Background: Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. Objective: In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF between 2006 and 2012 based on data obtained from the Bolu Provincial Directorate of Health (BPDH) were evaluated. Methods: BPDH data were reviewed for the period between 1 January 2006 and 31 July 2012. The locations where the tick had attached to the patient, the site of the tick bite on the patient's body, the dates of tick bite and removal, and the demographic characteristics of each patient were recorded. BPDH data on the total number of tick bites, patients with confirmed CCHF, and deaths due to CCHF in Bolu Province during the study period were also evaluated. Results: A total of 46 patients with CCHF and 38 patients without CCHF but who had been bitten by ticks were admitted to the BPDH. Of the patients with CCHF, 54.3% were female. The mean age of the patients was 46.88 ± 2.05 years (range, 1-79 years). The mortality rate was 8.82%. Patients were predominantly observed in June and July. When the patients were distributed according to their occupations, the majority was houswife (48.6%), followed by animal husbandry worker (27.0%), farmer (10.8%), health worker (5.4%), and other (8.1%). The symptoms of the patients with CCHF included fatigue (60.9%), fever (60.9%), and myalgia (60.9%). Of those patients with CCHF, 41.3% were determined to have a high fever. Conclusions: The probability of developing CCHF decreased as the duration of tick attachment increased. Moreover, although the clinical presentation is important, it is not diagnostic. Physical examination and laboratory findings become more specific in later stages.
Background:To evaluate the all erythrocyte parameters in patients with brucellosis and to investigate the correlation between these parameters and inflammatory markers. Method: A total of 55 patients who had positive brucella tube agglutination tests were included in the study. The computerized laboratory database records were reviewed for the following data and recorded: Age and gender of the patients, brucella tube agglutination tests, erythrocyte sedimentation rate, C-reactive protein, erythrocyte parameters. Results: Mean age of the patients was 45.4 ± 18.1 years with a female/male ratio of 25/30. Post-treatment hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration values were significantly higher than the pre-treatment values. Conclusion:Evaluation of the erythrocyte parameters may help to improve understanding of anemia and its nature related with brucellosis. Amaç: Bruselloz hastalarında tüm eritrosit parametrelerini değerlendirmek ve bu parametreler ile inflamatuar belirteçler arasındaki ilişkiyi araştırmak. Yöntem: Çalışmaya brusella tüp aglütinasyon pozitif toplam 55 hasta alındı. Hastaların yaş ve cinsiyetleri, brusella tüp aglütinasyon testi sonuçları, eritrosit sedimantasyon hızları, C-reaktif protein ve eritrosit parametreleri ile ilgili veriler laboratuvar kayıtlarından incelendi. Bulgular: Hastalarda ortalama yaş 45,4 ± 18,1 ve kadın/erkek oranı 25/30'du. Tedavi sonrası hemoglobin, hematokrit, ortalama eritrosit hacmi, ortalama eritrosit hemoglobin ve ortalama eritrosit hemoglobini konsantrasyon değerleri tedavi öncesi değerlere gore anlamlı olarak daha yüksek bulundu. Sonuç: Eritrosit parametrelerinin değerlendirilmesi aneminin ve brusellozla ilişkili doğasının anlaşılmasında fayda sağlayabileceği düşünülmüştür.
Objectives: Antimicrobials are the most widely used drug groups and antibiotic resistance due to irrational antimicrobial usage is a major problem in the world. The aim of this study is to evaluate attitudes of family physicians antimicrobial prescribing. Materials and methods:This study was conducted in November 2006 in Bolu and Duzce provinces where the first family physician practices were initiated in Turkey. The records of family physicians were reviewed retrospectively. Patients' data, social security institution of the patients, the diagnosis and prescribed antibiotics, duration, dosage and routes of antibiotic administration were recorded.Results: A total of 4,497 patients were included in the study consisting of 1,752 (39%) men, and 2,745 (61%) women. The mean age of the patients was 36.6 ± 22.7 years. Antimicrobials were prescribed to 1,167 patients (25.9%). Among 1,167 antibiotics, 1,064 (91.2%) were administered orally, 77 (6.6%) were paranteral and 26 (2.2%) were taken through other routes. In 39 (3.3%) patients, there was no indication for antimicrobial use. In 103 patients (9.1%) from the accurate antibiotic indication group, the choice of the agent was not consistent with the guidelines. In 273 patients (23.4%) on antimicrobial therapy, duration of the antibiotic was inappropriate. The most common indication of the antibiotic prescription was tonsillopharyngitis and the most prescribed antibiotics for this diagnosis were beta lactam/beta lactamase inhibitors. Sonuç: Sonuç olarak, solunum yolu enfeksiyonları başta olmak üzere birinci basamakta tedavi verilen hastalarda, antibiyotik kullanımı oldukça fazladır. Birinci basamakta çalışan hekimlere rasyonel antimikrobiyal kullanımı ile ilgili mezuniyet sonrası periyodik eğitimler düzenlenmelidir. Conclusions
Hydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.
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