A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To determine the value of patient characteristics, laboratory parameters, and imaging procedures in the assessment of the severity and prognosis of diabetic foot infections (DFIs). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Demographic and clinical characteristics of 71 patients with DFI were evaluated retrospectively. Patient characteristics and clinical data including diabetes status and wound related information, laboratory and radiologic findings, and outcomes were recorded. R Re es su ul lt ts s: : In patients between 35 and 60 years old, the frequency of recurrent diabetic foot infections were four and half-times higher than in those over 60 years (OR 4.55, 95% CI 1.50-13.83, p= 0.007). The white blood cell count was significantly higher in severe infections (p<0.05). Gram negative microorganisms were predominantly isolated from the wound cultures of patients aged between 35 and 65 years (p= 0.04). Pathological findings in Doppler Ultrasonography (dUSG) was correlated with smoking (p= 0.004). There was no significant association between the severity of the wound and pathological findings in dUSG. However, presence of a pathological finding in dUSG was correlated with amputation (p=0.001). Moreover, the probability of poor outcome was four-fold higher in patients with a pathology in dUSG in the logistic regression analysis (OR 4.32, 95% CI, 1.24-14.97, p= 0.025). C Co on nc cl lu us si io on n: : In the management of empirical therapy, gram negative microorganisms should be considered, especially in patients of 35-65 years of age. Pathological findings in dUSG were found to be related to poor outcome such as amputation. Therefore, all patients with diabetic foot should be screened with dUSG to identify those at risk for amputation.K Ke ey y W Wo or rd ds s: : Diabetic foot; risk factors; prognosis; ultrasonography, doppler Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada, diyabetik ayak enfeksiyonlarında klinik, laboratuvar ve radyolojik bulguların enfeksiyon şiddetine ve prognozuna etkisi değerlendirilmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Diyabetik ayak enfeksiyonu olan 71 hasta retrospektif olarak incelenmiştir. Hastaların özellikleri, diyabet ve diyabetik ayak yarası ile ilgili bilgileri, laboratuvar ve radyolojik bulguları ve prognozları değerlendirilmiştir. B Bu ul lg gu ul la ar r: : Hastalarda tekrarlayan lezyon gelişme sıklığının, 35-60 yaş arası hasta grubunda, >60 yaş hasta grubuna göre yaklaşık 4.5 kat fazla olduğu saptanmıştır [Odds Oranı (OO) 4.55, %95 GA 1,50-13,83, p= 0,007]. Şiddetli enfeksiyon ile lökositoz arasında anlamlı bir ilişki saptanmıştır (p< 0,05). Yaşları 35-65 arasında olan hastaların yara yeri kültürlerinde gram negatif mikroorganizlar daha sık izole edilmiştir (p=0,04). Sigara kullanma ile Doppler ultrasonografi (USG) incelemesinde patoloji olması arasında anlamlı bir ilişki bulunmuştur (p= 0,004). Doppler USG'de patoloji ile yaranın ciddiyeti arasında herhangi bir ilişki gözlenmemiştir. ...
Echinococcosis is a parasitic disease characterized by cysts in especially liver and lung. We report a long-term survival of a 44-year-old female patient with disseminated echinococcal disease involving the brain, lung, liver, spleen, kidney, mediastinum, thyroid gland, parotid gland, pancreas, peritoneum, rectus muscle, pararenal area, left thigh, skin and breast tissue from Turkey in 2016.
ÖzTularemi ülkemizde endemik olarak görülen zoonotik enfeksiyonlar içerisinde yer almaktadır.Tüm dünyada en sık görülen tularemi formu ülseroglandüler form olmasına rağmen Türkiye'de en sık görülen formu orofaringeal form tularemidir. Orofaringeal form tularemi kontamine su veya gıdaların ağız yoluyla alınmasıyla bulaşır, su kaynaklı salgınlara neden olabilir.Bu yazıda beş gün önce kırsal alana gitme öyküsü olan, ancak kaynak suyu içme, vahşi hayvan teması, kemirgen tarafından ısırılma öyküsü olmayan bir orofaringeal tularemi olgusu sunuldu. Hastanın tanısı mikroaglütinasyon testinde 1/320 titrede pozitiflik saptanması ile konuldu. Daha önceden beta-laktam antibiyotik tedavisi alan ancak servikal böl-gedeki lenfadenopatisi gerilemeyen olgunun moksifloksasin tedavisi sırasında lenfadenopatisi fistülize olarak spontan drene oldu, ondört gün tedavi sonrası lezyonu geriledi.Anahtar Kelimeler: Tularemi, orofaringeal form, tedavi, spontan drenaj AbstractTularemia is one of the endemic zoonotic infections seen in Turkey. Although the ulceroglandular form of the disease is the most common form in the world, oropharyngeal tularemia is the most common form in our country. Oropharyngeal tularemia can be acquired by ingesting contaminated water or food and can cause outbreaks.In this paper, a tularemia case who had a history of being at a rural region five days ago was presented. He hadn't history of bite or contact with wild animals or ingestion of spring water. Diagnosis was made by positivity in microagglutination test with a titer of 1/320. He was given beta-lactam antibiotics prior to the admission but his cervical lymphadenopathy hadn't regressed. During the moxifloxacin therapy cervical lymphadenopathy was fistulated spontaneously and then regressed after 14 days therapy.
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