Efficacy of Colistin Therapy in Patients with Hematological Malignancies: What if There is Colistin Resistance?

Objective: The objective of this study was to evaluate the clinical efficacy and appropriateness of colistin therapy in patients with hematological malignancies. Methods: Age, gender, type of hematologic malignancy, and potential carbapenem-resistant microorganism risk factors were all noted in this retrospective study. In empirical and agent-specific treatment groups, differences in demographic features, risk factors, treatment responses, and side effects were compared. Results: Sixty-three patients were included, 54% were male, and the median age was 49. In the last three months, the hospitalization rate history was 68%, and four patients had a hospitalization history in the ICU. Carbapenem-resistant K. pneumoniae colonization was present in 22 patients (35%). Gram-negative microorganisms were isolated in 34 patients (54%). The carbapenem, quinolone, and colistin resistance rates were 82%, 76%, and 4% respectively. Clinical and microbiological response rates were 60% and 69%. 7 and 28-day mortality rates were 17% and 35%. There was no significant difference in demographic data and comorbidities in empirical (n=48) and agent-specific (n=15) treatment groups. The rate of carbapenem and glycopeptide treatments before colistin was higher in the empirical treatment group (p = 0.004; p = 0.001). The rate of starting combined antibiotics was higher in the empirical treatment group (p = 0.016). Two of the patients developed renal failure in the first week after treatment. Conclusion: The use of empirical colistin may be unavoidable given the risk considerations. Shortly, colistin-resistant strains may also be a factor affecting treatment success negatively

A case of Crimean Congo hemorrhagic fever complicated with acute pulmonary embolism

Background Crimean-Congo hemorrhagic fever (CCHF) is one of the common causes of tick-borne hemorrhagic infections. The study aims to report a case of a female patient with severe CCHF with pulmonary embolism. Case report A 61-year-old woman admitted to the emergency department with complaints of high fever, nausea, and weakness. The patient was dealing with animal husbandry and had a tick bite history. At laboratory findings, bicytopenia, abnormal liver function tests, and elevated coagulation parameters were observed. Real-time plymerase chain reaction confirmed the diagnosis of CCHF. Three sessions of plasmapheresis were performed due to continued fever and worsening in laboratory values. Pulmonary embolism was detected in computerized thorax tomography carried out due to respiratory alkalosis on the 6th day. She was successfully treated with supportive and anticoagulation therapy. Conclusion CCHF demonstrates different types of clinical presentations apart from fever and hemorrhage. Acute pulmonary embolism is a rare complication that has not been reported before

A case of Crimean Congo hemorrhagic fever complicated with acute pulmonary embolism

Background Crimean-Congo hemorrhagic fever (CCHF) is one of the common causes of tick-borne hemorrhagic infections. The study aims to report a case of a female patient with severe CCHF with pulmonary embolism. Case report A 61-year-old woman admitted to the emergency department with complaints of high fever, nausea, and weakness. The patient was dealing with animal husbandry and had a tick bite history. At laboratory findings, bicytopenia, abnormal liver function tests, and elevated coagulation parameters were observed. Real-time plymerase chain reaction confirmed the diagnosis of CCHF. Three sessions of plasmapheresis were performed due to continued fever and worsening in laboratory values. Pulmonary embolism was detected in computerized thorax tomography carried out due to respiratory alkalosis on the 6th day. She was successfully treated with supportive and anticoagulation therapy. Conclusion CCHF demonstrates different types of clinical presentations apart from fever and hemorrhage. Acute pulmonary embolism is a rare complication that has not been reported before

Ocular Findings Before and After Pegylated Interferon Treatment in Chronic Hepatitis B and C Patients

Objective: Interferons are used in the treatments of chronic hepatitis B and C since they inhibit viral replication and have immunomodulatory effects. Common side effects include: flu-like syndrome, hematologic abnormalities, cardiovascular system and gastrointestinal system symptoms, diabetes, autoimmune disorders, pulmonary dysfunction, and suffering from depression. In this study, the development of retinopathy, a rare side effect of interferon, was aimed to be investigated

Optic nerve and dura mater involvement as the first sign of multiple myeloma

WOS: 000352200400015PubMed ID: 24832040Purpose: To report a case of optic nerve and dura mater involvement as the first sign of multiple myeloma. Methods: Case report. Results: A 43-year-old woman presented with a headache and decreased vision in both eyes. Ophthalmic examination revealed anterior uveitis and subretinal mass around the optic nerves with accompanying disc edema bilaterally. Magnetic resonance imaging showed dural and optic nerve infiltration with tram-track enhancement in the optic nerve sheath. The diagnosis of multiple myeloma was made as a result of systemic investigations. The patient underwent systemic chemotherapy and cranial radiotherapy. After treatment, the patient's headache disappeared, the papilledema regressed, and the ocular findings improved but complete recovery could not be achieved because of fibrous subretinal tissue and degenerative changes of the optic nerve. Conclusions: Neurologic and ophthalmic involvement in multiple myeloma may appear as the first manifestation of disease. The correct diagnosis is important because it can be life-saving

Increased Subfoveal Choroidal Thickness and Retinal Structure Changes on Optical Coherence Tomography in Pediatric Alport Syndrome Patients

Objective. To evaluate optical coherence tomography (OCT) findings of pediatric Alport syndrome (AS) patients with no retinal pathology on fundus examination. Materials and Methods. Twenty-one patients being followed up with the diagnosis of AS (Group 1) and 24 age- and sex-matched healthy volunteers (Group 2) were prospectively evaluated. All participants underwent standard ophthalmologic examination, retinal nerve fibre layer (RNFL) analysis, and horizontal and vertical scan macula enhanced depth imaging OCT (EDI-OCT). Statistical analysis of the data obtained in this study was performed with SPSS 15.0. Results. Macula thickness was significantly decreased in the temporal quadrant in Group 1 compared to those of the control group (p=0.013). RNFL measurements revealed statistically significant thinning in the temporal, superior, inferotemporal, and inferonasal quadrants and in average thicknesses in cases with AS compared to the controls (p<0.001, p<0.001, p=0.022, p=0.016, p<0.001, respectively). The mean subfoveal coronial thickness (SCT) was 362.2 ± 77.8 μm in Group 1 and 256,18 ± 71.7 μm in Group 2. There was a statistically significant difference between the two groups in terms of mean CT (p<0.001). Conclusion. OCT provides valuable information in identifying the structural changes and evaluation of ocular findings in patients with AS. Even if no pathological retinal findings were found in the clinical examination, structural changes in the OCT examination begin in early period of AS

Long-Term Immunogenicity and Safety of a Homologous Third Dose Booster Vaccination with TURKOVAC: Phase 2 Clinical Study Findings with 32-Week Post-Booster Follow-Up

Vaccine-induced immunity wanes over time and warrants booster doses. We investigated the long-term (32 weeks) immunogenicity and safety of a third, homologous, open-label booster dose of TURKOVAC, administered 12 weeks after completion of the primary series in a randomized, controlled, double-blind, phase 2 study. Forty-two participants included in the analysis were evaluated for neutralizing antibodies (NAbs) (with microneutralization (MNT50) and focus reduction (FRNT50) tests), SARS-CoV-2 S1 RBD (Spike S1 Receptor Binding Domain), and whole SARS-CoV-2 (with ELISA) IgGs on the day of booster injection and at weeks 1, 2, 4, 8, 16, 24, and 32 thereafter. Antibody titers increased significantly from week 1 and remained higher than the pre-booster titers until at least week 4 (week 8 for whole SARS-CoV-2) (p 50: 6-fold; FRNT50: 5.4-fold) for NAbs and 32 weeks for S1 RBD (7.9-fold) and whole SARS-CoV-2 (9.4-fold) IgGs. Nine participants (20.9%) tested positive for SARS-CoV-2 RT-PCR between weeks 8 and 32 of booster vaccination; none of them were hospitalized or died. These findings suggest that boosting with TURKOVAC can provide effective protection against COVID-19 for at least 8 weeks and reduce the severity of the disease