Oral Amoxicillin/Clavulanate and Ciprofloxacin Treatment in Low-Risk Febrile Neutropenic Patients with Solid Tumors

Objective: The aim of this study was to collect the data of low-risk febrile neutropenic patients with solid tumors orally treated with amoxicillin/clavulanate and ciprofloxacin. Material and Methods: Adult patients with solid tumors who were treated with conventional dose of chemotherapy, presented with fever (axillary temperature 38 degrees C on two occasions or 38.3 degrees C on a single occasion) and neutropenia (absolute neutrophil count, 500 cells/mL), and met low risk criteria (above 20) according to "The Multinational Association for Supportive Care in Cancer" (MASCC) were eligible for this study. All patients received empirical therapy with oral ciprofloxacin (500 mg twice daily) plus amoxicillin/clavulanate (1000 mg, three times daily). Results: Twenty-one episodes of febrile neutropenia in 20 patients (including two episodes of a patient with lung cancer) were studied retrospectively. The mean age was 55.5 years (range, 30 to 77 years), and most were females (70%). On the initial evaluation, two of these patients had mild diarrhea and the others had a fever of unknown origin. Treatment was successful in 76% of the episodes. Twenty-seven percent of episodes required modification of initial antibiotic therapy to intravenous administration of antibiotics. No death was observed due to the febrile neutropenic episode. Conclusion: In low-risk patients with solid tumors who have fever and granulocytopenia, oral therapy with ciprofloxacin plus amoxicillin/clavulanate seems to be an effective alternative approach for empirical therapy

Efficacy and safety of pegylated-interferon α-2a in hemodialysis patients with chronic hepatitis C

AIM: To evaluate the efficacy and safety of pegylated-interferon alpha-2a in hemodialysis patients with chronic hepatitis C

RAPID COMMUNICATION Efficacy and safety of pegylated-interferon a-2a in hemodialysis patients with chronic hepatitis C

AIM: To evaluate the efficacy and safety of pegylatedinterferon alpha-2a in hemodialysis patients with chronic hepatitis C. METHODS: Thirty-six hemodialysis patients with chronic hepatitis C were enrolled in a controlled and prospective study. All patients were treatment naive, positive tested for anti-HCV antibodies, and positive tested for serum HCV-RNA. Twenty-two patients received 135 μg peglyated-interferon a-2a weekly for 48 wk (group A). The remaining patients were left untreated, eleven refused therapy, and three were not candidates for kidney transplantation and were allocated to the control group (group B). At the end of the treatment biochemical and virological response was evaluated, and 24 wk afte

Management of Priapism: Results of a Nationwide Survey and Comparison with International Guidelines

Objective: The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. Methods: Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were considered most important and relevant to practices by using Google Forms. Results: Total number of responses was 340. Respondents reported that they recorded a detailed patient’s medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n = 323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n = 75) replied that they performed in >75% of cases. Participants (n = 311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most preferred drug for stuttering priapism (n = 141, 41%). Participants (n = 284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of participants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. Conclusion: It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency