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The primary objective of our study was to evaluate the predictive performance of serum inflammatory markers and the semiquantitative computed tomography severity scoring system on diagnosing the Covid 2019 disease and its course.Our study is a single-center retrospective cohort study. The data of 213 adults who were confirmed to have coronavirus disease 2019 by polymerase chain reaction tests in the period between April 2020 and August 2020 were evaluated. One hundred eighty four of these patients whose C-reactive protein, d-dimer, and ferritin levels, lymphocyte counts, and thoracic computed tomography images were obtained at the time of admission were included in the study. The semi-quantitative computed tomography severity score was calculated for all patients.The median age of the 184 patients included in the study was 51.5 (19-91) years. The incidence of intensive care need and mortality was 10.3% (n=19) and 5.4% (n=10), respectively. The intensive care need and mortality rate was significantly correlated with higher thoracic computed tomography involvement scores at admission. There was a statistically significant and positive correlation between the computed tomography scores and the C-reactive protein, d-dimer, and ferritin levels. Older age (65 years-old) and thoracic computed tomography scores of 11 and higher were independent factors correlated with need for intensive care.Serum inflammatory markers and semi-quantitative computed tomography severity scoring system were predictive in diagnosing the Covid 2019 disease and its course.

Background: The purpose of this study was to determine whether use of a video camera surveillance system for hand hygiene (HH) monitoring, video-based education, and feedback could improve the HH compliance in a neonatal intensive care unit (NICU). Methods and materials: This was an interventional before-after trial conducted in a level-III NICU between July 2019 and June 2020. HH compliance was measured using randomly selected video-camera footage in the baseline, intervention, and maintenance periods. After the baseline, an intervention consisting of feedback and education with video scenarios was implemented. The primary outcome was change in HH compliance. The compliance rates were analyzed as an interrupted time series (ITS) with a segmented regression model adjusted for autocorrelation for each study period. Results: We identified a total of 8335 HH indications. There were non significant increases in the total compliance rate (9.0%, 95% CI -2% to 20%) at the time of intervention and in the compliance rate after intervention (0.26%, 95% CI -0.31% to 0.84%) per day. The hand hygiene compliance before patient contact significantly increased (19.8%, 95% CI, 4.8%-34.8%). Incorrect glove use improved non-significantly with the intervention (-3.4%, 95% CI -13.4% to 6.7%). Conclusion: In this study of HH monitoring using video-camera footage combined with an intervention including feedback and education, there were inconsistent improvements in HH compliance. However, these improvements were not sustained in the long term. Frequent feedback and education may be required to sustain high compliance.

Background. Hashimoto’s thyroiditis (HT) is an auto-immune condition characterized with lymphocytic and fibroblastic infiltration of the thyroid gland. The rate of uric acid and HDL cholesterol – so called as uric acid to HDL ratio (UHR) has been shown to be elevated in inflammatory conditions diseases. We aimed to compare UHR and other laboratory parameters of the patients with HT to those values in healthy controls. Methods. The patients diagnosed with HT by medical history, physical examination, elevated thyroid autoantibodies in serum and characteristic sonographic findings in outpatient internal medicine clinics of our institution were enrolled to the present retrospective study. Age and sex matched healthy volunteers were enrolled as controls. UHR of the HT patients and control subjects were compared. Results. The mean UHR of the HT group was 11% ± 4 %, while UHR of the control group was 8% ± 2% (p Conclusion. We suggest that UHR is a reliable and useful marker for HT. Therefore, it may be helpful in establishing the diagnosis of HT in addition to other diagnostic tools.

Limited data are available on breakthrough COVID-19 in patients with hematologic malignancy (HM) after anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Adult patients with HM, ≥1 dose of anti-SARS-CoV-2 vaccine, and breakthrough COVID-19 between January 2021 and March 2022 were analyzed. A total of 1548 cases were included, mainly lymphoid malignancies (1181 cases, 76%). After viral sequencing in 753 cases (49%), the Omicron variant was prevalent (517, 68.7%). Most of the patients received ≤2 vaccine doses before COVID-19 (1419, 91%), mostly mRNA-based (1377, 89%). Overall, 906 patients (59%) received COVID-19-specific treatment. After 30-day follow-up from COVID-19 diagnosis, 143 patients (9%) died. The mortality rate in patients with the Omicron variant was 7.9%, comparable to other variants, with a significantly lower 30-day mortality rate than in the prevaccine era (31%). In the univariable analysis, older age (P < .001), active HM (P < .001), and severe and critical COVID-19 (P = .007 and P < .001, respectively) were associated with mortality. Conversely, patients receiving monoclonal antibodies, even for severe or critical COVID-19, had a lower mortality rate (P < .001). In the multivariable model, older age, active disease, critical COVID-19, and 2-3 comorbidities were correlated with a higher mortality, whereas monoclonal antibody administration, alone (P < .001) or combined with antivirals (P = .009), was protective. Although mortality is significantly lower than in the prevaccination era, breakthrough COVID-19 in HM is still associated with considerable mortality. Death rate was lower in patients who received monoclonal antibodies, alone or in combination with antivirals., EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).

Purpose: The purpose of this study was to evaluate the effectiveness of the CLUE protocol in COVID-19 triage.Materials and Methods: Patients who presented to the emergency department due to dyspnea with oxygen saturation below 95 % and were diagnosed with COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) tests were included in this prospective, observational study. Patients included in the study underwent lung ultrasound (LUS) in the light of the CLUE protocol, and were accordingly given LUS scores of between 0 and 36, also within the scope of the protocol. Patients were placed under observation, and clinical outcomes of discharge from the emergency department, admission to the ward, and admission to intensive care or discharge were recorded. ROC analysis was applied in the calculation of threshold values for LUS scores predicting discharge, admission to intensive care, and mortality. Results: Forty-five patients with a mean age of 63 ± 18 years were included in the study. Fifteen patients (33 %) were treated on an outpatient basis and discharged, while 12 (27 %) were admitted to the ward and 18 (40 %) to the intensive care unit. Mortality occurred in 15 (33 %) patients. An LUS score lower than 3 was 97 % sensitive and 80 % specific for discharge, a score greater than 10 was 94 % sensitive and 78 % specific for admission to the intensive care unit, and a score higher than 11 was 93 % sensitive and 87 % specific for mortality. Based on regression analysis, an LUS score higher than 10 emerged as an independent risk factor for intensive care requirement, a score lower than 3 for discharge, and a score over 11 for mortality.Conclusion: The CLUE protocol may be a useful bedside test in COVID-19 triage, and one that does not involve radiation or require laboratory tests., Amaç: Bu çalışmanın amacı, CLUE protokolünün COVID-19 triajındaki etkinliğini değerlendirmektirGereç ve Yöntem: Bu prospektif, gözlemsel çalışmaya nefes darlığı nedeniyle acil servise başvuran oksijen saturasyonu %95' in altında olan ve revers transkripsiyon polimeraz zincir reaksiyonu (RT-PCR) testleri ile COVID-19 tanısı konan hastalar dahil edildi. CLUE protokolü doğrultusunda çalışmaya dahil edilen hastalara akciğer ultrasonu (LUS) uygulandı ve yine protokol kapsamında hastalara 0 ile 36 arasında değişen LUS skorları verildi. Hastalar takibe alındı ve acil servisten çıkış, servise yatış, yoğun bakıma yatış veya çıkış klinik sonuçları kaydedildi. Taburculuk, yoğun bakıma yatış ve ölümleri öngören LUS puanları için sınır değerlerinin hesaplanmasında ROC analizi kullanıldı. Bulgular: Çalışmaya yaş ortalaması 63 ± 18 yıl olan 45 hasta dahil edildi. Hastaların 15' i (% 33) ayakta tedavi olmak üzere taburcu edildi, 12' si (% 27) servise, 18' i (% 40) yoğun bakım ünitesine yatırıldı. Toplam 15 (% 33) hastada ölüm meydana geldi. LUS puanının 3’ ün altın olması taburculuk için % 97 duyarlı ve % 80 spesifik, 10’ un üzerinde olması yoğun bakım ünitesine kabul için % 94 duyarlı ve % 78 spesifikti ve 11’ in üzerinde olması mortalite için % 93 duyarlı ve % 87 spesifik olarak bulundu. Regresyon analizine göre LUS skorunun 10’ un üzerinde olması yoğun bakım ihtiyacı için, 3’ ün altında olması taburculuk için ve 11’ in üzerinde olması ise mortalite için bağımsız bir risk faktörü olarak bulunmuştur.Sonuç: CLUE protokolü, COVID-19 triajında radyasyon içermeyen ve laboratuvar testleri gerektirmeyen yararlı bir yatak başı testi olabilir.

Background Preparedness for caregiving could balance the negative impacts of caregiving. The interventions aimed at increasing readiness among the caregivers are important during the illness period for both patients and their caregivers. Objectives The aims of this study were to review the interventions applied to the caregivers of cancer patients and to examine the effects of these interventions on the preparedness to care. Methods The ScienceDirect, Scopus, CENTRAL, Web of Science, MEDLINE, and PubMed were searched for relevant studies published between 2000 and 2020. The methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies. The statistical analyses were performed using the Comprehensive Meta-Analysis software version 3.0. The publication bias was assessed using the Egger test, for funnel plots. Results Eleven studies were selected for the meta-analysis, including those about psychoeducation programs (n = 5), education programs (n = 3), supportive programs (n = 2), and a self-care support program for the caregivers (n = 1). The methodological quality assessment revealed 2 studies as "strong." The results indicated an increase in the caregivers' preparedness to care after the interventions. The subgroup analysis revealed that the programs with higher ratios of female caregivers were more effective. Conclusion The interventions applied to the family caregivers can exert beneficial effects on caregivers' preparedness to care. Nonetheless, future studies should focus on methodological issues, such as randomization and blinding. Implications for practice Nurse-driven interventions may be used as a useful strategy to improve the preparedness to care among the caregivers of cancer patients. The male caregivers should be closely followed by healthcare professionals for knowledge and support needs.

Purpuse The carbapenem-resistant Bacteroides fragilis group (CR-BFG) bacteria have been reported in several countries recently with increasing global attention. The high incidence of CR-BFG isolated from our hospitalized patients has become an important problem. Therefore, we aimed to determine the frequency and associated factors for intestinal colonization by carbapenem-non-susceptible BFG (CNS-BFG) among adult patients hospitalized at intensive care units, neurosurgery and internal medicine wards in our hospital. Methods Rectal swabs (n = 1200), collected from 766 patients between February 2014 and March 2015, were inoculated onto kanamycin-vancomycin-leaked blood agar containing 0.125 mg/L meropenem. The isolates were identified by MALDI-TOF MS. Susceptibility testing was performed by agar dilution method. The carbapenemase gene (cfiA) was detected by PCR. Logistic regression analysis was used to evaluate the associated factors for intestinal colonization by CNS-BFG. Results A total 180 non-duplicate BFG isolates were obtained from 164 patients. Ten different species, including Parabacteroides distasonis (n = 46, 25.6%), and Bacteroides fragilis (n = 30; 16.6%), were identified. Twenty-five percent of the isolates were non-susceptible to meropenem (MIC >2 mg/L). The highest prevalence of meropenem resistant strains (MIC >8 mg/L) was detected among B. fragilis (n = 12), followed by Parabacteroides spp. (n = 4). All but one B. fragilis strains were cfiA gene positive. Hospital admission, increasing Charlson score, use of antibiotics; including carbapenems in past three months, colonization with other accompanying carbapenem-resistant Gram negative bacteria (Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa), and having undergone surgical operations were significantly associated with RCS- BFG colonization. Conclusions The high carriage rate of CNS-BFG in hospitalized patients may lead to worse clinical outcomes, such as serious infections and mortality, and deserves attention.

Background We report a nosocomial outbreak caused by Burkholderia cepacia that occurred among six patients admitted in the medical and surgical intensive care unit between 04 March 2019 and 02 April 2019 in Istanbul, Turkey. Methods The outbreak investigation was launched on 11 March 2019 five days after the detection of B. cepacia in four different patients. We defined potential reservoirs and started environmental screening. We sampled the liquid solutions used in patient care activities. Pulse-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness of environmental and patient samples. Results Burkholderia cepacia was isolated in tracheal aspiration cultures of six patients. Three out of six patients developed healthcare-associated pneumoniae due to B. cepacia. Environmental cultures in the ICUs revealed B. cepacia growth in 2% chlorhexidine-gluconate mouthwash solution that been used in the colonized patients as well as in samples obtained from the unused products. PFGE revealed the patient and a specific batch of chlorhexidine mouthwash solution samples had a 96% similarity. Conclusion Contamination of medical solutions used in critical patient care could cause outbreaks and should be detected early by infection control teams. Graphic abstract

Decompression sickness (DCS) causes venous and arterial embolization, resulting from decreased nitrogen solubility in the blood and tissues due to the rapid drop in external pressure, when rising to the surface after deep underwater dives. Neurological involvement is frequently seen in the medulla spinalis, but there may also be cranial involvement. A 36-year-old male patient, working as a professional diver, was brought to the emergency department with confusion, cerebellar syndrome findings, and paraplegia, soon after consecutive deep dives. Radiological examinations showed involvement of the bilateral cerebral and cerebellar hemispheres, along with the cervical and thoracic spinal cord. This patient with medulla spinalis and cranial involvement of DCS, observed simultaneously, was presented with follow-up clinical and radiological findings.

Background/aim: to evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods: a total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6-9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients' data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results: a total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21-73] vs. 44 years [20-79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion: although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored., Hacettepe Rheumatology Society

Background: Septic arthritis of the shoulder is a rare but devastating condition that may lead to joint destruction. There are few studies and limited outcome data on shoulder arthroplasty for infected native shoulders with end-stage glenohumeral arthritis (GHA). Hence, this study aimed to demonstrate the clinical outcomes of two-stage implantation in reverse shoulder arthroplasty (RSA) using an antibiotic spacer in the first stage for this challenging condition. Methods: We conducted a retrospective study on two-stage implantation in RSA in infected shoulders. Patients were diagnosed with end-stage GHA due to primary shoulder sepsis or infection following non-arthroplasty shoulder surgery. Laboratory data, range of motion (ROM), and functional scores including American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were assessed prior to spacer placement and at the latest follow-up. Furthermore, intraoperative and postoperative complications were recorded. Results: In this study, 10 patients with a mean age of 54.8 ± 15.8 years (range, 30–77 years) were included. The mean follow-up period was 37.3 ± 9.1 months (range, 25–56 months). All postoperative ROM measurements and functional scores were improved significantly. Although no reinfection was observed, a total of 5 complications including 2 hematomas, 1 intraoperative humeral fracture, 1 humeral stem loosening, and 1 anterior deltoid dysfunction were observed in 4 patients after a follow-up period of at least 2 years after RSA. Conclusions: Two-stage implantation in RSA is an effective method for improving the function and controlling the infection in postinfectious end-stage GHA in native shoulders.

Introduction: This study aimed to retrospectively analyze the extent of disability, age, gender, and diagnoses to determine the areas of social support for patients who applied to the disability health board of our hospital and were found to have a musculoskeletal disability. Methods: This study retrospectively analyzed the data of 410 patients who were evaluated in the orthopedics and traumatology outpatient clinic of our hospital’s adult disability health board between 01.02.2019 and 08.06.2021. The age, gender, diagnosis, affected anatomic region, and disability rate information of patients was recorded. The musculoskeletal disability rate of all patients was determined using the “Regulation on Disability Assessment for Adults.” Results: No significant difference was found between both genders in terms of total musculoskeletal system disability rate (p=0.17). The musculoskeletal system disability of the senior group was significantly higher than that of the adult group (p

Background/Aim: Hepatic fibrosis is caused by excessive accumulation of collagen-containing extracellular matrix proteins in chronic liver diseases. The gold standard for determining the degree of liver fibrosis is liver biopsy, which is an invasive method with complication risks. This study aimed to evaluate the potential role of ultrasound elastography, a non-invasive method, in the assessment of hepatic fibrosis among pediatric patients. Methods: Twenty-four pediatric (0-18 years) patients with chronic liver disease and suspected hepatic fibrosis were included in this study. All patients were evaluated with B-mode and sonoelastography using Hitachi EUB 7500 digital ultrasound equipment. The biopsy procedure was performed on all patients a week after sonoelastography. Elastographic scores of liver parenchyma were categorized into four main groups, nonfibrotic, mild, moderate, and severe fibrosis. Strain index values were calculated. The elastographic scores and mean strain index values of the liver parenchyma were correlated with their pathological diagnosis. Results: Elastographic scores and strain index values were significant for the presence of hepatic fibrosis (P=0.001 and P=0.006 respectively). Elastography has 100% sensitivity and 83.3% specificity to distinguish hepatic fibrosis when the cut-off value of strain index is 1.03. Conclusion: Our findings support that real-time elastography is a non-invasive method for the diagnosis and staging of hepatic fibrosis with the potential to prevent recurrent biopsy and complications.

Purpose: Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could predict the histopathological types of the primary lung cancer. Methods: In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated. Results: The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P < 0.001 and P = 0.003, respectively). ROC curve analysis showed diagnostic performance for mean ADC values (AUC=0.889, P = < 0.001) and FA values (AUC = 0.677, P = 0.002). Cut-off value of > 0.909 × 10-3 mm2/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC. Conclusion: DTI parameters of brain metastasis can discriminate SCLC and NSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer.

Objectives: antimicrobial stewardship programs (ASPs) have an important role in the appropriate utilization of antibiotics. Some of the core strategies recommended for ASPs are pre-authorization and prospective audit and feedback. In Turkey, a unique nationwide antibiotic restriction program (NARP) has been in place since 2003. The aim of this study was to measure the effect of a prospective audit and feedback strategy system along with the NARP. Methods: a prospective quasi-experimental study was designed and implemented between March and June 2017. A computerized pre-authorization system was used as an ASP strategy to approve the antibiotics. During the baseline period, patients with intravenous (IV) antibiotic use >= 72 h were monitored without intervention. In the second period, feedback and treatment recommendations were given to attending physicians in the case of IV antibiotic use >= 72 h. The modified criteria of Kunin et al. and Gyssens et al. were followed for appropriateness of prescribing. Days of therapy (DOT) and length of stay (LOS) were calculated and compared between the two study periods. Results: a total of 866 antibiotic episodes among 519 patients were observed. A significant reduction in systemic antibiotic consumption was observed in the intervention period (575 vs. 349 DOT per 1000 patient-days; p < 0.001). On multivariate analysis, prospective audit and feedback (odds ratio 1.5, 95% confidence interval 1.09-2.04; p = 0.011) and pre-authorization of restricted antibiotics (odds ratio 1.7; 95% confidence interval 1.2-2.31; p = 0.002) were the predictors of appropriate antimicrobial use. Mean LOS was decreased by 2.9 days (p = 0.095). Conclusions: this study showed that the antimicrobial restriction program alone was effective, but the system should be supported by a tailored ASP, such as prospective audit and feedback., NA

Bu çalışmada, Samsun Eğitim ve Araştırma Hastanesi Yanık merkezindeki hastaların yara kültürlerinden izole edilen etkenlerin ve antimikrobiyal duyarlılıklarının belirlenmesi amaçlanmıştır. Haziran 2019-Haziran 2020 tarihleri arasında yanık servisinde takip edilen hastalardan mikrobiyoloji laboratuvarına gönderilen ve üreme saptanan yara kültürleri çalışmaya dahil edildi. Kültürü yapılmak üzere gönderilen örnekler %5 koyun kanlı agara ve Eosin Methylene Blue (EMB) agara ekilmiştir ve Gram boyama için yayma hazırlanmıştır. 37°C’de 18-24 saat inkübasyon sonunda, üreyen suşların tür düzeyinde tiplendirme ve antibiyotik duyarlılıkları Vitek (BioMérieux, Fransa) otomatize siste-mlerinde çalışılmıştır. Çalışma süresi içerisinde mikrobiyoloji laboratuvarımıza yanık merkezimizden 110 tane yara sürüntüsü kültürü gönderilmiş olup 34 örnekte üreme saptanmıştır. Yapılan Gram boyalı preparatlarda polimorfonükleer hücrelerin varlığı enflamasyon belirteci olarak kabul edilmiş olup, kültürlerdeki üremeler yayma sonuçlarıyla birlikte değerlendirilmiştir. Yanık hastalarının yara sürüntü kültürlerinden izole edilen enfeksiyon etkenlerinin %76’sı Gram negatif, %18’i Gram pozitif ve %6’sı ise Candida türlerinden oluştuğu saptandı. En sık izole edilen bakteriler sırasıyla Pseudomonas aeruginosa (P.aeruginosa) (%26,5), Acinetobacter spp. (%23,6), E.coli (%8,8) and Staphylococcus aureus (S.aureus )(%8,8) olarak saptanmıştır. En yüksek direnç oranı ikinci sıklıkla izole edilen Acinetobacter suşlarında tespit edilmiş olup; amikasin direnci %62,5, meropenem, imipenem, piperasilin tazobaktam, seftazidim, siprofloksasin, SXT direnci %87,5 oranında saptanmıştır. Sonuç olarak; yanıklı hastalarda yanık enfeksiyonlarının kontrolü ve hastane enfeksiyonlarının gelişmemesi için öncelikle yanık alanının kontaminasyonu engellenmelidir. Kültür ve antibiyogram testleri tedavi protokolünün belirlenmesinde ve antimikrobiyal direnç gelişimiminin önlenmesinde önemli bir yol göstericidir., The aim of the current study was to determine the microorganisms and their susceptibility patterns which were isolated from burn wounds of patients at the Burns Clinic of Samsun Training and Research Hospital in Samsun, Türkiye. Wound cultures with growth detected that were sent to the microbiology laboratory from the patients followed up in the burn center between June 2019 and June 2020 were included in the study. Samples sent for culture were inoculated on 5% sheep blood agar (RTA, Türkiye) and Eosin Methylene Blue (EMB) agar (RTA, Türkiye) and a smear was prepared for Gram staining. At the end of 18-24 hours incubation at 37°C, species-level typing and antibiotic susceptibility of the growing strains were studied in Vitek (BioMérieux, France) automated systems. During the study period, 110 wound swab cultures were sent to our microbiology laboratory from our burn center, and growth was detected in 34 samples. The presence of polymorphonuclear cells in the Gram stained preparations was accepted as an inflammation marker, and the growths in the cultures were evaluated together with the smear results. 76% of the infectious agents isolated from wound swab cultures of burn patients were Gram negative, 18% were Gram positive, and 6% were Candida species. The most predominant bacterial isolate was Pseudomonas aeruginosa (P.aeruginosa) (26.5%), followed by Acinetobacter spp. (23.6%), E.coli (8.8%) and Staphylococcus aureus (S. aureus) (8.8%). The highest resistance rate was detected in Acinetobacter strains isolated with the second frequency; Amikacin resistance was determined as 62.5%, meropenem, imipenem, piperacillin tazobactam, ceftazidime, ciprofloxacin, SXT resistance was 87.5%. As a result; in burn patients, contamination of the burn area should be prevented in order to control burn infections and prevent nosocomial infections. Culture and antibiogram tests are an important guide in determining the treatment protocol and preventing the development of antimicrobial resistance.

Background. Hypoglycemia is an important complication of the treatment of type 2 diabetes mellitus, which constitutes a barrier in stringent diabetic control. Beside it constitutes nearly 10 % of emergency department admissions that caused by adverse drug events, it may also increase morbidities and mortality by inducing, cardiac arrhythmias, neurological impairment and ischemic events. Hypoglycemia is the most common side effect of insulin treatment, however, oral antidiabetic agents may also induce hypoglycemic complications. In present retrospective study, we purposed to observe general characteristics and laboratory data of the type 2 diabetic patients whom presented with mild or moderate/severe hypoglycemia. Materials and methods. Patients with type 2 diabetes mellitus whom presented to our institution with hypoglycemia between January 2019 and January 2020 were retrospectively analyzed. General characteristics and laboratory data of the subjects recorded. Patients grouped into two groups, group I consisted of subjects with mild hypoglycemia and group II consisted of patients with moderate/severe hypoglycemia. Data of the subjects in groups I and II were compared. Results. There were 15 subjects in group I and 23 in group II. HbA1c and other laboratory markers were not significantly different in study groups. Similarly diabetes duration and anti-diabetic treatment were not significantly different in study groups. The rate of geriatric patients was significantly higher in group II compared to group I (p = 0.04). Conclusions. Subjects with moderate/severe hypoglycemia tend to be more frequently in geriatric age and HbA1c not correlates with the degree of the hypoglycemia. Since neither duration of diabetes, nor anti-diabetic treatment were associated with the severity of the hypoglycemia, each case should be evaluated individually to prevent further episodes which could increase morbidity and mortality in diabetic population.

Background/Aim: Adult-onset Still’s disease (AOSD) is a multi-systemic, autoinflammatory disorder. Several activity scores have been proposed but none of them have been adopted universally. Our aim was to create a clinician-friendly activity scoring system by using simple clinical and laboratory parameters. Methods: AODS patients according to Yamaguchi criteria were included in this cross-sectional, multi-center study. Derivation and validation cohorts were constituted. Demographic, clinical and laboratory evaluation at study visit; patients’, and physicians’ global assessments of disease activity (both VAS/ Likert scale) were recorded. To develop the score; ordinal logistic regression model was used to determine independent predictors of patient’ global assessments of disease activity. Clinically and statistically significant variables were weighted according to regression coefficients. Then, performance of the score was tested on the validation cohort. Results: Total of 197 consecutive AOSD patient (125 in derivation, 72 in validation cohorts) were included. Final Still Activity Score was fever (2 points), arthralgia (2 points, plus 1 point if arthritis was present in ≥2 joints), neutrophilia≥65% (1 point) and ferritin≥350 ng/mL (1 point) (maximum of 7 points). The SAS yielded an AUC value of 0.98(0.96-1.00) in the derivation cohort and 0.91(95%CI:0.85-0.98) in the validation cohort to discriminate high AOSD activity from moderate-inactive AOSD. Correlation of SAS with PtGA was 83% for the derivation cohort and 76% for the validation cohort. Conclusions: SAS has shown a good test performance to distinguish active AOSD patients from the others. SAS may be a useful method for evaluating disease activity of AOSD patients in daily practice. Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: The present study was conducted in compliance with the Helsinki Declaration and was approved by the Local Ethics Committee of Hacettepe University (GO- 20/824). A written informed consent form was completed by all participants.

Objective The false sensorineural loss caused by otosclerosis due to stapes fixation is known as the Carhart notch. To examine the changes in air-bone gap (ABG) and bone-conduction (BC) hearing thresholds by comparing the preoperative and postoperative audiometry results in patients with chronic otitis media (COM), to investigate the effects of air conduction (AC) on BC, to determine the effects of postoperative improvement in AC on BC, to detect the presence of the Carhart notch in COM, and to determine the effects of surgery on the Carhart notch. Material and Methods A total of 104 patients who underwent type 1 tympnoplasty between January 2012 - March 2017 in our clinic were included in this retrospective study. Parameters measured during the preoperative and postoperative sixth month audiometric evaluation comprised AC hearing thresholds at the frequencies of 250-8,000 Hz, BC hearing thresholds at 500-4,000 Hz, and ABG values at 500-4,000 Hz intervals. Results Before surgery, the Carhart notch was present in 46 (44.2%) of the 104 patients. Postoperatively, the Carhart notch was observed to have been corrected in 25 (54.3%) of these patients (p=0.029). Conclusion After tympanoplasty, significant improvement in ABG may lead to improvement in BC at 2,000 Hz in COM cases with an intact and mobile ossicular chain. The Carhart notch may also be present in COM.

This study aims to investigate the relationship of the persistence of metopic suture (PMS), frontal sinus volume (FSV), and olfactory fossa depth (OFD).Tomography scans of 1,603 patients aged 18-65 years were evaluated for the presence of PMS. In the study, 74 PMS cases and 74 controls were included. The appearance of each individual's frontal sinus was classified as aplasia, hypoplasia, or normal. Two observers independently measured the lateral lamella length (LLL), OFD, and FSV. Interobserver agreement was evaluated with the intraclass correlation coefficient (ICC) and Cohen's kappa coefficient (κ).The prevalence of PMS was found to be 4.99% [95% confidence interval (CI): 4.03-6.17]. The PMS group had five times higher hypoplasia/aplasia than the controls (52.70%, 95% CI: 41.48-63.66 and 10.81%, 95% CI: 5.58-19.91, respectively; p0.001). An "almost perfect" agreement was detected among observers for the frontal sinus appearance classification: κ=0.807, p0.001. The ICC of continuous measurements for OFD, LLL, and FSV, respectively, presented "excellent" reliability: 0.956, 0.958, and 0.981, with p0.001 for each. LLL was shorter, OFD was shallower, and FSV was smaller in the PMS group than the control group (p0.001). There was a moderate positive correlation between OFD, LLL, and FSV (r=0.306, r=0.302).This study interprets that the presence of PMS is related frontal sinus development and volume. With PMS, a smaller FS, shorter lateral lamella, and shallower olfactory fossa may be expected.Bu çalışma, persistan metopik sütür (PMS) ile olfaktör fossa derinliği (OFD), ve frontal sinüs volümü (FSV) arasındaki ilişkiyi araştırmayı amaçlamaktadır.Yaşları 18-65 arasında değişen 1.603 hastanın tomografileri PMS varlığı açısından değerlendirildi. Yetmiş dört PMS olgusu ve 74 kontrol çalışmaya dahil edildi. Her bireyin frontal sinüs görünümü aplazi, hipoplazi veya normal olarak sınıflandırıldı. Lateral lamella uzunluğu (LLU), OFD ve FSV ölçümleri iki gözlemci tarafından bağımsız olarak yapıldı. Gözlemciler arası uyum değerlendirilirken, sürekli değişkenler için sınıf içi korelasyon katsayısı (ICC) ve Cohen’s kappa katsayısı (κ) kullanıldı.PMS prevalansı %4,99 [güven aralığı (GA) %95: 4,03-6,17] olarak bulundu. Hipoplazi/aplazi, PMS grubunda kontrol grubuna göre beş kat daha fazlaydı (sırasıyla %52,70; GA %95: 41,48-63,66 ve %10,81; GA %95: 5,58-19,91, p0,001). Frontal sinüs görünüm sınıflandırması için gözlemciler arasında “mükemmel” bir uyum tespit edildi: κ=0,807, p0,001. OFD, LLU ve FSV için ICC “mükemmel” güvenilirlik sundu: Her biri için sırasıyla 0,956, 0,958 ve 0,981 ve p0,001. PMS grubunda, LLU daha kısaydı, OFD daha sığdı ve FSV, kontrol grubuna göre daha küçüktü (her biri için p0,001). OFD, LLU ve FSV arasında orta derecede pozitif korelasyon vardı (r=0,306, r=0,302).Bu çalışmanın sonucunda, PMS’nin frontal sinüs gelişimi ve volümü ile ilişkili olduğu bulunmuştur. PMS varlığında daha küçük bir FS, daha kısa lateral lamella ve daha az derin olfaktör fossa beklenebilir.

Aim: Our aim was investigate the effect of polychlorobifenyls (PCBs) and other factors on puberty precocious (PP) in girls were diagnosed with idiopatic PP and premature thelarche (PT). Materials and Methods: The study group included 50 girls aged between 2-8 years old with PP and PT. The control group included 50 healthy girls with same age range and no puberty findings. Data was collected in terms of breast and pubic hair stages, weight, height, body mass index (BMI), standard deviation scores (SDSs), location of residence, gestational age and maternal age at menarche (AAM). Twenty-one PCB levels were evaluated in serum and urine. One-Way ANOVA test was used for comparison between the groups. For subgroup analysis, Mann-Whitney U test, multiple regression analysis were used. Results: The mean age of the study and control groups were 6.70 +/- 1.20 and 5.23 +/- 1.25 years, respectively. The studied PCBs were not detectable found in either the study or the control groups. The BMI SDSs of the patients in study and healthy groups were 0.49 +/- 1.09 and-0.12 +/- 1.28, respectively (p=0.1). Weight SDSs in the study group were found to be significantly higher than healthy group (0.72 +/- 1.35 vs-0.20 +/- 1.47, p=0.008 Maternal AAM of the patients in study group was significantly lower (p=0.006). In study group 98% of the patients were living in down town and district, whereas this ratio was 92% in control group (p=0.024). In study group 29 patients (58%) were diagnosed with PT. Basal follicle stimulating hormone and estradiol levels, bone age and uterine longest axis dimensions results were significantly different. Conclusion: We found that studied PCBs don't influence on PP in girls aged between 2-8 years old. However, weight SDS, maternal AAM, location of residence of the patients had a significant role on PP in this patient population.

Diabetic Nephropathy (DN) is a complication of Diabetes Mellitus and is associated with chronic and low-grade inflammatory burden. Novel inflammatory predictors, such as, C-reactive protein to serum albumin ratio (CAR) has been studied various inflammatory conditions, recently. Increased inflammatory burden accompany to both type 2 Diabetes Mellitus (T2DM) and DN, hence we aimed to compare CAR levels of the T2DM subjects with DN to those of without DN.Patients with T2DM were enrolled to the study. Study population grouped into two according to the presence (group A) or absence (group B) of DN. Characteristics and laboratory data, as well as CAR levels; of the study groups were compared.Median CAR levels of the groups A and B were 2.17% (0.02-13.2) and 0.39% (0.02-4.39), respectively (p0.001). CAR was found to be an independent risk factor for diabetic nephropathy (adjusted to age, BMI, fasting glucose, HbA1c, and body weight). One unit (0.1%) elevation in CAR increased the risk of nephropathy by 3.5 folds (p0.001, 95%CI: 2.24-5.45). CAR levels greater than 0.82% have 79% sensitivity and 78% specificity in predicting DN (AUC: 0.86 [95% CI: 0.80-0.92]; p0.001).In conclusion, elevated CAR levels are higher in type 2 diabetic patients with diabetic nephropathy. According to the ROC curve, a level higher than 0.82% presents the best sensitivity and specificity in the association with the presence of DN.

Pneumatosis intestinalis (PI) is a rare disease, which presents a wide range of severity. Numerous etiologies, including trauma, inflammation, infections, autoimmunity, drugs, and mechanical procedures, gave rise to this complication. Abdominal computerized tomography is the preferred diagnostic tool with high sensitivity. The diagnosis depends on free air detection in the intramural portion of the gastrointestinal system and main and intrahepatic branches of the portal venous structures. However, the exact mechanism is unknown. The clinical scenario may vary from benign to life-threatening. One of the etiological factors that cause PI is the chronic graft-versus-host disease (cGVHD), which must be considered in patients with solid organ or hematological malignancies. Especially, patients who received long-term immunosuppressive therapies and were diagnosed with cGVHD are prone to developing a PI. Many patients experience unnecessary operational risks if underdiagnosed. A multidisciplinary approach by the primary physician, general surgeon, and radiology specialist is necessary for the proper treatment of these patients. This case report aimed to discuss the clinical presentation of PI in the course of cGVHD in the intensive care unit.

Introduction Some evidence suggest that anxiety deteriorate the immune system. We aimed to determine the effect of anxiety on COVID-19 infection in hemodialysis (HD) patients. Methods Our study was conducted with 80 HD patients. State-Trait Anxiety Inventory (STAI), and Beck Anxiety Inventory (BAI) questionnaires were administered between April 15 and May 1, 2020. These patients were followed up for about 8 months and COVID-19 infection, hospitalization, and death rates were recorded. Results 21 (26%) of the patients were diagnosed with COVID-19 infection. 14/21 (66.6%) of the patients were hospitalized, and 8/21 (38%) of them died due to COVID-19. STAI-S (p=0.006) and BAI (p=0.021) scores were found to be higher and STAI-T (p=0.040) score was found to be lower in HD patients who were infected with COVID-19 compared to without, at the follow-up period. Conclusions It might be concluded in this study that COVID-19 was more common in anxious HD patients. This article is protected by copyright. All rights reserved.

Objective: Lightning injuries can cause a variety of injuries including “integumentary system, cardiac system, central nervous system, eyes and ears, and blunt trauma”, in which some of them may cause death. In this study, it was aimed to evaluate crime scene findings, autopsy findings and histopathological findings by presenting 9 cases that died due to lightning strike. Material and Methods: The 9 cases (0.3%) included this study were obtained from the screening of a total 24.755 cases that were performed autopsy at the Council of Forensic Medicine, Istanbul between 2007 – 2012. All cases’ age, gender, crime scene, circumstances during the event, witness statement, skin lession, autopsy findings, histopathological findings were evaluated. Results: Three (33.3%) cases were female and six (66.7%)cases were male, and the mean age was 39,66±13,36 (min:18, max:56). Fatal lightning strike occurred between April and September, but mostly in May. At autopsy, an external examination was revealed an electrical exit wound in 4 cases, burn areas on the skin in 5 cases, a Lichtenberg figure on the skin in 2 cases, and a burn in the hair surface in 4 cases. Conclusion: As a result, nonspecific findings are frequently detected in autopsies performed due to lightning strikes. However, crime scene investigation and the testimony of the witness may be the crucial indicative evidence for forensic investigators in getting an accurate diagnosis in cases of suspected lightning strikes. In addition, examining the clothes worn by victims provides important clues in diagnosis.

Background: Malpractice in medicine refers to the failure of a physician to meet a standard of diagnosis and treatment, damages/injuries caused by reprehensible ignorance, or negligence of a doctor. Methods: Allegedly malpractice cases of pediatricians and the cases in which causal link between malpractice and death was confirmed by the decision of the First Board of Specialization of the Council of Forensic Medicine between the dates of Januray 1, 2012 and December 31, 2014 were analyzed retrospectively. Results: The study revealed that in the majority of 286 cases, the infants were 0-28 days old (n = 115; 40.2%) and were hospitalized due to respiratory problems (n = 111; 38.8%). The allegations of malpractice cases were most frequently seen in private hospitals (n = 120; 42%). Malpractice was found in 17.5% of the cases (n = 50), in which the majority of cased were proved to be diagnostic errors (n = 24; 48%). The most common diagnostic error was the misdiagnosis of “healthy child” in medical malpractice cases (n = 11, 22%). Conclusions: In conclusion, it is considered to be important for the pediatricians to maintain proper communication with the relatives of the patients while monitoring their health condition, and pediatricians are expected to be more careful—especially in the diagnostic phase—in the cases involving 0-1 age group as children are most likely to be diagnosed as healthy in this age group.

Introduction: The aim of this study was to determine the effect of an educational program on the knowledge level of symptoms and attitudes about menopause. Methods: The questionnaire forms and health scales were completed by 36 women aged between 40 and 65 years before and after the education program. Following this education, women were encouraged to perform a self-examination of breasts (SEB) and self-examination of the vulva (SEV). Results: The mean age of the women was 50.66±4.45 and that the mean menopause age was 47.60±3.45. The most frequently described symptom was fatigue (91.7%). It was seen after the training that the Menopause Rating Scale (MRS) and the PSQI score decreased and the mean Quality of Life (SF-36) scale score increased. All these changes were statistically significant. As a result of SEB and SEV performed by the women after the education, it was found that 5.6% of the women had a breast deformity, 8.3% had a palpable mass in the breast, and that 13.9% detected vaginal discharge in the vulva examination (p, Giriş: Bu çalışmanın amacı, bir eğitim programının menopoza ilişkin belirti ve tutumların bilgi düzeyine etkisini belirlemektir. Yöntemler: Anket formları ve sağlık ölçekleri, eğitim programı öncesi ve sonrasında yaşları 40-65 arasında değişen 36 kadına doldurulmuştur. Bu eğitimin ardından kadınların kendi kendine meme muayenesi (KKMM) ve kendi kendine vulva muayenesi (KKVM) yapmaları teşvik edildi. Bulgular: Kadınların yaş ortalaması 50.66±4.45, ortalama menopoz yaşı 47.60±3.45 idi. En sık tanımlanan semptom yorgunluktu (%91,7). Eğitim sonrasında Menopoz Semptomlarını Değerlendirme ölçeği ve PUKİ puanının düştüğü, Yaşam Kalitesi (SF-36) ölçeği puan ortalamasının arttığı görüldü. Tüm bu değişiklikler istatistiksel olarak anlamlıydı. Kadınların eğitim sonrası yaptıkları KKMM ve KKVM sonucunda, kadınların %5.6'sında meme deformitesi, %8.3'ünde memede ele gelen kitle, %13,9'unda vulva muayenesinde vajinal akıntı tespit edildi (p

Objectives: Psoriatic arthritis is a chronic musculoskeletal disorder which may affect skin, joints, bone and enthesis. Conventional synthetic disease modifying anti-rheumatic drugs are first-line treatment options and biologic disease modifying anti-rheumatic drugs are recommended in psoriatic arthritis patients who are intolerant/not controlled well with conventional synthetic disease modifying anti-rheumatic drugs. Although survival data of the conventional synthetic disease modifying anti-rheumatic drugs without concomitant biologic disease modifying anti-rheumatic drugs are available, the effect of biologic disease modifying anti-rheumatic drugs on the retention of conventional synthetic disease modifying anti-rheumatic drugs is still a question of interest. Materials and Methods: Psoriatic arthritis patients who received at least 1 dose of biologic disease modifying anti-rheumatic drugs, using at least 1 conventional synthetic disease modifying anti-rheumatic drugs (methotrexate, leflunomide, hydroxychloroquine and sulfasalazine) at the time of biologic disease modifying anti-rheumatic drugs starting visit and registered in the Hacettepe University BIOlogical Database-Psoriatic Arthritis were included in this retrospective longitudinal analysis. Demographic and disease-specific data at first and last follow-up visit were collected. Unadjusted retention rate of each conventional synthetic disease modifying anti-rheumatic drugs was assessed. Overall prescription of conventional synthetic disease modifying anti-rheumatic drugs at first and last follow-up visit were compared. Results: A total of 266 (191(71.8%) female) patients was included. Median follow-up duration under biologic treatment was 43.4 (19.4-80.1) months. Median retention duration of each conventional synthetic disease modifying anti-rheumatic drugs were similar. Between the first and last visit; there was a 29.3% decrease in methotrexate use (61.7% vs. 43.6%; p

In this review, it was emphasized that natural and organic foods have a rich structure in terms of antimicrobial, antioxidant, and vitamin content. Physalis peruviana L., products contain minerals, amino acids, withanolides, flavonoids, and essential fatty acids, thus representing good sources of these compounds. These compounds have protective, regulatory, and nutritional roles in metabolism. Physalis peruviana L. is a wild fruit that has been widely used for centuries, mainly in folk medicine. The fruit and juice of Physalis peruviana L., contain high amounts of vitamin C, vitamin E, vitamin K1, and many other mineral substances. In addition, the ingredients in Physalis peruviana L., have antioxidant, antibacterial, antiviral, antiallergic, anti-inflammatory, and antineoplastic effects. The available evidence has demonstrated the nutritional value of different products of Physalis peruviana L., suggesting them to be potential candidates for use in the cosmetic industry, in the preparation of functional foods, and phytomedicine for the prevention.

Objectives The aim of this study was to evaluate the functional outcomes of patients with free gracilis muscle transfer (FGMT) for the restoration of elbow flexion. Patients and methods Between January 2012 and January 2019, a total of 16 patients (13 males, 3 females; mean age: 27.3±11.7 years; range: 18 to 53 years) who underwent FGMF to achieve elbow flexion after traumatic brachial plexus palsy (TBPP) were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, etiology, affected side, injury level, accompanying injuries, time between injury and surgery, follow-up time, complications, whether nerve reconstruction and artery repair were performed previously, and details of the procedure were recorded. The outcome measures were elbow range of motion in degrees, muscle strength, and Disabilities of the Arm, Shoulder and Hand (DASH) and Short Form-36 (SF-36) scores. Results The mean follow-up was 30±11.5 (range, 24 to 42) months. Two patients had C5-C8 injuries, two patients had C6-T1 injuries, and all other patients had injuries to the C5-T1 roots. Muscle strength was M3/M4 in 11 (68.8%) patients, M2 in two (12.5%) patients, and M0 in one (6.2%) patient. The median active range of motion of the elbow joint in patients with successful results (M3 and above) was measured as 75 (range, 30 to 100) degrees. A statistically significant improvement was observed in the pre- and postoperative DASH scores and in some SF-36 subscale scores of patients with successful results. Conclusion Free gracilis muscle flap is a reliable option in the restoration of elbow flexion in patients with TBPP. Although there is an improvement in functional results, disability, and quality of life, there may be no change in patients' mental status and pain.

The Banff 2017 report permits the diagnosis of pure chronic antibody-mediated rejection (cAMR) in absence of microcirculation inflammation. We retrospectively investigated renal allograft function and long-term outcomes of 67 patients with cAMR, and compared patients who received antihumoral therapy (cAMR-AHT, n = 21) with patients without treatment (cAMRwo, n = 46). At baseline, the cAMR-AHT group had more concomitant T-cell-mediated rejection (9/46 (19.2%) vs. 10/21 (47.6%); p = 0.04), a higher g-lesion score (0.4 ± 0.5 versus 0.1 ± 0.3; p = 0.01) and a higher median eGFR decline in the six months prior to biopsy (6.6 vs. 3.0 mL/min; p = 0.04). The median eGFR decline six months after biopsy was comparable (2.6 vs. 4.9 mL/min, p = 0.61) between both groups, and three-year graft survival after biopsy was statistically lower in the cAMR-AHT group (35.0% vs. 61.0%, p = 0.03). Patients who received AHT had more infections (0.38 vs. 0.20 infections/patient; p = 0.04). Currently, antihumoral therapy is more often administered to patients with cAMR and rapidly deteriorating renal function or concomitant TCMR. However, long-term graft outcomes remain poor, despite treatment.

Simple Summary Patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 are an even greater challenge for hematologists. To better clarify their outcome, we describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Overall, 343 (76.2%) patients received treatment for HM, and an overall response rate was observed in 140 (40.8%) patients after the first line of treatment. Thirty-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004). Statistical analysis showed that, together with age, severe/critical COVID-19, >= 2 comorbidities, lack of HM treatment was an independent risk factors for mortality. These observations suggest the importance of HM treatment in these patients; therefore, it should be delivered as soon as possible for patients requiring immediate therapy. Background: The outcome of patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 is unknown and there are no specific treatment guidelines. Methods: We describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Results: Acute leukaemia and lymphoma were the most frequent HM (35.8% and 35.1%, respectively). Overall, 343 (76.2%) patients received treatment for HM, which was delayed for longer than one month since diagnosis in 57 (16.6%). An overall response rate was observed in 140 (40.8%) patients after the first line of treatment. After a median follow-up of 35 days, overall mortality was 177/450 (39.3%); 30-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004), either before and/or after COVID-19, or compared to patients receiving HM treatment at least after COVID-19 (15.2%, p < 0.001). Age, severe/critical COVID-19, >= 2 comorbidities, and lack of HM treatment were independent risk factors for mortality, whereas a lymphocyte count >500/mcl at COVID-19 onset was protective. Conclusions: HM treatment should be delivered as soon as possible for patients with simultaneous diagnosis of COVID-19 and HM requiring immediate therapy.