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Objective: Our country has limited data on protective antibody levels following primary tetanus immunization. In this study, we planned to evaluate the tetanus antibody seroprevalence of healthcare workers in our hospital according to age and occupational groups. Methods: Tetanus antibody levels were determined by the enzyme-linked immunosorbent assay (ELISA) method. Antibody results were obtained through the hospital operating system, and the tetanus antibody level ≥0.5 IU/mL was considered seropositive. Results: 77.5% of 2082 healthcare workers were seropositive. According to age groups, the highest seropositivity was between 20-29; the lowest seropositivity was found in individuals over 50 years of age and over (66.3%). We determined that tetanus antibody protection decreased with age (p=0.03). There was no difference between tetanus seropositivity according to occupational groups. Conclusion: Antibody levels of tetanus decrease with age, and protection decreases significantly, especially over 50 years of age. It is important to apply a booster dose every ten years following the primary vaccine schedule in tetanus immunization.

Bu çalışmanın amacı, Türkiye’de tarım sektörüne yapılan tarımsal sabit sermaye yatırımlarının tarımsal büyüme üzerindeki etkisini incelemektir. Bu amaçla çalışmada tarımsal büyüme, tarımsal özel sabit sermaye, tarımsal kamu sabit sermaye yatırımları ve tarımsal istihdam değişkenleri 1995-2018 yılları arası yıllık veriler kullanılarak VAR Analizi ve Granger Nedensellik Testi yardımıyla incelenmiştir. VAR Modelinden elde edilen varyans ayrıştırması ve etki tepki fonksiyonlarının sonuçlarına göre değişkenlerin etkileşim içinde olduğu ve tarımsal büyümenin sabit sermaye yatırımları ve istihdam değişkenlerinden etkilendiği tespit edilmiştir. Granger nedensellik analizi sonuçları ise tarımsal büyüme ile istihdam arasında çift yönlü ve kamu sabit sermaye yatırımlarından da tarımsal büyümeye tek yönlü nedensellik olduğu yönündedir.

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.

Introduction The human population is aging at an astonishing rate. The aim of this study is to capture a situation snapshot revealing the proportion of individuals aged 65 years and over among inpatients in healthcare institutions in Turkey and the prevalence and type of infections in this patient group in order to draw a road map. Materials and Methods Hospitalized patients over 65 years at any of the 62 hospitals in 29 cities across Turkey on February 9, 2017 were included in the study. Web-based SurveyMonkey was used for data recording and evaluation system. Results Of 17,351 patients 5871 (33.8%) were ≥65 years old. The mean age was 75.1 ± 7.2 years; 3075 (52.4%) patients were male. Infection was reason for admission for 1556 (26.5%) patients. Pneumonia was the most common infection. The median length of hospital stay was 5 days (IQR: 2–11 days). The Antibiotic therapy was initiated for 2917 (49.7%) patients at the time of admission, and 23% of the antibiotics prescribed were inappropriate. Healthcare-associated infections developed in 1059 (18%) patients. Urinary catheters were placed in 2388 (40.7%) patients with 7.5% invalid indication. Conclusion This study used real data to reveal the proportion of elderly patients in hospital admissions. The interventions done, infections developed during hospitalization, length of hospital stay, and excessive drug load emphasize the significant impact on health costs and illustrate the importance of preventive medicine in this group of patients.

One of the major tools in agricultural finance is agricultural loans. Therefore, it is important to investigate the relationship between agricultural loans and agricultural production. In this study we aim to determine whether there is a causality relationship between the agricultural loan and agricultural production value. For this purpose we use the time series data for the years of 2005- 2018. In the study, we use Phillips-Perron unit root test to determine the stationarity levels of the variables examined. After we examine the stationary levels of time series, we perform Granger causality test to detect the causality relationship between agricultural loans and agricultural production. As a result of the Granger causality test, we determine that there is a unilateral causality relationship from the agricultural loan variable to the agricultural production value variable, that is, it can be said that agricultural loans affect the value of agricultural production. For this reason, we can state that facilitating the use of loans in the agricultural sector, and increasing the lending institutions will contribute to the increase of agricultural production value in meeting the input needs of the producers effectively.

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.

Aims: To assess diabetic patients’ knowledge and practices regarding foot care. Methods: This study was conducted as a cross-sectional study in 1030 patients between November 2017 and February 2018.The descriptive survey instrument was developed by the investigators. Survey content and format were based on prior surveys and guidelines. The survey sought socio-demographic characteristics of the patients and the level of knowledge about diabetic foot care practice. Results: 29.5% of patients had bad foot care, 49.6% of patients had moderate foot care and 20.8% of patients had good foot care. There were no significant differences between patient groups in regard to age, gender, foot infection history and having undergone amputation surgery. We found that patients who good at foot care had higher education status (p < 0.001), were more likely live in a city (p < 0.001), had higher income (p < 0.001), had been trained about foot care (p < 0.001) and were more likely to have type I DM (p = 0.015). Disease duration was longer in those who had good foot care compared to the other groups (p = 0.010). Conclusions: The mean knowledge and practice scores of our patients were moderate, indicating that much is to be done for the education of patients on this matter. We also found that knowledge about the importance of this practice, education status and disease duration had significant influence on the practice of foot-care in patients with DM. © 2019 Primary Care Diabetes Europe

Bu çalışmada, Türkiye Turunçgiller ihracatının 2001- 2016 yılları arasındaküresel pazarda rekabet gücünün analizi amaçlanmıştır. Bu amaçla AçıklanmışKarşılaştırmalı Üstünlükler Balassa, Grubel-Lloyd ve Net ihracat endeksleri kullanılmıştır.Elde edilen sonuçlara göre 2001-2016 yılları arasında Türkiye’nin turunçgillerürün grubunda güçlü bir rekabet gücüne sahip olduğu ifade edilmektedir. Endüstriiçi ticaretine ilişkin sonuçlara bakıldığında, 2001- 2016 yılları arasındadeğerlerin 0,50 değerinden düşük olduğu belirlenmiştir. Bu nedenle turunçgilsektöründe endüstri içi ticaret seviyesinin düşük olduğu ifade edilmektedir. Çalışmadakullanılan bir diğer endeks olan Net İhracat endeksi değerlerinden elde edilenhesaplama sonuçlarında ise turunçgil sektörünün dikkate alınan bütün yıllardapozitif bir değer aldığı görülmektedir. Bu sonuç ise Türkiye Turunçgil sektörünün,dikkate alınan yıllar arasında net ihracatçı ülke konumunda olduğunugöstermektedir., The purpose of this paper is to analyse the competitive performance of the Turkey for citrus trade in the global market during the period 2001-2016. To assess such performance the analysis considers comparative advantage and evaluates three indices: Balassa, Grubel- Lloyd and Net Export indices. According to the results that Turkey has a strong competitiveness for the citrus product between the years of 2001- 2016. The results of intra-industry trade indices it was determined that the values were lower than 0.50 between 2001 and 2016. Therefore, it is stated that the level of intra-industry trade in the citrus sector is low. In the results of the net export index, which is another index used in the study, it is observed that the citrus sector has a positive value for 2001- 2016 period. This means that, in citrus exports Turkey is a net exporter country for 2001- 2016.

Çalışmada,Türkiye’de uygulanan en kapsamlı bölgesel kalkınma projesi olan Güneydoğu Anadolu Projesi (GAP) illerini içeren Güneydoğu Anadolu (TRC) Bölgesine yapılan kamutarım yatırımlarının 2000-2017 yılları arasında hangi ölçüde eşit/eşitsizdağıldığı Gini Katsayısı ile ortaya konulmaktadır. Elde edilen ampirik bulgularinceleme döneminde kamu tarım yatırımları için hesaplanan Gini Katsayısınınortalama değerinin 0.712 seviyesinde bulunduğunu ve kamu tarım yatırımlarınınTRC Bölgesinde eşitsiz dağıldığını göstermektedir. TRC Bölgesinde bölge içi ve bölgeler arası eşitsizliğin toplameşitsizliğe katkısının ortaya çıkarılması amacıyla yapılan Gini KatsayısıAyrıştırma Analizi sonuçları ise 2000 yılından 2017 yılına gelindiğinde TRCBölgesinde bölgeler arası eşitsizliğin azalmaya başladığını ancak bölge içieşitsizliğin arttığını göstermektedir., Thestudy reveals the equal/unequal distribution of the public agriculturalinvestments that have been implemented in the region of Southeastern AnatoliaRegion (TRC) with the Gini coefficient. The region includes the districts ofSoutheastern Anatolia Project (GAP), as the most comprehensive regionaldevelopment project in Turkey. Theempirical findings reveal that the average value of the Gini Coefficient forpublic agricultural investments is 0.712. Therefore, public agriculturalinvestments are unevenly distributed in the TRC region. The results of the GiniCoefficient Decomposition Analysis conducted in order to explain the inequalityof intra-regional and inter-regional inequality in the TRC Region show that theinequality between regions has started to decrease in the TRC Region from 2000to 2017, while the inequality within the region has increased.

The purpose of this study is to examine the effects of fixed capital investments on agricultural growth in Turkey. For this purpose, in the study, agricultural growth, agricultural private fixed capital, agricultural public fixed capital investments and agricultural employment variables were analysed with the help of VAR Analysis and Granger Causality Test using annual data between 1995-2018. According to the results of variance decomposition and impact response functions obtained from the VAR Model, variables were interacted and agricultural growth was affected by fixed capital investments and employment variables. Granger causality analysis is that there is a two-way causality between agricultural growth and employment and one-way causality from public fixed capital investments to agricultural growth. © 2021, Centenary University. All rights reserved.

The purpose of this study is to examine the effects of fixed capital investments on agricultural growth in Turkey. For this purpose, in the study, agricultural growth, agricultural private fixed capital, agricultural public fixed capital investments and agricultural employment variables were analysed with the help of VAR Analysis and Granger Causality Test using annual data between 1995-2018. According to the results of variance decomposition and impact response functions obtained from the VAR Model, variables were interacted and agricultural growth was affected by fixed capital investments and employment variables. Granger causality analysis is that there is a two-way causality between agricultural growth and employment and one-way causality from public fixed capital investments to agricultural growth., Bu çalışmanın amacı, Türkiye’de tarım sektörüne yapılan tarımsal sabit sermaye yatırımlarının tarımsal büyüme üzerindeki etkisini incelemektir. Bu amaçla çalışmada tarımsal büyüme, tarımsal özel sabit sermaye, tarımsal kamu sabit sermaye yatırımları ve tarımsal istihdam değişkenleri 1995-2018 yılları arası yıllık veriler kullanılarak VAR Analizi ve Granger Nedensellik Testi yardımıyla incelenmiştir. VAR Modelinden elde edilen varyans ayrıştırması ve etki tepki fonksiyonlarının sonuçlarına göre değişkenlerin etkileşim içinde olduğu ve tarımsal büyümenin sabit sermaye yatırımları ve istihdam değişkenlerinden etkilendiği tespit edilmiştir. Granger nedensellik analizi sonuçları ise tarımsal büyüme ile istihdam arasında çift yönlü ve kamu sabit sermaye yatırımlarından da tarımsal büyümeye tek yönlü nedensellik olduğu yönündedir.

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: Central nervous system infections are infections with high morbidity and mortality that require urgent diagnosis and treatment. We aimed to help patient management by examining the CNS infections followed in our hospital.Methods: The data of 56 patients who were diagnosed with SSS infection between 2013 and 2020 in Ümraniye Training and Research Hospital were evaluated retrospectively.Results: The clinical classification of 56 patients diagnosed with CNS infection in seven years was examined. Bacterial meningitis (51.8%) was the most common type, aseptic meningitis- encephalitis (35.7%) was in the second order and followed by tuberculosis meningitis (12.5%). 87.2 % of the patient's CSF culture was sterile, S. pneumonia (10.3%) and E. coli (6.8%) were detected in CSF cultere. HSV1 PCR positivity was 10% in aseptic meningitis and encephalitis. Empirically, antiviral and antibiotic treatment was initiated together with 21.4%. Conclusion: In our study, the proportion of patients who could not distinguish between encephalitis and meningitis at the time of application is remarkable. In addition, it was observed that the agents could not be isolated in the majority of patients. It was concluded that the distribution of agents used in general empirical treatments can change the frequency order. Knowing the distribution of causative agents of CNS infections in the management of patients guides empirical treatment selection.

Agricultural sector is one of the important sectors that has need the financial resources for Turkey and the world economy. When the income of the producer is not sufficient, the producer applies to the institutions that provide financing for working capital and investment. Republic of Turkey (R. T.) Ziraat Bank is the most important credit institution providing agricultural finance in Turkey. Indeed, the history of the banking sector in Turkey is based on the R. T. Ziraat Bank. The foundation of R. T. Ziraat Bank goes back to the Country Funds. On November 20, 1863, Mithat Pasha established the Country Funds in the town of Pirot. Country Funds were named as Benefit Funds in 1883. The Capital of Benefit Funds was transferred to R. T. Ziraat Bank. Today, R. T. Ziraat Bank is the leading bank that provides agricultural credit financing to producers for existing or new agricultural firms. Although R. T. Ziraat Bank operates like commercial banks, its purpose is to provide farmers with production and investment loans. The aim of this study is to reflect the history and current case on today of R. T. Ziraat Bank which is of great importance for both the banking sector and the agricultural sector in Turkey since its establishment and to summarize the its banking sector information as an agricultural finance institution., Türkiye ve dünya ekonomisi için tarım sektörü, finansman kaynağına ihtiyacı olan önemli sektörlerden biridir. Üretici, geliri yeterli seviyede olmadığında, işletme sermayesi ve yatırım için finansman sağlayan kuruluşlara başvurmaktadır. Türkiye Cumhuriyeti (T. C.) Ziraat bankası, Türkiye’de tarımsal finansman sağlayan en önemli kredi kuruluşudur. Öyle ki, Türk bankacılık sektörünün tarihi de, T.C. Ziraat Bankası’na dayanmaktadır. T.C. Ziraat Bankası’nın temeli, Memleket Sandıklarına kadar uzanmaktadır. 20 Kasım 1863 tarihinde Mithat Paşa tarafından Pirot kasabasında Memleket Sandıkları kurulmuştur. Memleket Sandıkları, 1883 yılında Menafi Sandıkları olarak isimlendirilmiştir. Menafi Sandıkları’nın sermayeleri T.C. Ziraat Bankası’na devredilmiştir. Günümüzde, T.C. Ziraat Bankası üreticilere mevcut veya yeni kurulacak tarımsal işletmelerin tarımsal kredi finansmanını sağlayan lider bankadır. T.C. Ziraat Bankası, ticari bankalar gibi faaliyet gösterse de kuruluş amacı çiftçilere üretim ve yatırım kredisi vermektir. Bu çalışmanın amacı, Türkiye’de hem bankacılık sektörü hem de tarım sektörü açısından büyük önem taşıyan Ziraat Bankası’nın kuruluşundan itibaren tarihini ve günümüzdeki mevcut durumunu yansıtarak tarımsal finansman kuruluşu olarak bankacılık sektör bilgilerini özetlemektir.

WOS: 000388827200008, PubMed ID: 27138335, Objective Neuroimaging abnormalities in central nervous system (CNS) brucellosis are not well documented. The purpose of this study was to evaluate the prevalence of imaging abnormalities in neurobrucellosis and to identify factors associated with leptomeningeal and basal enhancement, which frequently results in unfavorable outcomes. Methods Istanbul-3 study evaluated 263 adult patients with CNS brucellosis from 26 referral centers and reviewed their 242 magnetic resonance imaging (MRI) and 226 computerized tomography (CT) scans of the brain. Results A normal CT or MRI scan was seen in 143 of 263 patients (54.3 %). Abnormal imaging findings were grouped into the following four categories: (a) inflammatory findings: leptomeningeal involvements (44), basal meningeal enhancements (30), cranial nerve involvements (14), spinal nerve roots enhancement (8), brain abscesses (7), granulomas (6), and arachnoiditis (4). (b) White-matter involvement: white-matter involvement (32) with or without demyelinating lesions (7). (c) Vascular involvement: vascular involvement (42) mostly with chronic cerebral ischemic changes (37). (d) Hydrocephalus/cerebral edema: hydrocephalus (20) and brain edema (40). On multivariate logistic regression analysis duration of symptoms since the onset (OR 1.007; 95 % CI 1-28, p = 0.01), polyneuropathy and radiculopathy (OR 5.4; 95 % CI 1.002-1.013, p = 0.044), cerebrospinal fluid (CSF)/serum glucose rate (OR 0.001; 95 % CI 000-0.067, p = 0.001), and CSF protein (OR 2.5; 95 % CI 2.32.7, p = 0.0001) were associated with diffuse inflammation. Conclusions In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.

Objectives: We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms. Methods: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. Results: In total, 791 patients with DFI were included, 531(67%) were male, median age was 62 (19–90). Severe infection was diagnosed in 85 (11%) patients. Osteomyelitis was diagnosed in 291(36.8%) patients. 536 microorganisms were isolated, the most common microorganisms were S. aureus (20%), P. aeruginosa (19%) and E. coli (12%). Methicillin resistance (MR) rate among Staphylococcus aureus isolates was 31%. Multidrug resistant bacteria were detected in 21% of P. aeruginosa isolates. ESBL (+) Gram negative bacteria (GNB) was detected in 38% of E. coli and Klebsiella isolates. Sixty three patients (8%) were re-hospitalized. Of the 791 patiens, 127 (16%) had major amputation, and 24 (3%) patients died. In multivariate analysis, significant predictors for fatality were; dialysis (OR: 8.3, CI: 1.82–38.15, p = 0.006), isolation of Klebsiella spp. (OR:7.7, CI: 1.24–47.96, p = 0.028), and chronic heart failure (OR: 3, CI: 1.01–9.04, p = 0.05). MR Staphylococcus was detected in 21% of the rehospitalized patients, as the most common microorganism (p < 0.001). Conclusion: Among rehospitalized patients, methicillin resistant Staphylococcus infections was detected as the most common agent, and Klebsiella spp. infections were found to be significantly associated with fatality. © 2018 The Authors

Objective: To present the outcomes of patients treated at a tertiary center for a diagnosis of genitourinary fistula secondary to gynecological and obstetric etiologies.Study Design: In this retrospective study, analysis was made of 18 patients with a diagnosis of genitourinary fistula in a tertiary center between January 2006 and June 2016. Patient data were taken from the archives and patient histories. A record was made of examinations, diagnostic methods such as cystoscopy and fistulography and appropriate medical treatments, demographic data, intraoperative and post-operative complications, duration of hospital stay, surgical operations and types, diameter and location of fistulas.Results: Of the 18 cases, 14 were secondary to obstetric trauma. In 10 of these 14 cases, fistula had developed after difficult vaginal delivery and in four cases, after caesarean section. Four of the 18 cases were secondary to gynecological surgeries, namely hysterectomy and cystocele repairs. Vesicovaginal fistulas were repaired transvaginally while vesicouterine fistulas and bilateral ureterovaginal fistulas were repaired transabdominally. The mean hospital stay was 3.8±1.5 days (2-7 days). Patients were followed up closely in the first 3 months and recurrence developed in only one case.Conclusion: Fistulas secondary to gynecological procedures are uncommon while fistulas secondary to inadequate perineal care, insufficient labor monitoring and difficulties in vaginal delivery techniques are more prevalent in Turkey. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgical

Introduction: Although diabetic foot infections are polymicrobial, gram-positive microorganisms comprise the majority. Daptomycin is a novel agent in treating infections due to multidrug-resistant gram-positive pathogens. In this multicenter study, the outcomes of the daptomycin treatment were evaluated retrospectively in the treatment of diabetic foot infectious without osteomyelitis. Materials and Methods: Patients with diabetic foot infection without osteomyelitis and who received daptomycin treatment were included into the study. Sociodemographic characteristics of the patients, risk factors for methicillin resistant Staphylococcus aureus (MRSA), antimicrobial treatment, and the data of microbiological and clinical outcomes of the cases were registered in a standard form by eleven centers. Clinical success was defined as a combination of end-of-treatment laboratory parameters, clinical and microbiological responses. Results: A total of 46 patients (30 males, 16 females) were clinically evaluated for the outcome of daptomycin therapy. Mean age was 61.09 ± 11.82 years (31-81) and mean diabetes duration was 13 ± 8.2 years. The number of mild, moderate and severe infections identified according to the infection scoring system of the Infectious Diseases Society of America (IDSA) were 12 (26.1%), 25 (54.3%), and 9 (19.6%) respectively. Duration of daptomycin therapy was 17.5 ± 9.3 days and overall daptomycin success rate was 82.6% (n= 38). Two patients developed side effects. Conclusion: The clinical success rate of this study which assessed the efficacy of daptomycin in diabetic foot infections was 82.6%. Daptomycin can be safely used even in severe cases having had no success with previous antibiotic therapy.

Toka, Onur/0000-0002-4025-4537; Yoruk, Gulsen/0000-0002-0357-5884; Cinar, Gule/0000-0002-7635-8848; Hakyemez, Ismail Necati/0000-0001-6133-9604; Tulek, Necla/0000-0002-3952-4982 WOS:000511173500009 Objective: Both chronic hepatitis B (CHB) and hepatosteatosis may lead to necroinflammation in liver. Therefore, the presence of hepatosteatosis might negatively affect the efficacy of antiviral therapy. We aimed to determine the effect of hepatosteatosis on virological response in patients with CHB receiving entecavir (ETV) and tenofovir (TDF) treatment. Methods: The study was designed retrospectively. All patients receiving antiviral therapy due to CHB in the departments of Infectious Diseases and Clinical Microbiology of 29 different hospitals between January 2012 and June 2017 were searched by examining medical records. Results: A total of 1069 patients were included. Six hundred and fifty of the patients had been receiving TDF and 419 of them had been receiving ETV. The rate of virological response obtained at the 48'h week of TDF was higher in patients with steatosis (p=0.029). Virological response at the 24th week and 48th week of ETV were higher in the patients without steatosis (p=0.001). TDF and ETV therapies were compared in the patients with hepatosteatosis and it was found that the virological response at 48th week was higher in the TDF group. Conclusion: Although steatosis has an effect on virological response in the short-term results of nucleos(t)ide therapy, it does not have any effect on virological response in the long-term results.

Aim: The aim of this study is to evaluate the attitudes of healthcare workers against seasonal influenza vaccine and the reasons for vaccine avoidance. Materials and Methods: This national survey was conducted from April 1st to June 30th in 2017. The study was carried out among health care workers working in primary, secondary and tertiary care settings. A total of 12 questions were sent to 5046 health care professionals from 55 different cities who agreed to participate in the survey.Results: 7% of the participants stated that they get vaccinated regularly every year. 65.8% of the participants stated that they don’t get vaccinated at all. The most important reason for those who did not receive influenza vaccination was their disbelief in the necessity of the vaccination (51.9%). The most common reason for the seasonal influenza vaccination was the prevention of influenza infection (56.7%).Conclusion: The results of the study showed that HCWs influenza vaccination rates are very low. Doctors have been found to have slightly better rates than other HCWs. The high level of education and the increase in professional experience had a positive effect on the vaccination rate. It is important to know the HCWs attitudes and behaviors towards the vaccination to increase the rates., Amaç: İnfluenza tüm dünyada önemli ölçüde morbidite, mortalite ve maliyet yükünden sorumludur. Sağlık çalışanları (HCP) mesleksel bulaş açısından risk altındadırlar. Bu çalışmada sağlık çalışanlarının mevsimsel influenza aşısına karşı tutumlarının ve aşıdan kaçınma nedenlerinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çok merkezli ulusal anket çalışması 1 Nisan-30 Haziran 2017 tarihleri arasında gerçekleştirildi. Ankete katılmayı kabul eden 55 şehirden toplam 5046 HCP uzaktan katılım yoluyla cevaplamaları için toplam 12 sorudan oluşan bir anket gönderildi.Bulgular: Çalışmaya katılanların %7’si her yıl düzenli olarak aşı yaptırdığını belirtti. Hiç yaptırmıyorum diyenlerin oranı %65,8 idi. İnfluenza aşışını yaptırmayanların en önemli nedeni grip aşısının gerekliliğine inanmama idi (%51,9). Mevsimsel grip aşısı yaptıranların en önemli gerekçesi grip infeksiyonundan korunma (%56,7) idi.Sonuç: Sonuçlarımız, tüm HCP influenza aşılama oranlarının çok düşük olduğunu göstermiştir. Doktorların diğer HCP’lerden biraz daha iyi oranlara sahip olduğunu görülmüştür. Eğitim düzeyinin yüksek olması ve mesleki tecrübenin artması aşılama oranını olumlu yönde etkilemiştir. Sağlık çalışanlarının aşılanma oranlarının artırılabilmesi için öncelikle aşı konusundaki tutum ve davranışlarının bilinmesi gerekir.