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Micafungin is recommended especially in patients with liver and kidney failure and in the presence of other side effects due to antifungals apart from its known priority indications such as invasive candidiasis. The aim of this study was to evaluate the children who have received micafungin treatment. In the study, 125 children who were hospitalized in the pediatric wards and intensive care units of our hospital and had used micafungin between November 2016 and January 2019 were analyzed retrospectively. Clinical data, micafungin indication, blood values on the first and fourth days of the treatment, side effects of the drug and efficacy were evaluated. Sixty percent (75/125) of the patients were male and the mean age of all the patients were 58 ± 67 (0-215, 30) months. Approximately half of the cases (48%) had malignancy and 13% of them were premature. Sixty-two percent (n= 37) of the malignencies were hematological (27 acute lymphocytic leukemia, nine acute myeloid leukemia, one myelodysplastic syndrome) and 38% (n= 23) were oncological (six neuroblastoma, four Hodgkin lymphoma, two Non-Hodgkin's lymphoma, five sarcomas, one hepatoblastoma, five others) malignencies. The major cause of hospitalization was sepsis (53%). The patients had several risk factors like immunosuppressive therapy (n= 68, 54%), neutropenia (n= 61, 49%), central venous catheter (n= 102, 82%), nasogastric tube (n= 63, 50%), endotracheal intubation tube (n= 49, 39%), urinary catheter (n= 14, 11%) and total parenteral nutrition (n= 81, 65%). Thirteen percent (n= 16) of the cases were post-operative patients. Candida species were cultivated in 97 clinical specimens (blood, endotracheal aspirate, sputum, urine, etc.) among 23 (18%) of the patients. Thirteen (10%) of the patients had candidemia and 62% of them were non-albicans strains. In all candidemias, strains were echinocandin susceptible, and blood cultures were negative within four days. When all the patients (n= 125) were evaluated, a significant decrease in C-reactive protein, an increase in sodium, and a decrease in alanine aminotransferase were observed on the fourth day of micafungin treatment (p

Amaç: Bupivakain toksisitesinde kurtarıcı etkinliği kanıtlanan lipid emülsüyonlar, yüksek lipofilik özellikteki diğer ajanların toksikasyonlarının tedavisi için de umut vermektedir. Amacımız verapamil infüzyonu sırasında kardiyak toksisite belirtileri geliştiğinde %20 intralipid ve kalsiyumun farklı zamanlarda verildiklerindeki etkinliklerini araştırmaktır. Çalışmada 24 adet erişkin Spraque-Dawley cinsi sıçan kullanıldı. Sıçanlar kontrol, kalsiyum, %20 intralipid sonrası kalsiyum ve %20 intralipid eşzamanlı kalsiyum olmak üzere rastgele, her grupta altı sıçan olacak şekilde 4 gruba ayrıldı. Ketamin anestizisi altında mönitörize edildikten sonra kuyruk veni kanüle edildi, cerrahi trakeostomi açılarak mekanik vetilasyon uygulandı ve invazif monitörizasyon amacıyla abdominal aort kanüle edildi. İnvazif girişimler sonrası 10 dk stabilizasyon sonrasında KAHb ve OABb kaydedilip, OABb de %50 düşüş olana kadar bütün gruplara 37,5 mg/kg/s verapamil infüzyonu yapıldı. İnfüzyon sonu KAH0 ve OAB0 kayıtları alınarak verapamil infüzyonu 15mg/kg/s e azaltılarak eş zamanlı olarak gruplar için belirlenen tedavi ajanları uygulandı. 60 dakika içinde sıçanların KAH, OAB, ve asistol zamanları kaydedildi. İstatistiksel değerlendirmede Kruskal Wallis ve doğrusal karmaşık model (linear mixed model) testlerinden yararlanıldı. İstatistiksel olarak anlamlılık düzeyi p

Background The Global Influenza Hospital Surveillance Network was established in 2012 to obtain valid epidemiologic data on hospital admissions with influenza-like illness. Here we describe the epidemiology of admissions with influenza within the Northern Hemisphere sites during the 2013/2014 influenza season, identify risk factors for severe outcomes and complications, and assess the impact of different influenza viruses on clinically relevant outcomes in at-risk populations. Methods Eligible consecutive admissions were screened for inclusion at 19 hospitals in Russia, Turkey, China, and Spain using a prospective, active surveillance approach. Patients that fulfilled a common case definition were enrolled and epidemiological data were collected. Risk factors for hospitalization with laboratory-confirmed influenza were identified by multivariable logistic regression. Findings 5303 of 9507 consecutive admissions were included in the analysis. Of these, 1086 were influenza positive (534 A(H3N2), 362 A(H1N1), 130 B/Yamagata lineage, 3 B/Victoria lineage, 40 untyped A, and 18 untyped B). The risk of hospitalization with influenza (adjusted odds ratio [95% confidence interval]) was elevated for patients with cardiovascular disease (1.63 [1.33–2.02]), asthma (2.25 [1.67–3.03]), immunosuppression (2.25 [1.23–4.11]), renal disease (2.11 [1.48–3.01]), liver disease (1.94 [1.18–3.19], autoimmune disease (2.97 [1.58–5.59]), and pregnancy (3.84 [2.48–5.94]). Patients without comorbidities accounted for 60% of admissions with influenza. The need for intensive care or in-hospital death was not significantly different between patients with or without influenza. Influenza vaccination was associated with a lower risk of confirmed influenza (adjusted odds ratio = 0.61 [0.48–0.77]). Conclusions Influenza infection was detected among hospital admissions with and without known risk factors. Pregnancy and underlying comorbidity increased the risk of detecting influenza virus in patients hospitalized with influenza-like illness. Our results support influenza vaccination as a measure for reducing the risk of influenza-associated hospital admission.

We report on observations of the effect of potassium in YBCO (123) high temperature superconductors with nominal composition Y\( 1-0,2x \) Ba\( 2-0.2x \) K\( x \) Cu\( 3 \) O\( y \). The electrical resistivity measurements show that the critical temperature Tc \) (R=0) shifted slightly to lower temparature due to the K doping process. This process also decreases the transport critical current density and the activation energy for thermally activated flux flow. The magnetic field dependence of \( jc \) was measured at 77 K after zero field cooling (ZFC) when the applied magnetic field is impressed (ZFCV) and removed (ZFCD). The results are discussed in terms of ``return'' magnetic flux density associated with the magnetization of the grains. Activation energy was determined from the Arrhenius resistivity plot versus temperature curve. The XRD patterns are also presented for sample characterization.

The aim of this study was to compare the pulmonary effects of recruitment maneuver with positive end-expiratory pressure after pediatric open heart surgery. Thirty patients undergoing open heart surgery with cardiopulmonary bypass were randomized into two groups after the operation: recruitment maneuver with 30 cmH2O continuous positive airway pressure (CPAP) (Group 1, n=15) and 5 cmH2O positive end-expiratory pressure (PEEP) (Group II, n=15). In the group I, 30 cmH2O peak inspiratory pressure was applied for 10 seconds, then PEEP was reduced to 10 cmH2O and ventilation was continued with baseline parameters with PEEP decreased until the best PauO2 was achieved. In group II, 5 cmH2O PEEP was applied postoperatively. In both groups, after the maneuver PaO2/FiO2 (P/F) ratio was measured 15 minutes, 1, 2, 4, 6 hours later, and after the extubation period 15 minutes and 24 hours later. At the same time intervals mean arterial blood pressure, central venous blood pressure, heart rates were recorded. There was no difference between the groups regarding the P/F ratioes throughout the mechanical ventilation period, the P/F ratioes of the Group I were higher compared to Group II right after the extubation. The atelectasis scores of the groups were similar. Recruitment maneuver was found to be hemodinamically stable. The groups were identical regarding the mechanical ventilation, intensive care unit and hospitalization periods. The recruitment technique with postmaneuver PEEP improved oxygenation by a higher extent and atelectasis frequency was statistically similar between two groups.

Bupivakain toksisitesinde kurtarıcı etkinliği kanıtlanan lipid emülsüyonlar, yüksek lipofilik özellikteki diğer ajanların toksikasyonlarının tedavisi için de umut vermektedir. Amacımız verapamil infüzyonu sırasında kardiyak toksisite belirtileri geliştiğinde standart tedavi ilaçları uygulanmaksızın %20 intralipid ve %20 medialipid'in etkinliğini araştırarak solüsyon seçimine dikkat çekmektir. Çalışmada onsekiz adet erişkin Spraque-Dawley cinsi sıçan kullanıldı. Sıçanlar kontrol, intralipid ve medialipid olmak üzere rastgele, her grupta altı sıçan olacak şekilde üç gruba ayrıldı. Ketamin anestizisi altında mönitörize edildikten sonra kuyruk veni kanüle edildi, cerrahi trakeostomi açılarak mekanik vetilasyon uygulandı ve invazif monitörizasyon amacıyla abdominal aort kanüle edildi. İnvazif girişimler sonrası kan gazı analizi yapıldı ve 10 dk stabilizasyon sonrasında KAHb ve OABb kaydedilip, OABb'de %50 düşüş olana kadar bütün gruplara 2,5 mg/kg/dk verapamil infüzyonu yapıldı. İnfüzyon sonu KAH0 ve OAB0 kayıtları alınarak Grup K'ya %0,9 NaCl, Grup I'ya %20 intralipid, Grup M'ye %20 medialipid 12.4 mL beş dakika içinde uygulandı. Atmış dakika içinde sıçanların KAH, OAB, ve asistol zamanları kaydedildi. İstatistiksel değerlendirmede Kruskal Wallis ve doğrusal karmaşık model (linear mixed model) testlerinden yararlanıldı. İstatistiksel olarak anlamlılık düzeyi p

Nasal septal surgery is frequently performed in otolaryngology practice. Bleeding, septal hematoma, infection, abscess formation, synechiae, and septal perforation can be seen as postoperative complications. Nasal packs that are made of various materials are used in order to prevent a portion of these complications. Some of these packs lead to pain and discomfort as a result of foreign body sensation. In this paper, we present a life-threatening complication of nasal packing resulted in patient's aspiration during drawing back.