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

Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Efficient numerical treatment of nonlinearities in the advection-diffusion-reaction equations

WOS: 000457050100006Purpose The purpose of this study is to propose a non-classical method to obtain efficient and accurate numerical solutions of the advection-diffusion-reaction equations. Design/methodology/approach Unlike conventional numerical methods, this study proposes a numerical scheme using outer Newton iteration applied to a time-dependent PDE. The linearized time dependent PDE is discretized by trapezoidal rule, which is second order in time, and by spline-based finite difference method of fourth order in space. Findings Using the proposed technique, even when relatively large time step sizes are used in computations, the efficiency of the proposed procedure is very clear for the numerical examples in comparison with the existing classical methods. Originality/value This study, unlike these classical methods, proposes an alternative approach based on linearizing the nonlinear problem at first, and then discretizing it by an appropriate scheme. This technique helps to avoid considering the convergence issues of Newton iteration applied to nonlinear algebraic system containing many unknowns at each time step if an implicit method is used in time discretization. The linearized PDE can be solved by implicit time integrator, which enables the use of large time step size

ANN-based Drug-isolate-fold-change model predicting the resistance profiles of HIV-1 protease inhibitors

: Drug resistance is a primary barrier to effective treatments of HIV/AIDS. Calculating quantitative relations between genotype and phenotype observations for each inhibitor with cell-based assays requires time and money consuming experiments. Machine learning models are good options for tackling these problems by generalizing the available data with suitable linear or nonlinear mappings. The main aim of this paper is to construct drug isolate fold change (DIF)-based artificial neural network (ANN) models for estimating the resistance potential of molecules inhibiting the HIV-1 protease (PR) enzyme. Throughout the study, seven of eight protease inhibitors (PIs) have been included in the training set and the remaining ones in the test set. Using the 7-in 1-out procedure, eight ANN models have been produced to measure the learning capacity of models from the descriptors of the inhibitors. The mean value of eight ANN models for unseen inhibitors is and 95% confidence interval (CI) is Predicting the fold change resistance for hundreds of isolates allowed for robust comparison of drug pairs. These eight models have predicted the drug resistance tendencies of each inhibitor pair with the mean 2D correlation coefficient 0.933 and 95% CI A classification problem has been created to predict the ordered relationship of the PIs and the mean accuracy, sensitivity and specificity values are obtained as 0.954, 0.791 and 0.791, respectively. The currently derived ANN models can accurately predict the drug resistance tendencies of PI pairs, and this observation could help test new inhibitors with various isolates

Acromegaly with No Evidence of Pituitary Adenoma or Ectopic Source

WOS: 000417410900008Acromegaly is caused by the uncontrolled hypersecretion of growth hormone (GH) and secondary increases of insulin-like growth factor-1. More than 95% of patients with acromegaly have a growth hormone-secreting pituitary adenoma. Ectopic GH or growth hormone releasing hormone (GHRH)-secreting tumors are rare cause of acromegaly. Pituitary adenomas that cause the hypersecretion of GH are nearly always visible on magnetic resonance imaging. Rarely, patients without an ectopic source may have normal pituitary imaging. In managing this rare circumstance, exploring pituitary or medical treatment with a somatostatin analog might be useful. We describe a patient with acromegaly with no pituitary adenoma and no evidence of ectopic source, who was treated with long-acting octreotide

Novel bis-crown ethers and their sodium complexes as antimicrobial agent: synthesis and spectroscopic characterizations

WOS: 000340071200007A series of new compounds containing formyl and imine group were synthesized. New formyl-substituted compounds were prepared by the reaction of 1,2-bis(bromomethyl)benzene with benzaldehyde derivatives in the presence of NaOH. New bis-crown ether imine compounds were prepared by the condensation of corresponding aldehydes with 4'-aminobenzo-15-crown-5. Sodium complexes of the bis-crown ethers form crystalline 2:1 (Na+:ligand) stoichiometries were also been synthesized. The prepared compounds were structurally confirmed by analytical and spectral data and evaluated for their antibacterial and antifungal activities. The results show that the antibacterial activity of compounds including o-methoxy group was significantly higher against S. epidermis compared to the other studied antimicrobial group.Scientific and Technical Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [TBAG 210T122]; Ahi Evran UniversityAhi Evran University [SBA-11-23]The authors gratefully acknowledge the financial assistance of the Scientific and Technical Research Council of Turkey (TUBITAK), Grant No: TBAG 210T122 and Ahi Evran University, Grant No: SBA-11-23

Atypical Diabetic Ketoacidosis: Case Report

WOS: 000351489300022PubMed: 25759786Background: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus and can lead to death if untreated. It is a complex metabolic state characterised by hyperglycaemia, acidosis and ketonuria. Bonsai is one of the herbal incense products that contains synthetic cannabinoid and can be easily accessible via the internet in many countries. It cannot be detected in blood and urine studies using conventional methods. Synthetic cannabinoid abuse is associated with severe side effects, including tachycardia, high blood pressure, acidosis, excess sedation and coma. Case Report: A 17-year-old male patient was brought to the emergency department with sudden onset of dyspnoea. Laboratory investigations revealed hyperglycaemia, acidosis and ketonuria. He was admitted to the intensive care unit with a diagnosis of diabetic ketoacidosis. He was not considered a typical case of diabetic ketoacidosis because of the tendency to hypokalaemia, persistent tachycardia and bronchoscopic findings. We learned from his friends that he had used cannabis for a week and used bonzai on the day that he was brought to the emergency service. Conclusion: Diabetic ketoacidosis with prolonged acidosis and tendency to hypokalaemia are investigated for the consumption of synthetic cannabinoids

Klinefelter Syndrome with Portal Vein Aneurysm: Case Report

WOS: 000432704800022Klinefelter syndrome (KS) is the most common chromosomal disorder in men characterized by clinical features of hypogonadism and infertility. About 90% of cases have classically 47, XXY karyotype and the remaining have additional X or Y chromosomes, high grade aneuploidies or X chromosome structural abnormalities. Portal vein aneurysms are very rare. Reported cases are increasing due to use of modern imaging techniques in clinic practise. Here we report a 19-year-old man with KS who was admitted with complaints of abdominal pain, nausea and vomiting. Further investigations revealed 23 mm anechoic, saccular expansion in the left branch of the portal vein. It is well known that KS is associated with venous thromboembolic diseases including portal venous thrombosis, but association with portal vein aneurysm has not been previously reported

The Nutritional Content of Common Bean (Phaseolus vulgaris L.) Landraces in Comparison to Modern Varieties

In terms of safe food and a healthy food supply, beans (Phaseolus spp.) are a significant source of protein, carbohydrates, vitamins and minerals especially for poor populations throughout the world. They are also rich in unsaturated fatty acids, such as linoleic and oleic acids. From the past to the present, a large number of breeding studies to increase bean yield, especially the common bean (P. vulgaris L.), have resulted in the registration of many modern varieties, although quality and flavor traits in the modern varieties have been mostly ignored. The aim of the present study, therefore, was to compare protein, fat, fatty acid, and some mineral content such as selenium (Se), zinc (Zn) and iron (Fe) of landraces to modern varieties. The landrace LR05 had higher mineral contents, particularly Se and Zn, and protein than the modern varieties. The landrace LR11 had the highest linoleic acid. The landraces are grown by farmers in small holdings for dual uses, such as both dry seed and snap bean production, and are commercialized with a higher cash price. The landraces of the common bean are, not only treasures that need to be guarded for the future, but also important genetic resources that can be used in bean breeding programs. The results of this study suggest that landraces are essential sources of important nutritional components for food security and a healthy food supply