Evaluation of Viral Agents Detected in Children Admitted to Hospital Due to Lower Respiratory Infection

INTRODUCTION: Background\Aim: Viruses are among the most common causes of acute respiratory tract infections. In this study we aimed to investigate the viral pathogens detected in the nasopharyngeal swab specimens obtained from children in our pediatric ward being followed up due to acute lower respiratory tract infection and to analyse the distribution of the pathogens by age and months. METHODS: Method: This research was carried out between January 2019-January 2020, 289 patients (44.2% female, 55.7% male) admitted for acute respiratory tract infection were included. Patient records were reviewed retrospectively. Viral agents distribution was analysed according to age, sex and months (seasons/seasonall variation). RESULTS: Findings: In 117 (40.5%) of 289 patients viruses were not detected (negative) in the respiratory tract, in 172 (59.5%) they were detected (positive). In 148 (86%) patients a single agent, in 22 (12.8%) patients two agents, in 1 (0.6%) patient three agents, in 1 (0.6%) patient four agents were found. The most common virus detected was rinovirüs (HRV) (23.9%), the second most common was found to be respiratory syncytial virus A (RSVA) (16.3%). The most common agent in ages 0-3 was HRV, after 3 years the most common agent was influenza B virüs (IBV). IBV was the most common during the winter, HRV was the most common in the other seasons. DISCUSSION AND CONCLUSION: Results: In our study 59.5% of admitted children were found to have at least one respiratory virus. Multiplex PCR is a sensitive and specific method which detects viruses that are undetectable by classical methods, gives results in a shorter time compared to classical methods and also a method in which more than one specimen can be processed at the same time. With a faster method diagnosis of viruses, inappropriate use of antibiotics and development of antibiotic resistance can be prevented

Evaluation of Tracheal Aspirate Cultures of Patients Followed with Home Mechanical Ventilators

Purpose: To investigate the underlying diseases, and complaints of patients upon admission, isolated microorganisms from tracheal aspirate (TA) samples and their resistance to antibiotics in patients followed up with a home mechanic ventilator (HMV). Materials and Methods: Between January 1, 2020 and January 1, 2021, TA cultures, identification of bacteria and their antibiotic susceptibilities were evaluated by VITEK 2 (bioMeriux, France) automated identification system. The patients' age, gender, underlying diseases, duration of home ventilator use, complaints, and laboratory data were reviewed. Results: Of the 91 prediagnosed ventilator-associated pneumonia (VAP) patients, 72 (79%) were male and mean age was 91.64 ± 64.07 months. The most common reason for referral was fever and dyspnea and 43.76% of the patients were diagnosed with cerebral palsy/epilepsy and 10.4% with syndromes. Of the samples; 12 (13.3%) were defined as Gram-positive and 79 (86.7%) as Gram-negative. Pseudomonas aeruginosa was detected in 44 (48.4%) samples, Serratia marcescens in 9 (9.9%), Klebsiella spp. in 8 (8.8%) and Staphylococcus aureus was in 12 (13.3%) samples. Carbapenem resistance was 18.75% for Pseudomonas aeruginosa, 16% for Klebsiella spp, 12.5 for Escherichia coli and 12% for Acinetobacter baumannii. Conclusion: TA culture should be taken from patients with HMV who were admitted with signs of infection such as fever and respiratory distress and treatment should be arranged according to the result. It was observed that the TA culture antibiotic resistance rates of the patients with HMV were lower than the TA cultures sent from the patients hospitalized in the intensive care unit in the literature

Turkish version of the test your memory (Tym-tr) as a screening tool in memory clinics

Introduction: This study compared the Turkish version of Test Your Memory (TYM) MMSE (Mini-Mental State Examination) and CDT (Clock Drawing Test) in patients with neurocognitive disorder. Methods: After a thorough medical workup, patients with a diagnosis of neurocognitive disorder were enrolled. A cross-sectional design was used to compare the TYM results with those of MMSE and CDT. Results: This study was conducted on 100 patients, including 46 males and 54 females, aged 52 to 86. The majority of patients were diagnosed with vascular neurocognitive disorder. The z-score of TYM-TR was significantly lower in the domains of registration, recall, visuospatial, and total score. The same results were achieved when CDT was added to MMSE. The same pattern was observed separately for those who were diagnosed with a mild or major neurocognitive disorder. Conclusion: Patients’ cognitive deficits might be more evident when measured by the TYM-TR compared to the MMSE

The use of inflammatory markers as a diagnostic and prognostic approach in neonatal calves with septicaemia

The objective of this study was to evaluate the usefulness of inflammatory markers as a diagnostic and prognostic approach in neonatal calves with septicaemia. The study material consisted of 13 neonatal calves with septicaemia (septicaemic calves, SC) and ten healthy neonatal calves (control calves, CC). Blood samples were collected for biochemical, haematological and microbiological analyses. In addition, faecal samples were collected for microbiological and virological analyses. Three of neonatal calves with septicaemia were positive for E. coli (E. coli O157 serotype) by microbiological examination, but all neonatal calves with septicaemia were negative for rota- and coronaviruses. By haematological examination, there were no significant differences between SC and CC for white blood cell (WBC) and neutrophil (NEU) counts (P > 0.05). NEU counts were higher on day 0 than on day 15 in SC (P < 0.05). Red blood cell (RBC) counts and packed cell volume (PCV) values were higher on day 0 in the SC than in the CC (P < 0.05). By biochemical analyses, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), procalcitonin (PCT), haptoglobin (Hp), and fibrinogen (Fb) concentrations were higher on day 0 in the SC than in the CC (P < 0.05). After treatment (on day 15), the serum IL-6, PCT, Hp, and Fb concentrations were significantly decreased in the SC compared to the CC (P < 0.05). The serum iron (Fe) concentrations were lower on day 0 in the SC than in the CC (P < 0.05), and were higher on day 15 than on day 0 in the SC (P < 0.05). The study revealed that inflammatory markers could be used for determining the diagnosis and prognosis in neonatal calves with septicaemia

A PEDIATRIC CASE WITH CUTANEOUS LEISHMANIASIS

Leishmaniasis bazı kum sinekleri ile taşınan parazitik bir hastalıktır. Leishmania türleriintrasellüler yerleşim göstererek farklı klinik tablolar oluşturlar. Bunlar kutanöz, visseral vemukokutanöz leishmaniasis olarak adlandırılır. Dünyanın bir çok bölgesinde endemikenfeksiyon yapar. Kutanöz leishmaniasis, Türkiye\'nin batı ve güneydoğu bölgelerinde endemikolarak görülmektedir. Kliniği, parazit ve konak ile ilgili çeşitli faktörlere bağlı olarakoldukça farklılık gösterebilmektedir.Burada hastanemize başvurusundan iki yıl önce yüz bölgesinde ülseratif lezyonları ortayaçıkan ve lezyondan yapılan direk yaymalarında leishmania amastigotları görülen iki buçukyaşındaki erkek hastayı sunduk.Leishmaniasis is a parasitic disease that is transmitted through a bite of some species ofsandflies. It is caused by obliged intra-cellular protozoa of the genus Leishmania and isresponsible for a broad spectrum of clinical syndromes: cutaneous leishmaniasis, visceralleishmaniasis and mucocutaneous leishmaniasis. Leishmaniasis is an endemic infection inmany parts of the world. Cutaneous leishmaniasis is endemic in the western and southeasternparts of Turkey. Its clinical presentations are extremely diverse and dependent on avariety of parasite and host factors.Here we reported two years and six month old male child who had ulcerative lesions on theface that had persisted two years before the admission to our hospital and leishmaniaamostigotes were seen on direct smears prepared from the lesion

A PEDIATRIC CASE WITH SWYER JAMES MAC LEOD SYNDROME

Swyer James Mac Leod sendromu, pulmoner vasküler yapının kaybına bağlı oluşan, tek akciğer veya lobda radyolojik olarak hiperlüsensi ile karakterize, nadir ve kompleks bir tablodur. Çocukluk çağında geçirilen viral bronşiolit ve pnömoniler sonrası akkiz olarak geliştiği düşünülmektedir. Tek taraflı hiperlüsensi ile seyreden diğer birçok klinik tablodan ayırıcı tanısının yapılması gerekmektedir. Birçok hasta klinik bulgularla tanı alır ve bu hastaların patolojik bulguları ile ilgili literatürde sayılı olgu sunumları vardır. Biz tekrarlayan bronşiolitlerine ikincil olarak geliştiğini düşündüğümüz Swyer James Mac Leod sendromlu beş yaşındaki bir erkek hasta sunuldu. Swyer James Mac Leod syndrome is an uncommon and complex disease characterized by roentgenographic hyperlucency of one lung or lobe due to loss of the pulmonary vascular structure. This syndrome seems to be an acquired disease that follows viral bronchiolitis and pneumonitis in childhood. It must be differantiated from many other causes of unilateral lung that is hyperlucent. Most patients with this syndrome can be managed clinically, and whose pathological findings have been described in only a few reports. We describe here a five years old boy with Swyer James Mac Leod syndrome resulting in severe recurrent bronchiolitis

The efficacy of cinacalcet in the treatment of hyperparathyroidism in Turkish hemodialysis patient population

WOS: 000393291900012OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population

Drainage characteristics of the Cappadocia region

Kapadokya bölgesinde erozyonal süreçlere bağlı olarak ignimbirit ve tüfler üzerinde kırgıbayır topografyası yaygın olarak oluşmaktadır. Kırgıbayır topografyası içerisinde en dikkati çeken yer şekilleri ise peribacalarıdır ve bölge içerisinde peribacalarının oluşumunu denetleyen çok fazla sayıda faktör bulunmaktadır. İgnimbiritlerin tabakanlanma, sertlik ve gözeneklilik özellikleri, topografik eğim koşulları, ignimbiritler içerisindeki süreksizliklerin şekli, boyutu ve sıklığı, iklimsel özellikler, drenaj koşulları vb. unsurlar başta peribacaları olmak üzere kırgıbayır topografyasının gelişimi üzerinde etkilidir. Bu çalışmada alandaki kırgıbayır topografyası ve peribacası gelişimini denetleyen ana etmenlerden bir tanesi olan drenaj özellikleri 1/25.000 ölçekli topografya haritalarına göre incelenmiştir. İlk olarak topografya haritalarından tespit edilen tüm vadiler CBS ortamında sayısallaştırılmıştır. Ardından her bir vadiye dizin numarası girilmiş ve drenaj yoğunluğu haritası oluşturulmuştur. Haritalama çalışmalarına göre 553 km2 ’lik alan içerisinde en yüksek akarsu yoğunluklarına Göreme Milli Parkı sınırları içerisindeki ignimbirit ve tüflerde ulaşılmaktadır (15.3 km/km2 ). Maximum akarsu yoğunluğunda en düşük değerler güney kesimdeki plato yüzeylerinde bazalt (9 km/km2 ), andezit (3.2 km/km2 ) ve dasitler (4.2 km/km2 ) üzerinde görülür. Strahler yöntemine göre akarsu dizinlerinin %53’ü 1. ve %22.7’si 2. dizine aittir. Elde edilen bu sonuçlar Göreme Milli Parkını içine havzalarda en yüksek akarsu yoğunluğunun milli park içerisindeki ignimbirit ve tüfler üzerinde olduğunu göstermiştir.The morphology of the widespread badlands in the region of Cappadocia has mainly been the result of erosional processes on ignimbrite and tuff formations. Fairy chimneys are the most characteristic landforms of badlands morphology and many factors are responsible for the formation of these landforms in the region. Bedding, hardness and porosity of ignimbrites, shape, size and frequency of discontinuities in ignimbrites, slope, climate and drainage properties etc. of the area all significantly contribute to the development of badlands and fairy chimneys. In this study, drainage properties, which are one of the main controlling factors in this development, were investigated referencing 1/25.000 scale topography maps. Firstly, all valley thalwegs were digitized using GIS. Subsequently, the Strahler order numbers of each stream were determined, and a drainage density map was created. Basing our results on maximum drainage densities, the highest drainage density (15.3 km/km2 ) in the study area was identified in ignimbrite and tuffs in the Göreme National Park, whilst, the lowest drainage densities were located on plateau surfaces (basalt (9 km/km2 ), dacite (4.2 km/km2 ) and andesite (3.2 km/km2 ) in the southern part of the study area. According to the Strahler order method, 53% and 22.7% of all streams belong to first and second orders, respectively. All these results show that drainage conditions on ignimbrite and tuffs are determinant factors in the formation of both badlands morphology and fairy chimneys