Malignancies in individuals living with HIV/AIDS

Background. The incidence of malignancy is heightened in individuals infected with Human Immunodeficiency Virus (HIV). Despite a decrease in the incidence of HIV infection resulting from antiretroviral therapy (ART), the prevalence of HIV-associated malignancies remains substantial. Objective. Our objective was to examine the types of cancer that initially manifest in individuals infected with HIV or emerge during their subsequent observation period. Material and method. The study conducted a retrospective analysis of demographic characteristics, malignancy types, presenting symptoms, mode of transmission, HIV-RNA levels, and CD4/CD8 ratios in individuals living with HIV who developed malignancies and were under follow-up at the Infectious Diseases Polyclinic between October 2018 and December 2022. Results. Out of the 465 patients who were monitored during the study, 27 individuals (5.8%) were diagnosed with various malignancies. Among these patients, 22 (81%) were men and 5 (19%) were women. The average age of the patients ranged from 45.87 to 9.12 years. Among the patients, 17 (63%) were married and 10 (17%) were single. In terms of education, 16 patients (59.3%) had completed primary school, 7 patients (25.9%) were university graduates, and 4 patients (14.8%) had completed high school. The mode of HIV transmission in all patients was through sexual intercourse. The reasons for testing varied, with 8 patients (29.7%) being tested due to fever, 6 patients (22.2%) before undergoing surgery, 3 patients (11.1%) due to weight loss, and 2 patients (7.4%) tested for reasons such as job application, diarrhea, pre-blood donation, lymphadenomegaly, and dysphagia. The most common types of malignancies observed in the patients were non-Hodgkin’s lymphoma (NHL) with 11 cases (40.7%), followed by Kaposi’s sarcoma (KS) with 5 cases (18.5%), and cervical carcinoma with 3 cases (11.1%). Conclusion. The incidence of cancer is higher among individuals with HIV. There is a need to enhance the awareness among both healthcare providers who specialize in HIV care and those who do not

Transrektal ultrasonografi kılavuzluğunda prostat biyopsisi yapılan hastalarda enfektif komplikasyonlar ve rektal floradaki siprofloksasine dirençli Escherichia coli kolonizasyonunun rolü

WOS: 000402553200019PubMed ID: 28717548Objective: In the present study, we aimed to invastigate the ciprofloxacin resistance in rectal flora of the patients undergoing prostate biopsy in our department. Additionally, the possible effects of the presence of ciprofloxacin resistant bacteria in faecal flora on the risk of infective complications after the procedure as well as the effect of antibiotic prophylaxis on such infectious complications have been evaluated. Material and methods: A total of 142 patients undergoing transrectal ultrasound-guided prostate biopsy were included into the study program. Rectal swab samples were taken from all patients prior to biopsy. The presence of complications have been evaluated after a week following the biopsy procedure. Patients with fever were also evaluated. The possible correlation between the presence of ciprofloxacin-resistant bacteria in faecal flora and the risk of urinary tract infection development and the other complications were evaluated. Results: E. coli bacteria were present in all cultures of rectal swab samples obtained from 142 patients prior to prostate biopsy. Of all these patients, while ciprofloxacin-resistant E. coli (CR E. coli) grew in 76 (53.5%) patients; ciprofloxacin susceptible E. coli (CS E. coli) was obtained in 66 (46.5%) patients. In 16 patients (11.3%), infectious complications were observed. While the infective complications were present in the 14.5% of patients with CR E. coli; they were present in the 7.6% of patients with CS E. coli (p=0.295). High fever was observed in nine patients (6.3%). Of these nine patients, although six had CR E. coli growth as detected during culture sensitivity tests; three had CS E. coli growth in their rectal swab culture tests. Sepsis was observed in three (2.1%) of these patients with high fever. Ciprofloxacin-resistant E. coli grew in all of the rectal swab cultures obtained from these patients with sepsis. Conclusion: In the light of our findings we may say that, it will be appropriate to reconsider the ciprofloxacin prophylaxis and prefer to use other prophylactic agents for a certain period of time in populations with higher rates of resistance to this medical agent. Furthermore, it will be appropriate again to obtain rectal swab specimens for culture tests before biopsy procedure in order to perform targeted prophylaxis according to the culture antibiogram test results. This approach will enable us to evaluate the cost-effectiveness of the procedure in detail.Bu çalışmada, kliniğimizde prostat biyopsisi uygulanan hastalarda rektal floradaki bakterilerin siprofloksasine direncini araştırdık. Aynı zamanda fekal florada siprofloksasine dirençli bakterilerin bulunmasının işlem sonrası gelişebilecek enfektif komplikasyon riskine olası etkisini ve bu açıdan profilaktik antibiyotik kullanımının söz konusu enfeksiyöz komplikasyonlar üzerine etkisini değerlendirmeyi amaçladık. Gereç ve yöntemler: Çalışmaya transrektal ultrasonografi kılavuzluğunda prostat biyopsisi yapılan toplam 142 hasta dahil edildi. Biyopsi öncesinde tüm hastalardan rektal sürüntü örneği alındı. Biyopsi yapıldıktan 1 hafta sonra tüm hastalar komplikasyonların varlığı açısından sorgulandı. Ateş yüksekliği olan hastalar ayrıca değerlendirmeye alındı. Fekal florada siprofloksasin dirençli bakteri taşıyıcılığının, prostat biyopsisi sonrası üriner sistem enfeksiyonu ve diğer komplikasyonların gelişimi ile olan ilişkisi değerlendirildi. Bulgular: Prostat biyopsisi yapılan 142 hastanın biyopsi öncesi yapılan rektal sürüntü örneklerinin tamamında E. coli üremesi oldu. Bunların 76 tanesinde (%53,5) siprofloksasine dirençli E. coli (SR E. coli) ürerken 66 tanesinde (%46,5) siprofloksasin duyarlı E. coli (SS E. coli) üredi. Toplam 16 hastada (%11,3) enfektif komplikasyonlar gözlendi. SR E. coli grubunda enfektif komplikasyonlar %14,5 oranında gözlenirken, bu oran SS. E. coli grubunda %7,6 idi (p=0,295). Toplam 9 hastada (%6,3) yüksek ateş gözlendi. Bu hastaların 6 tanesinin rektal sürüntü kültüründe SR E. coli ürerken 3 tanesinin rektal sürüntü kültüründe SS E. coli üremişti. Yüksek ateş gözlenen bu hastaların 3 tanesinde (%2,1) sepsis gözlendi. Sepsis gelişen 3 hastanın da rektal sürüntü kültürlerinde siprofloksasine dirençli E. coli üredi.Sonuç: Kanaatimizce siprofloksasin profilaksisinin yeniden gözden geçirilmesi ve direnç oranı yüksek toplumlarda en azından belli bir süre başka bir profilaksi ajanının kullanılması gerektiğini söyleyebiliriz. Maliyeti ayrıca değerlendirmek şartıyla biyopsi öncesi rektal sürüntü kültürü alınması ve buradaki antibiyogram sonucuna göre hedefe yönelik profilaksi yapılması uygun olacaktır

The Clinical Characteristics of Patients Applied to Covid-19 Outpatient Clinics of a Tertiary Hospital in Turkey in the First Wave of Pandemic

Background: The first wave of COVID-19 pandemic began to spread in Turkey in March 2020. As one of the first pandemic hospitals, very intense patient admissions have been made to our outpatient clinics in this period. For better understanding the disease characteristics, we investigated the clinical findings, comorbidities, and radiological pulmonary involvement of the COVID-19 patients.Methods:&nbsp;The SARS-CoV-2 RT-PCR test results of 6966 patients, applied to Kartal Lutfi&nbsp;Kırdar City Hospital InfectiousDiseases and Clinical Microbiology COVID-19 outpatient clinics between March and June 2020, were analyzed retrospectively. Demographic, clinical, and thoracic computed tomography data of the patients with positive test results were evaluated.Results:&nbsp;2672(38.4%) patients were SARS-CoV-2 RT-PCR positive (1465 males, 1207 females). The mean age of the patients with a definite diagnosis of COVID-19 was 40.4±14.5 years (12-94 years). There was a statistically significant relationship between the age and COVID-19 (75.3% were &gt;65 years, p&lt;0.001). The main clinical findings were fever (n:2437, 91.2%), cough (n:2013, 75.3%), dyspnea (n:809, 30.2%), sore throat (n:257, 9.6%), weakness (n:244, 9.1%), myalgia (n:228, 8.5%), nausea/vomiting (n:135, 5.1%), diarrhea (n:80, 3%), anosmia (n:54, 2%), and loss of taste (n:54, 2%). The comorbidities found in our COVID-19 patients were hypertension(HT) (n:94, 3.5%), diabetes mellitus(DM) (n:70, 2.6%), chronic obstructive pulmonary disease(COPD) (n:68, 2.5%), coronary artery disease(CAD) (n:32, 1.2%) and malignancy (n:16, 0.6%). 4113 patients (75.2%), out of 5484 patients who had thorax CT, had COVID-19 compatible radiological involvement, with 3315(80.6%) positive and 798(19.4%) negative SARS-CoV-2 RT-PCR test results.Conclusion:&nbsp;The most frequent symptoms in the patients admitted to our hospital in the first wave of pandemic were fever, cough, dyspnea, sore throat, and weakness. Despite lockdown, the elderly above 65 years were most affected. The&nbsp;rate of COVID-19 compliant radiological involvement was moderately high. The most common comorbidities were HT, DM, COPD, CAD and malignancy.</div