In a Real-Life Setting, Direct-Acting Antivirals to People Who Inject Drugs with Chronic Hepatitis C in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naive patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis

Factors Affecting Inadequate Empirical Antimicrobial Therapy and the Clinical Course of Upper Urinary Tract Infections in Elderly Patients: A Multicenter Study

7th International Congress of Infectious-Diseases-and-Clinical-Microbiology-Speciality-Society-of-Turkey -- MAY 08-13, 2018 -- Antalya, TURKEYIntroduction: In this study, we aimed to determine the risk factors associated with inadequate empirical antibiotherapy (IEAT) and hospital-related mortality in elderly patients being treated for upper urinary tract infections (UTI). Materials and Methods: This study included individuals aged 65 years and over who were hospitalized after being diagnosed of community-acquired UTI or community-onset healthcare-associated UTI and followed-up in clinics and/or intensive care units (ICU) of 33 hospitals between March and September 2017. Results: A total of 525 patients (48% males; mean age: 76.46 +/- 7.93 years) were included in the study. Overall, 68.2% of the patients were hospitalized through the emergency department and 73.9% of patients were followed-up for pyelonephritis. Gram-negative, Gram-positive, and Gram-negative and positive mix growths were determined in 88%, 9.3%, and 2.7% of urine cultures, respectively. Fifty-six (10.7%) of the patients died. In multivariate analysis, the presence of chronic obstructive pulmonary disease [Odds ratio (OR): 2.278], age 85 years and over (OR: 2.816), admission to the ICU (OR: 14.831), and IEAT (OR: 2.364) were independent factors that significantly affected mortality. The presence of a urinary catheter, being followed-up in the ICU, benign prostate hypertrophy, use of antibiotics other than piperacillin-tazobactam and carbapenem were determined as independent factors that significantly affected IEAT (p<0.05). Conclusion: In our study, we found a direct correlation between IEAT and mortality. Therefore, knowing the most frequent microorganisms and antibiotic susceptibility profiles observed in the UTI of elderly patients may help to decrease the mortality and morbidity associated with these infections.Infect Dis & Clin Microbil Special Soc Turkiy

Interview with Marjorie Harkins Buchanan Kiewit

In this interview with Julia Stringfellow, Marjorie Harkins Buchanan Kiewit, LU class of 1943, discusses her time as a student as well as her time on the Board of Trustees.https://lux.lawrence.edu/oralhistories/1036/thumbnail.jp

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

Hastane enfeksiyonu etkeni Candida türlerinin epidemiyolojisi ve antifungal duyarlılık sonuçları

TEZ5153Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2004.Kaynakça (s. 61-76) var.vii, 76 s. ; 30 cm.

Current Treatment of HIV Infection

With current antiretroviral therapy options, eradication of human immunodeficiency virus (HIV) is not possible, yet. For this reason many patients have to face lifelong treatment. Several epidemiological studies suggest a normal life expectancy for HIV-infected patients with a regular and continuous treatment. The success of treatment can be evaluated by virologic, immunologic and clinical parameters. Viral load is the most important indicator of response to treatment. Today, especially in therapy-naive patients without pre-existing mutations, the risk of treatment failure is very low. All current initial regimens consist of two nucleoside analogues combined with an integrase inhibitor, a boosted protease inhibitor, or nonnucleoside reverse-transcriptase inhibitor. In this review, treatment of HIV infection is summarized in the light of current guidelines

Resistance Issue In Tuberculosis: Definitions And Suggestions

Resistance in tuberculosis treatment is a major concem especially because of its effect on increasing the spread of disease worldwide. The challenging resistances in the treatment are described as multi drug resistance (MDR) and extensively drug resistance (XDR). Conditions like being abi e to perform resistance assays for second line drugs, provide these drugs and inpatient treatment conditions have key-like importance at the management of tuberculosis resistance. [Archives Medical Review Journal 2009; 18(1.000): 37-48

Kronik lenfositik lösemisi olan bir olguda orijini bilinmeyen ateş nedeni: Richter transformasyonu

Kronik lenfositik lösemi (KLL) pek çok ülkede en sık karşılaşılan lösemi grubunu oluşturmaktadır. Enfeksiyonlar bu hastalık grubunda morbidite ve mortalitenin en sık sebebidir ve kemoterapi ile ilişkili lenfoid hücre disfonksiyonu ve nötropeni, enfeksiyonlara yatkınlığın başlıca nedenlerini oluştururlar. Bu neden ile ateşi olan KLL’li olgularda enfeksiyöz durumlar mutlaka dışlanmalıdır. Richter transformasyonu (RT) KLL olgularında nadir görülen bir lenfoma türüdür ve orijini bilinmeyen ateşlerin de nadir sebebini oluşturmaktadır. RT ilişkili orijini bilinmeyen ateş olguları anekdotal raporlar şeklinde bildirilmiştir. Burada KLL tanısı olan ve ateş nedeni olarak RT saptanan bir olgu sunulmuş ve literatür gözden geçirilmiştir.Chronic lymphocytic leukemia (CLL) is the most common leukemia in many countries. Infections are the most common causes of morbidity and mortality; lymphoid cell dysfunction and neutropenia associated with chemotherapy are main predisposing conditions for infection. For this reason infectious conditions must be excluded in a case with CLL and fever. Richter's transformation (RT) is a kind of lymphoma that is a rare condition in CLL cases Fever of unknown origin is a rare finding in Richter's transformation (RT) but it has been reported as anecdotal reports. Here a case with RT as the cause of fever in a case with CLL was reported and literature was reviewed