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Figen Sarıgül Yıldırım,1 Aslıhan Candevir,2 Sıla Akhan,3 Selçuk Kaya,4 Mehmet Çabalak,5 Gülden Ersöz,6 Dilara Ä°nan,7 Nurgül Ceren,8 Ä°lkay Karaoğlan,9 Tuba Damar Çakırca,10 Şafak Özer Balin,11 Sevil Alkan,12 Özlem Kandemir,6 Ülkü Üser,13 Oğuz Karabay,14 Mustafa Kemal Çelen15 1Antalya Life Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey; 2Cukurova University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkey; 3Kocaeli Üniversity, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Kocaeli, Turkey; 4Karadeniz Teknik University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey; 5Mustafa Kemal University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Hatay, Turkey; 6Mersin University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Mersin, Turkey; 7Akdeniz University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey; 8Health Science University, Haydarpaşa Numune Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ä°stanbul, Turkey; 9Gaziantep University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Gaziantep, Turkey; 10Health Science University, Şanlıurfa Numune Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Şanlıurfa, Turkey; 11Fırat University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Elazığ, Turkey; 12Çanakkale 18 Mart University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Turkey; 13Health Science University, Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey; 14Sakarya University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Hatay, Turkey; 15DicleUniversity, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Diyarbakır, TurkeyCorrespondence: Figen Sarıgül Yıldırım, Antalya Life Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey, Tel +90 532 473 44 46, Email drfigensarigul@yahoo.com.trBackground: Rapid initiation of antiretroviral therapy (ART) reduces the transmission of HIV infection in the community. This study aimed to determine whether rapid ART initiation is effective compared to standard ART treatment in our country.Methods: Patients were grouped based on time to treatment initiation. HIV RNA levels, CD+4 T cell count, CD4/CD8 ratio, and ART regimens were recorded at baseline and follow-up visits for 12 months.Results: There were 368-ART naive adults (treatment initiated at the time of HIV diagnosis; 143 on the first day, 48 on the second-seventh day, and 177 after the seventh day). Although virological suppression rates at 12th months were higher in all groups, over 90% on average, there were no statistically significant differences in HIV-1 RNA suppression rates, CD+4 T cell count, and CD4/CD8 ratio normalization in the studied months but in multivariate logistic regression analysis; showed a significant correlation between both virological and immunological response and those with CD4+ T < 350 cells/mL at 12th month in total patients.Conclusion: Our findings support the broader application of recommendations for rapid ART initiation in HIV patients.Keywords: HIV, ART, antiretroviral, rapid start

Face masks are devices worn over the mouth and nose to protect against splashes, infectious respiratory droplets, or aerosols generated during breathing or coughing according to their filtering capacity. Medical masks, respirators, or cloth masks have been used for source control and for the protection of the exposed. After the first case on March 11, 2020, in Turkey, National COVID-19 Scientific Advisory Board published various contents for the correct use of masks. Medical face masks have been used in healthcare settings for both source control and potential personal protection before the COVID-19 pandemic. Adverse events associated with using masks are very sparse and mainly associated with tight-fitting respirators or dermatitis due to prolonged use and should not be a reason for refusal to use. Studies suggest the use of masks mainly in the healthcare facilities but also in the community for source control of people who have respiratory symptoms of communicable diseases other than COVID-19. They are likely to be acceptable if recommended, particularly in more severe epidemics and pandemics. Metaanalysis, case control, cross sectional, cohort, retrospective, retrospective cross sectional, research, randomized controlled, and controlled comparison studies were reviewed on the protective effect of masks on COVID-19 with laboratory evidence. Optimum use of face masks with additional precautions has been found to be useful controlling the spread of the respiratory viruses such as SARS-CoV-2 in most of the studies and metaanalyses. As a conclusion, the recent evidence in COVID-19 pandemic is consistent with the previous studies which have shown association between face mask use and decreased risk of viral infections, and medical face mask use should be encouraged both for the community and healthcare facilities along with other infection control measures such as hand hygiene, during outbreaks when there is widespread community transmission.

Background/aim HIV infection increase the risk of serious disease resulting from common vaccine-preventable infections. Vaccinations are particularly important for HIV infected adults. We aimed to investigate the immunity rates against measles, mumps, rubella, hepatitis A, B, and tetanus in newly diagnosed HIV patients. Materials and methods Patients who admitted to outpatient clinics of three centers with newly diagnosed HIV infection, between 1 January 2015 and 31 June 2017 were included. Measles, mumps, rubella, varicella zoster virus, hepatitis A, hepatitis B, and tetanus antibody levels were measured by commercial diagnostic kits. Demographical and laboratory data of the patients were recorded. Results Five hundred and twenty-three patients were enrolled in the study. Of the patients 87% were male (n = 455) and the mean age was 38 ± 13 years. Serology was available for measles 74.2% (388/523), mumps 73.8% (386/523), rubella 77.8% (407/523), hepatitis A 88.5% (463/523), hepatitis B 97.7% (511/523), tetanus 8.6% (45/523), and VZV 79.9% (418/523). Seropositivity was 82% for measles, 75.6% for mumps, 92.1% for rubella. Of the patients whom all three of the components of the MMR vaccine was tested, 37.7% (127/337) were susceptible at least one and needed the vaccine. Mean age was lower in patients who are nonimmune to measles and mumps (p = 0.008). Younger patients were also nonimmune for hepatitis A, while older patients were nonimmune for hepatitis B. Conclusion In our study we found that rates of nonimmunity can increase up to one third of the patients even though there is a national vaccination program. Nonimmune individuals should be detected and vaccinated in line with recent guidelines and response should be monitored because of the possibility of impaired immunity and possible suboptimal response. National campaigns can be launched for adult immunization and physicians should be aware of the importance of adult immunization.

Candida species are responsible for 70-90% of invasive fungal infections in the intensive care unit. Early diagnosis and treatment is important in candidemia. Improper diagnosis and treatment increases mortality and morbidity significantly. Because of the late results of blood cultures and low sensitivity of the serological tests when used alone, molecular methods should be investigated in this field. In this study, the results of the Candida real-time polymerase chain reaction (Rt-PCR) test, which was studied from blood culture and whole blood, were compared in patients with high candidemia risk who were followed in the General Surgery Intensive Care and Anesthesiology and Reanimation Unit of Cukurova University Faculty of Medicine. It was aimed to investigate the practical utility of Candida RT-PCR test, which is a rapid diagnosis method in patients with suspected candidemia. In our study, 90 patients with high risk of candidemia according to the criteria determined according to the guidelines were evaluated prospectively. Urine, perineum, axilla, tracheal aspirate culture and two sets of blood cultures were obtained from the patients. Blood sample was also drawn into an ethylenediaminetetraacetic acid (EDTA) tube and stored at -40°C for later Candida Rt-PCR study. In Candida Rt- PCR, species-specific primers were used to distinguish species. Candida score (CS) of the patients was calculated. Forty one (45.5%) of the patients were female and 49 (55.5%) were male. The median age of the patients was 61.5 years. Candida was positive in blood culture in three (3.3%) of the patients included in the study, while Candida Rt-PCR was positive in 17 (18.9%). Candida species detected in the blood culture and Rt-PCR test were compatible with each other. Rt-PCR was significantly more positive (p= 0.006). Candida Rt-PCR positivity was significantly higher in patients receiving total parenteral nutrition (p= 0.028), malignancy (p= 0.021), and history of surgery in the last three months (p=0.003). The difference in CS between patients with PCR positive and PCR negative was statistically significant (p= 0.015). Our study was conducted in a high-risk population for candidemia and the results of Candida Rt-PCR was found to be more positive than blood culture. Rt-PCR positivity and blood culture positivity were associated with high CS. In the light of these data, it was thought that it would be appropriate to use molecular methods in the diagnosis and support them with CS, especially in patients with high risk of candidemia. Considering that blood culture, which is the gold standard for the diagnosis of candidemia, gives late results and is 50% positive, using faster diagnostic methods for candidemia is important to reduce mortality and morbidity. The fast and good results of Candida PCR method have shown that it can be used in diagnosis. However, lack of standardization of primers used in PCR tests may cause false positives. Additional studies are needed in this respect.

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 CoronaVac, an inactivated whole-virion SARS-CoV-2 vaccine, has been shown to be well tolerated with a good safety profile in individuals aged 18 years and older in phase 1/2 trials, and provided a good humoral response against SARS-CoV-2. We present the interim efficacy and safety results of a phase 3 clinical trial of CoronaVac in Turkey. Methods This was a double-blind, randomised, placebo-controlled phase 3 trial. Volunteers aged 18-59 years with no history of COVID-19 and with negative PCR and antibody test results for SARS-CoV-2 were enrolled at 24 centres in Turkey. Exclusion criteria included (but were not limited to) immunosuppressive therapy (including steroids) within the past 6 months, bleeding disorders, asplenia, and receipt of any blood products or immunoglobulins within the past 3 months. The K1 cohort consisted of health-care workers (randomised in a 1:1 ratio), and individuals other than health-care workers were also recruited into the K2 cohort (randomised in a 2:1 ratio) using an interactive web response system. The study vaccine was 3 mu g inactivated SARS-CoV-2 virion adsorbed to aluminium hydroxide in a 0.5 mL aqueous suspension. Participants received either vaccine or placebo (consisting of all vaccine components except inactivated virus) intramuscularly on days 0 and 14. The primary efficacy outcome was the prevention of PCR-confirmed symptomatic COVID-19 at least 14 days after the second dose in the per protocol population. Safety analyses were done in the intention-to-treat population. This study is registered with ClinicalTrials.gov (NCT04582344) and is active but no longer recruiting. Findings Among 11 303 volunteers screened between Sept 14, 2020, and Jan 5, 2021, 10 218 were randomly allocated. After exclusion of four participants from the vaccine group because of protocol deviations, the intention-to-treat group consisted of 10 214 participants (6646 [65.1%] in the vaccine group and 3568 [34.9%] in the placebo group) and the per protocol group consisted of 10 029 participants (6559 [65.4%] and 3470 [34.6%]) who received two doses of vaccine or placebo. During a median follow-up period of 43 days (IQR 36-48), nine cases of PCR-confirmed symptomatic COVID-19 were reported in the vaccine group (31.7 cases [14.6-59.3] per 1000 person-years) and 32 cases were reported in the placebo group (192.3 cases [135.7-261.1] per 1000 person-years) 14 days or more after the second dose, yielding a vaccine efficacy of 83.5% (95% CI 65.4-92.1; p, TUSEB, We are grateful to all participants who volunteered to be part of this study and to all members of the clinical research teams of the participating sites. We thank TUSEB for funding the study and Omega-CRO for the statistical analyses and production of figures, and providing the study protocol. We also thank the members of the data and safety monitoring board for their contributions in the safe execution of this study.

Amaç: Koronavirüs Hastalığı 2019 (COVID-19) tanı ve tedavi sürecinde Bilgisayarlı Tomografi (BT) bulguları, klinik ve laboratuvar verileri çok önemlidir. Bu çalışmada, bu bulgular arasındaki ilişki araştırılmıştır.Materyal ve metod: SARS-CoV-2 için Revers-Transkriptaz Polimeraz Zincir Reaksiyonu (RT-PCR) testi pozitif çıkan 93 hasta çalışmaya dahil edildi. BT bulguları, laboratuvar testleri ve Dünya Sağlık Örgütü Klinik İlerleme Ölçeği (DSÖ-KİÖ)değerlendirildi.Bulgular: Hastaların 52’si erkek, 41’I kadındı. Ortalama yaş 46 idi. En sık görülen laboratuvar bulgusu yüksek CRP düzeyleridir (%67,74). Buzlu cam, konsolidasyon, halo işareti ve hava bronkogramı en sık BT bulgularıydı. BT skorunun ortalaması 4.91 idi. BT skoru ile yaş, D-dimer, CRP, ferritin ve fibrinojen arasında istatistiksel olarak anlamlı pozitif korelasyon bulundu. BT skoru ile lenfosit sayısı ve oksijen satürasyonu arasında anlamlı negatif korelasyon mevcuttu. BT skoru ile prokalsitonin, cinsiyet ve komorbid hastalık varlığı arasında korelasyon yoktu. BT skoru ile IL-6 bloker kullanımı ve kortikosteroid tedavisi arasında orta derecede negatif korelasyon, BT skoru ile favipravir kullanımı arasında hafif negatif korelasyon vardı. BT skoru ile immünosupresan kullanımı arasındaki korelasyon anlamlı değildi. Ayrıca DSÖ-KİÖ ve BT skorları arasında orta düzeyde pozitif korelasyon bulduk.Sonuç: BT skoru bazı laboratuvar ve klinik belirteçlerle korelasyon göstermekte olup bu bulguların BT’nin tanıda olduğu kadar takipte de oldukça yararlı bir tetkik olduğuna işaret ettiğini düşünmekteyiz., Aim: Computed Tomography (CT) findings, clinical and laboratory data are very important in the diagnosis and treatment process of Coronavirus Disease 2019 (COVID-19). In this study, the relationship between these findings was investigated.Material and method: 93 patients with positive Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) test for SARS-CoV-2 were included in the study. CT findings, laboratory tests, and the World Health Organization Clinical Progress Scale (WHO-CPS) were evaluated.Results: Of the patients, 52 were male and 41 were female. The mean age was 46. The most common laboratory finding is high CRP levels (67.74%). GGO, consolidation, halo sign and air bronchogram were most frequent CT findings. The mean of CT score was 4.91. A statistically significant positive correlation was found between CT score and age, D-dimer, CRP, ferritin and fibrinogen. There was a significant negative correlation between CT score, lymphocyte count and oxygen saturation. There was no correlation between CT score and procalcitonin, gender and presence of comorbid disease. There was a moderate negative correlation between CT score and IL-6 blocker use and corticosteroid therapy, and a mild negative correlation between CT score and favipravir use. The correlation between CT score and immunosuppressant use was not significant. We also found a moderate positive correlation between WHO-CPS and CT scores.Conclusion: The CT score is correlated with some laboratory and clinical markers, and we think that these findings indicate that CT is a very useful test in the diagnosis as well as in the follow-up.

Objectives: Candida species are one of the most important causes of morbidity and mortality in the neonatal population. The probiotic use is not well documented in candida infections in neonates. The aim of this study was to evaluate candida infections in neonatal intensive care unit.Methods: A retrospective single-center, matched, case-control study was designed to identify individual risk factors for Candida infection in the NICU. Patients enrolled in the analysis were all neonates who were in the NICU during the study period for at least 72 h. For each case, 2 control cases with negative blood culture were matched on 3 factors: gestational age, birth weight, hospitalization time (within 1week compared to case patients).Results: 7696 newborns were admitted to and hospitalized >72 h in the NICU for eleven years and 51 cases (0.66 %) were followed with candida infection. Probiotic usage was higher in control group. Surgical interventions, central venous lines and parenteral nutrition duration, multiple antibiotic usages were found to be risk factors for candida infections. Conclusion: In NICU we should effectively focus on increasing using of probiotics, besides decreasing the overall use of multiple antibiotics, improving catheter care to reduce the incidence of candida infections. Probiotics might have protective effect against candida infections., Amaç: Candida türleri, yenidoğan popülasyonunda en önemli morbidite ve mortalite nedenlerinden biridir. Yenidoğanlarda kandida enfeksiyonlarında probiyotik kullanımı tartışmalıdır. Bu çalışmanın amacı yenidoğan yoğun bakım ünitesinde kandida enfeksiyonlarını değerlendirmektir.Metod: YYBÜ'de Candida enfeksiyonu için risk faktörlerini belirlemek için retrospektif tek merkezli, karşılaştırmalı bir vaka kontrol çalışması tasarlanmıştır. Çalışmaya alınan hastaların tümü, çalışma süresi boyunca en az 72 saat YYBÜ'de bulunan yenidoğanlardı. Her vaka için negatif kan kültürü olan 2 kontrol vakası 3 faktör açısından eşleştirildi: gebelik yaşı, doğum ağırlığı, hastanede kalış süresi (1 hafta içinde).Sonuç: 7696 yenidoğan on bir yıl boyunca YYBÜ'de 72 saatten fazla yatırıldı ve 51 vaka (% 0,66) kandida enfeksiyonu ile takip edildi. Kontrol grubunda probiyotik kullanımı daha yüksekti. Cerrahi müdahaleler, santral venöz hatlar ve parenteral beslenme süresi, çoklu antibiyotik kullanımları kandida enfeksiyonları için risk faktörleri olarak bulundu.Sonuç: YYBÜ'de kandida enfeksiyonlarının insidansını azaltmak için çoklu antibiyotiklerin genel kullanımını azaltmanın yanı sıra probiyotik kullanımını artırmaya, kateter bakımını iyileştirmeye etkin bir şekilde odaklanmalıyız. Probiyotiklerin Candida enfeksiyonlarına karşı koruyucu etkisi olabilir.

BackgroundFor a sustained and essential protective antibody response, it is important to understand how long the humoral immune response induced by the SARS-CoV-2 inactivated vaccine persists.AimsThis study aimed to detect the first and third-month concentrations and seroconversion rates of the antibodies induced by the inactivated vaccine.Study DesignThis is a vaccine efficacy study.MethodsThe study included 272 health workers who were vaccinated at days 0 and 28 by the inactivated SARS-CoV-2 vaccine (3μg/0.5ml). Anti-S-RBD-IgG and total anti-spike/anti- nucleocapsid-IgG antibody concentrations and seroconversion rates were examined in vaccinated health workers at the 1st and 3rd months after the vaccination. The test method used for the qualitative detection and differentiation of IgG antibodies (indirect method) to SARS-CoV-2 is a chemiluminescence reaction (CLIA).ResultsThe mean age of the health workers was 38.93±10.59 (min:21-max:64). A total of 45(16.5%) participants declared to have had COVID-19 before the first dose of the inactivated vaccine. The participants were found to be reactive for anti-S-RBD-IgG antibodies by 98.2% and 97.8% at the first and third months, respectively, after the administration of the second dose. The decrease in the mean plasma concentrations of anti-S-RBD IgG was observed as 56.7% in the cohort with only two doses of the vaccine (1st month:42.4AU/ml versus 3rd month: 18.2AU/ml). In the cohort with a history of COVID-19 prior to the vaccination, the decrease was observed as 25.1% (1st month:58.29 versus 3rd month:43.64 AU/ml) and at a mean of 57.4 (0-90) days prior to vaccination, the decrease was of 43.1% (1st month:55.05 AU/ml versus 3rd month:31.28 AU/ml), keeping more stable in participants infected at a mean of 183.1 (91-330) days prior to vaccination (a decrease of 5.2%; with 62.34 AU/ml at 1st and 59.08 AU/ml at 3rd months). Anti-S-RBD concentrations were observed to increase 10-fold (30.44 AU/ml at 1st and 310.64 AU/ml at 3rd months) in participants infected after the vaccination and to decrease among people aged 50 years and older.ConclusionAntibody concentrations at the 1st and 3rd months after the vaccination with two doses of the inactivated SARS-CoV-2 vaccine were found to be decreased, but still detectable (except in one participant). As participants who had COVID-19 at a mean of 181 (90-330) days before the vaccination presented with a more stable antibody level, it can be concluded that a booster at months 6-12, resulting in a schedule of 0-1-6 months, is recommended for the inactive SARS-CoV-2 vaccination.

Aims: Limited information is available about the efficacy and adverse events of COVID-19 vaccines introduced into public use with Emergency Usage Licences without completing phase-3 trials. Data refer to healthy and mostly younger people, with lacking evidence about the protectivity. This study aimed determining seroconversion rates and levels specific to anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 after the administration of two doses of the inactivated SARS-CoV-2 vaccine in Turkey, comparing three types of antibodies. It was also aimed to assess short-term adverse events due to the vaccine. It is intended to answer the questions about efficacy and safety, which lack in phase trials, especially at community level. It is also aimed to collect data, which will form the basis for assessing whether antibodies are protective at different community settings. Methods: The study carried out in Turkey, comprised 282 healthcare workers who received two doses of the inactivated SARS-CoV-2 vaccine administered in two 3µg doses, 28 days apart. In day-28 after the second dose, anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 were detected by in-vitro chemiluminescence immunoassay. Results: At day 28 after the second dose, the seroconversion rates were found to be 92.9% for total anti-spike/anti-nucleocapsid IgG and 15.2% for IgM and 98.2% for anti-S-RBD IgG antibodies. The immunogenicity was affected by pre-vaccination natural COVID-19 history and age. The incidence of at least one adverse event was found as 29.8% after the first dose and 24.1% after the second dose, with the most common events being pain at the injection site, weakness, fatigue and headache. Conclusion: A high rate of seroconversion was observed with no serious adverse events. Prior natural COVID-19 history and age significantly contributed to strong immunogenicity. A booster dose appears required for older ages and individuals without immune response.

COVID-19 has become a major public health problem since December, 2019 and no highly effective drug has been found until now. Numbers of infected people and deaths by COVID-19 are increasing every day worldwide, therefore self-isolation and protection are highly recommended to prevent the spread of the virus and especially to protect major risk groups such as the elderly population and people with comorbidities including diabetes, hypertension, cancer, cardiovascular diseases and metabolic syndrome. On the other hand, young people without any secondary disease have died by COVID-19 as well. In this study we compared two male patients infected by COVID-19 at the same age and one of them was diagnosed with G6PD deficiency. Both COVID-19 and G6PD deficiency enhance the risk of hemolysis and thrombosis. Serum biochemistry, hemogram and immunological parameters showed that risk of hemolysis and thrombosis may increase in the G6PD deficient patient infected by COVID-19.

Giriş: Plevral ampiyem (PA), plevra yaprakları arasında infekte mayi bulunmasıdır. Ampiyema nesessitatis (AN) ise PA’nın pariyetal plevra ve endotorasik fasiayı geçerek çevre yumuşak dokular içinde yayılması ve cilt altı yayılımı ile bazen cilde fistülize olmasıyla karakterize, nadir bir komplikasyonudur. Ayırıcı tanıda karmaşıklığa neden olur. Bu çalışmada, AN risk faktörlerinin tespit edilmesi, tanı ve tedavisinde tecrübelerimizin paylaşımı amaçlanmıştır. Materyal ve Metod: Yatarak takip ve tedavi edilen 766 PA hastası retrospektif olarak değerlendirildi. Hastaların demografik özellikleri (yaş, cinsiyet), yandaş hastalık, PA lokasyonu, lokülasyon varlığı, uygulanan medikal ve cerrahi tedaviler, ampiyemin nüksü, postoperatif veya posttravmatik olma durumu, kültür sonuçları, AN varlığı, morbidite ve mortalite oranları not edildi. İstatistiksel analiz için SPSS v20.0 programı kullanıldı. Bulgular: Ampiyema nesessitatis 11 (%1.4) hastada görüldü. İleri yaş ve Mycobacterium tuberculosis PA, AN gelişmesi için risk faktörleri olarak saptandı. Ampiyema nesessitatis grubunda etken mikroorganizmalar anlamlı olarak daha fazla tespit edildi ve majör cerrahi operasyon daha geç yapıldı. Bununla beraber cinsiyet, mevcut sağlık sorunları, PA tarafı, lokülasyon varlığı, göğüs tüpü uygulanması, M. tuberculosis dışı etken mikroorganizma, ampiyemin etyolojik sebebi ve majör cerrahi uygulanmış olması risk faktörü olarak saptanmadı. Sonuç: Ampiyema nesessitatis PA’nın nadir bir komplikasyonudur ve en önemli nokta gelişmesinin önlenmesidir. İleri yaşlarda daha sık görülür ve M. tuberculosis en sık etkendir. Medikal ve cerrahi tedavi prensipleri PA ile aynıdır. Hastalığın göğüs duvarı yumuşak doku infeksiyonu veya apsesi olarak tanı alması tedavide gecikmeye neden olur.

Background/aim Various COVID-19 vaccines are being developed around the world. Important questions to be answered regarding vaccines are efficacy, safety, and whether antibodies are protective when used in different communities. This study aimed to determine seroconversion rates of the inactivated SARS-CoV-2 vaccine in healthcare workers in a hospital and short-term adverse events due to the vaccine. Materials and methods The study carried out in Cukurova University, Turkey, comprised 282 healthcare workers who received two doses of the inactivated SARS-CoV-2 vaccine administered in two 3 µg doses, 28 days apart. On day 28 after the second dose, anti-S-RBD IgG and total anti-spike and anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 were detected by using in vitro chemiluminescence immunoassay method. Results The mean age of participants was 39.06±10.65 (min 21; max 65) with 43.6% males and 56.4% females. On day 28 after the second dose, the seroconversion rates were found to be 92.9% for total anti-spike and anti-nucleocapsid IgG and 15.2% for IgM and 98.2% for anti-S-RBD IgG antibodies and having natural COVID-19 prior to vaccination, age and comorbidity were found to be significant factors for immunogenicity. The incidence of at least one adverse event was found as 29.8% after the first dose and 24.1% after the second dose, with the most common events being pain at the injection site, weakness, fatigue and headache. Conclusion On day 28 after the second dose of 3 ?g of the inactivated SARS-CoV-2 vaccine administration, a high rate of seroconversion was observed with no serious adverse event. Prior natural COVID-19 history, age and comorbidity were significant contributors to the formation of a strong immune response. It can be concluded that a third dose may be considered in people aged 50 years and older and those with comorbidities.