Imperial rivalry and port-cities: a view from above

(Product of workshop No. 7 at the 8th MRM 2007

Osmanlı Toprak Mülk¡yet¡ ve T¡car¡ Tarım /

Kaçar, Hilm

ANTIPHOSPHOLIPID SYNDROME PRESENTING AS MASSIVE PULMONARY EMBOLISM IN A PATIENT WITH SARCOIDOSIS

Antiphospholipid antibodies may be detected in sarcoidosis generally without clinical consequences. The association between sarcoidosis and antiphospholipid syndrome was rarely reported. Herein a case with sarcoidosis and antiphospholipid syndrome presenting as massive pulmonary embolism is presented

INDEPENDENT PROGNOSTIC INDICATORS IN THE ELDERLY WITH PNEUMONIA: A SINGLE-CENTRE PROSPECTIVE OBSERVATIONAL STUDY

Background: The goal of this study was to identify and investigate the indicators of a poor prognosis in the elderly with pneumonia

Risk factors for development of vancomycin-resistant enterococcal bacteremia among VRE colonizers A retrospective case control study

Aims We aimed to determine the proportion of vancomycin-resistant enterococci (VRE) colonized patients among all inpatients who later developed VRE bacteremia during hospital stay and to identify the risk factors for VRE bacteremia at a tertiary hospital. Material and methods Patients with positive rectal screening or any clinically significant positive culture results for VRE were included in 1-year follow-up. Colonization with VRE was defined as a positive culture (rectal, stool, urinary) for VRE without infection and VRE bacteremia was defined as positive blood culture if the signs and symptoms were compatible with infection. To determine the risk factors for VRE bacteremia among VRE colonized patients, a retrospective case control study was performed. The two groups were compared in terms of variables previously defined as risk factors in the literature. Results Of 947 positive samples, 17 VRE bacteremia were included in the analysis. Cephalosporin use for more than 3 days within 3 months was a significant risk factor for bacteremia (p= 0.008). Prior use of carbapenems was found to be statistically significant for bacteremia (p= 0.007). In multivariate analyses the use of carbapenems and cephalosporins was an independent risk factor for developing bacteremia among VRE colonizers (odds ratio, OR, 6.67; 95% confidence interval, CI, 1.30-34;p= 0.022 and OR 4.32, 95% CI 1.23-15;p= 0.022,respectively). Conclusion A VRE colonization in patients receiving broad-spectrum beta-lactam antibiotics including carbapenems and cephalosporins may result in bacteremia. It is possible to keep mortality at very low levels in VRE bacteremia with effective infection control measures, rapid infectious diseases consultation and rational antimicrobial treatment based on current epidemiological data

Clinical Characteristics of Mild-Moderate COVID-19 Patients and Risk Factors for the Development of Pneumonia

Limited data exists to date on the predictors for the development of pneumonia in patients with mild and moderate coronavirus (COVID-19). In this study, it was aimed to evaluate the demographic characteristics and clinical findings of mild and moderate COVID-19 and to determine the risk factors for the development of COVID-19 pneumonia in patients admitted to the pandemic outpatient clinic of a university hospital. A total of 414 patients with laboratory confirmed COVID-19 were included. Of these, 220 (53.1%) were male, the mean age was 38.3 +/- 12.7. Median duration of hospital admission from the onset of symptoms was three days (0-11). Of the confirmed COVID-19 cases, 154 (37.2%) had a history of family contact and the most common symptoms were weakness (68.4%), myalgia (61.8%), headache (56.5%), loss of smell (45.2%), loss of taste (43.2%) and anorexia (42.8%). Among females, weakness (p= 0.016), headache (p= 0.008), sore throat (p= 0.032), nausea (p= 0.003), anorexia (p= 0.045), loss of taste (p= 0.005) and loss of smell (p30 were high, and 60.9% of the patients had pneumonia (p< 0.001). CRP (p< 0.001), D-dimer (p= 0.010) values were low, lymphocyte count (p= 0.001) was high among 106 (25.6%) active smokers, and 15.6% of the patients had pneumonia (p< 0.001). Of the patients reported with persistent symptoms, 25.9% had loss of smell, 25% had weakness, and 23.1% had loss of taste on the seventh day; 21.1% had loss of smell, 21.1% had myalgia, and 19.7% had loss of taste on the 14th day. During their follow-up, the COVID-19 polymerase chain reaction (PCR) test was studied in 286 patients for control purposes. The median time of being negative for COVID-19 PCR test was eight days (3-56). In conclusion, symptoms may last longer than 14 days in 20-30% of patients presenting with mild-moderate clinical findings. In addition, obesity should be considered as an important risk factor for COVID-19 pneumonia