Micafungin Effectiveness in Treating Pediatric Patients with Proven Candidemia

Aim:Micafungin is one of three currently available echinocandin for the treatment of candidiasis and candidemia. We aimed to discuss the effectiveness of micafungin and any possible side effects in the treatment of proven candidemia in children.Materials and Methods:In this study, children who were treated with micafungin for proven candidemia between May, 2017 and October, 2019 were included. The time to achieve negative culture, liver and renal functions as well as blood counts were recorded using the hospital data system.Results:Forty-five patients (52.3%) who received micafungin for proven candidemia were included in this study. The median age of the children who received micafungin due to invasive candidiasis (IC) was 4 months (range: 12 days to 216 months). Of these 45 IC patients, 10 (22.2%) were neonates, 19 (42.2%) were infants, 11 (24.4%) were between 1 and 5 years old, and 5 (11.1%) were between 10-18 years old. The median duration of micafungin treatment to culture negativity for C. albicans related candidemia episodes was shorter (6 days, 1-26 days) than non-albicans Candida spp. related candidemia episodes (7 days, 1-35 days) (p=0.10). Culture negativity could not be achieved at the end of the 14th day of micafungin treatment in 15 of the 45 (33.3%) candidemia episodes. The most commonly isolated Candida spp. in patients with treatment failure was C. parapsilosis (n=6), followed by C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=2) and C. tropicalis and C. guilliermondii co-infection (n=1) respectively. None of the patients developed side effects due to micafungin treatment.Conclusion:Micafungin was found to be safe and effective for the treatment of culture proven candidemia in pediatric patients, including neonates

Relationship Between Sick Building Syndrome and Indoor Air Quality in Hospital Staff

Background: Sick building syndrome (SBS) is defined as a condition occurring in those who live or work in a modern building and who suffer from symptoms such as headache, fatigue, lack of concentration and irritation of the skin and mucous membranes. Objectives: The aim of this study was to evaluate the relationship between personal characteristics, environmental factors and the prevalence of SBS among the secretaries working in a hospital. Method: In this cross-sectional study, questionnaires were administered to all secretaries who were working in Kutahya hospital in January and March 2018. The questionnaire used in the study included the sociodemographic characteristics of the participants and the question form "MM 040 NA Hospital" to evaluate SBS symptoms. These symptoms were the clinical symptoms reported by the secretaries as a result of exposure to factors within the hospital. Temperature, humidity, carbon dioxide concentration, light intensity and noise level were measured in the indoor environment of the hospital. Chi square test, Spearman's correlation coefficient and logistic regression models were used in the analysis of data. Results: The study was completed with 177 people, 61.6% women, and the mean age was 30.14 +/- 5.7. The prevalence of SBS was found to be 20.9%. The risk of SBS was found to be 2.9 times higher for females, 2.8 times higher for individuals who described the working environment as dusty, 2.6 times higher for subjects complaining of stuffy "bad" air, dry air and an unpleasant odour. All measurements were found to be within acceptable limits. The risk of SBS was found to be 1.2 times higher with increases in the measured noise level, and 2.1 times higher with increased carbon dioxide (CO2) concentrations. Conclusion: The factors impacting the risk of experiencing SBS were determined. Bearing these factors in mind, we think that hospital administrations should be informed about arrangements and measures that will improve the quality of the internal environment of the hospital

Risk Perception and Management Strategies in Agricultural Production: A Case Of Adana Province Of Turkey

This study aims to determine and analyze farmers’ risk perceptions and risk management strategies in agricultural production. Data were obtained in 2015 production year from face-to-face interviews of 99 farmers in Yüregir and Karaisalı district of Adana province of Turkey. Factor analysis was used in data reduction to identify a small number of factors related to risk sources and risk strategies in this study. Then, multiple regression model was used to evaluate the influence of socioeconomic characteristics on the farmers’ risk perceptions and risk management strategies using factor loadings. The results of this study show that the most important risk source that the farmers' perceive is availability of many middlemens in agriculture and food market and risk management strategy that the farmers' perceive is producing at the lowest cost. The result of factor analysis showed that the risk scale consists of 5 factors explaining 60.66% of total variance. The internal consistency coefficient Cronbach Alfa of the scale is 0.918 and KMO is 0.869. The risk management scale consists of 4 factors explaining 64.23% of total variance. The internal consistency coefficient Cronbach Alfa of the scale is 0.944 and KMO is 0.910. According to the results, perceptions are farmer-specific, a number of socio-economic variables are found to be related to risk and risk management. Improving of risk management strategies is useful for farmers as well and might help them to avoid many risks and reduce losses

Ahmed Glokom Valf İmplantasyonu Sonrası Ciddi Koroid Efüzyon Gelişimi ve Yönetimi: Olgu Sunumu

AMAÇ: Ahmed glokom valf (AGV) implantasyonu sonrası ciddi koroid efüzyonu gelişen bir olgunun klinik bulgularını, takip ve tedavi sonuçlarını sunmak.YÖNTEM: 39 yaşında bayan olgu kliniğimize seton cerrahisi sonrası ciddi koroid efüzyonu gelişmesi nedeniyle refere edilmiş idi. Bilateral afak olan olgunun sağ gözüne vitreoretinal cerrahi sonrası gelişen glokom nedeniyle dış merkezde 9 gün önce AGV implantasyonu yapılmıştı. Cerrahi sonrası ciddi koroid efüzyonu gelişen olguya dış merkezde sistemik steroid başlanmasına rağmen koroid efüzyonunda düzelme olmaması nedeniyle olgu kliniğimize yönlendirilmiş idi.BULGULAR: Oftalmolojik bakıda sağ gözde görme persepsiyon (+), projeksiyon (+) düzeyinde idi. Sağ gözde hipotoni (göz içi basıncı 2 mmHg) mevcuttu. Biyomikroskopik bakıda ön kamara sığdı. Ön kamarada üst kadranda AGV tüp ucu seçiliyordu. Fundus bakısında optik disk ve maküla seçilmiyordu. Oküler ultrasonografide ciddi koroid efüzyonu (öpüşen koroid) saptandı. Hastaya acil olarak genel anestezi altında koroid efüzyonu drenajı ve AGV implanta da revizyon işlemi uygulandı. AGV implant revizyonunda ön kamaradaki tüp ucu çıkarılarak geçici olarak konjonktiva altına yerleştirildi. Postoperatif 1. gün koroid efüzyonunun oldukça azalmış olduğu ve görme keskinliğinin 3 MPS düzeyinde olduğu görüldü ve göz içi basıncı (GİB) 10 mmHg saptandı. Takiplerde GİB yükselen olguya postoperatif 2. hafta transskleral diod lazer siklofotokoagulasyon uygulandı. Lazer sonrası GİB geçici düşen ve sonra tekrar yükselen olguda postoperatif 3. ayda AGV çıkarıldı ve çıkarılan implant alt nazal kadranda tüp ucu silier sulkusta olacak şekilde yerleştirildi. Göz içi basıncı bu cerrahiden sonra normal seviyede seyreden olgu halen kliniğimizde takip edilmektedir.SONUÇ: AGV implantasyonu sonrası ciddi koroid efüzyonu ile karşılaşılabilmektedir. Görmeyi tehdit eden ciddi koroid efüzyonu varlığında gecikmeden yapılacak drenaj ile yüz güldürücü sonuçlar alınabilir. Bu olgularda tekrar koroid efüzyonunu önlemek için gerekirse Ahmed glokom valfine revizyon da uygulanabilmektedir.</p