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Introduction: Vaccine-preventable diseases can be effectively managed through timely vaccine booster doses. In this study, the tetanus vaccination status of healthcare professionals and their level of knowledge about tetanus vaccination were investigated Methodology: The data were obtained through a survey questionnaire from 336 healthcare professionals. The survey participants were recruited on a voluntary basis among the personnel working in a tertiary hospital between 1 July 2021 and 30 September 2021. The participants were asked about their tetanus vaccination status and general awareness about the tetanus vaccine. Results: The survey participants included nurses (41.4%, n = 139), doctors (39.9%, n = 134) and support unit personnel (18.8%, n = 63). The support unit personnel had insufficient knowledge about military service period, pregnancy period, vaccination of women aged 15-49 years, and the necessity of booster tetanus vaccine every 10 years. Interestingly, the nurses had significantly inadequate knowledge of geriatric tetanus vaccination. Conclusions: Although the tetanus immunization program is widely implemented throughout the country, our study concluded that it is necessary to educate healthcare professionals on the importance of the tetanus vaccine.

Environment-friendly behavior is the need of the hour. The United Nation’s Sustainable Development Goals (SDGs) have placed a collective burden on countries around the globe to undertake measures to safeguard the planet by starting with their own territories and water bodies. The Sultanate of Oman is an example of a country where there is top-down participation in environmental initiatives. Nevertheless, it appears that the initiatives have to be current and on-going, accompanied by stringent monitoring and evaluation. In this context, the present study undertakes a scoping review of literature related to the factors that influence environment-friendly behavior in different individual and social contexts. The use of the Theory of Planned Behavior (TPB), a popular theoretical framework in recent studies on environment-friendly behavior, to identify the factors of environment-friendly behavior was utilized as the basis for the review. A set of 50 empirical studies from 2012-till February 2022 were included in the scoping review. Academic and managerial implications are offered based on the findings. Overall, it could be seen that despite considerable research in the area, environmental awareness was a significant contributor to environment-friendly behavior and the study recommends governmental, public and private attention to increasing environment-friendly behavior among citizens. Research paper Keywords: Theory of Planned Behavior, Oman, Consumer Behavior, Environment-Friendly Behavior Factors Reference to this paper should be made as follows: Al Salmi, H., Ali, A., & Ahmad, F. S. (2022). Factors Predicting Environment-Friendly Consumer Behavior: Reducing Plastic Consumption in Oman. Journal of Entrepreneurship, Business and Economics, 10(2S1),170–215.

Background: The aim of this national, multicenter, cross-sectional, retrospective chart review study was to determine the rate of patients in Turkey who received hepatitis C virus (HCV) treatment after receiving positive anti-HCV results during HCV screening. Methods: Data related to patients’ demographics, laboratory results, the time interval from obtaining a positive anti-HCV result to treatment initiation, the specialty of the physician requesting anti-HCV screening, and type of hospital were collected and analyzed. Results: Among 1000 patients who received a positive anti-HCV result, 50.3% were male and 78.5% were screened for HCV-RNA. Among HCV-RNA screened patients, 54.8% (n = 430) had a positive result. Among patients testing positive for HCV-RNA, 72.8% received HCV treatment in line with their positive anti-HCV results. The median time from obtaining a positive anti-HCV result to initiation of HCV treatment was 91.0 days (interquartile range 42.0 to 178.5). Non-surgical branches requested HCV-RNA testing more frequently than surgical branches (p < 0.001). The rate of access to HCV treatment was higher in patients screened in university hospitals than in patients screened in training and research hospitals (p < 0.001). Conclusions: Our results indicate a higher rate of treatment initiation in patients with HCV infection than is described in the published literature. Furthermore, the time from screening to treatment initiation was considerably shorter compared with other international studies. However, because HCV-RNA testing was not requested in a significant portion of patients with a positive test result for anti-HCV, there might be a large patient population with HCV who do not receive treatment.

Introduction: The aim of this study is to determine the frequency of Hepatitis b virus (HBV) serological groups in Rheumatoid arthritis (RA) and to compare the demographic characteristics and frequency of parenteral therapies between patient groups with and without previous HBV infection. Methods: Charts of RA patients were examined retrospectively. HBsAg, anti-HBc IgG, and anti-HBs test results were screened. All participants were divided into 3 serological groups (patients naive to HBV infection, previous HBV infection, vaccinated). Those with previous HBV infection were further divided into 3 serological subgroups (naturally immune, anti-HBc IgG positive only, chronic HBV infection). Findings were compared between RA patients with and without previous HBV infection. Results: Four hundred and fifty-one patients (female/male: 343/108) were included. The prevalence of patients naive to HBV infection, with previous HBV infection and vaccinated were 59.4%, 33.7%, and 6.9%, respectively. The prevalence of patients with naturally immune, anti-HBc IgG positive only, and chronic HBV infection were 25.7%, 4.4%, and 3.5%, respectively. Age in RA patients with and without previous HBV infection was 60.8±12.4 and 56.7±14.2 years, respectively(p

The COVID-19 pandemic has brought countries’ health services into sharp focus. It was drawn to our group’s attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.

Background/aim In this study, we aimed to evaluate the initial hematological findings analyzed on admission in confirmed COVID-19 patients who were transferred to the intensive care unit (ICU), to predict possible hematological indices. Materials and methods Initial neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), red cell distribution width to platelet ratio (RPR), mean platelet volume to platelet ratio, and lymphocyte multiplied by platelet count (LYM × PLT), of 695 patients with laboratory-confirmed COVID-19 were investigated and comparisons were made between the mild/moderate and severe groups. Results The proportion of COVID-19 cases admitted to the ICU was 3.9%. The median age of patients admitted to the ICU was significantly higher than those who were not; [68.5 (interquartile range (IQR); 21.5] years vs. 41.0 (IQR; 15.7) years; P < 0.001. Severe cases had higher NLR (6.6 vs. 2.4; P < 0.001), and MLR (0.40 vs. 0.28; P = 0.004) and lower PLR (180.0 vs. 129.0; P < 0.001) compared to that of mild or moderate patients. Among all of the parameters, the ROC curve of NLR gave us the best ability to distinguish serious patients at an early stage (AUC = 0. 819, 95% confidence interval 0.729–0.910; P < 0.001). Conclusion These data showed that age, initial NLR, PLR, and LYM × PLT were associated with the severity of COVID-19 disease and patients’ need for the ICU. Therefore, initial hemogram parameters may be essential to predict the prognosis of COVID-19 patients.

Objective: The presence of hepatitis B virus (HBV) infection in patients using biological drug therapy may cause reactivation. There is insufficient data on the frequency of HBV reactivation, especially after the use of new biological drugs such as tofacitinib, tocilizumab, and secukinumab. This study aims to examine HBV seroprevalence in rheumatology patients using biological drug therapy and investigate the frequency of reactivation in patients with previous HBV infection. Methods: The charts of 275 patients who were followed up in the rheumatology department and used biological drug therapy were examined to evaluate the HBsAg, anti-HBc IgG, and anti-HBs test results. The frequency of reactivation was investigated by examining the HBV DNA test results before and after the biological drug therapy and the alanin aminotransferase test results were checked throughout the biological drug therapy in anti-HBc IgG-positive patients. Results: Among the patients, HBsAg was positive in 0.4%, anti-HBs in 34.4%, and anti-HBc IgG in 25.1%. The reactivation frequency was investigated in 53 biological drug therapies applied in 41 patients. The use of prophylactic antiviral drugs, where reactivation was evaluated, was found as 28.6% in TNF inhibitors, 100% in rituximab, 75.0% in tofacitinib, 0% in tocilizumab, 50% in abatacept, and 0% in secukinumab. Reactivation was detected in one of the fifty-three biological drug therapies. The reactivation case was a patient with isolated anti-HBc IgG and initial HBV DNA tests positive, using tocilizumab and cortisone, and not using entecavir prophylactic treatment regularly. Conclusions: The frequency of previous HBV infection is high in patients using biological therapy. Although prophylactic antiviral drug therapy for HBV has not been used frequently during the use of biological drug therapies other than rituximab in anti-HBc IgG positive patients, reactivation is rare. The risk of reactivation may be low in those receiving tofacitinib and secukinumab therapy and high in those receiving tocilizumab therapy.

Coronavirus disease 2019 (COVID-19) has clinical manifestations ranging from mild symptoms to respiratory failure, septic shock, and multi-organ failure. Lymphocytes are divided into different subtypes based on their cytokine production pattern. In this study, we investigated the role of cytokine expressions of CD4

COVID-19 is a disease characterized by acute respiratory failure and is a major health problem worldwide. Here, we aimed to investigate the role of CD39 expression in Treg cell subsets in COVID-19 immunopathogenesis and its relationship to disease severity. One hundred and ninety COVID-19 patients (juveniles, adults) and 43 volunteers as healthy controls were enrolled in our study. Flow cytometric analysis was performed using a 10-color monoclonal antibody panel from peripheral blood samples. In adult patients, CD39

Objectives: Colistimethate sodium (colistin) is the member of polymyxins, the cyclic structured cationic polypeptide antibiotics. The purpose of our study is to determine the patients’ nephrotoxicity rates and risk factors related to nephrotoxicity development that are under colistin treatment in the tertiary intensive care unit (ICU). Methods: One-hundred colistin received patients files were reviewed retrospectively, who were in tertiary ICU in Bursa Yüksek Ihtisas Training and Research Hospital. Fifteen patients with the history of renal failurewere excluded from the study. The data before the first colistin treatment was taken into consideration for the patients received repetitive colistin treatment. RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) classification was used for the evaluation of nephrotoxicity. Results: The patients mean age was 67.81 ± 16.56 years (range: 21-94) and 52.9% were male. Nephrotoxicity was determined in 35 (41.2%) patients. According to the RIFLE classification the nephrotoxicity rates were determined for risk, injury and deficiency were 24.7%, 10.6% and 5.9%, respectively. Nephrotoxicity was detectedin 9 (25.7%) out of 35 patients on the first day of the colistin treatment. Mortality rate was observed as 82.9% in patients with nephrotoxicity. Conclusions: Colistin treatment is preferable for the treatment of multi drug resistant infections in intensive care unit. The patients,under certain circumstances, i.e., malignancy, using additional nephrotoxic agent and elder age must be closely monitored for the possible nephrotoxicity development.

WOS:000648816400007 PMID: 33960939 Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. Methods: Data from patients with chronic hepatitis C treated with SOF/LDV +/- RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 +/- 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV +/- RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV +/- RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.

To describe the change in the epidemiology of health care-associated infections (HAI), resistance and predictors of fatality we conducted a nationwide study in 24 hospitals between 2015 and 2018. The 30-day fatality rate was 22% in 2015 and increased to 25% in 2018. In BSI, a significant increasing trend was observed for Candida and Enterococcus. The highest rate of 30-day fatality was detected among the patients with pneumonia (32%). In pneumonia, Pseudomonas infections increased in 2018. Colistin resistance increased and significantly associated with 30-day fatality in Pseudomonas infections. Among S. aureus methicillin, resistance increased from 31 to 41%. WOS:000617831800002 2-s2.0-85101454721 PubMed: 33586014

To describe the change in the epidemiology of health care-associated infections (HAI), resistance and predictors of fatality we conducted a nationwide study in 24 hospitals between 2015 and 2018. The 30-day fatality rate was 22% in 2015 and increased to 25% in 2018. In BSI, a significant increasing trend was observed for Candida and Enterococcus. The highest rate of 30-day fatality was detected among the patients with pneumonia (32%). In pneumonia, Pseudomonas infections increased in 2018. Colistin resistance increased and significantly associated with 30-day fatality in Pseudomonas infections. Among S. aureus methicillin, resistance increased from 31 to 41%.

Objective: In recent years, there has been worldwide recognition of the problems associated with Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS). The prevalence of cardiovascular disease in the HIV-infected population is increasing. Repolarization abnormalities, the significant contributor to life-threatening arrhythmias and mortality, are the most frequent electrocardiographic changes in this population. This study aimed to evaluate the changes in Tp-e interval, Tp-e/QT and Tp-e/corrected QT (QTc) ratios, and traditional electrocardiographic features of electrical dispersion in adults infected with HIV. Subjects and Methods: A total of 235 participants were selected in the current study. The HIV group consisted of 85 subjects (median age 36 years [25–48], and the control group included 150 individuals (median age 39 years [27–51]). Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measured by the 12-lead electrocardiogram. Results: Tp-e interval, cTp-e interval, and Tp-e/QT and Tp-e/QTc ratios were significantly higher in HIV patients compared to the control group (p = 0.006, p = 0.004, p = 0.003, and p = 0.002, respectively). In correlation analysis, there was inverse correlation between the mean cTp-e interval and CD4 count and Tp-e/QTc ratios and CD4 count (r = – 0.407, p < 0.001, r = – 0.416, p < 0.001, respectively). Besides, there was correlation between the mean cTp-e interval and high-sensitivity C-reactive protein (hsCRP) and Tp-e/QTc ratios and hsCRP (r = 0.403, p = 0.001, r = 0.406, p = 0.001, respectively). Conclusion: Our study revealed that the cTp-e interval, Tp-e/QT and cTp-e/QT ratios were prolonged and correlated to the severity of the disease in HIV-infected patients. Our findings may shed light on the cTp-e interval and Tp-e/QTc ratio and lead to further studies showing a relationship with ventricular arrhythmias and mortality in HIV-infected individuals.

Rationale, aims, and objectives Pressure ulcers (PUs), which are preventable complications, increase the cost of health care and the risk of prolonged hospital stay, as well as morbidity and mortality. In this study, we aimed to describe the prevalence, clinical features, and risk factors for PUs among hospitalized patients. Method This study was cross-sectional and conducted over a single day in all the care units. Data were recorded on a patient observation form that included demographic data, diagnosis of admission to the hospital or intensive care unit (ICU), comorbidity and chronic diseases, location, stage of PU, and Braden Scale score. Acute physiology and chronic health evaluation (APACHE) II score, Glasgow coma score (GCS), PaO2 /FiO2 ratio, and albumin level were recorded for ICU patients. Results A total of 1548 adult patients participated in the study. Of these patients, 177 (11.43%) had PU. The patients with PU had more advanced age, lower body mass index (BMI), and longer duration of hospital and ICU stay (for all P = .001). Evaluation of PU in the first 24 hours after hospital admission and the last PU evaluation time also showed a significant effect (both P = .001). Braden Scale score less than or equal to 13 in the first evaluation after hospital admission increased the risk of PU. Albumin was 2.78 ± 0.57 gm/dL in ICU patients, and albumin level was significantly lower in patients with PU (P = .001). PUs were located mainly in the sacrum (47.59%) and were classified as stage II (42.76%) for all patients. Conclusions The prevalence of PU is related to the age and severity of patient clinical status, as predicted by the Braden Scale score and APACHE II score, and length of hospital and ICU stay. Low albumin level is also related to development of PUs in ICU patients.

NMEA 0183; deniz sistemlerindeki elektronik cihazlar arasindaki iletisimde kullanilan bir standarttir. Bu uygulama bildirisinde; ilk once NMEA 0183 standardi ile ilgili genel bilgiler verilecektir. Sonra ise; GPS alicisindan gonderilen NMEA 0183 standardindaki mesajlarin nesneye yonelik programlamanin temel prensiplerinden olan “genislemeye acik fakat degisiklige kapali” prensibine uygun olarak strateji ve fabrika tasarim kaliplari ile yazilim tasariminin nasil yapildigi anlatilacaktir.

WOS: 000429311800001, Background: Hepatitis B virus (HBV) has a high mutation rate due to its unusual replication strategy leading to the production of a large number of virions with single and double mutations. The mutations, in turn, are associated with the development of drug resistance to nucleos(t)ide analogs (NUCs) in patients before and during NUCs therapy. Objectives: The current study aimed at investigating the molecular characterization of HBV in Turkish patients with chronic hepatitis B (CHB) infection. Methods: Polymerase chain reaction (PCR) amplification and direct sequencing procedures were used to analyze mutations. The detected drug resistance mutations were divided into the nucleos(t) ide analogs primary, partial, and compensatory resistance groups. The amino acid substitutions of hepatitis B surface antigen (HBsAg) were categorized into antiviral drug - associated potential vaccine-escape mutations (ADAPVEMs) and typical HBsAg amino acid substitutions, which included hepatitis B hyperimmunoglobulin (HBIg) - selected escape mutation, vaccine escape mutation, hepatitis B misdiagnosis, and immune - selected amino acid substitutions. Results: The number of patients included in the study was 528 out of which 271 (51.3%) were treatment - naive and 351 (66.3%) were hepatitis B e antigen (HBeAg) - negative. Moreover, 325 (61.6%) were males with a mean age of 38 years (range: 18 - 69). Primary, partial, and compensatory resistance to NUCs was reported in 174 (32.9%) patients. Six different ADAPVEM motifs were determined in both treatment - naive and treatment - experienced patients, namely, sF161L/rtI169X, sE164D/rtV173L, sL172L/rtA181T, sL173F/rtA181V, sS195M/rtM204V, and sS196L/rtM204I. The prevalence of ADAPVEMs and typical HBsAg escape mutations was 5.3% (n = 28) and 34.8% (n = 184), respectively. Conclusions: The analysis of drug resistance should constitute a fundamental part of the follow - up period of patients with CHB undergone treatment with NUCs. The surveillance of development of drug resistance mutations, while receiving treatment for hepatitis B is of paramount importance to monitor and control the emerging resistance.

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are widespread health problems all over the world and have high morbidity and mortality. Hemodialysis patients are more frequently exposed to these viruses as they have poor immune system and frequently undergo parenteral interventions. The vaccination against HBV prevents infection and it has been recommended for the prevention of HBV infection in all susceptible dialysis patients. This study aimed to determine the seroprevalence of HBV and HCV infections and analyzed the factors affecting inadequate response to HBV vaccine in dialysis patients. Methods: The data for 584 dialysis patients that were followed up at seven dialysis centers were analyzed. The patients received four doses of 40 μg recombinant hepatitis B vaccine at 0, 1, 2, and 6 months and were tested for anti-HBs titer after one month of completion of vaccination. If patients showed a titer of anti-HBs 30 (p = 0.019), over the age of 65 years (p = 0.009), and duration of dialysis treatment >5 years (p = 0.001). There was no statistically significant difference between gender, causes of renal disease, erythropoietin treatment, and the type of dialysis. Conclusion: Hepatitis C infection, obesity, being elderly, and having long hemodialysis period reduced the hepatitis B vaccination response in hemodialysis patients. © 2017, Springer Science+Business Media Dordrecht.

Introduction: The treatment of postoperative mediastinitis is very important because of its high morbidity, mortality, and increased hospital stay and hospital costs. The aims of our research were to investigate whether linezolid alone can be an effective treatment agent for methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis, and to determine whether linezolid can provide synergistic activity when given in combination with rifampin., Methods: A partial upper median sternotomy was performed on 70 rats. The animals were divided into seven groups: an uncontaminated control group; an untreated contaminated group; three contaminated groups that received antibiotic therapy with either 25 or 50 mg/kg linezolid twice a day, or rifampin 5 mg/kg twice a day; and two contaminated groups that received a combination therapy consisting of 25 or 50 mg/kg linezolid and rifampin 5 mg/kg twice a day. The antibiotic treatment tasted 7 days. Tissue samples from the upper ends of the sternum and swab specimens of the upper mediastinum were obtained and evaluated microbiotogically., Results: The 25-mg/kg dose of linezotid, either atone or combined with rifampin, was not effective in reducing the bacterial. counts in mediastinum and sternum. Quantitative bacterial cultures of mediastinum and sternum were significantly lower in the groups receiving 50 mg/kg linezolid alone or in combination with rifampin compared with the control. Adding of rifampin to linezotid therapy did not result in a significant change in bacterial. counts versus linezotid atone., Conclusion: A high dose of linezotid should be considered as a possible therapeutic agent for the treatment of post-sternotomy infection caused by MRSA. (c) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Infection is one of the most fearful complications of cardiovascular surgery operations because of its association with increased mortality, morbidity, hospital stay and economic cost. In this study we aimed to present the prospective surveillance results of nosocomial infections in Cardiovascular Surgery Unit between January 01 and December 31, 2004. This study was performed with laboratory and clinical based active surveillance method. Twenty-five nosocomial infections were determined in twenty-two of 558 patients hospitalized in the clinic during one year follow up period and the incidence of nosocomial infection ratio was found to be 4.3% (95% CI; 2.4-6.1%). This percentage was 6.4% (95% CI; 3.6-9.1%) in patients undergone any surgical intervention. Twenty of the patients were male, two were female and the mean age was 64.8 ± 11.5 years. The most frequent nosocomial infection was found to be surgical site infection. White blood cell counts in the patients with nosocomial infection varied between 4700-29300 (mean: 13382.6). The most frequent isolated microorganism was Staphylococcus aureus and 57.1% of them were methicillin-resistant. The most frequent used regimens in the treatment of the infection attacks were: glycopeptides (24%), beta-lactam/beta-lactamase inhibitor combination plus glycopeptid plus amikacin (24%) and beta-lactam/beta-lactamase inhibitor combinations (16%). We treated 96% of the patients successfully, and one patient died. It should be paid attention to surgical site infection in patients undergone cardiovascular surgical intervention. Follow up period after hospital discharge is very important and empirical treatment should be chosen by considering that the dominant microorganism is methicilin-resistant S. aureus in our hospital.

Objectives. Pandemic influenza is a contagious disease caused by the new pandemic influenza A H1N1 virus, originated from the genetic combination of human, pig and avian influenza viruses. Our research aimed to determine the level of pandemic influenza vaccination in healthcare providers and the factors influencing this level. Methods. Doctors, midwives and nurses working in primary, secondary and tertiary health institutions in Denizli established the universe of the research. Four nurses visited these health institutions on five workdays between the 4th and 8th of April 2011, informed the healthcare providers that participation to the research was voluntary and handed over data collection forms in the institutions visited. Then, these data collection forms were collected by the same nurses. Research data were analyzed with SPSS package program. Frequency, percentage, chi-square and logistic regression analyses were used in the evaluation. Results. 44.7% of the healthcare providers participating in the study stated that they had been vaccinated with pandemic influenza vaccine. When factors effecting the vaccination decision with pandemic influenza vaccine of the individuals participating the study was evaluated; statistically significant difference between vaccination and occupation ( p =0.001), sex ( p =0.001), and age ( p =0.026) was detected. The proportion of doctors, males and individuals older than 40 years was higher among the vaccinated professionals. Conclusions. It is important to make announcements about vaccination with determination and by taking support from media and non-governmental organizations. Statements and explanations should be released with this in mind and media, and nongovernmental organizations should also take responsibility regarding this matter.

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases set up a task force to develop a consensus report focused on chronic hepatitis B in pregnancy, a complex issue for both the mother with an advanced liver disease and the unborn child who is under the risk of hepatitis B virus (HBV) transmission. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented in the report. An algorithm adapted from actual publications is also proposed for management of chronic hepatitis B in the pregnant patient. Since many women of childbearing age are in the immune tolerant phase of infection, there is generally no need for therapy and no indication to start therapy during the early stages of pregnancy. Initiation of antiviral therapy in the beginning of the third trimester in highly viremic (HBV DNA > 200 000 IU/mL) pregnant women can prevent mother-to-child-transmission of HBV despite postnatal passive and active immunoprophylaxis provided. Given its potency and its high genetic barrier to resistance, tenofovir might be an appropriate option for mothers who might need to continue their treatment for active hepatitis B after delivery.

Brucellosis is a zoonotic disease endemically seen in Turkey, which occurs with various clinical findings. It can lead to complications affecting many systems. Endocarditis is an infrequent, but serious complication of brucellosis.The aim of this case presentation is to remind that endocarditis can be a complication of brucellosis and if is undiagnosed or misdiagnosed, progresses fatal in a high rate.

Background: Few studies have addressed the indirect costs of chronic hepatitis B and C, and none has assessed the real costs of these conditions, including indirect costs caused by loss of work, in Turkey. Aims: This study therefore analysed the costs of treatment, follow-up, and complications of chronic hepatitis B and hepatitis C infections to the community. Study design: Cross-sectional study. Methods: This study analysed patients with chronic hepatitis B and hepatitis C treated at Pamukkale University Hospital Infectious Diseases and Clinical Microbiology Clinic, Denizli, Turkey between June 2009 and June 2010. Costs of antiviral treatment and follow-up were calculated from patients' medical records, and indirect costs were analysed from questionnaires completed by patients. Results: Data were analysed for 284 patients with chronic viral hepatitis. Indirect, hospital, treatment and total expenses were significantly higher for patients with chronic hepatitis B than for inactive hepatitis B virus carriers and patients with chronic hepatitis C. Hospital and total expenses of patients with complications were significantly higher than for patients with chronic hepatitis C. Hospital and total expenses were significantly higher for patients with than for individuals without cirrhosis. Indirect, hospital, treatment and total costs of patients were significantly higher for patients receiving combination therapy than monotherapy. Conclusion: Reducing the costs to society of chronic hepatitis requires the development of protection and screening programs. Turkish Başlık: Kronik Hepatit B ve Kronik Hepatit C Hastalarının Tedavi, Takip ve Komplikasyonlarının Maliyeti Anahtar Kelimeler:Maliyet, kronik hepatit B, kronik hepatit C Arkaplan: Kronik hepatit B ve C hastalıklarının dolaylı maliyetlerini inceleyen birkaç çalışma bulunmaktadır ancak işgücü kaybının yol açtığı dolaylı maliyetleri de içeren gerçek maliyetleri ortaya koyan bir çalışma Türkiye'de yapılmamıştır. Amaç: Bu çalışmada kronik hepatit B ve kronik hepatit C infeksiyonlarının tedavi, takip ve komplikasyonlarının topluma maliyeti incelenmiştir. Çalışma Tasarımı: Kesitsel çalışma Yöntemler: Bu çalışma Pamukkale Üniversitesi Hastanesi İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Denizli, Türkiye tarafından Haziran 2009- Haziran 2010 tarihleri arasında tedavi edilen kronik hepatit B ve hepatit C hastalarını incelemektedir. Antiviral tedavi ve takip maliyetleri hastaların tıbbi kayıtlarından hesaplanmıştır, ve dolaylı maliyetler hastalar tarafından doldurulan anketlerden hesaplanmıştır. Bulgular: Kronik viral hepatitli 284 hastanın verileri incelenmiştir. Kronik hepatit B hastalarının dolaylı, hastane, tedavi, ve toplam maliyetleri inaktif hepatit B taşıyıcıları ve kronik hepatit C hastalarından istatistiksel olarak anlamlı yüksek bulunmuştur. Komplikasyonlu hastaların hastane ve toplam maliyetleri kronik hepatit C hastalarından istatistiksel olarak anlamlı yüksek bulunmuştur. Sirozlu hastaların hastane ve toplam maliyetleri sirozu olmayan hastalardan istatistiksel olarak anlamlı yüksek bulunmuştur. Kombinasyon tedavisi alan hastaların dolaylı, hastane, tedavi ve toplam maliyetleri monoterapi alan hastalardan istatistiksel olarak anlamlı yüksek bulunmuştur. Sonuç: Kronik hepatitlerin topluma maliyetlerini azaltmak için korunma ve tarama programlarının geliştirilmesi gerekmektedir.

We used an experimental rat model to compare the therapeutic efficacy of teicoplanin, linezolid, and quinupristin/dalfopristin with that of vancomycin as standard therapy for infective endocarditis.Aortic endocarditis was induced in rats by insertion of a polyethylene catheter into the left ventricle, followed by intravenous inoculation of 106 colony-forming units of methicillin-resistant Staphylococcus aureus 24 hours later. Forty-eight hours after bacterial challenge, intravenous antibiotic therapies were initiated. There were 6 groups of 8 rats each: uninfected control; infected, untreated control; vancomycin-treated (40 mg/kg twice daily); teicoplanin-treated (20 mg/kg twice daily after a loading dose of 40 mg/kg); linezolid-treated (75 mg/kg 3 times daily for 1 day, then 75 mg/kg twice daily); and quinupristin/dalfopristin-treated (30 mg/kg twice daily and an additional 10 mg/kg dalfopristin infusion over 6 to 12 hr daily). At the end of therapy, the aortic valve vegetations in the drug-treated rats were evaluated microbiologically.Compared with the infected, untreated group, all drug-treated groups had significantly reduced bacterial titers in the vegetations. Vancomycin, teicoplanin, and quinupristin/dalfopristin all effectively reduced the quantitative bacterial cultures of aortic valve vegetations. In addition, there was no significant difference in the comparative efficacy of teicoplanin, linezolid, and quinupristin/dalfopristin. Vancomycin significantly reduced bacterial counts in comparison with linezolid, which was nonetheless also effective.Our experimental model showed that each of the investigated antimicrobial agents was effective in the treatment of infective endocarditis.

Background: Graft infections are severe complications of vascular surgery that may result in amputation or mortality. Staphylococci are the most frequent cause of vascular graft infections. Objective: In this study we assessed the prophylactic efficacy of linezolid in comparison with vancomycin in preventing prosthetic vascular graft infection due to methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE). Methods: This randomized, controlled, experimental study using healthy adult (aged >5 months) male Wistar rats was conducted in the research laboratory of the Pamukkale University, Denizli, Turkey. The study consisted of an uncontaminated control group and 3 groups for both staphylococcal strains: a contaminated group that did not receive any antibiotic prophylaxis; a contaminated group that received preoperative intraperitoneal (IP) prophylaxis with vancomycin; and a contaminated group that received preoperative IP prophylaxis with linezolid. All rats received a vascular Dacron graft placed inside a subcutaneous pocket created on the right side of the median line. Sterile saline solution (1 mL), to which MRSA or MRSE at a concentration of 2 × 107 colony-forming units per milliliter had been added, was inoculated onto the graft surface using a tuberculin syringe to fill the pocket. The grafts were explanted 7 days after implantation and assessed by quantitative culture. Results: Seventy rats (mean [SD]weight, 323.7 [17.9]g; mean [SD]age, 5.98 [0.64] months) were evenly divided between the 7 groups. Statistical analysis of the quantitative graft culture suggested that both vancomycin and linezolid were effective in significantly inhibiting bacterial growth when compared with the untreated contaminated groups (all, P < 0.001). However, a statistically significant difference was not observed between the bacteria count in the vancomycin and linezolid prophylaxis groups. When a comparison was made between the bacterial growth in the contaminated control groups, MRSA had significantly greater affinity to the Dacron prostheses than MRSE (all, P < 0.001). Conclusion: Our study found that linezolid was as effective as vancomycin in suppressing colony counts in MRSA- or MRSE-infected vascular Dacron grafts in rats. © 2007 Excerpta Medica, Inc.

Background: Acinetobacter baumannii is a major cause of nosocomial infections in many hospitals and appears to have a propensity for developing multiple antimicrobial resistance rapidly. Cases: We report two cases with post-surgical meningitis due to multidrug resistant A. baumannii which were successfully treated with high-dose intravenous meropenem therapy. Conclusions: Multidrug resistant Acinetobacter spp. in intensive care units are a growing concern. High-dose meropenem is used in the treatment of these infections.

Background: Hospital-acquired infection often occurs because of lapses in accepted standards of practice on the part of health care personnel. The aim of this study is to attract attention on poor hospital infection control practice in venepuncture and use of tourniquets and emphasize the importance of hand hygiene. Methods: Overall compliance with hygiene during usage of tourniquets and routine patient care before and after implementation of a hospital infection control measures was evaluated. Results: According to the questionnaire, only 26.9% of respondents always washed their hands both before and after venepuncture. In the second step of the study, based on direct observation, hands were washed both before and after venepuncture on only 41 (45.1%) occasions. Failure to remove gloves after patient contact was observed on 23.1% occasions. Conclusion: Our survey reveals poor infection control practice in hand hygiene, glove utilization, and usage of tourniquets and the implementation of infection control measures produced a moderate improvement in compliance with them. © 2006 Association for Professionals in Infection Control and Epidemiology, Inc.

Background The aim of the study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of Staphylococcus (S.) epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials. Methods Graft infections were established in the subcutaneous tissue of 120 male Wistar rats by implantation of Dacron/ePTFE grafts followed by topical inoculation with 2 × 107 CFUs of clinical isolate of methicillin-resistant S. epidermidis. Each of the graft series included a control group, one contaminated group that did not receive any antibiotic prophylaxis, two contaminated groups that received systemic prophylaxis with teicoplanin or levofloxacin and two contaminated groups that received teicoplanin-soaked or levofloxacin-soaked grafts. The grafts were removed 7 days after implantation and evaluated by quantitative culture. Results There was significant bacterial growth inhibition in the groups given systemic or local prophylaxis (P < 0.05). Methicillin-resistant S. epidermidis had greater affinity to Dacron graft when compared with ePTFE graft in the untreated contaminated groups (P < 0.05). Conclusion The study demonstrated that the usage of systemic or local prophylaxis and preference of ePTFE graft can be useful in reducing the risk of vascular graft infections caused by staphylococcal strains with high levels of resistance.