Bilgisayar Kontrollü Bs En 772-18 Standardına Uygun Donma- Çözülme Test Cihazının Geliştirilmesi ve Uygulanması

Yapı malzemeleri; üretim teknolojisi, uygun tasarım, kimyasal oran, yerleştirme ve sıkıştırma dereceleri, üretim standartları gibi kriterler dikkate alınarak değişken bir dayanım ölçeğinde izin verilen bir standartta üretilirler. Bu standartlardan uygun yapı kimyasallarının seçimi ve çevre şartları için özellikle tip ve dayanım sınıfı açısından tanımlı standartlar vardır. Yapı malzemelerinin dayanımını özellikle şiddetli çevresel şartlarda, kimyasal seçimi, içeriği oluşturan malzemelerin dona dayanıklılık, kimyasal direnç ve donatının korunması gibi dayanıklılık özelliklerine de dikkat edilir. Yapı malzemelerinin en büyük yapısal bozulma nedeni nemli ortamlarda donma çözülme olayının meydana gelmesidir. Bu bozulmalar binalarda enerji kaybına da neden olmaktadır. Bu çalışmada ayarlanabilen nemli ortamlarda istenen sıcaklıkta istenen zaman aralığında yapı malzemelerini tutabilen bilgisayar kontrollü donma çözülme test cihazı geliştirilmiştir. Bu cihaz ile yapı malzemelerinin yüksek sıcaklık ve donma- çözülme etkisinde mekanik ve fiziksel davranışı gözlemlenebilmektedir

Treatment of ventilator-associated pneumonia (VAP) caused by Acinetobacter: results of prospective and multicenter ID-IRI study

Ventilator-associated pneumonia (VAP) due to Acinetobacter spp. is one of the most common infections in the intensive care unit. Hence, we performed this prospective-observational multicenter study, and described the course and outcome of the disease. This study was performed in 24 centers between January 06, 2014, and December 02, 2016. The patients were evaluated at time of pneumonia diagnosis, when culture results were available, and at 72 h, at the 7th day, and finally at the 28th day of follow-up. Patients with coexistent infections were excluded and only those with a first VAP episode were enrolled. Logistic regression analysis was performed. A total of 177 patients were included; empiric antimicrobial therapy was appropriate (when the patient received at least one antibiotic that the infecting strain was ultimately shown to be susceptible) in only 69 (39%) patients. During the 28-day period, antibiotics were modified for side effects in 27 (15.2%) patients and renal dose adjustment was made in 38 (21.5%). Ultimately, 89 (50.3%) patients died. Predictors of mortality were creatinine level (OR, 1.84 (95% CI 1.279-2.657); p = 0.001), fever (OR, 0.663 (95% CI 0.454-0.967); p = 0.033), malignancy (OR, 7.095 (95% CI 2.142-23.500); p = 0.001), congestive heart failure (OR, 2.341 (95% CI 1.046-5.239); p = 0.038), appropriate empiric antimicrobial treatment (OR, 0.445 (95% CI 0.216-0.914); p = 0.027), and surgery in the last month (OR, 0.137 (95% CI 0.037-0.499); p = 0.003). Appropriate empiric antimicrobial treatment in VAP due to Acinetobacter spp. was associated with survival while renal injury and comorbid conditions increased mortality. Hence, early diagnosis and appropriate antibiotic therapy remain crucial to improve outcomes

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

Analysis of intestinal and nasopharyngeal microbiota of children with meningococcemia in pediatric intensive care unit: INMACS-PICU study

This article belongs to the Special Issue Pediatric Diagnostic Microbiology.Microbiota composition might play a role in the pathophysiology and course of sepsis, and understanding its dynamics is of clinical interest. Invasive meningococcal disease (IMD) is an important cause of community-acquired serious infection, and there is no information regarding microbiota composition in children with meningococcemia. In this study, we aimed to evaluate the intestinal and nasopharyngeal microbiota composition of children with IMD.[Materials and Methods]: In this prospective, multi-center study, 10 children with meningococcemia and 10 age-matched healthy controls were included. Nasopharyngeal and fecal samples were obtained at admission to the intensive care unit and on the tenth day of their hospital stay. The V3 and V4 regions of the 16S rRNA gene were amplified following the 16S Metagenomic Sequencing Library Preparation.[Results]: Regarding the alpha diversity on the day of admission and on the tenth day at the PICU, the Shannon index was significantly lower in the IMD group compared to the control group (p = 0.002 at admission and p = 0.001, on the tenth day of PICU). A statistical difference in the stool samples was found between the IMD group at Day 0 vs. the controls in the results of the Bray–Curtis and Jaccard analyses (p = 0.005 and p = 0.001, respectively). There were differences in the intestinal microbiota composition between the children with IMD at admission and Day 10 and the healthy controls. Regarding the nasopharyngeal microbiota analysis, in the children with IMD at admission, at the genus level, Neisseria was significantly more abundant compared to the healthy children (p < 0.001). In the children with IMD at Day 10, genera Moraxella and Neisseria were decreased compared to the healthy children. In the children with IMD on Day 0, for paired samples, Moraxella, Neisseria, and Haemophilus were significantly more abundant compared to the children with IMD at Day 10. In the children with IMD at Day 10, the Moraxella and Neisseria genera were decreased, and 20 different genera were more abundant compared to Day 0.[Conclusions]: We first found alterations in the intestinal and nasopharyngeal microbiota composition in the children with IMD. The infection itself or the other care interventions also caused changes to the microbiota composition during the follow-up period. Understanding the interaction of microbiota with pathogens, e.g., N. meningitidis, could give us the opportunity to understand the disease’s dynamics.This study was supported by the Eskisehir Osmangazi University Scientific Research Grant (2018/11046).Peer reviewe

Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases-International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (similar to 5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%-90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&amp;50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs' implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted. (C) 2022 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences

Bilgisayar Kontrollü Bs En 772-18 Standardına Uygun DonmaÇözülme Test Cihazının Geliştirilmesi ve Uygulanması

Yapı malzemeleri; üretim teknolojisi, uygun tasarım, kimyasal oran, yerleştirme ve sıkıştırma dereceleri, üretim standartları gibi kriterler dikkate alınarak değişken bir dayanım ölçeğinde izin verilen bir standartta üretilirler. Bu standartlardan uygun yapı kimyasallarının seçimi ve çevre şartları için özellikle tip ve dayanım sınıfı açısından tanımlı standartlar vardır. Yapı malzemelerinin dayanımını özellikle şiddetli çevresel şartlarda, kimyasal seçimi, içeriği oluşturan malzemelerin dona dayanıklılık, kimyasal direnç ve donatının korunması gibi dayanıklılık özelliklerine de dikkat edilir. Yapı malzemelerinin en büyük yapısal bozulma nedeni nemli ortamlarda donma çözülme olayının meydana gelmesidir. Bu bozulmalar binalarda enerji kaybına da neden olmaktadır. Bu çalışmada ayarlanabilen nemli ortamlarda istenen sıcaklıkta istenen zaman aralığında yapı malzemelerini tutabilen bilgisayar kontrollü donma çözülme test cihazı geliştirilmiştir. Bu cihaz ile yapı malzemelerinin yüksek sıcaklık ve donmaçözülme etkisinde mekanik ve fiziksel davranışı gözlemlenebilmektedi