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Objective: COVID-19 has been detected in Turkey since March 11, 2020. Istanbul has become an important center of the pandemic in Turkey. Various risk factors for COVID-19 infection, mortality, and morbidity are under investigation. Recent studies have suggested that certain blood groups are risk factors for the disease. The aim of this study is the evaluation the relationship between blood groups and the risk of contracting COVID-19 disease, clinical severity of the disease, and CT (computed tomography) imaging findings. Material and Methods: Age, gender, blood group data, clinical severity and CT images of 300 patients who were positive with RT PCR (Reverse transcription-polymerase chain reaction) and were followed up in the clinic were retrospectively scanned and recorded. The clinical severity of the disease and CT imaging findings were scored, and the data were evaluated statistically. Results: While the incidence of COVID-19 was high in the A blood group, it was low in the 0 blood group. Although there was no significant difference between blood types and clinical severity, the involvement in the B blood group was more severe on CT imaging. Conclusion: People with A blood group should pay more attention to protection and isolation. Investigating this difference and underlying pathogenic mechanisms can guide science with advanced studies.

Amaç: Santral sinir sistemi enfeksiyonları, acil tanı ve tedavi gerektiren morbidite ve mortalitesi yüksek enfeksiyonlardır. Hastanemizde takip edilen toplum kaynaklı santral sinir sistemi (SSS) enfeksiyonları irdelenerek hasta yönetiminde yardımcı olmak amaçlanmıştır.Yöntem: Ümraniye Eğitim ve Araştırma Hastanesi’nde 2013 ve 2020 yılları arasında SSS enfeksiyonu tanısı konan 56 hasta retrospektif olarak değerlendirildi. Bulgular: Yedi yıl içinde SSS enfeksiyonu tanısı konan 56 hastanın klinik sınıflaması incelendi. En sık akut pürülan menenjit (%51.8), ikinci sırada aseptik menenjit-ensefalit (%35.7) ardından tüberküloz menenjiti (%12.5) olduğu görüldü. Akut pürülan menenjit hastalarının %82.9’unda BOS kültürü sterildi. Bos kültüründe üreme olan hastalarda S. pneumonia (%10.3) ve E. coli (%6.8) saptandı. Aseptik menenjit ve ensefalitte %10 oranında HSV1 PCR pozitifliği mevcuttu. Başvuru esnasında klinik ayırım yapılamadığı için ampirik olarak antiviral ve antibiyotik tedavisi beraber başlanan hasta oranı %21.4 idi.Sonuç: Çalışmamızda başvuru esnasında ensefalit ve menenjit ayrımı yapılamayan hastaların oranı dikkati çekicidir. Ayrıca hastaların çoğunluğunda etkenin izole edilemediği görülmüştür. Genel olarak kullanılan ampirik tedavilerin etken izolasyonunu etkileyebileceği kanaatine varılmıştır. Hastaların yönetiminde SSS enfeksiyonlarına neden olan etkenlerin dağılımının bilinmesi ampirik tedavi seçiminde yol gösterici olmaktadır.

Objective: Frontline healthcare workers (HCW) exposed to coronavirus disease-2019 (COVID-19) patients at their work environment are at a higher risk of acquiring the disease. The aim of this study was to research the COVID-19 risks due to the occupational exposure of HCW and the clinical characteristics of the affected. Material and Methods: In this retrospective study, HCW, employed by The Umraniye Research and Training Hospital, who were diagnosed with COVID-19 between 20th March 2020 to 20th May 2020 were analysed. Results: A total of 128 (3.8%) HCW were diagnosed with COVID-19. Most of the infected HCW were medical staff (34%), nurses (24%), physicians (22%) and staff with no patient contact (20%). Fifty-six percent of the infected HCW were working in COVID-19 wards and out-patient clinics. Twenty-nine percent acquired the infection in hospital from an index patient and 32% of them from an infected HCW. The highest transmission was during the sharing of the same environment (53%) like offices. Thirteen per cent of the HCW took the virus during examination or treatment, 31% of the individuals were unaware of the transmission. The number of the infected HCW was higher during the beginning of the outbreak in Turkey. The symptomatic cases were more (88%) than the asymptomatic cases (12%). A total of 28 (22%) HCW were hospitalised and only 4% of the cases were severe. Conclusion: The asymptomatic COVID-19 carrying HCW are to be considered as the source of the spread of the disease among their colleagues. Stricter measures should be implemented to prevent in-hospital transmission. © 2021 by Turkiye Klinikleri.

Central nervous system (CNS) infections are inflammation of the brain meninges and parenchyma that can develop with many different microorganisms. Early diagnosis and effective treatment are important in the survival of patients. In our study, it was aimed to examine the clinical features of the patients followed up with the diagnosis of CNS infection.The data of 98 patients diagnosed with community acquired CNS infection in Ümraniye Training and Research Hospital and Fatih Sultan Mehmet Training and Research Hospital between February 2013 and December 2020 were evaluated retrospectively.Of the 98 patients diagnosed with CNS infection, 62 % (61) were male, mean age was 53.5±7.4 years. According to the classification, 43 (44 %) of the patients were acute bacterial meningitis, 38 (39 %) aseptic meningitis encephalitis, eight (8 %) tuberculous meningitis, five (5 %) brain abscess, and four (4 %) fungal meningitis. A predisposing factor was observed in 80 % of patients with brain abscess, 50 % of patients with fungal meningitis, and 31% of patients diagnosed with acute bacterial meningitis. Streptococcus pneumoniae (14 %), Escherichia coli (7 %) and Listeria monocytogenes (7 %) were most commonly grown in the cerebrospinal fluid culture of the acute bacterial meningitis patient group. In the aseptic meningitis encephalitis group, the most frequently isolated agent was VZV (18 %), followed by HSV type 1 (5 %) and HSV type 2 (5 %). Cryptococcus neoformans was isolated in all patients followed up with the diagnosis of fungal meningitis. Complications developed 50 % of the patients followed up with tuberculous meningitis.In our study, S.pneumoniae was most common in patients with acute bacterial meningitis and VZV was most common in patients with aseptic meningitis-encephalitis. Our findings will guide the management of patients with CNS infection., Santral sinir sistemi (SSS) infeksiyonları farklı birçok mikroorganizma ile gelişebilen, beyin meninks ve parankiminin enflamasyonu ile karakterize hastalıklardır. Hastaların sağ kalımında erken tanı ve etkin tedavi uygulanması önem arz etmektedir. Çalışmamızda SSS infeksiyonu tanısıyla takip edilen hastaların klinik özelliklerinin irdelenmesi amaçlanmıştır.Ümraniye Eğitim ve Araştırma Hastanesi’nde ve Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi’nde Şubat 2013 ve Aralık 2020 yılları arasında toplum kökenli SSS infeksiyonu tanısı konan 98 hastanın verileri retrospektif olarak değerlendirilmiştir.SSS infeksiyonu tanısı konan 98 hastanın % 62’sinin (61) erkek, yaş ortalamasının 53,5±7,4 olduğu görülmüştür. Yapılan sınıflamaya göre hastaların 43’ü (% 44) akut bakteriyel menenjit, 38’i (% 39) aseptik menenjit ensefalit, sekizi (% 8) tüberküloz menenjiti, beşi (% 5) beyin absesi, dördü (% 4) fungal menenjit tanısı almıştır. Beyin absesi tanılı hastaların % 80’inde, fungal menenjit tanılı hastaların % 50’sinde, akut bakteriyel menenjit tanısı konan hastaların % 31’inde predispozan bir faktör olduğu görülmüştür. Akut bakteriyel menenjit hasta grubunun beyin omurilik sıvısı kültüründe en sık Streptococcus pneumoniae (% 14), Escherichia coli (% 7) ve Listeria monocytogenes (% 7) üremiştir. Aseptik menenjit ensefalit grubunda ise en sık belirlenen etken VZV (% 18) ardından HSV tip 1 (% 5) ve HSV tip 2 (% 5) olmuştur. Fungal menenjit tanısı ile takip edilen hastaların hepsinde Cryptococcus neoformans izole edilmiştir. Tüberküloz menenjiti ile takip edilen hastaların % 50’sinde komplikasyon gelişmiştir.Çalışmamızda, akut bakteriyel menenjit hastalarında en sık S.pneumoniae, aseptik menenjit-ensefalit hastalarında da en sık VZV izole edilmiştir. Bulgularımız SSS infeksiyonu tanılı hastaların yönetiminde yol gösterici olacaktır.

SummaryCOVID-19 is a viral respiratory disease caused by SARS-CoV-2 infection. Global efforts of genomic surveillance of the virus give chance to track the spread of the pandemic. Global emergence of some viral mutations called attention and various studies have been suggested about increased infectivity of the virus. Herein, we sequenced viral genomes isolated from 184 patients in Istanbul and analyzed clinical metadata for the investigation of any viral mutation which affects the disease course of the host. We did not detect any viral mutations affecting the disease outcome in our cohort. Besides, we observed intra-host mutations in 76% of the isolates. Insertion/deletion and stop-gain mutations are also significantly less common among intra-host variants compared to consensus viral genome mutations. Longitudinal genomic surveillance is essential for timely detection of any lineages that might affect clinical outcome, the performance of diagnostic assays, or even the immunological escape of the virus.

INTRODUCTION[|]Hyperbaric oxygen therapy (HBOT) is a medical treatment method applied by intermittently breathing 100% oxygen and a commonly used supportive therapy for patients with diabetic foot ulcer (DFU). Our study aimed to evaluate the efficacy of HBOT in patients with DFU. [¤]METHODS[|]Thirty patients with HBOT and 42 patients without HBOT who were followed-up between 2016 and 2018 in our hospital were randomly selected and the epidemiologic, clinical characteristics of both groups, clinical outcomes of the patients were compared at the end of treatment.[¤]RESULTS[|]26 patients (86.7%) in the HBOT group and 14 patients (33.3%) in the non-HBOT group were PEDIS 3-4 (p = 0.000). The rates of re-hospitalization were significantly higher in the HBOT group (p = 0.005). Major and minor amputations were found to be similar in both groups, but in the HBOT group (p = 0.035 vs. p = 0.128). [¤]DISCUSSION AND CONCLUSION[|]In our study, it was thought that the rate of recurrent hospitalization and the need for surgical intervention in HBOT receiving group may be related to the presence of advanced stage of diabetic foot ulcers (DFU) in these patients. Amputation rates are similar in both groups and randomized, multicentre prospective studies are needed to evaluate HBOT efficacy. [¤]