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Non-steroidal anti-inflammatory drugs (NSAIDs) are often used in the treatment of chronic and acute pain and inflammation as an analgesic and anti-inflammatory agent. They inhibit the synthesis of prostaglandins which have influence on glomerular capillaries, vasa recta and tubular functions. They lead to significant complications such as hyperkalemia, hyponatremia, edema and hypertension. Usage of NSAIDs is a risk factor for acute kidney injury in some conditions such as advanced age, dehydration, vomiting, diuretics, ACE/ARB therapy, heart failure, nephrotic syndrome, cirrhosis and chronic kidney disease. Acute interstitial nephritis is not dependent on the drug dose and it is characterized by immunological inflammatory reaction and a decrease in creatinine clearance. Besides the classical findings, glomerules can be involved and minimal change disease or membranous glomerulonephritis can develop. Analgesic nephropathy is characterized by interstitial nephritis and papillary necrosis. Metabolites of NSAIDs are accumulated in renal medulla which has lowest oxygen pressure in kidney and they disrupt the renal parencymal perfusion by vasoconstriction. Respectively, papillar necrosis, glomerular sclerosis, interstitial fibrosis and cortical atrophy can develop insidiously. [ABSTRACT FROM AUTHOR]

Purpose: Nosocomial infections develop after 48-72 hours of hospitalization. Gram negative bacilli are generally the causative agent. 25% of all nosocomial infections develop in the intensive care units. Therefore, patients in the intensive care units are at high risk. This study aimed to determine the prevalence of nosocomial infections and causative gram negative bacilli in the Intensive Care Unit (ICU). Materials and Methods: 269 patients who were hospitalized in internal medicine intensive care unit (IMICU) of Dicle University Faculty of Medicine between june 2010- December 2010 were included in this study. Culture samples were taken from all of the patients who develops fever ( ≥38.5 C) after the hospitalization to the IMICU. Culture of blood, urine, sputum, central venous catheters, open wounds and deep tracheal aspirate were taken. Source and the prevalence of infection and distribution of the isolated causative pathogens were determined in the patients with gram negative bacilli reproduction. Results: 158 of the patients were male ( 58.7%) and 111 of the patients were female ( 41.3%). The mean ages of men and female were 58.81±16.91 and 56.44±19.16 years, respectively (p= 0.286). culture samples were taken from blood (16%), urine ( 8.6%), central venous catheter tips ( 6.3%), deep tracheal aspirates (10%), sputum (2.2%) and wound stabs (2.2%). Nosocomial infections were detected in 109 patients ( 40.5%). Pneumonia, urinary tract infections and gastrointestinal system infections were the most frequent infections respectively. Microorganisms were isolated from one sample in 97 patients, while 12 patients had more than focus. The most commonly isolated organisms were E.Coli (13.8%) and Pseudomonas Aeruginosa (7.4%), followed by Acinetobacter Baumannii (6.3%) and Stenotrophomonas Maltophilia (3.3%). Conclusion: Nosocomial infections in intensive care units have proved to be a serious problem. Surveillance studies should be performed for the isolated causative pathogens and measures should be taken to prevent the development of the ICU infections. [ABSTRACT FROM AUTHOR]