Pooled Analysis of Resistance Patterns of Escherichia coli Strains Isolated From Urine Cultures in Turkey: Comparison of 1997–2001 and 2002–2007 Periods

WOS: 00026328780028

Diagnostic value of combined serum biomarkers for the evaluation of liver fibrosis in chronic hepatitis C infection: A multicenter, noninterventional, observational study

Background/Aims: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. Materials and Methods: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest®, aspartate aminotransferase-to-platelet ratio index(APRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. Results: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. Conclusion: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further. © Copyright 2018 by The Turkish Society of Gastroenterology

Türkiye’de bulunan yoğun bakımlarda sabun, kağıt havlu ve alkol bazlı el dezenfektanı yeterli mi?: Phokai çalışması sonuçları

Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products.Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016).Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p<0.0001, p<0.0001) while the number of hand disinfectant units with alcohol-based disinfectant was significantly higher (p<0.0001).Conclusion: There should be adequate and accessible hand hygiene materials for effective hand hygiene. In this study, we found that soap and paper towels were inadequate on the observation days in 3-11% and 10-18% of units, respectively. Attention should be paid on soap and paper towel supply at weekends as well

Voiding symptoms in pregnancy: An assessment with International Prostate Symptom Score

Objective: The aim of the study was to evaluate the voiding symptoms of pregnant women and to compare the symptoms amongst trimesters and controls by means of the International Prostate Symptom Score (IPSS). Materials and Methods: Voiding symptoms of 256 pregnant and 230 non-pregnant healthy women hospitalized for other reasons were evaluated. Subjects who had a history of urological and neurological problems or previous pelvic surgery associated with urinary symptoms and those who had urinary tract infection were excluded from the study. The pregnant group was then subdivided into subgroups as to the trimesters of pregnancy. The IPSS assesses seven symptoms on a scale of 0 (no symptoms) to 5 (symptom always present) and was administered as a self-administered questionnaire with the assistance of a trained nurse. Symptom scores of each group and subgroup and the distribution of scores were assessed. Results: The mean scores for all questions in the pregnant group were significantly higher than controls. The comparison of mean scores according to trimesters showed a significant difference for the questions of frequency, intermittency, urgency, weak stream, nocturia, quality of life and for the total scores. The distribution of the scores for each question showed that frequency and nocturia were the most prominent symptoms in pregnancy. The percentage of the respondents with an IPSS score of >7 was 47.6% and the percentage of a quality of life score of greater than or equal to 4 (mostly dissatisfied) was 48.4%. Conclusions: Voiding symptoms during pregnancy are highly prevalent. These symptoms worsen as the pregnancy progresses. Copyright (C) 2003 S. Karger AG, Basel

A case of chronic hepatitis B with primary adefovir resistance [Adefovire primer dirençli bir kronik B hepatiti olgusu]

PubMed ID: 17682718Implementation of antiviral therapy leads to the emergence of mutant strains during the treatment in chronic hepatitis B. Hepatitis B virus (HBV) with primary antiviral resistance may be rarely encountered. In this report, a chronic hepatitis B case who had never received adefovir dipivoxil but had primary adefovir resistance, was presented. HBeAg positive 25-year-old male patient was treated with interferon (IFN)-alpha (thrice a week 10 MU) and lamivudine (100 mg/daily) combination for one year. At the end of this treatment although HBV-DNA was under the detectable limit and ALT levels returned to normal, anti-HBe antibodies did not develop. During the course of lamivudin treatment on the third year virus was found to be resistant to lamivudin [FLM+YMDD+YIDD+YVDD (Inno-LiPA HBV DR, Innogenetics Ghent, Belgium)] and adefovir was added to the lamivudin therapy. At the end of eight months of combination therapy, ALT levels did not return to normal and HBV-DNA was still in detectable levels. On the 11th month resistance to adefovir was analysed and rtA181T mutation was found by DNA sequence analysis (Big Dye Terminator Cycle Sequencing kit, Applied Biosystems, USA). Since there had been no response to adefovir from the initiation of the therapy, primary adefovir resistance was suspected. Primary adefovir resistance was confirmed by the detection of the same mutation in pre-adefovir treatment serum sample of the patient. Lamivudin was re-added to the therapy, however, HBV-DNA still remained positive on the third month of this combination therapy. The patient got out of routine follow-up after this period