Laparoscopic Infections in Urogenital and Gynecological System: A Systematic Review

There are several advantages of laparoscopic surgery, which is employed only in the presence of some indications, as follows: minimally invasive procedure, reduced postoperative pain and analgesic use, and short hospital stay. In this paper we examined infections of laparoscopic operations by scanning MEDLINE and PubMed. A total of forty-seven papers were examined using a meta-analytical framework. In studies including a large series in adrenalectomy, the infectious complication rate, including various infections such as pneumonia, urinary tract infection, sepsis, and wound infection, is observed to be less than 1%. While infection is generally not developed during laparoscopy in nephrectomy patients, it may occasionally be seen, generally in the form of wound infection. The infectious complication rate associated with laparoscopic cystectomy was found to be high, which was attributed to surgical inexperience, presence of chronic diseases, and a lack of adequate equipment in hospitals. Complications of infection of prostactomy were not observed after procedures. The infection rate of hysterectomy is low; abscess and urinary tract infection are the most common infectious complications. Myomectomy cases generally showed no infection. Finally, it is associated with a lower wound infection rate and a reduced degree of abdominal damage and incisional hernia due to less scarring. [Arch Clin Exp Surg 2013; 2(1.000): 43-48

Characteristics of acute bacterial meningitis in Southeast Turkey

BACKGROUND: Acute bacterial meningitis (ABM) remains a significant worldwide cause of death in adults. Even in the antibiotic era, the mortality rate in ABM remains significant and has been reported in the range of 8-40%. AIM: The aim of this study was to assess the characteristics of epidemiology, clinical manifestations, treatment modalities and outcome of patients with ABM in Southeast Turkey. SETTINGS AND DESIGN: This retrospective study included all cases of community-acquired ABM diagnosed and treated in Dicle University Hospital between June 1996 and December 2002. METHODS AND PATIENTS: The study group consisted of 186 adult patients (110 male, 76 female) with ABM, those patients who are older than 14 years, followed up at Dicle University Hospital from June 1996 to December 2002. Patients' charts were retrospectively reviewed, clinical characteristics were recorded and final data were analyzed. STATISTICAL ANALYSIS: In statistical analyses, the Chi-square test was used for binary variables and Student's t-test for continuous variables. RESULTS: The patients' mean age was 30.2 ± 15.3 years (range 14 to 90 years). On admission, typical symptoms of meningitis were found in most of the patients: headache in 92.5%, fever in 88.2%, and nuchal rigidity in 80.1%. The main predisposing factor for ABM was otitis media (40 patients, 21.5%) and closed head trauma (12 patients, 6.5%). Streptococcus pneumonia was the most common identified pathogen. Twenty-nine patients (15.6%) died during hospitalization period. In multivariate analyses, the significant mortality factor was found as initial level of consciousness, low cerebrospinal fluid/blood glucose ratio, high erythrocyte sedimentation rate and initial treatment by penicillin G. CONCLUSIONS: Although still remains as a serious infection, early diagnosis and effective treatment may reduce fatal outcome and improve the course of the disease in patients with ABM. Ceftriaxone should be considered as the drug of choice for initial empirical therapy, while waiting culture results and vancomycin must be withheld for patients having increased risk of penicillin resistant pneumococci strains

A sandfly fever virus outbreak in the East Mediterranean region of Turkey

Objectives: To report a sandfly fever virus (SFV) outbreak that occurred in Kahramanmaras Province, Turkey

Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B

Introduction: Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. Methodology: Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy Results: SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log(10) IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). Conclusions: Detection of a 1 log(10) decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR

Impact of antimicrobial drug restrictions on doctors' behaviors

Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did