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Introduction: The new coronavirus named SARS-CoV-2, emerged in Wuhan, China in December 2019 and caused a pandemic. Unusual clinic of viral pneumonia caused by this virus was named COVID-19 and pandemic was declared on 11 March 2020 by World Health Organization. In this study, it was aimed to investigate the epidemiological and clinical characteristics of pediatric and adult patients who were admitted to Ege University Faculty of Medicine (EUFM) Hospital, Izmir, Turkey with COVID-19 findings between March 2020 and February 2021 and whose diagnosis was confirmed by the SARS-CoV-2 RT-PCR test. Materials and Methods: Age and gender characteristics of the patients were screened according to the services and months they admitted to the hospital, and the severity of infection was evaluated in three groups as mild, moderate and severe. In the severe patient group, the relationship between the common comorbid diseases observed in the community and survival status of patients were also evaluated. All statistical analysis performed by SPSS V.26,0. Results: One year from the start of the pandemic, 75851 people applied to the EUFM Hospital with the suspicion of COVID-19. The age median of the patients who applied was 39 (age-range;0-96) and 50.7% were male patients. SARS-CoV-2 were detected in a total of 7951 (10.5%, median age 39) patients, of them 4044 (10.5%) were male and 3907 (10.5%) were female (p= 0.796). All of the patients, 66577 (87.8%) were adults and 9274 (12.2%) were children. The rate of positivity for SARS-CoV2 in pediatric and adult groups were 7.7% (n= 716) and 10.9% (7235), respectively (p= 0.000). The percentage of patients who were classified as mild, moderate, and severe were 92.7%, 3.4%, and 3.9%, respectively. As a result of paired comparisons for all three level case groups, a statistically significant difference was found between mild cases and others (p= 0.000). However, there was no statistically significant difference between moderate and severe cases (p= 0.298). The mild-moderate-severe clinical level distributions were 3721 (50.4%), 142 (52.7%), 181 (58.7%) in male, 3653 (49.5%), 127 (47.2%), 127 (41.2%) in female, respectively (p= 0.014). All severe clinical level patients, 234 (76%) were intensive care patients. Smoking, obesity, hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD), congestive heart failure (CHF), chronic renal failure (CRF), chronic obstructive pulmonary disease (COPD),malignancy, and chemotherapy p values were found 0.037, 0.001, 0.052, 0.025, 0.003, 0.004, 0.006, 0.558, 0.355, 0.056, respectively. Conclusion: As a result, in a one-year period, COVID-19 showed up a mild illness in both the pediatric and adult groups without the need for hospitalization. In the community, women and men were equally infected with COVID-19, but severe-clinical-level disease was more common in men and over 60 years of age. Mortality rates were found to be high, especially in patients treated in intensive care. Smoking, obesity, DM, CAD, CHF, CRF comorbidities and being ≥60 years old, associated with poor prognosis and death. Due to the Izmir earthquake at the end of October, COVID-19 peaked in Izmir, in November 2020.

Background CoronaVac, an inactivated whole-virion SARS-CoV-2 vaccine, has been shown to be well tolerated with a good safety profile in individuals aged 18 years and older in phase 1/2 trials, and provided a good humoral response against SARS-CoV-2. We present the interim efficacy and safety results of a phase 3 clinical trial of CoronaVac in Turkey. Methods This was a double-blind, randomised, placebo-controlled phase 3 trial. Volunteers aged 18-59 years with no history of COVID-19 and with negative PCR and antibody test results for SARS-CoV-2 were enrolled at 24 centres in Turkey. Exclusion criteria included (but were not limited to) immunosuppressive therapy (including steroids) within the past 6 months, bleeding disorders, asplenia, and receipt of any blood products or immunoglobulins within the past 3 months. The K1 cohort consisted of health-care workers (randomised in a 1:1 ratio), and individuals other than health-care workers were also recruited into the K2 cohort (randomised in a 2:1 ratio) using an interactive web response system. The study vaccine was 3 mu g inactivated SARS-CoV-2 virion adsorbed to aluminium hydroxide in a 0.5 mL aqueous suspension. Participants received either vaccine or placebo (consisting of all vaccine components except inactivated virus) intramuscularly on days 0 and 14. The primary efficacy outcome was the prevention of PCR-confirmed symptomatic COVID-19 at least 14 days after the second dose in the per protocol population. Safety analyses were done in the intention-to-treat population. This study is registered with ClinicalTrials.gov (NCT04582344) and is active but no longer recruiting. Findings Among 11 303 volunteers screened between Sept 14, 2020, and Jan 5, 2021, 10 218 were randomly allocated. After exclusion of four participants from the vaccine group because of protocol deviations, the intention-to-treat group consisted of 10 214 participants (6646 [65.1%] in the vaccine group and 3568 [34.9%] in the placebo group) and the per protocol group consisted of 10 029 participants (6559 [65.4%] and 3470 [34.6%]) who received two doses of vaccine or placebo. During a median follow-up period of 43 days (IQR 36-48), nine cases of PCR-confirmed symptomatic COVID-19 were reported in the vaccine group (31.7 cases [14.6-59.3] per 1000 person-years) and 32 cases were reported in the placebo group (192.3 cases [135.7-261.1] per 1000 person-years) 14 days or more after the second dose, yielding a vaccine efficacy of 83.5% (95% CI 65.4-92.1; p, TUSEB, We are grateful to all participants who volunteered to be part of this study and to all members of the clinical research teams of the participating sites. We thank TUSEB for funding the study and Omega-CRO for the statistical analyses and production of figures, and providing the study protocol. We also thank the members of the data and safety monitoring board for their contributions in the safe execution of this study.

Background/aim: This study aimed to retrospectively analyse patients with foreign body (FB) injuries in our hospital and to present a patient with missed penetrating sponge FB injury. Materials and methods: This study lasted 12 years (2008-2020) and reviewed all patients with FB injuries who were admitted to the emergency department (ED) of our hospital. Along with our overall results, we present a case with missed penetrating sponge FB injury in detail. Results: Approximately 377 patients were included in the study (age: 28.3 +/- 18.3 years, m/f: 229/148). The foot (n = 148, 39.3%) and the hand (n = 143, 37.9%) were the most frequently injured body parts. Regarding FB types, sewing needles (n = 140, 37.1%), metal pieces (n = 91, 24.1%), and glass (n = 80, 21.2%) were the most frequently observed objects. Most of the patients were injured at home, often by needles or glass. The injury-admission mean time was 7.38 +/- 2.5 days. FBs were frequently removed in the ED (n = 176, 46.7%). Plain radiography is the first line in identifying FBs. Soft tissue infection was the most common complication. MRIs were much useful than USGs in detecting the missed penetrating sponge injury of the single patient in the study. Conclusion: For diagnosis of FBs, besides recording the patient's history, obtaining a two-sided radiogram is of great importance. For nonradiolucent or deeply located FBs, further clinical or radiological investigation must be considered to avoid complications. Although most of the FBs can be removed in the ED, patients may require hospitalisation and operation for FB removal, depending upon FB location and age.

Objectives: It is not always possible to determine a clear relationship between the DNA level of hepatitis B virus (HBV) and histology. In this study, we aimed to determine the relationship between HBV-DNA level and liver histopathology in patients with chronic hepatitis. Materials and Methods: Between 2008 and 2016, 361 patients diagnosed with chronic HBV infection were retrospectively examined with age, sex, hepatitis B e antigen status, alanine aminotransferase (ALT) and HBV-DNA levels and liver biopsy scores according to modified Ishak criteria. Patients were divided into five groups (, Amaç: Hepatit B virüs (HBV)-DNA düzeyi ile histoloji arasında her zaman net bir ilişki saptamak mümkün olmamaktadır. Bu çalışmada kronik hepatit tanılı hastalarda HBV-DNA düzeyi ile karaciğer histopatolojisi arasındaki ilişkinin ortaya konması amaçlanmıştır. Gereç ve Yöntemler: 2008-2016 yılları arasında kronik hepatit B tanılı 361 hastanın; yaş, cinsiyet, hepatit B e antijeni durumu, alanin aminotransferaz (ALT) ve HBV-DNA düzeyleri ile modifiye Ishak kriterlerine göre karaciğer biyopsi skorları retrospektif olarak incelenmiştir. HBV-DNA düzeyi ile grade/stage skorları arasındaki istatistiksel ilişkinin araştırılması açısından hastalar, HBV-DNA düzeyine göre 5 gruba (

[No abstract available]

Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 +/- 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.

OZTURK, ANIL MURAT/0000-0001-8674-8877; Tasbakan, meltem/0000-0002-4689-720X, WOS:000512305000020, The rate of opportunistic infections has decreased with highly active antiretroviral therapy in HIV infected patients. HIV can be diagnosed concurrently with opportunistic infections. in this paper, it was aimed to present a 39-year-old male patient who was diagnosed with HIV while being followed-up for necrotizing skin soft tissue infection and necrotizing pneumonia. Acinetobacter baumannii was isolated from deep wound culture, but no agent was isolated from blood cultures and lower respiratory tract samples of the patient. Considering his clinical condition, anti-HIV was requested from the patient for possible immunodeficiency. The test result was positive. CDC recommends that everyone between the ages of 13-64 get tested for HIV as part of routine health care. For those with specific risk factors such as patients presenting with frequent recurrent infections, testing for HIV should come to mind.

In this study, we aimed to investigate retrospectively the patients with carbapenem-resistant Enterobacteriaceae urinary tract infections (UTIs) in the terms of demographic findings, antibiotic sensitivity patterns and clinical features along with the treatment options. This study was performed at a tertiary-care educational university hospital. Adult (>18 years old) patients diagnosed with culture proven UTI due to carbapenem-resistant Klebsiella pneumoniae (between December 2016 to December 2017) were included in the study. Antimicrobial susceptibility testing of the isolates was performed with the VITEK 2 system (bioMerieux). Resistance to imipenem, ertapenem, and meropenem was tested by E-test (bioMerieux). the results were interpreted according to the EUCAST criteria. A total number of 100 patients (34% female, mean age 61.69 +/- 1.65 years) were included in this study. One month all-cause mortality rate was 19%. Microbiologic eradication rate was 88.7% while it was significantly higher in combination therapy (65/70 vs. 14/19, p = 0.019) and carbapenem long-lasting (4 h) infusion subgroups (54/56 vs. 2/56, p = 0.005). Relapse and reinfection rates were 61.7 and 29.7%, respectively. Logistic regression analysis for mortality risk factors resulted as history of ertapenem usage (OR: 4.74, 95% CI: 0.678-33.201, p = 0.117), lack of microbiologic eradication (OR: 21.7, 95% CI: 1.906-247.375, p = 0.013) and ICU stay (OR: 54.8, 95% CI: 4.145-726.324, p = 0.002). Combination, carbapenem long-lasting infusion and double carbapenem therapies seem to result in higher microbiologic eradication rates and thus may effect the mortality rates of these group of patients. Randomized-controlled studies should be performed in this critical patient group to confirm these results.

WOS: 000488951800014, Primary cytomegalovirus (CMV) infection generally occurs during childhood/early adolescence and is usually an asymptomatic or mild and self-limiting disease in immunocompetent patients. Mononucleosis-like syndrome due to primary CMV may occur in middle-aged or advanced-aged adults, though rare. Three middle-aged patients from the same family admitted to our clinic with acute CMV infection. Two of the three cases were hospitalized, CMV antibodies were examined and at the same time the third case had an acute CMV infection. CMV transmission among middle-aged family members Is very rare. This study reports three cases of acute CMV infection and it's transmission from person to person in the same family.

Introduction: In this study, it was aimed to investigate the prevalence of rotavirus and norovirus in patients admitted to Ege University Medical Faculty Hospital with acute diarrhea in a period of about one year. Materials and Methods: Between September 2016-August 2017, stool specimens were collected from 408 (341 pediatric and 67 adult) patients with acute diarrhea. The age range of the patients was between one month to 84 years (median: 3 years, mean: 10.25 years). Stool specimens were obtained from 206 (50.5%) outpatients and 202 (49.5%) inpatients. Stool specimens of patients with acute gastroenteritis were tested by real time PCR BD MAX™ Enteric Viral Panel (BD Diagnostics, Baltimore, MD, USA). This is an automated in vitro diagnostic test used for the qualitative detection of norovirus (genotype I and II) and rotavirus species in stool specimens. In this multiplex PCR system, viral nucleic acid is extracted from the specimen and it undergoes reverse transcription to generate complementary DNA (cDNA). The target cDNA is amplified using real time PCR and then analyzed to detect the presence or absence of each virus in the panel. Results: Of the 408 specimens tested, 223 (54.7%) were positive for one or more gastrointestinal viruses. Of the 223 positive samples, 184 (45.1%) were rotavirus, 26 (6.4%) were norovirus genotype II, 1 (0.2%) was norovirus genotype I, and 12 (2.9%) were rotavirus/ norovirus genotype II. Of the 223 positive samples, 121 (54.3%) were outpatients and 102 (45.7%) were inpatients (p= 0.094). The rate of positivity for the rotavirus in pediatric and adult groups were 48.4% (165/341) and 46.3% (31/67) (p= 0.751), respectively. Rotavirus positivity was highest in the months of March (75%), February (70%) and January (60%). Conclusion: In conclusion, the rate of positivity for rotavirus and norovirus were found as 48% and 10%, respectively in fecal samples sent to the laboratory by viral acute gastroenteritis, especially in winter. There was no significant difference between the positivity rates of the inpatients or outpatients and the positivity rates of the pediatric or adult patients.

Introduction: Fungal infections are vital problems worldwide and their incidence have increased along with changing patient profile. Particularly candida species is still the most commonfungal agent, and the significance of non-albicans candida species have gained importance in recent years. In the present study, it was aimed to evaluate retrospectively the risk factors and distribution of candida species in patients with invasive candida infections, who were treated with anidulafungin., Materials and Methods: In the first three years (1 January 2012 to 31 December 2014) when anidulafungin came out in our country, we retrospectively evaluated the data of the patients with invasive candida infections who were treated by anidulafungin for more than 48 hours in seven university hospitals. Data were recorded to the case report forms., Results: Two hundreds and fifty-seven patients were included into the study. Fifty-six percent of the patients were male and mean age was 58.57 +/- 19.5 years. Two hundreds and three patients (79%) were hospitalized in intensive care units, 37 (14.3%) in internal medicine services, and 17 (0.07%) in surgery services. As previously described, we detected antibiotic usage in the last month (%96.9), presence of urinary catheter (90.3%) and presence of central venous catheter (82.1%) as risk factors for invasive candida infections. More than half of the patients (57.1%) with central venous catheter had candidemia. Sixty-six (47.7%) of the blood isolates were Candida albicans, 33 (23.7%) were Candida parapsilosis, 17 (12.2%) were Candida tropicalis and 13 (9.4%) were Candida glabrata. During follow up, 64.5% of 124 patients whose catheters couldn't be taken off and 47.6% of 86 patients whose catheters could be taken off died. During anidulafungin treatment, one anaphylaxis, one skin eruption and one thrombocytopenia were seen as side effects., Conclusion: In our study, we found that removal of central venous catheter of the patients with candidemia was a positive effect on mortality. We suggest that patients with candidemia, insisting on catheter removal besides antifungal treatment is necessary. We observed that anidulafungin is an effective and safe choice in invasive candida infections.

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 +/- 0.74. Sepsis (qSOFA >= 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 +/- 0.963) compared to upper-middle (0.17 +/- 0.482) and high-income (0.36 +/- 0.714) countries ( P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

Aim Coronavirus Disease 2019 (COVID‐19) changed the delivery of medical education in Turkey by moving to an emergency remote teaching system and led to many challenges for future doctors. In this study, we aimed to explore the impact of the COVID‐19 pandemic on medical students, to assess their anxiety level and their main anxiety sources related to this pandemic. Methods A Google Form was distributed to medical students using the virtual snowball sampling method. The form included the Beck Anxiety Inventory and additional 19 questions on sociodemographic characteristics, perceived level of knowledge about the epidemic, self‐risk perceptions of COVID‐19 and their anxiety levels about some other topics related to COVID‐19. Results Overall, 3105 medical students with a mean age of 22.37 ± 2.46, took the survey. Amongst the participants, only 32% of the students defined their knowledge about the precautions that should be taken during an epidemic disease as acceptable. Students reported highest anxiety level for the continuing spread of COVID‐19 in Turkey and transmitting coronavirus to another person. Clinically significant anxiety prevalence was 23.2%. Regression analysis revealed that factors that increased the risk of being anxious included being female, being other than a 5th‐year student, thinking that being a medical student would increase the risk of coronavirus transmission or being uncertain about it, being exposed to a patient with COVID‐19 or being uncertain about it, being anxious about the continuing spread of COVID‐19 in Turkey, being anxious about acquiring COVID‐19, being anxious for graduating and being on active duty, being anxious about a medical training interruption. Conclusion Our results suggest that anxiety is prevalent amongst Turkish medical students during the COVID‐19 pandemic and they have a weak preparedness for a pandemic such as COVID‐19. Based on our results, new strategies should be implemented for medical education and for alleviating students’ anxiety levels.

Introduction: In this study, it was aimed to obtain information about the perspectives of infectious diseases and clinical microbiology (IDCM) specialists on online education applications and web-based seminars, and their usage and utilization rates Materials and Methods: In this descriptive, cross-sectional study, online survey responses of the IDCM specialists in who were members of Infectious Diseases Clinical Microbiology Specialty Society of Turkey (EKMUD) were evaluated

Background/aim: The aim of this descriptive article is to share the experience in Ege University, Turkey with favipiravir in the treatment of severe SARS-CoV-2 pneumonia. Materials and methods: This retrospective descriptive study included patients diagnosed with COVID-19 who presented with or developed severe pneumonia. Results: Forty patients who completed a full course (at least 5 days) of favipiravir were included in the study. At baseline, 30 (75%) patients required treatment for respiratory distress. Thirty-three patients (82.5%) were discharged from the hospital with full recovery, 6 patients (15%) died and 1 case (2.5%) was still at the intensive care unit (ICU) when this paper was written. Conclusion: This study provides relevant information for the treatment of COVID-19, suggesting that favipiravir was associated with significant clinical and laboratory improvements in the majority of the patients, is a safe drug with no serious side effects and would merit further investigation.

Background/Aims: Despite surgical advances in liver transplantation and effective prophylactic strategies, posttransplant infections are the most important cause of morbidity and mortality. Diagnosis and management of infections because of developing immunosuppression is difficult and adversely affects mortality. This study aimed to review bacterial and fungal infections in patients after liver transplantation and to reveal the resistance rates. Materials and Methods: A total of 107 patients who underwent liver transplantation between January 2017 and February 2018 were evaluated retrospectively with regard to demographic characteristics, causes of transplantation, conditions that may lead to infection, postoperative infections, pathogens, and resistance patterns. Results: of the 107 patients who underwent liver transplantation, 48 (44.8%) had an infection. Bacterial infections were detected in 41% of the patients, and fungal infections were found in 13%. When we compared living and cadaveric transplants in terms of infection development, these rates were found to be 53% and 33%, respectively (p=0.034). No statistically significant results could be obtained when evaluating conditions such as sex, presence of underlying primary disease, Model for End-Stage Liver Disease MELD score, diabetes status, total parenteral nutrition, and risk factors for infection. Conclusion: After liver transplantation, infections are often seen in the first month of the postoperative period. Knowing the most common pathogens and resistance states in this process reduces infection-related deaths by providing appropriate treatment regimens at the right time., Infect Dis & Clin Microbiol Special Soc Turkey

In solid organ transplant recipients, it is recommended that the necessary vaccinations be completed at least 4 weeks before transplant. Chickenpox infection in adulthood can lead to serious clinical conditions such as pneumonia, hepatitis, and central nervous system infections. Herein, the case of chickenpox in a 36-year-old female patient with renal transplantation for end-stage renal disease due to vesicoureteral reflux 11 years previously and without a history of chickenpox or its vaccination before and after transplantation is reported. In this case, because of the development of thrombocytopenia associated with intravenous acyclovir, treatment was successfully concluded with oral valacyclovir.

Background/Aims: Ledipasvir (LDV) and sofosbuvir (SOF) as single-tablet regimen (STR) has been approved for treatment of chronic HCV infection (CHC) for treatment-naive or experienced cirrhotic or non-cirrhotic patients. Our aim was to analyse the effectiveness and safety of 12-24 weeks treatment of LDV/SOF (90mg/400 mg)+/- ribavirin in a real-life setting in Turkey. Materials and Methods: Between May-Dec 2016, 104 treatment-naive or experienced adult patients with CHC and with or without cirrhosis (including decompensated cirrhosis) were included in this observational study. Patients were administered LDV/SOF STR +/- ribavirin once daily for 12-24 weeks. SVR12 rates and effects of the baseline characteristics on SVR12 rates were assessed. Results: Out of 104 enrolled patients (61.5% female, mean age 62.0 years); 60.6% were cirrhotic, 76.0% previously used peg-IFN, 94.2% had GT1. At the end of the treatment, 77.8% (77/99, no data for 21 patients) had undetectable HCV-RNA and 98.9% (94/95) had SVR12. in the baseline characteristics subgroups, the SVR12 rates varied between 94.4% and 100%, and none of the baseline characteristics had a significant effect on the SVR12 rates. During the study, 6 (5.8%) patients died and none of the deaths was suspected to be related to the LDV/SOF. No treatment-emergent adverse event was reported. Conclusion: in conclusion, LDV/SOF +/- ribavirin yielded very high SVR12 rates, without any safety or tolerability concern in Turkey. the effectiveness of the LDV/SOF treatment was not affected by the patient demographics or medical characteristics such as fibrosis level, cirrhosis status, previous treatment status, HCV-RNA level or HCV genotype., Gilead Sciences, TurkeyGilead Sciences, This study was supported by Gilead Sciences, Turkey for editorial support in the preparation of this manuscript.

Background/aim The emergence of the coronavirus disease 2019 (COVID-19) outbreak has had an enormous emotional impact on some vulnerable groups, such as people living with human immunodeficiency virus (HIV) (PLHIV). This study was planned with the aim of assessing the anxiety levels of PLHIV and the sources of their anxiety. Materials and methods A web-based questionnaire was sent to PLHIV using the virtual snowball sampling method. The questionnaire included questions about sociodemographic status, information about HIV infection, and the Beck Anxiety Inventory (BAI). Additionally, some opinions of the participants about COVID-19 were asked. Results A total of 307 respondents, with a median age of 33 years, from 32 different cities, participated in the study. More than half of the respondents reported the belief that COVID-19 was not sufficiently well-known by the medical community and nearly 45% believed that they would have more complications if they contracted COVID-19. One-fourth of the participants had anxiety. Having a preexisting psychiatric disorder, perceiving that they were practicing insufficient preventive measures, not being sure about the presence of any individuals with COVID-19 in their environment, and living with a household member with a chronic disease were found to be the risk factors of PLHIV for having anxiety during this pandemic. The BAI scores were correlated with the patient-reported anxiety levels about the spread of COVID-19 in Turkey, acquiring COVID-19, transmitting COVID-19 to another person, and transmitting HIV to another person. Among the stated conditions, the most common concern was the spread of COVID-19 all over the country, while the least common was transmitting HIV to someone else. Conclusion The results revealed that a significant proportion of the sample had anxiety, and the findings were essential for developing evidence-based strategies for decreasing the anxiety of PLHIV, especially for those who had risk factors and to provide them with better health care during this pandemic or other pandemic-like crises.

WOS: 000449010500007, PubMed ID: 30381274, Background/Aims: Liver transplantation (LT) is now the standard of care for most end-stage liver diseases. Over the next 30 years, advances in medicine and technology will greatly improve the survival rates of patients after this procedure. The aim of the present study was to analyze retrospectively the results of 1001 patients withLT. Materials and Methods: Medical reports of 989 patients were analyzed retrospectively. Data were obtained from the patient's data chart. Descriptive statistics were used to describe continuous variables (mean, median, and standard deviation). Results: A total of 1001 LTs for 989 recipients were performed at Ege University Organ Transplantation and Research Center between 1994 and 2017. Therewere 639 male and 350 female recipients. Among 1001 LTs, there were 438 deceased donors and 563 living donors. The age interval of the patients was 4 months to 71 years old. The median Model for End-Stage Liver Disease score was 20. There were 12 deceased liver donors using the split method. There were 12 cases subject to retransplantation. In living donor LT grafts, 423 right lobes, 46 left lobes, and 94 left lateral sectors were used. In the first monitoring, the total annual mortality rate was 130 cases (13%). The mortality rate in retransplantation was found to be 66%. A 1-year survival rate of 87% was generally established. Conclusion: LThas been improving consistently over the last two decades. Ege University is one of the biggest liver transplant centers in Turkey for both technical and educational perspective.

Introduction: Skin findings in diabetic patients are not rare. Diabetic Foot Syndrome (DFS) is associated with a high risk of morbidity and mortality. The purpose of this retrospective study is to evaluate the causal relationships of skin findings of DFS patients and to identify the complications that may develop early and to direct them for treatment. Materials and Methods: A total of 241 patient files followed in the Diabetic Foot Council of Ege University Medical Faculty with the diagnosis of DFS were examined. Data on gender, age, diabetes type and duration, HbA1c levels, presence and type of infection, Wagner’s classification, and skin findings of the patients were recorded. These patients were assessed by dermatologists, who were members of the Council, and their findings were recorded. Results: In terms of frequency, 193 (80.1%) patients had xerosis, 80 (33.2%) had plantar hyperkeratosis, 54 (22.4%) had fissure, 55 (22.8%) had maceration and desquamation between toes, 46 (19.1%) had callus formation, 8 (3.3%) had diabetic dermopathy, and 2 (0.8%) had diabetic bulla. In terms of foot deformities, 32 patients (13.3%) had deformation in toes, 89 (36.9%) had claw foot, 38 (15.8%) had hammer/claw toes, 32 (13.3%) had acromegalic finger, 23 (9.5%) had hallux valgus, and 22 (9.1%) had Charcot deformity. According to Wagner classification; 18 (%7.5) patients were Stage 1, 66 (%27.4) were Stage 2, 69 (%28.6) were Stage 3, 64 (%26.6) were Stage 4, and 24 (%10) were Stage 5. In terms of infection, 67 (%27.8) patients had mild infection, 114 (%47.3) had intermediate infection and 60 (%24.9) had severe infection. On time of admission, 114 (%47.3) patients had osteomyelitis but 127 (%52.7) did not. Conclusion: The appearance of skin findings in a diabetic patient indicates the need for more strict patient care and the need for proper foot care. Patients with DFS should be evaluated together with other skin findings on the foot which may prevent complications to occur thanks to early diagnosis and treatment. This will help reduce morbidity and mortality which can cause high economic costs.

Tuberculosis is one of the oldest known diseases in the World, and it is still an important cause of mortality and morbidity in our country. Despite the improvements in diagnosis and treatment, resistance to anti-tuberculosis drugs still remains a serious problem. In this report, a multidrug-resistant bone-joint tuberculosis case was presented.

WOS: 000419586300002, The aim of this study was to screen the patients with solid organ malignancy for HBV (Hepatitis B virus) infection before the start of chemotherapy and follow up in the oncology department of our setting. All cases admitted to oncology department for chemotherapy were screened prospectively for HBV infection and reactivation between March 2013-September 2014. A total of 225 patients were included in the study and divided into 3 groups; Group I: having recovered past HBV infection: 43 patients (19.1%), Group II: isolated Anti-HBcAg total positive: 20 patients (8.9%) and Group III: chronic HBV infection with 10 patients (4.4%). HBV reactivation developed in one (5.9%) of 17 patients in group II, and two (28.6%) of seven patients in group III while under lamivudine prophylaxis. Neither hepatitis flare by HBV reactivation nor HBV-related death were observed in our study. In the moderate endemicity areas like Turkey for HBV infection, all patients must be screened for HBV before starting of chemotherapy.

WOS: 000427391500004, Brucellosis and fascioliasis are zoonoses which induce different type of cell-mediated immune responses and rarely cause hepatitis with together. Brucellosis induces T helper type 1 (Th1) immune response whereas Fasciola hepatica induces T helper type 2 (Th2) immune. It may be speculated that chronic fascioliasis can predispose to brucellosis by suppression of Th1 response against brucellosis. In this paper, we present a patient who was diagnosed with brucellosis as well as chronic fasciolasis on the basis of parasite that was seen incidentally during the abdomen ultrasonography. To our knowledge, this case is one of the few cases in the literature that showing the co-infection of the liver by both fascioliasis and brucellosis.

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.

Introduction: Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii. The disease is usually asymptomatic without any clinical signs in humans. Acute toxoplasmosis in pregnancy is important since it can lead to congenital anomalies. Materials and Methods: The aim of this study was to evaluate the knowledge level of physicians specialized in infectious diseases or obstetrics and gynaecology. A questionnaire about toxoplasmosis in pregnancy was prepared. The questions were including horizontal transmission rate, surveillance of serology and treatment. The questionnaires were filled by infectious diseases or obstetrics and gynecology specialists. Results: A total of 100 physicians (64 females, 36 males) filled out the questionnaire. Mean age was 35.7 ± 8.3 years. Sixty-four physicians were from infectious diseases, 36 were from gynaecology and obstetrics departments. The knowledge of possibility of congenital anomaly and transmission to the fetus were highest in the first trimester and third trimester were known by 88% and 83% of the participants, respectively. Conclusion: Management of toxoplasmosis in pregnancy is crucial to protect the fetus and pregnant woman from complications. It is generally hard to separate old and new infections and make desicion for treatment or termination of pregnancy.

There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI. The variables were analysed using logistic analysis. A total of 126 cases (33·2%) underwent amputation. The odds ratios in the amputation model were 3·09 for osteomyelitis (P 60 days (P = 0·001), 3·10 for ulcer depth > 15 mm (P < 0·001) and 10·28 for fungal DFI (P = 0·015). In this study, the unusual result of well-known literature was fungal DFI as an independent risk factor for amputation in patients with DFI.

In this multicenter prospective cohort study, it was aimed to evaluate the bacterial and viral etiology in community-acquired central nervous system infections by standart bacteriological culture and multiplex polymerase chain reaction (PCR) methods. Patients hospitalized with central nervous system infections between April 2012 and February 2014 were enrolled in the study. Demographic and clinical information of the patients were collected prospectively. Cerebrospinal fluid (CSF) samples of the patients were examined by standart bacteriological culture methods, bacterial multiplex PCR (Seeplex meningitis-B ACE Detection (Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Group B streptococci) and viral multiplex PCR (Seeplex meningitis-V1 ACE Detection kits herpes simplex virus-1 (HSV1), herpes simplex virus-2 (HSV2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV) and human herpes virus 6 (HHV6)) (Seeplex meningitis-V2 ACE Detection kit (enteroviruses)). Patients were classified as purulent meningitis, aseptic meningitis and encephalitis according to their clinical, CSF (leukocyte level, predominant cell type, protein and glucose (blood/CSF) levels) and cranial imaging results. Patients who were infected with a pathogen other than the detection of the kit or diagnosed as chronic meningitis and other diseases during the follow up, were excluded from the study. A total of 79 patients (28 female, 51 male, aged 42.1 ± 18.5) fulfilled the study inclusion criteria. A total of 46 patients were classified in purulent meningitis group whereas 33 were in aseptic meningitis/encephalitis group. Pathogens were detected by multiplex PCR in 41 patients. CSF cultures were positive in 10 (21.7%) patients (nine S.pneumoniae, one H.influenzae) and PCR were positive for 27 (58.6%) patients in purulent meningitis group. In this group one type of bacteria were detected in 18 patients (14 S.pneumoniae, two N.meningitidis, one H.influenzae, one L.monocytogenes). Besides, it is noteworthy that multiple pathogens were detected such as bacteria-virus combination in eight patients and two different bacteria in one patient. In the aseptic meningitis/encephalitis group, pathogens were detected in 14 out of 33 patients; single type of viruses in 11 patients (seven enterovirus, two HSV1, one HSV2, one VZV) and two different viruses were determined in three patients. These data suggest that multiplex PCR methods may increase the isolation rate of pathogens in central nervous system infections. Existence of mixed pathogen growth is remarkable in our study. Further studies are needed for the clinical relevance of this result.

WOS: 000401318800009, Objectives: Interferon (IFN) treatment has many neuropsychiatric side effects such as depression and anxiety disorder. Although untreated depression is a major contributor to dosage reduction or premature discontinuation of the IFN treatment, it is found that depressive symptoms among patients undergoing hepatitis C virus (HCV) treatment are commonly overlooked during routine clinical interviews. Besides depression, anxiety disorders are shown to affect adherence to pegylated IFN (Peg-IFN) treatment in patients with hepatitis C. Despite the occurrence of neuropsychiatric side effects of IFN treatment being widely reported in patients with hepatitis C, there are few studies studying patients infected with hepatitis B virus (HBV). The aim of this prospective study was to evaluate the incidence and risk factors of depressive and anxiety disorders that occur during Peg-IFN treatment of patients with HBV. Methods: The sample consisted of volunteer patients who were diagnosed with HBV infection and who were decided to receive IFN treatment. During the study period, all consecutive patients with HBV infection and who would have IFN treatment were informed about the study and invited to participate. Thirty-seven chronic hepatitis B (CHB) patients were recruited for the study, but four of them were excluded due to psychiatric diagnosis at the initiation of the treatment. Therefore, the sample consisted of 33 patients with CHB, meeting the inclusion criteria. The participants had psychiatric assessment before the treatment and at 1st, 3rd, 6th, and 12th months. At each visit, the subjects were assessed with Clinical Global Impressions Scale, Hamilton Rating Scale for Depression (HRSD), and Hamilton Anxiety Rating Scale (HAM-A). Results: Among the 33 patients with HBV, 22 (66.7%) were men. Mean age was 35.97 +/- 10.73 years. While follow-up, 6 patients dropped out from the study. Also, 13 patients were excluded from the study as they developed depression and/or anxiety disorder. Mean baseline HRSD and HAM-A scores were smaller than the following visits' scores. The difference was not statistically significant only for the 12th month assessments. Totally 14 (42.4%) patients developed depression/anxiety disorder during 1 year follow-up. Six (42.86%) of them received the diagnosis at the 1st month, 3 (21.43%) at the 3rd, 4 (28.57%), at 6th months, and 1 (7.14%) at the 12th month. When we compared the patients who developed depression/anxiety disorder with the patients who did not develop any psychiatric disorder, we found that the mean baseline HRSD score (t = 2.303, p =.028) and female percentage (p =.017) were statistically significantly higher in the depression/anxiety disorder group. Conclusions: There is an incidence of 42.4% for depression and/or anxiety disorders during Peg-IFN treatment. Females and patients with subsyndromal depressive symptoms should be referred to a psychiatrist and closely monitored especially for the first three months of the IFN treatment.

Almost 75% of women experience vulvovaginal Candida infection at least once during their lifetime and 90% of these infections are due to Candida albicans (Marchaim et al. 2012). Both diagnosis and ...

Visceral Leishmaniasis (VL) is a parasitic disease frequently seen in Mediterranean countries, including our country, which still constitute a major public health problem. In this study, it was aimed to investigated retrospectively 20 cases diagnosed with visceral leishmaniasis (VL) among the cases referred from different clinics/centers for further examination to our department due to fever of unknown origin in terms of demographic characteristics, underlying diseases, laboratory, clinical data and treatment results between 2007-2017. Adults with chronic systemic diseases are always at risk in endemic regions and VL should be considered in differential diagnosis, particularly in cases of fever of unknown origin.

Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1%) and TB was isolated in 65 patients (86.6%). PCR were performed to 37 (35.6%) biopsy samples and of these, 35 (94.6%) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9%). Upper gastrointestinal endoscopy was performed to 40 patients (38.5%) and colonoscopy in 74 (71.1%). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3%). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8%) patients died and 2 (1.9%) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery., SCOPUS: ar.j, info:eu-repo/semantics/published

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.

Background/aim: Carbapenem-resistant Klebsiella pneumoniae CR-KP infections encountered in urology patients differentiate from infections caused by other factors, both in respect to prophylaxis and treatment stage, and require a special approach. We aimed to analyse the predisposing factors and the antibiotherapies for CR-KP infection outbreak in a tertiary urology clinic.Materials and methods: There were 75 patients in the CR-KP positive group Group I and 146 patients in the CR-KP negative group Group II . Analysis of the predisposing factors for CR-KP infection and comparison of the reinfection rate and the antibiotherapies in the 2 groups were the endpoints.Results: In the first group, age, comorbidity, previous antibiotic use, and nephrostomy tube rates were higher P = 0.015, P = 0.001, P = 0.004, and P < 0.001, respectively . In the second group, open urological surgery rate, and the proportion of patients presenting with flank pain, lower urinary tract symptoms, and haematuria were higher P = 0.029, P < 0.001, P < 0.001, and P = 0.007 . In the first group, the proportion of patients treated with transurethral bladder tumour resection was higher, whereas, percutaneous nephrolithotomy was higher in the second group P = 0.045 for both . While hospitalization and Foley catheterization duration were longer in the first group P < 0.001 for both , double J stent and nephrostomy duration were longer in the second group P < 0.001 and P = 0.005 . Mean leukocyte count at admission was higher in the first group P < 0.001 .Conclusion: Advanced age, comorbidities, previous antibiotic use, and prolonged Foley catheterization duration are predisposing factors for this infection in the urology department. Two-week administration of combination antibiotic regimens containing carbapenem were effective for the treatment of this infection.

WOS: 000511368300018, [No abstract available]

Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042)., SCOPUS: ar.j, info:eu-repo/semantics/published

Objectives: Data about the psychosocial side effects of directacting antiviral agents (DAA) used for the treatment of hepatitis C virus (HCV) infection is scarce. in this study, it is aimed to assess the psychiatric and sexual effects of ledipasvir/sofosbuvir (L/S) combination and paritaprevir-ritonavir-ombitasvir-dasabuvir (PROD) combination in patients with HCV infection. Materials and Methods: the sample of this retrospective study consisted of patients who were diagnosed with HCV infection and received PROD or L/S treatment. the patients were assessed by the Hospital Anxiety and Depression (HAD) scale and Arizona Sexual Experiences (ASEX) scale at baseline and first-, third- and sixth-month visits. Besides these, demographic data and data about the liver disease were collected. Results: During the studied period, 42 patients were started DAA treatment. the average age of the sample was 56.64±12.04 years. Thirty-five (83.3%) patients achieved sustained viral response. Data of the patients who filled HAD or ASEX at baseline and at least in one of the following visits within six months were used. Anxiety, depression and sexual measures did not differ between baseline and following assessments. Conclusion: L/S and PROD do not seem to have a significant effect on anxiety and depression levels and sexual experiences of the patients while they made an improvement in viral load., Amaç: Hepatit C tedavisinde kullanılan direkt etkili antiviral ajanların (DAA) psikososyal yan etkileri ile ilgili veri çok sınırlıdır. Bu çalışmada ledipasvir/sofosbuvir (L/S) kombinasyonu ile paritaprevir-ritonavirombitasvir-dasabuvir (PROD) kombinasyonunun hepatit C virüsü (HCV) ile enfekte hastalardaki psikiyatrik ve cinsel etkilerinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif çalışmanın örneklemini HCV enfeksiyonu tanısı konan ve PROD ya da L/S tedavisi görmüş olan hastalar oluşturmaktadır. Hastalar tedavi öncesi ilk vizit ile birinci, üçüncü ve altıncı aylardaki vizitlerde Hastane Anksiyete Depresyon (HAD) ölçeği ve Arizona Cinsel Yaşantılar (ACYÖ) ölçeği ile değerlendirilmişlerdir. Bunların yanı sıra hastaların demografik ve karaciğer hastalığı ile ilgili verileri de çalışmada kullanılmıştır. Bulgular: Çalışma dönemi sürecinde 42 hastaya DAA başlanmıştır. Örneklemin ortalama yaşı 56,64±12,04’tür. Hastaların 35’inde (%83,3) kalıcı viral yanıt sağlanabilmiştir. Bazı hastaların ölçekleri tam olarak doldurmaması nedeniyle bazal ve takip eden altı ay içindeki en az bir vizitte HAD ya da ACYÖ’yü dolduran hastaların verileri kullanılmıştır. Anksiyete, depresyon ve cinsel yaşantı ile ilgili ölçümler açısından bazal ve izlemdeki değerlendirmeler arasında bir farklılık saptanmamıştır. Sonuç: L/S ve PROD tedavileri viral yük açısından iyileşme sağlarken, anksiyete ve depresyon düzeyleri ile cinsel yaşantı üzerinde belirgin bir etki göstermemiştir.

WOS: 000511368300009, Introduction: Necrotizing fasciitis (NF) is a complicated and rapidly spreading soft tissue infection that affects the superficial fascia, skin, and subcutaneous tissue. in this study, we evaluated patients who were diagnosed with NF and treated in two tertiary-care educational university hospitals. Materials and Methods: Patients diagnosed with NF in three centers (Ege University Department of Orthopedics and Traumatology and Department of Infectious Diseases and Clinical Microbiology and Celal Bayar University Department of Infectious Diseases and Clinical Microbiology) between November 2016 and December 2018 were retrospectively analyzed. the patients' demographic characteristics, significant risk factors for infection, sites of infection, models of surgical treatment, department(s) that performed the surgery, causative infectious agents, empirical and agent-specific treatment regimens and their duration, length of hospital stay, need for intensive care, and one month survival were evaluated. Results: Eighteen patients (10 females, mean age 53.7 [19-86 years]) who were diagnosed with NF were included in the study. Diabetes mellitus, trauma/surgery history, and decubitus wound were the most common predisposing factors. the most common anatomic site was lower extremity (n=10, 55.5%). All patients underwent surgical debridement. the most commonly isolated microorganisms were Escherichio coli (n=4), Klebsiella pneumoniae, Proteus mirabilis, and Acinetobacter boumannii (each n=3). Empirical treatment was initiated with meropenem in eight patients (32%) and tigecycline in four patients (12.5%), and the antibiotic was changed in five patients based on culture results. the mean duration of antibiotic therapy was 35.5 (9-68) days. the average hospital stay was 55 (11-186) days. Six patients (33.3%) required intensive care during follow-up. the mortality rate was 16.6%. Conclusion: NF is a fulminant disease, and early diagnosis and effective multidisciplinary treatment are crucial for reducing mortality rates. When the diagnosis is suspected, early surgical debridement should be performed and empirical antibiotherapy should be started immediately.

PubMedID: 30498901 Purpose: In this multicentre, retrospective, matched cohort study we aimed to evaluate the outcomes of neutropenic fever cases that were treated with daptomycin or a glycopeptide (vancomycin or teicoplanin). Methods: Data and outcomes of adult (aged > 18-years old) patients with neutropenic fever [(1) without clinical and radiological evidence of pneumonia, (2) who were treated with daptomycin or a glycopeptide (teicoplanin or vancomycin) for any reason and for at least 72 h] were extracted from the hospital databases. Matching was performed with all of the three following criteria: (1) underlying disease, (2) reason for starting daptomycin or glycopeptide (microbiologic evidence vs. microbiologic evidence, clinical infection vs. clinical infection and empirical therapy vs. empirical therapy) and (3) neutropenic status. Results: Overall 128 patients [(69/123) (56.1%) in the daptomycin cohort (D) and 59/123 (48%) in the glycopeptide cohort (G)] had a resolution of fever at the end of 72 h antibiotic treatment (p = 0.25). There was no significant difference in cured, improved and (cured + improved) rates between (D) and (G) cohorts as well as fever of unknown origin cases or microbiologically confirmed infections or clinically defined infections subgroups (p > 0.05). There was also no significant difference (p > 0.05), in terms of persistent response in the (D) versus (G) cohorts, Conclusions: These findings suggest that although not better, daptomycin efficacy is comparable to vancomycin if used as empiric therapy in the treatment of adult febrile neutropenia. We conclude that daptomycin may be used at least as a salvage therapy alternative to glycopeptides in the treatment of adult febrile neutropenia cases. A large, randomized-controlled trial may further consolidate the evidence related to this question. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Introduction: Despite global vaccination studies, healthcare personnel worldwide is infected with hepatitis B virus (HBV) during medical practices related to health care. In addition to insufficient infection control measures, healthcare personnel’s organizational and personal negligence related to HBV vaccination causes serious economic losses and threatens personal wellbeing, as well. This study aimed to analyze the data of health personnel for whom HBV hyperimmunoglobulin and vaccine were applied after they were exposed to HBV occupationally and to increase their responsiveness toward vaccine applications after their post-prophylaxis antibody levels were monitored. Materials and Methods: Healthcare personnel who were unimmunized to HBV and had occupational injury/exposure were screened retrospectively between January 2011 and November 2016 in terms of injury types and the efficacy of HBV hyper-immunoglobulin (10 IU/mL/kg) and vaccine (at 0.1 and 6 weeks). Results: In this study, 88 patients were included (39 female, 49 male; mean age (34.3 ± 9.1 years). Of these, 45 were nurses, one was a medical faculty student, and 42 were auxiliary healthcare workers. The hands of 76 personnel and the legs of two were injured by the injectors with unknown source; a contact had occurred in seven personnel as a result of percutaneous needlestick injury through an injector used in a patient who was diagnosed with chronic hepatitis B. In five personnel, mucosal contact occurred due to the fact that the blood of a patient who received HBV diagnosis was splashed to eyes. It was found that 83 of the 88 personnel were sensitive to HBV and five of them had insufficient antibody response (anti-HBsAg < 10 IU/mL). In 49 personnel, (55%) the antibody response could be checked one month after the first vaccine dose and anti-HBsAg was found as > 10 IU/mL in all. Six-month antibody responses were not controlled in 20 personnel (32%) and anti-HBsAg levels of all personnel were found above the protective level. In one personnel, anti-HBs was negative at 6 months. Conclusion: Despite all the efforts of the Turkish Ministry of Health and Personnel Health Centers, the presence of personnel sensitive to HBV is worrisome. The fact that a few of health personnel can deal with their HBV antibody levels is another problem.

Actinomycosis is a chronic, suppurative disease caused by gram-positive anaerobic bacteria from the Actinomycetaceae family. Actinomyces israelii is the most commonly encountered cause of actinomycosis. Other Actinomyces species responsible for actinomycosis are A. odontolyticus, A. meyeri, A. naeslundii, and A. viscosus. Based on the site of involvement, the four most common forms are cervicofascial, abdominal, thoracic and pelvic actinomycosis. Purulent matter, sputum, vaginal discharge, fistulae content or tissue biopsy specimens are generally used to diagnose actinomycosis. However, it is very difficult to identify Actinomyces in these samples due to other filamentous and anaerobic bacteria. In this study, we evaluated actinomycosis cases who were followed up in Ege University Infectious Diseases and Clinical Microbiology Clinic between 2011 and 2016, retrospectively. Cases were evaluated in terms of age, gender, form of application, symptoms, underlying diseases, location of infection, diagnosis, and treatment. Six patients [five women; mean age 52.16 ± 21.21 (min 20-max 83)] were included into this study. Two patients had pelvic, two had cervicofascial, one had skin involvement and one had pulmonary, skin and brain actinomycosis. As a result, actinomycosis is a rare and serious disease. Unless considered in differential diagnosis, appropriate treatment may be delayed. This cohort is one of the largest series reported in Turkey. Being aware of risk factors and clinical forms as well as being skeptical are important fordiagnosis and treatment.