Risk factors and clinical characteristics of Stenotrophomonas maltophilia infections in neonates

BackgroundThe aim of this study was to review the risk factors and clinical, bacteriological, and epidemiological characteristics of Stenotrophomonas maltophilia infections in our neonatal intensive care unit.MethodsA retrospective matched case–control study was performed by comparing 23 cases of S maltophilia with 45 controls to identify the potential risk factors. To identify the case patients, the admission and medical records of patients in the neonatal intensive care unit and records from the Microbiology Department were reviewed between 2003 and 2008.ResultsSepsis in two neonates (9%), conjunctivitis in two neonates (9%), and ventilator-associated pneumonia in 19 (82%) neonates were determined. Invasive-procedures, exposure to aminoglycoside and carbapenem, total parenteral nutrition, histamine 2 blockers, exposure to steroids, cholestasis, and duration of hospitalization were significantly associated with S maltophilia infections (p<0.05). On multivariate analysis, invasive procedures (odds ratio, 18.81) and duration of hospitalization (odds ratio, 1.06) were determined to be the risk factors for S maltophilia infection. The most active antimicrobial agent was trimethoprim/sulfamethoxazole (87%) for S maltophilia infection, and the mortality rate was 17%.ConclusionsNeonatologists should avoid from unnecessary invasive procedures and broad-spectrum antibiotics to reduce S maltophilia infections. Invasive procedures should be finished in the shortest time possible. Agent/factor-specific antibacterial treatment should be administered. Patients being discharged as early as possible will also reduce infection frequency. Stenotrophomonas maltophilia should be considered in patients with high Stenotrophomonas infection risk factors

Gender-related prognostic value of cardiac troponin-ı in covid-19 patients

Amaç: Kardiyak troponinler kardiyak ve non-kardiak birçok hastalıkta yükselebilmektedir. Çalışmamızda COVID-19 hastalarının hastaneye kabulünde kardiyak troponin-I seviyesinin yoğun bakım ihtiyacı ve tüm nedenlere bağlı mortalite riskini önceden tahmin etme kabiliyetinin belirlenmesi ve cinsiyet ile ilişkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışma, hastanemizde 1 Nisan 2020 ile 1 Şubat 2021 tarihleri arasında yatırılan ve ilk 24 saatteki kardiyak troponin-I bakılmış COVID-19 hastalarının elektronik tıbbi kayıtlarının retrospektif olarak analiz edilmesi ile yapıldı. Çalışmada araştırılan tüm değişkenler için istatistiksel analiz yapıldı. Bulgular: Çalışmaya toplam 362 COVID hastası dahil edildi. 90 hastada kardiyak troponin-I düzeyi anormaldi. Hastaların 39'unda yoğun bakım ihtiyacı gelişti. Yoğun bakıma ihtiyaç duyan hastaların 17'sinde, yoğun bakım ünitesinde takip edilmeyen hastaların 73'ünde kardiyak troponin-I düzeyi anormaldi. Erkek cinsiyette yoğun bakım ihtiyacının %71 daha fazla olduğu ve kardiyak troponin-I düzeyinin negatif prediktif değerinin %87,5 olduğu görüldü. Kardiyak troponin-I düzeyi ölen hastaların 11'inde, sağ kalan hastaların 79'unda anormaldi. Erkek cinsiyette ölüm riskinin %75 daha yüksek olduğu ve kardiyak troponin-I düzeyinin negatif prediktif değerinin %91,7 olduğu belirlendi. Sonuç: Bu çalışmada, hastaneye yatışın ilk 24 saatindeki normal troponin seviyesinin, mortalite için kadın ve erkek cinsiyette yüksek negatif prediktif değere sahip olduğu görülmüştür. Kardiyak troponin-I seviyelerinin COVID-19 hasta takibinde klinisyenlere yol gösterici bir biyobelirteç olabileceği ve kardiyak troponin-I seviyesi normal olan hastaların diğer hastalara göre daha erken taburcu edilebileceği düşünülmüştür.Objective: Cardiac troponin levels can be increased in many cardiac and non-cardiac diseases. In our study, we aimed to measure the troponin-I level of COVID-19 patients at admission to the hospital to determine its ability to predict the intensive care need and all-cause mortality risk and to evaluate its relationship with gender. Material and Methods: The study was carried out retrospectively by analyzing the electronic medical records of COVID-19 patients who were hospitalized in our hospital between April 1, 2020 and February 1, 2021 and were tested for cardiac troponin-I in the first 24 hours. Statistical analysis was performed for all variables investigated in the study. Results: A total of 362 COVID patients were included in the study. Cardiac troponin-I level was abnormal in 90 patients. In 39 of the patients, the need for intensive care developed. Cardiac troponin-I level was abnormal in 17 of the patients in need of intensive care and in 73 of the patients who were not followed up in intensive care unit. It was observed that the need for intensive care was 71% higher in male gender and the negative predictive value of cardiac troponin-I level was 87.5%. Cardiac troponin-I level was abnormal in 11 of the patients who died and in 79 of the patients who survived. It was determined that the mortality risk was 75% higher in the male gender and the negative predictive value of cardiac troponin-I level was 91.7%. Conclusion: In this study, it was observed that normal troponin level in the first 24 hours of hospitalization has a high negative predictive value for mortality in men and women. It was thought that cardiac troponin-I levels could be a guiding biomarker for clinicians in the follow-up of COVID-19 patients, and patients with normal cardiac troponin-I could be discharged earlier than other patients

No decrease in infection rate with the use of local vancomycin powder after partial hip replacement in elderly patients with comorbidities

Introduction The goal of this study was to evaluate the effects of local intra-wound vancomycin powder (VP) administration to decrease surgical site infections (SSIs), particularly in elderly patients with comorbidities, after having undergone partial hip replacement in the treatment of intertrochanteric (ITF) or femoral neck fractures (FNF). Methods We retrospectively reviewed patients who underwent partial hip replacement in the treatment of ITF or FNF in one year. We divided the patients into two groups. The non vancomycin-treated group received standard systemic prophylaxis only (1 gr cefazolin IV), while the vancomycin-treated group received 1 gr of VP in the surgical wound just before surgical closure in addition to the systemic prophylaxis. We included patients of 64 years or older who also had one or more comorbidities. We compared the post-operative SSI rates between the non vancomycin-treated group and the vancomycin-treated group. Results A total of 93 patients were included in the study. We detected post-operative wound infection in six patients (6.4%). The rate of SSI was found to be 5.7% in the vancomycin-treated group and 6.9% in the non vancomycin-treated group respectively, which showed no statistically significant difference (p:0.498). The incidence of SSI was statistically higher in the patients who had a follow-up in the post-operative intensive care unit than the patients who had not any follow-up in the intensive care unit. Conclusion Local application of VP in the surgical wound was found to be ineffective in reducing the incidence of SSI after partial hip replacement in elderly patients with comorbidities

Diagnostic value of Chest CT and Initial Real-Time RT-PCR in COVID-19 Infection

Objectives: To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting with typical clinical symptoms of COVID-19. Methods: The study with the participation of four center in Turkey was performed retrospectively from 20 March-15 April 2020 in 203 patients confirmed for COVID-19. The initial rtRT-PCR test was positive in 142 (70.0%) of the patients (Group-I) and negative in 61 patients (Group-II). Results: The mean age of the patients in Group-I was 49.718.0 years and the time between the onset of symptoms and admission to the hospital was 3.6 +/- 2.0 days; whereas the same values for the patients in Group-II were 58.1 +/- 19.9 and 5.3 +/- 4.2, respectively (p=0.004; p=0.026). Initial rtRT-PCR was found positive with 83.5% sensitivity and 74.1% PPV in patients with symptom duration of less than five days. It was found that rtRT-PCR positivity correlated negatively with the presence of CT findings, age, comorbidity, shortness of breath, and symptom duration, while rtRT-PCR positivity correlated positively with headache. Presence of CT findings was positively correlated with age, comorbidity, shortness of breath, fever, and the symptom duration. Conclusions: It should be noted that a negative result in the rtRT-PCR test does not rule out the possibility of COVID-19 diagnosis in patients whose symptom duration is longer than five days, who are elderly with comorbidities and in particular who present with fever and shortness of breath. In these patients, typical CT findings are diagnostic for COVID-19. A normal chest CT is no reason to loosen up measures of isolation in patients with newly beginning symptoms until the results are obtained from the PCR test

Alternative Treatment Method for Crimean Congo Hemorrhagic Fever: Coupled Plasma Filtration and Adsorption

Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever syndrome that can cause multi-organ failure with hyperactivation of the immune system. There is no proven treatment for CCHF, supportive care is essential for management. Extracorporeal depurative techniques have been used to remove inflammatory mediators from the bloodstream. This report aims to present the use of coupled plasma filtration and adsorption (CPFA) in CCHF patients. We performed CPFA on three patients with CCHF, all of which were confirmed with polymerase chain reaction. A 35-year-old female was admitted one week after tick-exposure. Despite supportive treatment, patient developed mucosal and gastrointestinal bleeding due to disseminated intravascular coagulation (DIC). After CFPA, her clinic situation and laboratory results improved. A 54-year-old female was admitted to the intensive care unit due to severe bleeding and had a history of tick bite nine-days-ago. She had multiple organ failure with DIC, we started CPFA. Patient didn’t respond to the treatment and died. A 69-year-old male was admitted to the hospital on the seventh-day of exposure to tick. He had diabetes, hypertension and coronary artery disease. Next day, patient developed alveolar hemorrhage and his liver enzymes, coagulation parameters deteriorated. We performed CFPA, however, the patient didn’t respond to treatment and died. We suggested that CPFA may have positive effects on the outcome and prognosis of critically ill CCHF patients. Only one patient responded well which can be a result of being young, early admission to the hospital and lack of comorbidity. CPFA may be an option to treat severe CCHF infection with cytokine storm. However,there is a need for further studies on when we should apply this treatment and whether early application prevents mortality

Comparison of two pandemics: H1N1 and SARS-CoV-2

OBJECTIVE: We aimed to compare the clinical, epidemiological, and prognostic features of the H1N1 pandemic in 2009 and the severe acute respiratory syndrome coronavirus 2 pandemic in 2020. METHODS: This retrospective study involved subjects from seven centers that were admitted and found to be positive for H1N1 or COVID-19 real-time polymerase chain reaction test. RESULTS: A total of 143 patients with H1N1 and 309 patients with COVID-19 were involved in the study. H1N1 patients were younger than COVID-19 ones. While 58.7% of H1N1 patients were female, 57.9% of COVID-19 patients were male. Complaints of fever, cough, sputum, sore throat, myalgia, weakness, headache, and shortness of breath in H1N1 patients were statistically higher than in COVID-19 ones. The duration of symptoms until H1N1 patients were admitted to the hospital was shorter than that for COVID-19 patients. Leukopenia was more common in COVID-19 patients. C-reactive protein levels were higher in COVID-19 patients, while lactate dehydrogenase levels were higher in H1N1 ones. The mortality rate was also higher in H1N1 cases. CONCLUSIONS: The severe acute respiratory syndrome coronavirus 2 pandemic is a major public health problem that continues to affect the world with its high rate of contagion. In addition, no vaccines or a specific drug for the benefit of millions of people have been found yet. The H1N1 pandemic is an epidemic that affected the whole world about ten years ago and was prevented by the development of vaccines at a short period. Experience in the H1N1 pandemic may be the guide to prevent the COVID-19 pandemic from a worse end

İzmir Aliağa endüstri bölgesinde hava kirliliğine neden olan organik ve inorganik kirleticilerin düzeylerinin, kaynaklarının ve sağlık etkilerinin belirlenmesi

TÜBİTAK ÇAYDAG01.07.200

Atmosferdeki Parçacık Sayısal Konsantrasyonu Ile Kütlesel Konsantrasyonu Arasındaki Iliskinin Kurulması Ve Parçacık Sayısal Boyut Dagılımlarının Atmosferik Olaylardan Ne Kadar Etkilendiginin Incelenmesi

Proje parçacık boyut dagılımı ve bu dagılımın çesitli çevresel faktörlerle iliskisini incelemeye yönelik bir çalısmadır. Diger bir deyisle atmosfrdeki parçacık boyut dagılımının ne tür parametrelerle ne sekilde degistigini ortaya çıkarmak hedeflemistir. Çalısma birisi Ankara?da ODTÜ?de digeri ise Marmaristeki meteoroloji radarında kurulan iki istasyonda yürütülmüstür. Bu istasyonlarda bulunan lazer spektrometreler yardımıyla daikalik sayısal boyut dagılımları ile PM10, PM2.5 ve PM1 kütlesel konsantrasyonları ölçülmüstür. Istasyonlardaki deneysel çalısmalar baslamadan önce çalısmada kullanılacak bütün cihazlar ankara?da bir araya getirilmis ve bir interkalibrasyon çalısması gerçeklestirilmistir. Intercalibrasyon çalısmasının sonunda farklı cihazlardan elde edilen sonuçların birbirleriyle çok uyumllu oldugu görülmüstür. Ayrıca, Ankara istasyonunda lazer spektrometre ile ölçülen PM10 ve PM2.5 konsantrasyonlarının Ankara?daki yedi hava kirliligi izleme istasyonunda ölçülen PM10 ve PM2.5 konsantrasyonları ile uyum içerisinde oldugu, ancak yüksek konsantrasyonlarda bizim istastasyonumuzun daha yüksek degerler ölçtügü görülmüstür. Yapılan ölçüm ve degerlendirmeler tozun boyut dagılımının çok stabil bir parametre olmadıgını ve meteorolji, tasınım gibi etmenlerle degisiklik gösterdigini ortya koymustur

Diagnostic performance of APRI, FIB-4 and Fibroscan for assessment of hepatic fibrosis in chronic hepatitis B patients receiving oral antiviral therapy; 7-year real life data

67th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases (AASLD) -- NOV 11-15, 2016 -- Boston, MAWOS: 000385493804200…Amer Assoc Study Liver Di