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WOS: 000471726700008, PubMed ID: 30989418, Brucellosis in pregnant women is reported to be associated with obstetric complications (OCs), and adequate data for human brucellosis during pregnancy are largely lacking. We performed this multicenter retrospective cross-sectional study to evaluate the epidemiology, clinical course, treatment responses, and outcomes of brucellosis among pregnant women. The study period comprised a 14-year period from January 2002 to December 2015. All consecutive pregnant women diagnosed with brucellosis in 23 participating hospitals were included. Epidemiological, clinical, laboratory, therapeutic, and outcome data along with the assessment data of the neonate were collected using a standardized questionnaire. Data of 242 patients were analyzed. The OC rate was 14.0% (34/242) in the cohort. Of the 242 women, 219 (90.5%) delivered at term, 3 (1.2%) had preterm delivery, 15 (6.2%) aborted, and 5 (2.1%) had intrauterine fetal demise. Seventeen (7.0%) of the newborns were considered as low birth weight. Spontaneous abortion (6.1%) was the commonest complication. There were no maternal or neonatal deaths and pertinent sequelae or complications were not detected in the newborns. Splenomegaly (p=0.019), nausea and/or vomiting (p41IU/L; p=0.025), oligohydramnios on ultrasonography (p=0.0002), history of taking medication other than Brucella treatment during pregnancy (p=0.027), and Brucella bacteremia (p=0.029) were the significant factors associated with OCs. We recommend that pregnant women with OC or with fever should be investigated for brucellosis if they live in or have traveled to an endemic area.

We aimed to develop a scoring system for predicting in-hospital mortality of community-acquired (CA) sepsis patients. This was a prospective, observational multicenter study performed to analyze CA sepsis among adult patients through ID-IRI (Infectious Diseases International Research Initiative) at 32 centers in 10 countries between December 1, 2015, and May 15, 2016. After baseline evaluation, we used univariate analysis at the second and logistic regression analysis at the third phase. In this prospective observational study, data of 373 cases with CA sepsis or septic shock were submitted from 32 referral centers in 10 countries. The median age was 68 (51-77) years, and 174 (46,6%) of the patients were females. The median hospitalization time of the patients was 15 (10-21) days. Overall mortality rate due to CA sepsis was 17.7% (n = 66). The possible predictors which have strong correlation and the variables that cause collinearity are acute oliguria, altered consciousness, persistent hypotension, fever, serum creatinine, age, and serum total protein. CAS (%) is a new scoring system and works in accordance with the parameters in third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The system has yielded successful results in terms of predicting mortality in CA sepsis patients.

Bu araştırmada okul öncesi 60-72 ay dönemdeki çocukların çevreye karşı tutumlarının araştırılması amaçlanmıştır. Bu amaç doğrultusunda çocuklara yönelik olan `Çocuklar İçin Çevresel Tutum Ölçeği (Children's Environmental Attitudes Scale)` okul öncesi eğitime devam eden 60-72 aylık çocuklara uygulanıp Minik TEMA programının çevreye yönelik tutumlarına etkisini belirlemede kullanılmıştır. Araştırma 2017-2018 Eğitim öğretim yılında Mersin ili Mut ilçesinde iki anaokulunda gerçekleştirilmiştir. Çalışma grubunu 60-72 ay grubunda öğrenim görmekte olan, deney ve kontrol gruplarından oluşmak üzere toplam 50 öğrenci oluşturmaktadır. Eğitim programının uygulanmasında deney grubunda 25, kontrol grubunda 25 çocuk araştırma kapsamına alınmıştır. Minik TEMA eğitim programı deney grubuna uygulanırken, kontrol grubuna Minik TEMA eğitim programı uygulanmamıştır. Araştırma nicel bir çalışma olup, ön test son test eşitlenmemiş kontrol gruplu yarı deneysel bir desen kullanılmıştır. Araştırmada veri toplama aracı olarak Çocuklar İçin Çevresel Tutum Ölçeği kullanılmıştır. Kullanılan ölçeğin; geçerlik-güvenirlik sonucu iç tutarlılık güvenirliği =.78 olarak belirtilmiştir (Kalburan-Cevher, 2009: 64). Çocuklar İçin Tutum Ölçeği ön test ve son test olarak iki gruba da uygulanmış, elde edilen veriler SPSS 23 programı kullanılarak istatistiksel olarak analiz edilmiştir. Araştırmadan elde edilen sonuçlara göre, Minik TEMA Çevre Eğitim Programı sonrasında, deney ve kontrol grubundaki çocukların, Çocuklar İçin Çevresel Tutum Ölçeğinden aldıkları puanlar arasında deney grubu lehine anlamlı farklılık bulunmuştur (p

Introduction: Brucellosis is a common zoonotic disease in some areas of the world. It may affect several organs and is known to involve the nervous system in 2.7–17.8% of affected patients. During the progression of brucellosis, peripheral neuropathies (PNs) have been reported. However, there are few studies investigating the presence of subclinical neuropathy in asymptomatic patients. In our study, we aimed to evaluate the presence of peripheral neuropathy using electrophysiological methods in newly-diagnosed untreated brucellosis patients. Methodology: The study included a control group of 60 healthy volunteers and 60 untreated brucellosis patients with a positive result of 1/160 or above on a brucella tube agglutination test. The patient and control groups were evaluated by electrophysiological methods. Results: In the patient group, all investigated motor nerves had slower average motor conduction speeds, reduced compound muscle action potential (CMAP) amplitudes and delayed F response and terminal latency compared to the control group. The sural nerve sensory conduction speed was slower and the sensory nerve action potential (SNAP) was found to be reduced. Conclusion: Among the 60 patients with acute brucellosis, 18% had sensorimotor peripheral neuropathy of widespread axonal character. Brucellosis can have many effects in the nervous system, including clinical or subclinical peripheral neuropathy in the peripheral nervous system. Brucellosis should be considered for differential diagnosis of patients with unexplained neurological and clinically relevant electrophysiological findings, especially in regions with endemic brucellosis.

OZET Objectives: This study aims to determine the reasons for not being able to access treatment of chronic hepatitis C (CHC) for patients who are followed up without treatment and to serve as a resource for future studies to be conducted to find solutions. Materials and Methods: The study was planned as a multi-center observational study. Universities, training and research hospitals, and public hospitals from different regions, most of which are members of the Association to Combat Viral HepatitisAcademic Camp, participated in the study. The reasons for untreated follow-up of CHC patients followed up without treatment were investigated. Patients who were hepatitis C virus (HCV) RNA negative, who had sustained viral response, and who had been receiving treatment were excluded from the study. Results: Two hundred and ninety patients diagnosed with CHC and followed up without treatment were reviewed in detail. The median age was 58 (23-87) years, the number of female patients was 157 (54%); 241 patients were genotype 1 (83%), 12 patients were genotype 2, 3 and 4 (4%), 37 patients were of unidentified genotypes (13%); 174 patients (60%) were treatment-naive; and 14 patients (12%) out of the Amac: Bu calismada, tedavisiz izlenen kronik hepatit C (KHC) hastalarinin, tedavisiz kalma nedenlerinin ortaya konmasi ve ileriye donuk cozum onerilerinin olusturulmasi

Summary Objective To review retrospectively the clinical symptoms, laboratory findings and treatment outcomes of patients with Brucellar epididymo-orchitis. Material and method Retrospective data of 28 patients with Brucellar epididymo-orchitis who admitted to four medical centers between 2005 and 2013 were retrospectively reviewed. Positive blood culture, positive Rose Bengal test results or high agglutination titres of ≥1/160 with the positive clinical and ultrasonographic findings of orchitis were accepted as the main criteria for Brucellar epididymo-orchitis. Results The mean patient age was 31 ± 16.9 years. Testicular involvement was on the left side in 16 patients and on the right side in 11 patients, one had bilateral disease. Testicular pain and swelling were the most common symptoms and elevation of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leucocytosis were the most common laboratory findings. Initial treatment was orchidectomy in six patients due to malignancy suspicion. All but three patients were successfully treated with antibiotic combinations of rifampicin, doxycycline and streptomycin. Two of three treatment resistant patients underwent orchidectomy. Conclusion Brucellosis is a common cause of epididymo-orchitis in endemic regions. Early diagnosis and treatment is crucial in the management and thus it must be kept in mind in endemic and non-endemic regions.

Introduction: Although the benefits of noninvasive positivepressure ventilation (NPPV) in the presence of acute exacerbations of chronic obstructive pulmonary diseases and pulmonary edema of cardiac origin have been determined clearly, the role of NPPV is still controversial in acute respiratory distress syndrome (ARDS). However, recent studies have shown an increased rate of success. Case Report: A 38-year-old female patient with ARDS due to serious community-acquired pneumonia, which was probably caused by a viral infection, was hospitalized in the intensive care unit. The patient was treated successfully with NPPV, a less invasive technique, in spite of her need for invasive mechanical ventilation (IMV). Conclusion: NPPV accompanying appropriate antibiotics can be used as an alternative method for the treatment of ARDS in intensive care units for patients with normal muscle strength and are conscious to avoid the side effects of IMV.

We evaluated the association between the mean platelet volume (MPV) and monocyte/lymphocyte ratio (MLR) with brucella-caused epididymo-orchitis to determine if they could be used to differentiate between brucella and non-brucella epididymo-orchitis. The charts of 88 patients with non-brucella and 14 patients with brucella epididymo-orchitis were retrospectively reviewed. Brucellosis was diagnosed by isolating Brucella spp from a blood culture or from a serum agglutination titer ≥ 1:160 along with accompanying clinical findings. The patients with brucella epididymo-orchitis were significantly more likely to have a lower MPV and a higher MLR than those with non-brucella epididymo-orchitis. Using a MPV cut-off level of less than 9.25 fl to differentiate brucella from non-brucella epididymo-orchitis gives a sensitivity of 78.6%, a specifity of 78.4%, a positive predictive value of 36.7% and a negative predictive value of 95.8%. Using a MLR cut-off level of greater than 0.265 to differentiate brucella from non-brucella epididymo-orchitis gives a sensitivity of 71.4%, a specifity of 65.9%, a positive predictive value of 25% and a negative predictive value of 93.5.%. MPV and MLR values may assist in differentiating between brucella and non-brucella epididymo-orchitis.

Background: Urinary tract infection (UTI) is a common problem in infants and children, as well as adults. Objectives: The aim of this study was to assess the most common bacterial uropathogens, their susceptibility, and resistance to antibiotics in children with UTI. Materials and Methods: This study included 7,365 urine samples sent from various departments to the Kars state hospital microbiology laboratory between January 2012 and May 2014. Bacterial isolation from clinical samples was made using standard microbiological methods. Antibiotic susceptibilities were determined by disk diffusion, according to CLSI recommendations. Results: Bacterial growth was obtained in 1,373 samples (18.5%). The percentage distributions of the isolates were as follows: Escherichia coli, 940 (68.5%); Proteus spp, 183 (13.3%); Staphylococcus spp, 85 (6.2%); Enterococcus spp, 65 (4.7%); Klebsiella, 62 (4.5%); Pseudomonas aeruginosa, 21 (1.5%); and other Gram-negative bacteria and Gram-positive bacteria, 17 (1.2%). UTIs were more prevalent, after two years of age, among females than males (P < 0.001). Conclusions: The identification of the most common microorganisms causing infectious diseases and regional resistance patterns is important in order to determine the antimicrobial policies and infection control guidelines of hospitals.

We hypothesize that apigenin may inhibit some cellular process of sepsis-induced spleen injury and simultaneously improve inflammation and oxidative stress. Therefore, the aim of this study was to investigate the potential protective effects of apigenin in a polymicrobial sepsis rat model of by cecal ligation and puncture.64 female Wistar albino rats were divided into 8 groups. The pro-inflammatory (tumor necrosis factor-alpha, interleukin-6, and interleukin-1-beta) and anti-inflammatory (tumor growth factor-beta and interleukin-10) cytokine levels were measured by enzyme-linked immunosorbent assay. CD3, CD68, and nuclear factor kappa B (NF-κB) positivity rates were detected by immunohistochemical methods. Oxidative stress parameters were measured by tissue biochemistry.Sepsis caused a significant increase in TNF-alpha, IL-1-beta, IL-6, and TGF-beta levels whereas it reduced IL-10 level. Additionally, it led to an increase in CD3, CD68, and NF-κB positivity rates as well as oxidative stress parameters levels. However, apigenin inhibited the inflammation process, increased the IL-10 level and normalized the oxidative stress parameters.Pretreatment with apigenin results in a significant reduction in the amount of inflammatory cells. The beneficial effect of apigenin on spleen injury also involved inhibition of NF-κB pathway, suppression of proinflammatory cytokines, and induction of anti-inflammatory cytokine production. Additionally, it led to a decrease in oxidative stress in spleen tissue. Taking everything into account, apigenin may be an alternative therapeutic option for prevention of sepsis-induced organ.

WOS: 000386954300001, PubMed: 27809934, Background: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. Methods: This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. Results: Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. Conclusions: The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.

EASL International Liver Congress -- APR 13-17, 2016 -- -- Barcelona, SPAIN, WOS: 000398711700582, …, EASL

This study aimed to find markers to predict complicated cases in brucellosis. Patients with and without complications were compared in terms of epidemiological, clinical and laboratory properties.A total of 700 patients hospitalised at the Department of Infectious Diseases and Clinical Microbiology were evaluated retrospectively.Of a total of 700 patients, 383 (54.7%) were male and mean age was 41.5 ± 17.0 years. Of the patients, 517 (73.8%) were classified as acute cases. Complications occurred significantly less frequently in acute infections (p0.001). Increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) occurred more frequently in patients with complicated cases (p = 0.005 and 0.021, respectively), whereas malaise, myalgia and blood culture positivity occurred significantly less frequently in those cases (p0.001,0.001 and 0.014, respectively). Fever at examination, loss of malaise and myalgia and blood culture negativity were statistically significant predictive factors for complicated patients in multivariate analysis (p0.001, for each). As compared to patients without orchitis, leukocytosis occurred more often in cases with orchitis (p0.001); leukopenia occurred more often in neurobrucellosis than in cases without neurobrucellosis (p = 0.008). Of patients who attended control regularly, 422 (98%) were treated successfully. All of the nine patients who did not recover fully were cases with osteoarticular involvement.Fever was the most significant predictive marker of complications. Other classical symptoms of brucellosis like myalgia and malaise were absent in most of the complicated cases. Blood culture was of limited value in the diagnosis of complicated cases most of the time.

Summary Background Pneumocephalus and pneumorrhachis are rare complications of neurosurgery. When a closed system such as the head and spinal area get injuried, it becomes open and the air can come in through that opening. In this case, we present a case of pneumocephalus and pneumorrhachis after spinal fusion surgery. Case Report Herein we present a case of diagnosis and treatment of pneumocephalus and pneumorrhachis after spinal fusion surgery. Conclusions Our patient developed postoperative pneumocephalus and pneumorrhachis as a late complication secondary to an infection. We wanted it to be considered as an important problem.

WOS: 000329981700003, PubMed ID: 24211227, Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.

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