Gençlik cinsel sağlığı: Türkiye'deki bir üniversitede öğrenciler arasında cinsel bilgi, tutumlar ve davranışlar]

Introduction: To determine sexual attitudes, behavior, and knowledge of Namik Kemal University (NKU) students about sexual health and sexually transmitted infections (STIs). Method: A sample representing 10% of the undergraduate population of NKU in 2009-2010, was studied. Of 1,500 questionnaires distributed, 1,314 (87.6%) were filled out. Results: The mean age of the respondents (52.9% male) was 20.07 +/- 1.75 years. The rate of students who had received sexual health education was 32.0%, and 15.3% had previously used a sexual health service. Eleven percent of the female students and 50.3% of the male students had had sexual intercourse. The average age of initial sexual intercourse was 16.83 +/- 2.07 years. Of the students who had had sexual intercourse, 46.6% reported that they did not use any contraception method. The most preferred method was condoms (37.6%). The rate of contraceptive use was 58.7% in sexually educated students and 43.9% in those not educated (p=0.004). The most well-known STI was AIDS (96.5%), with sexually educated students giving higher rates of correct answers about STIs (p<0.05) Conclusion: The students who had received sexual health education were more knowledgeable about vital consequences of STI's, even though it is not sufficient, than sexually active students. Awareness of safe sexual practices and changes in behavior, in particular, promoting condom use should be established in higher risk youths. Deficiencies in knowledge could be addressed by adding a sexual healthtraining component to the university curriculum, and unmet requirements could be met by reorganizing medico-social centers in universities

Advanced oxidation protein products and malondialdehyde — the new biological markers of oxidative stress — are elevated in postmenopausal women

Objectives: The aim of the study was to measure advanced oxidation protein products (AOPPs) as markers for oxidative stress to evaluate cardiovascular risk in pre- and postmenopausal women and to compare the results with malondialde­hyde (MDA) levels. Material and methods: Twenty premenopausal women and 84 naturally postmenopausal patients were enrolled in the study. AOPP and MDA plasma levels were measured. The postmenopausal group was further subdivided into two groups: postmenopausal age of 40–49 and of 50–59 years. AOPP and MDA levels were compared between premenopausal, 40–49 and 50–59 year old menopausal women. Results: Plasma AOPP and MDA levels in postmenopausal women were increased when compared with their premeno­pausal peers (123.83 ± 55.51 μmol/L vs. 61.59 ± 16.42 μmol/L and 6.50 ± 1.05 μmol/L vs. 5.98 ± 0.77 μmol/L; respectively). Mean plasma AOPP levels in the two menopausal age groups were both significantly higher from the premenopausal group (118.64 ± 59.1 μmol/L vs. 61.59 ± 16.42 μmol/L and 132.31 ± 48.97 μmol/L vs. 61.59 ± 16.42 μmol/L; respectively). No significant difference was found in mean AOPP levels between postmenopausal subjects of 40–49 and 50–59 years age (118.64 ± 59.12 μmol/L vs. 132.31 ± 48.97 μmol/L). Mean plasma MDA levels of each of two postmenopausal age groups were both significantly higher from the premenopausal group (6.50 ± 1.04 μmol/L vs. 5.98 ± 0.77 μmol/L and 6.50 ± 1.10 μmol/L vs. 5.98 ± 0.77 μmol/L; respectively). However, no statistically significant difference between the two postmenopausal age groups (6.50 ± 1.04 μmol/L vs. 6.50 ± 1.10 μmol/L) was found. Conclusions: AOPP and MDA levels are elevated in postmenopausal women as compared to their premenopausal peers, suggesting they can be used as markers for cardiovascular risk in postmenopausal women

A case report of brain abscess caused by carbapenem- resistant Klebsiella pneumoniae

The treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CR-Kp) strains is difficult due to the limited antimicrobial options and high mortality. There are many reports on intracranial infections caused by CR-Kp, but only a few on brain abscesses caused by CR-Kp. Here, we present a case of brain abscess caused by CR-Kp successfully treated with combined antibiotics. A 26-year-old male patient was admitted to our hospital due to high fever and headache. His past medical history includes a surgical intervention due to an acute subdural hematoma, performed at an external healthcare center. After the current diagnosis of cerebral abscess, he underwent two surgeries. During the procedure, multiple cerebral abscesses were drained and capsulotomies were performed under ultrasound guidance. The combination of meropenem and vancomycin was started. The contents of the abscesses were sent to the microbiology and pathology laboratory. On the 3rd day of treatment, the medical team was informed that CR-Kp grew in an abscess culture. The patient's treatment was changed to meropenem + colistin + tigecycline. The patient developed electrolyte disturbances during the follow-up and this was considered an adverse effect of colistin. On the 41st day of treatment, colistin was discontinued, fosfomycin was added, and meropenem and tigecycline were maintained. Treatment was discontinued on the 68th day, when the patient was discharged. The general condition of the patient, who has been followed up for two years, is satisfactory. The treatment of CR-Kp infections should be individualized, and the pharmacokinetics and pharmacodynamics of antibiotics should be considered in each case

A case report of brain abscess caused by carbapenem-resistant Klebsiella pneumoniae

The treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CR-Kp) strains is difficult due to the limited antimicrobial options and high mortality. There are many reports on intracranial infections caused by CR-Kp, but only a few on brain abscesses caused by CR-Kp. Here, we present a case of brain abscess caused by CR-Kp successfully treated with combined antibiotics. A 26-year-old male patient was admitted to our hospital due to high fever and headache. His past medical history includes a surgical intervention due to an acute subdural hematoma, performed at an external healthcare center. After the current diagnosis of cerebral abscess, he underwent two surgeries. During the procedure, multiple cerebral abscesses were drained and capsulotomies were performed under ultrasound guidance. The combination of meropenem and vancomycin was started. The contents of the abscesses were sent to the microbiology and pathology laboratory. On the 3 rd day of treatment, the medical team was informed that CR-Kp grew in an abscess culture. The patient’s treatment was changed to meropenem + colistin + tigecycline. The patient developed electrolyte disturbances during the follow-up and this was considered an adverse effect of colistin. On the 41 st day of treatment, colistin was discontinued, fosfomycin was added, and meropenem and tigecycline were maintained. Treatment was discontinued on the 68 th day, when the patient was discharged. The general condition of the patient, who has been followed up for two years, is satisfactory. The treatment of CR-Kp infections should be individualized, and the pharmacokinetics and pharmacodynamics of antibiotics should be considered in each case

Comparison of antibiotic use in the COVID-19 pandemic with the pre-pandemic period in a university hospital

Introduction: The appropriate use of antibiotics is an important strategy in slowing the development of antimicrobial resistance. This study aimed to evaluate antibiotic consumption and antibiotic use during the coronavirus disease 2019 (COVID-19) pre-pandemic period and pandemic period. Methods: Antibiotic consumption was evaluated with the antibiotic consumption index (ACI). Results: Antibiotics with the largest increase in ACI value during the pandemic period compared to the previous year increased from 0.4 to 1.8 DDI/100 bed days in moxifloxacin. Teicoplanin, linezolid, and clindamycin were not affected in terms of consumption. Conclusions: It was observed that the use of many intravenous antibiotics in our hospital increased during the pandemic period

A 5-year surveillance of healthcare-associated infections in a university hospital: A retrospective analysis

Objectives: Nosocomial infections or healthcare-associated infections are a significant public health problem around the world. This study aimed to assess the rate of laboratory-confirmed healthcare-associated infections, frequency of nosocomial pathogens, and the antimicrobial resistance patterns of bacterial isolates in a University Hospital. Methods: A retrospective evaluation of healthcare-associated infections in a University Hospital, between the years 2015 and 2019 in Tekirdag, Turkey. Results: During the 5 years, the incidence densities of healthcare-associated infections in intensive care units and clinics were 10.31 and 1.70/1000 patient-days, respectively. The rates of ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections in intensive care units were 11.57, 4.02, and 1.99 per 1000 device-days, respectively. The most common healthcare-associated infections according to the primary sites were bloodstream infections (55.3%) and pneumonia (20.4%). 67.5% of the isolated microorganisms as nosocomial agents were Gram-negative bacteria, 24.9% of Gram-positive bacteria, and 7.6% of Candida. The most frequently isolated causative agents were Escherichia coli (16.7%) and Pseudomonas aeruginosa (I 5.7%). The rate of extended-spectrum beta-lactamase production among E. coli isolates was 51.1%. Carbapenem resistance was 29.8% among isolates of P. aeruginosa, 95.1 % among isolates of Acinetobacter baumannii, and 18.2% among isolates of Klebsiella pneumoniae. Colistin resistance was 2.4% among isolates of A. baumannii. Vancomycin resistance was 5.3% among isolates of Enterococci. Conclusion: Our study results demonstrate that healthcare-associated infections are predominantly originated by intensive care units. The microorganisms isolated from intensive care units are highly resistant to many antimicrobial agents. The rising incidence of multidrug-resistant microorganisms indicates that more interventions are urgently needed to reduce healthcare-associated infections in our intensive care units

Investigation of Factors Affecting Viral Clearance Time by Real-Time Polymerase Chain Reaction Method in Nasopharyngeal Swab Samples of COVID-19 Patients

The coronavirus disease-2019 (COVID-19) pandemic continues to threaten the lives of millions of people. Viral shedding through the respiratory tract is the main risk factor for the transmission of the severe acute respiratory syndrome-2 (SARS-CoV-2) virus from sick individuals to healthy individuals. In this study, we aimed to investigate the viral clearance (VC) time in PCR tests of COVID-19 patients and the possible factors affecting this time. Seventy patients older than 18 years of age whose presence of SARS-CoV-2 virus was proven by real-time polymerase chain reaction (Rt-PCR) in nasopharyngeal swab samples were included in the study. The presence of SARS-CoV-2 RNA was investigated by RT-PCR in nasopharyngeal swab samples at 48-72 hour intervals, five days after the initial diagnosis. Demographic, physical examination, laboratory test, computed tomography (CT) results, concomitant diseases, and duration of VC were recorded. Of the cases, 41 were female and 29 were male. The mean age was 45.8 +/- 19.2 years. According to the CT results, in the group with no involvement, local involvement and widespread involvement, the duration of VC was 9.66 +/- 5.91 days, 9.99 +/- 4.68 days, and 10.94 +/- 5.34 days, respectively (p>0.05). While the duration of VC was determined as 8.93 +/- 4.33 days in the group without comorbidity, this period was found to be 12.26 +/- 5.69 days (p=0.025) in the group with the comorbidity. It was determined that the duration of VC was 9.55 +/- 6.37 days in women and 9.20 +/- 7.22 days in men (p=0.040). The duration of VC was found to be 10.18 +/- 7.1 days in patients over 50 years of age and 8.87 +/- 5.15 days under 50 years of age (p=0.03). A significant correlation was found between the laboratory test lactate dehydrogenase level and VC duration (p=0.007). However, a significant relationship could not be established between other laboratory test results and the duration of VC. In this retrospective observational study, the relationship between viral clearance duration in Rt-PCR and gender, age, CT results, comorbidities and laboratory results in nasopharyngeal swab samples was investigated and it was determined that the duration of VC was significantly prolonged in case of female gender, being over 50 years old and having a comorbid disease. The results obtained may contribute to predict the isolation times of the patients and to reveal the factors that may affect viral shedding

Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with postoperative meningitis

Background: Nosocomial meningitis is a rare complication following neurosurgical procedures and is associated with high morbidity and mortality. Aim: The aim of this study was to describe the clinical characteristics and the risk factors associated with mortality in patients who developed nosocomial meningitis following neurosurgical operations. Setting and design: Tertiary care hospital and an observational study. Materials and Methods: The study subjects included 2265 patients who underwent various neurosurgical operations during 2003-05. The diagnosis of nosocomial meningitis was based on the Center for Disease Control criteria. Statistical analysis: It was performed by using Statistical Package for Social Sciences for Windows 10.0 program. Results: The incidence of postoperative nosocomial meningitis was 2.7% (62 episodes in 49 patients among 2265 patients operated). Staphylococcus aureus and Acinetobacter spp. were the most frequently isolated pathogens. Of the 49 with meningitis 20 (40.8%) patients died. In the logistic regression analysis model, Glascow coma scale score less than 10 (Odds Ratio (OR): 19.419, 95% Confidence Interval (CI); 1.637-230.41, P = 0.001), and low cerebrospinal fluid glucose level (= 30 mg/dL) (OR: 10.272, 95% CI; 1.273-82.854, P= 0.002), and presence of concurrent nosocomial infection (OR: 28.744, 95% CI; 1.647-501.73, P= 0.001) were the independent risk factors associated with mortality. Conclusion: The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem

An unusual presentation of brucellosis: hepatic microabscesses

Hepatic abscess due to Brucella species is an extremely rare complication especially in acute illness. Here, we report a case of hepatic microabscesses probably caused by Brucella in a 33-year-old woman with acute infection who was successfully treated with a combination of doxycycline and rifampicin for 3 months

Procjena utjecaja atmosferske korekcije na podatke Landsat 8 i Sentinel-2 za određivanje saliniteta tla

Remote sensing technology effectively determines and evaluates salinity-affected areas\u27 spatial and temporal distribution. Soil salinity maps for large areas can be obtained with low cost and low effort using remote sensing methods and techniques. Remote sensing data are delivered raw as Level-1 data, and they can be further atmospherically corrected to surface reflectance values, Level-2 data. This study evaluates the atmospheric correction impact on Landsat 8 and Sentinel-2 data for soil salinity determination. The study has been supported with in-situ measurements in Alpu, Eskisehir, Turkey, where samples were collected from various agricultural fields simultaneously with the overpass of the satellites. Two different analysis cases have been used to determine the effect of atmospheric correction. The first is to examine the relationship between the measurements taken from the areas with mixed product groups and the salinity indices for both data types. The other is to investigate the relationship between the measurement values taken only from the wheat and beet groups and the salinity index values. The results show that atmospheric correction has a high effect on the relationship between spectral indices and in situ salinity measurement values. Especially in all cases examined in Landsat, it was observed that atmospheric correction led to an improvement of over 140%, while nearly 50% was observed in Sentinel on a product basis.Uz pomoć tehnologije daljinskih istraživanja učinkovito se određuje i procjenjuje prostorna i vremenska rasprostranjenost područja zahvaćenih salinitetom. Karte saliniteta tla za velika područja mogu se izraditi uz niske troškove i malo truda koristeći metode i tehnike daljinskih istraživanja. Podaci dobiveni daljinskim istraživanjima isporučuju se neobrađeni kao podaci Level-1 te se zatim mogu atmosferski korigirati na vrijednosti površinske refleksije, podaci Level-2. Ova studija procjenjuje utjecaje atmosferske korekcije na podatke Landsat 8 i Sentinel-2 za određivanje saliniteta tla. Studija je potkrijepljena mjerenjima in situ u Alpu, Eskisehir, Turska, gdje su uzorci bili prikupljeni na različitim poljoprivrednim poljima istovremeno s preletima satelita. Upotrijebljene su dvije različite analize kako bi se odredio učinak atmosferske korekcije. Prva je analiza primijenjena kako bi se ispitao odnos između mjerenja provedenih na područjima s miješanim skupinama proizvoda i indeksima saliniteta za obje vrste podataka. Druga je analiza primijenjena kako bi se istražio odnos između vrijednosti mjerenja dobivenih samo iz skupina pšenice i repe te vrijednosti indeksa saliniteta. Rezultati pokazuju da atmosferska korekcija ima visok učinak na odnos između spektralnih indeksa i vrijednosti mjerenja saliniteta in situ. Posebno se u svim slučajevima ispitivanja putem Landsata moglo primijetiti da je atmosferska korekcija dovela do poboljšanja za više od 140%, dok je gotovo 50% primijećeno za Sentinel na temelju proizvoda