The effect of COVID-19 infection on retinal nerve fiber layer and ganglion cell complex layer thicknesses

Aim:  To evaluate the possible effects of SARS-CoV-2 infection on retinal nerve fiber layer (RNFL) and ganglion cell complex layer (GC-IPL) thicknesses. Method: Patients who had been infected by SARS-CoV-2 and hospitalized because of severe pneumonia were found out from the database of COVID-19 pandemic hospital and formed the patient group. The control group was composed of non-COVID-19 age-matched subjects. The mean and fragmented RNFL and GC-IPL thicknesses were measured by optical coherence tomography (OCT), and compared between two groups, statistically. Results: Patient group 34 eyes of 34 subjects (18 male, 16 female) and 31 eyes of 31 subjects (14 male, 17 female) in the control group were enrolled. The mean age and gender were not statistically different between groups (p:0.56, 0,57, respectively).A statistically significant difference was not found between groups in terms of mean, superior, inferior, temporal, nasal RNFL thicknesses and mean superior, inferior, temporal, and nasal GC-IPL thicknesses. Conclusion: The mean and fragmented RNFL and GC-IPL thicknesses measured by OCT were not statistically different in patients who had moderate disease course and recovered from COVID-19 infection

Risk factors of multidrug-resistant bacteria in community-acquired urinary tract infections

Background: Urinary tract infections (UTIs) are one of the most seen infection among community. Objectives: In this cross-sectional study we aimed to investigate the risk factors of multidrug-resistant (MDR) bacteria that caused community-acquired UTI (CA-UTI). Methods: Consecutive patients admitted to the Urology and Infectious Diseases policlinics with the diagnosis of CA-UTI were included in the study. A standard form including possible predisposing factors for MDR bacteria was applied. Results: In total, 240 patients (51.3% females) were enrolled in the study. The mean age of participants were 59.8 \ub1 18.3 years old. Escherichia coli (n =166; 69.2%)was the most frequently isolated bacteria and its incidence was higher in females than in males (p=0.01). In total, 129 (53.8%) of the identified pathogens were MDR bacteria. According to multivariate analysis, the use of antibiotics three or more times increased the risk of infection with MDR bacteria by 4.6 times, the history of urinary tract infection in the last 6 months by 2 times, being male and over 65 years old by 3 times. Conclusion: Doctors should consider prescribing broad-spectrum antibiotics in patients with severe UTIs with a history of UTI, advanced age, male gender, and multiple antibiotic usage, even if they have a CA-UTI

Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Africa, Eastern Europe, Latin America, and the Middle East: Findings of the International Nosocomial Infection Control Consortium (INICC)

Objective: Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs. Design: Prospective cohort study. Setting: This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries. Participants: The study included patients admitted to ICUs across 24 years. Results: In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16-1.28; P <.0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07-1.08; P <.0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23-1.31; P <.0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57-15.48; P <.0001)Revisión por pare

A Study on the Age-Related Changes in Hepatitis B and C Virus Serology

OBJECTIVE: There are a limited number of studies on the seroprevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection in Turkey. This study aimed to compare HBV and HCV seroprevalence rates before and after the implementation of national hepatitis B vaccination program (NHPVP) and to explore age-related changes in the seroprevalences. MATERIALS AND METHODS: Results of Hepatitis B surface antigen (HBsAg), Hepatitis B virus surface antibody (antiHBs) and anti-HCV tests performed during 2009 and 2010 in a state hospital laboratory were reviewed retrospectively. As NHPVP was started in 1998, 12 years of age and younger children were considered post- NHPVP period subjects. RESULTS: A total of 3280 HBsAg, 2444 antiHBs and 3188 anti-HCV test results were reviewed, representing approximately 3% of the population of the city where the study was conducted. HBsAg, antiHBs and anti-HCV positivity were 3.2%, 36.12% and 0.97%, respectively. HBsAg and antiHBs positivity were higher among males (p<0.001). When assessed by age groups, HBsAg positivity was found to be the lowest in the age group 0–12 and highest in the age group 51–60. HBsAg positivity was lower in the post-NHPVP period versus pre-NHPVP period (p=0.01). Anti-HCV positivity was similar for pre- and post- NHPVP periods (p>0.05). CONCLUSION: Owing to the use of NHPVP, HBsAg seropositivity has decreased, and it is expected to decrease further in the next years with a wider implementation of the program. Efforts should be continued to increase the level of awareness in the community for HBV and the importance of immunization

Evaluation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio in patients with cellulitis

OBJECTIVE: Cellulite infection is a non-necrotizing inflammation of the skin and subcutaneous tissue and is one of the most common reasons for admission to hospital. This retrospective study aimed to investigate the Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and Lymphocyte to Monocyte Ratio (LMR) in patients with cellulitis. METHODS: In our study, we retrospectively analyzed 96 patients with cellulitis and 98 age- and sex-matched healthy controls. The study and control groups were compared regarding NLR, PLR, and LMR. RESULTS: The PLR and NLR of the cellulitis group were significantly higher than those of the control group (p = 65 years and <65 years, a statistically significant difference was noted in the NLR and LMR values (p < 0.05). In the ROC curve analysis, NLR had the highest discriminative power in distinguishing between cellulitis and healthy controls (AUC = 0.950, 95% CI: 0.920-0.979, p <0.001; 91.6% sensitivity and 89.8% specificity). CONCLUSION: NLR was significantly higher in differentiating cellulite and in patients older than 65 years. Larger, prospective studies are required to determine its usefulness in assessing differential diagnosis and prognosis in cellulitis patients.WOS:0005689547000282-s2.0-85091054676PubMed: 3293580

Comparison of uterine exteriorization and in situ repair during cesarean sections

To compare the peri- and postoperative complication rates of two cesarean delivery techniques

Antibiotic use and Influencing Factors Among Hospitalized Patients with COVID-19: A Multicenter Point-Prevalence Study from Turkey

Background: Broad-spectrum empirical antimicrobials arc frequently prescribed for patients with coronavirus disease 2019 (COVID-19) despite the lack of evidence for bacterial coinfection. Aims: We aimed to cross-sectionally determine the frequency of antibiotics use, type of antibiotics prescribed, and the factors influencing antibiotics use in hospitalized patients with COVID-19 confirmed by polymerase chain reaction. Study Design: The study was a national, multicenter, retrospective. and single-day point prevalence study. Methods: This was a national, multicenter, retrospective, and single-day point-prevalence study, conducted in the 24-h period between 00:00 and 24:00 on November 18, 2020, during the start of the second COVID-19 peak in Turkey. Results: A total of 1500 patients hospitalized with a diagnosis of COVID-19 were included in the study. The mean age +/- standard deviation of the patients was 65.0 +/- 15.5, and 56.2% (n = 843) of these patients were men. Of these hospitalized patients, 11.9% (n = 178) were undergoing invasive mechanical ventilation or ECMO. It was observed that 1118 (74.5%) patients were receiving antibiotics, of which 416 (372%) were prescribed a combination of antibiotics. In total, 71.2% of the patients had neither a clinical diagnosis nor microbiological evidence for prescribing antibiotics. In the multivariate logistic regression analysis, hospitalization in a state hospital (p 0.001), requiring any supplemental oxygen (p = 0.005). presence of moderate/diffuse lung involvement (p 0.001), C-reactive protein >10 ULT coefficient (p 0.001), lymphocyte count 800 (p = 0.007), and clinical diagnosis and/or confirmation by culture (p 0.001) were found to be independent factors associated with increased antibiotic use. Conclusion: The necessity of empirical antibiotics use in patients with COVID-19 should be reconsidered according to their clinical, imaging, and laboratory findings

Clozapine-Induced Febrile Neutropenia and Cellulitis

Clozapine is one of the atypical antipsychotics and is frequently prescribed to patients with treatment-resistant schizophrenia. Agranulocytosis is a major side effect that may lead to death, which limits its use. This is a case report of a patient that developed febrile neutropenia and cellulitis after treatment with clozapine for 20 weeks

IL-33 AND ST2 LEVELS IN CHRONIC KIDNEY DISEASE: ASSOCIATIONS WITH INFLAMMATION, VASCULAR ABNORMALITIES, CARDIOVASCULAR EVENTS AND SURVIVAL

WOS: 000469797100395

Comparable efficacy of tenofovir versus entecavir and predictors of response in treatment-naïve patients with chronic hepatitis B: a multicenter real-life study

Objective: To compare responses to tenofovir (TDF) and entecavir (ETV) therapy. Methods: This was a multicenter retrospective study including treatment-naïve patients with chronic hepatitis B (CHB) who received TDF or ETV. The primary end-points were undetectable HBV-DNA at 48 weeks and serological and biochemical responses. Results: Out of 195 CHB patients, 90 (46%) received TDF and 105 (54%) received ETV; 72% were male, their mean age was 43 ± 12 years, and the mean duration of treatment was 30.2 ± 15.7 months. Hepatitis B e antigen (HBeAg) seropositivity was 32% in the TDF group and 34% in the ETV group. HBeAg seroconversion rates in HBeAg-positive patients were 24% in the TDF group and 39% in the ETV group; the difference was not significant (p = 0.2). The mean time to alanine aminotransferase (ALT) normalization and rates of ALT normalization at 3, 6, 12, 18, and 24 months were similar in the two groups (p > 0.05). The mean time to undetectable HBV-DNA levels in the TDF and ETV groups was 11.5 ± 8.9 and 12.9 ± 10.8 months, respectively (p = 0.32). A significantly greater decline in HBV-DNA levels at 12 and 18 months was observed in the TDF group (p = 0.02 and p = 0.03, respectively). Seven (7%) patients on ETV therapy had virological breakthrough (p = 0.01). Only one patient in each group had hepatitis B surface antigen (HBsAg) clearance. None of the patients developed decompensation or hepatocellular carcinoma during treatment. Conclusions: The two drugs appear to have similar efficacy in CHB patients. However, 7% of patients on ETV therapy had virological breakthrough, while none of the patients on TDF therapy did