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Background A considerable percentage of empirical antibiotic treatment fails in hospitalized patients with community-acquired pneumonia (CAP). β-lactams and macrolid (BLM) combination or respiratory fluoroquinolones (FQ) are the most frequently used in these patients. The aim of the present study is to compare the treatment failure (TF) rates in BLM and FQ treatment and to analyze the predictive factors of TF. Method Hospitalized patients who were initially treated with either BLM or FQ were included retrospectively and treatment results of the two regimens were compared. Results Of the 144 patients included in the study, the mean age was 67±16 and 102 (71%) were male. Each group constituted of 72 patients. Antibiotic selection did not alter TF rates, length of stay (LOS) and 30-day mortality. Baseline higher levels of leucocytes, neutrophils to lymphocytes ratio (NLR), C-reactive protein (CRP), BUN/albumin, lactate dehydrogenase/aspartat aminotransferase (LDH/AST) levels and pneumonia severity index (PSI) scores were detected as predictors of TF. Conclusion Empirical treatments with either BLM or FQ do not correlate with TF, LOS and 30-day mortality. NLR, BUN/albumin and LDH/AST may suggest TF. These inexpensive and easily-reachable parameters have the potential as predictors of the treatment outcome in CAP.

Objective: The choice of steroids and antibiotics is optional for the management of acute exacerbation of chronic obstructive pulmonary diseases according to international guidelines. The study hypothesized that the steroid and antibiotic choice can be decided by using the neutrophil–lymphocyte ratio and peripheral blood eosinophilia in patients with acute exacerbation of chronic obstructive pulmonary diseases. This would reduce the rate of re-hospitalization in 28 days. Material and Methods: Patients were hospitalized due to acute exacerbation of chronic obstructive pulmonary diseases from February 1, 2018, to January 31, 2019. Patients were divided into 2 groups: Sureyyapasa protocol group and conventional group. In the Sureyyapasa protocol group, patients were divided into 4 subgroups according to peripheral blood eosinophilia and neutrophil–lymphocyte ratio values. Treatment success was defined as 5-7 days acute exacerbation of chronic obstructive pulmonary diseases treatment was enough to discharge and no re-hospitalization within 28 days. Treatment failure was defined that the hospital stay was longer than 7 days or transport to intensive care and death or readmission to the hospital due to acute exacerbation of chronic obstructive pulmonary diseases within 28 days after discharge. Results: The Sureyyapasa protocol group (n = 96) and the conventional group (n = 95) were randomly selected. The conventional group and Sureyyapasa protocol group had similar hospital stay ( P = .22), and antibiotic and steroid uses were significantly higher in the conventional group than the Sureyyapasa protocol group (antibiotic use 100% vs. 83%, P < .001 and steroid use 84% vs. 29%, P < .001, respectively). Treatment failure in the conventional Group (n = 23, 24%) is higher than the Sureyyapasa protocol group (n = 17, 18%). Conclusions: Initiating treatment by evaluating eosinophilia and neutrophil–lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary diseases in the ward reduces unnecessary antibiotic and steroid use and cost rates in hospitalizations.

The representation of women has always been different in comics from past to present. Some women have been shown in the comics, in the role of being saved by a male superhero, or in a sexy female image with pornographic elements. The scarcity of female illustrators and writers, being male among publishers consists of the necessary information for the research of comics among the gender studies. Just as there are gender and objectification elements in real life, there are also these approaches to the female body in comics. Towards the 21st century, together with the movements of feminism, both the technological conditions and the digitization of the comics have made women's representation a little more free. For this reason, the methodology of the research has been determined as Fourth Wave Feminism. Now, they can explain the female lesbian culture and sexual policies independently of society in the comics of Alison Bechdel's Fun Home and a series of images that depict Belden Sezen's A Snapshot. The handling of such female characters in comic books and graphic novels firstly enables the students to make accurate determinations while breaking the prejudice of the society, and then when determining the orientation of the young generation, and that women can live their identity freely as an individual. Based on all these information and results, in this research, the representation of women in comics will be explained through a historical evaluation and then criticized in terms of gender.

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