Objective The inflammatory/anti‐inflammatory balance has an important role in the clinical course of SARS‐CoV‐2 infection (COVID‐19), which has affected over 100 million people since it first appeared in China in December 2019. The aim of this study was to investigate the relationship between triggering receptor expressed on myeloid cells (TREM)‐1/TREM‐2 ratio and COVID‐19 severity. Methods A total of 171 individuals were included in the study: 121 patients who were admitted to the chest diseases department and intensive care unit of our hospital and diagnosed with COVID‐19 by real‐time PCR of nasopharyngeal swab samples from December 2020 to March 2021 and a control group consisting of 50 asymptomatic health workers in our hospital who had negative real‐time PCR results during routine COVID‐19 screening. Results TREM‐1 level was significantly higher in patients with severe disease compared with the moderate and control groups ( P = .003, P = .001). TREM‐2 levels did not differ significantly in moderate and severe patients ( P = .36) but were significantly higher in both patient groups compared with the control group ( P = .001 for both). TREM‐1/TREM‐2 ratio was significantly higher in the severe patient group than in the moderate and control groups ( P = .001 for both). In receiver operating characteristic curve analysis of TREM‐1/TREM‐2 ratio in patients with moderate and severe COVID‐19, the area under the curve was 0.723. Using a cut‐off value of 0.125 for TREM‐1/TREM‐2 ratio in the Youden index calculation, the sensitivity was 60% and specificity was 71%. Conclusion Experience with the positive effects of medical treatments to restore inflammatory balance in the course of COVID‐19 is steadily increasing. TREM‐1 and TREM‐2 have an important role in inflammation and may serve as biomarkers and therapeutic targets in the early treatment and follow‐up of COVID‐19.
ÖZETAmaç: Ventilatör ilişkili pnömoni (VİP), entübasyondan 48 saat sonra gelişen pnömoni olarak tanımlanabilir.(1) Amaç, anestezi yoğun bakımlarında çalışan uzmanlık öğrencisi doktorların VİP gelişimini önleme konusunda önerilmiş ve incelenmiş yöntemlere ilişkin bilgi birikimlerini değerlendirmektir Gereç ve Yöntem: Yirmi soruluk bir anket hazırlanmış ve kullanılmıştır. Anket soruları araştırmacı tarafından yüz yüze görü-şülerek uygulanmış ve yanıtlar kaydedilmiştir. Veriler PASW Statistics 18.0 SPSS programında değerlendirilmiştir.Bulgular: Doğru yanıtlar 100 üzerinden değerlendirilmiş ve katılımcıların aldıkları puan ortalaması 49.5±13.2 olarak bulunmuştur. Katılımcıların çalışma yıllarına göre bilgi puanları arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p=0.484). Katılımcıların % 65.8'i entübasyonda orotrakeal yolun seçilmesi gerektiğini, % 50'si ventilatör devresini, görünür kirlilik olmadıkça her yeni hastada değiştirmenin yeterli olduğunu, % 77'si ısı ve nem değiştiricili nemlendiricilerin kullanılması gerektiğini bilirken, bunların değiştirilme sıklığı ile ilgili soruda oran % 18.4'de kalmaktadır. Yüzde 76.3'ü önlük, eldiven ve maskenin birlikte, kullanılması gerektiğini, % 90.7'si her girişimden önce ve sonra el yıkanması gerektiğini ve % 72.4'ü subglottik sekresyonlarının aspirasyonunun VİP riskini azalttığını bilmiştir. Kinetik yatakların kullanımının VİP riskini azalttığını % 38.2'si bilirken, % 64.4'ü ise yarı oturur pozisyon verilmesinin VİP riskini azalttığını bilmiştir. Proflaktik antibiyotik kullanımının VİP riskini değiştirmediğini katılımcılarımızın % 68.4'ü bilirken, orofaringeal kolonizasyonun günde en az bir kez ağız bakımı yapılarak engellenmesi gerektiğini % 86.8 katılımcı bilmektedir.Sonuç: Anestezi ve reanimasyon uzmanlık eğitimi alan asistan doktorların VİP gelişimini önlemede yeterli bilgi düzeyine sahip olmadıkları görülmüştür. Yoğun bakımlarda VİP hızını düşürmek ve koruyucu önlemleri uygulamak için multidisipliner ve devamlı eğitim programları düzenlenmelidir. Anahtar kelimeler: ventilatör ilişkili pnömoni, mekanik ventilasyon SUMMARY Evidence-Based Guidelines for the Prevention of Ventilator Associated Pneumonia: Results of Knowledge Test Among Anesthesia Residents Employed in ICUObjective: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs after the first 48 hours of initiating mechanical ventilation. The aim of this study is to determine anaesthesia residents' knowledge about evidence-based guidelines for the prevention of ventilator-associated pneumonia.Material and Methods: A survey using multiple-choice questionnaire prepared according to the guidelines was designed to evaluate anesthesia residents' knowledge about prevention of VAP in ICU.Results: The mean total score of residents was 49.5±13.2. There were no significant differences between residents' scores according to their intensive care experencies. A 65.8 % of the responders confirmed that oral route had been recommended for intubation, while 50 % of the participants knew that the ...
BackgroundTraining of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.MethodsA cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.ResultsA total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.ConclusionsThe results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.
Background/aim: To investigate the distribution of viral genotypes, the extrahepatic manifestations, and the relationship between genotypes and extrahepatic manifestations in patients with chronic hepatitis C. Materials and methods:The study included 62 treatment-naive patients with chronic hepatitis C infection. Genotype determination was performed by DNA sequencing analysis. To investigate extrahepatic manifestations, the patients' data, recorded prospectively during the pretreatment period, were analyzed.Results: Genotype determination was successful in 74.2% of the cases. All patients were infected with hepatitis C virus (HCV) genotype 1b. At least 1 extrahepatic manifestation was identified in 37.1% of the patients. The most frequent clinical manifestations were type II diabetes mellitus (8.1%) and arthralgia or arthritis (8.0%). There was no relationship between extrahepatic manifestations and fibrosis or transaminase levels, but female sex and advanced age were risk factors. Because all patients were infected with the same genotype, the relationship between extrahepatic manifestations and genotype could not be examined. Conclusion:HCV genotype 1b is predominant in patients with chronic hepatitis C in the Eastern Anatolian Region of Turkey. In total, 37.1% of the patients had at least 1 extrahepatic manifestation. Female sex and advanced age were risk factors for having extrahepatic manifestations.
GirişBrucella türlerinden B. abortus, B. melitensis, B. suis ve nadiren de B. canis insanlarda hastalığa neden olur. B. canis insanlarda diğer türlere göre daha hafif veya asemptomatik infeksiyonlara neden olmaktadır. (1,2). Brucella endokarditi tanısı için kan kültürü, serolojik testler ve ekokardiyografi yapılması gerekmektedir (3,4). Kan kültürünün duyarlılığının düşük olması nedeniyle Brucella serolojik testlerinin önemi fazladır. Ancak, B. canis, rutinde kullanılan serolojik testlerle saptanamamaktadır. Bu nedenle, bruselloz belirtileri olan hastalarda rutinde uygulanan serolojik incelemelerde kullanılan S ("smooth") tipi Brucella antijenlerinin yanı sıra R ("rough") tipi antijenlerle hazırlanmış mikroaglütinasyon testi (MAT) gibi serolojik testlerin de yapılması öneril-mektedir (5,6).Bu bildiride, tanısı pozitif kan kültürüyle ve ekokardiyografik olarak desteklenen ve rutin serolojik yön-temlerin negatif sonuçlandığı ancak MAT pozitif olarak bulunan Brucella canis'e bağlı bir infektif endokardit olgusu sunularak tanı güçlüklerine dikkat çekilmek istenmiştir. AbstractIn this report, a case of infective endocarditis due to Brucella canis treated with antibiotics successfully in a 33-year-old man, having a history of rheumatic heart disease and raising animals, admitted with complaints of fever with chills, generalized myalgias, sweating and weakness was presented. Standard tube agglutination (STA) test was negative despite further dilutions to exclude prozone phenomenon. STA test repeated remained negative. Blood culture yielded Brucella spp. B. canis microagglutination test was detected to be positive in 1/160 dilution. A vegetation with dimensions of 0.5x0.7 cm detected on aortic valve echocardiographically became smaller after one month of doxycycline, rifampin, and streptomycin treatment, and was undetectable in second month. Repeat echocardiographic examination in the third month revealed no vegetation again, and treatment continued with doxycycline, rifampin and trimethoprim-sulfamethoxazole during outpatient period, and total duration of treatment was planned to be at least one year. Klimik Dergisi 2016; 29(3): 138-41.Key Words: Brucella canis, endocarditis. ÖzetBu bildiride, yüksek ateş, üşüme, titreme, yaygın vücut ağrısı, terleme ve halsizlik yakınmalarıyla başvuran, romatizmal kalp hastalığı öyküsü olan ve hayvancılık yapan 33 yaşında bir erkek hastadaki antibiyotiklerle başarıyla tedavi edilen Brucella canis'e bağlı bir infektif endokardit olgusu sunuldu. Hastanın Brucella standard tüp aglütinasyon testi (STA) prozon olayını dışlamak için dilüsyonların artırılmasına karşın negatifti. Olası blokan antikorlara yönelik olarak Coombs antiserumuyla yinelenen STA testi de negatif sonuçlandı. Hastanın kan kültürün-de Brucella spp. üredi. B. canis mikroaglütinasyon testi 1/160 titrede pozitif olarak saptandı. Aort kapağında ekokardiyografik olarak gözlenen 0.5x0.7 cm boyutlarındaki vejetasyon, doksisiklin, rifampisin ve streptomisin tedavisinin birinci ayında kü-çülmeye başladı ve ikinci ayda saptanmadı....
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.