Investigation of some changes and clonal relationship in enterococci isolates due to relocation of a hospital.

Objectives: To investigate the isolation rates, antimicrobial resistance rates, minimum inhibitory concentration values of antimicrobial agents, and clonal relationships of Enterococcus faecalis and Enterococcus faeciumdue to the relocation of a hospital to a newly constructed building. METHODS: The comparative, prospective study was conducted at adult general intensive care units of the Mus State Hospital, Mus, Turkey, in two phases; before the relocation from January 25 to December 1, 2014, and after the relocation from February 10 to May 24, 2015. Rectal swab samples were collected 72 hours post-hospitalisation. Identification of Enterococcus faecalis and Enterococcus faeciumisolates was determined by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and antimicrobial resistance with minimum inhibitory concentration values was detected with Vitek 2 system. The clonal relatedness among the strains was investigated by pulsed-field gel electrophoresis. Data was analysed using SPSS 23. RESULTS: Of the 69 patients, 37(53.62%) were related to pre-relocation phase; 20(54.1%) females and 17(45.9%) males with mean age 62.81±21.71 years. There were 32(46.37%) patients in the post-relocation phase; 13(40.6%) females and 19(59.4%) males with mean age 62.69±21.35 years (p>0.05). Of the 84 enterococci strains isolated, 51(60.7%) were Enterococcus faecium; 28(55%) before relocation and 23(45%) after relocation (p=0.77). The remaining 33(39.3%) isolates were Enterococcus faecalis; 16(48.5%) before relocation and 17(51.5%) after relocation (p=0.73). Multiple strains were located in 7(18.9%) patients before relocation and in 7(21.9%) after relocation. In 1(3.1%) patient after relocation, 2(8.7%) Enterococcus faecium isolates with different resistance and pulsed-field gel electrophoresis patterns were detected. There were no significant differences between the isolation and antibiotic resistance rates before and after relocation (p>0.05), and a clonal relation between the isolates was not detected (p>0.05). Decreased minimum inhibitory concentration values were noted for some antibiotics. CONCLUSIONS: Clonal relationship between the isolates and change in the rates of isolation and antimicrobial resistance of Enterococcus faecalis and Enterococcus faecium was not detected due to relocation. Minimum inhibitory concentration values could be used to reveal relocation-related changes in isolates obtained from patients hospitalised in intensive care units.

Relationship Between Optimism-Pessimism Levels of Mothers and Anxiety Levels of Children in Turkey During COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic affects all aspects of the population including children, elderly, and vulnerable people. The aim of this study is to examine, for the first time, the relationship optimism-pessimism levels of mothers and anxiety level of children in turkey during COVID-19 pandemic. SUBJECTS AND METHODS: Optimism-Pessimism Scale and Preschool Anxiety Scale were used to collect data from a representative sample of 33,362 mothers with children aged 3-6 years. RESULTS: Of the parents, 53% of them reported that their children were slightly anxious due to COVID-19 pandemic. Lower optimism and higher pessimism were significantly related with higher levels of children's anxiety including social, generalized, separation, and overall anxiety as well as obvious fear. Group comparison analysis indicated that very anxious children reported the highest level of different types of anxiety and fear compared to less anxious and not at all anxious children. CONCLUSION: These findings suggest that mental health of children has been adversely affected during the pandemic and this has important implications for designing and implementing interventions aimed at reducing anxiety levels of children and determining protective and risk factors associated with anxiety in the face of adversity.

Hydatid Cyst of the Spine: A Rare Case Report

Hydatid cyst is a zoonotic disease that can affect multiple organs and is difficult to diagnose and treat. Spinal hydatid cyst (SHC) is a rare hydatid cyst involvement observed in 1% of all cases. It can induce various neurological symptoms depending on the region of the involvement. Paraplegia is one of the most prevalent neurological symptoms. In this case report, a 63-year-old male patient with bilateral lower extremity paraplegia was operated on by neurosurgery and diagnosed with SHC at the level of Th 11 vertebra in the pathological examination of surgically removed materials. Thus, we aimed to emphasize the significance of pathological and microbiological examination in the differential diagnosis of spinal disorders.

Sources of information in times of health crisis: evidence from Turkey during COVID-19.

Aim: Media as a source of information can shape public opinion regarding the COVID-19 response. Identifying how and where people seek information during the COVID-19 outbreak is vital to convey the most effective message about managing the COVID-19 crisis. The purpose of this study was to determine the sources of information and investigate the role of various demographic factors-age, gender, educational attainment and perceived economic level-on sources of information. Subject and methods: An online survey (n = 4624) was conducted on Turkish public during the early stages of the COVID-19. Results: The results showed that internet journalism and social media were the most preferable sources of information. Higher age, educational attainment and economic level were related to higher levels of seeking information from TV, newspaper, internet journalism and informative meetings. Females obtained information more from their friends and family and social media than males. High school graduates or below watched more TV and obtained less information from internet journalism, while university graduates sought information from their families and friends, and postgraduates attended informative meetings and read newspapers. People with medium and high economic status, respectively, watched more TV and read more newspapers, while people with low socioeconomic status attended informative meetings less. Conclusion: In sum, this study provides evidence that a source of information might be influenced by demographic factors. Researchers and policymakers can use a source of information to develop crisis-response strategies by considering variations in the demographic factors.

The Effect of COVID-19 Anxiety on General Health: the Role of COVID-19 Coping.

The Coronavirus Disease 2019 (COVID-19) epidemic has unprecedently affected many aspects of people's lives including their health. This study examined the mediating effect of COVID-19 coping strategies on the relationship between COVID-19 anxiety and general health. Participants (70% females) included 4624 adults (M age = 30.29 ± 10.97 years) collected through an online survey using a convenience sampling approach. Exploratory and confirmatory factor analyses yielded a one-factor structure for the COVID-19 Anxiety Scale (CFI = .98, TLI = .96, SRMR = .02, RMSEA = .09), COVID-19 Coping Scale (CFI = .97, TLI = .97, SRMR = .03, RMSEA = .12), and General Health Scale (CFI = .99, TLI = .97, SRMR = .01, RMSEA = .04) which were developed for the purpose of this study and exhibited satisfactory reliability. Findings showed that COVID-19 anxiety was negatively related with COVID-19 coping and general health. COVID-19 coping had a positive relationship with general health. Hierarchical multiple regression analyses revealed that COVID-19 coping partially mediated the relationship between COVID-19 anxiety and general health. These findings shed more light on the mechanism underlying between COVID-19 anxiety and health. The findings are important for tailoring and implementing coping-based intervention strategies to reduce the impact of COVID-19 anxiety on general health.

The effectiveness of methotrexate and low-dose steroid therapy in the treatment of idiopathic granulomatous mastitis.

BACKGROUND: Idiopathic granulomatous mastitis (IGM) is a rare, chronic, benign, inflammatory breast disease of unknown cause. Patients usually present with a single breast mass, hyperemia, discharge, skin disorders, and fever. Radiological and clinical findings can mimic carcinoma and infection. OBJECTIVES: To examine the treatment of IGM with methotrexate (MTX) + low-dose steroid, and present the results and follow-up data from our center. MATERIAL AND METHODS: Sixty-two patients, diagnosed with IGM in our center between January 2009 and December 2017 were included in this study. Patients diagnosed with granulomatous mastitis histopathologically underwent testing with anamnesis, physical examination and imaging methods to exclude other diseases that cause granulomatous reactions. Patients with a history of malignancy, chronic infectious diseases such as hepatitis B and pregnant women were excluded from this study. Data collected from 62 patients were reviewed retrospectively for this study. RESULTS: The mean patient age was 36.58 ±5.83 years (range: 28-54 years). Lesions were present in the right breast in 30 (48.38%) patients, the left breast in 26 (41.94%) patients and both breasts in 6 (9.68%) patients. Methotrexate was administered orally at a dose of 15 mg/week and methylprednisolone at a dose of 8 mg/day. The mean clinical and radiological remission periods of these patients were 10.14 ±1.21 months (range: 3-14 months). All patients attended regular follow-up appointments. The recovery rate of patients during follow-up was determined to be 93.71%. CONCLUSION: Methotrexate + low-dose steroid therapy is successful in the treatment of IGM. Prospective, large case series and/or multi-center studies are needed to develop an IGM treatment algorithm.

Are average platelet volume, red cell distribution width and platelet distribution width guiding markers for acute appendicitis treatment options?

BACKGROUND: Acute appendicitis (AA) is the most common cause of surgery performed for the acute abdomen. The standard treatment for AA patients has been appendectomy for more than a century. The use of broad-spectrum antibiotics, the medical treatment option has come to the fore in the treatment of uncomplicated AA. AIM: Evaluate whether white blood cell (WBC), platelet count, mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW) and C-reactive protein (CRP) values of patients diagnosed with uncomplicated AA clinically, with laboratory tests and radiologically with abdominal computed tomography (CT) could be a marker for choosing medical or surgical treatment. MATERIALS AND METHODS: 519 patients aged between 20 and 65 years who were diagnosed with uncomplicated AA by abdominal CT in our centre between January 2016 and January 2019 were retrospectively analysed. The presence of at least one of the criteria of 7 mm or more appendix diameter and oedema or fluid accumulation around the appendix was accepted as uncomplicated AA. After the diagnosis of AA, 223 patients were treated medically, while 296 patients underwent laparoscopic appendectomy. The first group included patients who were treated medically and the second group included patients who underwent laparoscopic appendectomy. RESULTS: Group 2 patients had higher mean platelet count (P < .005) and RDW (P = .003) values compared to Group 1 patients, while mean PDW (P < .001) values were lower compared to those of Group 1 patients. The differences between the mean WBC, CRP and MPV values of the groups were not statistically significant (P > .05). CONCLUSIONS: Recently, studies supporting antibiotic therapy have been conducted in patients diagnosed with AA. As a result, we think that PDW, RDW, and platelet values in patients diagnosed with uncomplicated AA may be a guide in choosing patients to be treated with surgery or antibiotics.

Reliable treatment of perianal fistulas using laser ablation. Results in 67 patients.

BACKROUND: We aim to show that fistula ablation with laser (FAL) is a reliable method to repair a perianal fistula, and we share the results of a 24-month follow-up on FAL treatments of different perianal fistula types. STUDY DESIGN: The FAL procedure was performed using a ceramic diode laser platform (30-50 J/cm of energy at a wavelength of 1470 nm). All operations were performed under spinal anesthesia in the jackknife position. RESULTS: Of the 67 patients, 48 (71.6%) were male and 19 (28.4%) were female. Of these, 40 (59.7%) had intersphincteric fistulas, 21 (31.3%) had transsphincteric fistulas, 3 (4.47%) had suprasphincteric fistulas, and 3 (4.47%) had extrasphincteric fistulas. Based on perianal fistula disease severity scores, 40 patients (59.70%) experienced complete healing, 10 (14.92%) had persistent symptomatic drainage, 14 (20.89%) had slight drainage with minimal symptoms, and 3 (4.47%) had painful, symptomatic drainage. No major complications were observed in any patient. CONCLUSIONS: The FAL is a minimally invasive initiative with the lowest morbidity and highest curative recovery rate, especially for simple fistulas. KEY WORDS: Anal fistula, Fistula ablation with laser, Reliable surgery.

The impacts of vulnerability, perceived risk, and fear on preventive behaviours against COVID-19.

The world has been under the negative effect of the COVID-19 pandemic for the last few months. While people may take many preventive behaviours to minimize the risk, very little is known about the factors that can increase preventive behaviours during the COVID-19 pandemic. This study examined the effects of vulnerability, perceived risk, and fear on preventive behaviours of COVID-19. The study used a sample of 4,536 Turkish adults (M = 30.33 ± 10.95 years) recruited from 17 March through 1 April 2020. Vulnerability, perceived risk, fear, and preventive behaviours were measured with self-rating scales. Participants mostly engaged in avoidance of public transportation and frequent handwashing as preventive behaviours. Women had a significantly higher vulnerability to, perceived risk, and fear of new coronavirus compared to men. Correlation results indicated that age, gender, education level, vulnerability, perceived risk, and fear were related to preventive behaviours. Regression results demonstrated that vulnerability, perceived risk, and fear accounted for a significant amount of variance in preventive behaviours over and above the effects of demographic variables. The results suggest that vulnerability, perceived risk, and fear can significantly increase engagement in preventive behaviours during the novel coronavirus pandemic. The results have important implications for research and practice.

Selecting a surgical modality to treat a splenic hydatid cyst: total splenectomy or spleen-saving surgery?

AIM: We analyzed the outcomes and effectiveness of surgical treatments and clinical manifestations of splenic hydatid cysts. PATIENTS AND METHODS: Between 2000 and 2011, we retrospectively reviewed the cases of 11 patients who were operated on for a splenic hydatid cyst. The demographic features, medical history, physical examinations, biochemical and serological tests, imaging modalities, and surgical treatment of the patients were noted. RESULTS: The mean patient age was 36.45 years (range, 20-66 years). While isolated splenic hydatid disease was present in five patients, other abdominal hydatid cysts were accompanied by a splenic hydatid cyst in six patients. Left upper abdominal pain was present in seven (64%) patients, whereas four (36%) patients were asymptomatic. Eight patients (72.72%) had undergone a total splenectomy and three (27.28%) had undergone spleen-preserving surgery. Postoperative complications developed in four (36%) patients at 5-15 days postoperatively. CONCLUSION: Management of a splenic hydatid cyst is not consensual. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in selected patients. The choice of technique depends on the localization, number, and size of hydatid cysts, and the absence or presence of other hydatic organ cysts.