Does electrocardiography at admission predict outcome in Crimean-Congo hemorrhagic fever

Background & objectives: Crimean-Congo hemorrhagic fever is an acute viral hemorrhagic fever withconsiderable mortality. Despite increasing knowledge about hemorrhagic fever viruses, the pathogenesis ofCrimean-Congo hemorrhagic fever and causes of death were not well described. We aimed to evaluate whetherthere were electrocardiographic parameters designating mortality among these patients.Study design: This retrospective study was performed among confirmed Crimean-Congo hemorrhagic fevercases in Turkey. Electrocardiography was available in 49 patients within 24 h of hospitalization. Allelectrocardiograms were evaluated by two expert cardiologists according to Minnesota coding system.Results: Among patients with available electrocardiograms, there were 31 patients who survived, and 18patients who died of Crimean-Congo hemorrhagic fever. Both groups were similar in terms of age, sex, bodytemperature, heart rate, and blood parameters. T-wave changes and bundle branch block were more frequentlyencountered among those who died. Presence of T-wave negativity or bundle branch block in this cohort ofpatients with Crimean-Congo hemorrhagic fever predicted death with a sensitivity of 72.7%, specificity of92.6%, positive predictive value of 88.9%, negative predictive value of 80.6%.Conclusions: We think within the light of our findings that simple electrocardiography at admission may helprisk stratification among Crimean-Congo hemorrhagic fever cases

Effectiveness and safety of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate single-tablet combination among HIV-infected patients in Turkey: results from a real world setting

Background: Efficacy of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil (E/C/F/TDF) in treatment-naïve and experienced patients with HIV infection was demonstrated in phase 3 trials. The primary objective of this study was to evaluate effectiveness and safety of E/C/F/TDF in real world settings. Methods: Retrospective, observational data collected by the Turkish ACTHIV-IST study group between May 2015 and December 2016 were analysed. Results: A total of 387 patients were prescribed E/C/F/TDF; 210 patients with available data at 6th month were eligible; 91.5% were male, and mean age was 35.2 (SD: 10.8) years; 54.0% of males identified themselves as MSM. Sixty-three percent (133) of the study population were treatment-naïve patients, and 37% (77) were treatment experienced. HIV RNA level was below 100 copies/mL in 78.9% of treatment-naïve patients and 89.9% of treatment experienced patients at month 6. Median increase in CD4 T lymphocyte count was 218 copies/mL in treatment-naïve patients and remained stable or increased in treatment experienced patients. Adverse events were observed in 15% of the patients, and the regimen was discontinued in only six patients. Conclusion: Real world data on the effectiveness and safety of E/C/F/TDF is comparable with the phase 3 trial results Adverse events are uncommon and manageable. Keywords: Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate; HIV; effectiveness; safety

Crimean-Congo Hemorrhagic Fever Virus in High-Risk Population, Turkey

In the Tokat and Sivas provinces of Turkey, the overall Crimean-Congo hemorrhagic fever virus (CCHFV) seroprevalence was 12.8% among 782 members of a high-risk population. CCHFV seroprevalence was associated with history of tick bite or tick removal from animals, employment in animal husbandry or farming, and being >40 years of age

Crimean-Congo hemorrhagic fever: does it involve the heart?

Objective: Crimean-Congo hemorrhagic fever (CCHF) is an acute viral hemorrhagic fever with a high mortality rate. Despite increasing knowledge about viral hemorrhagic fevers, the pathogenesis of CCHF and causes of death have not been well described. In this study, we aimed to evaluate the cardiac functions of CCHF patients

Immunization rates of pneumococcal, influenza and tetanus vaccines and knowledge and attitudes of adult patients who receive inpatient treatment at hospital: Point prevalence study

The safety of vaccines, access to health care, the level of community's knowledge and the attention of physicians play a critical role in the rate of adult vaccination. This study aims to determine the immunization rate of pneumococcal, influenza and tetanus vaccines among the patients and their knowledge and attitudes in the hospital. The study is a cross-sectional point prevalence survey. The patients who agreed to participate in the study were interviewed using a questionnaire. Patients' gender, occupation, educational status, income level and risk factors (immunosuppressed and over 65 years old) were compared with the knowledge and attitudes about vaccinations. Of the 251 participants, 51.4% were female and 48.6% were male. The self-reported vaccination rate was 3.5% for pneumococcal, 8.6% for influenza and 26.6% for tetanus. Most of the patients have knowledge about influenza vaccination (90.3%). Patients with the high education level have significantly higher knowlege about tetanus vaccination and higher rate of tetanus vaccine compared to those with low education level (p = 0.04; p = 0.006). It was found that those with higher income levels had the more pneumococcal vaccination, more knowledge on tetanus vaccination, and more attitude that tetanus vaccine is necessary compared to those with lower income level (p < 0.05). Patients without risk factors have a higher rate of tetanus vaccination compared to those with risk factors (p < 0.001). It was inferred that the high level of education and income have a positive effect on the patients vaccination rates and their knowledge and attitude

HIV care in Istanbul, Turkey: How far is it from the UNAIDS 90-90-90 targets?

The prevalence of human immunodeficiency virus (HIV) infection is low but it is steadily increasing in Turkey. In the current study, we aimed to assess the status of HIV infection management with the proposed 90-90-90 targets in a large HIV cohort in Istanbul, Turkey. The cohort included 2382 patients (2082 male, 300 female, mean age was 36.3 +/- 11.3 years). Mean CD4 cell count was 399 cells/mm(3) and HIV-RNA level was 576,235 copies/ml. According to the modeling by the Modeling tool of European Center for Diseases Control Software, 72 and 74% of all HIV patients had been diagnosed in 2016 and 2017, respectively (the first target). Among 2382 patients, 2191 (92%) were on antiretroviral therapy (the second target). The third target of virally suppressing those on treatment was achieved among 70.2% of the patients. The current study suggests that both the fraction of those living with undiagnosed HIV and the proportion of those on treatment who are virally suppressed should be targeted to sustain optimal HIV care. Efforts should continue to surpass the targets of 90-90-90

LATE PRESENTATION AMONG PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN TURKEY

Objective: Late presentation of the patients with human immunodeficiency virus (HIV) infection is associated with less favourable treatment responses, more accelerated clinical progression, and a higher mortality risk. Although HIV prevalence is low in Turkey, it is steadily increasing and the information about late presentation among HIV-positives is limited. We aimed to analyze the status of late presentation among HIV-positive patients in Turkey

Prevalence and mortality of cancer among people living with HIV and AIDS patients: a large cohort study in Turkey

Background: Cancer is responsible for elevated human immunodeficiency virus (HIV)-related mortality but there are insufficient data about cancer in HIV-positive patients in Turkey