The evaluation of risk factors related to reduced bone mineral density in young people living with HIV

Background: Low bone mineral density (BMD) is one of the comorbidities that develop in people living with HIV (PLWHIV). Objective: This study was conducted to review the frequency and risk factors of reduced BMD according to age in HIV-infected patients in Turkey. Material and Method: This retrospective cohort study included HIV-infected patients aged 18-50. Bone density was analysed using dual-energy X-ray absorptiometry (DXA) according to the Z-score in three different regions including the lumbar, total-hip and femoral-neck. Results: The study included 224 PLWHIV with a mean age of 35.84-7.54, and 59.8% were ART naive. Of the patients, 40.6% had lower BMD than expected at least in one of the three examined regions including the lumbar, total hip and femoral neck. The low BMD ratios were found respectively as 11.6%, 11.6% and 28.6% in the femoral neck, total hip and lumbar regions. According to the logistic regression model, a high body mass index (p=0.003) and HIV-RNA level of ≥100.000IU/ml during the diagnosis in the ART-naive group (p=0.008) were associated with reduced bone demineralization. The low BMD frequency was high in the group that received ART for <24 months (p=0.001). Conclusion: Performing bone demineralization screening in the naive and young patient group, independently from ART status prior to making the diagnosis of HIV is important for organizing the bone health improvement methods. Keywords: HIV infection; bone density; antiretroviral therapy

ANXIETY AND DEPRESSION AMONG PEOPLE LIVING WITH HIV DURING THE COVID-19 PANDEMIC: A FACE-TO-FACE SURVEY FROM TURKEY

Background: During the COVID-19 pandemic, there have been some difficulties in the routine care of people living with HIV (PLWH). Subjects and methods: We aimed to evaluate the impact of COVID-19 on mental health of PLWH and their use of health services. This study was conducted using the face-to-face interview method in the outpatient clinic of a university hospital, between 01.09.2020 and 30.11.2020. Hospital Anxiety and Depression Scale and survey instrument designed by the researchers investigating socio-demographic data and access to health services were used. Results: The study included 217 patients, 91.7% (n=199) of whom were male. All of the patients were postponed their hospital appointments, 60.8% were concerned about not being able to contact their physician and 53% had concerned about being stigmatized if they went to the hospital. Of the participants, 27.6% had depression, 12.9% had anxiety and 8.3% had both depression and anxiety. Low income, job loss, and fear of being stigmatized were associated with depression and anxiety. Lower level of education, discontinuation of medications and lack of opportunity to work remotely were associated with depression, while history of psychiatric illness, worry about not being able to contact their physician and cessation of antiretroviral therapy were associated with higher anxiety levels. Conclusion: It is important to develop strategies ensuring the continuity of care for PWLH and identify and support those with a higher mental health impact

Naiv hepatit C enfeksiyonlu hastaların on-altı yıllık prognozu

Objectives: In this study, we aimed to evaluate the clinical course of treatment-naive patients infected with hepatitis C virus (HCV) who were followed up in various centers in Turkey. Materials and Methods: This was a retrospective study performed with the participation of 15 centers. Patients aged 18 years and older with HCV infection were included. Results: A total of 391 treatment-naive patients infected with HCV were included in this study. During the follow-up period, the final values of alanine aminotransferase, aspartate transaminase, and total protein were significantly decreased when compared to the initial values (p<0.001, p<0.001, and p=0.005, respectively). In the study group, 19.2% of the patients underwent liver biopsy and 4.1% underwent transient elastography (FibroScan). An increased histological activity index (HAI) score and fibrosis in the second biopsy were observed in one patient, only increased HAI in two patients and increased fibrosis in one patient, as shown on the FibroScan. In the 16 years of the study period, cirrhosis was radiologically detected in only one patient. Conclusion: Even if rapid progression is not observed, close monitoring of the clinical findings related to liver failure and fibrosis with invasive or non-invasive methods may be useful.Amaç: Bu çalışmada ülkemizin çeşitli merkezlerinde takip edilen naiv hepatit C virüs (HCV) ile enfekte hastaların klinik seyrini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu çalışma retrospektif olarak 15 merkezin katılımıyla gerçekleştirilmiştir. Çalışmaya 18 yaş üstü, HCV enfeksiyonu olan hastalar dahil edilmiştir. Bulgular: Çalışmada 391 tedavi-naiv HCV enfeksiyonlu hasta yer almıştır. Hastaların takip süresinde son alanine aminotransferase, aspartate transaminase ve total protein değerleri ilk düzeyine göre önemli düzeyde azalmıştır (sırasıyla p<0,001, p<0,001, p=0,005). Çalışma grubunda hastaların %19,2’sine karaciğer biyopsisi, %4,1’ine elastografi (FibroScan) uygulanmıştır. Takip esnasında bir hastada ikinci biyopside histolojik aktivite indeksi (HAI) ve fibroziste artma, iki hastada sadece HAI’da artma, birinde FibroScan ile fibrozis değerinde artma olduğu gözlenmiştir. Bir hastada 16 yıl içinde radyolojik olarak siroz saptanmıştır. Sonuç: Hızlı progresyon gözlenmemekle birlikte hastaların izleminde karaciğer yetmezliği ile ilgili klinik bulguların ve invaziv veya noninvaziv yöntemlerle fibrozisin yakın takibi yararlı olabilir

The Relationship Between Public, Private Sectors and Growth: the Case of Turkey

2nd International Conference on Education and Social Sciences (INTCESS) -- FEB 02-04, 2015 -- Istanbul, TURKEYThe basic purpose of this study is to analyze relationship between investmen and gross domestic products. For this purpose, fistly public ivestment, private sector investment and growth will be looked at theoretically and after this informations, to mesure the effect of public investment and prevate sector investment for gross domestic product from 1980 to 2013. For this measurement, it will be used multiple regression. According to the outcomes of the set econometrical multiple regression models there is a positive and close relationship between investment and gross domestic product.Int Org Ctr Acad Re

Comparison of Asymptomatic Bacteriuria Agents and Antimicrobial Susceptibility in Term and Preterm Pregnancies

Aim: The aim of this study was to compare the resistance to asymptomatic bacteriuria (ABU) between term and preterm pregnancies. Material and Methods: Pregnant women aged 17-41 years who were followed up in the obstetrics department of our hospital and whose urine cultures were sent to the laboratory for analysis and reported as ABU were included in the study. Patients were divided into two groups according to gestational weeks as preterm (&lt;37 weeks) and term (?37 weeks). The results were compared between the two groups. Results: From among a total of 123 pregnant women, 29 (23.6%) delivered at preterm and 94 (76.4%) at term. The most frequently identified pathogen throughout the study group was 52.0% (n=64) Escherichia coli (E. coli), followed by 16.3% (n=20) Streptococcus agalactiae (S. agalactiae). There was no statistically significant difference in terms of the distribution of E. coli and S. agalactiae between the term and preterm groups (p=0.698 and p=0.930). E. coli was resistant to ampicillin 56.3% (n=36), to cefuroxime 40.6% (n=26). While fosfomycin resistance was 1.6% (n=1), nitrofurantoin resistance was not found. Extended-spectrum beta-lactamase positivity was 23.4% (n=15) in E. coli strains. No statistically significant difference was found in antibiotic resistance rates of E. coli strains between the term and preterm groups. Conclusion: The most commonly isolated pathogen was E. coli which was highly resistant to beta-lactams. Screening of pregnant women for ABU and treatment with appropriate antibiotics; is the most effective way to prevent both maternal and fetal complications and antimicrobial resistance

The Cost Analysis of Preterm Infants from a NICU of a State Hospital in Istanbul

Objective: The objective of this study was assessment of hospital costs of 211 preterm babies admitted to NICU in a 12-month period. Methods: Preterm babies with gestational age 28-37 GW hospitalized in Dr. L. Kırdar Kartal Research and Training Hospital NICU between November 1st, 2006 to October 31st, 2007 were included in this retrospective study. The financial records of the babies were plotted and investigational, interventional, consumable costs, drugs and ancillary costs were determined. The average daily cost of a preterm has been determined. Group I and II consisted of babies with gestational ages 37-33 GW and 32-28 GWs respectively. The length of stay, ventilation duration and costs of each group were compared. Findings: The mean birth weight was 1689±497 gr. The mean length of hospital stay was 13.6±13.4 days. Hundred and four (49,5%) patients were found to be ventilated. The median ventilation day was 3 days. We found a statistically significant relation between length of hospital stay, ventilation duration, presence of intervention, RDS, sepsis and hospital costs. The mean total hospitalization cost and the daily cost of a preterm was determined as $4187 and$303 respectively. The highest intensive care costs of preterm neonates were found to be paid for interventional procedures, followed by NICU personnel salary and ancillary costs. Between two groups statistically significant difference was found for length of stay, duration of ventilation, interventional and consumable costs (P=0.014, P=0.019, P=0,001, P=0.03 respectively). Conclusion: Strategies for prevention of prematurity and early weaning from mechanical ventilation may shorten length of hospital stay leading to decreased NICU costs

Apurinic/Apyrimidinic Endonuclease (APE1) Gene Polymorphisms and Lung Cancer Risk in Relation To Tobacco Smoking

Background: Polymorphisms altering DNA repair capacity may lead to synergistic effects with tobacco carcinogen-induced lung cancer risk. Based on this hypothesis, the relationship between APEI polymorphism, smoking and the risk of lung cancer was explored. Materials and Methods: The distribution of the APE1 Asp148Glu polymorphisms in 98 lung cancer patients and 67 healthy individuals were compared using PCR-RFLP analysis. Results: Individuals carrying the APE1 Asp148Glu heterozygous and homozygous variant genotype had a 3.23-fold increased risk of lung cancer compared with these carrying the wild-type (Asp/Asp) genotype (P<0.0001), and those carrying the 148Glu homozygous genotype had a 3.17-fold increased risk (p=0.023). When stratified by smoking status, carriers of the Glu allele of APE1 were at a statistically increased risk of lung cancer among smokers (p=0.001). Conclusion: A statistically significant interaction of current smoking status with APE1 Asp148Glu polymorphism was found. These results suggest that the presence of one or two APE1 Glu allele was associated with the risk of developing lung cancer

Empirical cefepime+vancomycin versus ceftazidime+vancomycin versus meropenem+vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus study

Abstract Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p  0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci