Development of Attitude and Behavior Scale Towards Medical Wastes: A Methodological Study

Introduction: This study aims to develop a valid and reliable measurement tool that measures the attitudes and behaviors of healthcare professionals towards medical waste. Materials and Methods: In this methodological study, the item pool of the medical waste attitude and behavior scale (TATS) was first created, then the content validity of the 30-item scale was tested by taking expert opinions, and validity and reliability analyzes were conducted. The scale wa instrument s applied to 252 health workers working in a university hospital. Data were analyzed us hedef ing SPSS (22.0) and AMOS (24.0) programs. Results: After the exploratory and confirmatory factor analyses, the scale showed a four-factor structure consisting of 24 items and the total variance explained was 69.09%. As a result of confirmatory factor analysis, the goodness of fit values of the scale is within acceptable limits (χ²/sd= 2.97, RMSEA= 0.08, CFI= 0.90, SRMR= 0.05). There is a moderate positive correlation between the developed scale and the medical waste management evaluation scale (r= 0.55 and p< 0.001) and criterion validity are appropriate. The Cronbach’s alpha coefficient is 0.94 for the whole scale and between 0.77 and 0.95 for the sub-dimensions, and the scale has a high level of reliability. According to the difference evaluation made between the 27% groups who got the highest and lowest scores on the scale, it was determined that all of the items on the scale were distinctive and valid. It has been determined that the scale has no floor and ceiling effect. Conclusion: The developed medical waste attitude and behavior scale can be used as a valid and reliable scale to determine the attitudes and behaviors of health-care professionals

Temporal Arteritis in Etiology of Fever of Unknown Origin

Fever of unknown origin, defined as a temperature greater than 38.3°C on several occasions for three weeks and a failure to reach a diagnosis despite a week of in patient investigations. In the etiology of fever of unknown origin, infections are the most common cause. In this article the case of a temporal arteritis presented which is a less common cause of fever of unknown in many series. Visual loss is the most common and the major ischemic complications of the temporal arteritis. Although the blindness is complaint of application in many cases, in the presented case there was no abnormal finding in the ophtalmological examination. The symptoms of patient revealed with corticosteroid therapy. Temporal arteritis should be considered particularly in older patients with fever of unknown origin

Comparison of FibroTest-ActiTest with histopathology in demonstrating fibrosis and necroinflammatory activity in chronic hepatitis B and C

Aims: FibroTest and ActiTest are noninvasive tests used in determining the level of fibrosis and the degree of necroinflammator activity in the liver. In our study, we aimed to investigate whether these tests could be alternative to liver biopsy. Materials and Methods: Fifty patients were included in the study. Serum samples were obtained and liver needle biopsy was performed on the same day. Levels of fibrosis in FibroTest and levels of activity in ActiTest, both determined via serum biochemical markers, were compared with levels of fibrosis and activity in histopathological examination. For statistical analyses, Mc Nemar chi square test and Spearman's correlation tests were used. Results: There was a significant positive correlation between fibrosis in biopsy and the level of fibrosis in FibroTest in patients with hepatitis B virus (HBV) (rho: 0.67, P < 0.0001). However, no significant correlation was determined between the activity in biopsy and the degree of activity in ActiTest (rho: 0.29, P < 0.05). No significant correlation was determined between both fibrosis and activity established in biopsy and the results of FibroTest and ActiTest in the group of patients with hepatitis C virus (HCV) (rho: 0.22, P < 0.05 and rho: 0.15, P < 0.05, respectively). Conclusion: Our results suggest that novel and safer noninvasive biochemical tests are needed as an alternative to histopathology in patients infected with HBV and HCV. Consequently, we believe that liver biopsy maintains its place as a gold standard in determining the histopathological condition of the liver

The Seroprevalence of Hepatitis E in Different Age Groups in Isparta Region

Hepatitis E virus (HEV) is a major health problem in many developing countries. It is transmitted by water and food that are contaminated by feces. The aim of this study was to determine the prevalence of HEV infection in different ages in Isparta region. The study group included 1153 blood donors and 64 healthy children. Anti-HEV antibodies were detected by commercial ELISA kits. The seropositivies according to age groups were; 8-14 age 1.82%, 19-29 age 0.69%, 30-39 age 0.87%, 40-49 age 1.70%, 50-59 age 1.31% and 60-68 age 0.0%. The results indicated that HEV seropositivity obtained in Isparta was lower than those of other regions of Turkey

Are Given Doses of Meropenem Adequate for Elderly Patients?

Introduction: Infections are major contributing factors to morbidity and mortality in the elderly. Aging affects various aspects of antibiotic pharmacokinetics, including absorption, distribution, and elimination. Maintaining adequate antibiotic concentrations is crucial in elderly individuals due to the heightened risk of treatment inadequacy. In this study, our objective was to investigate the plasma concentrations of meropenem, a commonly utilized antibiotic in elderly populations, and assess the impact of age on these measurements. Materials and Methods: In this prospective observational study, we analyzed meropenem levels in a total of 177 blood samples obtained from 59 patients aged 65 and older. These patients were under the care of inpatient services outside the intensive care unit. Meropenem treatment was administered through intermittent infusions of 1 g in 0.5 hours every eight hours. A total of three blood samples were collected from each patient. These samples were collected on the third day of meropenem treatment, just before the next dose, at 30 and 120 minutes after the first dose. Plasma meropenem level was quantified using high-performance liquid chromatography-ultraviolet analysis. To determine the effect of age on the results, the obtained data were compared with the patient characteristics and laboratory parameters. Results: Our results showed that in the first samples (Ctrough) plasma antibiotic concentrations exceeded the MIC in 20.3% of patients, while 79.7% remained at the subtherapeutic level. In the second (Cmax) and third samples (Cmid) 5.1% and 1.7% of patients remained at the subtherapeutic level, respectively. The plasma meropenem level was 8 mg/L and above in participants with four and more comorbidities, and this result demonstrated statistical significance (p< 0.05). Conclusion: Current guidelines for beta-lactam antibiotics do not provide predictable trough antibiotic concentrations in older adults hospitalized for infections. There is a need for predictive factors to inform antibiotic dosing in the elderly population, and a greater emphasis on therapeutic drug monitoring of beta-lactams in these patients would be beneficial

Mortality indicators in pneumococcal meningitis: therapeutic implications

Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications