Background The first case of a novel coronavirus (COVID-19) infection was detected in Wuhan, fever and respiratory symptoms have been frequently reported in patients infected with this virus. Aim It was aimed to compare the symptoms of patients with COVID-19 positivity and patients without COVID-19 positivity hospitalized with suspicion of COVID-19. Methods Patients presenting to the Sakarya University Training and Research Hospital with suspicion of COVID-19 were included in the study. Samples were obtained from the patients and PCR tests were performed; the patients were grouped as COVID-19 positive and COVID-19 negative; these two groups were questioned for 15 symptoms and the results were compared. Results A total of 297 patients with suspicion of COVID-19 were included in the study. COVID-19 was positive in 143 patients and negative in 154 patients. The most common symptoms in the COVID-19 positive group were: cough (56.6%), weakness (56.6%), taste disorder (35.7%), myalgia (34.3%), and fever (33.6%); and in the COVID-19 negative group: cough (63%), weakness (45.5%), dyspnea (29.9%), headache (27.3%) and fever (24.7%). When these two groups were compared, taste disorder, smell disorder and diarrhea were significantly higher in the COVID-19 positive group (p = <0,00001, p = 0,00001 and p = 0,02). Conclusion Our study showed that taste and smell disorders and diarrhea were important markers in COVID-19 infection.
Introduction Although there are international guidelines for surgical antibiotic prophylaxis (SP), the use of inappropriate SP is still a common problem. Most studies investigated SP applications in clean and clean-contaminated cases. However, antibiotics in the discharge prescriptions of these cases have not been adequately investigated. In this study, we aimed to examine the antibiotics in SP applications and discharged prescriptions together and to find out the causes of inappropriate use. Materials and methods We retrospectively evaluated the data of patients admitted to our general surgery wards between 2014 and 2015. Patients with clean or clean-contaminated wound category operations were included. The patients were evaluated in terms of convenience of SP (choice of antibiotics, compliance with an indication for SP, timing of the first dose, SP>24 hours, and discharge prescription). In addition, to interpret the results, a questionnaire has been performed for the surgeons in the same clinics. Results A total of 1205 patients with clean and clean-contaminated wound class operation were enrolled in this study. The total accuracy rate of SP was 7.1%. SP application with the correct indication and timing of the first dose was compatible with guidelines: 55.6% and 81.9%, respectively. SP was applied >24 hours at 60.2% and antibiotic prescribing carried out after discharge at 80.6% of patients. According to questionnaire results, the use of SP over 24 hours and the prescription of antibiotics during discharge were: drain usage, hyperthermia, leukocytosis, surgeons feeling of comfort, avoidance of patients, and their relatives' reactions. Conclusion The total accuracy rate of SP rate was low in the present study and in surgeons prescribing the SP after discharge. In light of the present study, we suggest that discharge prescriptions should also be reviewed in clinics who have a high inappropriate surgical antibiotic prophylaxis rate.
Objective: The risk of infection with HBV and HCV in healthcare workers has been increased as risks such as contact with the blood or open wound of the infected people. The aim of the study was to investigate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among healthcare working at Tire State Hospital.Methods: Screening records of total 518 hospital personnel working in the Tire State Hospital between January 2012 and April 2017 were retrospectively reviewed. HBsAg, Anti-HBs and Anti HCV tests on the blood samples obtained for screening were performed in our laboratory using Siemens advia centaur XP chemiluminescence technique.Results: Between January 2012 and April 2017, a total of 518 health workers, ranging in age from 18 to 63 working in the State Hospital, were evaluated in infectious diseases and clinical microbiology clinics.Conclusion: Hospital workers should be screened for HBV and HCV and individuals without HBV vaccination should be vaccinated. In our country, HBsAg positivity in healthcare workers has decreased especially in recent years. Nevertheless, healthcare workers are still under the risk of HBV and HCV. Therefore, it is important to keep and review the records of hospital workers regularly. Disease and Clinical Microbiology, Izmir, Turkey e-mail: gokcenbudak@gmail.com Our personnel were negative for Anti-HBs 61 (11.8%) and anti-HBs positivity was detected in 457 (88.2%) of the obtained samples, 6 (1.2%) of these personnel were positive for HBsAg. It was detected that two cleaning personnel and a nurse were positive for anti-HCV. Keywords
Amaç: Çalışmamızda, üroloji kliniğinde tespit edilen çoklu antibiyotik dirençli üriner sistem enfeksiyonları için risk faktörlerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada Ocak 2007-Aralık 2009 tarihleri İzmir Bozyaka Eğitim Araştırma Hastanesi Üroloji kliniği idrar kültürlerinde çoklu antibiyotik dirençli üriner sistem enfeksiyon etkenleri üreyen 255 olgu taşıdıkları risk faktörleri yönünden sorgulandı. Asemptomatik bakteriürisi olan, üremesi kontaminasyon kabul edilen veya asemptomatik kandidürisi olan hastalar ile 18 yaşından küçük olan hastalar çalışmaya alınmadı. Bulgular: İdrar kültürlerinden 255 çoklu antibiyotik dirençli mikroorganizma soyutlandı. 255 kültürün 219'unda gram negatif (%86), 36'sında (%14) gram pozitif etken izole edildi. Çalışmaya alınan olguların yaş ortalaması 69 (18-82) idi. Olguların % 66' sı (167) erkek, % 34'ü (88) kadındı. Hastaların çoğunda birden fazla ürolojik tanı (Benign Prostat Hiperplazisi, üriner sistem taş hastalığı vb.) ve ürolojik girişim uygulanma öyküsü vardı. Yarıdan fazla olguda son 6 ay içinde geçirilmiş idrar yolu enfeksiyonu (%71) ve %86'sında son 6 ay içinde antibiyotik kullanım öyküsü mevcuttu. Hastaların %89'una en az bir kez üriner kateterizasyon uygulanmıştı ve en sık uygulanan kateterizasyon tipi mesane kateterizasyonuydu (%81). Tartışma: Çalışmamızda idrar kültürlerinde çoklu antibiyotik direnci saptanan hastaların tümünde hastaneye sık başvuru ve yatış, üriner kateterizasyon uygulaması ve tekrarlanan ürolojik cerrahi girişim öyküsü bulunmaktadır. Dirençli üriner enfeksiyon gelişimi için üriner kateterizasyon varlığı ve yakın zamanda antibiyotik kullanımını yüksek risk faktörü olarak tespit ettik.
Bladder stones account for 5% of all urinary system stones. They are frequently observed in old males and occur secondary to prostatic hyperplasia, neurogenic bladder, or other infravesical obstructions. Generally, bladder stones can be discharged spontaneously, while larger stones may block urination, resulting in full obstruction causing acute urinary retention. Furthermore, large bladder stones can cause unilateral or bilateral ureterohydronephrosis, while they can rarely cause renal failure. In this manuscript, we present a case of an acute renal deficiency and urosepsis that developed due to a large bladder stone in a young male patient who used a permanent catheter after a spinal cord injury. After the cystolithotomy, the removed stone weight was 280 g with a size of 5.5x4.2x3.6 cm. It should always be considered that very large bladder stones may render fatal clinical outcomes, though rarely. We aimed to emphasize the importance of periodic urinary system follow-up of patients with spinal cord injury. Key Words: Giant bladder stone, acute renal failure, urosepsis, spinal cord injury ÖzetMesane taşları, tüm üriner sistem taşlarının %5'ini oluşturur. Sıklıkla ileri yaşlı erkeklerde görülürler ve prostat hiperplazisi, nörojenik mesane gibi infravezikal obstrüksiyonlara sekonder oluşurlar. Genellikle mesane taşları spontan olarak atılabilmekle birlikte büyük taşlar mesanede tam obstrük-siyona neden olarak idrar çıkımını engelleyip, akut idrar retansiyonuna neden olabilirler. Ayrıca dev mesane taşları, tek taraflı ya da iki taraflı üre-terohidronefroza neden olabilmektedir. Dev mesane taşları nadiren böb-rek yetmezliğine sebep olabilir. Bu olgu sunumunda, omurilik yaralanması sonucu kalıcı sonda kullanan genç erkek hastada dev mesane taşına bağlı gelişen akut böbrek yetmezliği ve ürosepsis kliniğini sunduk. Yapılan sistolitotomide alınan taşın ağırlığı 280 gr, boyutları 5,5x4,2x3,6 cm idi. Dev mesane taşlarının nadir de olsa hayatı tehdit eden klinik tablolara sebep olabileceği akılda tutulmalıdır. Omurilik yaralanma sonrası periyodik üriner sistem takibinin önemini bu olgu ile bir kez daha vurgulamak istedik. S85 GirişMesane taşları tüm üriner sistem taş hastalıkların %5'ini oluş-turur (1). Mesane taşı genellikle mesane çıkım obstrüksiyonuna ikincil oluşmaktadır. Mesane taşı sık görülmektedir, ancak dev mesane taşına bağlı akut böbrek yetmezliği (ABY) nadir görü-lür. Mesane taşları genellikle kendiliğinden atılabilmekle birlikte nadiren dev mesane taşları idrar çıkımını engelleyerek tam obstrüksiyona neden olabilirler (2). Literatürde dev mesane taşları-nın üreterohidronefroza neden olduğu, böbrek yetmezliğine yol açtığı olgular bildirilmiştir (3,4). Bu yazıda, omurilik yaralanmalı genç erkek hastada dev mesane taşına bağlı gelişen ABY ve üro-sepsis olgusu sunulmaktadır.
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