Search

What is this summary about? This is a summary of an article about part of a clinical study for the BNT162b2 COVID-19 vaccine, also called the Pfizer-BioNTech vaccine. The article was published in the New England Journal of Medicine in September 2021. The part of the study described in the article began in July 2020 and is ongoing. This means that the final results may be different from the results included in this summary. What happened in this study? The participants in this study received 2 injections of either the BNT162b2 vaccine or a placebo, 21 days apart. The placebo looked like the BNT162b2 vaccine but had no active vaccine in it. None of the trial participants or study teams knew who received vaccine or placebo. What were the results? Most of the reactions to the injections were mild or moderate and lasted for a short period of time. The most common reactions were pain at the injection site, extreme tiredness (fatigue), and headache. These reactions usually happened in the first 7 days after receiving a vaccine dose. A small number of participants had severe reactions to the vaccine. Compared to participants who received the placebo, participants who received the BNT162b2 vaccine were much less likely to become ill if they were infected with the virus that causes COVID-19. The vaccine also had very good efficacy at preventing severe COVID-19. Participants in South Africa who received the BNT162b2 vaccine were less likely to become ill after infection with the beta variant of the virus compared to participants who received the placebo. The beta variant was very common in South Africa when the study was taking place. Clinical Trial Registration: NCT04368728 ( ClinicalTrials.gov )

An outbreak investigation was initiated after detecting an increase in the number of patients with Stenotrophomonas maltophilia bloodstream infections (SM-BSIs) througout the hospital. S. maltophilia was isolated from the cultures of blood-gas ınjectors containing liquid heparin. The incidence density of SM-BSIs decreased significantly after prohibiting the use of those injectors.

Amaç: Bu çalışmada yoğun bakımda yatan COVID-19 tanılı gebe ve lohusalarda mortalite prediksiyon modeli oluşturarak APACHE II, SAPS II ve SOFA skorları ile karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Hastanemizin COVID-19 yoğun bakım ünitelerine yatan Covid-19 tanısı doğrulanmış gebe ve lohusaların demografik, laboratuvar, radyolojik ve klinik verileri geriye dönük olarak kaydedildi. Bulgular: Çalışmaya dahil edilen 50 hastadan 13’ü kaybedildi. Yaş ortalaması ölen grupta 35.54±4.24 yıl, yaşayan grupta 30.03±4.91 yıl idi (p=0.002). Lojistik regresyon modeli, yaş, lenfopeni, yüksek CRP ve IL-6 düzeylerinin mortalite ile ilişkili olduğunu ortaya koydu. Modelin mortalite (AUC) için prediktif gücü 0.946±0.045 (p

Contains fulltext : 293869.pdf (Publisher’s version ) (Open Access) Antimicrobial resistance (AMR) has been exacerbated by the inappropriate use of diagnostics, leading to excessive prescription of antimicrobials, and is an imminent threat to global health. Diagnostic stewardship (DS) is an auxiliary to antimicrobial stewardship (AMS) and comprises ordering the right tests, for the right patient, at the right time. It also promotes the judicious use of rapid and novel molecular diagnostic tools to enable the initiation of proper antibiotic therapy, while avoiding excessive use of broad-spectrum antibiotics. Proper interpretation of test results is crucial to avoid overdiagnosis and excessive healthcare costs. Although many rapid diagnostic tools have been developed with a high diagnostic yield, they are often limited by accessibility, cost, and lack of knowledge regarding their use. Careful consideration of clinical signs and symptoms with knowledge of the local epidemiology are essential for DS. This enables appropriate interpretation of microbiological results. Multidisciplinary teams that include well trained professionals should cooperate to promote DS. Challenges and barriers to the implementation of DS are mostly caused by scarcity of resources and lack of trained personnel and, most importantly, lack of knowledge. The lack of resources is often due to absence of awareness of the impact that good medical microbiology diagnostic facilities and expertise can have on the proper use of antibiotics. 01 juli 2023

Due to the COVID-19 infection, which was recognized as a global pandemic by the WHO on March 11, 2020, the number of cases and disease-related deaths increases day by day globally. For this reason, antiviral agents used in treatment and vaccines, the most effective weapon in prevention, continue to be the most popular topic of the plan. Several situations are expected to affect the course of the pandemic. The loss of the ability of the virus to mutate and cause disease, the fact that those who become immunized by having the disease in the society reach a critical rate and create social immunity (herd immunity), and the provision of social immunity with effective vaccination can be counted as some of these situations. Candidate vaccines in the clinical phase among RNA-based vaccines: This review aimed to examine COVID-19 vaccine candidates using RNA technology and compile its current data. We used PubMed, Google Scholar, and World Health Organization (WHO) databases. Also, we followed up on the latest news and developments on vaccine companies’ websites. Conclusion: Vaccination trials, which started due to the seriousness and urgency of the situation that we are in, continue exceptionally quickly and effectively. As per the WHO›s data on July 9, 2021, there have been 291 vaccine trials, 107 of which are in the clinical phase, and 18 (16%) of the vaccine candidates in the clinical phase are RNA-based vaccines. Also, the number of RNA-based vaccines with ongoing preclinical trials is 2

Background BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine encoding a prefusion-stabilized, membrane-anchored severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) full-length spike protein. BNT162b2 is highly efficacious against coronavirus disease 2019 (Covid-19) and is currently approved, conditionally approved, or authorized for emergency use worldwide. At the time of initial authorization, data beyond 2 months after vaccination were unavailable. Methods In an ongoing, placebo-controlled, observer-blinded, multinational, pivotal efficacy trial, we randomly assigned 44,165 participants 16 years of age or older and 2264 participants 12 to 15 years of age to receive two 30-μg doses, at 21 days apart, of BNT162b2 or placebo. The trial end points were vaccine efficacy against laboratory-confirmed Covid-19 and safety, which were both evaluated through 6 months after vaccination. Results BNT162b2 continued to be safe and have an acceptable adverse-event profile. Few participants had adverse events leading to withdrawal from the trial. Vaccine efficacy against Covid-19 was 91.3% (95% confidence interval [CI], 89.0 to 93.2) through 6 months of follow-up among the participants without evidence of previous SARS-CoV-2 infection who could be evaluated. There was a gradual decline in vaccine efficacy. Vaccine efficacy of 86 to 100% was seen across countries and in populations with diverse ages, sexes, race or ethnic groups, and risk factors for Covid-19 among participants without evidence of previous infection with SARS-CoV-2. Vaccine efficacy against severe disease was 96.7% (95% CI, 80.3 to 99.9). In South Africa, where the SARS-CoV-2 variant of concern B.1.351 (or beta) was predominant, a vaccine efficacy of 100% (95% CI, 53.5 to 100) was observed. Conclusions Through 6 months of follow-up and despite a gradual decline in vaccine efficacy, BNT162b2 had a favorable safety profile and was highly efficacious in preventing Covid-19. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.)

SARS-CoV-2 genetic variants from alpha (first detected in the UK) to delta (discovered in India this spring) to lambda (currently Argentina, Brazil, Chile, Colombia, Ecuador, and Peru) have been emerging and circulating the world. Also, these variants have raised concerns about the continued effectiveness of COVID-19 vaccines. In this review, influential variants cause countries to review their vaccine strategies, create new vaccine programs, and accelerate existing vaccine studies. The effectiveness of currently available COVID-19 vaccines on variants is discussed. It is also intended to shed light on what should be known about the necessity of third doses.

The aim of this study was to determine the in-vitro activity of fosfomycin against Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) isolates and the frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant (CR) groups. A total of 346 isolates (126 E. coli and 220 K. pneumoniae) from nosocomial bloodstream infections were included. Carbapenem and fosfomycin susceptibility were tested by Etest (bioMerieux, France) and agar dilution methods, respectively and evaluated in accordance with EUCAST criteria. The presence of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases were conducted by using PCR method. Of the total 346 isolates, 185 (41 E. coli, 144 K. pneumoniae) were CR. Fosfomycin susceptibility of E. coli was higher than 95% and was not statistically significant between the CR and carbapenem-susceptible (CS) groups. Fosfomycin susceptibility of CS and CR K. pneumoniae was 90.7% and 69.4%, respectively, and statistically significantly lower in CR group. Of the total 185 CR isolates, 163 (32 E. coli, 131 K. pneumoniae) were producing carbapenemases. OXA-48 was the prominent carbapenemase type produced by E. coli (96.8%) and K. pneumoniae (70.9%). The frequency of NDM and KPC types produced by K. pneumoniae was 20.6% and 15.2%, respectively. Fosfomycin has substantial in-vitro activity against nosocomial CS and CR E. coli and CS K. pneumoniae bloodstream isolates. However, due to the risk of emerging resistance with fosfomycin monotherapy, combination therapy should be considered to obtain the possible additive or synergistic activity. Emerging fosfomycin resistance of CR K. pneumoniae isolates is alarming and OXA-48 is still the prominent carbapenemase type in Turkey.

Sepsis is defined as organ dysfunction due to an irregular host response to infection caused by bacteria, viruses, parasites or fungal microorganisms and may cause morbidity or mortality. The benefit of statins in atherosclerosis and various cardiovascular diseases is explained by their positive effect on the endothelium by lowering high cholesterol levels. Statins have pleiotropic effects such as anti-inflammatory, antithrombotic and antioxidant effects in addition to their lipid lowering effects. It has been shown that pretreatment with statins may affect survival in sepsis. In sepsis and septic shock, cytokine release from endothelial cells, procoagulant molecules and thrombocyte production are encouraged. In addition, with the development of inflammation in sepsis, vascular permeability increases in the infected tissue due to the increase of neutrophils and phagocytes and tissue damage occurs. Thus, homeostasis regulating vascular tone is disturbed and endothelial damage is formed. Statins act on sepsis by providing vascular relaxation in the endothelium and reducing the expression of adhesion molecules and cytokines. In the light of current knowledge, more comprehensive studies are needed to recommend the use of statins to benefit from its pleiotropic effects in the treatment of sepsis.

SARS-CoV-2 genetic variants from alpha (first detected in the UK) to delta (discovered in India this spring) to lambda (currently Argentina, Brazil, Chile, Colombia, Ecuador, and Peru) have been emerging and circulating the world. Also, these variants have raised concerns about the continued effectiveness of COVID-19 vaccines. In this review, influential variants cause countries to review their vaccine strategies, create new vaccine programs, and accelerate existing vaccine studies. The effectiveness of currently available COVID-19 vaccines on variants is discussed. It is also intended to shed light on what should be known about the necessity of third doses.

The number of cases and disease-dependent deaths continue to increase worldwide due to the COVID-19 infection accepted as a global pandemic by the World Health Organization on March 11, 2020. Therefore, the antivirals used in treatment and vaccines that are the most effective weapons for protection remain the most popular topic on the agenda. There are a few conditions that might have an impact on the course of the pandemic, including the mutation of the virus and losing its ability to cause disease, generating herd immunity by reaching a critical rate of immunized people in the community due to the disease, and ensuring herd immunity through effective vaccination. Vaccine trials, which have started owing to the severity and urgency of the situation we are in, continue highly rapidly and effectively. According to the March 2, 2021 data of WHO, there are 258 vaccine trials, 76 of which are at the clinical phase, and 9 of the vaccine trials that are at the clinical phase are RNA-based vaccines. In our study, it was aimed to investigate RNA-based COVID-19 vaccine candidates and review their current data.

The number of cases and disease-dependent deaths continue to increase worldwide due to the COVID-19 infection accepted as a global pandemic by the World Health Organization on March 11, 2020. Therefore, the antivirals used in treatment and vaccines that are the most effective weapons for protection remain the most popular topic on the agenda. There are a few conditions that might have an impact on the course of the pandemic, including the mutation of the virus and losing its ability to cause disease, generating herd immunity by reaching a critical rate of immunized people in the community due to the disease, and ensuring herd immunity through effective vaccination. Vaccine trials, which have started owing to the severity and urgency of the situation we are in, continue highly rapidly and effectively. According to the March 2, 2021 data of WHO, there are 258 vaccine trials, 76 of which are at the clinical phase, and 9 of the vaccine trials that are at the clinical phase are RNA-based vaccines. In our study, it was aimed to investigate RNA-based COVID-19 vaccine candidates and review their current data.

Background Despite the COVID-19 pandemic has been going on over 5 months, there is yet to be a standart management policy for all patients including to those mild-to-moderate cases. We evaluated the role of a combined effort of early hospitalization in combination with early antiviral therapy with COVID-19 patients in a tertiary care university hospital. Materials and Methods This was a prospective, observational, single center study on probable/confirmed COVID-19 patients hospitalized in a tertiary care hospital COVID-19 wards between March 20- April 30, 2020. Critically-ill patients requiring intensive care unit (ICU) at the time of admission were excluded. The demographic, laboratory, and clinical data were collected. Results We included 174 consecutive probable/confirmed COVID-19 adult patients hospitalized in the Internal Medicine wards of the University Adult Hospital between March 20 and April 30, 2020. The median age was 45.5 (19-92) years and 91 patients (52.3% ) were male. 120 (69%) were confirmed microbiologically, 41 (23.5%) radiologically diagnosed and, 13 (7.5%) were clinically suspected (negative microbiological and radiological findings compatible with COVID-19). According to WHO definitions, 35 (20.1%) had mild, 107 (61.5%) moderate disease, and 32 (18.4%) had severe pneumonia. Of 130/171 ( 74.3%) showed pneumonia; 80 were typical, 50 indeterminate infiltration for COVID-19. Patients admitted within a median of 3 days (0-14 days) after symptoms appear. The median duration of hospitalization was 4 days (0 - 28 days). In this case series, 13.2% patients were treated with hydroxychloroquine alone, 64.9% with hydroxychloroquine plus azithromycin, and 18.4% with regimens including favipiravir. A total of 15 patients (8.5%) were transferred to the ICU. Four patients died (2.2%). Conclusion In our series, early of 174 patients admitted to the hospital wards for COVID-19, 69% confirmed with PCR and/or antibody test. On the admission nearly one fifth of the patients had severe diseases. 95.4% of the patients received HQ alone or in combination. The overall case fatality rate was 2.2%.

To the editor, Favipiravir (FVP) was developed against the influenza virus infection and licensed for the treatment of influenza in Japan [1]. In addition to influenza viruses, FVP demonstrates a broad-spectrum activity against many RNA viruses including Ebola, Lassa, rabies, and severe fever with thrombocytopenia [2]. FVP exhibited a comparable in vitro efficacy against SARS-CoV-2 with remdesivir in a cell culture model [3].The authors would like to acknowledge the contributions of numerous physicians, nurses, and healthcare personnel of Hacettepe University's COVID-19 response team for their selfless efforts in follow-up and care of the patients. Authors declare that there is no conflict of interest.

Despite the advances in antiretroviral treatment (ART), persistent inflammation remained a challenge. We analyzed the inflammatory-score changes through 2-years in people living with HIV (PLWH) treated with different antiretroviral regimes. This study was conducted in Hacettepe University HIV/AIDS Treatment and Research Center. PLWH diagnosed between 2014 and 2020 were included. Inflammatory and metabolic markers (CD4/CD8 ratio, C-reactive protein (CRP), Systemic Inflammatory Index (SII), Neutrophil-Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV), Platecrite (PCT), and Low-Density Lipoprotein/High-Density Lipoprotein (LDL/HDL), Platelet-to-Lymphocyte Ratio (PLR) and ARTs were captured from database through 2-years from the diagnosis. The 2-year change (Δ) in markers was calculated and compared by ART type (backbone and 3rd agent). Mann-Whitney-U test and T-test were used for statistical analysis. This study included 205 PLWH; 175 (85.4%) were male, and the mean age was 38.98 (±10.88) years. The number of PLWH with suppressed viremia (

Background Sars-CoV-2 infection influences older individuals at the forefront, and there is still limited data on the COVID-19 vaccine response in the geriatric population. This study aimed to assess antibody response after vaccination with SARS-CoV-2 inactivated vaccine and examine possible factors affecting this response in a geriatric population. Methods individuals who have been on at least the 28th day after the second dose of the COVID-19 vaccine were included. Comprehensive geriatric assessment tools and the Clinical Frailty Scale were performed. SARS-CoV-2 spike-specific IgG antibodies were detected and, levels ≥1 U/ml were defined as seropositive, Results a total of 497 patients were included and divided into three groups according to the days past after the second dose of the vaccine (Group 1: 28–59 days, Group 2: 60–89 days and Group 3: 90 days and more). Groups included 188, 148 and 171 patients, respectively. Seropositivity rate in each group was 80.9,73.2 and 57.3%, respectively. In Groups 1 and 2, Charlson Comorbidity Index score was higher in the seronegative group (P = 0.023 and P = 0.011, respectively). In Group 3, the prevalence of frailty was significantly higher in the seronegative group (P = 0.002). Conclusion to the best of our knowledge, this is the first study assessing the antibody response after vaccination with Sars-CoV 2 inactivated vaccine in the Turkish geriatric population. Moreover, this is the first study revealing the relationship between antibody response and frailty. Larger studies are needed to confirm the antibody response duration and the association between frailty and COVID-19 vaccine response.

There are treatment options with partially shown efficacy against SARS-CoV-2. A drug with proven effect on survival has not yet been developed for the new coronavirus disease (COVID-19) defined in December 2019. Many chemicals that are being used or developed for different indications have been used for COVID-19 treatment, based on their effects observed in in vitro studies. Favipiravir, one of these drugs, was first used in Wuhan, the starting center of the pandemic. Since the spread of the infection to the world, it has been used in our country as well as countries such as Italy, Japan, Russia, Ukraine, Uzbekistan, Moldova and Kazakhstan, Bangladesh, Egypt, India. There are few studies conducted and published to evaluate the effectiveness of favipiravir, but many studies are ongoing. In this review, it was aimed to review and evaluate the studies and case reports reporting the efficacy of favipiravir in the treatment of COVID-19. With the literature search, 223 results were reached, 210 articles were fully accessed, and a total of 34 articles were included in the analysis. In the scope of the review, under the title of pharmacology of favipiravir, adverse effects and drug interactions in addition to pharmacokinetic and pharmacodynamic properties are mentioned. Favipiravir is one of the options for the treatment of COVID-19 patients, but randomized, controlled trials involving much more patients and longer follow-up periods need to be planned and the results of ongoing trials evaluated.

The incidence of hypersensitivity reaction with the use of beta-lactam antibiotics ranges from 5-18%. The prescribing tendency of other antibiotic groups in patients with beta-lactam hypersensitivity causes an increase in the incidence of resistant microorganism, health care costs and adverse effects from other prescribed drug groups. Due to the history of unverified hypersensitivity of the patient, the use of penicillin and cephalosporins was avoided, the incidence of resistant infections and antibiotic resistance increased. According to a few studies conducted, the route of administration of beta-lactam antibiotics does not cause a significant difference in terms of the risk of developing hypersensitivity reaction. However, hypersensitivity reactions and anaphylaxis have been reported rarely in oral administration compared to parenteral administration.

There are treatment options with partially shown efficacy against SARS-CoV-2. A drug with proven effect on survival has not yet been developed for the new coronavirus disease (COVID-19) defined in December 2019. Many chemicals that are being used or developed for different indications have been used for COVID-19 treatment, based on their effects observed in in vitro studies. Favipiravir, one of these drugs, was first used in Wuhan, the starting center of the pandemic. Since the spread of the infection to the world, it has been used in our country as well as countries such as Italy, Japan, Russia, Ukraine, Uzbekistan, Moldova and Kazakhstan, Bangladesh, Egypt, India. There are few studies conducted and published to evaluate the effectiveness of favipiravir, but many studies are ongoing. In this review, it was aimed to review and evaluate the studies and case reports reporting the efficacy of favipiravir in the treatment of COVID-19. With the literature search, 223 results were reached, 210 articles were fully accessed, and a total of 34 articles were included in the analysis. In the scope of the review, under the title of pharmacology of favipiravir, adverse effects and drug interactions in addition to pharmacokinetic and pharmacodynamic properties are mentioned. Favipiravir is one of the options for the treatment of COVID-19 patients, but randomized, controlled trials involving much more patients and longer follow-up periods need to be planned and the results of ongoing trials evaluated.

Community-acquired pneumonia (CAP) is an important cause of morbidity and mortality in our country and worldwide, and it imposes a serious economic burden on the health system. It is major cause of deaths due to infections in our country. Therefore, initiating CAP treatment with the most appropriate antibiotic as soon as possible is important in decreasing morbidity and mortality. For this purpose, many evidence-based guidelines have been created to assist physicians in the selection of antibiotics and to reduce the differences between clinical practices. Although these guidelines mainly have common content and recommendations, there are some differences according to the health systems of the countries. In addition, the guidelines contain a number of shortcomings and issues not addressed. This review waswritten to compare five CAP guidelines (British Thoracic Society, National Institute for Health and Care Excellence, European Society of Clinical Microbiology and Infectious Diseases, Spanish Pneumology and Thoracic Surgery Association, Turkish Thoracic Society), to identify and discuss their differences, and to discuss the issues not considered in the guidelines such as drug interactions, dose adjustment in kidney/liver dysfunction, dose adjustment in obesity, serious/common side effects, and pharmacokinetic-pharmacodynamic properties of the drugs.

Background/aim The COVID-19 pandemic originated in Wuhan, China, in December 2019 and became one of the worst global health crises ever. While struggling with the unknown nature of this novel coronavirus, many researchers and groups attempted to project the progress of the pandemic using empirical or mechanistic models, each one having its drawbacks. The first confirmed cases were announced early in March, and since then, serious containment measures have taken place in Turkey. Materials and methods Here, we present a different approach, a Bayesian negative binomial multilevel model with mixed effects, for the projection of the COVID-19 pandemic and we apply this model to the Turkish case. The model source code is available at https://github.com/kansil/covid-19. We predicted the confirmed daily cases and cumulative numbers from June 6th to June 26th with 80%, 95%, and 99% prediction intervals (PI). Results Our projections showed that if we continued to comply with the measures and no drastic changes were seen in diagnosis or management protocols, the epidemic curve would tend to decrease in this time interval. Also, the predictive validity analysis suggests that the proposed model projections should have a PI around 95% for the first 12 days of the projections. Conclusion We expect that drastic changes in the course of COVID-19 in Turkey will cause the model to suffer in predictive validity, and this can be used to monitor the epidemic. We hope that the discussion on these projections and the limitations of the epidemiological forecasting will be beneficial to the medical community, and policy makers.

Research started with the pneumonia cases that emerged in Wuhan, China in December 2019 and whose cause could not be determined clearly, revealed the existence of a new type of coronavirus. The infectious agent was named SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2), and the disease setting caused by the virus was entitled COVID-19 (coronavirus disease-2019). The increasing number of cases and mortality rates due to the disease worldwide has caused a large number of vaccine research studies to be initiated simultaneously. According to the World Health Organization (WHO) December 22nd 2020 data, the number of Covid-19 vaccine research studies currently ongoing all over the world is 233 and the number of studies that have passed the clinical trials stage is 61. 15 of these studies are at Phase 3 stage. There are 12 ongoing COVID-19 vaccine studies in our country and all of them are in the preclinical stage. In this review article, 15 vaccine candidate studies whose Phase 3 stage continues, were discussed among the COVID-19 vaccine research studies.

Identification of pathogens is critical as point-of-care applications, where various types of methods may be used for this purpose along with certain disadvantages for each method. To overcome these disadvantages and to build instruments that are simple, compact, user-friendly, cost-effective with quick response time and ideal for mass production are the biggest goals of research on this subject. Although many biosensing instruments are available, plasmonic makes it less difficult and more accurate to observe binding behavior at molecular level than many other types. Due to its noninvasive character, real-time, and label-free detection opportunities, plasmonic has now become an important optical biosensing platform for various applications ranging from pharmaceutical and biological sciences to diagnostic purposes and global health services. This chapter focuses on recent developments in the detection and quantification of bacteria and viruses using plasmonic biosensors based on nanoparticles, which are one of the promising candidates as biomedical instruments for medical diagnostics in the near future. Description of biosensors, including bioreceptors and transducers, and the nanoparticle-based plasmonic systems commonly used to detect the identification of bacteria and viruses are provided. Future problems and strategies are also discussed.