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AIM: To demonstrate the importance of an integrated viral surveillance to tackle the changing epidemiology and the continuing disease burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). BACKGROUND: International institutions such as European Centre for Disease Prevention and Control provide guidance for integrated surveillance of respiratory viruses. However, SARS-CoV-2 is not an integral part of sentinel influenza like illness and severe acute respiratory infections surveillance in Türkiye. METHODS: We utilized the database from the Global Influenza Hospital Surveillance Network project in Türkiye between November 1st, 2022 and May 31st, 2024 over two seasons. Patients admitted to five hospitals with influenza like illness symptoms in the last 7 days and stayed overnight in the hospital were screened three days a week and swabbed within 72 hours of admission in a standardized year around surveillance methodology. An oligonucleotide panel analysis was utilized during November 1st 2022 to October 31st 2023 and multiplex PCR was utilized thereafter to test for influenza A and B, SARS-CoV-2 and respiratory syncytial virus (RSV). RESULTS: A total of 984 inpatients were enrolled and 969 of them, 724 (75%) of whom were adults, had valid laboratory results. RSV was the most prevalent pathogen detected in 4.9% of the samples, followed by SARS-CoV-2 (4.8%) and influenza A and B (3%). CONCLUSIONS: SARS-CoV-2 is circulating and resulting in hospital admissions among all age groups adding onto the influenza and RSV peaks. Integrated respiratory virus surveillance is crucial to guide informed public health policies and effective vaccination programs.

Purpura fulminans (PF) is a rare but fatal thrombotic disease caused by microvascular thrombosis due to coagulation disorder. Necrosis can progress to muscle and bone tissue contributing to late mortality and morbidity. A healthy 4-month-old girl and a 7-month-old girl had previously admitted to our intensive care unit with severe PF due to meningococcemia. Both patients had a severe and critical period in the pediatric intensive care unit and were supported with extracorporeal treatments. We opened colostomy for perineal infection because of large and deep skin lesions. In addition, we waited for a full auto-amputation involving all extremities instead of early surgical amputation. Both survived and acceptable limb function and some mobilization capacity were preserved. In conclusion, we think that early colostomy in severe perineal infections and autoamputation options in severe extremity involvement should be preferred in order to get better results.

This study seeks to investigate the work titled “Do The Androids Dream of Electric Sheep?” a cult science fiction work written by Philip K. Dick in 1968, in terms of Ulrich Beck’s “Risk Society” theory. Although the overall aim is to analyse the work based on the relevant theory, another aim of the study is to interpret and evaluate the elements that have the characteristics of “Dystopia”, the events and concepts in this context. In the study, the events and phenomena caused by the global disasters that occurred in the Postmodern era during the post third Terminus World War were discussed within the scope of Risk Society theory along with examination of the damages caused by the risks that emerged after the mentioned war in the natural environment, fears, uneasiness and future concerns reflected in the social sphere. The dystopian characteristics of the work and whether the author’s imagination and fiction is an expected fiction in the future were examined. The findings were interpreted sociologically, and the elements reflected in the science-fiction genre were evaluated in terms of dystopian fiction and literature. This study includes comparative analyzes of the findings in terms of dystopian fiction and Ulrich Beck’s Risk Society theory.

Aim: Prompt diagnosis and determination of the clinical severity and intervention of lower respiratory tract infections (LRTI) is essential for the prevention and management of life-threatening complications. Laboratory tests do not serve as accurate indicators of clinical severity. Our aim was to evaluate the contribution of urinary amino-terminal pro-brain natriuretic peptide (NT-ProBNP) concentrations in children with LRTI to clinical assessment in terms of determining clinical severity and the necessity of hospitalization. Materials and Methods: This prospective non-randomised study included a total of 160 patients, aged 0-6 years, diagnosed with LRTI [(group 1=outpatient group (n=108), and (group 2=hospitalized patients (n=52)]. The control group (group 3) was comprised of 46 healthy children. Urinary NT-ProBNP level of each participant was measured by ELISA method. Results: Although not significant, the mean urinary NT-ProBNP level of all patients was higher than that of the control group (p=0.322). When we compared the three groups separately, the highest levels belonged to outpatients whereas hospitalized patients showed slightly lower levels than the control group without any statistical significance (p=0.128). As for newborns (n=16), patients showed higher levels than the controls (p=0.041). P value

Introduction: The aim of this study was to determine the frequency of central line-associated bloodstream infections, risk factors, their relationship with catheter insertion location, and the effect of central line-associated bloodstream infections on mortality and pediatric intensive care unit (PICU) length of stay. Methods: This was a prospective, observational and cohort study, carried out between November 2009 and February 2011. During this period, all the patients who had central-line were monitored for central line-associated bloodstream infection. Results: In the study period, 275 patients were admitted to our PICU. The frequency of invasive device usage was 38.9% (107) for central venous catheter, 38.2% (105) for mechanical ventilation, 53.3% (147) for urinary catheter, and 11.3% (32) for artery line. Central line-associated bloodstream infection was detected in 16 (14.8%) of the patients and 23 central line-associated bloodstream infection attacks were observed. There were 14 central line-associated bloodstream infection attacks in 1.000 central venous catheter usage days. There were 168 patients without central venous catheter and 4 (2.4%) of them had blood stream infection. Thirty-six patients died and the mortality rate was 13%. Five of these patients (13.8%) died due to central line-associated bloodstream infection, 27 (25%) of them had central venous catheter and 9 (6%) of them did not (p=0.001). Conclusion: In conclusion, central line-associated bloodstream infection is one of the serious healthcare-associated infections, and it is an important cause of morbidity and mortality in PICUs.

In this paper, two natural dyes were extracted from Junipers leaves (Juniperus oxycedrus L. and Juniperus excelsa Bieb.). Wool yarn (for carpet) was dyed with the extract using ferrous (II) sulfate, potassium dichromate and sodium sulfate as mordant. Then, CIELab (L*, a*, b*, c,* and h) values, color differences (ΔE) and color strength (K/S) values of dyed wool yarns were examined and the fastness properties of dyed wool against dry and wet rubbing were evaluated. According to the experimental results, the use of mordant increased the color strength of dye goods. All mordant increased the rub fastness of dyed samples such as similar scientific studies previously. Compared to two junipers, dyeing samples of J. excelsa are dyed darker than that of J. oxycedrus.

Abstract Background Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region. Methods The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre. Results A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect. Conclusion This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.

The clinical manifestations of SARS-CoV-2 infection mainly involve the respiratory system. However, there is increasing evidence that this virus can affect other organs, causing a wide range of clinical symptoms. This is the report of a 40-day-old patient who presented with sepsis and had no risk factors other than SARS-CoV-2 infection, whose radiological findings were compatible with cerebral sinus vein thrombosis.

Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children.Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined.Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5–14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1–3 years of age (9.3%), 148 were 3–6 years of age (12.8%), 298 were 6–12 years of age (25.8%), 233 were 12–15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1–3 days). Fever was median at 38.4°C (38.0–38.7°C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma).Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.

Abstract Aims We aimed to determine the use of sodium–glucose cotransporter 2 inhibitors (SGLT2is) and to identify clinical factors associated with their use in patients with heart failure (HF) in a real‐life setting. Methods Real‐world data on Empagliflozin and Dapagliflozin use in patients with HEART failure: The RED–HEART study is a multicentre, cross‐sectional and observational study that included HF patients in the outpatient setting regardless of ejection fraction from 19 cardiology centres between August 2023 and December 2023. Results The study population consisted of 1923 patients with HF, predominantly men (61.2%), with a median age of 66 (range: 19–101) years. Overall, 925 patients (48.1%) were receiving SGLT2is. Among the study population, 22.1% had HF with preserved ejection fraction, 21.5% had HF with mildly reduced ejection fraction, 56.4% had HF with reduced ejection fraction and the use of SGLT2is was 42.0%, 47.9% and 50.6% in each group, respectively (P = 0.012). The use of SGLT2is was 76.6% in patients with HF and diabetes, 19.8% in patients with HF and chronic kidney disease and 26.8% in patients without diabetes and chronic kidney disease (P

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Haemophilus influenzae type b (Hib) causes invasive infectious diseases such as meningitis, bacteremia and pneumonia. Invasive Hib infections occur mostly in children under five years old, but in the first 6-12 months of their life they are at greatest risk for the disease. After the introduction of conjugate Hib vaccines, the incidence of invasive Hib infections has decreased. There are still some cases of invasive Hib disease immunization with conjugate Hib vaccine. There is no evidence that non-type b infections have increased in frequency, but some cases have been reported. Patients with immune deficiency syndromes can also have invasive Hib infections because of inadequate antibody responses. Here, we present two cases with invasive Hib infections immunization with conjugate Hib vaccines. [ABSTRACT FROM AUTHOR]

Resumo Fundamento A Terapia Antiplaquetária Dupla (DAPT, do inglês dual antiplatelet therapy) é o tratamento de escolha para pacientes com síndromes coronarianas agudas e crônicas, uma vez que ela reduz mortalidade e previne complicações trombóticas recorrentes. A avaliação da carga isquêmica e do risco de sangramento é crucial na escolha da DAPT e de sua duração. Objetivos O objetivo de nosso estudo foi conduzir um acompanhamento clínico prospectivo de pacientes recebendo terapia combinada (AAS 75mg + clopidogrel 75 mg). Nosso estudo é um estudo multicêntrico, transversal, observacional, do tipo coorte. Métodos Foram incluídos 1500 pacientes que iniciaram DAPT combinada para o tratamento de síndrome coronariana aguda ou síndrome coronariana crônica. Os desfechos primários foram internação hospitalar por qualquer motivo, internação por causa cardiovascular, infarto agudo do miocárdio, trombose de stent, revascularização de vaso alvo e sangramento; os desfechos secundários foram morte por qualquer razão ou por causa cardiovascular e acidente vascular cerebral. O nível de significância adotado na análise estatística foi 5%. Resultados A idade mediana foi 63 anos; 78,5% dos pacientes estavam recebendo DAPT por síndrome coronariana aguda. As taxas de internação por causas cardiovasculares, de infarto agudo do miocárdio, de trombose de stent e de revascularização de vaso alvo foram 7,9%, 2,3%, 1,3% e 4,2%, respectivamente. Enquanto a taxa de sangramento segundo a escala BARC tipo 1 foi de 3,3%, a taxa de sangramento BARC tipo 5, 3, ou 2 foi 0,6%. As taxas dos desfechos secundários morte por qualquer razão, morte por causa cardiovascular e acidente vascular cerebral foram 0,5%, 0,3% e 0,3%, respectivamente. Conclusão Nosso estudo mostrou que a DAPT em regime combinado de doses fixas de AAS e clopidogrel é eficaz e seguro em pacientes com síndrome coronariana aguda ou crônica adequadamente selecionados.

Background: The recent 2019 European Society of Cardiology/European Atherosclerosis Society practice guidelines introduced a new risk categorization for patients with diabetes. We aimed to compare the implications of the 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society guidelines with regard to the lipid-lowering treatment use, low-density lipoprotein cholesterol goal attainment rates, and the estimated proportion of patients who would be at goal in an ideal setting. Methods: Patients with diabetes were classified into 4 risk categories according to 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidemia guidelines from the database of EPHESUS (cross-sectional, observational, countrywide registry of cardiology outpatient clinics) study. The use of lipid-lowering treatment and low-density lipoprotein cholesterol goal attainment rates were then compared according to previous and new guidelines. Results: This analysis included a total of 873 diabetic adults. Half of the study population (53.8%) were on lipid-lowering treatment and almost one-fifth (19.1%) were on high-intensity statins. While low-density lipoprotein cholesterol goal was achieved in 19.5% and 7.5% of patients, 87.4% and 69.6% would be on target if their lipid-lowering treatment was intensified according to 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society lipid guidelines, respectively. The new target

Objectives The aim of this study was to investigate the relationship between the C-reactive protein/albumin ratio and the prognosis of hypertensive COVID-19 patients. Methods It was designed as a single center retrospective study. PCR positive COVID-19 patients who were followed up in the intensive care unit (ICU) and received antihypertensive treatment were included in the study. The patients were divided into two groups as survivor and non-survivor. C-reactive protein/albumin (CAR) ratios of the patients were compared. The cut-off value was determined as a mortality predictor. The effect of CAR on mortality was evaluated using Logistic Regression analysis. Results 281 patients were included in the study. Groups consisted of 135 (non-survivor) and 146 (survivor) patients. CAR was significantly higher in the non-survivor group (p

Objective: Despite recommendations from heart failure guidelines on the use of pharmacologic and device therapy in patients with heart failure with reduced ejection fraction (HFrEF), important inconsistencies in guideline adherence persist in practice. The aim of this study was to assess adherence to guideline-directed medical and device therapy for the treatment of patients with chronic HFrEF (left ventricular ejection fraction ≤40%). Methods: The Adherence to guideline-directed medical and device Therapy in outpAtients with HFrEF (ATA) study is a prospective, multicenter, observational study conducted in 24 centers from January 2019 to June 2019. Results: The study included 1462 outpatients (male: 70.1%, mean age: 67+-11 years, mean LVEF: 30%+-6%) with chronic HFrEF. Renin–angiotensin system (RAS) inhibitors, beta-blockers, mineralocorticoid receptor antagonists (MRAs), and ivabradin were used in 78.2%, 90.2%, 55.4%, and 12.1% of patients, respectively. The proportion of patients receiving target doses of medical treatments was 24.6% for RAS inhibitors, 9.9% for beta-blockers, and 10.5% for MRAs. Among patients who met the criteria for implantable cardioverter–defibrillator (ICD) and cardiac resynchronization therapy (CRT), only 16.9% of patients received an ICD (167 of 983) and 34% (95 of 279) of patients underwent CRT (95 of 279). Conclusion: The ATA study shows that most HFrEF outpatients receive RAS inhibitors and beta-blockers but not MRAs or ivabradin when the medical reasons for nonuse, such as drug intolerance or contraindications, are taken into account. In addition, most eligible patients with HFrEF do not receive target doses of pharmacological treatments or guideline-recommended device therapy.

Objective: Peripheral neuropathy is an important potential side effect of statin use. This study was an investigation of the incidence of peripheral neuropathy in patients taking atorvastatin or rosuvastatin for hypercholesterolemia and the relationship to the dose and duration of the treatment. Methods: In all, 50 patients using a statin treatment and 50 healthy controls matched for age and gender who had never taken a statin were included in the study. Polyneuropathy was assessed with a neurological examination and electroneuromyography (ENMG). Results: While no polyneuropathy was detected in the control group, polyneuropathy was seen in 33 (66%) of the patients in the statin group (p1 year). Electrodiagnostic changes have been detected in motor and sensory nerves in nerve conduction studies of patients on long-term statin treatment. The assessment of neurological symptoms, like tingling, numbness, pain and tremor in the hands and feet, and unsteadiness during walking associated with peripheral neuropathy may be useful in the follow-up of the patients on long-term statin treatment. Early detection of peripheral neuropathy and changing hypercholesterolemia treatment may prevent permanent nerve damage.

Objective: Few studies have directly assessed suboptimal management of dyslipidemia in Turkey. This study was conducted to assess patients' understanding and perceptions of high cholesterol as well as physicians' knowledge and awareness of lipid management strategies. Methods: This was a multicenter, observational study (ClinicalTrials.gov identifier: NCT02608645). Consecutive patients admitted to the participating cardiology clinics who were at least 18 years of age and who had been classified in a secondary prevention (SP) group or a high-risk primary prevention (PP) group were enrolled. The study population included 1868 patients from 40 sites in Turkey. Two-thirds (67.5%) of the patients in the SP group had been prescribed a statin, whereas only 30.1% of the PP group patients received statin therapy (p

Background: This study aims to investigate the effects of goaldirected fluid therapy on the development of acute kidney injury in the perioperative period in patients undergoing cardiopulmonary bypass. Methods: Between November 2019 and May 2021, a total of 60 patients (46 males, 14 females; mean age: 62.5±9.6 years; range, 44 to 76 years) who were scheduled for elective coronary artery bypass grafting or valve surgery under cardiopulmonary bypass were included in the study. The patients were divided into two groups as the study group (Group S, n=30) and control group (Group C, n=30). The patients in Group C were treated with standard therapy, while the patients in Group S were treated with goal-directed fluid therapy. The Kidney Disease: Improving Global Outcomes (KDIGO) classification and renal biomarkers were used for the evaluation of acute kidney injury. Results: Acute kidney injury rates were similar in both groups (30%). Postoperative fluid requirement, intra-, and postoperative erythrocyte suspension requirements were significantly lower in Group S than Group C (p=0.002, p=0.02, and p=0.002, respectively). Cystatin-C was lower in Group S (p<0.002). The kidney injury molecule-1, glomerular filtration rate, and creatinine levels were similar in both groups. The length of hospital stay was longer in Group C than Group S (p<0.001). Conclusion: Although goal-directed fluid therapy does not change the incidence of acute kidney injury in patients undergoing cardiac surgery, it can significantly decrease Cystatin-C levels. Goal-directed fluid therapy can also decrease fluid and erythrocyte requirements with shorter length of hospital stay., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2023, Turkish Society of Cardiovascular Surgery.)

Abstract: Broad and deep perianal wounds are challenging in both adult and pediatric ICUs. These wounds, if contaminated with gastrointestinal flora, can cause invasive sepsis and death, and recovery can be prolonged. Controlling the source of infection without diverting stool from the perianal region is complicated. The option of protective colostomy is not well-known among pediatric critical care specialists, but it can help patients survive extremely complicated critical care management. These authors present three critically ill children who required temporary protective colostomy for perianal wounds because of various clinical conditions. Two patients were treated for meningococcemia, and the other had a total artificial heart implantation for dilated cardiomyopathy. There was extensive and profound tissue loss in the perianal region in the patients with meningococcemia, and the patient with cardiomyopathy had a large pressure injury. Timely, transient, protective colostomy was beneficial in these cases and facilitated the recovery of the perianal wounds. Temporary diverting colostomy should be considered as early as possible to prevent fecal transmission and accelerate perianal wound healing in children unresponsive to local debridement and critical care., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)