COVID-19 Hastalarında Lopinavir/Ritonavir ve Favipravir Deneyimi

Giriş: COVID-19 şu anda küresel sağlık için büyük bir tehdittir. Bununlabirlikte, tedavisi için spesifik bir antiviral ajan mevcut değildir. Buçalışmada; Favipiravir (FPV) ve Lopinavir/Ritonavir (LPV / RTV) ile tedavi edilen hastalarda tedavinin klinik etkinliğinin ve ilaç yan etkilerinin değerlendirmesi amaçlandı.Gereç ve Yöntem: Çalışmaya üçüncü basamak bir hastanede enfeksiyon hastalıkları servisinde 15.03.2020-30.04.2020 tarihleri arasında COVID-19tanısı ile yatırılarak takip edilen FPV ve LPV / RTV tedavisi alan 46 hasta dahil edildi. Tüm hastaların COVID-19 tanısı real time polimeraz zincir reaksiyonu(RT-PCR) ile konfirme edildi.Bulgular: COVID-19 tanısı alan 46 olgu çalışmaya alınmıştır. Hastaların 29’u(%63) erkek, 17’si (%37) kadındı. Toplam 46 hasta iki grupta değerlendirildi. Birinci grupta FPV kullanan 34 hasta, ikinci grupta LPV/RTV kullanan 12 hasta mevcuttu. Yaş ortalaması 57.8±17.7 (yaş aralığı 18-91). Birinci grubun yaş ortalaması 57,71±17,33, ikinci grubun yaş ortalaması 58.±18.8 idi. Hastaların tümünde ateş en sık başvuru semptomu idi (%69,6). FPV kolunda sırasıyla ateş (%68.8), halsizlik (%77.8), öksürük %69.2 en sık başvuru semptomları idi. LPV/RTV kolunda sırasıyla ateş (%31.2), öksürük (%30.8), boğaz ağrısı (%28.6)en sık başvuru semptomları idi. FPV kolunda ateşi olan hastaların tedavi ile ortalama normale dönüş süresi 3.56±1 gün iken LPV/RTV kolunda ateşin normale dönme süresi 4,42±1 gün idi. FPV kolunda daha hızlı olan ateşin normale dönme süresi istatistiksel olarak anlamlı bulundu (p: 0.03). Karaciğer enzim yüksekliği FPV kolunda belirgin yüksekti (%20.6). Bulantı-kusma ise LPV/RTV kolunda yüksek (sırasıyla %41.7, %25) görüldü. Bu yükseklik istatistiksel olarak anlamlı idi (p değeri sırasıyla 0.009 ve 0.04). İlaç kesilmesini gerektiren ciddi bir yan etki gelişmedi.Sonuç: SARS-CoV-2 enfeksiyonu için henüz bilinen, etkinliği güvenilir çalışma sonuçları ile gösterilmiş bir tedavi bulunmamaktadır belirli ilaçlar henüz şimdilik birleştirilmemiştir. Hedefimiz, eldeki verilerle etkili tedavileri tanımlamak için sonuçları paylaşmaktı. LPV/RTV tedavisi ile viral kilerens oldukça yüksek iken yan etki neredeyse tüm hastalarda görülmüştür. FVP kullanan hastalarda viral kilerens LPV/RTV koluna göre daha az olmakla beraber ilaca bağlı gelişen yan etkilerde daha azdı. Sonuçlarımız SARSCoV-2 enfeksiyonunun tedavisi için ön veri sağlamıştır. Ayrıca, antiviral tedavi denemeleri için birincil son nokta olarak kullanılabilen ve COVID-19 ile ilgili tedavileri araştıran protokollerin tasarlanması için faydalı bir sonuç olabilecek viral klirens zamanını ve yan etki spektrumunu göstermeye çalıştık COVID-19 tedavisinde etkinliği tam olarak bilinmeyen bu ilaçların yarar sağlayacağı umut edilmektedir

Psychiatric Patients' Perspective: Nursing Uniforms

This paper studied and determined the importance of the design and color of selected uniforms of psychiatric nurses and evaluate their effects and implications for patients. In this descriptive study, a questionnaire developed by the researchers and a nursing uniforms catalog were used during the data collection stage of the research. There were 40.9% of the participants who told that the design and color of a nursing uniform is important and 31.5% of the participants selected white uniform color from the catalog for psychiatric nurses and 33.9% of the patients expressed that they find white nursing uniforms comforting. (C) 2015 Published by Elsevier Inc

Genital ulcerative pyoderma gangrenosum in Behçet′s disease: A case report and review of the literature

Behçet′s disease (BD), first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease. Pyoderma gangrenosum (PG) is a rare, chronic, sterile pustular and progressive ulcerative process of unknown cause; sometimes can participate in the differential diagnosis of Behcet′s ulceration. A 33-year-old woman complained a severe genital ulcer. She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. A punch biopsy at ulcer margin showed that the lymphocytic panniculitis was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall. Based on the clinical and histological findings, she was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD

Atypical Acinetobacter baumannii Meningitis: Case Report

A patient with an unusual clinical form of acinetobacter meningitis is presented. A 42-year-old female patient who was a victim of domestic violence 1.5 months before was admitted to the emergency department with the complaints of fever, nausea, vomiting, and confusion. The cerebrospinal fluid (CSF) obtained from lumbar puncture (LP), showed normal pressure and appearance. No cells were found on microscopic examination of the CSF. CSF biochemistry revealed protein: 18 mg/dL, glucose: 75 mg/dL (concurrent blood glucose level: 102 mg/dL) and lactate dehydrogenase (LDH) < 30 U/L. A. baumannii was isolated from the CSF culture. Since all CSF parameters were within normal range and bedside CSF culture was not performed, a contamination was suspected, and LP was repeated. Follow-up LP also revealed normal CSF pressure, clear CSF, and no cells on microscopic examination. Biochemical examination revealed protein: 25.2 mg/dL, glucose: 84 mg/dL (concurrent blood glucose level: 118 mg/ dL) and, LDH: 44 U/L; A. baumannii grew on CSF culture. Growth on culture despite normal CSF findings prompted LP to be repeated once again. The last LP revealed normal CSF pressure and appearance and no cells on microscopic examination, but biochemical tests showed protein level of 25 mg/dL and glucose level of 82 mg/dL, with concurrent blood glucose level of 106 mg/dL. LDH was 30 U/L, and A. baumannii grew for the third time. The patient was diagnosed as acinetobacter meningitis, and treatment consisting of intrathecal and intravenous colistin together with meropenem was started. CSF culture after intrathecal colistin treatment on consecutive days yielded no growth. There was improvement regarding consciousness after this treatment. We emphasize that CSF culture is more valuable in the diagnosis of meningitis, and that meningitis, albeit rarely, can have an uncommon presentation

Molecular Characterization of Cyclamen Species Collected from Different Parts of Turkey by RAPD and SRAP Markers (vol 55, pg 87, 2017)

WOS: 000391977700009PubMed ID: 27639865

Molecular Characterization of Cyclamen Species Collected from Different Parts of Turkey by RAPD and SRAP Markers

The genus Cyclamen (family Myrsinaceae) contains about 20 species, most of which occur in the Mediterranean region. Turkey has critically important Cyclamen genetic resources. Molecular characterization of plant materials collected from different regions of Turkey in which Cyclamen species grow naturally, namely Adana, Antalya, Aydin, Mugla, Izmir, Denizli, Kahramanmaras, Osmaniye, Eskisehir, Trabzon, and Rize provinces, was performed using RAPD and SRAP markers. DNA was successfully amplified by 30 RAPD primers and 14 SRAP primer pairs. Among the 470 bands generated by the RAPD primers, 467 were polymorphic. The number of bands detected by a single primer set ranged from 11 to 22 (average of 15.6). The percentage polymorphism was 99.3 % based on the RAPD data. In the SRAP analysis, a total of 216 bands were generated, showing 100 % polymorphism. The number of bands detected by a single primer set ranged from 9 to 22 (average of 15.4). All data were scored and UPGMA dendrograms were constructed with similar results in both marker systems, i.e., different species from nine provinces of Turkey were separated from each other in the dendrograms with the same species being clustered together

Assessment of bone healing using ( Ti,Mg)N

Magnesium (Mg) based implants such as plates and screws are often preferred to treat bone defects because of the positive effects of magnesium in bone growth and healing. Their low corrosion resistance, however, leads to fast degradation and consequently failure before healing was completed. Previously, we developed Mg doped titanium nitrate (TiN) thin film coatings to address these limitations and demonstrated that <10 at% Mg doping led to enhanced mineralization in vitro. In the present study, in vivo performance of (Ti,Mg)N coated Ti6Al4V based plates and screws were studied in the rabbit model. Bone fractures were formed on femurs of 16 rabbits and then fixed with either (Ti,Mg)N coated (n= 8) or standard TiN coated (n= 8) plates and screws. X-ray imaging and mu CT analyses showed enhanced bone regeneration on fracture sites fixed with (Ti,Mg)N coated plates in comparison with the Mg free ones. Bone mineral density, bone volume, and callus volume were also found to be 11.4, 23.4, and 42.8% higher, respectively, in accordance with mu CT results. Furthermore, while TiN coatings promoted only primary bone regeneration, (Ti,Mg)N led to secondary bone regeneration in 6 weeks. These results indicated that Mg presence in the coatings accelerated bone regeneration in the fracture site. (Ti,Mg)N coating can be used as a practical method to increase the efficiency of existing bone fixation devices of varying geometry

Fever of unknown origin (FUO) on a land on cross-roads between Asia and Europa; a multicentre study from Turkey

Aims The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO aetiology and factors influencing the final diagnosis of FUO in Turkey

Turkish League Against Rheumatism (Tlar) Recommendations For The Pharmacological Management Of Rheumatoid Arthritis: 2018 Update Under Guidance Of Current Recommendations

Objectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining >= 70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected. Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics.WoSScopu