Evaluating the risk factors of venous thromboembolism patients

Aim: Pulmonary thromboembolism (PTE) is a serious health problem; nevertheless, diagnosing this disorder using today's technology is easier than it was in the past. However, identifying the risk factors associated with PTE and providing proper prophylaxis is as important as diagnosing it. In the present study, it was aimed to identify risk factors for pulmonary embolism and to determine, which patients will should receive special attention for prophylaxis. Material and Methods: This study included 355 patients with venous thromboembolism. Patient risk factors were evaluated, such as vital signs, laboratory findings, clinical symptoms, diagnosis and treatment methods, mortality rates, Wells scores, and PESI scores were evaluated. Results: Immobilization was the most common risk factor (42.5%) among the patients. Previous surgery (32 patients, 9%) and cancer (69 patients, 19.4%) were among the most common risk factors. In 44 patients (12.4%), no risk factor was identified. There was a significant correlation between pulmonary arterial pressure and PESI scores, and mortality. Discussion: In conclusion, iIt is vital to avoid delays in diagnosing and treating common diseases with high mortality rates, such as VTE and PTE. However, prevention is as important as diagnosis and treatment

Solunum yoğun bakımın patojen nadir alt solunum yolu etkenleri ve antibiyotik duyarlılık durumları

Amaç: Solunum yoğun bakımında yatan hastaların alt solunum yolu (ASY) kültürlerinde enfeksiyon etkeni olarak nadir üreyen mikroorganizmaların klinik özelliklerinin ve antibiyotik duyarlılıklarının saptanması Gereç ve Yöntem: Ocak 2019–Nisan 2023 tarihleri arasında solunum yoğun bakımında yatarak takip ve tedavi edilen ASY örneklerinde enfeksiyon etkeni olarak nadir üreyen mikroorganizmalar saptanan 42 hastanın demografik özellikleri, altta yatan hastalıkları ve risk faktörleri, APHACHE-II skorları ve kültür sonuçları ile antibiyotik direnç paternleri ile hastane içi mortalite durumları retrospektif olarak değerlendirildi. Bulgular: Çalışmaya ASY örneklerinde enfeksiyon etkeni olarak nadir üreyen mikroorganizma saptanan 30’u erkek, 12’si kadın 42 hasta alındı. Yaş ortalaması 73,7±10,9 yıl idi. Hastalarda en sık eşlik eden hastalıklar hipertansiyon, kronik obstrüktif akciğer hastalığı (KOAH), kalp yetmezliği idi. Nadir patojen mikroorganizma olarak en sık burkholderia cepaci (n=8), Stenotrophomonas maltophilia (n=6), proteus mirabilis (n=5), entobacter aerogenes (n=5) saptandı. Risk faktörü olarak da en sık idrar sondası, nadir patojen mikroorganizma üremesi öncesinde antibiyotik kullanımı saptandı. Yoğun bakımda yatış sırasında hastalardan 22’si yaşarken, 20’si eksitus oldu. ASY örneklerinde ilk üremenin saptandığı gün (p=0.012) ve yaşayan gruptaki APHACHE-II skorları eksitus olan gruba göre anlamlı olarak düşüktü (p=0.012). Sonuç: Yoğun bakımlarda sık üreyen mikroorganizmalar gibi nadir üreyen mikroorganizmalarda da hastane içi mortalitenin yüksek olduğu bu nedenle antibiyotik direnç paternlerinin daha yüksek sayıdaki olgularla değerlendirilmesinin ülkemizde ve yoğun bakımlarımızda antibiyotik kullanımına katkı sağlayacağını düşünmekteyiz

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV mortality prediction score (IMPRES)

KUCUK, Ahmet Oguzhan/0000-0002-6993-0519; Kirakli, Cenk/0000-0001-6013-7330; KUCUK, Mehtap PEHLIVANLAR/0000-0003-2247-4074; Aksoy, Iskender/0000-0002-4426-3342WOS: 000504051300010PubMed: 31655511Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: 8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data

Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA External Quality Assessment National Program Results

MOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load. The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products