Aim: Candidemia has high morbidity and mortality rate in critically ill patients hospitalized in intensive care units. Prompt initiation of accurate anti-fungal therapy is essential for survival. In ...this study, a 6-year retrospective candidemia analysis of pediatric intensive care unit (PICU) was performed to review candida species distribution, risk factors for candidemia and change in the antifungal resistance in years.
Material and Method: The candidemia episodes of children followed in the PICU of XXX Hospital between January 2014 and January 2020 were analyzed. The demographic and clinical characteristics, laboratory findings, treatments and outcomes of the patients were obtained from the medical records.
Results: Fifty-nine episodes of candidemia (54.2% female) were reported in six years, median age at diagnosis was 43 months (range 1-225), median hospital stay was 48 days (range 3-664). All patients had used broad-spectrum antibiotics, majority had comorbidities (89.8%), nasogastric tube (84.7), central venous catheter (78.0%), and on mechanic ventilation (76.3%). Type of candida species was identified in 36 episodes of candidemia; 47.2% of these episodes were caused by C. parapsilosis, 38,9% by C. albicans, 8.3% by C. glabrata (8.3%), 2.8% by C. lusitaniae, and 2.8% by C. tropicalis. Length of hospital stay was longer among patients with nonalbicans candidemia, and these patients had higher leucocyte count at diagnosis. The rate of antifungal resistance increased over the years. Overall, thirty-day mortality rate was 16.9%.
Conclusion: For critically ill patients with markedly elevated leucocyte count and long hospital stay, empiric antifungal treatment should cover nonalbicans candida with antifungal resistance.
Amaç: Kandidemi yoğun bakım ünitelerinde yatan kritik hastalarda yüksek morbidite ve mortalite oranına sahiptir. Sağ kalım için doğru anti-fungal tedavinin gecikmeden başlanmasının hayati önemi vardır. Bu çalışmada, kandida türlerinin dağılımını, kandidemi için risk faktörlerini ve yıllar içinde anti-fungal dirençteki değişimi gözden geçirmek için bir Çocuk Yoğun Bakım Ünitesi (ÇYBÜ)’inde gözlenen kandidemi ataklarının 6 yıllık retrospektif analizi yapıldı.
Gereç ve Yöntem: Ocak 2014- Ocak 2020 tarihleri arasında XXX Hastanesi ÇYBÜ’inde yatan hastalarda gözlenen kandidemi atakları incelendi. Hastaların demografik ve klinik özellikleri, laboratuvar bulguları, tedavileri ve sonuçları tıbbi kayıtlarından elde edildi.
Bulgular: Altı yılda 59 kandidemi atağı (%54,2) olmuştu, tanı anındaki medyan yaş 43 ay (aralık 1-225), medyan hastanede kalış süresi 48 gün (aralık 3-664) idi. Hastaların tümü antibiyotik kullanmıştı, çoğunda komorbidite (%89,8), nazogastrik tüp (84,7), santral venöz kateter (%78,0) ve mekanik ventilasyon (%76,3) vardı. Otuz altı kandidemi epizodunda etken olan kandida türleri tanımlanmıştır; bu atakların %47,2’si C. parapsilosis, %38,9’u C. albicans, %8,3’ü C glabrata, %2,8’i C lusitaniae ve %2,8’i C. tropicalis’den kaynaklanmıştı. Non-albicans kandidemili hastalarda albicans kandidemili hastalara göre hastanede kalış süresi daha uzundu ve bu hastaların tanı anında lökosit sayısı daha yüksekti. Yıllar geçtikçe anti-fungal direnç oranında artış vardı, ancak istatiksel olarak anlamlı fark yoktu. Genel olarak, otuz günlük ölüm oranı%16,9 idi.
Sonuç: Belirgin derecede yüksek lökosit sayısı ve uzun hastanede kalış süresi olan kritik hastalarda, başlanacak ampirik antifungal tedavi antifungal direnci olabilen nonalbicans candida'yı kapsamalıdır
Bu çalışma Ankara Üniversitesi Yabancı Diller Yüksekokulu Almanca hazırlık sınıfı öğrencilerinin yazılı anlatımlarında yaptıkları yanlışların kaynaklarının yanlış çözümlemesi uygulanarak tespit ...edilmesi ve böylece yazma eğitiminde iyileştirici uygulamaların tespiti amacını taşıyan betimsel bir çalışmadır.Bu çalışmada öğrencilerden iki öğretim yılı boyunca yazma dersinde belirli zaman aralıklarıyla yazılı dilde veriler alınmış, alınan bu veriler geliştirilen “ Almanca Yazılı Anlatım Değerlendirme Ölçeği” ile belirli başlıklar altında sınıflandırılıp yorumlanmıştır. Araştırmacının bu veriler toplanırken veya yıl boyunca devam eden yabancı dil öğrenme süresince ders işleme tekniği ve materyal bakımından herhangi bir müdahalesi olmamıştır. Alınan verilerin hepsi öğrencinin kendi dil bilgisini yansıtmaktadır. Öğrenci profilini daha geçerli bir şekilde belirlemek ve öğrencilerin yaptıkları yanlışlarla ilgili tutum ve düşüncelerini ortaya koyabilmek için, öğrencilerden 16 çoktan seçmeli sorudan oluşan “ Kişisel Bilgi Formu” ‘na cevap vermeleri istenmiştir (bkz. EK-1). “Kişisel Bilgi Formu”sorularına verilen cevaplar ve “ Almanca Yazılı Anlatım Değerlendirme Ölçeği” verileri SPSS İstatiksel Analiz Programı ile değerlendirilerek, bulguların yüzdelik oranları ve yorumlanması yapılmıştır.Elde edilen verilerin sonuçlarına göre, yanlışların genellikle ana dilden yapılan yanlış aktarımlardan kaynaklandığı tespit edilmiştir. Bu nedenle kaynağı kesin belli olan problemli noktaların yanlış çözümlemesi yoluyla çözümlenmesiyle tamamlayıcı öğretim ile iyileştirilmesi amaçlanmaktadır.
In this study, the goal was to evaluate the impact of nosocomial rotavirus gastroenteritis in pediatric patients by determining the incidence of nosocomial rotavirus gastroenteritis, the resulting ...duration of hospital stay, and direct cost. To our knowledge, this is the first study in Turkey that evaluates the impact of pediatric nosocomial rotavirus gastroenteritis on duration of hospital stay and calculates the direct cost.
Forty-nine patients who were diagnosed with nosocomial rotavirus gastroenteritis and hospitalized were included in the study. Nosocomial infection rates, organ systems affected by the nosocomial infections, and patients who had nosocomial rotavirus gastroenteritis were identified. A direct cost analysis of patients who were diagnosed with nosocomial rotavirus gastroenteritis was performed using copies of the invoices for the hospital bills.
During the study period, there were 49 cases of nosocomial rotavirus gastroenteritis. The length of hospitalization was extended, on average, by more than 6.3 days in cases of nosocomial rotavirus gastroenteritis. The cost of hospitalization for patients with nosocomial rotavirus gastroenteritis was on average 1,554 ± 2,067 US dollars, compared to a cost of only 244 ± 103 US dollars for patients who did not have nosocomial rotavirus gastroenteritis. This difference in cost was statistically significant (p < 0.05).
Nosocomial rotavirus gastroenteritis is important because it significantly prolongs hospital stay and increases the social and economic burden of the hospitalization. Nosocomial rotavirus gastroenteritis can be reduced with prevention measures such as handwashing, isolation, and cohorting.
COVID-19 immunization was implemented with emergency-use authorization. We had concerns/lack of information on mRNA vaccine side effects in different inborn errors of immunity (IEI) types.
We ...enrolled 141 patients (IEIP) and 151 healthy controls(HC) who received SARS-CoV-2 vaccine/s(Sinovac and/or Pfizer-BioNTech(mRNA vaccine), one to five doses), questioned them for side-effects, evaluated in three groups according to the vaccine/s they received; only Sinovac, only Pfizer-BioNTech, and both vaccines.
Arm pain, generalized weakness, myalgia, and fever were common side effects in IEI-P and HC groups. Generalized weakness/fatigue, fever, and palpitation were significantly frequent in IEI-P who experienced COVID-19 compared to those who did not (p = 0.021, p = 0.047, and p = 0.024, respectively). Severe symptoms after vaccination, new-onset splenomegaly and pancytopenia, urticaria, herpes simplex virus (HSV), and varicella zoster virus (VZV) reactivation were seen in four IEI-P (2.8%).
IEI-P mRNA vaccination is relatively safe compared to the conventional vaccine. Individuals who experience uncommon side effects should undergo immunological screening.
Our aim in this study was to compare the depression and anxiety risk in patients with AS and healthy controls and also to determine the relationship between disease activity, quality of life and ...psychological well-being. Two hundred and forty-three patients with ankylosing spondylitis (AS) and 118 age-, sex- and education-matched healthy controls were enroled into the study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index, and Metrology Index, Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), Hospital Anxiety and Depression Scale (HADS) including depression subscale (HADS-D) and anxiety subscale (HADS-A), Ankylosing Spondylitis Quality of Life (ASQoL) Scale, duration of morning stiffness, pain-visual analogue scale (VAS), patient and physician’s global assessment of disease activity (100 mm VAS) were used to assess clinical and psychological status. Patients had similar HADS-D but higher HADS-A than healthy controls. Patients with high risk for depression and anxiety had higher scores in BASDAI, BASFI and also poorer scores in VAS pain, patient global assessment, physician global assessment, HAQ-S and ASQoL. There was a negative correlation of HADS-D and HADS-A scores with educational level of the patients. Higher scores in HADS-D and HADS-A indicated poorer functional outcome and quality of life. Multivariate logistic regression analysis revealed that the HADS-D (OR = 6.84), HAQ-S (OR = 1.76), VAS pain score (OR = 1.03) and ESR (OR = 1.02) were independent risk factors for higher anxiety scores whereas HADS-A (OR = 1.36) and ASQoL (OR = 1.24) were independent risk factors for higher depression scores. The psychological status had close interaction with disease activity and quality of life in patients with AS.
To assess the frequency of juvenile onset ankylosing spondylitis (JOAS) in Turkish patients with AS and to compare with adult onset AS (AOAS) in a cross-sectional study design.
A total of 322 ...patients were recruited from the joint database of 5 university hospitals in eastern Turkey.
Patients with JOAS (n = 43, 13.4%) had significantly longer diagnostic delay (9.21 vs 5.08 yrs), less severe axial involvement and more prevalent uveitis (OR 2.92, 95% CI 1.25-6.79), and peripheral involvement at onset (OR 3.25, 95% CI 1.51-6.98, adjusted for current age; and OR 2.26, 95% CI 1.07-4.76, adjusted for disease duration). Patients with AOAS had higher radiographic scores and more restricted clinimetrics but similar functional limitations and quality of life.
JOAS and AOAS had distinctive courses and Turkish patients with AS had similar features compared to other Caucasian patient populations.
The aim of this study was to assess the point prevalences of hay fever, asthma, and atopic dermatitis in OA, RA, and AS, and to compare with healthy controls.
A total of 935 patients and healthy ...controls were included. Demographic and clinical features were recorded, and a questionnaire assessing the existence of atopic disorders like asthma, hay fever, and atopic dermatitis in all groups was applied. "Either atopy" implied that an individual was either diagnosed with or had symptoms of one or more of these disorders, such as asthma, hay fever, or atopic dermatitis.
When compared to the controls, only patients with AS had an increased risk for hay fever (OR 1.52, 95 % CI 1.00-2.41). Patients with RA had increased risks for hay fever, atopic dermatitis, and either atopy compared to the patients with OA (2.14, 95 % CI 1.18-3.89; 1.77, 95 % CI 1.00-3.18; and 3.45, 95 % CI 1.10-10.87, respectively). Steroid use had no effect on the prevalence of atopic disorders in patients with RA.
Patients with OA, RA, and AS seem to have similar risks for asthma, atopic dermatitis, and either atopy to healthy controls. However, the prevalence of hay fever may increase in AS. Patients with RA have a higher risk of atopy than patients with OA.
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