Objective:We aimed to find the incidence and risk factors of hematologic adverse effects of piperacillin-tazobactam (TZP).Materials and Methods:Adult patients who used TZP for more than 10 days were included in the study.Results:The incidence of leukopenia, neutropenia, and eosinophilia in 110 TZP therapy episodes was found to be 16.3%, 10%, and 10%, respectively. Lower Charlson Comorbidity Index score, lower initial leukocyte count, combination of TZP with another antibiotic, and total duration of TZP therapy were found to be independent risk factors for leukopenia, while initial higher eosinophil count (IHEC) and usage of TZP for >20 days were independent risk factors for neutropenia and IHEC and total duration of TZP therapy were independent risk factors for eosinophilia.Conclusion:Longer duration of therapy, combination with other antibiotics, younger age with fewer comorbidities, and IHEC could result in hematologic adverse effects in patients treated with TZP. Patients with IHEC may be more prone to allergic reactions, so immunological mechanisms may facilitate the development of hematological adverse effects of TZP.

Objective: In this study, we aimed to determine the characteristics of COVID-19 pneumonia patients, and also predict factors affecting the severity of the disease.Methods: This is a retrospective, single-center study. Hospitalized COVID-19 pneumonia patients aged over 18 years between March 19 th 2020, and May 19 th 2020 were included in the study. The demographic, and clinical characteristics of patients, and factors associated with severe COVID-19 were analyzed. Mul-ÖZET Amaç: Bu çalışmada COVID-19 pnömonili hastalarının özelliklerini ve aynı zamanda hastalığın şiddetini etkileyen faktörleri belirlemeyi amaçladık.Gereç ve Yöntem: Çalışmamız tek merkezli, retrospektif bir çalışmadır. Çalışmaya 19 Mart -19 Mayıs 2020 tarihlerinde hastanede yatan, 18 yaş ve üstü, COVID-19 pnömonili hasta dahil edildi. Hastaların demografik, klinik özellikleri ve şiddetli COVID-19 ile ilişkili faktörler analiz edildi. Şiddetli COVID-19'u öngören faktör-Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Objective: In this study, we aimed to determine the demographic and clinical characteristics of HIV-positive patients seen in our faculty; and to put forward the differences in virological response, immunological response and adverse effects of administered antiretroviral therapy (ART) regimens in these patients. Methods: Medical records of 175 HIV-positive patients over 18 years old followed between 2003 and 2015 and have not been treated before, and regularly monitored for a minimum of six months from the beginning of the therapy were included in the study. Demographic, clinical and laboratory data of patients were collected retrospectively. IBM SPSS Statistics for Windows. Version 21.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA) was used in statistical analysis of the study data. Results: Mostly used ART regimens in our outpatient clinic were ritonavir-boosted lopinavir (LPV/r) (n=102) and efavirenz (EFV) (n=39) combined with tenofovir/emtricitabine (TDF/FTC). Patients who used LPV/r were in a more advanced disease stage. Acquisition rate of virological response was 59% in the group receiving EFV and 53.9% in the group receiving LPV/r. The average increase in CD4+ T lymphocyte count at the sixth month of therapy was 258±222/μL in LPV/r group, 189±197/ μL in EFV group. The rate of increase in CD4+ T lymphocyte count was in favor of LPV/r group (p=0.017). Skipped drug doses (p=0.211), clinical adverse effects (p=0.276) and modification in ART regimen (p=0.044) were more common in EFV group. Increased cholesterol and low-density lipoprotein (LDL) level and decreased high-density lipoprotein (HDL) level were seen Özet Amaç: Fakültemizde izlenen HIV-pozitif hastaların demografik ve klinik özelliklerinin belirlenmesi ve bu hastalara uygulanan antiretroviral tedavi (ART) rejimleri arasında virolojik yanıt, immünolojik yanıt ve istenmeyen etkiler açısından ne gibi farklar olduğunun ortaya konulması amaçlandı. Yöntemler: 2003-2015 yıllarında polikliniğimizde izlenen, HIV infeksiyonu nedeniyle daha önce herhangi bir tedavi görmemiş ve ilk kez başlanan ART'nin en az altı aydır düzenli olarak sürdürüldüğü 18 yaşından büyük 175 hasta çalışma kapsamına alındı. Bu hastaların demografik, laboratuvar ve klinik bilgileri retrospektif olarak toplandı. Çalışma verilerinin istatistiksel analizinde IBM SPSS Statistics for Windows. Version 21.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, ABD) kullanıldı. Bulgular: Hastalarda en çok kullanılan rejimler, tenofovir/emtrisitabin (TDF/FTC)'in ritonavirle güçlendirilmiş lopinavir (LPV/r) (n=102) ya da efavirenz (EFV) (n=39) ile kombine edildiği rejimlerdi. LPV/r uygulananların arasında daha ileri evrelerdeki hastalar ağır basmaktaydı; bu hastalarda eşlik eden fırsatçı infeksiyonlar ve profilaktik ilaç kullanımı da daha fazlaydı (p<0.05). Virolojik yanıt elde etme oranı, EFV alan grupta %59; LPV/r alan grupta %53.9'du. Tedavinin 6. ayında CD4+ T lenfositi sayısındaki ortalama artış, LPV/r grubunda 258±222/μl, EFV grubunda 189±197/μl ol...

COVID-19 vaccines are highly protective against severe disease; however, vaccine breakthrough infections resulting in hospitalization may still occur in a small percentage of vaccinated individuals. We investigated whether the clinical and microbiological features and outcomes were different between hospitalized COVID-19 patients who were either fully vaccinated with Coronovac or not. All hospitalized COVID-19 patients who had at least one dose of Coronavac were included in the study. The oldest unvaccinated patients with comorbidities, who were hospitalized during the same period, were chosen as controls. All epidemiologic, clinical and laboratory data of the patients were recorded and compared between the fully vaccinated and unvaccinated individuals. There were 69 and 217 patients who had been either fully vaccinated with Coronavac or not, respectively. All breakthrough infections occurred in the first 3 months of vaccination. Fully vaccinated patients were older and had more comorbidities than unvaccinated patients. There were minor differences between the groups in symptoms, physical and laboratory findings, anti-spike IgG positivity rate and level, the severity of COVID-19, complications, and clinical improvement rate. The mortality rate of fully vaccinated patients was higher than the mortality rate in unvaccinated patients in univariate analysis, which was attributed to the fact that vaccinated patients were older and had more comorbidities. The severity and clinical outcomes of hospitalized patients with breakthrough COVID-19 after Coronavac vaccination were similar to those of unvaccinated patients. Our findings suggest that the immune response elicited by Coronovac could be insufficient to prevent COVID-19-related severe disease and death within 3 months of vaccination among elderly people with comorbidities.

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