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Objective: Extrapulmonary tuberculosis (EPTB) can be easily missed due to challenges in diagnosis or overlooked in the differential diagnosis. Therefore, EPTB should be considered in endemic regions, especially in the differential diagnosis of fever of unknown origin. Methods: Adult patients diagnosed and treated for EPTB at Ondokuz Mayıs University School of Medicine Hospital between 2005 and 2018 were analyzed retrospectively. Results: One hundred and nineteen patients with a mean age of 48.4±17.8 years, including 75 (63%) females and 44 (37%) males, were included in the study. The mean age of female patients was 51.8±16.7, and the mean age of male patients was 42.6±18.4. Female patients were significantly older than male patients (p<0.05). Urban and rural residency rates were 45.4 and 40%, respectively. EPTB involved lymph nodes in 60 (50.4%), the central nervous system in 15 (12.6%), the vertebral column in 14 (11.8%), bone in 7 (5.9%), the urogenital system in 7 (5.9%), peritoneum in 6 (5%), the gastrointestinal system in 6 (5%), pleura in 3 (2.5%) and eye in 1 (0.8%) patient. Acid-fast bacilli were seen in 4 (8.1%) of 49 samples; Mycobacterium tuberculosis grew in cultures of 29 (48.3%) of 60 samples; and the polymerase chain reaction was positive for tuberculosis in 24 (52%) of 46 samples. In the histopathologic examination, caseous granulomatous inflammation was the most reported finding (41.2%). The most common adverse event related to antituberculosis drugs was hepatotoxicity. Conclusion: EPTB can involve various organ systems and should be included in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) continues to be a serious worldwide public health problem despite widespread efforts to control the disease. Today, with the introduction of high-active antiretroviral therapy, AIDS-related mortality rates are significantly reduced and life expectancy for HIV-infected patients has increased. In this study, it was aimed to evaluate AIDS-defining illnesses during the clinical course of HIV infection and the effects of immune status on clinical outcomes. Methods: The medical records of HIV infected patients who were followed up between January 2005 and November 2018 were retrospectively investigated. Results: During the study period, 336 HIV-infected patients were followed up. Among 336 patients, 45 (13.3%) had experienced one or more, a total of 59 episodes of AIDS-defining illnesses during follow-ups. Of 45 patients who had experienced AIDS-defining illnesses, 42 (93,3%) were male, the mean age was 41.1±9.7 years and 12 of them were found to have died when this study conducted. The median count of CD4 T lymphocytes and the mean age at the time of diagnosis of 33 alive and 12 died patients were 106 cells/mm3, 40.1±9.9 years, and 94 cells/mm3, 43.9±8.5 years, respectively. There was no statistically significant difference between the median count of CD4 T lymphocytes and the mean age of alive and died patients. The most common AIDS-defining illness was Pneumocystis jirovecii pneumonia with 28.8%. The most common diagnosed cause of mortality was AIDS-related carcinomas with 33%. Discussion and Conclusion: These findings reveal that the most important preventive measure for survival in HIV-infected patients is the early diagnosis of the disease and the initiation of antiretroviral therapy before the emergence of AIDS-defining illnesses due to severe immune deficiency. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of olfactory dysfunction on the course and severity of COVID-19 and its prognostic and predictive significance for COVID-19. Study Design: Prospective case-control study. Setting: Ondokuz Mayıs University School of Medicine. Methods: Reverse transcription polymerase chain reaction (PCR)–positive patients, patients with COVID-19–related symptoms who had a negative PCR result, and healthy controls were included in the study. Clinicodemographic characteristics, inflammatory markers, and computed tomography stages were recorded. Disease progression and intensive care unit admission were registered. The visual analog scale (0, worst; 10, best) was used to evaluate subjective olfactory, taste, and nasal breathing ability, and the Sniffin' Sticks identification (SS-ID) test was used for psychophysical olfactory assessment. Results: Mean SS-ID scores were significantly lower in the positive group (8.77) than in the negative (10.43) and healthy control (12.17) groups. VAS-smell scores were significantly lower and anosmia was more prevalent in PCR-positive patients (P <.01). SS-ID and VAS-smell scores were significantly correlated (r = 0.681, P <.001). The inflammatory parameters, pulmonary infiltration stage, disease progression, and ICU admission were not associated with SS-ID scores. A cutoff SS-ID score <9 resulted in 55.56% sensitivity in predicting COVID-19 positivity, and a cutoff VAS-smell score <8 yielded 72.22% sensitivity. Conclusion: Olfactory dysfunction was detected objectively and subjectively in the PCR-positive group, and no difference was found in terms of taste function and nasal breathing. The severity and prognosis of COVID-19 are not exclusively dependent on olfactory dysfunction. The degree of olfactory dysfunction can be useful in predicting PCR positivity. [ABSTRACT FROM AUTHOR]

Copyright of Klimik Journal / Klimik Dergisi is the property of DOC Design & Informatics Co. Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To investigate the frequency of concurrent drug use and drug interactions in patients with human immunodeficiency virus (HIV) infection. Methods: The medical records of HIV-infected patients followed up at Ondokuz Mayis University Hospital in the last six months were retrospectively reviewed to assess the antiretroviral therapy (ART) regimens used, the prescribed concurrent drugs, and their interactions Results: The records of 268 patients were evaluated; of these, 43 (16 %) were women, and 225 (84 %) were men. The mean age of the patients was 43.8 ± 12.1 years. Concurrent drugs were prescribed to 210 (78.3 %) patients. Drug interactions were detected in 115 (42.9 %) patients. Of the 210 drug interactions detected, 168 (80 %) were potential interactions, 39 (18.6 %) were weak interactions, and 3 (1.4 %) were contraindicated. A statistically significant relationship was not observed in gender, age, and rate of concurrent drug prescription. Increased nephrotoxicity was the most common potential drug interaction. Non-steroidal anti-inflammatory drugs were the most commonly prescribed class of drugs along with ART. Conclusion: Physicians treating HIV-infected patients should be conscious of, and careful about the concurrent use of drugs and their potential drug interactions. [ABSTRACT FROM AUTHOR]

In December 2019, several cases of pneumonia of unknown origin were reported in the city of Wuhan, province of Hubei, China. The pathogen was named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease was named coronavirus disease 2019 (COVID-19). Acute phase reactans (APRs) are critical in the early diagnosis, treatment, and for monitoring the progression of COVID-19. Seventy two patients were included in the study and infections confirmed by real-time reverse transcription polymerase chain reaction. Clinical parameters, the level of APFs and D-dimer were assessed and results were retrived from the patients' medical records. Chest computed tomography (CT) findings were described for each patient and they were divided into two groups, with or without COVID-19 pneumonia. The correlation between APRs and CT findings and the patients' prognosis were evaluated. Twenty eight (38.8%) of the 72 patients were female and 44 (61.2%) were male. The most common symptom was cough (43%) and the most common associated chronic disease was hypertension (12.5%). Thirty (41.6%) patients had completely normal chest CT, while 42 (58.4%) patients had typical findings in terms of COVID-19 pneumonia. C reactive protein (CRP), lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), ferritin, procalcitonin and D-Dimer levels were statistically significantly higher in patients with pneumonia than in those without pneumonia and these parameters were also statistically significantly higher in patients with severe illness. In conclusion, CRP, LDH, ESR, ferritin, and D-Dimer were associated with severe COVID-19 pneumonia. These biomarkers can be used to evaluate the prognosis to predict the clinical course of disease, allowing a proper management and treatment of the patients. [ABSTRACT FROM AUTHOR]

In this article, we present a case of Plasmodium falciparum malaria in a male patient who developed acute kidney injury during antimalarial treatment. A 38-years-old Turkish male patient was admitted to the emergency department with the complaints of fever and chills. The patient stated that he had no chronic illness, his complaints had started four days ago, and he had returned from Guinea 10 days ago. Multiple ring-shaped P. falciparum trophozoites were observed in Giemsa-stained thin blood smears, which were evaluated with a preliminary diagnosis of malaria due to travel history and clinical findings. Artemeter + Lumefantrine supplied by the provincial health directorate on the same night was administered according to the manufacturer's recommended dose posology. On the third day of clinical follow-up, clinical, vital and peripheric smear findings continued to improve, while laboratory tests showed an acute increase in creatinine values, which is a signs of acute kidney injury. The patient's creatinine values returned to normal on the sixth day with appropriate intravenous hydration. Keeping in mind that acute kidney injury can develop not only prior to treatment but also during the treatment period when patients receive antimalarial treatment, therefore, proper hydration and close monitoring of kidney functions during treatment are also important. [ABSTRACT FROM AUTHOR]

Objective: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) continues to be one of the most important health, social and safety issues faced by the global community. In 2014, the United Nations HIV/AIDS joint program (UNAIDS) proposed a new target for global antiretroviral treatment (ART) program. This new target, known as "9090-90", recommends that by 2020, 90% of all people living with HIV will be knowing their HIV serology, 90% of all people with diagnosed HIV infection will be receiving ART and 90% of all people on ART will achieve viral suppression. The aim of our study was to evaluate the HIV/AIDS cohort data of our clinic in the context of "90-90-90" targets. Methods: The medical records of HIV-infected patients followed in the Department of Infectious Diseases and Clinical Microbiology Ondokuz Mayıs University Faculty of Medicine between 2005 and 2018 were reviewed retrospectively. Results: In our clinic, 336 HIV-infected patients were followed during the study period. Of these patients, 284 (84.5%) were male. Of the 317 surviving patients, 240 (75.7%) were examined at the outpatient clinic at least once within the last 6 months and 239 (75.3%) were on ART. According to the latest laboratory results of 239 patients on ART, virological suppression was achieved in 206 (86.1%) patients. In the analysis of 33 patients with a detectable viral load on ART, it was found that 11 patients were on ART for less than 6 months, 8 patients did not use their medication regularly, and one patient did not have a test result. Conclusions: Although it was determined that "90-90-90" targets are achievable within the scope of the patient group that we serve in our hospital, the compilation of nationwide data and screening programs to identify all HIV-infected patients in the community, will be guiding to achieve "90-90-90" targets. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases.Methods: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases.Results: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%.Conclusion: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future. [ABSTRACT FROM AUTHOR]

Objective: As the Coronavirus disease 2019 (COVID-19) pandemic spread globally, more human immunodeficiency virus (HIV) positive patients began to appear infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to evaluate the clinical course of HIV and SARS-CoV-2 co-infected patients from a local perspective., Methods: HIV and SARS-CoV-2 co-infected patients diagnosed between March 2020 to June 2021 at a tertiary hospital in Turkey were analyzed retrospectively., Results: Thirty HIV and SARS-CoV-2 co-infected patients were included. Five patients were female, 25 were male, and the mean age was 44.5 ±10.2 years. Twenty-three (76.7%) patients were known to be HIV-positive before their admission to the hospital, and seven (23.7%) patients, were detected by screening after the diagnosis of COVID-19. All patients were known to be HIV-positive; they were on antiretroviral therapy (ART) and virologically suppressed. Twenty-seven patients had a mild course. Three patients were hospitalized, and of them, two patients had died. All hospitalized patients were male and were ART-naïve., Conclusion: HIV infection alone did not increase the severity of the course of COVID-19 and did not increase the mortality in COVID-19., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Objectives: A new type of coronavirus outbreak has emerged in China and caused a pandemic. World Health Organization (WHO) announced the official name of this disease 'COVID-19'. The main purpose of this study is to evaluate pain in COVID-19 patients., Methods: Patients who were followed in the ward of an infectious diseases department because of possible or confirmed COVID-19 between May and September of 2020 were included in the study. The Turkish version of the Brief Pain Inventory (BPI) was applied. Demographic features, frequency, location, the intensity of pain, and response to analgesics were analyzed., Results: A total of 178 participants were included in the study. Ninety-one (51.1%) of patients had pain complaints and the mean pain score (MPS) was 2.28±2.81 over 10. Fifty-nine (56.0%) of participants with pain required analgesic therapy and 41 (80.3%) of them showed ≥50% pain relief with simple analgesics. Twelve of the remaining 18 who did not get enough pain relief with simple analgesic were taking their analgesics pro re nata (PRN) rather than around the clock (ATC). Pain frequency and intensity and mean hospitalization duration (MHD) were similar between confirmed and possible cases., Conclusion: Regarding the results, we conclude that pain is not one of the challenging symptoms and easily manageable in patients with a mild-moderate intensity of COVID-19. Our results were not enough to make a correlation between pain and the clinical course of the disease. Further studies are required for the evaluation of pain including patients in intensive care units.

Human toxocariasis is a parasitic disease transmitted to humans by ingestion of Toxocara spp. larvae. Rural area residents and children have higher risk for this parasitic infection. The disease is frequently asymptomatic; however, it may cause symptoms such as cough, fever, headache, myalgia or other conditions such as lymphadenopathy and granulomatous hepatitis. Albendazole is used for the treatment of toxocariasis diagnosed by serologic and immunological methods. Herein, we report two cases of toxocariasis that were investigated due to hypereosinophilia and lymphadenopathy for a long time.

Deaths related with human immunodeficiency virus (HIV) infections have been decreased by the introduction of combined anti-retroviral therapy (ART) into the clinical practice. Combined ART usually consists of two nucleoside/nucleotide analogs reverse transcriptase inhibitors (NRTI) that is called backbone and a third drug that belongs to either non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTI), protease inhibitors (PI), integrase strand transfer inhibitors (INSTI) or entry inhibitors. During abacavir therapy which is a member of NRTI, hypersensitivity reactions can occur approximately 4-9% of the patients that lead difficulties for the management of HIV infections. It is known that, the development of hypersensitivity reactions to abacavir is strongly associated with the presence of HLA-B*57:01 allel, therefore, HLA-B*57:01 screening should be performed prior to abacavir use. Since there is no data on HLA-B*57:01 prevalence in HIV-1-infected cases in Turkey, this is the first study that screened HLA-B*57:01 allels among HIV-1 infected adults in Turkey. A total of 100 HIV-1-infected patients (81 male, 19 female; mean age: 42.31±11.97 years) who have admitted to the Department of Infectious Diseases and Clinical Microbiology of Ondokuz Mayıs University School of Medicine, Samsun, Turkey, were included in the study. Genomic DNAs were isolated from the blood samples of patients by using a commercial spin column procedure (QIAamp® DNA Blood Mini Kit; QIAGEN GmbH, Germany). HLA-B*57:01 genotyping was performed by the method of sequence-specific primer (SSP)-based amplification using a commercial OlerupSSP® HLA-B*57:01 high-resolution test kit (Olerup SSP AB, Sweden) according to the manufacturer's protocol. The products of polymerase chain reaction were electrophoresed on a 2% agarose gel stained with Olerup SSP GelRed dye (Olerup SSP AB, Sweden), and the bands were evaluated under UV light. In our study, three (2 male, 1 female) out of 100 patients were found positive for HLA-B*57:01 gene with a prevalence of 3%, which is a moderate level. Although the medical usefulness of HLA-B*57:01 screening before the abacavir therapy is emphasized, it was also noted that this application is not cost-effective for the populations with low HLA-B*57:01 prevalence, in contrast to populations with high prevalence. Considering of the incidence of HIV/AIDS in Turkey which is 0.12, the value and cost-effectiveness of HLA-B*57:01 screening in HIV-1 positive cases before abacavir therapy should be analysed by further studies.