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Objective: The primary aim of the study was to analyze the changes in time in HIV care and management and virologic success rates. The secondary aims were to analyze the epidemiological features, clinical and laboratory findings, and factors affecting survival. Methods: HIV-infected individuals aged ≥ 18 years presenting to our clinic between January 1996 and December 2015 were included. Data were collected retrospectively from medical records, and two decades (1996-2005 and 2006-2015) were analyzed. Results: Overall, 80% were male; the median age (min; max) was 36.43 (17; 77) years. Patients with stage 3 disease were significantly higher in the first decade compared to the second decade (p=0.00). The median (min; max) CD4+ T lymphocyte count at baseline was 160 (3; 650) and 355 (0; 1800) cells/mm3 in the first and second decades, respectively (p=0.00). The treatment initiation rate was 94.2%; virologic suppression rates at six months of treatment and throughout the total follow-up time were 70.1% and 78.1%, respectively. The difference between the two decades in virologic suppression was significant (p=0.004). AIDS-defining disease developed in 12.9% (52.6% in the first and 11% in the second decade) (p=0.01). The adverse event rate was 60.8%; hyperlipidemia was the most common (60.2%). The death rate was 6.5% and lymphoma (14.3%) and tuberculosis (10.9%) were the most common causes of death. The estimated survival time was 272 months (95% confidence interval 225-320). The inability to achieve virologic suppression, an AIDS-defining disease, and a baseline CD4+ T lymphocyte count

Objective: This study aimed to determine the birth control methods preferred by women living with human immunodeficiency virus (HIV) followed by our clinic and to review their pregnancy management strategies. Methods: The medical records of HIV-infected women followed by our clinic between 1999 and 2021 were analyzed retrospectively. The following parameters were recorded from medical files: Demographic characteristics, birth control methods used and the duration of usage, conception methods in those who became pregnant after being infected with HIV, whether the pregnancy was planned or not, the antiretroviral treatments used before pregnancy and whether treatment was modified during pregnancy, HIV-1 RNA and CD4+ T lymphocyte counts before delivery, type of delivery, prophylaxis given to the baby and the mother and its duration, and HIV serological status of the babies. Results: Out of 80 women actively followed by our clinic, 75 (93.7%) with available data were included in the study. The mean age of the cases was 43.5 +/- 11.4 (min=18-max=68). The number of cases using any birth control method was 51 (68%). The most common contraceptive method was a condom used by their partners (n=31, 60.7%). Thirty-six pregnancies developed in 25/60 (41.6%) sexually active cases not in the menopausal period and 33 babies were born. One baby was infected with HIV. Conclusion: Contraception methods in sexually active HIV-infected women should be chosen upon discussion between the healthcare provider and the patient. Close monitoring and standard care during pregnancy are critical for the long-term prognosis of both the mother and the baby.

This study aimed to evaluate the influencing variables for outcomes in patients with septic shock having culture-proven carbapenem-resistant Gram-negative pathogens. It included 120 patients (mean age 64.29 ± 1.35 years and 58.3% female). The mean Sequential Organ Failure Assessment score during septic shock diagnosis was found to be 11.22 ± 0.43 and 9 ± 0.79 among the patients with mortality and among the survivors, respectively (P = 0.017). The logistic regression analysis showed that empirical treatment as mono Gram-negative bacteria-oriented antibiotic therapy (P = 0.016, odds ratio (OR) = 17.730, 95% confidence interval (CI): 1.728-182.691), Charlson Comorbidity Index2 (P = 0.032, OR = 7.312, 95% CI: 5.7-18.3), and systemic inflammatory response syndrome score 3 or 4 during septic shock diagnosis (P = 0.014, OR = 5.675, 95% CI: 1.424-22.619) were found as independent risk factors for day 30 mortality. Despite early diagnosis and effective management of patients with septic shock, the mortality rates are quite high in CRGNP-infected patients.

Amaç: Bu çalışmada, Korona virüs aşısı için başvuran gönüllülerin Korona virüs aşısı hakkında bilgi düzeyleri ile aşıya olan güveni arttıran faktörlerin ve erişkin aşılaması durumlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışma, tanımlayıcı, kesitsel bir çalışmadır. Çalışmaya 1-31 Aralık 2020 tarihleri arasında Korona virüs aşısı için başvuran 18 yaş ve üzeri gönüllüler dahil edildi. Gönüllülere, sosyodemografik özellikleri, Influenza, Hepatit B ve pnömokok enfeksiyonlarına karşı aşılanma durumları ve Korona virüs aşısı hakkında bilgi edinme yolları ile bilgi düzeyleriyle ilgili sorulardan oluşan bir anket uygulandı. İstatistiksel analiz Ki kare testi ile yapıldı ve p

Objectives: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection. Design: GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires. Results: The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p, Fondazione Cassa di Risparmio in Bologna; Ministero dell’Istruzione, dell’Università e della Ricerca, MIUR; Korean Society of Neurogastroenterology and Mobility, KSNM; Fondazione del Monte di Bologna e Ravenna: H2020, SC1-BHC-01-2019; United European Gastroenterology, UEG; Fondazione Roma, GB’s contribution to this research was partly supported by funding from Fondazione Cassa di Risparmio in Bologna, the Italian Ministry of Education, University and Research; and Fondazione del Monte di Bologna e Ravenna and European Grant H2020, DISCOvERIE, SC1-BHC-01-2019, We thank the European Society of Neurogastroenterology and Motility, the United European Gastroenterology, and the Rome Foundation for supporting this study.

Background: The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes. Methods: In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines. Findings: 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04–1·11; p

Introduction: In this study, it was aimed to determine the risk factors for developing acute kidney injury (AKI) and effects of ascorbic acid on the development of nephrotoxicity in patients receiving systemic colistin sodium therapy. Materials and Methods: We retrospectively reviewed records of cases who were treated with systemic colistin sodium and did not have any known renal disease in our hospital between the years of 2014 and 2019. The demographic characteristics, indications for systemic colistin, other antibiotics applied and nephrotoxic drugs, vasopressor necessity, daily creatinine values, development of acute kidney injury, and ascorbic acid use were evaluated. Acute kidney injury was assessed according to KDIGO 2017. Results: Sixty-six patients were included in the study. In addition to colistin therapy, 33 cases who received at least three grams of ascorbic acid per day and 33 cases who received only colistin therapy were evaluated retrospectively. Acute kidney injury developed in 12 (36.4%) of those receiving ascorbic acid and 15 (45.5%) in those not receiving ascorbic acid (p= 0.617). Acute kidney injury developed in 9.1 ± 5.9 days in ascorbic acid patients and 7.1 ± 4.4 days in non-ascorbic acid patients (p= 0.314). The rate of septic shock development was significantly lower in patients receiving ascorbic acid (30.3% vs 57.6%, p= 0.046). Advanced age (p= 0.005), sepsis (p= 0.046), and underlying cardiac disease (p= 0.01) were found to be statistically significant in terms of the development of nephrotoxicity. Conclusion: Although no statistically significant effect of ascorbic acid using on the development of colistin-related nephrotoxicity was determined in our study, we think that high dose vitamin C may be beneficial in selected patient groups in terms of the fact that AKI is seen less in the group using ascorbic acid, does not have serious side effects and has a positive effect on preventing from septic shock. However further research is needed with more patients.

Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease frequently transmitted by tick bite and accompanied by fever and bleeding. It may cause important public health problems. Besides clinical symptoms and epidemiological history, blood count and biochemical test results are the first clues for CCHF. In this study, we aimed to retrospectively evaluate 16 patients who were followed and treated due to CCHF in our hospital. Materials and Methods: The patients who were followed up and treated with CCHF between 2009-2019 in our clinic were evaluated retrospectively in terms of demographic characteristics, presenting complaints, presence of tick history, laboratory parameters, necessity of blood products replacement, hospitalization periods, ribavirin treatment and one-month survival. Results: Sixteen patients [ten females, six males, mean age 50.37 ± 18.01 (min: 18-max: 79)] with the diagnosis of CCHF were included into the study. Presenting complaints were fever (16/16, 100%), fatigue (16/16, 100%), bleeding (9/16, 56.2%), petechial rash (7/16, 43.7%). nausea and vomiting (6/16, 37.5%). There was a history of tick contact in 14 cases (87.5%) but not in two cases. Supportive treatment was applied to all cases, and droplet and contact isolation were applied. Blood product replacement was performed in five patients (31.2%), and ribavirin was administered in nine patients (56.2%). Mortality rate was 6.3% (1/16). Conclusion: Crimean-Congo Hemorrhagic Fever is an endemic disease in our country. Especially in spring and summer months, patients with fever and cytopenia on hemogram should be questioned, and tick contact should be sought.

Common variable immunodeficiency is the most common primary immunodeficiency syndrome in adults, characterized by recurrent opportunistic infections, particularly bacterial, and hypogammaglobulinemia. In this report, a 50-year-old male patient with common variable immunodeficiency was presented with complaints of gastrointestinal infection. Salmonella enterica subsp. enterica was yielded in the bacteriological examination of the stool sample. Cryptosporidium spp. oocysts were also seen in concurrent parasitological examination. In patients with common variable immunodeficiency, infectious causes of acute and chronic diarrhea should be kept in mind both in diagnosis and choosing of empirical treatment.

[No abstract available]

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

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

Background. Common variable immunodeficiency (CVID) is a rare disease characterized by humoral immunodeficiency, often causing sinopulmonary and gastrointestinal infections, and may cause enteropathy in some patients, which leads to severe malnutrition and electrolyte deficiencies. Although many autoimmune diseases are seen with increased frequency in CVID patients, primary hypoparathyroidism is extremely rare. Case presentation. A 50-year-old man with CVID presented with diarrhea. The patient had complaints for 2 years and was cachectic. He had severe electrolyte and vitamin deficiencies that did not respond to oral treatment. The diarrhea causes such as celiac, inflammatory bowel diseases, and gastrointestinal infections were excluded and the endoscopy showed enteropathic changes in the duodenum and colon. Concomitant hypoparathyroidism was also detected in the patient with hypocalcemia despite adequate replacement. Conclusion. Parenteral therapy should be considered in the management of CVID enteropathy cases that do not respond to oral replacement. Although very rare, hypoparathyroidism should be considered in the differential diagnosis of CVID patients with treatment-resistant hypocalcemia.

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.

Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease frequently transmitted by tick bite and accompanied by fever and bleeding. It may cause important public health problems. Besides clinical symptoms and epidemiological history, blood count and biochemical test results are the first clues for CCHF. In this study, we aimed to retrospectively evaluate 16 patients who were followed and treated due to CCHF in our hospital. Materials and Methods: The patients who were followed up and treated with CCHF between 2009-2019 in our clinic were evaluated retrospectively in terms of demographic characteristics, presenting complaints, presence of tick history, laboratory parameters, necessity of blood products replacement, hospitalization periods, ribavirin treatment and one-month survival. Results: Sixteen patients [ten females, six males, mean age 50.37 ± 18.01 (min: 18-max: 79)] with the diagnosis of CCHF were included into the study. Presenting complaints were fever (16/16, 100%), fatigue (16/16, 100%), bleeding (9/16, 56.2%), petechial rash (7/16, 43.7%). nausea and vomiting (6/16, 37.5%). There was a history of tick contact in 14 cases (87.5%) but not in two cases. Supportive treatment was applied to all cases, and droplet and contact isolation were applied. Blood product replacement was performed in five patients (31.2%), and ribavirin was administered in nine patients (56.2%). Mortality rate was 6.3% (1/16). Conclusion: Crimean-Congo Hemorrhagic Fever is an endemic disease in our country. Especially in spring and summer months, patients with fever and cytopenia on hemogram should be questioned, and tick contact should be sought.

Pneumocystis jirovecii is an opportunistic respiratory pathogen causing Pneumocystis pneumonia (PcP) in immunocompromised patients. The aim of this study was to investigate the genetic diversity of P. jirovecii isolates (n: 84) obtained from PcP patients using multilocus sequencing method based on mt26S, SOD, and CYB loci. Among the 84 clinical samples that were positive for P. jirovecii DNA, 31 (36.90%) of them were genotyped using at least one locus. Of the 31 clinical samples, 26 of them were successfully genotyped using all loci whereas three samples were genotyped using either mt26S/CYB loci or mt26S/SOD loci. Additionally, there were two more clinical samples that were genotyped using CYB or SOD locus. Using mt26S locus, genotypes 2, 3, 7, and 8 were detected. Frequencies of genotype 7 and 8 were higher and both of them were found in 11 (n: 29; 37.93%) clinical samples. Using SOD locus, SOD 1, 2, and 4 genotypes were detected. SOD 1 was the predominant genotype (20/28; 71.42%). During the analyses of CYB locus, CYB 1, 2, 5, 6, and 7 as well as a new CYB genotype were detected. CYB 1 (16/29; 55.17%) and 2 (10/29; 34.48%) were the predominant genotypes. Overall, according to the multilocus sequencing results E, F, M, N, P, and V multilocus genotypes were detected among the PcP patients. In addition, SOD 1 was the predominant genotype and CYB had a more polymorphic locus. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature., 2013TIP050, TGA-2019-20253, This study was supported by Ege University Scientific Research Projects Coordination Unit (Project Numbers: TGA-2019-20253 and 2013TIP050).

Yaygın değişken immünyetmezlik (YDİ), başta bakteriyel olmak üzere tekrarlayan fırsatçı infeksiyonlar ve hipogamaglobulinemi ile karakterize, erişkinde en sık görülen primer immünyetmezlik sendromudur. Bu yazıda, YDİ tanılı gastrointestinal sistem infeksiyonu yakınmalarıyla başvuran 50 yaşında erkek bir olgu sunulmaktadır. Dışkı örneğinin bakteriyolojik incelemesinde Salmonella enterica subsp. enterica üremesi olmuştur. Eş zamanlı parazitolojik incelemesinde de Cryptosporidium spp. ookistleri görülmüştür. YDİ tanılı olgularda infeksiyöz nedenli akut ve kronik ishal etkenleri hem tanı hem de ampirik tedavi seçiminde akılda tutulmalıdır., Common variable immunodeficiency is the most common primary immunodeficiency syndrome in adults, characterized by recurrent opportunistic infections, particularly bacterial, and hypogammaglobulinemia. In this report, a 50-year-old male patient with common variable immunodeficiency was presented with complaints of gastrointestinal infection. Salmonella enterica subsp. enterica was yielded in the bacteriological examination of the stool sample. Cryptosporidium spp. oocysts were also seen in concurrent parasitological examination. In patients with common variable immunodeficiency, infectious causes of acute and chronic diarrhea should be kept in mind both in diagnosis and choosing of empirical treatment.

Coronavirus disease 2019, which emerged in Wuhan in China in early December 2019, gradually spread across the world and was declared a pandemic by the World Health Organization on March, 12 2020. the disease shows a wide spectrum, ranging from asymptomatic course to severe acute respiratory syndrome. Although data on SARS-CoV-2 infection in HIV-infected cases are still limited, it is thought that the presence of comorbidities is important for mortality and morbidity in infected cases. in this report, it was aimed to evaluate SARS-CoV-2 infection in a patient diagnosed with HIV for six years with negative HIV-1 viral load and a CD4 lymphocyte count of 240 cells/mm(3).

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

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

Manure-based biogas may make an important contribution both to the energy transition and to the reduction in greenhouse gas emissions. Despite these benefits, in Switzerland the use of manure as an energy source is still very limited. The engagement of farmers in biogas production is low and the barriers to their participation are not well known. This study investigates the behavior of Swiss farmers towards anaerobic digestion and the potential impact of changing incentives. Based on a comprehensive survey, including a choice experiment, their willingness to participate in manure-based biogas production is investigated at different levels. An Agent-Based Model (ABM) is designed and used to simulate the development of biogas facilities under different framework conditions. The agent's' properties are derived from the farmers’ survey. Simulation results show that revenue for produced energy is the main driver. An increase of 0.10 CHF/kWh energy revenues (compared to 0.45 CHF/kWh today) would enable the establishment of 10 additional biogas facilities (10% more than today) enabling the manure of an additional 4285 livestock units to be mobilized for biogas, (

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

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

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