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Introduction:This study aimed to investigate the prevalence of Coronavirus disease-2019 (COVID-19) infection among healthcare workers in our hospital with the risk factors affecting the transmission and course of the disease and to determine the control measures.Methods:Medical records of healthcare workers diagnosed with COVID-19, confirmed by polymerase chain reaction (PCR) between 11 March and 30 April 2020, were retrospectively analyzed in our hospital in the center of İstanbul, the city with the highest number of cases in our country. Realtime PCR detection was used to verify the diagnosis of the healthcare workers. A rapid diagnostic test kit for COVID-19 immunoglobulin M (IgM) and IgG antibodies was used in seroconversion analysis.Results:In our hospital, 4,177 COVID-19 cases confirmed by the laboratory between March 11 and April 30 2020 were followed. Of the 4177 cases, 165 (3.95%) were healthcare workers. The majority of healthcare workers with positive test results were nurses (36.3%), and 118 (71.5%) of the healthcare workers worked 40 h or more per week. Thoracic tomography examinations were performed in all infected healthcare workers, and 69 (41.8%) were diagnosed with pneumonia by the detection of ground patchy lesions.Conclusion:During the epidemic, early training of healthcare workers on the disease, use of personal protective equipment, and infection control are extremely important to reduce the risk of infection among healthcare workers. Periodic screening of asymptomatic healthcare workers can also help protect patients and hospital staff and prevent loss of workforce.

OBJECTIVE: It was aimed to investigate the effects of the COVID-19 pandemic on the professional activities and lives of nurses, as well as their compliance with infection control measures during their health care services. MATERIALS AND METHODS: This descriptive, cross-sectional survey study was conducted between August 1st and September 1st, 2022 on the nurses who worked during the COVID-19 pandemic at Prof. Dr. Murat Dilmener Emergency Hospital, Istanbul, Turkey. RESULTS: Of the 200 nurses whose questionnaires were evaluated in the study, 147 (73%) were female, 53 (26.5%) were male, and 133 (66%) were clinical nurses. Of these, 152 (76%) had recovered from COVID-19, and 86 (56%) of them had experienced moderate symptoms, although almost all of them fully used personal protective equipment during the COVID-19 pandemic process and 190 (95%) of them had COVID-19 vaccines. The uncertainty of the pandemic process, the presence of a large number of care patients, and the respiratory distress of patients were recorded as the most distressing issues. CONCLUSION: Nurses have been most affected by the uncertainty of the pandemic. It was observed that compliance with infection controls increased in those who recovered from COVID-19 and did not want to be infected again. Nurses who were afraid of death due to COVID-19 needed more psychological support in proportion to the severity of their symptoms. The high rates of COVID-19 among nurses suggest that the virus is highly contagious and will continue to pose a danger with its pathogenic features and emerging new variants.

Resumo Fundamento A nova doença por coronavírus (COVID-19) pode levar a uma enfermidade grave e causar a morte. Sabe-se que a COVID-19 afeta o sistema cardiovascular. A detecção precoce da progressão para um estágio grave da doença que afeta o sistema cardiovascular pode desempenhar um papel crítico no tratamento da COVID-19. Objetivos Explorar a possível relação entre a pneumonia por COVID-19 e os achados de strain do ventrículo direito no eletrocardiograma (ECG). Métodos Foi realizado um estudo retrospectivo de 141 pacientes hospitalizados com COVID-19. A correlação de Spearman e as análises de regressão logística foram aplicadas para avaliar as relações entre as manifestações de strain ventricular direito na ECG e os níveis de biomarcadores e outros achados laboratoriais e de imagem do tórax. O nível de significância foi considerado estabelecido como p < 0,05. Resultados Os sinais de ECG de estresse ventricular direito foram significativamente mais frequentes e os níveis de fibrinogênio, PCR e ferritina foram significativamente mais elevados em pacientes com COVID-19 com níveis elevados de hs-cTnI, procalcitonina e dímero-D. A análise univariada mostrou que existem relações significativas entre a presença de pneumonia bilateral, a maioria dos sinais eletrocardiográficos de strain ventricular direito e lesão cardíaca e biomarcadores inflamatórios e trombóticos. A análise multivariada revelou que o supradesnivelamento do segmento ST em V1 e padrão S1Q3T3 são preditores independentes de lesão cardíaca ( odds ratio =0,23; IC95%, 0,06 a 0,90; p=0,035) e níveis elevados de procalcitonina ( odds ratio =0,19; IC 95%, 0,06 a 0,62; p=0,006), respectivamente. Conclusão Os achados do presente estudo sugerem que a dano cardíaco direito é prevalente na COVID-19. Além disso, nosso estudo demonstra o valor clínico do ECG na avaliação e monitoramento de pacientes com pneumonia por COVID-19.

Objective: Taking precations to prevent contamination and developing prevention programs play a key role in the outbreak For this purpose, the use of personal protective equipment (PPE) of healthcare workers (HCWs) and their compliance with hand hygiene were investigated in the current Coronavirus disease-19 (COVID-19) outbreak Methods: In study, 117 HCW, who were diagnosed with COVID-19 between 11 March and 18 May 2020, and 117 HCW, who did not meet the case definition, 234 HCW were included in the study, A survey consisting of 28 questions was applied to obtain the research data The survey consisted of multiple choice questions and was prepared by the researchers using the knowledge of the literature Results: It was determined that 65 8% of the participants were women, 41 9% were nurses, 82 1% did not have additional diseases and 62 8% did not smoke Positivity was significantly higher in young patients aged 20-30 (p=0 05) In the use of PPE, the use of gloves as "always recommended" was found higher in infected HCW with 77 8% (p=0 012) The use of overalls/ gowns was found to be statistically significantly lower in infected healthcare workers (p=0 01) In terms of the hand hygiene application variable after touching the patient between the groups, compliance was found to be low in healthcare workers diagnosed with COVID-19 (p=0 005) Conclusion: It was observed that the risks of healthcare workers getting COVID-19 decreased significantly if the infection control measures were followed It is thought that it would be beneficial to investigate new methods to ensure that protective measures are fully implemented by HCW (English) [ABSTRACT FROM AUTHOR] Amac: Salgin surecinde saglik calisanlarinda (SC) bulasmayi onlemek acisindan onlemlerin alinmasi ve onleme programlarinin gelistirilmesi anahtar role sahiptir Bu amacla, halen yasanmakta olan Koronavirus hastaligi-19 (COVID-19) salgininda, SC'nin kisisel koruyucu ekipmanlari (KKE) kullanimi ve el hijyenine uyumu arastirilmistir Yontemler: Calismamizda 11 Mart-18 Mayis 2020 tarihleri arasinda laboratuvar tarafindan dogrulanmis COVID-19 tanisi alan 117 saglik calisani ile olasi olgu tanimini karsilamayan 117 saglik calisani olmak uzere 234 saglik calisani calismaya dahil edildi Arastirma verilerini elde etmek icin 28 sorudan olusan anket uygulanmistir Anket, coktan secmeli sorulardan olusmus ve arastirmacilar tarafindan literatur bilgisinden yararlanilarak hazirlanmistir Bulgular: Katilimcilarin %65,8'inin kadin, %41,9'unun hemsire oldugu, %82,1'inin ek hastaliginin olmadigi, %62,8'inin sigara kullanmadigi saptanmistir Yirmi-30 yas arasi genc hastalarda pozitiflik anlamli oranda yuksek saptanmistir (p=0,05) KKE "her zaman onerildigi gibi" seklinde eldiven kullanimi %77,8 ile enfekte SC'lerde daha yuksek bulunmustur (p=0,012) Ozellikle tulum/onluk kullanimi enfekte SC'lerinde istatistiksel acidan anlamli olarak dusuk saptanmistir (p=0,01) Gruplar arasinda hastaya dokunduktan sonra el hijyeni uygulama degiskeni acisindan COVID-19 tanili SC'lerinde uyumun dusuk oldugu saptanmistir (p=0,005) Sonuc: Enfeksiyon kontrol onlemlerine uyuldugu takdirde SC'lerin COVID-19'a yakalanma risklerinin anlamli olarak dustugu gozlenmistir Buna ragmen, COVID-19 pandemisi surecinde, SC'lerin KKE kullanimindaki eksikliklerini gormek, KKE protokollerini iyilestirmek ve egitimlerini yenilikci yontemler kullanarak gelistirmek icin detayli arastirmalara ihtiyac vardir (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Bezmialem Science is the property of Galenos Yayinevi Tic LTD STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Background Coronavirus disease 2019 (COVID-19) has quickly turned into a global pandemic with close to 5 million cases and more than 320,000 deaths. Cancer patients constitute a group that is expected to be at risk and poor prognosis in COVID pandemic. We aimed to investigate how cancer patients are affected by COVID-19 infection, its clinical course and the factors affecting mortality. Methods In our single-center retrospective study, we included cancer patients with laboratory confirmed COVID-19 in our hospital. Demographic, clinical, treatment, and laboratory data were obtained from electronic medical records. Logistic regression methods were used to investigate risk factors associated with in-hospital death. Results In the hospital, 4489 patients were hospitalized with COVID infection and 77 were cancer patients. The mean age of cancer patients was 61.9 ± 10.9 and 44 of them were male (62%). While the mortality rate in non-cancer patients was 1.51% (n = 68), this rate was significantly higher in cancer patients, 23.9% (n = 17). The stage of the disease, receiving chemotherapy in the last 30 days also lymphopenia, elevated troponin I, d-dimer, CRP, and CT findings were associated with severe disease and mortality. Severe lung involvement (OR = 22.9, p = 0.01) and lymphopenia (OR = 0.99, p = 0.04) are the most important factors influencing survival in logistic regression. Conclusions The disease is more severe in cancer patients and mortality is significantly higher than non-cancer patients. These data show that it may be beneficial to develop dynamic prevention, early diagnosis and treatment strategies for this vulnerable group of patients who are affected by the infection so much.

The gold standard for routine microbiological diagnosis of coronavirus disease 2019 (COVID-19) is quantitation of viral RNA in respiratory specimens by reverse-transcription polymerase chain reaction (RT-PCR). Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific IgM and IgG antibodies in patient sera are additional diagnostic tests. It has been known that virus release begins a few days before clinical signs appear, and therefore, beginning from 2-3 days before the manifestation of clinical symptoms, virus RNA can be detected in the respiratory tract during the symptomatic period of the disease. Since the viral load is higher in lower respiratory tract samples such as bronchoalveolar lavage and tracheal aspirate, PCR positivity rate might be found higher compared to nasopharyngeal samples. Confirmatory PCR tests require specific equipment and trained personnel, and they are also time-consuming and costly. Antibody assays are simple, faster tests, do not require much equipment and applicable in any laboratory. They can even be performed with 2-3 drops of blood collected from the finger tip of patients using relatively inexpensive chromatographic-rapid tests. These tests can be used in the later period of the disease since specific antibodies appear on the 7-10th day of clinical signs in patients with COVID-19. Rapid antibody card tests have an average specificity and sensitivity, while antibody tests using microELISA have higher sensitivity and specificity., Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) için rutin mikrobiyolojik tanıda altın standart, solunum yolu örneklerinde viral RNA’nın gerçek zamanlı revers-transkriptaz polimeraz zincir reaksiyonu (RT-PCR) ile gösterilmesidir. Hasta serumunda şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)’ye spesifik olan IgG ve IgM antikorların gösterilmesi de ek tanısal testlerdir. Virüs atılımının klinik bulgulardan birkaç gün öncesinden başladığı ve bu yüzden semptomların başlamasından 2-3 gün öncesinden itibaren klinik dönem boyunca virus RNA’sının solunum yollarında tespit edilebileceği bilinmektedir. Bronkoalveolar lavaj ve trakeal aspirat gibi alt solunum yolu örneklerinde viral yük daha fazla olduğundan PCR pozitiflik oranı nazofaringeal örneklere kıyasla daha yüksektir. Zaman alıcı ve pahalı olan doğrulayıcı PCR testleri, özel ekipman ve deneyimli personel gerektirir. Antikor testleri ise basit, hızlı sonuç verebilen, ciddi ekipman gerektirmeyen ve hemen her laboratuvarda yapılabilen testlerdir. Nispeten ucuz olan kramotografik hızlı kart testlerle parmak ucundan alınan 2-3 damla kanla, hasta başında bile yapılabilir. COVID-19 geçiren kişilerde hastalığın 7-10. gününden itibaren oluşan antikorlar sebebiyle, bu testler daha geç bir zamanda kullanılabilir. Hızlı antikor kart testleri ortalama bir özgüllük ve duyarlılığa sahipken, mikroELISA ile çalışılan antikor testlerinin duyarlılık ve spesivitesi ise daha yüksektir.

Autosomal recessive IRF7 deficiency was previously reported in three patients with single critical influenza or COVID-19 pneumonia episodes. The patients' fibroblasts and plasmacytoid dendritic cells produced no detectable type I and III IFNs, except IFN-β. Having discovered four new patients, we describe the genetic, immunological, and clinical features of seven IRF7-deficient patients from six families and five ancestries. Five were homozygous and two were compound heterozygous for IRF7 variants. Patients typically had one episode of pulmonary viral disease. Age at onset was surprisingly broad, from 6 mo to 50 yr (mean age 29 yr). The respiratory viruses implicated included SARS-CoV-2, influenza virus, respiratory syncytial virus, and adenovirus. Serological analyses indicated previous infections with many common viruses. Cellular analyses revealed strong antiviral immunity and expanded populations of influenza- and SARS-CoV-2-specific memory CD4+ and CD8+ T cells. IRF7-deficient individuals are prone to viral infections of the respiratory tract but are otherwise healthy, potentially due to residual IFN-β and compensatory adaptive immunity. ispartof: JOURNAL OF EXPERIMENTAL MEDICINE vol:219 issue:7 ispartof: location:United States status: published

Background The aim of this study was to demonstrate the presence of the virus in tear and conjunctival secretions of clinically-confirmed COVID-19 pneumonia patients. Methods This prospective study was conducted at Bakirkoy Dr. Sadi Konuk Training and Research Hospital (2020/190). Nasopharyngeal and ocular samples were obtained by swab technique and investigated by RT-PCR. Results A total of 83 patients were included. The mean age was 61.88 ± 16.04 years. 28.92% of the patients had mild, 65.06% moderate and 6.02% severe pneumonia radiologically. RT-PCR was positive in 31 (37.35%) patients in the first nasopharyngeal swabs and in 19 (22.89%) in the second swabs. 17 of 19 patients had positive both first and second nasopharyngeal swabs; only the second swabs of two patients were positive. The first conjunctival swabs RT-PCR were positive in 5 out of 83 clinically-confirmed patients or 33 laboratory-confirmed patients (rates: 6.02% and 15.15%). There were no positives detected in the second conjunctival swabs. Conclusions SARS-CoV-2 can be detected in the conjunctival swabs of patients with COVID-19 pneumonia.

Introduction We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance. Methodology This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy. Results None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80–3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group. Conclusions PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.

Aim:We aimed to evaluate the effects of the application of the electronic blood tracking system and transfusion nursing on the transfusion process.Methods:Blood transfusion tracking forms were included in the hospital information Management System (HIMS) in July 2015 and the users were able to electronically record all data, including order, approval, transfusion tracking, and destruction and reaction notification. The transfusion nurse in the blood center followed the processes and gave feedback. Nurses were periodically trained on transfusion, unintended events and reaction reporting. The effects of this application were evaluated based on 36 months of pooled data.Results:With the electronic registration application, the location of the blood products could be tracked via the HIMS. During this 36-month period, 401 in-house and in-clinic trainings were conducted in our hospital; there was a statistically significant increase in the feedback rates in 2016 (p=0.006), and this increase continued in 2017 (p=0.049); the increase in the first period was more prominent (p=0.010). It was observed that the number of inappropriate cases decreased. There was a decrease blood product transfer time in 2017 compared to 2016 (p=0.036).Results:Electronic recording of all transfusion processes in hospitals, in which a large number of blood transfusions are performed, can increase the safety of transfusion and transfusion feedback.

Objective: To investigate whether tacrolimus (Tac), mycophenolate mofetil (MMF), mycophenolic acid (MPA), prednisolone (Pred) and methylprednisolone (MP) are affect the COVID-19 pathogenesis and on its progression in kidney transplantation recipients diagnosed with COVID-19 patients. Materials and Methods: Among patients hospitalized due to COVID-19, patients who had kidney transplantation were retrospectively detected on the online database of our center. Referral complaints, laboratory and radiological data at referral, applied treatment protocols, and ultimate conditions of the patients were documented. Results: Among the total of 11 patients, 73% (8) were male and 27% (3) were female. The mean age was 49.63 (27-71). Hypertension and diabetes mellitus were the most common comorbid diseases. The most common symptoms were coughing, fever and exhaustion-fatigue. High serum reactive protein and lymphopenia were detected in almost all patients. Acute renal failure was observed in seven patients (73%). While all patients were using Tac and Pred, nine patients (82%) were using MMF and two patients (18%) were using MPA. Hydroxychloroquine, favipiravir, and azithromycin were treatments for COVID-19. RT-PCR results of 11 patients were positive in 7 and negative in 4 patients. The mean hospital stay of the discharged patients was 8.8 days. Eight patients recovered and were discharged, treatment of two intubated patients continues in intensive care unit and one patient died. Conclusion: Clinical characteristics of COVID-19 in kidney transplanted patients are similar to the general population and it should be kept in mind that the disease occurs with moderate-severe pneumonia in this patient group. Disease progress can be stopped through early treatment.

The COVID-19 pandemic caused by SARS-CoV-2 commenced in Wuhan China in 2019 and soon spread worldwide. SARS-CoV-2 enters the cell by binding to the ACE II receptor and begins viral replication. The effects and clinical findings of SARS-CoV-2 on the liver, kidney, heart, gastrointestinal (GI) system and especially lungs have been widely discussed. However, the effects on the pancreas-another organ that also expresses ACE II-have not been studied.This work prospectively evaluated data from 316 patients who were admitted with a diagnosis of COVID-19 pneumonia. The patients were categorized into three according to the severity of pneumonia (mild, severe, critical). Demographic data, rate of pancreatitis, biochemical parameters, and radiological images from each group were analyzed. The patients were divided into two groups and outcomes were compared: COVID-19 patients with acute pancreatitis (Group P) and without acute pancreatitis (Group C).The median age was 54 (18-87), and the median age for patients with acute pancreatitis was 55 (26-84). As an expected finding, we found a positive correlation between advanced age and mortality (Acute pancreatitis alone is a clinical condition that can lead to mortality and may be one of the reasons for the exaggerated immune response developing in the progression of COVID-19. Our results point out that the presence of pancreatic damage triggered by SARS-CoV-2 can deteriorate the clinical condition of patients and the mortality rate may increase in these patients.

Objectives: We aimed to study the effect of seasonal influenza (flu) vaccination on the susceptibility to coronavirus disease 2019 (COVID-19). Methods: A total of 203 healthcare workers of a pandemic centre of Istanbul, Turkey, were included in this retrospective study. According to the presence or absence of flu vaccination, participants were divided into group 1 and group 2. A comparison of the rate of COVID-19 was done between these two groups. Also, the mean age and the sex ratio of females/males were evaluated and compared between these two groups. Results: Group 1 participants (n = 65) were older than participants in group 2 (n = 138) (p < 0.05). Despite of this, interestingly, the COVID-19 infection rate was lower in the 1st group (in comparison to the 2nd group) (p < 0.05). Conclusion: Our study results showed that, even if low, the flu vaccination may have a protective effect on the susceptibility to COVID-19 infection. Using this beneficial adjuvant effect of the vaccine may help us in this unpredictable battle with the COVID-19 pandemic. Further studies are needed to confirm this assumption.

BackgroundTuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The“Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown.MethodsA multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively.ResultsA total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P P P ConclusionBoth criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.

Aim To observe the clinical course of symptomatic pregnant women diagnosed with or suspected of having COVID‐19. Methods This study analyzed the clinical and laboratory results of 27 patients with real‐time polymerase chain reaction (RT‐PCR)‐confirmed COVID‐19 and 25 patients with a suspected COVID‐19 diagnosis based on their symptoms and chest computed tomography (CT) findings. The patients' coagulation parameters and acute‐phase reactants were evaluated both before and after treatment. The maternal and neonatal outcomes were also reviewed. Results The mean duration of hospitalization was 6.1 ± 3 days. The gestational age of the patients ranged from 6w2d to 40w2d. Thirty‐five patients' CT scan findings suggested viral pneumonia. Four patients delivered vaginally, and 10 patients underwent a cesarean section during the study period. Four of the cesarean deliveries were indicated due to COVID‐19 hypoxemia‐related fetal distress. Four patients were admitted to the intensive care unit (ICU) after the cesarean section. Conclusion Early hospitalization and medical treatment can alleviate symptoms, improve the clinical course and reduce the need for ICU in symptomatic pregnant patients with suspected or confirmed COVID‐19. Chest CT scans are a suitable option for suspected but unconfirmed COVID‐19 infection.

Background: Syphilis is a global health issue, which continues to occur at high rates worldwide, particularly in HIV-infected men, who have sex with men (MSM). Hepatitis can present as an uncommon manifestation of syphilis, and the diagnosis may be overlooked in favor of more common causes of liver injury in this group. Objectives: This study aimed to determine the prevalence and risk factors of syphilitic hepatitis among HIV-infected individuals diagnosed with acute syphilis. Methods: This cross-sectional study was conducted on HIV-infected individuals who regularly attended a tertiary clinic in Istanbul. The data were collected and analyzed between 2016 and 2019. Cases of syphilitic hepatitis were included according to the following criteria: (I) VDRL-confirmed Treponema pallidum infection after or simultaneously diagnosed with HIV infection; (II) elevated liver enzymes, including ALT, AST, and ALP, that resolved after penicillin treatment; and (III) exclusion of other causes of hepatitis. Sociodemographic characteristics of the participants, clinical and laboratory findings were evaluated using medical records. Results: Among 1,057 HIV-infected patients, 141 (13.3%) were diagnosed to have an early stage of syphilis, 138 of them were male. Nine (6.4 %) out of 141 patients had syphilitic hepatitis, and all of them were self-identified MSM. Moreover, 5 out of these 9 patients were simultaneously diagnosed with syphilis and HIV infection. Up to 10-fold increase in ALT/AST was noted in all of them, and a 3.5-fold increase in bilirubin was observed in two cases. The most prominent laboratory abnormalities in syphilitic hepatitis patients were the detection of a considerable increase in ALP and HIV RNA levels. Conclusions: Syphilitic hepatitis is not encountered rarely in HIV-infected individuals, predominantly MSM populations. Since HIV/syphilis coinfected patients are more infective as a result of higher HIV RNA levels, early diagnosis, and treatment are crucial.

Fever is one of the critical symptoms of collagen vascular diseases, malignancies, and infectious diseases. Patients with a fever of unknown origin (FUO) were evaluated to determine the etiology.In this study, 110 cases with FUO who were admitted to two hospitals with a total of 800 beds, in which 5000 daily outpatient patients were admitted between 2006 and 2016 have been evaluated retrospectively. Anamnesis and the findings were obtained from hospital records. Patients with a temperature higher than 38.3°C and lasting three weeks or longer without diagnosis despite one week of investigation in the hospital were included as FUO cases in this study. Nosocomial and neutropenic cases were excluded from the present study.Fifty-seven patients were male (52%), and the mean age was 40.2 ± 17.2. The distribution of the classic and HIV-associated cases was 85 (77.3%) and 18 (16.4%). Tuberculosis (TB) was the most frequent disease in both groups. The etiology was infectious in 68.2%, autoimmune in 14.5%, and neoplastic in 5.4%. There was no case of collagen vascular disease in the HIV-associated FUO group.As a result of our study, infectious diseases and TB were still the leading factors that caused FUO. TB has been notably found higher in the HIV-associated group than the classic group. FUO is usually either a rare cause or an unusual clinical presentation of a well-known infectious disease in Turkey. Therefore, it should be noted that various manifestations of extra-pulmonary tuberculosis may be considered a FUO case.

Objective To identify the taste and smell impairment in coronavirus disease 2019 (COVID-19)–positive subjects and compare the findings with COVID-19–negative subjects using the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Anosmia Reporting Tool. Setting Tertiary referral center/COVID-19 pandemic hospital. Study Design Comparative study. Subjects and Methods After power analysis, 128 subjects were divided into 2 groups according to real-time polymerase chain reaction (RT-PCR) COVID-19 testing results. Subjects were called via telephone, and the AAO-HNS Anosmia Reporting Tool was used to collect responses. Results The mean age of the study group was 38.63 ± 10.08 years. At the time of sampling, rhinorrhea was significantly high in the COVID-19–negative group, whereas those complaints described as “other” were significantly high in the COVID-19–positive group. There was a significant difference in the smell/taste impairment rates of the groups (n = 46% [71.9%] for the COVID-19–positive group vs n = 17 [26.6%] for the COVID-19–negative group, P = .001). For subjects with a smell impairment, anosmia rates did not differ between the groups. The rates of hyposmia and parosmia were significantly high in the COVID-19–positive group. For the subjects with taste impairment, ageusia rates did not differ between groups. The rate of hypogeusia and dysgeusia was significantly high in the COVID-19–positive group. Logistic regression analysis indicates that smell/taste impairment in COVID-19–positive subjects increases the odds ratio by 6.956 (95% CI, 3.16-15.29) times. Conclusion COVID-19–positive subjects are strongly associated with smell/taste impairment.

In people living with human immunodeficiency virus (HIV), several complaints related to the gastrointestinal system, mainly diarrhea can be determined. In our study, we aimed to detect the existence of intestinal parasites with conventional methods based on microscopy and with molecular methods based on multiplex-PCR among 90 anti-retroviral treatment (ART) naive or ART adherent HIV/AIDS cases. The existence of Giardia spp., Blastocystis spp., Entamoeba histolytica, Dientamoeba spp. and Cryptosporidium spp. were searched in stool samples and the relation with the existence of these parasites and demographic/clinical data of the cases were determined. The demographic and clinical data of the participants included in the study were as follows; the average age was 34.02 ± 9.7 years, average time of diagnosis was 2.4 ± 1.7 years. Gender distribution was as follows; 85.6% male and 14.4% female. HIV transmission was related with heterosexual intercourse in 60%, homosexual intercourse in 33.3%, blood/blood products contact in 1.1% and with unknown routes in 5.6% of the cases. Fifty percent of the patients were in pre-ART and 50% was in on-ART state. The average CD4+ T lymphocyte count was detected as 400 cells/mm3 and the median of viral load was 114.527 copies/ml. An overall prevalence of at least one intestinal parasitic infection was recorded as 36.7% and the prevalence of this infection due to Blastocystis spp. was 22.2%, followed by Dientamoeba spp. (13.3%), E.histolytica (4.4%), Cryptosporidium spp. (3.3%), Giardia spp. (2.2%) and multiple parasitic infections (7.7%). The type of sexual behaviours related with the detection of intestinal parasites were statistically significant especially in homosexual intercourse (p< 0.001). The increase in CD4+ T lymphocyte counts were reversely associated (p= 0.062) and the increase in the levels of viral load were positively associated (p< 0.001) with detection rate of intestinal parasite. The detection of parasites by molecular methods was statistically significant in pre-ART participants (p= 0.002) and participants with diarrhea (p= 0.019). In the present study, the increase in the frequency of intestinal parasitic infections has shown that essential interventions are required. In all HIV/AIDS cases, routine parasitic screening should be performed by more sensitive methods to manage early and specific treatment.

Background To determine and compare nasopharyngeal microbiota (NM) composition, in vitro basal (Nil tube), provoked (Mitogen tube) production of cytokines at the early stage of COVID-19. Methods This cross-sectional study included 4 age and sex-matched study groups; group 1 (recovered COVID-19) (n = 26), group 2 (mild COVID-19) (n = 24), group 3 (severe COVID-19) (n = 25), and group 4 (healthy controls) (n = 25). The study parameters obtained from the COVID-19 (group 2, and 3) at the early phase of hospital admission. Results The results from the reaserch deoicted that the Mean ± SD age was 53.09 ± 14.51 years. Some of the in vitro cytokines production was significantly different between the study groups. Some of the findinggs on cytokines depicted a significant differences between study groups were interleukin (IL)-1β Nil, IL-1β Mitogen, and their subtraction (i.e Mitogen-Nil). Regarding IL-10, and IL-17a levels, Mitogen, and Mitogen-Nil tube production levels were significantly different between the groups. Surprisingly, most of these measures were lowest in the severe COVID-19 patients’ group. Using discriminant analysis effect size (LEfSe), Taxa of NM with significant abundance was determined. About 20 taxa with an LDA score > 4 were identified as candidate biomarkers. Some of these taxa showed a significant correlation with IL-1β and IL-10 Mitogen and Mitogen- Nil levels (R > 0.3 or Conclusions The findings of this perticular study regarting the early stage of COVID-19 showed that in vitro cytokines production, studies might be more useful than the ordinary cytokines' blood level measurement. Besides, the study identified some NM species that could be candidate biomarkers in managing this infection. However, further detailed studies are needed in these fields.

The conditions of working life are changing fast and continuously and workplace competition increases depending on economic, demographic and social changes. The interactions of the subject in the workplace become difficult and lead to newly occurring safety and health risks arise. Mobbing (psychological intimidation) is not currently discussed due to several reasons although it is a very common issue in working life. The definition of mobbing involves a process in which employee or the employer harasses the other person or persons by disturbing and immoral speech or behaviors systematically in a manner of psychological violence. Mobbing is a malevolent behavior model in order to create job unsatisfaction and leaving the workplace by unfair blame, implication, sarcasm, discrediting reputation by committing malicious gossip, humiliation, emotional exploitation and harassment. Mobbing is a workplace complication since establishment of the oldest working environment even though it is newly introduced concept in the literature. The intense and destructive effects of the psychological intimidation lead to emotional, physical and economic damages in the mobbing victims. Contrarily to the developed countries, both academic environment and either labor and occupational organizations are not interested in this issue efficiently. This review will evaluate mobbing in details such as history, causes, components, judicial characteristics and methods for prevention.

Aim: This study analyzed diabetic foot infections (DFI) in patients who were followed up in our clinic. Methods: We retrospectively evaluated demographic characteristics and clinical and laboratory findings in 27 patients (12 female, 15 male) with DFI who were followed up in our clinic between June 2013 and January 2014. The foot ulcerations in the patients were classified according to Wagner’s classification. Results: The mean age of the patients was 59 years. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and white blood cell levels were found to be high in 89%, 78% and only 22% of patients, respectively. 78% of patients had grade 2 and lower grade ulcerations. Growth of methicillin-resistant Staphylococcus aureus, Enterobacter cloacae and Enterococcus spp. was encountered in five (28%) of 18 patients in whom deep tissue culture test could be performed. Conclusion: Appropriate diagnosis and treatment planning can be achieved by guiding classifications performed by regarding clinical, neurological and vascular conditions as well as ulcer depth. In follow-up of cases, ESR and CRP tests are very useful in diagnosis and treatment of the complications such as osteomyelitis, which may lead to amputation. Treatment should be conducted with a multidisciplinary approach in tertiary healthcare facilities.

WOS: 000388827200008, PubMed ID: 27138335, Objective Neuroimaging abnormalities in central nervous system (CNS) brucellosis are not well documented. The purpose of this study was to evaluate the prevalence of imaging abnormalities in neurobrucellosis and to identify factors associated with leptomeningeal and basal enhancement, which frequently results in unfavorable outcomes. Methods Istanbul-3 study evaluated 263 adult patients with CNS brucellosis from 26 referral centers and reviewed their 242 magnetic resonance imaging (MRI) and 226 computerized tomography (CT) scans of the brain. Results A normal CT or MRI scan was seen in 143 of 263 patients (54.3 %). Abnormal imaging findings were grouped into the following four categories: (a) inflammatory findings: leptomeningeal involvements (44), basal meningeal enhancements (30), cranial nerve involvements (14), spinal nerve roots enhancement (8), brain abscesses (7), granulomas (6), and arachnoiditis (4). (b) White-matter involvement: white-matter involvement (32) with or without demyelinating lesions (7). (c) Vascular involvement: vascular involvement (42) mostly with chronic cerebral ischemic changes (37). (d) Hydrocephalus/cerebral edema: hydrocephalus (20) and brain edema (40). On multivariate logistic regression analysis duration of symptoms since the onset (OR 1.007; 95 % CI 1-28, p = 0.01), polyneuropathy and radiculopathy (OR 5.4; 95 % CI 1.002-1.013, p = 0.044), cerebrospinal fluid (CSF)/serum glucose rate (OR 0.001; 95 % CI 000-0.067, p = 0.001), and CSF protein (OR 2.5; 95 % CI 2.32.7, p = 0.0001) were associated with diffuse inflammation. Conclusions In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.

PubMedID: 25801665 SummaryBackground The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the differential diagnosis of TBM when these two systems suggest the presence of TBM. Method BME and TBM patients from 35 tertiary hospitals were included in this study. Overall 294 adult patients with BME and 190 patients with TBM were enrolled. All patients involved in the study had microbiological confirmation for either TBM or BME. Finally, the Thwaites and Lancet scoring systems were assessed in both groups. Results The Thwaites scoring system more frequently predicted BME cases (n = 292, 99.3%) compared to the TBM group (n = 182, 95.8%) (P = 0.017). According to the Lancet scoring system, the mean scores for BME and TBM were 9.43 ± 1.71 and 11.45 ± 3.01, respectively (P < 0.001). In addition, TBM cases were classified into "probable" category more significantly compared to BME cases, and BME cases were categorized into the "possible" category more frequently. Conclusions When the Thwaites or Lancet scoring systems indicate TBM, brucellar etiology should also be taken into consideration particularly in endemic countries. © 2015 Elsevier Ltd. All rights reserved.

INTRODUCTION[|]To evaluate the prevalence of Toxoplasma gondii, rubella and cytomegalovirus (CMV) among the pregnant Turkish women as well as Syrian refugees in Istanbul.[¤]METHODS[|]Among pregnant women who are admitted to \\\"xxxx\\\" Maternity and Children Hospital in İstanbul between January 2014 and January 2015, antibodies against Toxoplasma gondii, rubella and CMV were measured using the micro-elisa method. The test results were evaluated retrospectively.[¤]RESULTS[|]Out of total 1066 pregnant women screened in this study, 963 (90.3%) were Turkish, and 103 (9.7%) were Syrian refugees. IgM positivity rates of T. gondii rubella and CMV were determined as 0,2%, 0%, 0,2% in Turkish women and 0,1%, 0%, 0% in Syrian refugees, IgG positivity rates were determined as 26,3%, 93,8%, 99,5% in Turkish women and 58,3%, 87,4%, 100% in Syrian refugees. The seroprevalence of T. gondii was lower and the rubella seroprevalence was higher among pregnant Turkish women and among pregnant Syrian refugees and statistically significant ( p< 0.05).[¤]DISCUSSION AND CONCLUSION[|]Since immunity against T. gondii in pregnant Turkish women is lower than in Syrian refugees, who are in reproductive age group, should get routine screenings. Immunization against rubella should be considered for Syrian refugees who are in reproductive age group. [¤]