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Myroides türleri insanlarda nadiren enfeksiyon yapan gram negatif bir bakteridir. İnsan mikrobiyotasının bir parçası olmasa da Myroides türleri çevrede yaygın olarak bulunur. Myroides enfeksiyonlarının tipik olarak kontamine su ile temas sonrası geliştiği bildirilmiştir. Sıklıkla bağışıklığı baskılanmış hastalarda enfeksiyona neden olmaktadır. Bu olguda, çoklu ilaca dirençli Myroides odoratimimus’un neden olduğu bir üriner sistem enfeksiyonu sunuyoruz.

Aim: Healthcare-associated infections are a major source of concern in all areas of hospitals, particularly in intensive care units. The goal of our study was to look at the current situation and evaluate the measures that can be taken based on the data obtained by examining the rates and factors of healthcare-associated infections in the general intensive care units of our hospital over a one-year period. Materials and Methods: Between January 2020 and December 2020, 665 patients who were followed up and treated in the general intensive care unit of Meram State Hospital were followed up in terms of healthcare-associated infections, and their outcomes were evaluated. Results: 5354 hospitalization days of 665 patients who were followed up in the general intensive care units for a year were evaluated, and it was determined that 53 of the patients developed healthcare-associated infections. Twenty-two (41.5%) of patients with healthcare-associated infections were female, while 31 (58.5%) were male. It was discovered that the patients' mean age was 71,7±14 (19-94). The infection rate was calculated to be 5.86 and the density to be 7.28. Furthermore, the rates of invasive device-associated nosocomial infection are as follows: 1.02 for central line-associated bloodstream infections, 0.56 for catheter-associated urinary tract infections, and 0 for ventilator-associated pneumonia. Conclusion: Healthcare-associated infections are a significant cause of mortality and morbidity in intensive care units. Due to the improvement in medical care and the increase in life expectancy in parallel with this, effective surveillance practices are of critical importance.

Amaç: Çalışmamızda insan immün yetmezlik virüsü (HIV) / kazanılmış bağışıklık yetmezliği sendromu (AIDS) hastaları ile sağlıklı gönüllüler karşılaştırılarak yaşam kalitesi skorlarının değerlendirilmesi hedeflendi.Yöntemler: Çalışmaya Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniğinde takipli 20 HIV/AIDS ve 40 sağlıklı gönüllü olmak üzere 60 kişi dahil edildi. Tüm bireylere yaşam kalitesi değerlendirilmesi amacıyla “short form -36” (SF-36) anketi yapıldı.Bulgular: HIV/AIDS hastalarının yaş ortalaması 35,9±8,9 ve sağlıklı kontrol grubunun ise 34,5±8 idi. HIV/AIDS grubunun 18’i (%90) erkek 2’si (%10) kadın, ve sağlıklı gönüllülerin 16’sı (%40) erkek, 24’ü (%60) kadın idi. HIV ile enfekte hastalar ile sağlıklı gönüllüler arasında istatistiksel olarak anlamlı fark elde edilmedi. Kadınların fiziksel yaşam kalitesi açısından daha avantajlı olduğu, genel sağlık durumu değerlendirildiğinde ise erkek cinsiyetin daha avantajlı olduğu saptanmıştır. Evlilerin sadece mental sağlık parametresinin daha yüksek olduğu saptandı.Sonuç: HIV/AIDS hastaları gibi kronik hastalığı olan hastaların sağlıkla ilişkili yaşam kaliteleri sıklıkla fiziksel, mental ve sosyal alanlara sahip olarak kavramsallaştırılmaktadır ve bağımsızlık, maneviyat ve çevresel faktörlerle önemli ölçüde etkilenebileceği kabul edilmektedir. Fakat çalışmamızda HIV/AIDS hastalarında yaşam kalitesi skorları toplum ile benzer çıkmıştır. Bununla beraber bilinmektedir ki birçok kronik hastalıkta gerekli durumlarda bu hastalar psikiyatri klinikleri tarafından desteklenmelidir. Bu şekilde multidisipliner yaklaşım ile hastaların yaşam kalitelerinin artırılması sağlanmalıdır.

Aim: The aim of this study was to determine the characteristics and risk factors associated with severe disease in COVID-19. Materials and Methods: A total of 186 adult patients (97 female) hospitalized with a diagnosis of COVID-19 (laboratory-confirmed cases, SARS-CoV-2-RNA detected with the molecular method) between March 2020-May 2020 were included in the study. The possible risk factors evaluated were age, gender, comorbidities, smoking, symptoms, and laboratory parameters at the time of admission to the hospital. Results: The patients comprised 97 (52.2%) females, evaluated as severe COVID-19 in 43 (23.1%) cases and non-severe COVID-19 in 143 (76.9%) cases. Multivariate logistic regression analysis identified risk factors for severe COVID-19 to be age >65 years (odds ratio (OR)=5.289, 95% confidence interval (CI):1.680-16.651, p:0.004), and elevated levels of LDH (OR=8.521, 95% CI:2.445-29.702, p:0.001), ferritin (OR=7.436, 95% CI:2.171-25.468, p:0.001), D-dimer (OR=10.076, 95% CI: 2.758-36.813, p65 years, and elevated LDH, ferritin, D-dimer, CK-MB, and troponin levels are independent risk factors. Clinicians should consider these potential risk factors for progression to severe disease when treating COVID-19 patients.

Introduction: Behçet's disease defined by Turkish dermatologist Hulusi Behçet is an inflammatory disease of unknown etiology and characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis and skin lesions. We aimed to evaluate hepatitis B virus, hepatitis C virus and human immunodeficiency virus seroprevalence in Behçet's Disease. Material and Method: Patients diagnosed with Behçet’s diseaseand followed up by the dermatology outpatient clinic during 12-years period between July 2008 and July 2020 were retrospectively analyzed. Demographic datas and HBsAg, anti-HBs, anti-HCV, Anti-HIV results of the patients were recorded. Results: 359 patients with Behçet’s disease were been evaluated in this study. Of these patients, 189 (52.6%) were female, 170 (47.4%) were male and the mean age was 37.7±12.3 years. HBsAg was positive in 6 (1.6%) patients and Anti-Hbs ab in 82 (7.7%) patients. Anti HIV ab was negative in all patients. Anti-HCV antibodies were found positive in only one case (0.2%), and this was confirmed by testing for hepatitis C virus-ribonucleic acid (HCV RNA). HCV RNA was negative in this patient. Conclusion: When compared with the general population, seropositivity rates were not detected to be high in Behçet's patients. In fact, the immunity rates were found very low. Based on such a finding, it was concluded that screening is required due to increasing immunosupressive treatments today, and individuals should be vaccinated in cases where HBV indicators are negative.In the other studies, investigating the entity, seropositivity rates have been found similar to those in the population. Considering that serological data show regional differences, we thought that, our study will contribute to the literature both national and international grades due to large patient population in our region.

Background: The aim of this national, multicenter, cross-sectional, retrospective chart review study was to determine the rate of patients in Turkey who received hepatitis C virus (HCV) treatment after receiving positive anti-HCV results during HCV screening. Methods: Data related to patients’ demographics, laboratory results, the time interval from obtaining a positive anti-HCV result to treatment initiation, the specialty of the physician requesting anti-HCV screening, and type of hospital were collected and analyzed. Results: Among 1000 patients who received a positive anti-HCV result, 50.3% were male and 78.5% were screened for HCV-RNA. Among HCV-RNA screened patients, 54.8% (n = 430) had a positive result. Among patients testing positive for HCV-RNA, 72.8% received HCV treatment in line with their positive anti-HCV results. The median time from obtaining a positive anti-HCV result to initiation of HCV treatment was 91.0 days (interquartile range 42.0 to 178.5). Non-surgical branches requested HCV-RNA testing more frequently than surgical branches (p < 0.001). The rate of access to HCV treatment was higher in patients screened in university hospitals than in patients screened in training and research hospitals (p < 0.001). Conclusions: Our results indicate a higher rate of treatment initiation in patients with HCV infection than is described in the published literature. Furthermore, the time from screening to treatment initiation was considerably shorter compared with other international studies. However, because HCV-RNA testing was not requested in a significant portion of patients with a positive test result for anti-HCV, there might be a large patient population with HCV who do not receive treatment.

Introduction and Objective: Nosocomial infections (NIs) in intensive care units (ICUs) are serious problems because of high mortality and morbidity. Here, it was aimed to evaluate diagnoses, distribution and pathogens of NIs in two tertiary general ICUs (GICU) of a hospital and develop new infection control strategies based on the data. Material and Methods: NIs followed in the infectious diseases department and recorded by active prospective surveillance between January 2018-December 2019 in GICUs were retrospectively analyzed. Results: Ninety-five NI episodes were identified in 90 patients during 8468 hospitalization days of 1189 patients in a two-year period. While NI rate in GICUs was 7.98, incidence of NI density was determined as 11.21. Considering the distribution of NIs, lower respiratory tract infections (LRTI) (36.8%) were detected as highest and followed as specific laboratory findings by pneumonia (33.6%), ventilator-associated pneumonia (VAP) (10.5%), central venous catheter-related blood stream infections (CVCR-BSI) (9.4%), laboratory-proven BSI (6.3%) and catheter-associated urinary tract infections (CR-URI) (3.1%). Given the distribution of the factors concerning system infections, agents leading to LRTI other than pneumonia were as follows: Acinetobacter spp. (48.7%), Klebsiella pneumoniae (25.6%), Pseudomonas aeruginosa (12.8%), Serratia marcescens (5.1%), Escherichia coli (2.5%), Enterobacter cloacae (2.5%) ) and Candida albicans (2.5%), and 11.4% were polymicrobial. Conclusion: NIs are inevitable entities in hospitals, especially in ICUs, and one of the vital goals of hospitals is to control and manage such a situation. Timely and appropriate therapeutic interventions should be designed to reduce NI rates. If needed, catheters should be inserted with correct indication, and catheter application should be reduced. It is important that hospitals develop comprehensive antibiotherapy programs based on their own surveillance data.

Objective: Coronavirus Disease 2019 (COVID-19) is characterized by high fever, sudden developing respiratory distress, and radiological findings failing to respond to conventional treatments. The purpose of this study is to identify the association of D-dimer levels and lymphocyte counts with poor prognosis and to predict the clinical course in patients with COVID-19. Methods: A total of 118 hospitalized adult patients diagnosed with COVID-19 were included in the study. According to the National Institutes of Health (NIH) COVID-19 treatment guidelines, patients were divided into two groups with severe disease (n= 26) and non-severe (n= 92) disease. Detected at the time of diagnosis, D-dimer levels and lymphocyte counts were compared between severe and non-severe COVID-19 patient groups. Distinctive performance analysis of these values was performed, and cut-off values were determined. Results: The mean age of patients was 62 ± 7 years (range 42-80 years), and 63 (53.4 %) were female. The lymphocyte count was lower (p

Background: Licensing of next-generation direct-acting antiviral agents (DAA) has revolutionized the treatment of Hepatitis C Virus (HCV) infection. These agents are important due to their high virological efficacy, high resistance barrier, short duration of treatment, and rare serious side effects. The purpose of our study was to present real-life data of chronic hepatitis C (CHC) infected patients with genotypes 2 and 3 who were treated with glecaprevir/pibrentasvir regimen.Methods: Glecaprevir/pibrentasvir treatment was initiated in 127 patients infected with CHC genotype 2 and 3. Patients received glecaprevir/pibrentasvir (100 mg/40 mg) orally in the form of three tablets once a day as per recommendations of the Republic of Turkey, Ministry of Health. In the assessments of patients at the time of diagnosis and following DAA use, virological response criteria HCV-RNA value was

Introduction: COVID-19 is currently a major threat to global health. However, there is no specific antiviral agent available for its treatment. In this study; It was aimed to evaluate the clinical efficacy of treatment and drug side effects in patients treated with Favipiravir (FPV) and Lopinavir / Ritonavir (LPV / RTV). Material and Method: 46 patients who were hospitalized with the diagnosis of COVID-19 and received FPV and LPV / RTV treatment between 15.03.2020- 30.04.2020 in an infectious diseases service in a tertiary hospital were included in the study. The diagnosis of COVID-19 in all patients was confirmed by real time polymerase chain reaction (RT-PCR).Results: Forty-six cases diagnosed with COVID-19 were included in the study. Twenty-nine (63%) of the patients were male and seventeen (37%) were female .A total of 46 patients were evaluated in two groups. There were 34 patients using FPV in the first group and 12 patients using LPV / RTV in the second group. Average age 57.8±17.7 (age range 18-91). The mean age of the first group was 57.71±17.33, the second group was 58.±18.8. Fever was the most common symptom in all patients (69.6%). In the FPV arm, fever (68.8%), weakness (77.8%), cough were the most common symptoms at 69.2%, respectively. Fever (31.2%), cough (30.8%) and sore throat (28.6%) were the most common presenting symptoms in the LPV / RTV arm, respectively. Patients with fever in the FPV arm had a mean recovery time of 3.56±1 days with treatment, and 4.42±1 days in the LPV / RTV arm. The time to return to normal fever in the FPV arm was statistically significant (p: 0.03). Liver enzyme elevation was significantly higher in the FPV arm (20.6%). Nausea and vomiting were observed to be high in the LPV / RTV arm (41.7%, 25%, respectively). This height was statistically significant (p value 0.009 and 0.04, respectively). There were no serious side effects that required drug withdrawal.Conclusion: There is no known treatment for SARS-CoV-2 infection yet, with proven efficacy with reliable study results, certain drugs have not yet been combined. Our goal was to share the results with the available data to identify effective treatments. While viral clearance is quite high with LPV / RTV treatment, side effects were observed in almost all patients. Although viralclearance was less in patients using FVP compared to the LPV / RTV arm, side effects due to the drug were less. Our results provided preliminary data for the treatment of SARS-CoV-2 infection. In addition, we tried to show the viral clearance time and the spectrum of side effects, which can be used as the primary endpoint for antiviral treatment trials and can be a useful outcome for designing protocols investigating COVID-19-related treatments., Giriş: COVID-19 şu anda küresel sağlık için büyük bir tehdittir. Bununlabirlikte, tedavisi için spesifik bir antiviral ajan mevcut değildir. Buçalışmada; Favipiravir (FPV) ve Lopinavir/Ritonavir (LPV / RTV) ile tedavi edilen hastalarda tedavinin klinik etkinliğinin ve ilaç yan etkilerinin değerlendirmesi amaçlandı.Gereç ve Yöntem: Çalışmaya üçüncü basamak bir hastanede enfeksiyon hastalıkları servisinde 15.03.2020-30.04.2020 tarihleri arasında COVID-19tanısı ile yatırılarak takip edilen FPV ve LPV / RTV tedavisi alan 46 hasta dahil edildi. Tüm hastaların COVID-19 tanısı real time polimeraz zincir reaksiyonu(RT-PCR) ile konfirme edildi.Bulgular: COVID-19 tanısı alan 46 olgu çalışmaya alınmıştır. Hastaların 29’u(%63) erkek, 17’si (%37) kadındı. Toplam 46 hasta iki grupta değerlendirildi. Birinci grupta FPV kullanan 34 hasta, ikinci grupta LPV/RTV kullanan 12 hasta mevcuttu. Yaş ortalaması 57.8±17.7 (yaş aralığı 18-91). Birinci grubun yaş ortalaması 57,71±17,33, ikinci grubun yaş ortalaması 58.±18.8 idi. Hastaların tümünde ateş en sık başvuru semptomu idi (%69,6). FPV kolunda sırasıyla ateş (%68.8), halsizlik (%77.8), öksürük %69.2 en sık başvuru semptomları idi. LPV/RTV kolunda sırasıyla ateş (%31.2), öksürük (%30.8), boğaz ağrısı (%28.6)en sık başvuru semptomları idi. FPV kolunda ateşi olan hastaların tedavi ile ortalama normale dönüş süresi 3.56±1 gün iken LPV/RTV kolunda ateşin normale dönme süresi 4,42±1 gün idi. FPV kolunda daha hızlı olan ateşin normale dönme süresi istatistiksel olarak anlamlı bulundu (p: 0.03). Karaciğer enzim yüksekliği FPV kolunda belirgin yüksekti (%20.6). Bulantı-kusma ise LPV/RTV kolunda yüksek (sırasıyla %41.7, %25) görüldü. Bu yükseklik istatistiksel olarak anlamlı idi (p değeri sırasıyla 0.009 ve 0.04). İlaç kesilmesini gerektiren ciddi bir yan etki gelişmedi.Sonuç: SARS-CoV-2 enfeksiyonu için henüz bilinen, etkinliği güvenilir çalışma sonuçları ile gösterilmiş bir tedavi bulunmamaktadır belirli ilaçlar henüz şimdilik birleştirilmemiştir. Hedefimiz, eldeki verilerle etkili tedavileri tanımlamak için sonuçları paylaşmaktı. LPV/RTV tedavisi ile viral kilerens oldukça yüksek iken yan etki neredeyse tüm hastalarda görülmüştür. FVP kullanan hastalarda viral kilerens LPV/RTV koluna göre daha az olmakla beraber ilaca bağlı gelişen yan etkilerde daha azdı. Sonuçlarımız SARSCoV-2 enfeksiyonunun tedavisi için ön veri sağlamıştır. Ayrıca, antiviral tedavi denemeleri için birincil son nokta olarak kullanılabilen ve COVID-19 ile ilgili tedavileri araştıran protokollerin tasarlanması için faydalı bir sonuç olabilecek viral klirens zamanını ve yan etki spektrumunu göstermeye çalıştık COVID-19 tedavisinde etkinliği tam olarak bilinmeyen bu ilaçların yarar sağlayacağı umut edilmektedir

Introduction: Brucellosis can present with clinical hepatitis and rarely as acute cholestatic hepatitis. The aim of the study is to demonstrate acute cholestatic hepatitis as a rare presentation caused by Brucella melitensis. Case Presentation: A thirty-nine-years-old male patient was admitted to our department with the complaints of fever, malaise, fatigue and sweating. At hospitalization, the temperature was 39°C. Laboratory tests: White blood count (WBC) 4800 cells/mm3, platelet (PLT) 173 000/mm3, erythrocyte sedimentation rate (ESR) 38mm/h, C-reactive protein (CRP) 257 mg/L, alanine transferase (ALT) 284 U/L, aspartate transferase (AST) 300U/L, γ-glutamyl transpeptidase (GGT) 1152U/L, alkaline phosphatase (ALP) 1762U/L, total bilirubin (T-Bil) 2.8mg/dL, direct bilirubin (D-Bil) 1.3mg/dL, lactate dehydrogenase (LDH) 705 U/L. Gruber Widal test was negative. Wright serum agglutination test was found to be positive at 1/2560 titer. Conclusions: Brucellosis should be kept in mind, especially in the differential diagnosis of the patients with acute hepatitis and cholestasis accompanied by fever.

Objective: Tuberculosis (TB) that can involve all organs is a disease progressing with a wide range of clinical presentations. It is especially difficult to diagnose the cases of extrapulmonary tuberculosis (EPTB) due to the atypical course, and the cases of EPTB constitute approximately 35% of all TB cases in our country. In our study, it was aimed to examine the distribution rates, diagnostic methods, and treatment processes of EPTB in terms of the involved systems. Material-Method: Of 308 patients diagnosed with TB, 119 cases having EPTB were retrospectively analyzed in The Konya Training and Research Hospital of Health Sciences University between 1st January 2015 and 30th June 2019. Results: While 119 (38.6%) EPTB cases of 308 cases diagnosed with TB were included in the study. 63 (52.9%) and 56 (47%) patients were women and men, respectively. The average age was found as 44.42±18.8 years (min: 18- max: 91 years). The distribution of involvement sites of EPTB was as follows: lymphadenitis, 45.3%; pleural tuberculosis, 24.3%; peritonitis, 14.2%; bone-joint tuberculosis, 7.5%; meningitis, 2.5%; miliary tuberculosis, 1.6%; others, 4.2%. In terms of EPTB, 83 (69.7%) cases were diagnosed histopathologically, 28 (23.5%) and nine (7.5%) were found to have culture and acido-resistant bacilli (ARB) positivity, respectively. A total of 29 (24.3%) cases were diagnosed microbiologically, and the purified protein derivative (PPD) positivity was detected in 106 (89%) cases. While the success rate of the treatment was found to be 93.2%, the mortality rate was measured as 3.3%. Conclusion: It should be kept in mind that TB is a common multisystem disease in our country and may present itself with a wide range of symptoms. In the presence of clinical suspicion, supportive tests should be performed; biopsy and culture samples should be obtained from the appropriate tissues; anti-TB treatment should be initiated at once if clinicians have sufficient evidence.

Interferon-free direct-acting antiviral (DAA) therapies in the chronic hepatitis C virus (HCV) infections have low side effects. Sofosbuvir / ribavirin (SOF / RBV) therapy combination is among in the currently approved treatment regimens. Aleopecia areata is a very rarely comlication of this treatment. A case of alopecia areata developed after SOF / RBV combination therapy in a patient with chronic hepatitis C infection is presented.

Mimarlık ve kavramlar arasındaki ilişki tarihsel süreçte çeşitli anlatımlarla tanımlanmaktadır ve yorumlanmaktadır. Mimari kavramlara yön veren felsefi oluşumlar da bu çalışmanın hareket noktalarından biridir. Mimarlık için de tekrar kavramı, değişen düşünsel ve biçimsel değerlendirmelerle tarihte ifade bulmuştur. Bu çalışmada tekrarın güncel mimarlıktaki yeri sorunsallaştırılarak, Gilles Deleuze’ün felsefesinde tekrar söylemi üzerinden biçimsel bir okuma üretmek amaçlanmıştır. Bu noktada ilk olarak, Deleuze’ün tekrara getirdiği söylemler ışığında çalışmanın kavramsal çerçevesi kurulmuştur. İkinci olarak, tekrarın tasarım düşüncesindeki değişimini görmek açısından mimarlıkta tekrarın genel bir değerlendirilmesi yapılmıştır. Son olarak da bazı çağdaş mimarların tekrar söylemleri ile kavrama dair değişim tartışılmıştır. Özellikle Deleuze’ün tekrar yaklaşımına referans veren çağdaş mimarlık yaklaşımları ele alınmıştır. Çalışmada tekrarın mimarlık için yeni anlamı, sunduğu bakış açısı ve mimarlıkta yaratıcı düşünceye katkısı çağdaş mimarların tasarım yaklaşımları ile okunarak değerlendirilmiştir. Buradan hareketle tekrardaki farkı ortaya çıkarmak çağdaş mimarlıkta tasarım yaklaşımlarında bir ifade biçimine dönüştüğü gözlemlenmiştir.

Türkiye’de okul öncesi dönemde kaynaştırma eğitimine yönelik önemli adımlar atılmıştır. Ancak araştırmalar, uygulamaların genel olarak yetersiz kaldığını göstermektedir. Bu noktada farklı ülkelerdeki uygulamaları görmek önemlidir. İngilizce dışında diller konuşulduğu için bilgi birikiminin sınırlı olduğu ve uluslararası öğrenci değerlendirme raporlarında başarı gösteren Finlandiya, Norveç ve İsveç gibi Kuzey Avrupa ülkelerindeki uygulamaların ülkemizdeki uygulamalara ışık tutacağı düşünülmektedir. Bu doğrultuda bu derlemenin amacı Finlandiya, Norveç ve İsveç’te okul öncesi dönemde özel gereksinimli çocuklara sunulan kaynaştırma eğitiminin özelliklerini aktarabilmektir. Çalışma kapsamında bu ülkelerdeki çalışmalar ve yasal dokümanlar taranmıştır. Alan yazın taraması sonucunda önemli sonuçlara ulaşılmıştır: Üç ülkede de okul öncesi eğitim yerel yönetimlerin yetki alanı içindedir ve özel gereksinimli çocuklar kaynaştırma eğitimine dâhil olma hakkına yasal olarak sahiptir. Finlandiya’da erken tanılama ön plandadır. Özel gereksinimli çocukların kaynaştırma eğitimine dâhil olma oranı yüksektir. İsveç’te öğretmen yetiştirme programlarında tüm alanlarda özel gereksinimli bireylere yönelik eğitime yer verilmektedir. Norveç’te özel gereksinimli çocuklar için hazırlanan planlarda disiplinler arası çalışılmaktadır., In Turkey, important steps lately have taken to the early childhood inclusive education. However; studies show that the practices remain generally insufficient. At this point, it is important to see that practices in different countries such as Finland, Norway and Sweden which are successful in international student assessment reports. In this respect, the aim of the study is to examine the characteristics of the early childhood inclusive education in Finland, Norway and Sweden. Findings revealed that early childhood education comes under the local authorities and children with special needs have a legal right to enroll preschool classrooms in all three countries. Early diagnosis remains at the forefront and the proportion of children with special needs included into preschool classrooms remains high in Finland. In Sweden, all areas of teacher education programs have special education lessons. Multidisciplinary are worked in preparing plans of children with special needs in Norway.