Investigation of the Parameters That May Predict Hemodialysis Frequency

DergiPark: 819242tmsjAims: This study investigates the relationship between the clinical parameters at the beginning of hemodialysis therapy and the changing in the frequency of weekly hemodialysis sessions in ongoing treatment. Methods: The study population was composed of all of the patients that were started chronic hemodialysis treatment between January 2015 and January 2020. The patients were classified as twice-weekly (2/7) and thrice-weekly (3/7) groups according to the hemodialysis schedule at the start of treat- ment. The 3/7 group is additionally subdivided according to the dialysis schedule switches to the thrice-weekly program. Basal demographics and biochemical parameters were obtained from medical records at the start of hemodialysis. Results: The total number of subjects in the study was 433 (141 in the twice-weekly program, 292 in the thrice-weekly program). Forty-six (32.6%) patients in twice-weekly hemodialysis program were shifted to a thrice-weekly program during the follow-up. The female/ male ratio in the 2/7 program is different from the 3/7 program. Serum creatinine and C-reactive protein levels were higher in patients on the 3/7 program. Serum calcium and albumin levels were higher in patients on a 2/7 program. The statistically sig- nificant increments were found in calcium, hemoglobin, hematocrit, urea, creatinine, and potassium levels between the before and after switch results of the 3/7 group which switched from 2/7. Conclusion: Urea, creatinine, and potassium levels can guide the decision to compose a hemodialysis schedule. However, patients' future weekly treatment schedules cannot be predicted by biochemical parameters obtained at the start of hemodialysis

Prospective observational study on antibiotic-associated bloody diarrhea: report of 21 cases with a long-term follow-up from Turkey

WOS: 000303826200012PubMed ID: 22433794Objective Antibiotic-associated hemorrhagic colitis is a distinct form of antibiotic-associated bloody diarrhea (AABD) in which Clostridium difficile is absent. Although the cause is not exactly known, reports have suggested the role of Klebsiella oxytoca and/or C. difficile. Materials and Methods Between 2001 and 2006, stool samples of 21 consecutive patients with AABD were cultured for common enteric pathogens and K. oxytoca, and were tested for the presence of parasites and C. difficile toxin A + B within the first 24 h of their initial admission and a colonoscopy was performed when available. The patients were followed up prospectively by telephone interviews. Results The occurrence of symptoms ranged between 6 h and 14 days following the first dose of the antibiotic responsible and the duration of the AABD ranged between 6 h and 21 days. The antibiotic responsible was oral ampicillin/sulbactam in 18 (85%) cases. C. difficile toxin A + B production by enzyme-linked immunosorbent assay and K. oxytoca growth in stool cultures were detected in six (29%) and 11 (51%) of 21 patients, respectively. Endoscopic morphology and histology in a limited number of patients revealed no more than a nonspecific inflammation and acute colitis, respectively. Conclusion This study confirms that antibiotic-associated hemorrhagic colitis, as a distinct entity in relation to K. oxytoca, is seen in half of the patients with AABD. Most of the cases are seen within a week following the antibiotic use. Almost all of the patients did not develop any flares during the long-term antibiotic-free follow-up. In some of the patients with AABD, there was coexistence of K. oxytoca with C. difficile toxin A + B. Eur J Gastroenterol Hepatol 24: 688-69

The Turkish Clinical Microbiology and Infectious Diseases Society (KLİMİK) Evidence-Based Guideline for the Diagnosis and Treatment of Brucellosis, 2023

Bruselloz, dünyada ve ülkemizde çok yaygın olarak görülmesine rağmen hastalığın tanı ve tedavisini yönlendirmede kullanılabilecek kanıta dayalı bir rehber bulunmamaktadır. Bu rehber, brusellozun tanı ve tedavisi ile ilgilenen farklı uzmanlık alanlarından hekimlere kanıta dayalı öneriler sunmak üzere Türk Klinik Mikrobiyoloji ve İnfeksiyon Has- talıkları Derneği tarafından hazırlanmıştır. Rehberin hazırlanmasında, ABD İnfeksiyon Hastalıkları Derneği (IDSA)’nin Klinik Uygulama Rehberi Geliştirme Kı- lavuzu önerileri esas alınmıştır. Rehberi hazırlayan grup üyeleri tarafından, bruselloz tanı ve tedavisinde önemli olduğu düşünülen 20 soru belirlenmiş ve PICO [hasta/popülasyon (P), müdahale/indikator (I), karşılaştırma/kontrol (C), sonuç (O)] formatında oluşturulan bu sorulara yanıt verebilecek yayınlar, ULAKBİM TR Dizin, PubMed ve Cochrane veritabanlarından, tarih kısıtlaması olmadan taranmıştır. Her bir PICO sorusu ve her bir ayrı sonlanım için kanıtların derecelendirilmesinde ve önerilerin gücünün belirlenmesinde “Grading of Recommendations, Assessment, Develop- ment and Evaluation (GRADE) Working Group” yöntemi kullanılmıştır. PICO sorularına yanıt oluşturabilecek şekilde karşılaştırmalı klinik araştırmaların olması halinde bunların meta-analizleri, olmaması halindeyse olgu sunumları ve olgu serilerinden elde edilen verilerle “individual participant data” (IPD) meta-analizleri yapılmıştır. Önerilerin yeni çalışmaların sonuçları doğrultusunda belli aralıklarla güncellenmesi planlanmaktadır.Although brucellosis is very common in the world and Türkiye, there are no evidence-based guidelines to guide the diagnosis and treatment of the disease. This guide has been prepared by the Turkish Society of Clinical Microbiology and Infectious Diseases to provide evidence-based recommendations to physicians from different specialties interested in the diagnosis and treatment of brucellosis. The recommendations of the Clinical Practice Guide Development Guide of the Infectious Diseases Society of Amer- ica (IDSA) were taken as the basis for preparing this guide. The guideline preparation group determined 20 questions considered to be important in the diagnosis and treatment of brucellosis, and the publications that could answer these questions prepared in PICO (Population/Patient [P], Intervention [I], Comparison [C], Outcome [O]) format, were searched in ULAKBİM Tr Dizin, PubMed, Cochrane databases without date restrictions. The Grading of Recommen- dations, Assessment, Development, and Evaluation (GRADE) Working Group method was used to rank the evidence and determine the strength of the recommendations for each PICO question and for each individual outcome. Me- ta-analyses of comparative clinical studies were performed to answer the PICO questions. Individual participant data (IPD) meta-analyses with data obtained from case reports and case series were conducted in the absence of comparative clinical studies. It is planned to update the recommendations at regular intervals in line with the results of new studies

Comprehensive dissection of prevalence rates, sex differences, and blood level-dependencies of clozapine-associated adverse drug reactions

Clozapine is often underused due to concerns about adverse drug reactions (ADRs) but studies into their prevalences are inconclusive. We therefore comprehensively examined prevalences of clozapineassociated ADRs in individuals with schizophrenia and demographic and clinical factors associated with their occurrence. Data from a multi-center study (n=698 participants) were collected. The mean number of ADRs during clozapine treatment was 4.8, with 2.4% of participants reporting no ADRs. The most common ADRs were hypersalivation (74.6%), weight gain (69.3%), and increased sleep necessity (65.9%), all of which were more common in younger participants. Participants with lower BMI prior to treatment were more likely to experience significant weight gain (>10%). Constipation occurred more frequently with higher clozapine blood levels and doses. There were no differences in ADR prevalence rates between participants receiving clozapine monotherapy and polytherapy. These findings emphasize the high prevalence of clozapine-associated ADRs and highlight several demographic and clinical factors contributing to their occurrence. By understanding these factors, clinicians can better anticipate and manage clozapine-associated ADRs, leading to improved treatment outcomes and patient well-being

Weak Imaginary potential Effect on the 18,19,20O + 12C Fusion Reactions at Low Energies

We analysed the fusion cross sections of 18,19,20O + 12C systems at energies near and belowCoulomb barrier within the optical model. To make compherensive analysis, we have usedthree different density distributions of 18,19,20O nuclei. Also, we apply two different theoreticalapproaches which consist of semi-microscopic and fully microscopic double folding potentials.Our results are in good agreement with the experimental data and we showed that the weakimaginary potential is very important in explaining the fusion cross section of 18,19,20O+ 12Csystems.</p