Organik Sultani Çekirdeksiz Üzüm Yetiştiriciliği

Bu projede, organik ürün olarak, talebi oldukça fazla Sultani Çekirdeksiz kuru üzüm üretimi ele alınmıştır. Çalışma, iki alt projeden oluşturulmuştur. I. Alt projede organik tarımda istenen minimum toprak işlemesi yanında ülkemizde bulunan ve birçok olumlu özelliklere sahip Zeolit (Klinoptilolitie mineral [Agro-clıno (NMF 900)]) kullanımı da denemede yer almıştır. II. Alt proje de ise Ege Bölgesi bağlarının ana hastalığı olan külleme mücadelesinde NaHCO3’ (içme sodasının) mevcut koşullardaki kullanım olanakları projede ele alınmıştır Bağlardaki ana zararlı da salkım güvesi olup her iki alt projede, salkım güvesi mücadelesinde tuzaklar asılarak zararlının ergin populasyonu bu tuzaklarla ilk ergin çıkışından uçuşlar sona erinceye kadar haftalık olarak izlenmiştir. Uçuş eğrileri ile tahmin-uyarı istasyonlarından elde edilen meteorolojik veriler ışığında gerekli uygulamalar yapılmıştır. Çalışmanın sonucunda, KULTIVATOR ile toprak işleme sisteminin toprağa olumsuz etkisinin de en az düzeyde olduğu da dikkate alınarak önerilebileceği ortaya çıkmıştır. Yeşilyurt yöresi topraklarındaki mikrobiyal aktiviteyi arttırmada malç uygulaması önerilmesine karşın, bu uygulama diğer disiplinler tarafından uygun görülmediğinden alternatif olarak KULTIVATOR uygulaması tercih edilmektedir. Kükürt ve içme sodası uygulanan parsellerde külleme hastalık şiddeti konvansiyonel olan şahit parsele göre istatistiki öneme sahip düzeyde azalma kaydetmiştir. Konvansiyonel koşullardaki hastalığın daha fazla görülmesini uygun koşulları yaratacak yoğun vejetatif gelişmenin yaratmış olduğu düşünülmektedir. Kükürdün zararlıları baskılayıcı etkisi de bilindiğinden organik yetiştiricilikte Külleme mücadelesinde içme sodasına nazaran özellikle kükürdün tercih edilmesi uygun bulunmaktadır. Denemenin başladığı 2003 yılı baz alındığında Zeolit (Klinoptilolitie mineral [Agro-clıno (NMF 900)]) uygulamalarında verim ve kalite kriterlerinde artış olduğu tespit edilmiştir. Toprak işleme uygulamalarından toprağı çizerek işleme salkım sayısı ve verim bakımından önemli bulunurken pulluk+ diskharow ile işleme salkım ağırlığını; malç uygulamasının ise kuru maddeyi ve tane tutumunu arttırdığı görülmektedir. Yaprak alma uygulamalarından, 6 adet yaprak alınması kontrole nazaran verim, salkım sayısı ve salkım ağırlığını nispeten arttırmıştır. Proje konusu çalışma birimleri itibarıyla değerlendirildiğinde toprağın çizilerek işlenmesi (KULTIVATOR sistemi) ön plana çıkmaktadır

Clinical and microbiological features of resistant gram-negative bloodstream infections in children

Summary: Background: Bloodstream infections (BSIs) caused by Gram-negative (GN) bacteria cause significant morbidity and mortality. There is a worldwide increase in the reported incidence of resistant microorganisms; therefore, surveillance programs are important to define resistance patterns of GN microorganisms causing BSIs. The objective of this study was to describe the clinical and microbiological features of resistant GN BSIs in a tertiary pediatric hospital in Turkey. Methods: Patients between 1 month and 18 years of age hospitalized between January 2005 and December 2012 were included in this study. The presence of ESBL and AmpC type beta-lactamase activity were evaluated using the Clinical and Laboratory Standards Institute (CLSI) disk diffusion and double-disk synergy tests. Results: A total of 209 resistant GN bacterial BSI episodes were identified in 192 patients. Of 192 children, 133 (69.2%) were aged ≤48 months of age. Sixty-six (31.6%) of the BSIs were considered community-acquired and 143 (68.4%) were hospital-acquired infections. The most common isolates were non-fermenting GN bacteria (n = 117, 55.9%). The major causative pathogens were Pseudomonas spp. in non-fermenting GN bacteria. The resistance rates to imipenem for Pseudomonas spp. and Acinetobacter spp. were 40.5% and 41.6%, respectively. The most common isolates in fatal patients were Pseudomonas spp. followed by Escherichia coli. The overall 28-day mortality rate was 16.3%. Conclusions: Although our study was performed at a single center and represents a local population, based on this study, it is concluded that surveillance programs and studies of novel antibiotics for resistant GN bacteria focusing on pediatric patients are required. Keywords: Bloodstream infection, Gram-negative, Resistance, Childre

Clinical Characterics, Laboratory Features, and Management of Odontogenic Facial Cellulitis

Giriş: Diş çürükleri, dünya çapında en yaygın kronik hastalıklardandır. Bu çalışmanın amacı diş kaynaklı fasiyal selülit nedeniyle hastaneye ya-tırılan çocuk hastaların klinik özelliklerinin ve tedavi yöntemlerinin de-ğerlendirilmesidir.Gereç ve Yöntemler: Bu çalışmada, diş kaynaklı fasiyal selülit tanısı ile Ocak 2013-Aralık 2017 tarihleri arasında çocuk enfeksiyon hastalıkları servisinde yatırılarak takip edilen hastaların diş sağlığına ilişkin öyküle-ri, klinik ve laboratuvar özellikleri ile tedavi şekilleri geriye dönük olarak değerlendirildi.Bulgular: Çalışmaya ortanca yaşları 86 ay (min-maks: 19-207 ay) olan 98 (43 kız, 55 erkek) hasta alındı. Hastaların 45 (%45.9)’inin düzenli diş fırçalama alışkanlığı yoktu. Kırk sekiz (%48.9) hastanın herhangi bir diş tedavisi öyküsü yoktu. On sekiz (%18.3) hasta hiç diş hekimine başvur-mamıştı. Hastaların 75 (%76.5)’i ilk kez diş kaynaklı fasiyal selülit tanısı alırken, 4 (%4)’ü daha önce aynı tanıyla hastanede yatırılmıştı. Otuz yedi (%37.8) hastanın başvuruda ateşi vardı. Hastaların başvurudaki ortala-ma beyaz küre sayısı 11.981 4.233/mm3, eritrosit sedimentasyon hızı 29.1 17.6 mm/saat ve C-reaktif protein (CRP) değeri 35.2 39.4 mg/L olarak saptandı. Ortalama intravenöz (IV) antibiyotik tedavi süresi 5.5 2.5 gün, toplam antibiyotik tedavi süresi 12.5 2.9 gündü. Hastaların 82 (%83.7)’sine ampisilin-sulbaktam başlanmıştı. On beş (%15.3) hastanın tedavisine klindamisin eklenmişti. Başvurudaki beyaz küre sayısı arttıkça hastanede yatış süresinin arttığı (p 0.036) ve yüksek CRP düzeyi olanlarda toplam medikal tedavi süresinin arttığı saptandı (p 0.032). Teda-visine klindamisin eklenen hastaların IV ve toplam tedavi süresinin daha uzun olduğu saptandı (p 0.001 ve p 0.001).Sonuç: Diş çürükleri erken tanınıp tedavi edilmediği takdirde ilerleyerek selülite ve çocuklarda hastaneye yatışa neden olabilir. Hayat boyu temel sağlığın ayrılmaz bir parçası olan ağız sağlığının iyileştirilmesi için koru-yucu önlemler alınmalı ve diş sağlığı sorunlarına bir halk sağlığı sorunu olarak yaklaşılmalıdır.Objective: Dental caries remain one of the most common chronic diseases in childhood, globally. The purpose of this study is to determine clinical characteristics and treatment modalities of pediatric patients with odontogenic facial cellulitis.Material and Methods: Medical records of children with odontogenic facial cellulitis hospitalized in pediatric infectious disease clinic were analyzed retrospectively between January 2013 and December 2017.Results: Ninety-eight patients (43 girls, 55 boys) with median age of 86 months (min-max: 19-207 months) were evaluated. Forty-five (45.9%) patients had no regular toothbrushing habits. Forty-eight (48.9%) patients had no any dental treatment procedure history. Eighteen (18.3%) patients had never recoursed to a dentist. Seventy-five patients(76.5%) were diagnosed with odontogenic facial cellulitis for the first time. Four patients (4%) were hospitalized with the same diagnosis previously. On admission, 37 (37.8%) patients had fever. On admission, the mean white blood cell (WBC) count, erythrocyte sedimentation rate, and C-reactive protein (CRP) were 11.981 4.433/mm3, 29.1 17.6 mm/h and 35.2 39.4 mg/L, respectively. The mean duration of intravenous antibiotic treatment was 5.5 2.5 days, and total medical treatment was 12.5 2.9 days. Ampicillin-sulbactam was started to 82 (83.7%) of the patients. Clindamycin was added to 15 (15.3%) patients. Increased mean WBC count on admission was correlated with duration of hospital stay (p 0.036), while increased CRP level was correlated with total medical treatment duration (p 0.032). Patients who received clindamycin had longer duration of intravenous and total medical treatment (p 0.001 and p 0.001).Conclusion: If dental caries are not recognized and treated immediately, they may spread into surrounding connective tissue as cellulitis and may lead to hospitalization in young patients. Oral health is a mainstone of life-long well-being, so oral health problems should be considered as a major public health problem and preventive measures should be taken to improve oral health

The effectiveness of topical 1% lidocaine with systemic oral analgesics for ear pain with acute otitis media

Background: Acute otitis media (AOM) is one of the most common childhood infections. Ear pain, the main symptom of AOM, results in parents frequently seeking medical assistance for their children. The aim of this study was to compare the effectiveness of topical 1% lidocaine ear drops administered with oral analgesics with that of oral analgesics alone. Methods: This multicenter randomized, open-labeled study was conducted at 15 centers with 184 pediatric AOM patients with bilateral ear pain (aged 1–5 years) between May 1, 2016, and June 31, 2018. All patients received oral paracetamol or ibuprofen and topical 1% lidocaine, which was administered to each ear according to the randomization list. The ear pain score was evaluated within 48 h using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale, and the patients were followed up for 10 days. Results: The median age was 31.8 months (min–max, 12–84.2 months). Of those patients enrolled, 22.3% received paracetamol, and 24.5% received paracetamol with lidocaine ear drops; 23.4% received ibuprofen, and 29.9% received ibuprofen with lidocaine ear drops. Lower pain scores were significantly measured at baseline and 10th minutes by a reduction 25% (RR 13.64, 95% CI 4.47–41.63, p = 0.001, RR 0.14, 95% CI 0.06–0.35, p = 0.001) and 50% (RR 4.76, 95% CI 1.63–13.87, p = 0.004, RR 0.14, 95% CI 0.05–0.4, p = 0.001) in the paracetamol and lidocaine versus paracetamol groups and the ibuprofen and lidocaine versus ibuprofen groups, respectively. No serious side effects were evident during follow-up. Conclusion: This randomized study suggests that topical 1% lidocaine ear drops with paracetamol or ibuprofen seems to provide effective and rapid relief for children presenting with ear pain attributed to AOM

682. The Changing Epidemiology Of Bacterial Meningitis During 2015–2017 In Turkey: A Hospital-Based Prospective Surveillance Study

Background The etiology of bacterial meningitis in Turkey has been changed after the implementation of conjugated vaccines against Streptococcus pneumonia and Haemophilus influenzae type b (Hib) in Turkish national immunization schedule. Methods. This prospective study was conducted in 25 hospitals located seven regions of Turkey (representing 30% of Turkey population) and children aged between 1 month and 18 years with suspected meningitis and hospitalized were included. Cerebrospinal fluid samples were collected and bacterial identification was made according to the multiplex PCR assay results. Results. During the study period, 927 children were hospitalized for suspected meningitis and Hib (n:1), S. pneumonia (n:17) and Neisseria meningitidis (n:59) were detected in 77 samples (Figure 1, Table 1). During 2015–2016, N. meningitidis serogroup W, B, A, Y, X frequencies were as 5 (13.9%), 16 (44.4%), 1 (2.8%), 1 (2.8%), 1 (2.8%), respectively. There were 12 nongroupable N. meningitidis samples and serogroup C was not detected. In 2017, of meningococcal meningitis serogroup B, W, A, Y and X were identified in two (8.7%), 15 (65.2%), two (8.7%), 1 (4.3%) and 1 (4.3%) cases, respectively (Figure 2). There were four deaths in this study period, all of them were caused by N. meningitidis serogroup B and three of them were under 1 year old. Conclusion. The epidemiology of meningococcal diseases has been varied in time with or without any apparent reasons. Hajj is a well-known cause for serogroup W epidemics and serogorup W was the most common cause of meningitis in Turkey during 2009–2014 as in other Middle East countries. After the impact of serogroup W epidemics related to Hajj seen in 2010’s was diminished, serogroup B has been leading cause of childhood meningitis since 2015. In countries affected from Hajj like Turkey, vaccination of children with serogroup B meningococcal vaccine as well as quadrivalentconjugated vaccine seems to be very important. It should be kept in mind that meningococcal epidemiology is dynamic and needed to be closely monitored to detect changes in years Disclosures All authors: No reported disclosures.PubMe