Ertapenem for the treatment of complicated urinary tract ınfections caused by extended-spectrum β-lactamase-producing bacteria: A case series report

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Urinary tract infections with extended-spectrum beta-lactamases (ESBL) are an increasing public health concern. We evaluated our experience with the use of ertapenem for complicated urinary tract infections (cUTI) caused by ESBL- producing bacteria. Sixty-four patients aged >18 years who had a cUTI caused by ESBL- producing microorganisms that were treated with ertapenem at Sisli Etfal Training and Research Hospital, from January 1st, 2010 to December 31st, 2011, were included in this study. Data on patients demographic, clinical and laboratory results were collected. The median age was 65.8 years (range, 30 to 95). All patients had at least one risk factor complicating factor except two of them. The most common underlying problem was prior antibiotic exposure. The pathogens isolated from urine samples were ESBL-producing E. coli in 49, ESBL-producing K. pneumoniae in 12 and ESBL-producing K. oxytoca in 2 patients. All were susceptible to ertapenem in vitro. The average duration of ertapenem therapy was 14+/-4 days for upper UTI and 11+/-2 days for lower UTI. All patients achieved clinical cure and bacteriological eradication in urine. One patient had relapse and six of them had reinfection. Only one case had diarrhea which did not require discontinuation of therapy. Our results demonstrate that ertapenem is suitable for the treatment of cUTI cause by ESBL-producing bacteria

Posterior pericardial ascending-to-descending aortic bypass through median sternotomy

Background and Aim: Adult patients with complex forms of descending aortic disease remain a surgical challenge and have a high risk of postoperative mortality and morbidity. Surgical management may be complicated when there is an associated cardiac defect, necessitating repair, or a hostile anatomy exists. We present our experience with extra-anatomic bypass through posterior pericardial route at the same stage with intracardiac/ascending aortic aneurysm repair. Methods: Patients that underwent one-stage surgery with posterior pericardial bypass between ascending and descending aorta during 2003-2007 were reviewed. Data from early and mid-term follow-up, including mortality, perioperative blood loss, graft-related complications, patency, and persistant hypertension, were noted. Results: Six male patients with a mean age of 20.8 +/- 0.7 years were operated for coarctation of the aorta associated with additional pathologies (three cases of ascending aortic aneurysm-one with associated aortic valve insufficiency, one case of isolated aortic valve regurgitation, two cases of mitral valve regurgitation). No early or mid-term mortality was observed during follow-up of a mean of 21.6 +/- 10.0 months. No late graft-related complications or reoperations were observed with patent grafts. Systolic blood pressure decreased after surgery by an average of 43 mmHg. Conclusions: Coarctation of the aorta with concomitant cardiac lesions can be repaired simultaneously through sternotomy and posterior pericardial approach, when patients present in adulthood, to minimize morbidity and mortality

The Spectrum Of Diseases Causing Fever Of Unknown Origin In Turkey: A Multicenter Study

Objective: The purpose of this trial was to determine the spectrum of diseases with fever of unknown origin (FUO) in Turkey. Methods: A prospective multicenter study of 154 patients with FUO in twelve Turkish tertiarycare hospitals was conducted. Results: The mean age of the patients was 42 +/- 17 years (range 17-75). Fifty-three (34.4%) had infectious diseases (ID), 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.3%) had malignant diseases (MD), and eight (5.2%) had miscellaneous diseases (Mi). In 24 (15.6%) of the cases, the reason for high fever could not be determined despite intensive efforts. The most common ID etiologies were tuberculosis (13.6%) and cytomegalovirus (CMV) infection (3.2%). Adult Still's disease was the most common NIID (13.6%) and hematological malignancy was the most common MD (7.8%). In patients with NIID, the mean duration of reaching a definite diagnosis (37 +/- 23 days) was significantly longer compared to the patients with ID (25 +/- 12 days) (p = 0.007). In patients with MD, the mean duration of fever (51 +/- 35 days) was longer compared to patients with ID (37 +/- 38 days) (p = 0.052). Conclusions: Although infection remains the most common cause of FUO, with the highest percentage for tuberculosis, non-infectious etiologies seem to have increased when compared with previous studies. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.WoSScopu

What have we learned from Turkish familial hypercholesterolemia registries (A-HIT1 and A-HIT2)?

WOS: 000445908000052PubMed ID: 30270069Background and aims: Familial hypercholesterolemia (FH) is a common genetic disease of high-level cholesterol leading to premature atherosclerosis. One of the key aspects to overcome FH burden is the generation of largescale reliable data in terms of registries. This manuscript underlines the important results of nation-wide Turkish FH registries (A-HIT1 and A-HIT2). Methods: A-HIT1 is a survey of homozygous FH patients undergoing low density lipoprotein (LDL) apheresis (LA). A-HIT2 is a registry of adult FH patients (homozygous and heterozygous) admitted to outpatient clinics. Both registries used clinical diagnosis of FH. Results: A-HIT1 evaluated 88 patients (27 +/- 11 years, 41 women) in 19 centers. All patients were receiving regular LA. There was a 7.37 +/- 7.1-year delay between diagnosis and initiation of LA. LDL-cholesterol levels reached the target only in 5 cases. Mean frequency of apheresis sessions was 19 +/- 13 days. None of the centers had a standardized approach for LA. Mean frequency of apheresis sessions was every 19 +/- 13 (7-90) days. Only 2 centers were aware of the target LDL levels. A-HIT2 enrolled 1071 FH patients (53 +/- 8 years, 606 women) from 31 outpatients clinics specialized in cardiology (27), internal medicine (1), and endocrinology (3); 96.4% were heterozygous. 459 patients were on statin treatment. LDL targets were attained in 23 patients (2.1% of the whole population, 5% receiving statin) on treatment. However, 66% of statin-receiving patients were on intense doses of statins. Awareness of FH was 9.5% in the whole patient population. Conclusions: The first nationwide FH registries revealed that FH is still undertreated even in specialized centers in Turkey. Additional effective treatment regiments are urgently needed.Turkish Society of Cardiology; Aegerion; Amyrit; AmgenAmgen; PfizerPfizer; SanofiSanofi-AventisA-HIT1 and 2 registries are sponsored by the Turkish Society of Cardiology that receives funding from a variety of sources (including unrestricted research grants from Aegerion, Amyrit, Amgen, Pfizer, and Sanofi)

Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey

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

Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey

balkan, ilker inanc/0000-0002-8977-5931; Altindis, Mustafa/0000-0003-0411-9669; Sahin, Ahmet Ziyaettin/0000-0003-1060-6746; atilla, aynur/0000-0001-8027-1991WOS: 000386954300001PubMed: 27809934Background: 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