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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.

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.

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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.

Introduction: The most prominent characteristic of adult attention deficit hyperactivity disorder (ADHD) is impulsive behavior and deficits in executive functions, which require long-term organization and discipline. This may have serious implications in terms of adherence to treatment among adults living with HIV (PLWH). This study aimed to determine the prevalence of ADHD among non-perinatally infected PLWH and its effect on adherence to antiretroviral treatment (ART) and scheduled appointments. Methodology: The PLWH admitted to our centers between January 2012 and February 2016 were invited to the study. ADHD diagnosis was made according to the novel criteria guided interviews. The first ART interruption for ≥ 6 days per month (≤ 80%) was defined as ‘‘ART-event’’ and the first non-attendance of any scheduled appointment was defined as ‘‘appointment-event’’. Kaplan-Meier plot with a Log-rank test was used for event-free adherence (EFA). Results: Twenty-five patients out of 85 were diagnosed with ADHD (29.4 %) which was significantly higher than the highest percentage reported (7.3 %) for the general population (p < 0.0001). Both ART-event (p = 0.0002) and appointment-event (p = 0.02) were significantly higher among ADHD participants compared to those without. Additionally, both ART-EFA (p = 0.00014) and appointment-EFA (p = 0.023) were significantly shorter among ADHD participants compared to those without. Conclusion: ADHD is significantly higher in adult PLWH and people with ADHD had a significant tendency for non-adherence to ART and follow-up. Screening for ADHD as well as providing treatment when required would be beneficial to achieve and maintain virologic success.

WOS: 000219732100013, Introduction: Hydatid disease is a zoonotic infection caused by the cestode Echinococcus spp. It is transmitted by ingestion of infectious cestode eggs, especially through dog feces. The two organs most commonly affected are the liver and the lung. In this paper, a series of 15 cases with symptomatic hydatid cysts hospitalized in our clinic and evaluated via consultations are presented. Materials and Methods: Patients, who were treated with hydatid disease between April 2006 and June 2015, were included in the study. Demographic characteristics, symptoms (fever, abdominal pain, pruritus, weakness, icterus, cough, sputum, nausea-vomiting), signs (hepatomegaly, splenomegaly), radiological-laboratory findings, complications, involvements of other body parts and treatment modalities were evaluated retrospectively. Results: Ten (66.7%) of the patients were female. The mean age of the patients was 52.3 +/- 18.3 year. Twelve (80%) patients had at least one cystic lesion in the liver. Four cases were complicated with a lung cyst, three with spondylodiscitis, three with splenic cyst, two with renal cyst, two with amoebic liver abscess, one with intraabdominal dissemination and one case was complicated with anaphylactic shock. Seven patients (46.7%) had leukocytosis and three (20%) had eosinophilia. All patients received treatment with albendazole p.o 2x400 mg tablets. The mean duration of treatment was 27.4 +/- 18.5 weeks. Conclusion: Hydatid cyst is an infectious disease that may cause severe organ involvement. Patients with hydatid cyst in any part of the body should be checked carefully for other system involvement, including the liver, abdominal and/ or retroperitoneal organs.

Solid organ transplantation (SOT) is a treatment method that improves quality of life and survival of patients with end-stage organ failure. Immunosuppressive treatments given to these patients may predispose to the development of invasive fungal infections (IFI). The incidence of IFI in SOT recipients, which is between 5% and 42%, depends on the organ to be transplanted. Although Candida spp., followed by Aspergillus spp. are the most common microorganisms, among fungal pathogens, this situation varies according to transplant type. The mortality rate associated with these IFI can be high. Therefore, antifungal prophylaxis may be necessary for SOT recipients. Many transplantation centers employ antifungal strategies according to their own experience because of the lack of randomized controlled studies. If the antifungal prophylaxis is given to all patients, antimicrobial resistance and drug-drug interactions may occur. Therefore, it is important to identify patients at a high risk of developing IFI. In this paper, epidemiology, risk factors, literature data and antifungal prophylaxis associated with IFI in liver, kidney, small intestine, pancreas, heart, and lung transplant recipients are reviewed.

Background Cardiovascular disease (CVD) is a major cause of mortality in HIV infected patients. Agreement between commonly used risk prediction equations for classification of high-risk individuals is varied in different populations. We aimed to compare the degree of agreement of four CVD risk calculators in a multicenter cohort. Methods A cross-sectional study was conducted among adult HIV patients who are followed in five tertiary centers between July 2016 and February 2017. Inclusion criteria were: age 40–74 years, without known CVD and not receiving statins. All necessary information to calculate risk scores were collected during follow-up visits with a standardized form. Web-based tools for each score were used for calculations. Persons were considered at higher risk if 10-year CVD risks ≥20% with FRS-CVD, >10% with SCORE for high-risk countries, >7.5% for ASCVD, and 5 year risk ≥5% with DAD or if they had additional risk factors defined for each score for automatic high-risk stratification. Based on the interpretation of CVD risk, the patients were placed in two categories: low/medium and high/very high. Agreement between scores was assessed by Cohen’s kappa (κ) statistics. Results Of 667 patients who were active during the study period, CVD scores of 527 HIV-infected patients (82% male) were assessed. Median (interquartile range) age was 48 (43–54) years. Prevalence of CVD risk factors were: 11% family history of early-onset CVD, 50% current smokers, 57% overweight or obese, 22% hypertension, and 8% diabetes mellitus. The prevalence of high CVD scores or risk equivalents was high ranging from 20.3% to 36.3%. The DAD-full, DAD-reduced, ASCVD and SCORE had 83.9%, 85%, 83.5% and 93.2% agreement compared with the FRS-CVD (κ = 0.55, 0.59, 0.61 and 0.80), respectively. European AIDS Clinical Society, European Society of Cardiology, Adult Treatment Panel-III and 2013 American College of Cardiology/American Heart Association guidelines would recommend statin therapy for 35.1%, 21.8%, 31.9% and 36.4% of patients, respectively. Conclusion We found moderate/substantial agreement among risk prediction tools evaluated in this study. Agreement was high for lower scores and at higher ages. Whether those scores accurately estimate risk at population level needs further evaluation. Disclosures All authors: No reported disclosures.

Amaç: HIV/AIDS hastalarının ve yakınlarının hastalığın yaşamlarını nasıl etkilediğinin ve damgalanma deneyimlerinin saptanmasıdır. Gereç ve Yöntem: Çalışma İzmir’de yer alan üç devlet hastanesinin katılımı ile gerçekleştirilmiştir. Altı odak görüşmesi 32 HIV/AIDS hastası ve 11 yakınının katımı ile gerçekleştirilmiştir. Ayrıca katılımcılar HIV/AIDS hastalığı ve damgalanma hakkında soruları içeren bir anket formunu tamamlamışlardır. Bulgular: Odak grup görüşmelerinin sonuçlarına göre hasta ve yakınlarının belirttiği en önemli sorunlar, toplumla ilgili sosyal problemler, damgalanma ve sağlık hizmetlerine erişimdir. Hasta ve yakınlarının hastalık hakkında bilgilerinin de yetersiz, ayrımcılık konusunda duyarlı olduğu saptanmıştır. Sonuç: HIV pozitif hasta ve yakınlarının desteklenmesi ve eğitilmeleri gerektiği belirlenmiştir. Hastaları izleyen sağlık personelinin daha fazla çaba göstermesi gerekmektedir., Objective: the aim of this study was to describe how AIDS, as well as the stigma associated with it, affects the lives of HIV positive patients and their family members. Materials and Methods: Three large state hospitals in the metropolitan area of Izmir participated in the study. Six focus groups were conducted with people infected with HIV (n=32) and their family members (n=11). Participants were asked to fill out a questionnaire to assess their HIV/AIDS knowledge and to convey how the stigma had affected them. Results: the most important problems identified were society and work-related social problems and access to health services. the patients and their family members stated that education was needed to correct misconceptions about HIV and to help them cope with related problems. We found that patients and their family members were sensitive about disclosure. Conclusion: We determined the education, counseling and support needs of HIV-infected patients and their families. Additionally, we found that health personnel who monitor the patients should make more efforts on patients‘ education and counselling.

WOS: 000302272100014, Objective: The objective of the study was to assess HIV/AIDS related knowledge, attitudes and risk perception among health care providers in Izmir. Material and Methods: A pretest and posttest patterned intervention study was conducted in 2007 among health care providers participating in a training course on HIV/AIDS and universal precautions. The participants consisted of 158 health care professionals from 7 public hospitals and 2 public dental clinics. Information was collected regarding demographic details, HIV/AIDS related knowledge, attitudes and perceptions about patients at the beginning and the end of the course. Pre- and post-training dichotomous point scale scores were compared. Results: Of the participants, 72.6 % were females. Only 30.0 % of the respondents reported a scalpel or needle stick injury at least once last year. Some of the participants (40%) thought that it was necessary to take extra infection control precautions for patients with HIV. The average pre- and post-training mean knowledge scores were 9.32 +/- 2.1 (3-13) and 12.76 +/- 2.3 (5-17), respectively. The mean pre- and post-training beliefs scores were 12.37 +/- 3.1 (3-19) and 15.57 +/- 3.8 (6-22), respectively. There were significant differences in the pre- and post-training mean scores of the responses related to attitudes toward patients with AIDS. Conclusion: There was improvement in knowledge and negative attitudes on patients with AIDS at the end of the training. The results of this study suggested that the negative attitudes of health care providers towards individuals with AIDS due to the fear of transmission and inadequate knowledge could be improved with training.