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

Moxifloxacin Induced Acute Delirium with Visual Hallucinations

A few reports accuse and implicate moxifloxacin as a contributor to delirium state.Here, we report the A 60-year-old female patient, who developed acute delirium with visual hallucinations following treatment with moxifloxacin for atypical pneumonia. [Med-Science 2015; 4(3.000): 2694-9

Coagulopathy Induced by Cefoperazone/Sulbactam in a Geriatric Patient

Cefoperazone, which is a third generation cephalosporin, has a broad spectrum activity. In clinical studies, only a few adverse effects of this agent have been reported, and these effects are similar to those seen with other cephalosporins. An 86 year-old man was admitted to emergency department with complaints of high fever, cough and weakness. On his physical examination; the patient was alert and had a limited orientation, as well as a reduced general condition. After our investigations, the coagulation disorder was bonded with C/S treatment and we stopped administration of Cefoperazone/Sulbactam(C/S). The bleeding was controlled with intravenous vitamin K and fresh frozen plasma and coagulation tests were recovered to normal values. His antibiotherapy was changed with meropenem. Unfortunately, the patient died due to the progression of respiratory and renal failure. In conclusion, the clinician should keep in mind this complication while administrating this agent. Therefore, close follow-up of coagulation parameters is crucial. [Med-Science 2015; 4(4.000): 2978-81

Antibiotherapy with and without Bone Debridement in Diabetic Foot Osteomyelitis: A Retrospective Cohort Study

Background and Objective: The treatment of diabetic foot osteomyelitis (DFO) is a controversial issue, with disagreement regarding whether the best treatment is surgical or conservative. The purpose of this study was to compare the outcome of patients with DFO who were treated with antibiotherapy alone and those who underwent concurrent minor amputation. Methods: Hospital records of patients who were diagnosed as having DFO within a 2-year study period were retrospectively reviewed. Patients were divided into two groups: those who received antibiotherapy alone and those who underwent concurrent minor amputation. Groups were compared in terms of duration in hospitalization, antibiotherapy, and wound healing. Results: Thirty seven patients were included in the study. These comprised patients who received antibiotherapy alone (ABG, n = 15) and patients who underwent concurrent minor amputation (AB-MAG, n = 22). Hospitalization duration was 37.2 (+/- 16.2) days in ABG and 52.8 (+/- 40.2) days in AB-MAG (p = 0.166). Mean duration of antibiotherapy was 45.0 (+/- 21.7) days in ABG and 47.7 (+/- 19) days in AB-MAG (p = 0.689). Wound healing duration was 265.2 (+/- 132.7) days in ABG and 222.6 (+/- 85.9) days in AB-MAG (p = 0.243). None of the outcome measures were significantly different between ABG and AB-MAG. Conclusions: Our results have shown similar outcomes for both patient groups who received antibiotherapy alone and who underwent concurrent minor amputations. Considering the small sample sizes in this study, it is important to confirm these results on a larger scale.Wo

Clinical Significance of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume for Predicting the Severity of Hepatic Fibrosis in Patients with Chronic Hepatitis B [Kronik Hepatit B Hastalarinda Karaciger Fibrozisinin Ciddiyetinin Belirlenmesinde Notrofil/Lenfosit Orani ve Ortalama Trombosit Hacminin Klinik Onemi]

In this study, we aimed to determine the clinical significance of the neutrophil to lymphocyte (NLR) ratio, mean platelet volume (MPV) and other biochemical parameters for predicting the degree of liver fibrosis in patients with chronic hepatitis B (CHB) infection. A total of 95 biopsy-proven naïve CHB cases patients were included in the study. The complete blood count variables including white blood cell, hemoglobin, hematocrit, platelet count, neutrophil, lymphocyte, MPV, and other routine biochemical parameters were tested. Liver biopsy samples were examined using the Ishak scoring system. Individuals with a fibrosis score of 0, 1 and 2 were included in Group 1 and 3,4,5 and 6 were included in Group 2. Data analyses were carried out using SPSS 15 software. Statistical significance was set at a p-value of less than 0.05.Of the 95 cases, 76 (80%) were men and 19 (20%) were women. The mean age of the patients was 39.91±18.6 years, and 30 cases (31.5%) had HBeAg positivity. Fibrosis scores of 36 cases (37.8%) were greater than or equal to 3, whereas 59 cases (62.2%) had fibrosis scores less than 3. There was a significant difference between these two groups for NLR (Group 1; 2.38± 0.96, Group 2; 1.64 ± 0.60, p [Med-Science 2016; 5(1.000): 147-59

Use of quantitative hepatitis B surface antigen levels in the follow-up of HBV-Infected patients with Genotype D

To determine the role of quantitative HBsAg levels in follow up of chronic HBV treatment and investigate the relationship between qHBsAg, HBV DNA levels and liver histopathology. 74 CHB patients with genotype D visited our Infectious Diseases outpatient clinic were included into the study. Patients were grouped according to treatment status; Group-I (patients new to treatment, 31 patients) and group-II (patients with long-term treatment history). All group-I patients had their serum HBsAg titers (qHBsAg) measured before treatment, at 3 and 6-month time periods after treatment. Group-II consisted of 43 CHB patients who had been on anti-viral treatment for at least 5 years. qHBsAg levels were measured and compared to that of patient in group II. Patients from group I were divided into two groups according to HBeAg positivity. The mean qHBsAg and HBVDNA levels and fibrosis scores were statistically higher (p=0.002, p =0.034, p=0.002) in HBeAg positive patients. For all patients in group-I, a positive correlation was found between qHBsAg and HBV DNA levels before treatment (p=0.003). Serum qHBsAg and HBVDNA levels that were measured before treatment, 3-month and 6-month after treatment were statistically different (p&lt; 0.05) from each other. Group-II patients were classified according to YMDD mutations and virologic breakthrough during treatment. Serum qHBsAg levels of patients with YMDD mutations and virologic breakthrough were found to be statistically higher (p=0.010) than those who did not although these patients were receiving potent antivirals. Quantitative HBsAg levels may differ among chronic HBV patients according to their treatment protocols and duration. In patients who are new to treatment, HBeAg positive patients may have statistically higher levels of qHBsAg. Moreover, this difference was also observed when patient who are new to treatment were compared to those who had been under treatment for a longer time. For clinicians, qHBsAg levels should not be employed only in patients undergoing interferon therapy but also those undergoing antiviral therapy as well.. [Med-Science 2018; 7(3.000): 515-23

Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients

Objective Hepatitis B virus infection is still one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide. Liver biopsy is the gold-standard method to assess the severity of liver fibrosis, but the invasive nature of this method limits its usage. Currently, noninvasive parameters are utilized to estimate liver histology. In the present study, we aimed to investigate the relationship between the severity of fibrosis and red blood cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV), and MPV and red blood cell distribution width to platelet ratio (RPR) in patients with chronic hepatitis B (CHB)