... AKMANa, Dr. Cengiz SEN*, Dr. Mehmet A$IK**, Dr. Sercan AKPINAR***, Dr. H. Kazim GEDÌK* ÖZET: ... more ... AKMANa, Dr. Cengiz SEN*, Dr. Mehmet A$IK**, Dr. Sercan AKPINAR***, Dr. H. Kazim GEDÌK* ÖZET: Klinigimizde Eyliil 1995 ... gelisebilecek kink haricindeki problemieri kismen önleyebildigi gibi, hekim-hasta-hasta yakini arasindaki güvenin daha saglam olmasini saglayacaktir. ...
Introduction: Today, the frequency of Transcatheter aortic valve replacement (tavr) is increasing... more Introduction: Today, the frequency of Transcatheter aortic valve replacement (tavr) is increasing. The increase in the number of procedures causes us to encounter more complications. In addition, patients who undergo TAVR are high-risk elderly patients and the incidence of coronary artery disease is high. In this case, we offered the manegement of patient with NONST elevated myocardial infarction (MI), who also had advanced aortic stenosis that undergoing TAVR in the same session, after right common femoral dissection developed. Case report: an 85-year-old male patient with nonst elevation MI admitted to our hospital. Echocardiography revealed advanced aortic stenosis in the patient with long-term dyspnea. The patient was planned to undergo TAVR because of concurrent risk of percutaneous coronary intervention and surgery. After successful stenting of LAD, TAVR was completed. In peripheral artery control angiography, right Commons femoral artery was dissected and subtotal occluded. The left femoral artery was inserted with IMA catheter and 0.014 glidewire wire. Passeo 5 × 60 mm balloon dilatation was performed on this wire to the lesion zone. Then the lesion was passed with 0,035 wire. On top of this, atrium was placed in 8 × 59 mm graft stent lesion area. Complete femoral artery opening was provided to the patient. Conclusion: Both coronary and peripheral complications may develop in patients at advanced age. Catheters should be prepared for the management of these complications as both experience and material.
European Journal of Clinical Microbiology & Infectious Diseases, 2017
Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognos... more Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognostic factors affecting mortality in tetanus patients have been described in the literature. In this study, we aimed to analyze the factors affecting mortality in hospitalized tetanus patients in a large case series. This retrospective multicenter study pooled data of tetanus patients from 25 medical centers. The hospitals participating in this study were the collaborating centers of the Infectious Diseases International Research Initiative (ID-IRI). Only adult patients over the age of 15 years with tetanus were included. The diagnosis of tetanus was made by the clinicians at the participant centers. Izmir Bozyaka Education and Research Hospital's Review Board approved the study. Prognostic factors were analyzed by using the multivariate regression analysis method. In this study, 117 adult
Journal of Infection in Developing Countries, Mar 31, 2023
Introduction: We aimed to evaluate the prevalence and clinical outcomes of COVID-19 in healthcare... more Introduction: We aimed to evaluate the prevalence and clinical outcomes of COVID-19 in healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods. In addition, we determined factors associated with the development of COVID-19 after vaccination. Methodology: In this analytical cross-sectional epidemiological study, HCWs who were vaccinated between January 14, 2021, and March 21, 2021, were included. HCWs were followed up for 105 days after the 2 doses of CoronaVac. Pre-vaccination and post-vaccination periods were compared. Results: A total of 1,000 HCWs were included, 576 patients (57.6%) were male, and the mean age was 33.2 ± 9.6 years. In the last 3 months during the pre-vaccination period, 187 patients had COVID-19, and the cumulative incidence of COVID-19 was 18.7%. Six of these patients were hospitalized. Severe disease was observed in three patients. In the first 3 months post-vaccination period, COVID-19 was detected in 50 patients, and the cumulative incidence of the disease was determined to be 6.1%. Hospitalization and severe disease were not detected. Age (p = 0.29), sex (OR = 1.5, p = 0.16), smoking (OR = 1.29, p = 0.43), and underlying diseases (OR = 1.6, p = 0.26) were not associated with postvaccination COVID-19. A history of COVID-19 significantly reduced the likelihood of the development of post-vaccination COVID-19 in multivariate analysis (p = 0.002, OR = 0.16, 95% CI = 0.05-0.51). Conclusions: CoronaVac significantly reduces the risk of SARS-CoV-2 infection and alleviates the severity of COVID-19 in the early period. Additionally, HCWs who have been infected and vaccinated with CoronaVac are less likely to be reinfected with COVID-19.
Objective: It was aimed to investigate the effects of the COVID-19 pandemic on the professional a... more Objective: It was aimed to investigate the effects of the COVID-19 pandemic on the professional activities and lives of nurses, as well as their compliance with infection control measures during their health care services. Materials and Methods: This descriptive, cross-sectional survey study was conducted between August 1 st and September 1 st , 2022 on the nurses who worked during the COVID-19 pandemic at Prof. Dr.
Journal of Infection in Developing Countries, Sep 12, 2014
Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) coloni... more Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) colonization and VRErelated bacteremia in patients with hematological malignancies in terms of routine screening culture and its cost-effectiveness. Materials and Methods: All patients of the hematology department who were older than 14 years of age and who developed at least one febrile neutropenia episode during chemotherapy for hematological cancers between November 2010 and November 2012 were evaluated retrospectively. Results: We retrospectively analyzed 282 febrile episodes in 126 neutropenic patients during a two-year study period. The study included 65 cases in the first study-year and 78 cases in the second study-year. The numbers of colonization days and colonized patient were748 days of colonization in 29 patients (44%) in the first study-year and 547 colonization days in 21 patients (26%) in the second study-year, respectively. Routine screening culture for VRE cost $4516,4 (427 cultures) in the first study-year, $5082,7 (504 cultures) in the second study-year depending on the number of patients and their length of stay. Conclusion: In line with our study results, routine screening of hematological patients for VRE colonization is not costeffective. Routine surveillance culture for VRE should be considered with respect to the conditions of health care setting.
Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) coloni... more Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) colonization and VRErelated bacteremia in patients with hematological malignancies in terms of routine screening culture and its cost-effectiveness. Materials and Methods: All patients of the hematology department who were older than 14 years of age and who developed at least one febrile neutropenia episode during chemotherapy for hematological cancers between November 2010 and November 2012 were evaluated retrospectively. Results: We retrospectively analyzed 282 febrile episodes in 126 neutropenic patients during a two-year study period. The study included 65 cases in the first study-year and 78 cases in the second study-year. The numbers of colonization days and colonized patient were748 days of colonization in 29 patients (44%) in the first study-year and 547 colonization days in 21 patients (26%) in the second study-year, respectively. Routine screening culture for VRE cost $4516,4 (427 cultures) in the first study-year, $5082,7 (504 cultures) in the second study-year depending on the number of patients and their length of stay. Conclusion: In line with our study results, routine screening of hematological patients for VRE colonization is not costeffective. Routine surveillance culture for VRE should be considered with respect to the conditions of health care setting.
Mediterranean journal of infection, microbes & antimicrobials, Jul 22, 2019
Giriş: Maligniteler latent tüberkülozun (TB) aktif hastalığa ilerlemesinde önemli risk faktörleri... more Giriş: Maligniteler latent tüberkülozun (TB) aktif hastalığa ilerlemesinde önemli risk faktörleri arasında yer almaktadır. Tüberkülin deri testi (TDT) latent TB tanısında tüm dünyada yaygın olarak kullanılmaktadır. Yeni T-hücre bazlı interferon-gama salınım testleri, örneğin; QuantiFERON-TB Gold Introduction: Malignancies are among the most important risk factors for progression of latent tuberculosis (TB) to active disease. The tuberculin skin test (TST) has been used worldwide for the diagnosis of latent TB. New T-cell-based interferon-gamma release assays such as QuantiFERON-TB Gold In-Tube (QFT-GIT) have yielded promising results in this regard, but little information is available on their use in hematopoietic stem cell recipients. The aim of this study was to evaluate the agreement between QFT-GIT and TST in the diagnosis of latent TB in hematopoietic stem cell transplantation (HSCT) candidates. Materials and Methods: Patients who underwent HSCT in our hospital between November 1, 2013 and July 31, 2015 were retrospectively evaluated from patient files. Those who had both QFT-GIT and TST before transplantation were included in the study. Isoniazid prophylaxis was initiated one week before transplantation and continued for nine months for patients with positive results in one or both tests. The kappa (κ) coefficients were calculated to analyze the agreement between two tests. Results: The study included 122 patients, (53.3% autologous and 46.7% allogeneic hematopoietic stem cell recipients). The median age was 43.5 years (25-75% IQR: 30-54) and 73% were men. Bacillus Calmette-Guérin (BCG) scars were seen in 84.4% of the patients. Tuberculin skin test and QFT-GIT test were positive in 38 (31.1%) and 26 (21.3%) of the patients, respectively. Both TST and QFT-GIT were positive in 17 patients (13.9%). There was no statistically significant relationship between the two tests and BCG scars. Statistically significant, fair agreement was found between positive TST and QFT-GIT results (κ=0.37 and p<0.001). Patients were followed until July 2018. The median follow-up time of all patients was 39 months (IQR: 10.8-49.0). None of the patients developed active TB during follow-up, but 44.3% of the patients died due to malignancy and/or opportunistic infections. Conclusion: Further research is needed to demonstrate the agreement between these two tests in the diagnosis of latent TB in HSCT patients. For now, the combination of these two tests seems to be most rational for these patients.
İnvaziv araç ilişkili hastane enfeksiyonları sürveyansının enfeksiyon kontrol önlemlerinin planla... more İnvaziv araç ilişkili hastane enfeksiyonları sürveyansının enfeksiyon kontrol önlemlerinin planlanmasında önemli rolü vardır. Bu çalışmada amacımız, 2009-2013 yılları arasında yoğun bakım ünitesinde yatan hastalarda invaziv araç ilişkili hastane enfeksiyonlarının değerlendirmesi ve malignite varlığının mortalite oranları üzerindeki etkisini araştırmaktır. YÖNTEM ve GEREÇLER: Hastanemiz yoğun bakım ünitesinde hastane enfeksiyonlarına yönelik aktif sürveyans yapılmaktadır. Hastalara ait veriler Ulusal Hastane Enfeksiyonları Sürveyansı Ağı kayıtlarından alınmıştır. Mikroorganizma tanımlaması klasik yöntemlerle yapılmış, VITEK 2 otomatize sistem ile teyit edilmiştir. Hastane enfeksiyonu tanısı "Centers for Diseases Control and Prevention" kriterlerine göre konulmuştur. BULGULAR: Yoğun bakım ünitesinde hastane enfeksiyonu insidansı bu dönem içinde ortalama 40,75/1000 hasta günü olup, %85-100'ünü invaziv araç ilişkili hastane enfeksiyonları oluşturmuştur. Santral venöz kateter kullanım oranı ile santral venöz kateter ilişkili kan dolaşımı enfeksiyonu hızlarında beş yılda anlamlı azalma saptanmıştır (p= 0,0005). Santral venöz kateter ilişkili kan dolaşımı enfeksiyonları ve ventilatör ilişkili pnömonilerde Gram negatif basiller daha fazla izole edilmiş ve özellikte Acinetobacter spp' nin önemli sorun teşkil ettiği gözlemlenmiştir. Kateter ilişkili üriner sistem enfeksiyonlarında Gram negatif basiller ve kandidalar en çok izole edilen mikroorganizmalar olmuştur. İnvaziv araç ilişkili hastane enfeksiyonu gelişen maligniteli hastalarda yoğun bakım mortalite oranı 2013 yılında, diğer hastalara göre anlamlı olarak daha yüksek bulunmuştur (p= 0,010). TARTIŞMA ve SONUÇ: Hastanemizde santral venöz kateter ilişkili kan dolaşımı enfeksiyonu hızlarında bir miktar gerileme varken diğer invaziv araç ilişkili enfeksiyonların yüksek seyrettiği gözlemlenmiştir. Yoğun bakım ünitemizde Acinetobacter spp enfeksiyonlarının ciddi bir problem oluşturduğu ortaya çıkmıştır. Ayrıca invaziv araç ilişkili hastane enfeksiyonu olan hastalarda malignite varlığının yoğun bakım mortalite oranlarını artırdığı gözlemlenmiştir.
Innovative Journal of Medical and Health Science, Mar 9, 2019
Aim: The chronic diseases of childhood affect significantly on those who take careof them. Mostly... more Aim: The chronic diseases of childhood affect significantly on those who take careof them. Mostly this is the duty of mothers. Mothers are the primary caretakers,so they may have psychological problems. There are limited numbers of studies onthe depression of mothers who take care of the children with Familial MediterraneanFever. Aim of the study was to investigate depression levels and factors related todepression in mothers of children with Familial Mediterranean Fever.Material and Methods: The mothers of children diagnosed with Familial Mediterraneanfever, aged between 24 and 54 years, educated and voluntarily wanted to jointhe research were selected (n:53). Socieodemographic and clinic data form and BeckDepression Inventory form were given to them.Results: The mean beck depression inventory score was 16.36.8. According to theclassification of Beck Depression Inventory, 35.8% of mothers had minimal depression,32.1% had mild, 26.4% had moderate and 5.7% had severe depression. A weak positiverelationship was found between the Beck Depression Inventory score and the numbersof child in the family. The mean attack of Familial Mediterranean Fever in the lastyear was statistically and significantly high in those mothers who were depressed thanwho were not.Conclusion: The level of depression in the mothers of children diagnosed with FamilialMediterranean Fever was close to the cut-off point of Turkish standards (17 points).The severity of the Familial Mediterranean Fever and the depression of the motherswere having a parallel relationship. Children of depressed mothers were having moreFamilial Mediterranean fever episodes.
Objective: The aim of this study was to evaluate mood changes in mothers of infants diagnosed wit... more Objective: The aim of this study was to evaluate mood changes in mothers of infants diagnosed with infantile colic. Materials and Methods: In this prospective case-control study, mothers with infants who were referred to the Pediatric Clinic of Ministry of Health Okmeydanı Research and Training Hospital and diagnosed with infantile colic between November 2014 and February 2015 were compared with those of infants without infantile colic using the Beck Depression Inventory and a questionnaire. Results: A total of 31 mothers with male infants (51%) and 30 mothers with female infants (49%) participated in the study. The mean Beck depression inventory scores were 18.3 (min 5-max 35 points; median score: 21) in the infantile colic group and 14.6 (min 5-max 33; median score: 12) in the control group. Beck depression inventory scores in the infantile colic group were significantly higher than those of control group. The mean Beck depression inventory scores were 17.0 (min 5-max 32 points; median score: 17) in mothers who had no problems during the pregnancy and 24.9 (min 5-max 35 points; median score: 25.5) in mothers who had problems during the pregnancy, respectively. Beck depression inventory scores in mothers who had problems during the pregnancy were significantly higher than those who had no problems during pregnancy. Conclusion: Beck depression inventory scores in mothers with infants diagnosed with infantile colic were significant compared to the control group. Mothers of infants diagnosed with infantile colic may require psychological support.
Objective: Acute lower respiratory tract infections are seen as a major public health problem in ... more Objective: Acute lower respiratory tract infections are seen as a major public health problem in many developing countries. This study was carried out in order to evaluate plasma and urine malonyldialdehyde (MDA) levels which represents the lipid peroxidation and hence of oxidative stress in infants diagnosed with acute bronchopneumonia which is a cause of high mortality and morbidity in children. Material and methods: This case-control study was carried out at the department of Paediatrics, Ministry of Health Bakırköy Sadi Konuk Training and Research Hospital in 2005. The patient group comprised of 25 patients who were admitted to the hospital with the diagnosis of acute bronchopneumonia. The control group consisted of 10 healthy children of the same age range who had no pathological findings on physical examination. MDA values of urine and plasma samples were compared between both groups as an oxidative stress indicator. Results: The mean serum MDA value of the patient group was 3.91 ± 1.55 micromol/L and that of the control group was measured as 1.03 ± 0.1micromol/L. The difference was significantly higher (p<0.001) in the patient group. The mean first day urine MDA value of the patient group were 1.05 ± 0.90 micromol/L and that of the control group was 0.009 micromol/L. The difference was significantly higher (p<0.05) in the patient group. The mean urine MDA value of the patient group was found similar to that of the control group at the third and fifth day of follow up (p>0.05). Conclusion: The urine MDA values on the first day of follow-up and the plasma MDA values may be used as a parameter in the diagnosis and following-up treatment of oxidative stress in the infants with acute bronchopneumonia.
Objectives: Our aim in this study was to compare the values of omentin-1, which is an adipokine a... more Objectives: Our aim in this study was to compare the values of omentin-1, which is an adipokine associated with postnatal metabolic complications, in the cord blood of newborns who were small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA). Methods: This prospective, cross-sectional study was carried out with the measurement of omentin-1 values by Enzyme-Linked Immunosorbent method in the cord blood of the infants who were born at the delivery room of Ministry of Health, Istanbul Okmeydani Training and Research Hospital between 01/08/2016 and 31/01/2017. Results: In the study, omentin-1 values of 30 infants with AGA, 25 infants with LGA and 20 infants with SGA were measured and compared with each other. The mean of cord blood omentin-1 values in the newborn group with SGA was found to be significantly low compared to that of the newborns with AGA. However, no statistically significant difference was found between omentin-1 values of the three groups. Conclusions: We have determined serum omentin-1 levels to be lower in infants with SGA. Metabolic follow-up of infants with SGA is thought to be beneficial because low levels of omentin-1, which is an adipokine in metabolic functions in infants with SGA, may lead to the development of metabolic complications.
Journal of preventive medicine and care, Mar 26, 2019
Reverse Shapiro's syndrome is described as unexplained hyperthermia coexisting with agenesis of t... more Reverse Shapiro's syndrome is described as unexplained hyperthermia coexisting with agenesis of the corpus callosum. Its pathophysiology dwells on the role of dopaminergic hypersensitivity caused by hypothalamic dysfunction. Until now, only 5 cases have been described in the literature as reverse Shapiro's syndrome. We present a case of a 6-month-old girl who is now the sixth patient described in the literature. A 6-month-old female patient was admitted to the pediatrics unit for fever of unknown origin. Her fever occurred 2-3 times a day on average between 38°C and 39.5°C, and lasted for 1-2 hours. The fever was not diurnal, and antipyretics or staying in an air-conditioned room had no effect. She also had 2 convulsions during her hospital stay. Cranial magnetic resonance imaging (MRI) was requested owing to the patient's convulsion history and retarded development. The cranial MRI showed diffuse hypoplasia of the corpus callosum in the midline sagittal T2-weighted image. T1-weighted imaging showed hypointensity due to delayed myelination of the genu of the corpus callosum (Figure 2, white arrow), which should normally appear hyperintense like the posterior limb of the internal capsule. Although dopamine agonists and serotonin agonists are recommended for the treatment, the rate of response to medical treatment is very low. Our patient did not benefit from cyproheptadine and methyl prednisolone.
Acta microbiologica et immunologica Hungarica (Print), Sep 21, 2022
We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of d... more We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of disease severity, need for intensive care unit (ICU) admission, and death. In addition, we determined the factors affecting the COVID-19 severity in vaccinated patients. Patients aged 18-65 years who were hospitalized for COVID-19 between September and December 2021 were retrospectively analyzed in three groups: unvaccinated, partially vaccinated, and fully vaccinated. A total of 854 patients were included. Mean age was 47.9 ± 10.6 years, 474 patients (55.5%) were male. Of these, 230 patients (26.9%) were fully vaccinated, 97 (11.3%) were partially vaccinated, and 527 (61.7%) were unvaccinated. Of the fully vaccinated patients, 67% (n 5 153) were vaccinated with CoronaVac and 33% (n 5 77) were vaccinated with Pfizer-BioNTech. All patients (n 5 97) with a single dose were vaccinated with Pfizer-BioNTech. One hundred thirteen (13.2%) patients were transferred to ICU. A hundred (11.7%) patients were intubated and 77 (9.0%) patients died. Advanced age (P 5 0.028, 95% CI 5 1.00-1.07, OR 5 1.038) and higher Charlson Comorbidity Index (CCI) (P < 0.001, 95% CI 5 1.20-1.69, OR 5 1.425) were associated with increased mortality, while being fully vaccinated (P 5 0.008, 95% CI 5 0.23-0.80, OR 5 0.435) was associated with survival in multivariate analysis. Full dose vaccination reduced the need for ICU admission by 49.7% (95% CI 5 17-70) and mortality by 56.5% (95% CI 5 20-77). When the fully vaccinated group was evaluated, we found that death was observed more frequent in patients with CCI>3 (19.1 vs 5.8%, P < 0.01, OR 5 3.7). Therefore, the booster vaccine especially in individuals with comorbidities should not be delayed, since the survival expectation is low in patients with a high comorbidity index.
Introduction: Three treatment-naïve cases with chronic hepatitis B (CHB) were reported in terms o... more Introduction: Three treatment-naïve cases with chronic hepatitis B (CHB) were reported in terms of a partial response to tenofovir disoproxil (TDF) monotherapy and antiviral-drug resistance. Methodology: In this retrospective, case series study, patients who were treated for CHB at the departments of infectious diseases and clinical microbiology, University of Medical Science Bakırköy Dr. Sadi Konuk Training and Research Hospital were evaluated. Results: A 26-year-old female patient and a 59-year-old male patient achieved sustained viral response with TDF (245 mg) or tenofovir alafenamide (TAF, 25 mg) + entekavir (ETV, 1 mg) combination therapy after failure with TDF monotherapy. The son of the female patient who was diagnosed with CHB infection due to a probable mother-to-child transmission did not achieve a complete viral response with interferon alfa-2b therapy for three months followed by lamivudine therapy for 19 months. Conclusions: A TDF (245 mg) or TAF (25 mg) + ETV (1 mg) c...
... AKMANa, Dr. Cengiz SEN*, Dr. Mehmet A$IK**, Dr. Sercan AKPINAR***, Dr. H. Kazim GEDÌK* ÖZET: ... more ... AKMANa, Dr. Cengiz SEN*, Dr. Mehmet A$IK**, Dr. Sercan AKPINAR***, Dr. H. Kazim GEDÌK* ÖZET: Klinigimizde Eyliil 1995 ... gelisebilecek kink haricindeki problemieri kismen önleyebildigi gibi, hekim-hasta-hasta yakini arasindaki güvenin daha saglam olmasini saglayacaktir. ...
Introduction: Today, the frequency of Transcatheter aortic valve replacement (tavr) is increasing... more Introduction: Today, the frequency of Transcatheter aortic valve replacement (tavr) is increasing. The increase in the number of procedures causes us to encounter more complications. In addition, patients who undergo TAVR are high-risk elderly patients and the incidence of coronary artery disease is high. In this case, we offered the manegement of patient with NONST elevated myocardial infarction (MI), who also had advanced aortic stenosis that undergoing TAVR in the same session, after right common femoral dissection developed. Case report: an 85-year-old male patient with nonst elevation MI admitted to our hospital. Echocardiography revealed advanced aortic stenosis in the patient with long-term dyspnea. The patient was planned to undergo TAVR because of concurrent risk of percutaneous coronary intervention and surgery. After successful stenting of LAD, TAVR was completed. In peripheral artery control angiography, right Commons femoral artery was dissected and subtotal occluded. The left femoral artery was inserted with IMA catheter and 0.014 glidewire wire. Passeo 5 × 60 mm balloon dilatation was performed on this wire to the lesion zone. Then the lesion was passed with 0,035 wire. On top of this, atrium was placed in 8 × 59 mm graft stent lesion area. Complete femoral artery opening was provided to the patient. Conclusion: Both coronary and peripheral complications may develop in patients at advanced age. Catheters should be prepared for the management of these complications as both experience and material.
European Journal of Clinical Microbiology & Infectious Diseases, 2017
Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognos... more Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognostic factors affecting mortality in tetanus patients have been described in the literature. In this study, we aimed to analyze the factors affecting mortality in hospitalized tetanus patients in a large case series. This retrospective multicenter study pooled data of tetanus patients from 25 medical centers. The hospitals participating in this study were the collaborating centers of the Infectious Diseases International Research Initiative (ID-IRI). Only adult patients over the age of 15 years with tetanus were included. The diagnosis of tetanus was made by the clinicians at the participant centers. Izmir Bozyaka Education and Research Hospital's Review Board approved the study. Prognostic factors were analyzed by using the multivariate regression analysis method. In this study, 117 adult
Journal of Infection in Developing Countries, Mar 31, 2023
Introduction: We aimed to evaluate the prevalence and clinical outcomes of COVID-19 in healthcare... more Introduction: We aimed to evaluate the prevalence and clinical outcomes of COVID-19 in healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods. In addition, we determined factors associated with the development of COVID-19 after vaccination. Methodology: In this analytical cross-sectional epidemiological study, HCWs who were vaccinated between January 14, 2021, and March 21, 2021, were included. HCWs were followed up for 105 days after the 2 doses of CoronaVac. Pre-vaccination and post-vaccination periods were compared. Results: A total of 1,000 HCWs were included, 576 patients (57.6%) were male, and the mean age was 33.2 ± 9.6 years. In the last 3 months during the pre-vaccination period, 187 patients had COVID-19, and the cumulative incidence of COVID-19 was 18.7%. Six of these patients were hospitalized. Severe disease was observed in three patients. In the first 3 months post-vaccination period, COVID-19 was detected in 50 patients, and the cumulative incidence of the disease was determined to be 6.1%. Hospitalization and severe disease were not detected. Age (p = 0.29), sex (OR = 1.5, p = 0.16), smoking (OR = 1.29, p = 0.43), and underlying diseases (OR = 1.6, p = 0.26) were not associated with postvaccination COVID-19. A history of COVID-19 significantly reduced the likelihood of the development of post-vaccination COVID-19 in multivariate analysis (p = 0.002, OR = 0.16, 95% CI = 0.05-0.51). Conclusions: CoronaVac significantly reduces the risk of SARS-CoV-2 infection and alleviates the severity of COVID-19 in the early period. Additionally, HCWs who have been infected and vaccinated with CoronaVac are less likely to be reinfected with COVID-19.
Objective: It was aimed to investigate the effects of the COVID-19 pandemic on the professional a... more Objective: It was aimed to investigate the effects of the COVID-19 pandemic on the professional activities and lives of nurses, as well as their compliance with infection control measures during their health care services. Materials and Methods: This descriptive, cross-sectional survey study was conducted between August 1 st and September 1 st , 2022 on the nurses who worked during the COVID-19 pandemic at Prof. Dr.
Journal of Infection in Developing Countries, Sep 12, 2014
Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) coloni... more Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) colonization and VRErelated bacteremia in patients with hematological malignancies in terms of routine screening culture and its cost-effectiveness. Materials and Methods: All patients of the hematology department who were older than 14 years of age and who developed at least one febrile neutropenia episode during chemotherapy for hematological cancers between November 2010 and November 2012 were evaluated retrospectively. Results: We retrospectively analyzed 282 febrile episodes in 126 neutropenic patients during a two-year study period. The study included 65 cases in the first study-year and 78 cases in the second study-year. The numbers of colonization days and colonized patient were748 days of colonization in 29 patients (44%) in the first study-year and 547 colonization days in 21 patients (26%) in the second study-year, respectively. Routine screening culture for VRE cost $4516,4 (427 cultures) in the first study-year, $5082,7 (504 cultures) in the second study-year depending on the number of patients and their length of stay. Conclusion: In line with our study results, routine screening of hematological patients for VRE colonization is not costeffective. Routine surveillance culture for VRE should be considered with respect to the conditions of health care setting.
Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) coloni... more Background and objective: We evaluated the rates of vancomycin-resistant enterococci (VRE) colonization and VRErelated bacteremia in patients with hematological malignancies in terms of routine screening culture and its cost-effectiveness. Materials and Methods: All patients of the hematology department who were older than 14 years of age and who developed at least one febrile neutropenia episode during chemotherapy for hematological cancers between November 2010 and November 2012 were evaluated retrospectively. Results: We retrospectively analyzed 282 febrile episodes in 126 neutropenic patients during a two-year study period. The study included 65 cases in the first study-year and 78 cases in the second study-year. The numbers of colonization days and colonized patient were748 days of colonization in 29 patients (44%) in the first study-year and 547 colonization days in 21 patients (26%) in the second study-year, respectively. Routine screening culture for VRE cost $4516,4 (427 cultures) in the first study-year, $5082,7 (504 cultures) in the second study-year depending on the number of patients and their length of stay. Conclusion: In line with our study results, routine screening of hematological patients for VRE colonization is not costeffective. Routine surveillance culture for VRE should be considered with respect to the conditions of health care setting.
Mediterranean journal of infection, microbes & antimicrobials, Jul 22, 2019
Giriş: Maligniteler latent tüberkülozun (TB) aktif hastalığa ilerlemesinde önemli risk faktörleri... more Giriş: Maligniteler latent tüberkülozun (TB) aktif hastalığa ilerlemesinde önemli risk faktörleri arasında yer almaktadır. Tüberkülin deri testi (TDT) latent TB tanısında tüm dünyada yaygın olarak kullanılmaktadır. Yeni T-hücre bazlı interferon-gama salınım testleri, örneğin; QuantiFERON-TB Gold Introduction: Malignancies are among the most important risk factors for progression of latent tuberculosis (TB) to active disease. The tuberculin skin test (TST) has been used worldwide for the diagnosis of latent TB. New T-cell-based interferon-gamma release assays such as QuantiFERON-TB Gold In-Tube (QFT-GIT) have yielded promising results in this regard, but little information is available on their use in hematopoietic stem cell recipients. The aim of this study was to evaluate the agreement between QFT-GIT and TST in the diagnosis of latent TB in hematopoietic stem cell transplantation (HSCT) candidates. Materials and Methods: Patients who underwent HSCT in our hospital between November 1, 2013 and July 31, 2015 were retrospectively evaluated from patient files. Those who had both QFT-GIT and TST before transplantation were included in the study. Isoniazid prophylaxis was initiated one week before transplantation and continued for nine months for patients with positive results in one or both tests. The kappa (κ) coefficients were calculated to analyze the agreement between two tests. Results: The study included 122 patients, (53.3% autologous and 46.7% allogeneic hematopoietic stem cell recipients). The median age was 43.5 years (25-75% IQR: 30-54) and 73% were men. Bacillus Calmette-Guérin (BCG) scars were seen in 84.4% of the patients. Tuberculin skin test and QFT-GIT test were positive in 38 (31.1%) and 26 (21.3%) of the patients, respectively. Both TST and QFT-GIT were positive in 17 patients (13.9%). There was no statistically significant relationship between the two tests and BCG scars. Statistically significant, fair agreement was found between positive TST and QFT-GIT results (κ=0.37 and p<0.001). Patients were followed until July 2018. The median follow-up time of all patients was 39 months (IQR: 10.8-49.0). None of the patients developed active TB during follow-up, but 44.3% of the patients died due to malignancy and/or opportunistic infections. Conclusion: Further research is needed to demonstrate the agreement between these two tests in the diagnosis of latent TB in HSCT patients. For now, the combination of these two tests seems to be most rational for these patients.
İnvaziv araç ilişkili hastane enfeksiyonları sürveyansının enfeksiyon kontrol önlemlerinin planla... more İnvaziv araç ilişkili hastane enfeksiyonları sürveyansının enfeksiyon kontrol önlemlerinin planlanmasında önemli rolü vardır. Bu çalışmada amacımız, 2009-2013 yılları arasında yoğun bakım ünitesinde yatan hastalarda invaziv araç ilişkili hastane enfeksiyonlarının değerlendirmesi ve malignite varlığının mortalite oranları üzerindeki etkisini araştırmaktır. YÖNTEM ve GEREÇLER: Hastanemiz yoğun bakım ünitesinde hastane enfeksiyonlarına yönelik aktif sürveyans yapılmaktadır. Hastalara ait veriler Ulusal Hastane Enfeksiyonları Sürveyansı Ağı kayıtlarından alınmıştır. Mikroorganizma tanımlaması klasik yöntemlerle yapılmış, VITEK 2 otomatize sistem ile teyit edilmiştir. Hastane enfeksiyonu tanısı "Centers for Diseases Control and Prevention" kriterlerine göre konulmuştur. BULGULAR: Yoğun bakım ünitesinde hastane enfeksiyonu insidansı bu dönem içinde ortalama 40,75/1000 hasta günü olup, %85-100'ünü invaziv araç ilişkili hastane enfeksiyonları oluşturmuştur. Santral venöz kateter kullanım oranı ile santral venöz kateter ilişkili kan dolaşımı enfeksiyonu hızlarında beş yılda anlamlı azalma saptanmıştır (p= 0,0005). Santral venöz kateter ilişkili kan dolaşımı enfeksiyonları ve ventilatör ilişkili pnömonilerde Gram negatif basiller daha fazla izole edilmiş ve özellikte Acinetobacter spp' nin önemli sorun teşkil ettiği gözlemlenmiştir. Kateter ilişkili üriner sistem enfeksiyonlarında Gram negatif basiller ve kandidalar en çok izole edilen mikroorganizmalar olmuştur. İnvaziv araç ilişkili hastane enfeksiyonu gelişen maligniteli hastalarda yoğun bakım mortalite oranı 2013 yılında, diğer hastalara göre anlamlı olarak daha yüksek bulunmuştur (p= 0,010). TARTIŞMA ve SONUÇ: Hastanemizde santral venöz kateter ilişkili kan dolaşımı enfeksiyonu hızlarında bir miktar gerileme varken diğer invaziv araç ilişkili enfeksiyonların yüksek seyrettiği gözlemlenmiştir. Yoğun bakım ünitemizde Acinetobacter spp enfeksiyonlarının ciddi bir problem oluşturduğu ortaya çıkmıştır. Ayrıca invaziv araç ilişkili hastane enfeksiyonu olan hastalarda malignite varlığının yoğun bakım mortalite oranlarını artırdığı gözlemlenmiştir.
Innovative Journal of Medical and Health Science, Mar 9, 2019
Aim: The chronic diseases of childhood affect significantly on those who take careof them. Mostly... more Aim: The chronic diseases of childhood affect significantly on those who take careof them. Mostly this is the duty of mothers. Mothers are the primary caretakers,so they may have psychological problems. There are limited numbers of studies onthe depression of mothers who take care of the children with Familial MediterraneanFever. Aim of the study was to investigate depression levels and factors related todepression in mothers of children with Familial Mediterranean Fever.Material and Methods: The mothers of children diagnosed with Familial Mediterraneanfever, aged between 24 and 54 years, educated and voluntarily wanted to jointhe research were selected (n:53). Socieodemographic and clinic data form and BeckDepression Inventory form were given to them.Results: The mean beck depression inventory score was 16.36.8. According to theclassification of Beck Depression Inventory, 35.8% of mothers had minimal depression,32.1% had mild, 26.4% had moderate and 5.7% had severe depression. A weak positiverelationship was found between the Beck Depression Inventory score and the numbersof child in the family. The mean attack of Familial Mediterranean Fever in the lastyear was statistically and significantly high in those mothers who were depressed thanwho were not.Conclusion: The level of depression in the mothers of children diagnosed with FamilialMediterranean Fever was close to the cut-off point of Turkish standards (17 points).The severity of the Familial Mediterranean Fever and the depression of the motherswere having a parallel relationship. Children of depressed mothers were having moreFamilial Mediterranean fever episodes.
Objective: The aim of this study was to evaluate mood changes in mothers of infants diagnosed wit... more Objective: The aim of this study was to evaluate mood changes in mothers of infants diagnosed with infantile colic. Materials and Methods: In this prospective case-control study, mothers with infants who were referred to the Pediatric Clinic of Ministry of Health Okmeydanı Research and Training Hospital and diagnosed with infantile colic between November 2014 and February 2015 were compared with those of infants without infantile colic using the Beck Depression Inventory and a questionnaire. Results: A total of 31 mothers with male infants (51%) and 30 mothers with female infants (49%) participated in the study. The mean Beck depression inventory scores were 18.3 (min 5-max 35 points; median score: 21) in the infantile colic group and 14.6 (min 5-max 33; median score: 12) in the control group. Beck depression inventory scores in the infantile colic group were significantly higher than those of control group. The mean Beck depression inventory scores were 17.0 (min 5-max 32 points; median score: 17) in mothers who had no problems during the pregnancy and 24.9 (min 5-max 35 points; median score: 25.5) in mothers who had problems during the pregnancy, respectively. Beck depression inventory scores in mothers who had problems during the pregnancy were significantly higher than those who had no problems during pregnancy. Conclusion: Beck depression inventory scores in mothers with infants diagnosed with infantile colic were significant compared to the control group. Mothers of infants diagnosed with infantile colic may require psychological support.
Objective: Acute lower respiratory tract infections are seen as a major public health problem in ... more Objective: Acute lower respiratory tract infections are seen as a major public health problem in many developing countries. This study was carried out in order to evaluate plasma and urine malonyldialdehyde (MDA) levels which represents the lipid peroxidation and hence of oxidative stress in infants diagnosed with acute bronchopneumonia which is a cause of high mortality and morbidity in children. Material and methods: This case-control study was carried out at the department of Paediatrics, Ministry of Health Bakırköy Sadi Konuk Training and Research Hospital in 2005. The patient group comprised of 25 patients who were admitted to the hospital with the diagnosis of acute bronchopneumonia. The control group consisted of 10 healthy children of the same age range who had no pathological findings on physical examination. MDA values of urine and plasma samples were compared between both groups as an oxidative stress indicator. Results: The mean serum MDA value of the patient group was 3.91 ± 1.55 micromol/L and that of the control group was measured as 1.03 ± 0.1micromol/L. The difference was significantly higher (p<0.001) in the patient group. The mean first day urine MDA value of the patient group were 1.05 ± 0.90 micromol/L and that of the control group was 0.009 micromol/L. The difference was significantly higher (p<0.05) in the patient group. The mean urine MDA value of the patient group was found similar to that of the control group at the third and fifth day of follow up (p>0.05). Conclusion: The urine MDA values on the first day of follow-up and the plasma MDA values may be used as a parameter in the diagnosis and following-up treatment of oxidative stress in the infants with acute bronchopneumonia.
Objectives: Our aim in this study was to compare the values of omentin-1, which is an adipokine a... more Objectives: Our aim in this study was to compare the values of omentin-1, which is an adipokine associated with postnatal metabolic complications, in the cord blood of newborns who were small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA). Methods: This prospective, cross-sectional study was carried out with the measurement of omentin-1 values by Enzyme-Linked Immunosorbent method in the cord blood of the infants who were born at the delivery room of Ministry of Health, Istanbul Okmeydani Training and Research Hospital between 01/08/2016 and 31/01/2017. Results: In the study, omentin-1 values of 30 infants with AGA, 25 infants with LGA and 20 infants with SGA were measured and compared with each other. The mean of cord blood omentin-1 values in the newborn group with SGA was found to be significantly low compared to that of the newborns with AGA. However, no statistically significant difference was found between omentin-1 values of the three groups. Conclusions: We have determined serum omentin-1 levels to be lower in infants with SGA. Metabolic follow-up of infants with SGA is thought to be beneficial because low levels of omentin-1, which is an adipokine in metabolic functions in infants with SGA, may lead to the development of metabolic complications.
Journal of preventive medicine and care, Mar 26, 2019
Reverse Shapiro's syndrome is described as unexplained hyperthermia coexisting with agenesis of t... more Reverse Shapiro's syndrome is described as unexplained hyperthermia coexisting with agenesis of the corpus callosum. Its pathophysiology dwells on the role of dopaminergic hypersensitivity caused by hypothalamic dysfunction. Until now, only 5 cases have been described in the literature as reverse Shapiro's syndrome. We present a case of a 6-month-old girl who is now the sixth patient described in the literature. A 6-month-old female patient was admitted to the pediatrics unit for fever of unknown origin. Her fever occurred 2-3 times a day on average between 38°C and 39.5°C, and lasted for 1-2 hours. The fever was not diurnal, and antipyretics or staying in an air-conditioned room had no effect. She also had 2 convulsions during her hospital stay. Cranial magnetic resonance imaging (MRI) was requested owing to the patient's convulsion history and retarded development. The cranial MRI showed diffuse hypoplasia of the corpus callosum in the midline sagittal T2-weighted image. T1-weighted imaging showed hypointensity due to delayed myelination of the genu of the corpus callosum (Figure 2, white arrow), which should normally appear hyperintense like the posterior limb of the internal capsule. Although dopamine agonists and serotonin agonists are recommended for the treatment, the rate of response to medical treatment is very low. Our patient did not benefit from cyproheptadine and methyl prednisolone.
Acta microbiologica et immunologica Hungarica (Print), Sep 21, 2022
We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of d... more We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of disease severity, need for intensive care unit (ICU) admission, and death. In addition, we determined the factors affecting the COVID-19 severity in vaccinated patients. Patients aged 18-65 years who were hospitalized for COVID-19 between September and December 2021 were retrospectively analyzed in three groups: unvaccinated, partially vaccinated, and fully vaccinated. A total of 854 patients were included. Mean age was 47.9 ± 10.6 years, 474 patients (55.5%) were male. Of these, 230 patients (26.9%) were fully vaccinated, 97 (11.3%) were partially vaccinated, and 527 (61.7%) were unvaccinated. Of the fully vaccinated patients, 67% (n 5 153) were vaccinated with CoronaVac and 33% (n 5 77) were vaccinated with Pfizer-BioNTech. All patients (n 5 97) with a single dose were vaccinated with Pfizer-BioNTech. One hundred thirteen (13.2%) patients were transferred to ICU. A hundred (11.7%) patients were intubated and 77 (9.0%) patients died. Advanced age (P 5 0.028, 95% CI 5 1.00-1.07, OR 5 1.038) and higher Charlson Comorbidity Index (CCI) (P < 0.001, 95% CI 5 1.20-1.69, OR 5 1.425) were associated with increased mortality, while being fully vaccinated (P 5 0.008, 95% CI 5 0.23-0.80, OR 5 0.435) was associated with survival in multivariate analysis. Full dose vaccination reduced the need for ICU admission by 49.7% (95% CI 5 17-70) and mortality by 56.5% (95% CI 5 20-77). When the fully vaccinated group was evaluated, we found that death was observed more frequent in patients with CCI>3 (19.1 vs 5.8%, P < 0.01, OR 5 3.7). Therefore, the booster vaccine especially in individuals with comorbidities should not be delayed, since the survival expectation is low in patients with a high comorbidity index.
Introduction: Three treatment-naïve cases with chronic hepatitis B (CHB) were reported in terms o... more Introduction: Three treatment-naïve cases with chronic hepatitis B (CHB) were reported in terms of a partial response to tenofovir disoproxil (TDF) monotherapy and antiviral-drug resistance. Methodology: In this retrospective, case series study, patients who were treated for CHB at the departments of infectious diseases and clinical microbiology, University of Medical Science Bakırköy Dr. Sadi Konuk Training and Research Hospital were evaluated. Results: A 26-year-old female patient and a 59-year-old male patient achieved sustained viral response with TDF (245 mg) or tenofovir alafenamide (TAF, 25 mg) + entekavir (ETV, 1 mg) combination therapy after failure with TDF monotherapy. The son of the female patient who was diagnosed with CHB infection due to a probable mother-to-child transmission did not achieve a complete viral response with interferon alfa-2b therapy for three months followed by lamivudine therapy for 19 months. Conclusions: A TDF (245 mg) or TAF (25 mg) + ETV (1 mg) c...
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