We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae.

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Yeni tip Korona virus enfeksiyonun erişkin yaş grubunda klinik bulguları değişkenlik göstermekle birlikte en sık semptomlar ateş, kuru öksürük ve nefes darlığıdır. Bunlara boğaz ağrısı, myalji, başağrısı ve halsizlik eşlik edebilir. Daha nadir olarak anozmi, tat kaybının yanısıra bulantı, ishal gibi gastrointestinal semptomlar da saptanabilir. İleri yaş ve eşlik eden komorbid hastalıkların varlığı klinik tablonun ağırlaşmasında rol oynar. Klinik ARDS'ye ilerleyebilir. Olası ve kesin olgu tanımlarında laboratuvar ve radyolojik verilerin yanında klinik bulgular önem taşır.

Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien–Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk.

Background It could be of great benefit to determine smell and taste dysfunction in COVID-19 patients and to investigate the relationship between these symptoms and clinical characteristics as the determination of points requiring attention during the clinical course of the disease. Method Evaluations of patients diagnosed with COVID-19 were made using a questionnaire method. Those with smell and taste dysfunction completed a visual analog scale (VAS) to determine severity. The patients were evaluated at the end of 1 and 2 months. Results Evaluation was made of a total of 105 patients with a mean age of 55.9±17.6 years. Smell and taste dysfunction was present in 56 (53.3%) patients with a mean age of 48.7±17.6 years and the 49 (46.7%) patients with no smell and taste dysfunction had a mean age of 64±13.6 years. It was determined that as age increased, the complaints of smell and taste dysfunction decreased. Full recovery was determined in 31 (55%) patients after 1 month, and in 16 (28%) patients, smell and taste dysfunction continued at the end of the second month. The symptoms of smell and taste dysfunction were determined to last longer in patients with no comorbidities, no symptoms of fever or shortness of breath, and those treated as outpatients (p=0.043, p=0.031, p=0.034, p=0.028, respectively). In the older age patient group, the VAS scores were observed to be higher and the time to recovery was shorter (p=0.007, p=0.018, respectively). Conclusion Smell and taste dysfunction in COVID-19 patients is seen more as age decreases and recovery takes longer. Smell and taste dysfunction is seen more in patients with symptoms of cough, nasal obstruction, and headache and lasts longer in patients without symptoms of fever and shortness of breath, with no comorbidities and in those treated as outpatients.