Objective:Urinary tract infections (UTI) are the second most common infection in geriatric population. This study investigated clinical findings, diagnostic approaches, complicating factors, prognosis, causative microorganisms and antimicrobial susceptibility in geriatric patients diagnosed with UTI.Methods:A total of 140 hospitalised patients with UTIs were evaluated within three years between January 2011-January 2015 at the Eskisehir Yunus Emre State Hospital. UTI diagnosed when there were systemic and urinary signs and symptoms and a positive dipstick test and urine culture result, leukocyte and CRP like serum parameters.Results:Among the studied patients, 41.4% had urological diseases, 20.7% had diabetes mellitus and 19.2% had neurological diseases. The most common symptoms and signs were fever, dysuria nausea/vomiting, general condition impairment, pyuria, haematuria. The laboratory values for CRP, ESR and leukocyte count were 84 mg/dL, 56 mm/s and 11.9 (10^3μL), with mean values being determined. Among patients having a urinary catheter (17.1%), 27.9% had a history of UTI, while 29.3% had been hospitalised. Escherichia coli and Klebsiella pneumoniae were the most commonly identified microorganisms. The mean duration for hospitalisation was 7.6 days, while a 5% mortality rate was observed over the course of the disease.Conclusion:Because of the potential for serious complications and mortality, elderly patients with urinary tract infection, should receive immediate empirical treatment based on anamnesis, clinical evaluation and urinalysis and should be re-examined using results from cultures and antibiograms upon follow-up.

The aim of this study was to compare the results of nine non-invasive serum biomarkers with liver biopsies to predict liver fibrosis stage. HCV-RNA-positive, HCV genotype 1, treatment-naive patients with chronic HCV infections were included from 14 centers (n=77). The platelet count, AST/ALT ratio (AAR), cirrhosis discriminate score (CDS), FIB4, AST/platelet ratio index (APRI), age-platelet (AP) index, Göteborg University cirrhosis index (GUCI), FibroTest, and ActiTest were calculated and compared to histologic findings. All serum biomarkers, except AAR, were weakly or moderately correlated with liver biopsy results (ISHAK fibrosis score). The mean scores of FibroTest, FIB4, APRI, and AP index were significantly different between F0-F2 and F3-F4 groups and the negative predictive values (NPVs) of the F3-F4 group were 95%, 85%, 85%, and 83%, respectively, for these serum biomarkers. Our study suggests that serum biomarkers may help to diagnose significant fibrosis but inadequate to detect fibrosis in early stages. Although liver biopsy is still the gold standard to diagnose liver fibrosis, FibroTest, FIB4, APRI, or AP index may be used to exclude significant fibrosis with >80% NPV.

ÖzetAmaç: Bu çalışmada, bir devlet hastanesindeki sağlık çalışanla-rında HBV, HAV, HCV ve HIV infeksiyonu seropozitifliğinin araş-tırılması amaçlandı. Yöntemler: 2012-2013 yılları arasında hastanemizde çalışan 586 sağlık personeline ait kayıtlar retrospektif olarak incelendi. Tarama amacıyla alınan kan örneklerinde HBsAg, anti-HBs, anti-HCV, anti-HAV ve anti-HIV kemilüminesans esasına dayanan "enzyme-linked immunosorbent assay" (ELISA) yönte-miyle çalışıldı. Bulgular: Personelimizin 208 (%35.5)'i erkek, 378 (%64.5)'i kadın olup, yaş ortalaması 35.78±8.76 (minimum 18, maksimum 64) yıldı. Çalışmaya katılan personelimizin 282 (%48.1)'si hemşire, 99 (%16.9)'u doktor, 102 (%17.4)'si temizlik personeli, 47 (%8)'si anestezi teknikeri, 56 (%9.6)'sı laboratuvar teknikeriydi. AbstractObjective: The aim of this study was to determine the seroprevalence of HAV, HBV, HCV and HIV infection among health personnel in a state hospital. Methods: Medical records of 586 health personnel who worked between 2012 and 2013 in our hospital were analyzed retrospectively. Serum samples were tested for HBsAg, anti-HBs, anti-HCV, anti-HAV, anti-HIV markers by "enzyme-linked immunosorbent assay" (ELISA) method based on the method of chemiluminescent immunoassay. Results: The staff comprised 208 (35.5%) male, and 378 (64.5%) women workers. The mean age was 35.78±8.76 (minimum 18, maximum 64) years. There were 282 (48.1%) nurses, 99 (16.9%) doctors, 102 (17.4%) cleaning staff, 47 (8%) anesthesia technicians and 56 (9.6%) laboratory technicians. The divisions of the workers were as follows: 125 (21.3%) were working at internal services, 204 (34.8%) at the operating room, 98 (16.7%) at intensive care units, 61 (10.4%) at emergency room and 28 (4.8%) at dialysis unit. While 504 personnel (86%) were positive for anti-HBs, only 5 (0.9%) were found positive for HBsAg. Only 1 (0.2%) cleaning staff was positive for anti-HCV. None was positive for anti-HIV. Anti-HAV has been studied in a total of 152 personnel, 109 (71.7%) of whom were positive. Anti-HBc IgG has been studied in a total of 250 personnel 7 (2.8%) of whom were positive. Conclusions: Healthcare personnel who are at high risk of HBV, HAV, HCV, and HIV infection should be screened for viral hepatitis and those who are not immunized should be vaccinated against HBV and HAV. It is important to follow standard infection control precautions in all patients to prevent diseases transmitted by blood and through contact. Klimik Dergisi 2013; 26(2): 64-7.

Objectives: The study aimed to evaluate the complications and quality of the specimens of percutaneous liver biopsy in patients with chronic viral hepatitis who were scheduled for treatment and also to evaluate the contribution of the knowledge of ultrasound guided (USG) biopsy localization to the existing data. Methodology: Liver biopsies conducted at our clinic between 2003 and 2008 were retrospectively evaluated. In 53.8% of the cases, hepatobiliary USG was performed to mark the localization of the biopsy site. An automatically triggered Tru-Cut biopsy gun was used. Results: Biopsies waere taken from the livers of 236 patients (46.6% male, 53.4% female) with a mean age of 47.1 ± 12.5 years. The majority of patients had hepatitis C (61.9%); 1.6% experienced major complications (3 patient biliary peritonitis, 1 patient liver bleeding); 52.1% of the samples were ≥ 1 cm in length; And 69.7% of the biopsy samples with specified portal area had ≥ 4 portal areas. There was no statistically significant difference between the patients with localized and non-localized biopsy site in terms of major complications and length of biopsy samples ( respectively p = 1.000, p = 0.209 ). Conclusion: We believe that percutaneous liver biopsy using Tru-Cut biopsy gun can be peformed safely, with complications in 1.6% of the procedures. The length of the biopsy specimen is shorter than ideal values. Evaluation of the patients with and without USG-guided biopsy revealed no significant difference in terms of major complications and specimen size.