can be an alternative method to NPS sampling in rapid and accurate diagnosis of COVID-19.

Amaç: Aşı ile önlenebilir hastalıklardan korunmanın sağlanması toplum sağlığı açısından oldukça önemlidir. Fakat ülkemizde erişkin bağışıklama konusunda uygulamada önemli eksiklikler mevcuttur. Bu çalışmada ikinci basamak bir devlet hastanesi olan Batman Bölge Devlet Hastanesinde kurulan ‘Erişkin Bağışıklama Ünitesi’nin deneyimleri aktarılmıştır. Yöntem: Kasım 2017-Şubat 2018 tarihleri arasındaki 3 aylık süreçte ünitede yapılan Hepatit A, Hepatit B ve konjuge pnömokok aşıları aşı yapılan kişilerin epidemiyolojik özellikleri, aşı endikasyonları ve yönlendirildikleri klinikler açısından analiz edilmiştir. Bulgular: Kayıtlarının retrospektif incelemesinde toplamda 85 hastaya aşı yapıldığı saptandı. Bu hastaların %35.3’ü (n=30) kadın olarak saptandı. Hastaların tümü 16 yaş üzeri idi. Yaş ortalaması 57.6 olarak saptandı. Yapılan aşıların dağılımına bakıldığında %80 (n=68) hastanın konjuge pnömokok aşısı ile aşılandığı, %17.6 (n=15) hastaya Hepatit B, %2.4 (n=2) hastaya ise hepatit A aşısı uygulandığı görüldü.Aşılama endikasyonlarına bakıldığında %5.9 (n=5) hasta 65 yaş üstü olması nedeni ile, %36.5 (n=31)hasta böbrek yetmezliği nedeni ile, %1.2 (n=1) hasta romatolojik tedavi adayı olması nedeni ile, %8.2 (n=7) birey evde riskli temaslı birey-tümü Hepatit B açısından- olması nedeni ile, %4.7 (n=4) birey ise sağlık personeli olduğu için aşılanırken, %42.4 (n=36) birey ise başta KOAH olmak üzere altta yatan akciğer hastalıkları nedeni ile aşılanmış olarak tesbit edilmiştir. Sonuç: Erişkin Bağışıklama Merkezleri’ ikinci ve üçüncü basamak sağlık hizmeti veren tüm kurumlar için gereklidir. Özellikle başvuran hasta sayısının çok ve hasta grubunun da çeşitli olduğu hastaneler aslında aşı gereksinimi olan hasta popülasyonun da fazla olduğu hastanelerdir. Aşılanma oranlarını gerekli seviyeye ulaştırabilmek için hastaneler bünyesinde bu merkezlerin aktif olarak çalışmalıdır.

Owing to impaired immune function, surgical procedures, and multiple hospitalizations, patients with end-stage liver disease are at risk for numerous infectious complications while waiting for transplantation. Infection in transplant recipients remains the main cause of mortality and morbidity, despite advances in surgical techniques and the development of new repressive agents. The purpose of this study is to examine the infections that develop during the pretransplantion period in live donor liver transplant recipients and their effect on post-transplant clinical outcomes. The retrospective analysis of adult live donor liver transplant recipients in the last 4 years was conducted at Ankara University Hospital, a 1900-bed tertiary-care university hospital, in Ankara, Turkey. Demographic characteristics, preoperative infections, and clinical outcomes were analyzed. Patients were divided into 2 groups according to whether they had developed an infection before transplantation. The diagnoses were based on clinical, laboratory, and microbiological findings. Statistical analyses were performed using Stata version 9.0 (StataCorp, College Station, Tex., United States), and P In univariate analyses, having diabetes mellitus or a pretransplant infection, the number of pretransplant infection attacks, the need for a reoperation, and developing a post-transplant infection were the statistically significant factors associated with 1-year mortality (P Our study showed the effect of pretransplantation infections on post-transplant morbidity but not on rejection or mortality. According to the situation of patients, manageable pretransplantation infection is not an absolute contraindication for liver transplantation. Awareness of the increased risk for post-transplant infections and fast-acting antimicrobial coverage are the most important facts for patient survival.

CoronaVac, the first coronavirus disease 2019 vaccine administered in our country, was found safe in clinical trials.We aimed to reveal the rate and features of CoronaVac vaccine-associated allergic reactions among vaccinated healthcare workers (HCWs) in real-life.This study was planned as a questionnaire-based study. Participants who reported a postvaccination allergic reaction were interviewed on phone and their medical records were also checked for confirmation.A total of 2,488 HCWs took part in the study and 4,054 postvaccination complete questionnaire-responses were obtained. Twenty-one HCWs (female: male, 17:4) with a mean age of 40.95 ± 10.09 stated that they had an allergic reaction after a total of 23 vaccine injections. Accordingly, the reaction rate was 0.56% among all vaccine doses. The most common reactions were systemic skin reactions (2.7%) consisting of generalized pruritus, diffuse pruritic erythema, urticaria, and maculopapular rash. That was followed by local injection site reaction (0.12%). Anaphylaxis was reported in 4 cases (0.09%) with a mean onset time of 12 ± 6 minutes. One of them had a history of anaphylaxis with 2 drugs, another had venom and food allergy. Three of the subjects had level 2 diagnostic certainty according to the Brighton Collaboration criteria and one had level 3. All anaphylaxis cases were discharged within 24 hours and none of them required intensive care.Our study demonstrated that allergic reactions to CoronaVac were rare and mostly mild. Although anaphylaxis was also rare, the importance of early intervention with close follow-up was once again emphasized.

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.

Barotrauma is a commonly reported complication in critically ill patients with ARDS caused by different etiologies, it's rate is reported to be around %10. Pneumothorax/pneumomediastinum in COVID-19 patients seem to be more common and have different clinical characteristics. Here we report 9 patients who had pneumothorax and/or pneumomediastinum during their stay in the ICU. Patients who were admitted to ICU between March 2020 and December 2020, were reviewed for presence of pneumothorax, pneumomediastinum and subcutaneous emphysema during their ICU stay. Demographic characteristics, mechanical ventilation settings, documented ventilation parameters, outcomes were studied. A total of 161 patients were admitted to ICU during the study period, 96 were invasively ventilated. Nine patients had developed pneumothorax, pneumomediastinum and/or subcutaneous emphysema during their admission. Five of them were men and median age was 66.6 years. All patients were intubated and mechanically ventilated. All patients were managed conservatively. One patient was discharged from ICU, the others were lost due to other complications related to COVID-19. Upon detection of pneumothorax and/or mediastinum all patients were managed conservatively by limiting their PEEP and maximum inspiratory pressures and were followed by daily chest X-rays (CXR) for detection of any progress. None of the patients showed increase in size of their pneumothorax and/or pneumomediastinum. Hemodynamically instability due to pneumothorax and/or pneumomediastinum was not observed in any of the patients. Tension pneumothorax was not observed in any of the patients. Most common reason for death was sepsis due to secondary bacterial infections. Acute deterioration with rapid oxygen desaturation or palpation of crepitation over thorax and neck in a COVID-19 patient should prompt a search for pneumothorax or pneumomediastinum. Conservative management may be an option as long as the patients are stable.

Background: The hepatitis B virus (HBV) is one of the major causes of chronic liver disease. From the perspective of hospital workers (HWs), employees are at risk of hepatitis B infection because of occupational exposure. Apart from this occupational risk, health professionals may still be affected by HBV, depending on the epidemiological characteristics of the country and geographical region they live in. Objectives: This study aimed to determine HBV, HCV, and HIV seroprevalence among HWs using data obtained from 21 hospitals located in six geographical regions in Turkey and the Turkish Republic of Northern Cyprus. Methods: The study was designed as a retrospective, multicentre, descriptive study. Twenty hospitals from Turkey and one hospital from the Turkish Republic of Northern Cyprus were involved in the study. The variables of the study were vaccination status against HBV and hepatitis A and HBsAg, anti-HBs, anti-HBcIgG, anti-HAVIgG, anti-HCV, anti-HDV, and anti-HIV serology results belonging to the previous year. Results: Women constituted 58.9% (n = 5,622) of the HWs included in the study. The mean age was 36.3 +/- 9.09 years (min =18, max = 72). In terms of occupation, 42.5% (n = 4, 064) were nurses/health officers, and 24.8% (n = 2365) were physicians. HBsAg seroprevalence was found to be 1.8% (n =169; 95% CI = 1.5% - 2.0%), while anti-HBs seropositivity was 75.7% (n = 7,234). About 7.3% (n = 701) had natural immunity to hepatitis B. About 21.6% (n = 2,066) of the HWs did not receive hepatitis B vaccine. Conclusions: This study is the first study involving a large sample size from different locations of Turkey. According to the results, hepatitis B and hepatitis A vaccines should be administered to susceptible individuals and HWs. WOS:000534475500002 2-s2.0-85085751514

In 5%-20% of chronic HCV patients, cirrhosis or other complications like liver cancer may be seen and these may be directly or undirectly related. The development of a sustained viral response (SVR) does not change this fact. In the case of a 52-year-old female diabetic patient whose Anti-HCV was positive, HCV-RNA 2.230.000 IU/mL was decided to be followed up due to an ALT 68 UI/L, AST 55 UI/L. As a result of the biopsy (ISHAK, fibrozis= 2, HAI= 8), Pegile interferon alfa 2a 180 g/week + ribavirin 1000 mg/day was started. The patient was put under treatment for 48 weeks and as a result, SVR was obtained and the patient accepted as cure. The patient was told to come for check-up every six months. This patient who had actually started getting better stopped coming to our center in 2015 and did not return for a long time. The patient came back in 2016 with a fatigue complaint. As a result of the examination, AFP was 38.6 and all other parameters were found normal. Although there was no sign of a mass image in her liver ultrasound, there was a hepatocellular carcinoma (HCC) compatible lesion which was 190 x 150 x 90 mm in segment 6-7 in her contrasted MR result. The patient was urgently referred to a transplant center. However, it was determined at the center that since the tumor had made a vein invasion, there was no chance for a transplant. The patient died in June 2017. The cure in HCV treatment does not exclude the reality of HCC, which shows that patients who get the treatment must be followed up very closely. Routine clinical follow up, AFP level screening, effective ultrasound and dynamic imagination are of utmost importance.

Millions of people have been lost due to HIV/AIDS after complete presentation of the disease. Mortality rates decrease significantly with effective treatments. However, HIV/AIDS is an important infectious disease and a concern for public health. Therefore, knowing fatality rates and mortality rates are very important in patient follow-up. In this study, it was aimed to calculate the fatality rate in patients followed up in a university hospital for eleven years.

Both nosocomial and community acquired gram-negative bacterial infections cause serious morbidity and mortality. However, old antibiotics, which have toxic side effects, should be re-used because of the lack of newly developed antibiotics. One of these is colistin which has both nephrotoxic and neurotoxic side effects. Especially due to nephrotoxicity side effec, serious problems can be experienced in the use of colistin. In this article, a case of reversible nephrotoxicity after colistin usage is presented.

Carbapenemase-producing Enterobacteriacea (CPE) cause serious and life-threatening infections. They are resistant to carbapenems and many other classes of commonly used antimicrobial agents; therefore, managing infections caused by them poses a substantial challenge in clinical practice. They can also cause morbidity and mortality in patients with liver transplant. A retrospective analysis of CPE culture-positive patients with a history of liver transplant can help to examine the epidemiology and microbiology of these bacteria, as well as gain information on the possible infection sources, susceptibility patterns, and expected mortality in infected populations. In addition, study of these bacteria could help formulate a consensus on the appropriate use of empirical and directed antibiotic therapy, which can effectively reduce infections in these patients. We reviewed the medical records of 142 subjects who underwent liver transplantation at Ankara University Hospital, a 1900-bed tertiary care university hospital, in Ankara, Turkey, between January 2014 and August 2018. Patients showing signs of infection with culture positivity for CPE-producing organisms were included from the study. Statistical analysis was performed and a value of P .05 is considered statistically significant. In most cases, the source of infection was the abdomen. Klebsiella species was also predominant in these cases. Model for End-Stage Liver Disease scores and length of hospital stay were higher and statistically significant when compared to patients who were CPE negative. Mortality was highest in the CPE-positive group. Infection is the most important cause of mortality and morbidity after liver transplantation and increases the cost of treatment. Regarding the culture sensitivity patterns and resistance mode, empirical therapy with carbapenems does not produce a solid result. The high mortality observed with these infections reflects very limited therapeutic options.