Search

Background: The progression of COVID-19 has different clinical presentations, which raises a number of immunological questions. Objectives: This study aimed to investigate MMP-9 and TIMP-1 levels in patients diagnosed with COVID-19 and whether the MMP-9/TIMP-1 ratio is associated with lung involvement in COVID-19. Methods: This study was conducted with 192 patients and 45 healthy controls. ELISA was used to measure the MMP-9 and TIMP-1. Results: The MMP-9 and TIMP-1 levels of the patients were found to be higher than those of the controls. MMP-9 and TIMP- 1 were detected more in patients with lung involvement on chest CT scans than in those with no lung involvement on chest CT scans. A comparison of lung involvement levels revealed no difference was found between the groups. The MMP-9/TIMP-1 ratio was 5.8 in the group with lung involvement on chest CT scans and 6.1 in the group without lung involvement on chest CT scans. No difference was found between the two groups. A comparison with respect to lung involvement levels showed that theMMP-9/TIMP-1 ratio difference was found between the groups. Conclusion: Diagnostic and treatment methods targeting MMP-9 activity or neutrophil activation may be important in predictinglung involvement in COVID-19 and directing clinical outcomes. Keywords: COVID-19; MMP-9; TIMP-1.

Giriş: Mantar protez eklem enfeksiyonları, tüm protez enfeksiyonu vakalarının az bir kısmını oluşturur ve candida türleri de bu vakaların çoğunluğunda etkendir. Mantar protez eklem enfeksiyonlarının çoğu revizyon artroplastisinden sonra ortaya çıkar. Olgu: Yetmiş iki yaşında erkek hasta, gonartroz nedeniyle sağ dizine yönelik total diz protez operasyonu uygulanmış. Yaklaşık 5 ay sonra bakteriyel protez enfeksiyonu nedeni ile yatırılarak tedavi edildi. Taburculuktan 8 gün sonra sağ dizde şişlik, ağrı, ısı artışı ve kızarıklık şikayetleri ile tekrar başvurdu. Protez enfeksiyonu nedeni ile tekrar yatırıldı. Hastanın diz ekleminde Candida albicans üremesi olması nedeni ile hastaya antifungal tedavi başlandı. Toplamda 2.5 ay antifungal tedavi verildi. Sorunsuz şekilde iyileşen hasta poliklinik takiplerine devam etmektedir. Tartışma: Biz bu olgu sunumunda protez enfeksiyonunda risk faktörleri varlığında etkenin mantar da olabileceğini unutmamamız gerektiğini, operasyon esnasında mutlaka kültür alınması gerektiğini ve sonuçta mantar ilişkili protez enfeksiyonlarında etkili ve uzun bir süre antifungal tedavi verilmesi gerektiğini vurgulamak istedik.

Coronavirus disease 2019 (COVID-19) has a wide clinical spectrum from asymptomatic to mild, moderate, and severe cases. There are still many unknowns about the role of immunoregulatory mechanisms in COVID-19. We aimed to study regulatory T cells (Tregs) and B cell subsets and evaluate their correlations with severity of COVID-19.In total, 50 patients with COVID-19 confirmed by PCR (mean age = 49.9 ± 12.8 years) and 40 healthy control (mean age = 47.9 ± 14.7 years) were included in this study. The patients were classified as 14 mild (median age = 35.5 [24-73] years), 22 moderate (median age = 51.5 [28-67] years) and 14 severe (median age = 55.5 [42-67] years). Within 24 h of admission, flow cytometry was used to assess the lymphocyte subsets, Tregs and Bregs without receiving any relevant medication.In all patients with COVID-19, the proportion of CD3+CD8+ T cells was reduced (p = 0.004) and the CD8+ Tregs were increased compared with control (p = 0.001). While the levels of regulatory B cells, plasmablasts, and mature naive B cells were found to be significantly high, primarily memory B-cell levels were low in all patients compared with controls (p0.05). Total CD3+ T cells were negatively correlated with the length of stay in the hospital (r = -0.286, p = 0.044).The changes in T and B cell subsets may show the dysregulation in the immunity of patients with COVID-19. In this context, the association between CD8+ Tregs and COVID-19 severity may help clinicians to predict severe and fatal COVID-19 in hospitalized patients.

Background: The aim of this national, multicenter, cross-sectional, retrospective chart review study was to determine the rate of patients in Turkey who received hepatitis C virus (HCV) treatment after receiving positive anti-HCV results during HCV screening. Methods: Data related to patients’ demographics, laboratory results, the time interval from obtaining a positive anti-HCV result to treatment initiation, the specialty of the physician requesting anti-HCV screening, and type of hospital were collected and analyzed. Results: Among 1000 patients who received a positive anti-HCV result, 50.3% were male and 78.5% were screened for HCV-RNA. Among HCV-RNA screened patients, 54.8% (n = 430) had a positive result. Among patients testing positive for HCV-RNA, 72.8% received HCV treatment in line with their positive anti-HCV results. The median time from obtaining a positive anti-HCV result to initiation of HCV treatment was 91.0 days (interquartile range 42.0 to 178.5). Non-surgical branches requested HCV-RNA testing more frequently than surgical branches (p < 0.001). The rate of access to HCV treatment was higher in patients screened in university hospitals than in patients screened in training and research hospitals (p < 0.001). Conclusions: Our results indicate a higher rate of treatment initiation in patients with HCV infection than is described in the published literature. Furthermore, the time from screening to treatment initiation was considerably shorter compared with other international studies. However, because HCV-RNA testing was not requested in a significant portion of patients with a positive test result for anti-HCV, there might be a large patient population with HCV who do not receive treatment.

Background: Respiratory viruses such as SARS-CoV-2 spread via different transmission routes. While the droplet path plays the most important role in transmisson, contamination of the mucous membranes with contaminated hands also plays an important role in the spread. Thus, the aim of the present study was to assess the face-touching behaviors of HCWs and intern doctors during the COVID-19 pandemic. Methods: This study was conducted in July 2020 and in the Selcuk University Faculty of Medicine in Konya, Turkey. While 1-hour COVID-19 training was given to healthcare personnel and interns, participants face-touching behavior was monitored through video recording and was tallied with a scoring sheet. Results: A total of 141 intern doctors, 46 assistant doctors, 14 nurses, 10 associate doctors, and eight staff members participated in the study. On average, each of the participants touched their face a mean of 17.2 times (median: 16; range: 0–45) per hour. Of all the face touches, 85.2% (3,228/3,787) involved contact with a face mask, whereas 14.7 % (559/3787) involved contact with the eye mucosa. Intern doctors touched their faces significantly less often with a mean of 13.7 times per hour (P < 0.001), while nurses touched their faces more often with a mean of 28 times per hour (P < 0.001). Although nurses touched their eye mucosa more often than interns and assistant doctors (P < 0,001), their contact with the face mask was significantly less frequent than that of the other participants (P < 0.001). Conclusions: To date, there are no effective vaccines or antiviral drugs for SARS-CoV-2. For the time being, isolation, social distancing measures, and individuals’ protective behaviors are essential for preventing infection. HCWs, medical students, and the broader community should be informed about self-inoculation, which can result from touching one’s mucosa or mask with contaminated hands.

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis that can affect all organs and tissues. The clinical forms of primary cutaneous tuberculosis are tuberculosis primary complex (tuberculosis chancre) and tuberculosis cutis miliaris (miliary cutaneous tuberculosis). Secondary cutaneous tuberculosis includes lupus vulgaris, tuberculosis cutis verrucosa, scrofuloderma, tuberculosis cutis officials, and metastatic tubercular abscesses. The most common form is lupus vulgaris. Cutaneous tuberculosis is a rare form of tuberculosis presenting with nonspecific lesions. It is difficult to diagnose due to its non-specific clinical characteristics thus it can be confused with many other diseases. In this paper, we reviewed five patients with cutaneous tuberculosis who presented to our clinic within the past one year and we aimed to emphasize that cutaneous tuberculosis can manifest in different clinical forms.

Introduction: The COVID-19 pandemic continues to affect the world with serious number of cases and deaths. For this reason, knowing the clinical findings and course of the disease is important for early diagnosis and treatment. In this article, COVID-19 cases followed up after quarantine were discussed. Materials and Methods: In this study, the data of 99 patients who were followed up during travel and post-Umrah quarantine between 31 March and 15 April 2020 were retrospectively reviewed. Results: Of the 99 patients included in the study, 66 (66.7%) were females, 33 (33.3%) were males, and mean age was 59.8 ± 11.4 years. SARS-CoV-2 RT-PCR test was positive at the time of admission in 97 (98.0%) of the 99 patients. Thirty-nine (39.4%) of the patients were symptomatic and 25.3% of the patients had cough, 8.1% had fever, and 7.1% had shortness of breath. While SARSCoV-2 RT-PCR test was negative in 2 (3.3%) of the 60 patients without complaints, 58 (96.7%) of them were positive for SARS-CoV-2 RT-PCR test. Leukopenia was detected as 3%, lymphopenia 66.7%, D-dimer height 47.5%, LDH elevation 38.4%, CRP elevation 45.5%. Ground glass opacities were present in 81 (81.8%) of the patients with lung involvement, and consolidation areas were present in 40 patients (40.4%). Underlying disease was present in 38 (38.4%) of the patients. Hypertension and diabetes mellitus were the most common underlying diseases. It was observed that 89 (89.4%) of our cases had negative SARS-CoV-2 RT-PCR test on the 5th day. Conclusion: COVID-19 infection is an infectious disease that can present with many different clinics. In asymptomatic COVID-19 cases, lung involvement findings and disorders in laboratory parameters may be observed. It should be kept in mind that asymptomatic cases pose a risk in terms of transmission.

Objective We aimed to evaluate the relationship between perceived social support, coping strategies, anxiety, and depression symptoms among hospitalized COVID-19 patients by comparing them with a matched control group in terms of age, gender, and education level. Method The patient group (n = 84) and the healthy controls (HCs, n = 92) filled in the questionnaire including the socio-demographic form, Hospital Anxiety Depression Scale, Multidimensional Perceived Social Support Scale, and Brief Coping Orientation to Problems Experienced through the online survey link. Results The COVID-19 patients had higher perceived social support and coping strategies scores than the HCs. However, anxiety and depression scores did not differ significantly between the two groups. In logistic regression analysis performed in COVID-19 patients, the presence of chest CT finding (OR = 4.31; 95% CI = 1.04–17.95) was a risk factor for anxiety and the use of adaptive coping strategies (OR = 0.86; 95% CI = 0.73–0.99) had a negative association with anxiety. In addition, the use of adaptive coping strategies (OR = 0.89; 95% CI = 0.79–0.98) and high perceived social support (OR = 0.97; 95% CI = 0.93– 0,99) had a negative association with depression symptoms. Conclusions Longitudinal studies involving the return to normality phase of the COVID-19 pandemic are needed to investigate the effects of factors such as coping strategies and perceived social support that could increase the psychological adjustment and resilience of individuals on anxiety and depression.

Introduction: The COVID-19 pandemic continues to affect the world with serious number of cases and deaths. For this reason, knowing the clinical findings and course of the disease is important for early diagnosis and treatment. In this article, COVID-19 cases followed up after quarantine were discussed. Materials and Methods: In this study, the data of 99 patients who were followed up during travel and post-Umrah quarantine between 31 March and 15 April 2020 were retrospectively reviewed. Results: Of the 99 patients included in the study, 66 (66.7%) were females, 33 (33.3%) were males, and mean age was 59.8 ± 11.4 years. SARS-CoV-2 RT-PCR test was positive at the time of admission in 97 (98.0%) of the 99 patients. Thirty-nine (39.4%) of the patients were symptomatic and 25.3% of the patients had cough, 8.1% had fever, and 7.1% had shortness of breath. While SARSCoV-2 RT-PCR test was negative in 2 (3.3%) of the 60 patients without complaints, 58 (96.7%) of them were positive for SARS-CoV-2 RT-PCR test. Leukopenia was detected as 3%, lymphopenia 66.7%, D-dimer height 47.5%, LDH elevation 38.4%, CRP elevation 45.5%. Ground glass opacities were present in 81 (81.8%) of the patients with lung involvement, and consolidation areas were present in 40 patients (40.4%). Underlying disease was present in 38 (38.4%) of the patients. Hypertension and diabetes mellitus were the most common underlying diseases. It was observed that 89 (89.4%) of our cases had negative SARS-CoV-2 RT-PCR test on the 5th day. Conclusion: COVID-19 infection is an infectious disease that can present with many different clinics. In asymptomatic COVID-19 cases, lung involvement findings and disorders in laboratory parameters may be observed. It should be kept in mind that asymptomatic cases pose a risk in terms of transmission.

Objective: Understanding the natural course of COVID-19 and determining its clinical findings are essential for early diagnosis and treatment In this study, we aimed to investigate clinical and laboratory characteristics of cases followed with a diagnosis of COVID-19 in Selcuk University Faculty of Medicine Department of Infectious Diseases and Clinical Microbiology Methods: Among patients followed with a diagnosis of pos-sible/definitive COVID-19, those with a positive SARS-CoV-2 RT-PCR test were evaluated retrospectively in terms of their clin-ical, laboratory and thorax computed tomography (CT) data Results: Among 407 patients followed with a diagnosis of pos-sible/definitive COVID-19, 149 (36 6%) were SARS-CoV-2 RT-PCR test-positive 82 (55%) of the patients were female and 67 (45%) were male Mean age was 49 3±7 6 years 11 (7 4%) were health care workers While the most common symptom was cough with 46 3%, fever was observed in 29 5%, sore throat in 27 5% and malaise in 26 8% of the patients 94 (63 1%) of the patients had underlying diseases Hypertension and diabetes mellitus were the most common underlying disease Laboratory findings were leukopenia in 12 (8 1%), lymphopenia in 34 (22 8%), throm-bocytopenia in 24 (16 1%), elevated D-dimer levels in 43 (28 9%), elevated lactate dehydrogenase levels in 73 (49%), and elevated C-reactive protein (CRP) levels in 45 (30 2%) patients While 71 (47 6%) of the patients had normal thorax CT, 43 (28 9%) had mild pneumonia, and 35 (23 5%) moderate pneumonia D-dimer and CRP levels were higher in those with pneumonia than those without pneumonia (p=0 001 and p=0 001, respectively) As the pneumonia level increased, the increase of D-dimer and CRP levels became evident (p=0 003 and p=0 001, respectively) Conclusions: The clinical course of COVID-19 patients varies It is noteworthy that there is a positive correlation between the severity of pneumonia and the increase in D-dimer and CRP levels in COVID-19 Klimik Dergisi 2020;33(2): 122-7

Tuberculosis is an important public health problem in the world. Peritoneal tuberculosis occurs in about 1% of all cases of tuberculosis. Delay in treatment is the reason for the increase in morbidity and mortality. Since its symptoms mimic the symptoms of ovarian cancer and cirrhosis, it can be misdiagnosed and cause problems. In both peritoneal carcinomatosis and intraabdominal tuberculosis, abdominal pain, thickening of the acid, peritoneum and omentum and the presence of lymphadenopathies can be seen. Therefore, differential diagnosis should be made. Caseification necrosis is the main pathological finding of tuberculosis. Some cases, however, may progress with non-caseified granulomas. Successful results are obtained with standard antituberculosis drugs in the treatment of tuberculosis peritonitis. In this article, three cases of intraabdominal tuberculosis are presented.

Aims: Laboratory findings in COVID-19 patients vary according to the severity of the disease. This study aimed at defining a system of formulas that may predict the presence of thoracic CT involvement, the extent of such involvement and the need for intensive care stay on the basis of patient laboratory data using the Waikato Environment for Knowledge Analysis (WEKA) software. Methods: This study was conducted with 508 patients whose SARS-CoV-2 RT-PCR test was positive. These patients were divided into 2 groups, with and without thoracic CT involvement typical for COVID-19. Then, those patients who had signs of typical involvement for COVID-19 in their thoracic CT were divided into 3 groups depending on the extent of their lesions. J48 Decision Tree classification and Linear Regression methods were used on the WEKA software. The codes implemented in the Python programming language were used at the estimation, classification and testing stages. Results: Thoracic CT scans showed that lung involvement was absent in 93 of the patients, mild in 114, moderate in 115, and severe in 159. The success rates of WEKA Linear Regression Formulas calculated using laboratory values and demographic data, respectively 78.92%, 71.69% and 91%. The success rate of the J48 Decision Tree formula used to predict the presence of involvement in thoracic CT was found to be 95.95%. The success rate of the J48 Decision Tree, which was used to predict the degree of involvement in thoracic CT, was 84.39%. The success rate of the J48 Decision Tree used to predict the need for intensive care was found to be 93.06%. Conclusion: The results of this study will facilitate revealing the presence of lung involvement and identification of critical patients in the COVID-19 pandemic and particularly under circumstances and can be used effectively to ensure triage.

WOS: 000511173500021, Syphilis is a multisystemic chronic infection caused by Treponema pallidum. As with other sexually transmitted infections, syphilis's tendency to spread in the community is considered to be an indicator of the spread tendency of human immunodeficiency virus (HIV) infection. With the increase in the prevalence of HIV infection, there is a significant increase in syphilis cases. Neurosyphilis is a clinical form of the disease that can be observed at any stage leading to central nervous system involvement. Eye involvement in neurosyphilis often appears in the tertiary period and it might be the first and only finding of neurosyphilis. The most common ocular presentation is uveitis, and it may mimic many ocular pathologies. In this report, a case diagnosed with neurosyphilis while investigating the etiology of uveitis is presented.

Fever is a common finding in many diseases. Seen mostly in infections, it can also occur in noninfectious pathologies. Thyroiditis is one of its rare causes found when exploring the etiology of fever with unknown origin. It can be diagnosed easily if it is considered when making a differential diagnosis. In this paper, we described three thyroiditis cases that were encountered when exploring the etiology of fever with unknown origin in our clinic. Their common complaints were fever, sore throat and weight loss. The thyroid glands were found sensitive in all cases during physical examinations. High erythrocyte sedimentation rate, leukocytosis, and thyroid stimulating hormone inhibition were found in their laboratory tests.

Septic arthritis is the inflammation of synovial membrane and synovial fluid in joints, which is caused by bacterial, viral or fungal agents. Staphylococcus aureus is the most common cause in all age and risk groups. In the presence of chronic septic arthritis, Mycobacterium species may be the causative agent. Osteoarticular tuberculosis may mimic many bone joint pathologies. Rapid diagnosis and treatment are important because they can cause destructive osteoarthritic outcomes in untreated cases. In this article, we report a case of recurrent septic arthritis with tuberculous arthritis.

WOS:000648816400007 PMID: 33960939 Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. Methods: Data from patients with chronic hepatitis C treated with SOF/LDV +/- RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 +/- 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV +/- RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV +/- RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.

Background: Respiratory viruses such as SARS-CoV-2 spread via different transmission routes. While the droplet path plays the most important role in transmisson, contamination of the mucous membranes with contaminated hands also plays an important role in the spread. Thus, the aim of the present study was to assess the face-touching behaviors of HCWs and intern doctors during the COVID-19 pandemic.Methods: This study was conducted in July 2020 and in the Selcuk University Faculty of Medicine in Konya, Turkey. While 1-hour COVID-19 training was given to healthcare personnel and interns, participants face-touching behavior was monitored through video recording and was tallied with a scoring sheet.Results: A total of 141 intern doctors, 46 assistant doctors, 14 nurses, 10 associate doctors, and eight staff members participated in the study. On average, each of the participants touched their face a mean of 17.2 times (median: 16; range: 0–45) per hour. Of all the face touches, 85.2% (3,228/3,787) involved contact with a face mask, whereas 14.7 % (559/3787) involved contact with the eye mucosa. Intern doctors touched their faces significantly less often with a mean of 13.7 times per hour (P < 0.001), while nurses touched their faces more often with a mean of 28 times per hour (P < 0.001). Although nurses touched their eye mucosa more often than interns and assistant doctors (P < 0,001), their contact with the face mask was significantly less frequent than that of the other participants (P < 0.001).Conclusions: To date, there are no effective vaccines or antiviral drugs for SARS-CoV-2. For the time being, isolation, social distancing measures, and individuals’ protective behaviors are essential for preventing infection. HCWs, medical students, and the broader community should be informed about self-inoculation, which can result from touching one’s mucosa or mask with contaminated hands.

Aim To investigate the frequency of fatigue and musculoskeletal symptoms and their correlation with laboratory data in patients with COVID‐19. Methods This study included 80 patients hospitalised and treated for COVID‐19 in the infectious diseases clinic between March 2020 and May 2020. Data analysis was performed retrospectively from the hospital medical charts. Demographic data, clinical symptoms, and laboratory findings were noted. Clinical symptoms and correlations with laboratory results were assessed. Besides, an analysis of patients with and without chronic disease was performed for clinical symptoms and laboratory findings. Results The frequencies of myalgia and fatigue were 46.1% and 50%, respectively. In the laboratory data, there was a significant increase in creatinine kinase (CK) level and lymphocyte count in the patients with myalgia symptoms (P

Toka, Onur/0000-0002-4025-4537; Yoruk, Gulsen/0000-0002-0357-5884; Cinar, Gule/0000-0002-7635-8848; Hakyemez, Ismail Necati/0000-0001-6133-9604; Tulek, Necla/0000-0002-3952-4982 WOS:000511173500009 Objective: Both chronic hepatitis B (CHB) and hepatosteatosis may lead to necroinflammation in liver. Therefore, the presence of hepatosteatosis might negatively affect the efficacy of antiviral therapy. We aimed to determine the effect of hepatosteatosis on virological response in patients with CHB receiving entecavir (ETV) and tenofovir (TDF) treatment. Methods: The study was designed retrospectively. All patients receiving antiviral therapy due to CHB in the departments of Infectious Diseases and Clinical Microbiology of 29 different hospitals between January 2012 and June 2017 were searched by examining medical records. Results: A total of 1069 patients were included. Six hundred and fifty of the patients had been receiving TDF and 419 of them had been receiving ETV. The rate of virological response obtained at the 48'h week of TDF was higher in patients with steatosis (p=0.029). Virological response at the 24th week and 48th week of ETV were higher in the patients without steatosis (p=0.001). TDF and ETV therapies were compared in the patients with hepatosteatosis and it was found that the virological response at 48th week was higher in the TDF group. Conclusion: Although steatosis has an effect on virological response in the short-term results of nucleos(t)ide therapy, it does not have any effect on virological response in the long-term results.

Objective: this study aimed to evaluate the awareness and knowledge levels of all physicians administering immunosuppressive treatment concerning hepatitis B virus (HBV) reactivation, and draw attention to the importance of the subject through evaluation. Methods: the study was carried out by infectious diseases and clinical microbiology specialists in 37 health centers, and it was performed in Turkey between January and March 2017. All specialists providing a written consent and working in the departments of Medical Oncology, Hematology, Dermatology and Venereology, Physical Medicine and Rehabilitation, and Rheumatology of each study center were included in the study. Results: a total of 430 physicians participated in the study. Their mean age was 39.87 +/- 7.42 years, and 47.9% of them were males. During their career, 39.3% of these physicians had encountered patients developing HBV reactivation while receiving immunosuppressive treatment. The rate of encountering patients who died due to HBV reactivation was 6.5%. 97% of physicians who participated, considered the risk of HBV reactivation to be important. 70.2% of physicians stated that guidelines related to HBV reactivation and antiviral treatment for these patients were discussed in the congresses they participated, regarding their specialties. The rate of performing hepatitis screening among physicians whose patients developed HBV reactivation was statistically significantly higher than those physicians who had no patients with HBV reactivation (p, NA

Pulmoner enfeksiyonlar, tuberkuloz disi mikobakterilerin neden oldugu enfeksiyonlarin en sik gorulen formlaridir. Oksuruk, kanli balgam, halsizlik ve kilo kaybi sikayetleri olan ve amamnezinde tedavi edilmis pulmoner tuberkuloz hikayesi bulunan 54 yasinda erkek hasta vakasini bildiriyoruz. Radyolojik bulgular ve sabah alinan aclik mide suyunun mikobakteriyolojik kulturu, M.szulgai’nin neden oldugu fibrokaviter akciger enfeksiyonuna isaret etmistir. Hasta, 12 ay boyunca her 2 ayda bir yeniden degerlendirilmek uzere standart 6 aylik antituberkuloz tedavi rejimi ile basariyla tedavi edilmistir. Klinisyenler, ozellikle risk faktorlerini tasiyan bireylerde, klinik uyumlulugun olmasi ve mikrobiyolojik bulgularin da desteklemesi durumunda, tuberkuloz disi mikobakterilerin neden oldugu enfeksiyonlari dusunmelidirler. M.szulgai, izole edildigi zaman, enfeksiyon etkeni patojen olarak degerlendirilmelidir.

WOS: 000388326300001, PubMed: 27401586, Background: Drug resistance development is an expected problem during treatment with protease inhibitors (PIs), this is largely due to the fact that Pls are low-genetic barrier drugs. Resistance-associated variants (RAVs) however may also occur naturally, and prior to treatment with Pls, the clinical impact of this basal resistance remains unknown. In Turkey, there is yet to be an investigation into the hepatitis C (HCV) drug associated resistance to oral antivirals. Materials and methods: 178 antiviral-naive patients infected with HCV genotype 1 were selected from 27 clinical centers of various geographical regions in Turkey and included in the current study. The basal NS3 Pls resistance mutations of these patients were analyzed. Results: In 33 (18.5%) of the patients included in the study, at least one mutation pattern that can cause drug resistance was identified. The most frequently detected mutation pattern was T54S while R109K was the second most frequently detected. Following a more general examination of the patients studied, telaprevir (TVR) resistance in 27 patients (15.2%), boceprevir (BOC) resistance in 26 (14.6%) patients, simeprevir (SMV) resistance in 11 (6.2%) patients and faldaprevir resistance in 13 (7.3%) patients were detected. Our investigation also revealed that rebound developed in the presence of a Q80K mutation and amongst two V55A mutations following treatment with TVR, while no response to treatment was detected in a patient with a R55K mutation. Conclusion: We are of the opinion that drug resistance analyses can be beneficial and necessary in revealing which variants are responsible for pre-treatment natural resistance and which mutations are responsible for the viral breakthrough that may develop during the treatment. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases., Department of Scientific Research Project of Kocaeli University; Turkish Society of Clinic Microbiology and Infectious Diseases, This study was funded by Department of Scientific Research Project of Kocaeli University and Turkish Society of Clinic Microbiology and Infectious Diseases.

Malaria is an infectious disease caused by an intracellular parasite, Plasmodium, which is transmitted to humans after the bite of an Anopheles mosquito. This disease has been prevalent for decades. It has caused great epidemics in history and has also delayed social and economic development. It is endemic in the Eastern Mediterranean and Southeastern Anatolia regions of our country. The most common plasmodium in our country is P. vivax. In P. vivax infections, patients should be treated with primaquine to eradicate hypnozoites. Here, we present a case of relapse with P. vivax, and we emphasize the importance of primaquine in the treatment.

WOS: 000429311800001, Background: Hepatitis B virus (HBV) has a high mutation rate due to its unusual replication strategy leading to the production of a large number of virions with single and double mutations. The mutations, in turn, are associated with the development of drug resistance to nucleos(t)ide analogs (NUCs) in patients before and during NUCs therapy. Objectives: The current study aimed at investigating the molecular characterization of HBV in Turkish patients with chronic hepatitis B (CHB) infection. Methods: Polymerase chain reaction (PCR) amplification and direct sequencing procedures were used to analyze mutations. The detected drug resistance mutations were divided into the nucleos(t) ide analogs primary, partial, and compensatory resistance groups. The amino acid substitutions of hepatitis B surface antigen (HBsAg) were categorized into antiviral drug - associated potential vaccine-escape mutations (ADAPVEMs) and typical HBsAg amino acid substitutions, which included hepatitis B hyperimmunoglobulin (HBIg) - selected escape mutation, vaccine escape mutation, hepatitis B misdiagnosis, and immune - selected amino acid substitutions. Results: The number of patients included in the study was 528 out of which 271 (51.3%) were treatment - naive and 351 (66.3%) were hepatitis B e antigen (HBeAg) - negative. Moreover, 325 (61.6%) were males with a mean age of 38 years (range: 18 - 69). Primary, partial, and compensatory resistance to NUCs was reported in 174 (32.9%) patients. Six different ADAPVEM motifs were determined in both treatment - naive and treatment - experienced patients, namely, sF161L/rtI169X, sE164D/rtV173L, sL172L/rtA181T, sL173F/rtA181V, sS195M/rtM204V, and sS196L/rtM204I. The prevalence of ADAPVEMs and typical HBsAg escape mutations was 5.3% (n = 28) and 34.8% (n = 184), respectively. Conclusions: The analysis of drug resistance should constitute a fundamental part of the follow - up period of patients with CHB undergone treatment with NUCs. The surveillance of development of drug resistance mutations, while receiving treatment for hepatitis B is of paramount importance to monitor and control the emerging resistance.

WOS: 000357330600005, PubMed: 26185714, Background: The use of pegylated interferon alpha and ribavirin (PegIFN/RBV) for the retreatment of chronic hepatitis C virus (HCV) infection without a sustained virological response (SVR) prior to PegIFN/RBV treatment has resulted in low success rates. Aims: To investigate the efficacy and safety of telaprevir (TVR) in combination with PegIFN/RBV in patients infected with HCV genotypes 1 and 4 who were previously treated with PegIFN/RBV and failed to achieve SVR. Study Design: Multi-center, retrospective, cross-sectional study. Methods: The study included 111 patients: 80 prior relapsers, 25 prior null responders, and six prior partial responders to PegIFN/RBV treatment. The patients were given TVR/PegIFN/RBV for 12 weeks, followed by a 12-week PegIFN/RBV treatment; virological response results were assessed at weeks 4, 12, and 24. Treatment was discontinued in patients with HCV RNA >1000 IU/mL at week 4 or with negative RNA results at week 4 but >1000 IU/mL at week 12. Rapid virological response (RVR), early virological response (EVR), extended rapid virological response (eRVR), and virological response at 24th week of treatment were evaluated. The side effects of combination therapy and the rates of treatment discontinuation were investigated. Results: The mean age of the patients was 56.02 +/- 9.96 years and 45.9% were male. Ninety-one percent of the patients were infected with viral genotype 1, 69.6% with the interleukin (IL) 28B genotype CT and 20.2% were cirrhotic. The RVR rate was 86.3% in prior relapsers, 56% in prior null responders, and 50% in prior partial responders (p=0.002). EVR rates in those groups were 91.3%, 56%, and 83.3%, respectively (p

Aims: Toll - like receptors ( TLR s) play a central role in initiating innate response by mediating inflammatory reactions against a wide range of pathogens. We aimed to determine if TLR2 Arg753Gln, TLR4 Asp299Gly and Thr399Ile polymorphisms are associated with chronic hepatitis B (HBV) infection. Study Design: A case - control study . Methodology: Genomic DNA was obtained from peripheral blood of 100 patients with chronic HBV infection and 108 healthy volunteer controls. The TLR2 and TLR4 polymorphisms were Original Research Article

Amaç: Bu çalışmada kronik hepatit B (KHB)'de karaciğer biyopsisinde saptanan fibrozis ve inflamasyon derecesi referans alınarak fibrotestin (FT) fibrozisi ve actitestin (AT) nekroinflamatuar aktiviteyi belirlemedeki duyarlılığının araştırılması amaçlandı. Gereç ve Yöntem: Bu prospektif çalışmaya 2013 yılı içerisinde takip edilen 53 KHB hastası dahil edildi. Biyopsiler modifiye Knodell skorlama sistemine gore değerlendirildi. Karaciğer biyopsisi yapıldığı gün hastalardan FT ve AT için kan örneği alındı. Bulgular: Çalışmaya alınan hastaların 22'si kadın, 31'i erkekti. KHB hastalarında karaciğer biyopsisi ve FT karşılaştırılmasında ciddi fibrozisi tespit etmek için FT'nin duyarlılığı %93.5, seçiciliği ise %54.5 olarak tespit edildi. FT'nin pozitif prediktif değeri (PPD) %74.3, negatif prediktif değeri (NPD) ise %85.7 olarak hesaplandı. FT için ROC analizi sonucu eğri altında kalan alan %75.1'ti (p0.003). KHB hastalarında karaciğer biyopsisi ve AT karşılaştırılmasında ise ciddi nekroinflamasyonun tespiti için AT'nin duyarlılığı %89.2, seçiciliği %64'tü. PPD %73.5 ve NPD ise %84.2 olarak hesaplandı. AT için ROC analizi sonucu eğri altında kalan alan % 65'ti (p0.001). Sonuç: KHB'de FT ve AT'nin ciddi fibrozis ve nekroinflamasyonu göstermedeki duyarlılıkları yüksekti. Bununla birlikte FT ve AT biyopsi yapılmaksızın tek başına kullanılabilecek bir belirteç olarak görülmemektedir., Objectives: In this study, we aimed at investigating the accuracy of fibrotest (FT) in measuring fibrosis and actitest (AT) in measuring necroinflammatory activity by taking the fibrosis and inflammation level found in liver biopsy as reference in chronic hepatitis B (CHB). Material and Methods: This prospective study included 53 CHB patients who were being monitored in 2013. The biopsies were assessed in line with the modified Knodell scoring system Blood samples were drawn from the patients for FT and AT on the day when their liver biopsies were performed. Results: Twenty two of the patients included in the study were female and 31 male. FT sensitivity of 93.5% and selectivity of 54.5% was detected to identify severe fibrosis in CHB patients as a result of comparison of liver biopsy with FT. Positive predictive value (PPV) of FT was calculated as 74.3% and negative predictive value (NPV) as 85.7%. ROC curves analysis showed an AUC value of 75.1% for FT (p0.003). In comparison of the liver biopsy with AT, on the other hand, an AT sensitivity of 89.2% and selectivity of 64% was detected to identify severe necroinflammation in CHB patients. PPV was calculated as 73.5% and NPV as 84.2%. ROC curves analysis showed an AUC value of 65% for AT (p0.001). Conclusion: The accuracy of FT and AT in showing fibrosis and necroinflammation in CHB was quite high. However FT and AT does not seem to be a marker to be used alone without performing a liver biopsy.

WOS: 000419248500008, Objective: Nosocomial infections (NI) are serious threats for patients, especially those treated in intensive care units (ICU), which have high risk. Therefore, determining the infectious agents in this area and treating the infections are crucial for both the prognosis of primary disease and the time of stay in hospital. In this study, we aimed to perform an active infection surveillance in the neurological ICU (NICU). Materials and Methods: Two hundred ninety-one patients who stayed in NICU over a twelve-month period were included in the study. Data obtained by infection control committee of our faculty according to "Centres for Disease Control and Prevention" diagnostic criteria were used for the diagnosis of NI. Isolated microorganisms and their systemic involvement were examined. Results: The infections in NICU constituted 6.39% of all NI in the hospital. These were skin and soft tissue infections (3.13%), bloodstream infections (9.38%), pneumonia not associated with mechanical ventilator (9.38%), pneumonia associated with mechanical ventilator (6.25%), and urinary tract infections (UTI) (71.88%). Fourteen different microorganisms were determined in the unit over the twelve months. Conclusion: Caution is advised regarding urinary catheter insertion and care because catheters are the most common cause of infection, UTI, in the ICU. Also, diagnosis of NI and determining the antibiotic sensitivity of the causal microorganisms are very important for the determination of empiric treatment and reducing mortality and morbidity.

WOS: 000419259100008, Objective: The objective of this study was to compare the anxiety, depression and quality of life scores of chronic hepatitis B (CHB) patients and inactive hepatitis B virus (HBV) carriers with healthy control subjects and to demonstrate the need for a multidisciplinary approach in the follow-up and treatment of patients with HBV infection. Methods: The study was carried out by comparing 200 subjects including 100 CHB patients and 100 inactive HBV carriers, who were admitted to the Outpatient Clinic of Infectious Diseases and Clinical Microbiology Department, Faculty of Medicine, Selcuk University between August 2013 and August 2014 with 100 healthy control subjects. All subjects were given Hospital Anxiety and Depression (HAD) Scale and Short Form-36 (SF-36) to assess their quality of life. Results: Based on the HAD Scale, anxiety risk among the carriers was higher than the control group (p=0.031). Depression risk in the patient (p=0.031) and carrier groups (p=0.046) were higher than the control group. There was no significant difference between the patient and carrier groups with regard to anxiety risk or depression risk (p>0.05). Females had higher anxiety risk in the patient (p=0.015), carrier (p=0.035) and control (p=0.001) groups. Depression risk was also higher in females in the patient (p=0.037) and carrier (p=0.038) groups. There were no significant relations between marital status, family type, place of living and anxiety and depression risks (p>0.05). Three quality of life parameters including general health, role limitations due to physical health and vitality scores in the inactive HBV carriers and CHB patients were lower than those of the control group (p

Chronic suppurative otitis media is an infectious disease associated with meningitis and brain abscess. Intracranial abscesses secondary to autologous infections commonly occur in the temporal lobe and cerebellum, suggesting dissemination of the microorganism via direct contact. Proteus spp., streptococci, anaerobes, and gram-negative bacteria are the most commonly reported pathogens in the cerebral abscesses developing as a complication of chronic suppurative otitis media-related meningitis. The follow-up of these patients is important since despite appropriate treatment, brain abscess may develop in case of chronic suppurative otitis media associated meningitis. Surgical intervention in addition to empirical antimicrobial treatment may be warranted in the presence of a cerebral abscess developing as a complication of chronic suppurative otitis media-related meningitis. Response to treatment is better when surgery and medical treatments are given concurrently and the pathogen is detected in culture. In this case report, two cases developing brain abscess while inappropriate treatment for chronic suppurative otitis media associated acute bacterial meningitis were evaluated.

Malaria and salmonella infections are endemic especially in developing countries, however malaria and salmonella co-infection is a rare entity with high mortality. The basic mechanism in developing salmonella co-infection is the impaired mobilization of granulocytes through heme and heme oxygenase which are released from haemoglobin due to the breakdown of erythrocytes during malaria infection. Thus, a malaria infected person becomes more susceptible to develop infection with Salmonella spp. In this report a case with Plasmodium falciparum and Salmonella Typhi co-infection was presented. A 23-year-old male patient was admitted to hospital with the complaints of diarrhea, nausea, vomiting, abdominal pain, fatigue and fever. Laboratory findings yielded decreased number of platelets and increased ALT, AST and CRP levels. Since he had a history of working in Pakistan, malaria infection was considered in differential diagnosis, and the diagnosis was confirmed by the detection of P.falciparum trophozoites in the thick and thin blood smears. As he came from a region with chloroquine-resistant Plasmodium, quinine (3 x 650 mg) and doxycycline (2 x 100 mg/day) were started for the treatment. No erythrocytes, parasite eggs or fungal elements were seen at the stool microscopy of the patient who had diarrhoea during admission. No pathogenic microorganism growth was detected in his stool culture. The patient's blood cultures were also taken in febrile periods starting from the time of his hospitalization. A bacterial growth was observed in his blood cultures, and the isolate was identified as S. Typhi. Thus, the patient was diagnosed with P.falciparum and Salmonella Typhi coinfection. Ceftriaxone (1 x 2 g/day, 14 days) was added to the therapy according to the results of antibiotic susceptibility test. With the combined therapy (quinine, doxycycline, ceftriaxone) the fever was taken under control, his general condition improved and laboratory findings turned to normal values. However, on the fifth day of his anti-malaria therapy sudden bilateral hearing loss developed due to quinine use. Thus, the treatment was replaced with an artemisinin-based (arthemeter/lumefantrine) combination therapy. No adverse effects were detected due to artemisinin-based therapy, and the patient completely recovered. In conclusion, if a patient is diagnosed with malaria, he/she should be closely monitored in terms of having co-infections and appropriate diagnostic methods including blood cultures taken in febrile episodes should be performed.