Multicenter Hospital-Based Prospective Surveillance Study of Bacterial Agents Causing Meningitis and Seroprevalence of Different Serogroups of Neisseria meningitidis, Haemophilus influenzae Type b, and Streptococcus pneumoniae during 2015 to 2018 in Turkey.

The etiology of bacterial meningitis in Turkey changed after the implementation of conjugated vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) in the Turkish National Immunization Program (NIP). Administration of Hib vaccine and PCV-7 (7-valent pneumococcal conjugate vaccine) was implemented in NIP in 2006 and 2009, respectively. In 2011, PCV-7 was replaced with PCV-13. Meningococcal vaccines have not yet been included in Turkish NIP. This prospective study comprised 27 hospitals located in seven regions of Turkey and represented 45% of the population. Children aged between 1 month and 18 years who were hospitalized with suspected meningitis were included. Cerebrospinal fluid (CSF) samples were collected, and bacterial identification was made according to the multiplex PCR assay results. During the study period, 994 children were hospitalized for suspected meningitis, and Hib (n = 3, 2.4%), S. pneumoniae (n = 33, 26.4%), and Neisseria meningitidis (n = 89, 71%) were detected in 125 samples. The most common meningococcal serogroup was MenB. Serogroup W comprised 13.9% (n = 5) and 7.5% (n = 4) of the meningococci in 2015 to 2016 and 2017 to 2018, respectively. Serogroup C was not detected. There were four deaths in the study; one was a pneumococcus case, and the others were serogroup B meningococcus cases. The epidemiology of meningococcal diseases has varied over time in Turkey. Differing from the previous surveillance periods, MenB was the most common serogroup in the 2015-to-2018 period. Meningococcal epidemiology is so dynamic that, for vaccination policies, close monitoring is crucial.IMPORTANCE Acute bacterial meningitis (ABM) is one of the most common life-threatening infections in children. The incidence and prevalence of ABM vary both geographically and temporally; therefore, surveillance systems are necessary to determine the accurate burden of ABM. The Turkish Meningitis Surveillance Group has been performing a hospital-based meningitis surveillance study since 2005 across several regions in Turkey. Meningococcus was the major ABM-causing agent during the 2015-to-2018 period, during which MenB was the dominant serogroup.

[The effect of neck metastasis on survival following surgery for laryngeal cancer]. / Larenks kanseri cerrahisinde boyun metastazinin sagkalima etkisi.

OBJECTIVES: We evaluated the effect of neck metastasis on the survival rate of patients who underwent surgery for laryngeal cancer. PATIENTS AND METHODS: A total of 256 patients who had undergone surgery between 1995 and 1999 were retrospectively reviewed. Of these, 186 patients (72%; 185 males, 1 female; mean age 57.5 years) who were accessible for follow-up were evaluated with respect to the localization and type of the primary tumor, neck metastasis, surgical procedures, and the survival. Survival rates were determined by the Kaplan-Meier method and compared by the log-rank test. The rates of neck metastasis and extracapsular spread in survivors and non-survivors were compared with the use of the chi-square test. The minimum follow-up period was two years (mean 41.2 months). RESULTS: Twenty-nine patients died from locoregional recurrences or distant metastasis and six patients died from other causes. The cumulative survival period was 69 months (75 months and 54 months with or without neck metastasis, respectively; log rank test 27.96, p<0.0001). The rates of neck metastasis and extracapsular spread in survivors (22%, 33/151; 7%, 10/151) and non-survivors (69%, 20/29; 59%, 17/29) were significantly different (p<0.001). CONCLUSION: Neck metastasis and cervical recurrence were found as the most important factors affecting the results of laryngeal cancer surgery.

[Evaluation of hearing performance in cochlear implant patients]. / Koklear implantasyonlu hastalarda isitme performanslarinin karsilastirilmasi.

OBJECTIVES: To determine the speech perception levels of cochlear implant patients and to evaluate the possible effects of implant type, duration of deafness, and bacterial meningitis on the patients' hearing performance. PATIENTS AND METHODS: A three-section test battery on speech perception was administered to 21 cochlear implant patients (12 males, 9 females; mean age 25 years; range 9 to 40 years). The patients' performance was assessed with respect to single- or multi-channel implant design, duration of hearing loss, and etiologic factors of hearing loss. RESULTS: The overall mean success score was 74.6 (range 49-100). No significant difference was found between patients using single- or multi-channel implants. The mean score of 12 patients whose duration of hearing loss was below the average (8.2 years) was significantly higher than those of nine patients with a longer history of hearing loss (85.7 versus 59.6, p=0.001). Patients with meningitis-associated hearing loss exhibited a significantly lower performance than those presenting with other etiologic factors (61.9 versus 84.1, p=0.001). CONCLUSION: Early diagnosis and rehabilitation are essential to achieve better performance following cochlear implantation.

[Comparison of hearing levels and tympanic membrane healing obtained by cartilage palisade and temporal fascia tympanoplasty techniques: preliminary results]. / Palisad timpanoplasti ile temporal fasya kullanilarak yapilan timpanoplastilerde zar iyilesmesi ve isitme düzeylerinin karsilastirilmasi (ön sonuçlar).

OBJECTIVES: We compared the levels of hearing and tympanic membrane healing obtained by cartilage palisade and temporal fascia tympanoplasty techniques. PATIENTS AND METHODS: Tympanoplasty procedures with the use of cartilage palisade (30 patients; 14 males, 16 females; mean age 28 years; range 10-62 years) and temporal fascia (30 patients; 17 males, 13 females; mean age 30 years; range 12-58 years) were compared with respect to tympanic membrane healing and hearing levels. The size of perforations in the cartilage tympanoplasty group was greater than that of the temporal fascia group. Audiological assessments were performed in the postoperative third and sixth months. The follow-up period was at least six months. Tympanic membrane healing and hearing levels were statistically analyzed using the chi-square and Mann-Whitney U-tests. RESULTS: Tympanic membrane healing rates were 80% (24 patients) and 86% (26 patients) in the temporal fascia and cartilage tympanoplasties, respectively. Postoperatively, hearing levels improved in both groups. However, no significant differences were found between the two treatment groups with respect to tympanic membrane healing and hearing levels. CONCLUSION: Our findings suggest that cartilage palisade graft can be safely used in the treatment of tympanic membrane perforations, with no adverse effects on the hearing levels in the postoperative six months.