The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study

BACKGROUND: We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings. METHODS: A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated. RESULTS: A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT. CONCLUSION: CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series

A rare case series of central nervous system cystic echinococcosis

A total of three cases of childhood central nervous system (CNS) echinococcosis with spinal or posterior fossa involvement having rare localizations, have been presented. Case presentation: A 7-year-old boy with spinal involvement applied to our hospital with left leg weakness and inability to walk. A 16-year-old girl with posterior fossa involvement had peripheral facial paralysis, while a 9-year-old girl had headache and vomiting. These cases, diagnosed with cystic echinococcosis with the necessary laboratory and imaging methods, improved with appropriate medical treatment and surgery. Discussion: Especially in endemic areas, it should be kept in mind that cystic echinococcosis may present with CNS involvement and should become to mind in the differential diagnosis when neurological findings are detected. Lay Summary: With this report, we attempted to share our experience with cystic echinococcosis in the spinal region and posterior fossa in three children over 1 year, including a description of associated signs and symptoms as well as laboratory and radiological findings. It should be kept in mind that cystic echinococcosis may present with CNS involvement in endemic areas and should be considered in the differential diagnosis when neurological findings are detected. Afterward, the diagnosis should be confirmed with appropriate laboratory and imaging methods. In these cases, rapid recovery can be achieved with appropriate surgical intervention as well as medical treatment

CROSS-Sectional Assessment of Damage in Takayasu Arteritis with A Validated Tool.

Annual Scientific Meeting of the American-College-of-Rheumatology (ACR) and Association-of-Rheumatology-Health-Professionals (ARHP) -- NOV 09-14, 2012 -- Washington, DCWOS: 000309748305284…Amer Coll Rheumatol (ACR), Assoc Rheumatol Hlth Profess (ARHP

Evolution of clinical characteristics of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab in turkey: a multicenter retrospective analysis

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare X-linked genetic disorder. On the contrary to its name, it is a multisystemic disease and various symptoms other than hemoglobinuria could be occurred. It could be life threatening especially because of thromboembolic events. In the last decade, a terminal complement inhibition with eculizumab approved with promising results for PNH patients. We conducted this study to evaluate the long term experience of eculizumab therapy from Turkey for the first time. Our cohort included 138 patients with PNH treated with eculizumab between January 2008 and December 2018 at 28 centers in Turkey. Laboratory and clinical findings at the time of diagnosis and after eculizumab therapy were recorded retrospectively. The median age was 39 (range 18-84) years and median granulocyte PNH clone size was 74% (range 3.06-99.84%) at the time of diagnosis. PNH with bone marrow failure syndrome was detected in 49 patients and the rest of 89 patients had classical PNH. Overall 45 patients (32.6%) had a history of any prior thrombotic event before eculizumab therapy and only 2 thrombotic events were reported during the study period. Most common symptoms are fatigue (75.3%), hemoglobinuria (18.1%), abdominal pain (15.2%) and dysphagia (7.9%). Although PNH is commonly related with coombs negativity, we detected coombs positivity in 2.17% of patients. Seven months after the therapy, increased hemoglobin level was seen and remarkably improvement of lactate dehydrogenase level during the treatment was occurred. In addition to previous studies, our real life data support that eculizumab is well tolerated with no serious adverse events and improves the PNH related findings.WOS:000672609100010PubMed: 3432229

Evaluation of Patients with PNH Treated By Eculizumab: Real World Data from Turkey

61st Annual Meeting and Exposition of the American-Society-of-Hematology (ASH) -- DEC 07-10, 2019 -- Orlando, FL[Abstract Not Available]Amer Soc HematolWOS:00057716460421

HSV-1 Encephalitis Presenting with Diplopia: Effects of Infection or Autoimmunity?

This report describes a case in which diplopia was developed as a finding of postinfectious anti-N-methyl-d-aspartate receptor encephalitis. Infectious encephalitis, especially herpes simplex virus, is essential as it is one of the triggers of autoimmune encephalitis. Even if the cases present unexpected clinical findings, we should be vigilant in terms of autoimmune processes, such as diplopia seen in our case

Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children aged less than five years

Purpose: In Turkey, pneumococcal conjugate vaccine (PCV) was introduced to the national immunization program as PCV7 in 2008, and was replaced with PCV13 in 2011. The aim of the study was to demonstrate the pneumococcal carriage rate and the serotype distribution in healthy children under 5 years in Turkey who were vaccinated with PCV13. Methods: We conducted a cross-sectional study including the collection of questionnaire data and nasopharyngeal (NP) specimens among children aged <5 years from five centers from March 2019 to March 2020. Pneumococcal isolates were identified using optochin sensitivity and bile solubility. Serotyping was performed using a latex agglutination kit and Quellung reaction. Results: NP swab samples were collected from 580 healthy children. The observed overall carriage rate was 17.8%. None of the hypothesised predictors of S. pneumoniae carriage, except maternal education level was statistically significant (p = 0.017). High maternal education level appeared to decrease the risk (lower vs. higher maternal education OR: 1.992 [95% CI; 1.089–3.643], p = 0.025). The overall NP S. pneumoniae carriage prevalence for the PCV13-vaccinated children was 17.8% (103/580). The most common serotypes detected were serotype 15B (n = 10, 9.7%), serotype 23F (n = 9, 8.7%), serotype 23A (n = 9, 8.7%), serotype 11A (n = 7, 6.7%), serotype 19F (n = 5, 4.8%) and serotype 15F (n = 5, 4.8%). Of the isolates, 28 (27.2%) were in PCV13 vaccine strains (VSs), and 75 (72.8%) strains were non-VS. The serotype coverage rate was 27.2% for PCV13. Conclusion: The overall S. pneumoniae carriage rate was higher than in earlier studies from Turkey. Post-vaccine era studies from around the world have reported a decrease in VS serotypes and a ‘serotype replacement’ to non-VS serotypes, as we determined in our study

Kronik Böbrek Hastalığı Nedeniyle Takip Edilen Çocukların Ebeveynlerinin Mevsimsel Grip Aşısı ile İlgili Bilgi ve Görüşlerinin Değerlendirilmesi

Amaç: Bu çalışma ile çocuk nefroloji kliniğimizde kronik böbrek hastalığı (KBH) tanısı ile izlenen çocukların ebeveynlerinin mevsimsel grip aşısı hakkında bilgi, tutum ve görüşlerinin değerlendirilmesi amaçlanmıştır. Yöntem: Kasım 2019-Şubat 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi, İzmir Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Nefroloji Kliniği’ne başvuran 6 ay-18 yaş arası KBH tanılı hastaların gönüllü bir ebeveynine mevsimsel grip aşısı hakkında oluşturulan anket uygulandı ve anketi tamamlayanlar çalışmaya dahil edildi. Bulgular: Çalışmanın yapıldığı dönemde başvuran KBH tanılı 64 hastanın ebeveyni anketi tamamlayarak teslim etti. Mevsimsel grip aşısı hakkında 44 (%68,8) katılımcının aşı hakkında bilgi sahibi olduğu, 20 (%31,3) katılımcının ise daha önceden aşı ile ilgili herhangi bir bilgi edinmediği öğrenildi. Altmış dört katılımcıdan 10’unun (%15,6) KBH tanılı çocuğuna mevsimsel grip aşısı yaptırdığı görüldü. Çocuğuna aşı yaptırmamış olan 54 katılımcının en sık aşı yaptırmama gerekçesi ise aşı gerekliliği ile ilgili yeterli bilgilerinin olmaması idi. İmmünsüpresif ilaç kullanan ve kullanmayan hastaların oluşturduğu iki grup arasında aşı olma oranları arasında anlamlı fark saptanmadı. Her iki gruptan aşı ile ilgili bilgi sahibi olan katılımcıların bilgiye ulaşma yolları arasında ise istatistiksel olarak anlamlı fark saptandı. Hastalar; böbrek nakli olan ve diğer KBH tanılı olarak iki gruba sınıflandırıldığında; böbrek nakilli çocukların ebeveynlerinin bilgi sahibi olma oranları ve çocuklarının influenza açısından yüksek riskli olduğunun farkındalığı, diğer gruba göre anlamlı olarak yüksek saptandı. Sonuç: KBH tanılı ve mevsimsel grip aşısı endikasyonu olan çocuk hastalarda aşılanma oranı oldukça düşük olup; aileler influenza aşısı hakkında yeterli bilgi sahibi değildir. Bu nedenle çocuk nefroloji kliniklerinde hekimler tarafından ebeveynlere influenza enfeksiyonu ve aşısı hakkında yeterli bilgi verilmesi ile bu oranın artırılabileceği düşünülmektedirObjective: We evaluated the knowledge and opinions of the parents of children who were followed up with chronic kidney disease (CKD) in our pediatric nephrology clinic. Methods: A seasonal influenza vaccine questionnaire was administered to a voluntary parents of patients with CKD between the ages of 6 months and 18 who applied to the Pediatric Nephrology Department of Health Sciences University İzmir Tepecik Training and Research Hospital between November 2019 and February 2020, and those who completed the questionnaire were included in the study. Results: Parents of 64 patients diagnosed with CKD completed the questionnaire. It was learned that only 44 (68.8%) participants were informed about the vaccine. It was seen that 10 patients (15.6%) had seasonal flu vaccine. Fifty-four participants who had not yet had their child vaccinated were asked about their reasons for not getting vaccine. The most frequent answer was that families did not have sufficient information about the vaccine requirement. There was no significant difference in the rate of vaccination between the two groups of patients who were administered and did not use immunosuppressive drugs. A statistically significant difference was found between accessing the information about the participants who had knowledge about vaccine. The children diagnosed with CKD were classified into two groups as having kidney transplantation and other patients. The knowledge about influenza vaccine and the awareness of the high risk of their children of influenza infection to parents of children with kidney transplantation was significantly higher. Conclusion: The rate of vaccination against influenza is very low in pediatric patients with CKD. Therefore, it is thought that this ratio can be increased by increasing the giving of information about influenza infection and vaccination to parents by physicians in pediatric nephrology clinics