Cerebral Infarction in an Elderly Patient with Coronavirus Disease

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The epidemiology, Clinical Manifestations, radiology, microbiology, treatment, and prognosis of echinococcosis: Results of NENEHATUN study

Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 +/- 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important

Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases-International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (similar to 5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%-90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs' implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted. (C) 2022 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences

Outcomes of passive-active ımmunoprophylaxis administered to infants of mothers infected with hepatitis B Virus in Erzurum, Turkey

GİRİŞ ve AMAÇ: Hepatit B virüsü (HBV) ile infekte annelerden doğan bebekler pasif-aktif immünoprofilaksiye rağmen infekte olabilirler. Bu çalışmada HBV’nin bulaşmasında maternal vireminin rolünü ve HBV ile infekte annelerden doğan bebeklerin pasif-aktif immunoprofilaksi sonuçlarını değerlendirmeyi amaçladık. YÖNTEM ve GEREÇLER: Bu çalışmaya bir Kadın Hastalıkları ve Doğum hastanesinde 2014 ve 2016 yılları arasında HBV ile infekte anneler ve pasif-aktif immünoprofilaksi uygulanan bebekleri dahil edildi. Hastaların sosyodemografik verileri, hepatit belirteçleri, viral yükleri ve çocukların hepatit belirteçleri değerlendirildi. BULGULAR: 2014-2016 yılları arasında 26925 gebe kadın HBsAg için tarandı. 328 HBsAg pozitif gebe kadının 271’i hastanemizde doğum yaptı. Sadece 53 anne ve bebeğine ulaşabildik. HBsAg pozitif 53 anneden 2(% 3,72)’si HBeAg pozitif, 51(% 96,23) anne ise AntiHBe pozitifti. Beş annede(% 9,43) viral yük ≥2000 IU / ml idi. 28(% 52,83) annenin viral yüklerine ulaşılamadı. Maternal HBeAg durumu ve viral yük ile infant antikor yanıtı arasında istatistiksel olarak anlamlı ilişki vardı (p 0,05). TARTIŞMA ve SONUÇ: HBV ile infekte annelerin bebeklerinde pasif-aktif immunoprofilaksi, perinatal bulaşmanın önlenmesinde oldukça etkilidir. HBsAg taraması tüm gebelere hamilelikleri sırasında yapılmalıdır. Hamileliklerinde HBsAg pozitif olarak saptanan annelerin bebeklerine doğumdan 6-12 saat içinde pasif-aktif immunoprofilaksi verilmelidir. Sonrasında mutlaka immünizasyon sonuçları değerlendirilmelidir. Ebeveynlere taburculuk sırasında bilgi verilmesi, toplumun farkındalığını artıracak ve hepatit B'nin ortadan kaldırılmasına katkıda bulunacaktır.OBJECTIVES: Infants born to mothers with hepatitis B virus (HBV) may be infected despite receiving passive-active immunoprophylaxis. The purpose of this study was to assess the role of maternal viremia in the transmission of HBV and the passive-active immunoprophylaxis outcomes of infants born to women infected by HBV. METHODS: HBV-infected mothers and infants up to 12 months of age receiving passive-active immunoprophylaxis at the Erzurum Nenehatun Obstetrics and Gynecology Hospital, Turkey, between 2014 and 2016 were included in the study. Socio-demographic data for the patients, and hepatitis markers, viral loads and hepatitis markers of children were evaluated. RESULTS: A total of 26,925 pregnant women were screened for HBsAg between 2014 and 2016. Three hundred twenty-eight HBsAg-positive pregnant women, of whom 271 delivered at our hospital, and 53 mother-infant pairs were included in the study. Of the 53 HBsAg-positive mothers, HBeAg status was positive in 2 (3.72%) and antiHBe status was positive in 51 (96.23%). Viral load was ≥2000IU/ml in 5 mothers (9.43%). The viral loads of 28 mothers (52.83%) were unavailable. Statistically significant associations were determined between maternal HBeAg status, maternal viral load and antibody response (p0.05). CONCLUSIONS: Passive-active immunoprophylaxis in babies of HBV-infected mothers was highly efficacious in preventing perinatal transmission. Antepartum HBsAg markers must be examined in all pregnancies, and passive-active immunoprophylaxis should be given in the first 6-12 h of life to infants of mothers who are HBsAg-positive during pregnancy. Immunization results should be evaluated subsequently. Healthy generations can be produced by treating HBsAg-positivity with high maternal viremia by means of passive-active immunoprophylaxis, thus reducing the economic impact of diseases and care, and improving quality of life. Giving information to parents during discharge training will increase community awareness and contribute to the eradication of hepatitis B

The Relationship of Headache with Inflammatory Serum Parameters and Disease Severity in COVID-19 Patients

Aim: Most of the coronavirus disease 2019 (COVID-19) patients have respiratory symptoms;however, various neurological symptoms, such as headache, can be seen. Thepathophysiological mechanism of headache in COVID-19 is unknown completely. In ourstudy, we aimed to investigate the relationship between headache and inflammatory markersand disease severity in COVID-19 patients.Material and Methods: Two hundred and three hospitalized patients with a polymerase chainreaction (PCR)-confirmed COVID-19 diagnosis between 15 March and 01 June 2020 wereretrospectively investigated. A total of 62 patients with headache symptoms (n=31) andwithout headache symptoms (n=31), who were age and gender-matched, were included in thestudy. The demographic characteristics, inflammatory serum parameters,neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP)/albumin ratio (CAR),hospitalization times, and disease severity were determined.Results: Of the 203 COVID-19 patients, 36 (17.7%) had a headache, and it was the fourthmost common symptom. Headache accompanied other symptoms in all patients. Of thepatients with headache, 14 (45.2%) were female, 17 (54.8%) were male, and the mean age was37.74±16.65 years. In our COVID-19 patients, the neutrophil count, NLR, CRP, CAR weresignificantly higher, and hospital stay was longer in patients with headache than those withoutheadache (p=0.023, p=0.041, p=0.034, p=0,048 and p=0.049, respectively).Conclusion: As a result, the increased inflammatory response may play a role in thepathogenesis of headache in COVID-19 patients. Our study is the first study that evaluated therelationship between headache symptom and inflammation in COVID-19 patients. Furtherresearch is needed on this subject

The Relationship of Headache with Inflammatory Serum Parameters and Disease Severity in COVID-19 Patients

Aim: Most of the coronavirus disease 2019 (COVID-19) patients have respiratory symptoms;however, various neurological symptoms, such as headache, can be seen. Thepathophysiological mechanism of headache in COVID-19 is unknown completely. In ourstudy, we aimed to investigate the relationship between headache and inflammatory markersand disease severity in COVID-19 patients.Material and Methods: Two hundred and three hospitalized patients with a polymerase chainreaction (PCR)-confirmed COVID-19 diagnosis between 15 March and 01 June 2020 wereretrospectively investigated. A total of 62 patients with headache symptoms (n=31) andwithout headache symptoms (n=31), who were age and gender-matched, were included in thestudy. The demographic characteristics, inflammatory serum parameters,neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP)/albumin ratio (CAR),hospitalization times, and disease severity were determined.Results: Of the 203 COVID-19 patients, 36 (17.7%) had a headache, and it was the fourthmost common symptom. Headache accompanied other symptoms in all patients. Of thepatients with headache, 14 (45.2%) were female, 17 (54.8%) were male, and the mean age was37.74±16.65 years. In our COVID-19 patients, the neutrophil count, NLR, CRP, CAR weresignificantly higher, and hospital stay was longer in patients with headache than those withoutheadache (p=0.023, p=0.041, p=0.034, p=0,048 and p=0.049, respectively).Conclusion: As a result, the increased inflammatory response may play a role in thepathogenesis of headache in COVID-19 patients. Our study is the first study that evaluated therelationship between headache symptom and inflammation in COVID-19 patients. Furtherresearch is needed on this subject

Evaluation of Injuries Involving Exposure to Blood and Body Fluids Among Hospital Healthcare Workers

Introduction: Injuries involving exposure to blood and body fluids are among the risks that healthcare staff frequently encounter. In this study, injuries that occurred in Nenehatun Obstetrics Hospital from January 2011 to May 2016 were evaluated and preventive measures to reduce injuries among healthcare workers are presented. Materials and Methods: "Staff Injury Forms" recorded by the hospital Infection Control Committee (ICC) between January 2011 and May 2016 in Nenehatun Obstetrics Hospital were retrospectively assessed. In addition, a survey concerning blood and body fluid exposure in the last five years was conducted among the 180 staff members who could be reached from a total of 252 healthcare personnel. Data were analyzed using SSPS v.15.0 (SPSS Inc, Chicago, Illinois, USA) data analysis system. Results: Of 38 cases reported to the ICC, 18% (n=7) of the employees were male and 82% (n=31) were female. Only 2.63% involved mucosal contact with blood and body fluid exposure, the remaining 97.3% were percutaneous sharp object injuries. Analysis of the survey data revealed that 0.5% of the injuries consisted of exposure to blood and body fluids and 26.4% consisted of percutaneous injuries. According to ICC data, 72.9% were needlestick injuries. The group of healthcare workers injured most often was cleaning staff according to ICC data (31.5%) and doctors and nurses according to the survey data (24.5%). Injuries mostly took place in delivery room according to ICC data; however, survey results indicated that injuries mostly occurred in the surgery room. According to the investigation of immunity status of 38 healthcare staff, all were negative for anti-HCV and anti-HIV; while 92.1% (n=35) were found positive for anti-HBs and 7.9% (n=3) were negative for anti-HBs. Of the source patients of the blood or body fluid, 10.5% (n=4) were positive for HBsAg, 2.6% (n=1) were positive for anti-HBs, and 71% (n=27) were negative for anti-HBs. Seroconversion was not detected in any of the cases. Conclusion: In addition to standard infection control measures, the occupational hazards faced by healthcare workers can be decreased by providing immunity against vaccine-preventable diseases, eliminating problems concerning staff recruitment, improving usage of safe medical instruments, implementing continuous employee training, and repeating training to increase the quality and awareness of the staff