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The current outbreak of the Coronavirus, severe acute respiratory syndrome Coronavirus-2, which originated in the Wuhan province of the People's Republic of China became a pandemic. Although the clinical findings of the infection vary in adults, the most common symptoms are fever, dry cough, and shortness of breath. The diagnosis of the Coronavirus disease-2019 (COVID-19) is made by clinical symptoms, laboratory tests, and radiological methods. Many drugs such as antivirals, antibiotics, and corticosteroids are used in the treatment of COVID-19. For the successful control of the pandemic, prevention strategies are the key. There is strong consensus that, in addition to wearing masks, hand hygiene, and social distancing, an effective COVID-19 vaccine is probably the most effective approach to sustainably control the pandemic. In this article, current information about the pathogenesis, epidemiology, risk groups, diagnosis, treatment, prevention strategies, and vaccination of the disease in the first year of the COVID-19 pandemic are discussed.

Coronavirus disease 2019 (COVID-19) has caused thousands of deaths since it was declared as a pandemic and continues to be one of the most followed topics in the world in terms of its course and treatment. Favipiravir is a broad-spectrum anti-viral agent that has been shown to be effective against various Coronaviruses in vitro. However, as with any drug use, side effects may develop with the use of favipravir treatment. We aimed to present a case of angioedema and acute urticaria whom had COVID 19 pneumonia, that we cannot distinguish as a rare side effect due to favipiravir treatment or COVID-19 cutaneous manifestation. According to the available literature, this is the first case reported in our country.

BackgroundTuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The“Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown.MethodsA multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively.ResultsA total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P P P ConclusionBoth criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.

Background: Because of their similar modes of transmission, thesimultaneous infection of viral hepatitis and human immunodeficiencyvirus are increasingly seen as a big problem related to human health.Aims: To determine the drug mutations in hepatitis B virus and/or hepatitis C virus co-infected human immunodeficiency virus-1patients in Turkey.Study Design: Retrospective cross-sectional study.Methods: The present study was conducted between 2010 and 2017.HBsAg, anti-hepatitis C virus, and anti-human immunodeficiencyvirus were tested with ELISA. All anti-human immunodeficiencyvirus positive results by ELISA were verified for anti-humanimmunodeficiency virus positivity by a Western blot test, and Antihuman immunodeficiency virus positive patients with HBsAg and/oranti-hepatitis C virus positivity were included in the study. Subtypingand genotypic resistance analyses were performed by populationsequencing of the viral protease and reverse transcriptase regions ofthe human immunodeficiency virus-1 pol gene.Results: We detected 3896 human immunodeficiency virus-1 positivepatients whose sera were sent from numerous hospitals across thecountry to our polymerase chain reaction unit for detection of drugresistance mutations and whose molecular laboratory tests werecompleted. Viral hepatitis co-infections were detected in 4.3% (n=170)of patients. Hepatitis B virus and hepatitis C virus co-infection wereobserved in 3.2% and 0.5% of all human immunodeficiency virus-1infected patients, respectively. The major human immunodeficiencyvirus-1 subtype detected was group M, subtype B (62.9%). However,13.5% of drug resistance mutation motifs were found in humanimmunodeficiency virus-1 genomes of patients included in the study.Conclusion: Due to similar transmission routes, HIV1 patients are atrisk of hepatitis B and C virus co-infection. However, antiretroviraldrug resistance mutation model is similar to patients with hepatitisnegative.

Introduction: Although diabetic foot infections are polymicrobial, gram-positive microorganisms comprise the majority. Daptomycin is a novel agent in treating infections due to multidrug-resistant gram-positive pathogens. In this multicenter study, the outcomes of the daptomycin treatment were evaluated retrospectively in the treatment of diabetic foot infectious without osteomyelitis. Materials and Methods: Patients with diabetic foot infection without osteomyelitis and who received daptomycin treatment were included into the study. Sociodemographic characteristics of the patients, risk factors for methicillin resistant Staphylococcus aureus (MRSA), antimicrobial treatment, and the data of microbiological and clinical outcomes of the cases were registered in a standard form by eleven centers. Clinical success was defined as a combination of end-of-treatment laboratory parameters, clinical and microbiological responses. Results: A total of 46 patients (30 males, 16 females) were clinically evaluated for the outcome of daptomycin therapy. Mean age was 61.09 ± 11.82 years (31-81) and mean diabetes duration was 13 ± 8.2 years. The number of mild, moderate and severe infections identified according to the infection scoring system of the Infectious Diseases Society of America (IDSA) were 12 (26.1%), 25 (54.3%), and 9 (19.6%) respectively. Duration of daptomycin therapy was 17.5 ± 9.3 days and overall daptomycin success rate was 82.6% (n= 38). Two patients developed side effects. Conclusion: The clinical success rate of this study which assessed the efficacy of daptomycin in diabetic foot infections was 82.6%. Daptomycin can be safely used even in severe cases having had no success with previous antibiotic therapy.

Ventilator-associated pneumonia (VAP) due to Acinetobacter spp. is one of the most common infections in the intensive care unit. Hence, we performed this prospective-observational multicenter study, and described the course and outcome of the disease. This study was performed in 24 centers between January 06, 2014, and December 02, 2016. The patients were evaluated at time of pneumonia diagnosis, when culture results were available, and at 72 h, at the 7th day, and finally at the 28th day of follow-up. Patients with coexistent infections were excluded and only those with a first VAP episode were enrolled. Logistic regression analysis was performed. A total of 177 patients were included; empiric antimicrobial therapy was appropriate (when the patient received at least one antibiotic that the infecting strain was ultimately shown to be susceptible) in only 69 (39%) patients. During the 28-day period, antibiotics were modified for side effects in 27 (15.2%) patients and renal dose adjustment was made in 38 (21.5%). Ultimately, 89 (50.3%) patients died. Predictors of mortality were creatinine level (OR, 1.84 (95% CI 1.279–2.657); p = 0.001), fever (OR, 0.663 (95% CI 0.454–0.967); p = 0.033), malignancy (OR, 7.095 (95% CI 2.142–23.500); p = 0.001), congestive heart failure (OR, 2.341 (95% CI 1.046–5.239); p = 0.038), appropriate empiric antimicrobial treatment (OR, 0.445 (95% CI 0.216–0.914); p = 0.027), and surgery in the last month (OR, 0.137 (95% CI 0.037–0.499); p = 0.003). Appropriate empiric antimicrobial treatment in VAP due to Acinetobacter spp. was associated with survival while renal injury and comorbid conditions increased mortality. Hence, early diagnosis and appropriate antibiotic therapy remain crucial to improve outcomes. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042)., SCOPUS: ar.j, info:eu-repo/semantics/published

Neurosyphilis (NS) has different clinical manifestations and can appear during any stage of syphilis. We aimed to identify the factors affecting poor outcome in NS patients. Patients with positive cerebrospinal fluid Venereal Disease Research Laboratory test, and positive serological serum treponemal or nontreponemal tests were classified as definite NS. The data of 141 patients with definite NS were submitted from 22 referral centers. Asymptomatic NS, syphilitic meningitis, meningovascular syphilis, tabes dorsalis, general paresis, and taboparesis were detected in 22 (15.6%), 67 (47.5%), 13 (9.2%), 10 (7%), 13 (9.2%), and 16 patients (11.3%), respectively. The number of HIV-positive patients was 43 (30.4%). The most common symptoms were headache (n = 55, 39%), fatigue (n = 52, 36.8%), and altered consciousness (50, 35.4%). Tabetic symptoms were detected in 28 (19.8%), paretic symptoms in 32 (22.6%), and vascular symptoms in 39 patients (27.6%). Eye involvement was detected in 19 of 80 patients (23.7%) who underwent eye examination and ear involvement was detected in eight of 25 patients (32%) who underwent ear examination. Crystallized penicillin was used in 109 (77.3%), procaine penicillin in seven (4.9%), ceftriaxone in 31 (21.9%), and doxycycline in five patients (3.5%). According to multivariate regression analysis, while headache was a protective factor in NS patients, double vision was significantly associated to poor outcome. We concluded that double vision indicated unfavorable outcome among NS patients. A high clinical suspicion is needed for the diagnosis NS. As determined in our study, the presence of headache in syphilitic patients can help in early diagnosis of central nervous system disease.

WOS: 000467448000016, PubMed ID: 30786094, Aims and objectives To determine the factors affecting the first-attempt success of peripheral intravenous catheter (PIVC) placement in older emergency department patients. Background In older patients who require intravenous treatment, establishing a PIVC as fast as possible is clinically important. Design This is a prospective, observational, descriptive study. Methods Using a data collection form, researchers questioned both the patient and the nurse performing the procedure in terms of patient- and operator-related factors. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (See Supporting Information Appendix S1). Results A total of 472 patients were included in the final analyses. According to the logistic regression analysis, independent factors which affected first-attempt failure were found to be: choosing a nonupper extremity site for PIVC (OR: 4.72, 95% CI: 1.35-16.45, p-value: 0.015), history of difficult intravenous access (OR: 3.02, 95% CI: 1.72-5.29, p-value

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

We aimed to develop a scoring system for predicting in-hospital mortality of community-acquired (CA) sepsis patients. This was a prospective, observational multicenter study performed to analyze CA sepsis among adult patients through ID-IRI (Infectious Diseases International Research Initiative) at 32 centers in 10 countries between December 1, 2015, and May 15, 2016. After baseline evaluation, we used univariate analysis at the second and logistic regression analysis at the third phase. In this prospective observational study, data of 373 cases with CA sepsis or septic shock were submitted from 32 referral centers in 10 countries. The median age was 68 (51-77) years, and 174 (46,6%) of the patients were females. The median hospitalization time of the patients was 15 (10-21) days. Overall mortality rate due to CA sepsis was 17.7% (n = 66). The possible predictors which have strong correlation and the variables that cause collinearity are acute oliguria, altered consciousness, persistent hypotension, fever, serum creatinine, age, and serum total protein. CAS (%) is a new scoring system and works in accordance with the parameters in third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The system has yielded successful results in terms of predicting mortality in CA sepsis patients.

WOS: 000406500600002, Objective: Inflammatory breast cancer (IBC) is a rare and aggressive form of locally advanced breast cancer. Currently, almost all women with IBC have lymph node involvement and approximately one-third have distant metastases. Therefore, there is still need for understanding of the molecular biology and new therapy alternatives in IBC. The purpose of this study was to determine the potential role of the cyclooxygenase-2 (COX-2) expression pattern in the aggressive and fatal course of IBC and to investigate the possibility of using COX-2 inhibitors as therapy options in the treatment of IBC. Materials and Methods: IBC samples obtained from breast cancer patients treated Between 2000-2009 in Ege University Faculty of Medicine Department of Medical Oncology were retrospectively evaluated. Immunohistochemical analysis was performed by a special breast cancer pathologist and manually assessed using an immunohistochemical scoring for both staining intensity and percentage. Results: In this study, the molecular subtypes identified in IBC patients were: basal (31%), luminal B/human epidermal growth factor receptor 2 (HER2)-(22%), luminal B/HER2+ (22%), HER2 (17%) and luminal A (8%). COX-2 expression was found to be positive in 92.6% of patients. Conclusion: In this context, it was concluded that the relatively high expression rate of COX-2 could be a reason for poor prognosis and also might lead to the use of COX-2 inhibitors not only as a single agent but also in combination with current chemotherapeutic agents in patients with IBC.

ResumoJustificativa e objetivosOs filtros antibacterianos para cateter epidural são barreiras da analgesia/anestesia controlada pelo paciente para evitar a contaminação do local de inserção epidural. A eficácia desses filtros varia de acordo com o material e o tamanho dos poros.MétodoA capacidade de aderência bacteriana dos dois filtros foi medida em experimento in vitro. Avaliamos a capacidade de aderência das cepas padrão de Staphylococcus aureus (ATCC 25923) e Pseudomonas aeruginosa (ATCC 27853) de dois filtros diferentes (Portex e Rusch), mas com poros do mesmo tamanho. Uma suspensão bacteriana grau 0,5 de McFarland foi colocada na bomba de analgesia controlada pelo paciente e filtrada a uma velocidade de 5mL/h em infusão contínua por 48horas e acumulada em frasco. Os dois filtros foram comparados com contagens de colônias de bactérias nos filtros e frascos. Ao mesmo tempo, os filtros e as bactérias aderidas foram monitorados com microscópio eletrônico de varredura.ResultadosO exame dos filtros por microscópico eletrônico mostrou que a estrutura do filtro Portex era granulada e a do filtro Rusch fibrilar. A contagem de colônias do cateter e do frasco mostrou que ambos os filtros tinham uma capacidade de adesão bacteriana significativa (p

PubMedID: 29960893 Objectives: In this study we retrospectively reviewed A. baumannii meningitis cases treated with tigecycline including regimens and evaluated the efficacy of tigecycline in the therapy. Patients and Methods: Study was performed in seven tertiary-care educational hospitals from five cities of Turkey and one center from France. We extracted data and outcomes of all adult (aged >18) patients with culture proven A. baumannii meningitis treated with tigecycline including antibiotic therapy until April 2016. Results: A total of 23 patients (15 male and eight female) fulfilled our inclusion criteria. All Acinetobacter strains were carbapenem-resistant and susceptible to tigecycline. Six cases received tigecycline monotherapy while 17 received tigecycline including combination therapy (10 with colistin, 4 with netilmicin, 3 with amikacin, 4 with meropenem). Seven of 23 cases (30%) died during the tigecycline including therapy (1 in monotherapy, 4 in colistin, 2 in netilmicin, 1 amikacin, one case received tigecycline + netilmicin followed by tigecycline + colistin). Hence, overall end of treatment (EOT) success was 70%. However, since further 27% died due to additional nosocomial infections, overall clinical success (relieved symptoms at the EOT and one-month post-therapy survival without any relapse or reinfection) decreased to 43%. Conclusion: We conclude that tigecycline may be an alternative in the salvage treatment of nosocomial multidrug-resistant Acinetobacter spp. meningitis. Acinetobacter spp. Meningitis. © 2018 Elsevier B.V.

Giriş: Diyabetik ayak infeksiyonları polimikrobiyal infeksiyonlar olmasına karşın, bu olgularda gram-pozitif mikroorganizmalar çoğunluğu oluşturmaktadır. Daptomisin, çoklu ilaca dirençli gram-pozitif patojenler için yeni bir ajandır. Bu çok merkezli çalışmada, daptomisin ile tedavi edilen diyabetik ayak infeksiyonu olan olgular retrospektif olarak değerlendirilmiştir.Materyal ve Metod: Diyabetik ayak infeksiyonu olup osteomiyeliti olmayan ve tedavide daptomisin alan hastalar çalışmaya dahil edildi. Sosyodemografik özellikler, metisiline dirençli Staphylococcus aureus (MRSA) için risk faktörleri ve olguların tedavi verileri standart bir formla kaydedildi. Çalışmaya 11 merkez katıldı. Klinik başarı, tedavi sonu laboratuvar parametreleri ile klinik ve mikrobiyolojik yanıtların bir kombinasyonu olarak tanımlandı.Bulgular: Daptomisin tedavisinin sonunda toplam 46 (30 erkek, 16 kadın) hasta klinik olarak değerlendirildi. Ortalama yaş 61.09 ± 11.82 yıl ve ortalama diyabet süresi 13 ± 8.2 yıl idi. "Infectious Diseases Society of America (IDSA)" infeksiyon skorlamasına göre tanımlanan hafif, orta ve şiddetli infeksiyon sayıları sırasıyla 12 (%26.1), 25 (%54.3) ve 9 (%19.6) idi. Daptomisin tedavisinin süresi 17.5 ± 9.3 gün ve genel daptomisin başarı oranı %82.6 (n= 38) idi. İki hastada yan etki gelişti. Sonuç: Diyabetik ayak infeksiyonlarında daptomisin etkinliğini değerlendiren bu çalışmada klinik başarı ortalama %82.6 olarak bulunmuştur. Daptomisinin, daha önceki antibiyotik tedavisi ile başarısız olan ağır olgularda bile güvenli bir şekilde kullanılabileceğini düşünüyoruz, Daptomycin in the Treatment of Diabetic Foot Infections without Osteomyelitis; A Multicenter Study

Amaç: Bu çalışmada perioperatif antimikrobiyal profilaksi (PAP) uygulamalarında güncel rehberlere uyum oranlarını ve bu oranları etkileyen faktörleri belirlemeyi amaçladık.Gereç ve Yöntemler: 30 Mayıs - 30 Haziran 2013 tarihleri arasında 15 farklı merkezde uygulanan ankete yedi farklı branştan 410 cerrah katıldı. Çoktan seçmeli ve açık uçlu 40 soru içeren anketler yüz yüze görüşme yöntemiyle uygulandı. Bulgular: Katılımcıların ortalama yaşı 38,01±9,1, %83,4'ü erkek idi. Ankete katılan cerrahların %46,2'si "kurumlarında cerrahi profilaksi rehberi varlığı hakkında bilgisi olmadığını," %34'ü ise "rehberin bulunduğunu ve profilaksi uygulamalarının rehbere uygun olduğunu" belirtti. Ankete katılan cerrahların %56,1'inin kurum içinde cerrahi profilaksi konusunda herhangi bir eğitim toplantısına katılmadığı, son üç yıl içinde cerrahi profilaksi eğitimi alanlarda rehbere uyumun istatistiksel olarak daha yüksek olduğu belirlendi (p, Aim: We aimed to determine the rates of compliance with current guidelines for practices of perioperative antimicrobial prophylaxis (PAP) and the factors affecting these rates.Materials and Methods: Four hundred and ten surgeons from seven different branches attended the survey conducted between May 30 and June 30, 2013, in fifteen different centers. A 40-question questionnaire consisting of multiple choice and open-ended questions was prepared and applied by interviewing the surgeons. Results: The mean age was 38.01 ± 9.1 years; and 83.4% of the participants were male. Of the surveyed surgeons 46.2% stated that they had no information about the existence of any guidelines for surgical prophylaxis in their institutions and 34% stated that institutional guidelines were available and their prophylaxis practices were in accordance with them. Surgeons who were trained on surgical prophylaxis within the last three years were found to have a statistically higher (p

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are widespread health problems all over the world and have high morbidity and mortality. Hemodialysis patients are more frequently exposed to these viruses as they have poor immune system and frequently undergo parenteral interventions. The vaccination against HBV prevents infection and it has been recommended for the prevention of HBV infection in all susceptible dialysis patients. This study aimed to determine the seroprevalence of HBV and HCV infections and analyzed the factors affecting inadequate response to HBV vaccine in dialysis patients. Methods: The data for 584 dialysis patients that were followed up at seven dialysis centers were analyzed. The patients received four doses of 40 μg recombinant hepatitis B vaccine at 0, 1, 2, and 6 months and were tested for anti-HBs titer after one month of completion of vaccination. If patients showed a titer of anti-HBs 30 (p = 0.019), over the age of 65 years (p = 0.009), and duration of dialysis treatment >5 years (p = 0.001). There was no statistically significant difference between gender, causes of renal disease, erythropoietin treatment, and the type of dialysis. Conclusion: Hepatitis C infection, obesity, being elderly, and having long hemodialysis period reduced the hepatitis B vaccination response in hemodialysis patients. © 2017, Springer Science+Business Media Dordrecht.

WOS: 000384527500014, PubMed ID: 27625226, Aims: There is no report on the factors affecting the resolution of symptoms related to meningitis during treatment of tuberculous meningitis (TBM). Thus, we examined the factors associated with early therapeutic responses. Materials and Methods: This multicenter study included 507 patients with microbiologically confirmed TBM. However, 94 patients eligible for the analysis were included in this study from 24 centers. Six out of 94 patients died and the statistical analysis was performed with 88 survivors. Early and late responder groups were compared in the statistical analysis. P < 0.05 were considered to show a significant difference. Results: In the multivariate analysis, the presence of vasculitis (P = 0.029, OR = 10.491 [95% CI, 1.27u86.83]) was found to be significantly associated with a delayed fever response whereas hydrocephalus was associated with altered mental status for 9 days duration (P = 0.005, OR = 5.740 [95% CI, 1.68u19.57]). According to linear regression analysis, fever was significantly persisting (7 days) in the presence of vasculitis (17.5 vs. 7, P< 0.001) and hydrocephalus (11 vs. 7, P = 0.029). Hydrocephalus was significantly associated with persisting headache (21 vs. 12, P = 0.025), delayed recovery of consciousness (19.5 vs. 7, P = 0.001), and a delay in complete recovery (21 vs. 14, P = 0.007) in the linear regression analysis. Following institution of treatment, the complaints seemed to disappear in up to 2 weeks among TBM survivors. Conclusions: In the absence of hydrocephalus or vasculitis, one week of anti-tuberculosis treatment seems to be adequate for the resolution of TBM symptoms. Hydrocephalus and vasculitis delay the resolution of TBM symptoms in response to antimycobacterial treatment.

Conference of the Asian-Pacific-Association-for-the-Study-of-the-Liver (APASL) -- MAR 12-15, 2014 -- Brisbane, AUSTRALIA, WOS: 000370967500005, PubMed: 26966614, Background: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. Aims: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naive. Study Design: A multicenter, retrospective observational study. Methods: The study was conducted retrospectively on 1214 treatment naive-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients' data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient's demographic characteristics, baseline viral load, genotype, and fibrosis scores. Results: The mean age of the patients was 50.74 (+/- 0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early virological response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%). Conclusion: Our findings showed that the rate of SVR to dual therapy was higher in treatment-naive Turkish patients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients., Asian Pacific Assoc Study Liver

WOS: 000364000400001, PubMed ID: 26538030, Background: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM. Methods: Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line antituberculosis drugs, streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). Results: Twenty of 142 isolates (14.1 %) were resistant to at least one antituberculosis drug, and five (3.5 %) were resistant to at least INH and RIF, [multidrug resistant (MDR)]. The resistance rate was 12, 4.9, 4.2 and 3.5 % for INH, SM, EMB and RIF, respectively. The monoresistance rate was 6.3, 1.4 and 0.7 % for INH, SM and EMB respectively. There was no monoresistance to RIF. The mortality rate was 23.8 % in fully susceptible cases while it was 33.3 % for those exhibiting monoresistance to INH, and 40 % in cases with MDR-TBM. In compared to patients without resistance to any firstline drug, the relative risk of death for INH-monoresistance and MDR-TBM was 1.60 (95 % CI, 0.38-6.82) and 2.14 (95 % CI, 0: 34-13: 42), respectively. Conclusion: INH-resistance and MDR rates seemed not to be worrisome in our study. However, considering their adverse effects on treatment, rapid detection of resistance to at least INH and RIF would be most beneficial for designing anti-TB therapy. Still, empiric TBM treatment should be started immediately without waiting the drug susceptibility testing.

Alpay, Yeşim (Balikesir Author), "Background: Manynoninvasive methods, including aspartateaminotransaminase (AST)/alanineaminotransaminase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), Bonacini cirrhosis discriminant score (CDS), fibrosis-4 (FIB4) index, and age-platelet index (API), have been described to determine the stage of hepatic fibrosis. However, thesemethodsare developed for patients with chronic hepatitisC(CHC) andproduce conflicting results in the prediction of liver fibrosis in patients with chronic hepatitis B (CHB). Objectives: The aim of this study was to evaluate the relationship between 7 noninvasive models, including AAR, APRI, CDS, API, FIB-4, neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width (RDW)-to-platelet ratio (RPR) in patients with CHB. Methods: The study population included all patients with CHB, undergoing liver biopsy to determine HBsAg and HBV DNA positivity in more than 6 months. Results: A total of 2520 treatment-naive CHB patients from 40 different centers were included in the study. In total, 62.6% of the patients were male, and the mean age was 40.60 +/- 12.34 years (minimum, 18 years; maximum, 77 years). The Ishak fibrosis score was >= 3 in 29.8% of the patients, indicating significant fibrosis. The mean API, APRI, CDS, NLR, FIB4, and RPR scores in the noninvasive models were significantly different between the groups with significant and low fibrosis (P < 0.05). All the noninvave models (API, APRI, AAR, CDS, NLR, RPR, and FIB4) were found to be significant in the discrimination of cirrhosis (P < 0.05). In the multiple logistic regression analysis, CDS, albumin, alkaline phosphatase (ALP), total bilirubin, neutrophil count, NLR, mean platelet volume (MPV), and FIB4 were independent indices for cirrhosis. Conclusions: In the present study, the role of noninvasive tests in the prediction of liver fibrosis stage and cirrhosis was evaluated in a large cohort of CHB patients. Overall, noninvasive models are gradually becoming more promising. Accordingly, the need for liver biopsy can be reduced with a combination of noninvasive methods in the future."

Background: Oxybutynin is a tertiary amine and has chemical similarities like protamine sulfate. Protamine sulfate's effect on bacterial viability has been shown in some studies; however, there is scanty data regarding the effect of oxybutynin on bacterial viability. Accordingly, the aim of the present study was to investigate the effect of oxybutynin on bacterial viability. Methods: Twenty of Staphylococcus epidermidis (S. epidermidis) strains were isolated from patients who had catheter-associated urinary tract infection. These strains were exposed to 5 different concentrations of oxybutynin in tryptic soy broth (TSB) media (max: 5 mg/mL, min: 0.05 mg/mL). Quantitative growth patterns were measured by spectrophotometer. Under the same media conditions, biofilm production of individual strains was measured by Deighton's micromethod at the end of the 6-hour incubation period. Results: After the incubation period, weak and strong slime-producing bacteria groups were obtained and both groups' slime productions were extensively low at 5 mg/mL concentration of oxybutynin. Slime production of S. epidermidis was inversely correlated with oxybutynin concentrations. Conclusion: Although there was a dose-dependent reduction of biofilm production, there seemed to be no bactericidal effect of oxybutynin on S. epidermidis.

Objective: The aim of this study was investigation of ASB prevalence and the relation for development of UTI in the people aged over 65 living in three nursing homes in Izmir province, Turkey. Methods: The people aged over 65 in three nursing homes in Izmir, who did not suffer from any urinary system symptoms, on whom no urinary catheterizations were applied within the last 15 days, and who had not received any antibacterial treatments for the last one week for any reason, were included in the study between 2003 and 2004. First urine specimens were collected in the morning and the second were collected 24 to 48 hours later. ASB were included in clinical follow-up for six months and whether or not any UTI developed was recorded at intervals. At the third month, however, it was investigated whether ASB continued in patients or not. Patients were also examined in terms of ASB facilitating factors at same time. Results: ASB was detected in 146 (24.1%) of 606 patients and more frequent in females than males (%27.8 vs. %18.6; p=0.009). The prevalence of ASB increased by age and length of stay in the nursing home. UTI was not developed and no death occurred in any of the patients during the follow-up period. At the third follow up month, it was observed that the ASB except Proteus spp. continued likewise. Conclusion: The ASB prevalence was found as quite high in elderly in our country. Direct or indirect relationship between ASB and UTI has not been established., Giriş: Ülkemizde 65 yaş üstü popülasyonda üriner sistem enfeksiyonu (ÜSİ) gelişmesinde önemli yeri olan asemptomatik bakteriüri (ASB) prevelansı iyi tanımlanmamıştır. Bu çalışmanın amacı İzmir, Türkiye’deki 65 yaş üzeri huzurevi popülasyonunda ASB prevelansı ile üriner sistem enfeksiyonu gelişmesi arasındaki bağlantının araştırılmasıdır.Metot: Bu çalışma İzmir’de üç büyük huzurevindeki 65 yaş üstü üriner sistem semptomu olmayan, son 15 gün içinde üriner kateterizasyon uygulanmamış ve herhangi bir nedenle son bir haftadır antibakteriyel tedavi almayanlar ve 2003 ile 2004 yılları arasında yapıldı. Hastalardan sabah ilk orta akım idrar örnekleri ve 24-48 saat sonra ikinci idrar örnekleri alındı. ASB tespit edilenler ve edilmeyenler altı ay klinik takibe alınarak aralıklarla üriner sistem enfeksiyonu gelişip gelişmediği kayıt edildi. Üçüncü ayda ise hastalarda ASB’nin devam edip etmediği araştırıldı. Hastalar aynı zamanda ASB’yi kolaylaştırıcı etkenler açısından da incelendi.Bulgular: Toplam 606 hastadan 146’sında ASB tespit edildi (% 24,1). ASB sıklığı kadınlarda erkeklere göre daha sık idi (% 27,8 vs. % 18,6; p=0,009). ASB görülme oranının yaş ve huzurevindeki kalış süresiyle arttığı sonucuna varıldı. Takipte hastaların hiçbirisinde üriner sistem enfeksiyonu ve ölüm gelişmedi. Üçüncü aydaki kontrollerde Proteus spp. dışındaki ASB etkenlerinin aynen devam ettiği görüldü.Sonuç: ASB prevelansı ülkemizde de yaşlılarda oldukça yüksektir. ASB ile üriner sistem enfeksiyonu arasında dolaylı veya doğrudan bir ilişki kurulamamıştır

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Oncul, Oral/0000-0002-1681-1866; Leblebicioglu, Hakan/0000-0002-6033-8543; demirdal, tuna/0000-0002-9046-5666; Ciftci, Ergin/0000-0002-4955-160X; Erben, Nurettin/0000-0003-0373-0132; Kendirli, Tanil/0000-0001-9458-2803; Acar, Ali/0000-0003-2008-5112; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; KAYA, ZEYNEP/0000-0002-8468-2103; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517 WOS: 000347654600011 PubMed: 25564124 Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

WOS: 000353295400011, PubMed ID: 25634680, Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases set up a task force to develop a consensus report focused on chronic hepatitis B in pregnancy, a complex issue for both the mother with an advanced liver disease and the unborn child who is under the risk of hepatitis B virus (HBV) transmission. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented in the report. An algorithm adapted from actual publications is also proposed for management of chronic hepatitis B in the pregnant patient. Since many women of childbearing age are in the immune tolerant phase of infection, there is generally no need for therapy and no indication to start therapy during the early stages of pregnancy. Initiation of antiviral therapy in the beginning of the third trimester in highly viremic (HBV DNA > 200 000 IU/mL) pregnant women can prevent mother-to-child-transmission of HBV despite postnatal passive and active immunoprophylaxis provided. Given its potency and its high genetic barrier to resistance, tenofovir might be an appropriate option for mothers who might need to continue their treatment for active hepatitis B after delivery.

WOS: 000348654600010, PubMed ID: 25667788, Background: Intraoperative frozen section procedure may be required in some operations performed for breast masses. Aims: We investigated the effect of frozen section procedure on the immunoprofile of breast carcinoma cells. Study Design: Cross-sectional study. Methods: A total of 53 breast carcinoma cases evaluated with intraoperative frozen sections were included in this study. Immunohistochemically, oestrogen (ER), progesterone (PR) and HER2 primary antibodies were evaluated in both frozen and non-frozen sections of each tumour sample. Results: No difference was found between the frozen and non-frozen sections in 33 cases in terms of staining rate and intensity of ER, PR and HER2. A decrease was found in the ER, PR and HER2 staining rate (in 10 cases, 9 cases and 6 cases, respectively). Likewise, a decrease was detected in ER, PR and HER2 staining intensity in 6 patients for each. Although there was no staining in frozen sections, immunopositivity was observed in 3 non-frozen sections for ER, in 2 for PR and in 5 for HER2. Statistically, a significant difference was found between the frozen and non-frozen sections in terms of staining rate and intensity for each of the three markers. Conclusion: In this study, the frozen section procedure in breast carcinoma had a negative effect on the immunoprofile. However, considering the importance of hormone receptor status in the treatment, these results should be supported with larger series.

WOS: 000340538700017, PubMed ID: 24789652, The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.

WOS: 000329981700003, PubMed ID: 24211227, Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.

The musculoskeletal system involvement of tuberculosis (TB) other than spinal TB is a rare and less-known entity. Furthermore symptoms of musculoskeletal involvement of TB infection are non-spesific, relatively slow and indolent. The diagnosis of TB is less considered by clinicians among other common causes of shoulder pain including traumatic and degenerative conditions. We reported a 72-year-old patient suffering shoulder pain for the last 2 years who was diagnosed with glenohumeral joint TB arthrithis associated with multiple cold abscesses in adjacent soft tissues; emphasising significant clinical and imaging findings.

WOS: 000345825900004, PubMed ID: 24849547, We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon- release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Lowenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p

BACKGROUND AND OBJECTIVES: Epidural catheter bacteria filters are barriers in the patient-controlled analgesia/anaesthesia for preventing contamination at the epidural insertion site. The efficiency of these filters varies according to pore sizes and materials. METHOD: The bacterial adhesion capability of the two filters was measured in vitro experiment. Adhesion capacities for standard Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) strains of the two different filters (Portex and Rusch) which have the same pore size were examined. Bacterial suspension of 0.5 Mc Farland was placed in the patient-controlled analgesia pump, was filtered at a speed of 5 mL/h. in continuous infusion for 48 h and accumulated in bottle. The two filters were compared with colony counts of bacteria in the filters and bottles. At the same time, the filters and adhered bacteria were monitored by scanning electron microscope. RESULTS: Electron microscopic examination of filters showed that the Portex filter had a granular and the Rusch filter fibrillary structure. Colony counting from the catheter and bottle showed that both of the filters have significant bacterial adhesion capability (p < 0.001). After the bacteria suspension infusion, colony countings showed that the Portex filter was more efficient (p < 0.001). There was not any difference between S. aureus and P. aeruginosa bacteria adhesion. In the SEM monitoring after the infusion, it was physically shown that the bacteria were adhered efficiently by both of the filters. CONCLUSION: The granular structured filter was found statistically and significantly more successful than the fibrial. Although the pore sizes of the filters were same - of which structural differences shown by SEM were the same - it would not be right to attribute the changes in the efficiencies to only structural differences. Using microbiological and physical proofs with regard to efficiency at the same time has been another important aspect of this experiment. JUSTIFICATIVA E OBJETIVOS: Os filtros antibacterianos para cateter epidural são barreiras da analgesia/anestesia controlada pelo paciente para evitar a contaminação do local de inserção epidural. A eficácia desses filtros varia de acordo com o material e o tamanho dos poros. MÉTODO: A capacidade de aderência bacteriana dos dois filtros foi medida em experimento in vitro. Avaliamos a capacidade de aderência das cepas padrão de Staphylococcus aureus (ATCC 25923) e Pseudomonas aeruginosa (ATCC 27853) de dois filtros diferentes (Portex e Rusch), mas com poros do mesmo tamanho. Uma suspensão bacteriana grau 0,5 de McFarland foi colocada na bomba de analgesia controlada pelo paciente e filtrada a uma velocidade de 5 mL/h em infusão contínua por 48 horas e acumulada em frasco. Os dois filtros foram comparados com contagens de colônias de bactérias nos filtros e frascos. Ao mesmo tempo, os filtros e as bactérias aderidas foram monitorados com microscópio eletrônico de varredura. RESULTADOS: O exame dos filtros por microscópico eletrônico mostrou que a estrutura do filtro Portex era granulada e a do filtro Rusch fibrilar. A contagem de colônias do cateter e do frasco mostrou que ambos os filtros tinham uma capacidade de adesão bacteriana significativa (p < 0,001). Após a infusão da suspensão bacteriana, as contagens de colônias mostraram que o filtro Portex foi mais eficiente (p < 0,001). Não houve qualquer diferença entre as adesões de bactérias S. aureus e P. aeruginosa. Na monitoração por MEV após a infusão, ficou fisicamente evidente que as bactérias foram aderidas de modo eficaz por ambos os filtros. CONCLUSÃO: O filtro com estrutura granular foi estatística e significativamente mais bem- sucedido do que o filtro com estrutura fibrilar. Embora o tamanho dos poros dos filtros fosse igual - as diferenças estruturais mostradas pelo MEV eram semelhantes -, não seria justo atribuir as alterações de eficiência apenas às diferenças estruturais. O uso ao mesmo tempo de provas microbiológicas e físicas para avaliar a eficácia foi outro aspecto importante deste experimento.

Amaç: fiizotipal özellikler şizofreniye genetik yatkınlıkla ilgilidir. fiizotipinin farklı boyutlarının standart biçimde değerlendirilmesi şizotipal kişilik bozukluk ve şizofreniye genetik yatkınlığın klinik ve nörobiyolojik yansımalarını anlamak için gereklidir. Şizotipinin farklı boyutları vardır ve bu boyutlar cinsiyetler arası fark gösterebilir. Bu çalışmada, kullanı lan en yaygın şizotipi ölçeği olan ve şizotipinin farklı boyutlarını de- ğerlendiren fiizotipal Kişilik Ölçeği (fiKÖ) Türkçe formunun psikometrik özellikleri incelenmiştir. Yöntem: Çalışmaya 388 tıp fakültesi öğrencisi alınmış ve ölçeğin iç tutarlığı, %10 kesme noktası çalışılmıştır. Test-tekrar test güvenirliği için ölçek 71 öğrenciye yeniden uygulanmıştır. Uyum geçerliği için ölçeğin 86 öğrencide, Büyüsel Düşünce Ölçeği (BDÖ) ile ilişkisi incelenmiştir. Ölçeğin cinsiyetin şizotipiye etkisini ne ölçüde ortaya koyabildiği sı- nanmıştır. Bulgular: Ölçeğin ortalama puanı 25.9, %10 yüksek kesme puanı 42 bulunmuştur. Cronbach alfa katsayısı ölçek için 0.91 ve alt ölçekler için 0.66-0.83 arasında bulunmuştur. Ölçeğin test tekrar puanları arası korelasyon 0.84’dür. BDÖ ile korelasyon toplam puan için 0.49, bilişsel- algısal şizotipi için 0.74’dür. Erkeklerde kişilerarası şizotipi puanı yüksek bulunmuştur. Ölçeğin faktör yapısı incelenmiş ve yapı geçerli- ğine sahip olduğu düşünülmüştür. Sonuç: fiKÖ’nün genç popülasyonda, şizotipinin farklı boyutlarını de- ğerlendirme de kullanılabilecek güvenilir bir ölçek olduğu söylenebilir., Objective: The patients with schizotypal personality disorder and many nonaffected relatives of patients with schizophrenia shares many neurophysiological, neurocognitive and neuroanatomic features of schizophrenia. The concept of schizotypy is useful to investigate the characteristics of liability for schizophrenia. Schizotypy has several distinct dimensions similar to schizophrenia. There is an impact of gender on schizotypal features. This study investigates the psychometric characteristics of Turkish version of Schizotypal Personality Questionnaire (SPQ). Method: The sample of the study consists of 388 medical students. The internal consistency and %10 cut-off scores were studied. Seventy-one students were readministered the scale to measure the test-retest reliability. The Magical Ideation Scale (MIS) was also administered to 86 students besides SPQ with the aim of testing concurrent validity. The factor structure of the scale was also examined. Results: The mean score of the scale was 25.9 and 10% high cut-off score was 42. The Crohnbach alpha coefficient of the scale was 0.91, the Cronbach coefficients for the subscales ranged from 0.66 to 0.83. Test- retest scores were highly correlated (r=0.84). The correlation coefficients of MIS with total score of SPQ and cognitive perceptual schizotypy score were 0.49 and 0.74 respectively. Males had significantly higher scores on the interpersonal schizotypy subscale. Factor analysis of the items and subscales supported the construct validity of the scale. Conclusions: SPQ is a reliable and valid instrument for studying several dimensions of schizotypy in young adults.

Oral antibiotics are often prescribed, especially for respiratory tract infections in the community. The widespread use of broad-spectrum antibiotics causes an increased incidence of antibiotic-associated diarrhea (AAD). Although AAD has been studied in hospitalized patients, there is little available information concerning the characteristics of AAD in outpatient populations. The aim of this study was to investigate the clinical and laboratory findings of adult patients with community-acquired AAD. Between June 1998 and December 2003, the clinical reports of 288 patients were retrospectively reviewed. We observed that the duration between the start of antibiotic treatment and onset of symptoms was 7 days in most of the patients (86%), and the mean time was 9 +/- 1.0 days. The diarrhea was self-limited in all cases and mean duration of symptoms was 3 (+/- 1.0) days (1-7 days). The most common symptoms were abdominal discomfort and tenesmus (61.1%), while elevated WBC counts and fever were detected rarely. We were able to perform microbiologic investigations in only 88 patients because of the financial problems. Of the 88 stool specimens tested, none of them were positive for pathogenic bacterial growth or toxin A production.

Introduction: Invasive aspergillosis mostly involves lungs. Patients may present with fever, cough, hemoptysis and many other sign and symptoms. Underlying conditions that compromises pulmonary and immune responses to inhaled Aspergillus species serve as risk factors for pulmonary invasive aspergillosis. We are presenting a case of simple aspergilloma, successfully treated by caspofungin and surgery. Case Report: A 64­ year­old male patient has rheumatoid arthritis for ten years. Since three months he had interstitial pulmonary disease secondary to rheumatoid arthritis and hemoptysis. We performed microbiologic and pathologic investigations of the brochoalveolar lavage after computerized tomography for diagnosis of aspergillosis. Caspofungin was used for initial treatment of simple aspergilloma and also for follow­up treatment after apical wedge resection. The patient was discharged from the hospital at eighth week on itraconazol antifungal therapy. Conclusion: Three classes of drugs are available for the treatment of aspergillosis: polyens, azoles and echinocandins. Echinocandins have activity against Aspergillus spp. But have a limited role because they have not been studied for initial treatment of invasive aspergillosis.