Giris ve Amac: Kadina yonelik siddet ozellikle gebelik doneminde hem anne hem de fetal sagligi etkileyen bir sorundur. Bununla birlikte depresyon, posttravmatik stres bozuklugu, preterm eylem, dusuk, fetal gelisme geriligi, dusuk dogum agirlikli bebek gibi bircok olumsuz saglik sorununa yol acabilmekte ve hatta bazen kadinin olumu ile sonuclanabilmektedir. Turkiye genelinde en az bir kez gebe kalmis her on kadindan biri gebeligi sirasinda esi veya birlikte oldugu kisi(ler) tarafindan fiziksel siddet yasamistir. Calismamizda ……ili…..Ilce Saglik Mudurlugu Saglikli Hayat Merkezi’ne(SHM) 2019 yilinin ikinci yarisinda basvuran gebelerin aile ici siddetle karsilasma durumlarinin degerlendirilmesini amacladik. Gerec ve Yontem: Kesitsel nitelikteki arastirmamizin evrenini 15 Haziran-15 Aralik 2019 tarihleri arasinda…….Ilce Saglik Mudurlugu SHM’ne basvuran tum gebeler olusturmustur. 15 Eylul 2019’a kadar 78 gebeye anket uygulanmistir. Bu veriler calismamizin 3 aylik ara sonuclarinin degerlendirilmesine aittir. 15 Aralik 2019 tarihine kadar veri toplama asamasi devam edecektir. Yuz yuze gorusme yonteminin kullanildigi anket formunun uygulamasi yaklasik 15 dakika surmustur. Arastirmamizin bagimli degiskeni; gebelik suresince aile ici siddetle karsilasma durumudur. Siddetle karsilasma durumu fiziksel, sozlu, cinsel, psikolojik(duygusal), finansal, sosyal siddetle karsilasma durumu alt basliklarinda irdelenmistir. Bagimsiz degiskenler ise; sosyodemografik, evlilik durum, gebelik durumu ve siddet ile ilgili degiskenler alt basliklarda incelenmistir. Verilerimiz ara donem sonuclari oldugundan dolayi tanimlayici istatistiklerle ozetlenmistir, analitik yonde inceleme yapilamamistir. Veri toplama asamasi tamamlandiktan sonra bu yondeki analizler yapilacaktir. Verilerin analizinde SPSS 22.0 paket programi kullanilmistir. Arastirma etik kurallar cercevesinde yurutulmustur. Calismadan once ……..Universitesi Bilimsel Arastirmalar ve Yayin Etik Kurulundan ve …….Il Saglik Mudurlugunden onay alinmistir. Bulgular: SHM’ne basvuran gebelerin yas ortalamasi 28,9±4,5 ve eslerinin yas ortalamasi 32,3±4,8’dir. Katilimcilarin %69.2’sinin ogrenimi universite duzeyinde, %55.1’i herhangi bir iste calisiyor, %32.1’inin meslegi ev hanimi, %21.8’i ise saglik calisanidir. Katilanlarin eslerinin %53,8’inin egitim duzeyi universite, %94.9’u calisiyor. Katilimcilarin %64.1’i evlerinde 2 kisi olarak yasamaktaydilar. Katilimcilarin %84,6’sinin evlenme bicimi medeni nikah ve imam nikahi idi. Katilimcilarin evlenme yasi ortalamasi 24,9±4,1 idi. Ankete katilanlarin %94,9’unun ilk evliligi idi. Calismamiza katilanlarin %59,0’inin ilk gebeligi idi. Katilimcilarin gebelik haftasina bakildiginda %41.0’inin 3.trimesterde, %39.7’sinin 2.trimesterde oldugu bulunmustur. Katilanlarin %87,2’sinin gebelikleri planli gebelik idi. Ankete katilanlarin %1,3’u gebelik oncesi donemde siddete maruz kaldigini bildirdi. Katilimcilarin %5,1’i suanki gebelik doneminde aileici siddetin herhangi bir turune maruz kaldigini bildirdi. Sonuc ve Oneriler: Calismamizin ara sonucunda gebelerin aile ici siddetle karsilasma sikliginin dusuk oldugu gorulmustur. Ayrica egitim duzeyi yuksek ve calisan gebeler daha cok SHM’ye basvurmustur. Hamilelik sirasinda aile ici siddete karsi korunma konusunda farkindalik yaratmak ve siddet yonunden risk altindaki gebeleri saptayip uzmanlara yonlendirmek faydali olacaktir. Anahtar sozcukler: Gebe, Siddet, Aile ici siddet, Mugla, Saglikli Hayat Merkezi
BackgroundThe aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications.MethodsThis retrospective, multicenter cohort study involved a 15-year period (1998–2012). Culture-positive cases (n = 306) were included solely from 38 centers.ResultsFifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230–15.557) and age over 50 years (OR 3.908, 95% CI 1.820–8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195–0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949–4.912).ConclusionsCeftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment.
Objective: Following the antimycobacterial resistance that has been emerging, and struggling the against resistance has become as important as effective treatment in tuberculosis control. The drug susceptibility test (DST) results of 229 M.tuberculosis (MTB) which had been isolated on Lowenstein-Jensen (L-J) medium from various clinical samples were evaluated. Material and Methods: All isolates are originated from112 pulmonary samples and 117 extrapulmonary samples. After decontamination and L-J culture procedures, all isolates were identified as MTB complex by using conventional biochemical tests including niacin, nitrate, catalase and catalase tests implemented at 68°C. DST was performed by E test (AB Biodisk, Sweeden) method for isoniazid (INH), rifampicin (RIF), ethambuthol (EMB) and streptomycin (SM) according to manufacturer advices. L-J proportion method was performed for 59 MTB isolates in addition to E test. Results: The overall resistance rates of INH and RIF were 4% and resistance to SM was 2% and of EMB was 1%. The resistant isolates were found generally in the isolates originated from pulmonary samples. The resistance rates to INH and RIF were 7%, to SM 3% and to EMB 2% for pulmonary; and to INH, RIF and SM were 1% and to EMB was 0% for extrapulmonary isolates, respectively. INH and RIF resistance was significantly higher in pulmonary isolates (p< 0.05). In 59 MTB isolates, agreement between E test and L-J proportion was 95% for INH and EMB, 86% for RIF, and 85% for SM. Conclusion: According to DST results, antimycobacterial resistance rates in extrapulmonary MTB isolates were significantly lower than pulmonary isolates. E test method which is known as a reasonably fast test in comparison with conventional susceptibiliy tests may be used as a rapid diagnostic test method for DST. However, there is a need for further E test studies comparing standard methods in more MTB isolates.
Abstract Background We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15–20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in ~ 80% of cases. Methods We report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded. Results No gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7 , with an OR of 27.68 (95%CI 1.5–528.7, P = 1.1 × 10 −4 ) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR = 3.70[95%CI 1.3–8.2], P = 2.1 × 10 −4 ). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR = 19.65[95%CI 2.1–2635.4], P = 3.4 × 10 −3 ), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR = 4.40[9%CI 2.3–8.4], P = 7.7 × 10 −8 ). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD] = 43.3 [20.3] years) than the other patients (56.0 [17.3] years; P = 1.68 × 10 −5 ). Conclusions Rare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old.
To identify the taste and smell impairment in coronavirus disease 2019 (COVID-19)-positive subjects and compare the findings with COVID-19-negative subjects using the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Anosmia Reporting Tool.Tertiary referral center/COVID-19 pandemic hospital.Comparative study.After power analysis, 128 subjects were divided into 2 groups according to real-time polymerase chain reaction (RT-PCR) COVID-19 testing results. Subjects were called via telephone, and the AAO-HNS Anosmia Reporting Tool was used to collect responses.The mean age of the study group was 38.63 ± 10.08 years. At the time of sampling, rhinorrhea was significantly high in the COVID-19-negative group, whereas those complaints described as "other" were significantly high in the COVID-19-positive group. There was a significant difference in the smell/taste impairment rates of the groups (n = 46% [71.9%] for the COVID-19-positive group vs n = 17 [26.6%] for the COVID-19-negative group, P = .001). For subjects with a smell impairment, anosmia rates did not differ between the groups. The rates of hyposmia and parosmia were significantly high in the COVID-19-positive group. For the subjects with taste impairment, ageusia rates did not differ between groups. The rate of hypogeusia and dysgeusia was significantly high in the COVID-19-positive group. Logistic regression analysis indicates that smell/taste impairment in COVID-19-positive subjects increases the odds ratio by 6.956 (95% CI, 3.16-15.29) times.COVID-19-positive subjects are strongly associated with smell/taste impairment.
Cardiac complications are becoming increasingly important in patients with HIV infection.Right-sided endocarditis are more common in intravenous drug users (IVDU) with HIV infection.Some studies have pointed out that the clinical outcome of such patients depends on the affected valve referred to the responsible agent rather than the HIV serostatus.However, severe immunosupression and low CD 4 count are associated with increased risk of death.This report presents a case of isolated tricuspid valve endocarditis with advanced HIV infection who was also an IVDU.
Background: The COVID-19 pandemic caused by SARS-CoV-2 commenced in Wuhan China in 2019 and soon spread worldwide. It is a viral disease that involves many organs and progresses with high mortality. SARS-CoV-2 enters the cell by binding to the ACE II receptor and begins viral replication. A serious immune response occurs where it settles leading to to tissue damage. The effects and clinical findings of SARS-CoV-2 on the liver, kidney, heart, gastrointestinal (GI) system and especially lungs have been widely discussed. However, the effects on the pancreas—another organ that also expresses ACE II—have not been studied. Methods: This work prospectively evaluated data from 316 patients who were admitted with a diagnosis of COVID-19 pneumonia. The patients were categorized into three according to the severity of pneumonia (mild, severe, critical). Demographic data, rate of pancreatitis, biochemical parameters, and radiological images from each group were analyzed. The patients were divided into two groups and outcomes were compared: COVID-19 patients with acute pancreatitis (Group P) and without acute pancreatitis (Group C). Findings: 12·6% of the patients had acute pancreatitis. While pancreatitis was not seen in patients on mild status, the rate of pancreatitis was 32·5% in critical patients. Hospitalization and mortality rates were higher in patients with COVID-19 accompanied by acute pancreatitis (p = 0·0038 and p <0·0001, respectively). Interpretation: Acute pancreatitis alone is a clinical condition that can lead to mortality and may be one of the reasons for the exaggerated immune response developing in the progression of COVID-19. In this study, the effects of pancreatic damage related to acute pancreatitis were investigated in terms of morbidity and mortality in COVID-19 patients.Funding Statement: This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.Declaration of Interests: All other authors declare no competing interests.Ethics Approval Statement: This study was carried out in accordance with the 1964 Helsinki Declaration and its recent amendments. Consents were obtained from conscious patients and from first degree relatives in unconscious patients. Permission was obtained from the local ethics committee (Ref. Nr:2020/148) and the Ministry of Health Scientific Research Institution (Ref. Nr:2020-05-04T_11_33_11).
One of the reasons for the high mortality in COVID-19 patients is the increased risk of disseminated intravascular coagulation (DIC) and venous thromboembolism. For this reason, the use of anticoagulant treatments has become widespread. One of the rare complications of anticoagulant therapy is retroperitoneal hemorrhage. These hemorrhagies require immediate intervention. Retroperitoneal hemorrhage should be kept in mind among the many complications that develop in the patient who was followed up during the pandemic period. For this purpose, we present 2 cases who developed spontaneous retroperitoneal bleeding while clinically recovering under COVID-19 treatment.
Objective: H1N1 pandemic which is the first pandemic of 21st century has currently affected worldwide including our country. The aim of the present research was to analyze the clinical, laboratory and radiological characteristics of 46 confirmed cases who were hospitalized with H1N1 influenza in our clinic. Materials and Methods: Among probable patients for H1N1, 46 confirmed cases who tested positive for the H1N1 virus by real-time PCR were included in present study. All of them were treated with oseltamivir while patients suggested bacterial superinfection were also treated with antibiotics. Results: Thirty (65%) were females; six were pregnant and 10 (22%) were imported cases. They aged between 17 and 58 years old (median: 30,65±10,21). Fever, cough, sore throat and myalgia were the most frequent symptoms. The median time from the onset of illness to hospital admission was three days. Most of patients had diffuse bilateral pulmonary infiltrates in chest X-rays. Four patients had been admitted to an intensive care unit (ICU); three (7%) of them died; all of them had an underlying disease. Twenty three (50%) patients received antibiotics in addition to oseltamivir. Conclusion: The influenza A pandemic due to novel H1N1; mostly affected children, young adults, healthy people and pregnants in Turkey as other countries. The hospitalization rates rised due to severe pneumonia and need for ICU. Severe course and death were seen especially in patients who had underlying disease. Therefore, risky groups should be vaccinated, public should be informed about measures which will prevent contamination like hand washing.
