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Amaç: COVİD-19 pandemisi döneminde bazı sağlık anksiyetesi çalışmaları literatürde mevcuttur.Bununla birlikte mortalite ve morbiditesi yüksek, aynı zamanda toplumda damgalanma riski olan HİVpozitif kişilerin pandemi dönemine ait sağlık anksiyesini değerlendiren sınırlı sayıda çalışma mevcuttur.Literatürde, COVİD-19 pandemi döneminde genel ve sağlık anksiyetesini değerlendiren anket çalışmalarıbulunmaktadır. Sağlık anksiyetesini değerlendiren -Sağlık anksiyete envanteri- (HAI)’de 18 soru mevcut,sorular 0-3 arası puanlandırmıştır. Bu ölçeklendirme envanteri Türkçe’ye valide edilmiştir. Puan arttıkçasağlık anksiyetesi yükselmektedir. Literatürde HİV ve COVİD-19 pandemisi için özel bir ölçeklendirmebulunmadığı için bu ölçeklendirmeden faydalanılarak 14 soruluk mini bir anket oluşturuldu. Bilindiğiüzere HİV ile infekte bireylerin mortalite ve morbiditesi yüksektir. Bu nedenle bu hasta grubunda normalşartlarda anksiyetesi yüksek olan bireylerdir. Çalışmamızda pandemi döneminde toplum genelinde artansağlık anksiyetesinin özellikle HİV ile infekte olan kişilerdeki durumunu irdelemeyi amaçladık.Yöntem: Çalışmaya kliniğimizde takip ettiğimiz HİV ile infekte bireyler dahil edildi. Gönüllü olur formusözel olarak kendilerine iletilecek ve sözlü olarak onamları alındı ve telefon uygulaması üzerinden anketsoruları aktarıldı. Ankete katılan kişilerin demografik verileri, pandemi döneminde iş durumları ve HİV tanıve takibi ile ilgili süreci değerlendirilen sorular yanı sıra 14 soru anksiyetenin varlığını değerlendirmek içinsoruldu ve 0-3 arası puanlandı. Anket sonunda yüksek puan alan kişilere psikiyatrik muayene önerisindebulunuldu. Bu kişilerin sonrasında takibi yapıldı ve ilaç kullanımları da ayrıca sorgulandı.Bulgular: Çalışmaya 196 kişi dahil edildi. Bunların %86,7’si erkek (n=170), yaşlarının ortalaması 41,16±10,96ve tanı alma yıllarının ortancası 3,39 (1,5-5,6) idi. -Sağlığımla ilgili her zaman endişelenirim-, -Dışgörünüşüme ilgimi kaybettim-, -Eskiden zevk aldığım şeylerden eskisi kadar zevk alamıyorum-, -Gerginhissediyorum-, -Ailem ve dostlarım hastalık hastası olduğumu söyler- sorularına kadınlar anlamlı şekildeyüksek puan verdi (sırasıyla p=0,03, p=0,001, p=0,02, p=0,01 ve p=0,004) idi. Anti-psikiyatrik ilaç ihtiyacıve psikolog desteğine ihtiyacı olduğunu ifade edenler her iki cinsiyette benzerdi (p=0,05 ve p=0,26).Anti-psikiyatrik ilaç ihtiyacı olanların ve olmayanların yaş ortalamaları benzerdi (p=0,19)Sonuç: Çalışmamız salgın döneminde HİV ile yaşayan bireylerin COVİD-19 pandemisi döneminde özelliklekadın cinsiyette olanların ruh sağlığı açısından daha fazla etkilendiğini göstermektedir. HİV ile yaşayanbireylerin normal koşullarda dahi onları zorlayan şartların yanı sıra pandeminin getirdiği yeni duygusal vemaddi yüklerle ruh sağlıklarının daha fazla etkileneceği dikkate alınarak bu popülasyon için daha ayrıntılıtestlerin geliştirilmesinin yararlı olacağı kanısındayız.Anahtar Kelimeler: HİV, COVİD-19, anket

Objectives: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) is a recommended and widely used regimen for HIV infection. In this study, we aimed to determine the efficacy and safety of E/C/F/TAF in people living with HIV (PLWH), who are either treatment-naïve or switched from any tenofovir disoproxil fumarate-containing regimen. For switched patients, we aimed to determine the impact of switching from tenofovir disoproxil fumarate (TDF) to TAF on lipid profile and kidney functions. Methods: ACTHIV-IST Study Group produced a database, and five dedicated HIV centres in Istanbul entered data of PLWH who switched from any TDF-containing regimen to E/C/F/TAF and treatment-naïve patients who were initiated with the E/C/F/TAF regimen between January 2017 and December 2019. Clinical findings, viral parameters, lipid studies, renal function tests, adverse events and adherence to the treatment were recorded in this prospective observational study. Results: The study included a total of 614 switched and treatment-naïve patients. Of 430 treatment-experienced patients, 89% (382) were men, and the mean age was 42 ± 12 years. Among them, 47% (181/382) self-identified as men who have sex with men (MSM). The median duration of HIV diagnosis was 54 ± 29 months. The median duration of E/C/F/TAF use was 20 ± 36 months and that of previous treatment was 23 ± 18 months. HIV-RNA was undetectable at baseline and month 12 in 84.1% (360/428) and 86.1% (328/381) of patients, respectively ( p > 0.05). Mean CD4 counts were 708 ± 287 cells/µL and 802 ± 305 cells/µL at baseline and month 12, respectively ( p < 0.001). Serum creatinine levels remained stable during the treatment period. Mean total cholesterol levels at baseline and month 12 were 172 and 211 mg/dL ( p < 0.01), LDL-cholesterol 104 and 138 mg/dL ( p < 0.01), HDL-cholesterol 39 and 49 mg/dL ( p < 0.01) and triglycerides 134 and 174 mg/dL ( p < 0.01), respectively. The treatment was generally well tolerated. Eight patients discontinued the therapy (drug interaction: 3; lost to follow-up: 1; pregnancy: 1; pulmonary tuberculosis: 1; side effect: 1; patient’s decision: 1). Of 184 treatment-naïve patients, 88% (162) were men, and the mean age was 36.5± 12 years. Among them, 50% (81/162) self-identified as MSM. The mean duration of HIV infection was 21.6 ± 17.1 months. The mean duration of E/C/F/TAF use was 16 ± 4 months. HIV-RNA was undetectable at baseline and month 12 in 1% and 89.1% of patients, respectively. Mean CD4 counts at baseline and month 12 were 469 ± 223 cells/µL and 740 ± 298 cells/µL, respectively. During the treatment period, creatinine levels remained stable. Total cholesterol, LDL-cholesterol, triglyceride and also HDL-cholesterol levels increased. Mean total cholesterol levels at baseline and month 12 were 167 and 211 mg/dL ( p < 0.01), LDL-cholesterol 108 and 143 mg/dL ( p < 0.01), HDL-cholesterol 41 and 47 mg/dL ( p < 0.01) and triglycerides 136 and 172 mg/dL, respectively ( p < 0.01). The treatment was generally well tolerated. Three patients discontinued the therapy (drug interaction: 1; non-responder: 1; patient’s decision: 1). Conclusion: Starting with or switching to E/C/F/TAF in PLWH effectively suppresses HIV infection, is associated with an increase in CD4 cell count and is well tolerated in a real-life setting. Renal functions remained stable during the treatment. E/C/F/TAF use was associated with an increase in LDL-cholesterol and triglyceride levels along with an increase in HDL-cholesterol levels.

Objective: We aimed to evaluate the patient factors which increase the probability of achieving a positive blood culture, distribution of microorganisms grown, and to reveal the impact of various factors during collection of blood on blood culture positivity.

The prevalence of human immunodeficiency virus (HIV) infection is low but it is steadily increasing in Turkey. In the current study, we aimed to assess the status of HIV infection management with the proposed 90–90–90 targets in a large HIV cohort in Istanbul, Turkey. The cohort included 2382 patients (2082 male, 300 female, mean age was 36.3 ± 11.3 years). Mean CD4 cell count was 399 cells/mm3and HIV-RNA level was 576,235 copies/ml. According to the modeling by the Modeling tool of European Center for Diseases Control Software, 72 and 74% of all HIV patients had been diagnosed in 2016 and 2017, respectively (the first target). Among 2382 patients, 2191 (92%) were on antiretroviral therapy (the second target). The third target of virally suppressing those on treatment was achieved among 70.2% of the patients. The current study suggests that both the fraction of those living with undiagnosed HIV and the proportion of those on treatment who are virally suppressed should be targeted to sustain optimal HIV care. Efforts should continue to surpass the targets of 90–90–90.

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.

Streptococcus parasanguinis is a natural member of oral flora. It is an opportunistic pathogen, and rarely cause systemic infections due to it's low virulence. Subacute infective endocarditis may present with various clinical manifestations (eg., spondylodiscitis). A sixty-five years old male patient from Northern Iraq has referred to our emergency service with high fever, weight loss, back pain and inability to walk. The patient was a veterinarian. He was operated three years ago for colonic carcinoma and irradiated. In magnetic resonance imaging, spondylodiscitis was detected localized in lumbar 1-2 region. Transthorasic echocardiography demonstrated aortic valve vegetation. S. parasanguinis was identified in the blood cultures. In conclusion; all in all, it's remarkable to isolate S. parasanguinis as a causal agent of infective endocarditis in a patient who is a veterinarian with history of colonic carcinoma presented with clinical manifestation of spondylodiscitis. [Cukurova Med J 2016; 41(3.000): 591-594]

Objective: In recent years, a lot of non-invasive tests have been examined for estimating the severity of liver fibrosis in patients with chronic hepatitis B (CHB). We aimed to evaluate the role of simple and valuable platelet-derived indices in estimating the stage of fibrosis and cirrhosis in patients with CHB.

Background/aim: This study was undertaken to identify subjects with human immunodeficiency virus and tuberculosis (HIV/TB) coinfection in a group of HIV-positive patients followed at five different healthcare centers, and to determine the demographic and clinical characteristics of these subjects as well as the predictors of mortality. Materials and methods: A database search for subjects with TB coinfection was performed among 1475 HIV-positive adult patients and a total of 66 individuals were identified with HIV/TB coinfection. Results: There were 66 patients (4.5%) with TB coinfection. Twenty-one percent (n = 14) of the patients with TB coinfection died during the study period and these patients had significantly lower baseline CD4 counts at the time of TB diagnosis (P = 0.005). None of the patients with CD4 count of ≥200 cells/mm3 died during follow-up and a low CD4 count at the time of TB diagnosis (

Pseudomonas stutzeri is non-fermentative gram negative bacteria which rarely leads to infections. In this report, we presented for the first time a liver abscess which was caused by P. stutzeri. [Cukurova Med J 2016; 41(0.100): 17-19]

Purpose: Klebsiella pneumoniae is the most common endogen agent for nosocomial infections. In this study, mortality markers were investigated in patients with nosocomial K. pneumoniae blood stream infection (NKp BSI). Methods: The characteristics of patients >16 years who had NKp BSI diagnosis by daily active surveillance between January 2012 and January 2016 were retrospectively evaluated. Patients who died until 28th day of the clinical follow up and those who survived until this time were statistically compared in terms of various risk factors. Results: One hundred ninety patients were included into the study. Mortality rate was 47.9%, carbapenem resistance was 43.2%. Statistical analysis have shown that in presence of post-NKp BSI sepsis, septic shock, following in intensive care unit (ICU), meropenem resistance, kidney failure, NKp BSI secondary to pneumonia, use of invasive instruments such as central venous catheter (CVC), urinary catheter (UC) and mechanical ventilator (MV), colostomy, transfusion and hemodialysis mortality was significantly higher. In patients admitted into the hospital for neurological disorders, pancreaticobiliary tract (PBT) diseases and patients who have undergone endoscopic retrograde cholangiopancreatography (ERCP) and patients in whom NKp BSI secondary to PBT infection mortality rate was lower. Conclusions: Sepsis, septic shock, clinical conditions requiring ICU treatment and meropenem resistance increase mortality rates in NKp BSI significantly. Mortality was higher also in patients with NKp BSI secondary to pneumonia, in kidney failure and when invasive instruments were used. On the other hand, in patients who were admitted to the hospital for neurological disorders and PBT diseases mortality rate was lower.

Objectives: This study aimed to examine the changes in HIV demographics over time in an exceptionally low prevalence population, with particular emphasis on men who have sex with men (MSM). Methods: A total of 1292 newly diagnosed HIV-positive patients registered in the ACTHIV-IST Study Group database between 2000 and 2014 were included. The changes occurring over time in the characteristics of patients at the time of initial admission were examined retrospectively. Results: A gradual increase in the total number of newly diagnosed patients was evident during the study period; however, it was not possible to show an increase in the proportion of MSM within the study population (p = 0.63). There was a male predominance throughout the study (85% vs. 15%), with further increases in the proportion of males in recent years. The mean age was lower at the end of the study (p