Global landscape review of serotype-specific invasive pneumococcal disease surveillance among countries using PCV10/13: The pneumococcal serotype replacement and distribution estimation (PSERENADE) project

Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon

Global Landscape Review of Serotype-Specific Invasive Pneumococcal Disease Surveillance among Countries Using PCV10/13: The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) Project.

Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon

The Effects of Utility Based Accessibility on Transportation Mode Choice

The Effects of Utility Based Accessibility on Transportation Mode Choic

Does Acute Appendicitis in Pregnancy a Clinical Challenge in Surgery Practice? Our Experience

Objective. This study was designed to compare the diagnosis, treatment, and results of acute appendicitis in pregnant and non-pregnant women. Material and Methods. Women between the ages of 18 and 40 who were operated for acute appendicitis between 2015 and 2020 were included in the study. Results. There were 27 (3.8%) patients in Group Pregnant, and 679 (96.2%) patients in Group non-Pregnant. The mean WBC values in Group P and Group non-P was 16.53±2.91 and 13.99±4.31 (x103), and there was a significant difference between the groups.Mean pain symptom duration time was 3.40±1.90 in Group P and 1.91±1.34 day in Group non-P, while it was significantly longer in Group P . When the preoperative USG reports were evaluated, no significant difference was found between the groups.The diagnosis was made by MRI in 2 (7.4%) pregnant patients who non-visualized according to the USG report. In Group P, 10 patients were laparoscopic, 17 patients open; In group non-P, 153 patients laparoscopic and 526 patients were operated using open surgery technique. While the mean operation time did not differ significantly between the groups. Length of hospital stay was significantly higher in Group P with 3.48±4.26 days to 1.95±1.45 days. Conclusion. Diagnosis and treatment of acute appendicitis during pregnancy may be difficult, but with advanced radiological examinations and experienced surgeons, these difficulties can be easily overcome

Preoperative Pulmonary Function Testing Predicts Cough Effectiveness Early After Laparoscopic Bariatric Surgery

Background: Cough is a protective mechanism providing bronchial drainage and helps to protect secretion retention in postoperative patients. Although laparoscopic bariatric surgery significantly decreases postoperative respiratory complications, there is an increase in patients with abnormal pulmonary function test results. The aim of the study was to investigate the relationship between preoperative pulmonary function testing (PFT) variables and cough effectiveness early after laparoscopic bariatric surgery

The effect of systemic vancomycin on central venous catheter colonization

Central venous catheter (CVC) related infections are a major cause of morbidity and mortality. We undertook a clinical follow-up study in order to determine the value of systemic vancomycin usage before catheter insertion against catheter colonization. During the study period 70 patients with central venous catheters were prospectively studied. Patients were selected to one of two groups. All patients using vancomycin, without any other antibiotics, due to previous catheter related bacteraemia, were selected for group A. At the end of the vancomycin therapy a new CVC was inserted to a new site within an hour after the last dose (8 mg/kg). All the patients who had not used any antibiotics before and during catheter insertion were selected for Group B. None of the patients in both groups received any antibiotics for the duration that their catheters were kept in place. The catheters were removed at the end of the 7th day and cultured. In group A and group B colonization was detected with six (24.4%) and with 34 (75.6 %) CVCs, respectively. In group B colonization was detected with a significantly higher rate in comparison with group A with an odds ratio of 17.53 (95% CI: 4.150-7.054). In group A Gram positive cocci was not isolated from the catheter tip in comparison with group B in which the most commonly isolated organisms were Gram-positive cocci (n=21, 58.3%) (p<0.001). These results observed in a relatively homogeneous patient population, suggest that systemic usage of vancomycin before catheter insertion may reduce the incidence of CVC colonization, especially with Gram-positive cocci, and Gram-negative organisms dominate for the colonization