Atmospheric conditions of extreme precipitation events in western Turkey for the period 2006–2015

This paper investigates the precipitation types and background physical mechanisms of extreme precipitation events (EPEs) over western Turkey during the period 2006–2015. The EPEs are described as the precipitation values above the 90th percentile obtained from the hourly precipitation dataset, which has high spatial resolution. Precipitation types associated with EPEs are identified by using radar outputs and the Lamb weather type (LWT) approach. It is found that EPEs occurred more frequently in the Marmara and Aegean regions during autumn and winter months. In Marmara, mainly 21&thinsp;%, 17&thinsp;%, and 15&thinsp;% of total autumn EPEs show convective, cyclonic, and sea-effect precipitation characteristics, respectively. While convective EPEs are seen more commonly in the southern portions, cyclonic and sea-effect-originated EPEs mainly affect the southwest and northeastern parts of Marmara. Among these three precipitation types, convective mechanisms generally produce more intense daily precipitation (66.1&thinsp;mm on average) in the Marmara Region under the proper synoptic conditions (high-pressure center over the Balkan Peninsula and low-pressure center over the eastern Mediterranean). Based on the hourly observations, convective types of extreme precipitation (EP) show two peak values during afternoon and evening times of the day and are linked to diurnal heating. In terms of the Aegean Region, cyclone-originated EP, which includes 65&thinsp;% of the total winter EPEs, is more common in the whole territory and reaches its peak value during the early hours of the day.</p

Predictors for limb loss among patient with diabetic foot infections: an observational retrospective multicentric study in Turkey

We aimed to investigate the predictors for limb loss among patients with diabetes who have complicated skin/soft-tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centres in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total, 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients had used antibiotics within the last month, and 121(27%) had osteomyelitis. Of the 208 microorganisms isolated, 92 (44.2%) were Gram-positive cocci and 114 (54.8%) were Gram-negative rods (GNR). The most common GNR was Pseudomonas; the second was Escherichia coli, with extended spectrum beta-lactamase positivity of 33%. Methicillin-resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these were major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR 1.75, 95% Cl 1.04-2.96, p 0.034), duration of diabetes >20 years (OR 1.9, 95% Cl 1.18-3.11, p 0.008), infected ulcer versus cellulitis (OR 1.9, 95% Cl 1.11-3.18, p 0.019), history of peripheral vascular disease (OR 2, 95% Cl 1.26-3.27, p 0.004), retinopathy (OR 2.25, 95% Cl 1.19-4.25, p 0.012), erythrocyte sedimentation rate >70 mm/hr (OR 1.6, 95% Cl 1.01-2.68, p 0.05), and infection with GNR (OR 1.8, 95% Cl 1.08-3.02, p 0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of diabetes >20 years, infected ulcers, history of peripheral vascular disease and retinopathy, detection of GNR was a significant predictor of limb loss. Clinical Microbiology and Infection (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved