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Objectives We aimed to investigate the value of leukocyte biomarkers and disease scores for the early detection of infection in patients who have undergone elective colorectal surgery for malignancy. Methods We conducted a prospective study at a training and research hospital. Patients who developed infection were considered to be an Infection group, and the others were regarded as a Control group. For individuals in both groups, the Sequential Organ Failure Assessment Score (SOFA), quick SOFA, and National Early Warning Score (NEWS) were calculated and blood samples were collected for flow cytometry analysis. A model was developed using logistic regression analysis to identify parameters that were predictive of mortality. Results One hundred thirty-two patients were included in the study. Infections developed in 36 (27.3%) of the participants, of which 14 (38.9%) were intra-abdominal, 10 (27.8%) were pneumonia, 8 (22.2%) were superficial incisional infections, and 4 (11.1%) were urinary tract infections. The NEWS was the most effective parameter for the detection of early infection in patients undergoing surgery for colorectal malignancy. Conclusion The NEWS score can be easily used to predict infection soon after surgery for colorectal malignancy.

Objective Staphylococcus aureus causes infections ranging from mild skin conditions to life-threatening diseases such as endocarditis. The incidence of S. aureus infections is increasing due to the rise in invasive procedures and immunosuppression. Inflammatory markers such as C-reactive protein level, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio are useful for monitoring disease severity. This study aimed to identify the clinical and laboratory predictors of mortality in patients with S. aureus infections. Methods This retrospective observational study included patients aged >18 years with S. aureus growth who were treated at a tertiary hospital between 1 November 2013 and 1 February 2022. Infections were classified as pneumonia or infections of the bloodstream, bone and joint, and skin and soft tissue. Results Univariate analysis revealed that age >73 years, emergency department admission, and methicillin resistance were significant mortality risk factors. Multivariate analysis showed that age >73 years, pneumonia, and C-reactive protein level >86 mg/L increased the mortality rate by 3.5-, 7.6-, and 4.4-fold, respectively. Conclusion C-reactive protein level, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio are accessible, cost-effective markers that aid in predicting mortality. Integrating these biomarkers with clinical parameters such as advanced age and pneumonia can improve early risk stratification in patients with S. aureus infections.

Objectives Acute leukemia often leads to severe complications such as febrile neutropenia. Mortality rates remain high, underscoring the need for novel prognostic markers. Regulatory T cells (Tregs) have not been extensively studied in this context. Methods This prospective observational, single-center study included 114 patients diagnosed with acute leukemia. Tregs percentages were measured using flow cytometry. Statistical analyses involved logistic regression to identify factors significantly associated with survival. Results Of the 114 patients, 78 recovered, while 36 died. The median Treg percentages were 5.9% in patients under 65 years and 5.38% in those 65 and older. A lower percentage of Tregs was associated with higher mortality in the older group (p = 0.04). Multivariate analysis highlighted the presence of comorbidities, documented infections, and day seven C-reactive protein levels as significant predictors of survival. Conclusion This study supports the importance of monitoring chronic diseases and infection foci alongside traditional markers like C-reactive protein. Future research should explore the mechanistic roles of Tregs in immunosuppression and survival in this vulnerable population.

Sepsis remains a major cause of morbidity and mortality in intensive care units (ICUs). Although various scoring systems and biomarkers have been studied, the prognostic significance of early dynamic changes in laboratory parameters remains unclear. This study aimed to investigate the prognostic value of 48 h changes in routinely monitored biomarkers for in-hospital mortality in septic patients. This retrospective, single-center study was conducted in the Anesthesiology and Reanimation ICU of a tertiary teaching hospital. A total of 174 adult patients (≥18 years) diagnosed with sepsis according to SEPSIS-3 criteria between January 2017 and December 2022 were included. Laboratory data were recorded at ICU admission and after 48 h. Patients who died within 48 h or had missing follow-up data were excluded. Receiver operating characteristic (ROC) analysis and logistic regression models were used to assess the prognostic performance of clinical and laboratory parameters. The median age was 71 years, and 58% of patients were male. Comorbidities were present in 76% patients, and malignancy was associated with higher mortality ( = 0.012). The overall in-hospital mortality rate was 58.6%. Inappropriate empirical antibiotic therapy significantly increased mortality risk ( = 0.001). Non-survivors had higher baseline SOFA and APACHE II scores. At 48 h, mortality was associated with increased procalcitonin, lactate, and CRP/albumin ratio and greater albumin decline. ROC analysis identified procalcitonin ≤ 28% decrease, lactate > 23% increase, albumin > 7% decrease, and CRP/albumin ratio > 31% increase as optimal cutoffs. Multivariate analysis revealed SOFA score > 6, inappropriate antibiotic therapy, procalcitonin ≤ 28% decrease, lactate > 23% increase, and platelet > 37% decrease as independent mortality predictors. The change in albumin level was included in the model but was not statistically significant. Forty-eight-hour biomarker changes, particularly in lactate and platelet count, may provide complementary prognostic information to baseline SOFA scores and may support early risk stratification in sepsis. These findings should be considered exploratory and require confirmation in prospective multicenter studies before clinical implementation.

Background Herpes zoster (HZ) results from the reactivation of varicella-zoster virus (VZV) in dorsal root ganglia, often triggered by immune decline. This multicenter study aimed to describe the frequency, clinical and demographic characteristics, and risk factors of HZ in Türkiye to inform clinical management and prevention strategies. Methods This retrospective analysis was conducted on 503 patients diagnosed with HZ between 2014 and 2024 across 17 hospitals in nine Turkish provinces. Data included demographics, comorbidities, immunosuppressive therapy, dermatomal involvement, rash duration, antiviral treatment, and vaccination status. Descriptive statistics were applied. Results A total of 503 patients were included in the study. Of these, 281 (55.9%) were female including 10 pregnant women (3.5%) and 222 (44.1%) were male, with a mean age of 59 ± 16 years (range: 20–101). Sixty-one patients (12.1%) were using immunosuppressive drugs during the zoster episode, and 324 (64.4%) had comorbid diseases. Strikingly, only one patient (0.2%) had received the zoster vaccine, highlighting a critical gap in preventive medicine. While 246 (48.9%) patients had a history of chickenpox during childhood, 11 (2.2%) had experienced more than one episode of zoster previously. Forty-three (8.6%) patients had multiple dermatome involvement, while 459 (91.4%) had single dermatome involvement. The distribution of dermatome involvement in order of frequency was as follows: thoracic ( n  = 256, 50.9%), lumbar ( n  = 110, 21.9%), sacral ( n  = 51, 10.1%), trigeminal ( n  = 100, 19.9%), cervical ( n  = 16, 3.2%), and periorbital ( n  = 16, 3.2%). The mean duration of rash was 15.1 days for all patients, while this duration was 15.3 days in those with comorbidities, 18.6 days in patients using immunosuppressive drugs, and 17.2 days in pregnant women. The antivirals used in treatment were valacyclovir ( n  = 310, 61.6%), acyclovir ( n  = 145, 28.8%), and brivudine ( n  = 18, 3.6%). The duration of rash was 14.6 days in those treated with valacyclovir, 16.1 days in those treated with brivudine, and 17.0 days in those treated with acyclovir. Conclusion HZ is a disease whose frequency increases particularly with advancing age, and careful management is required especially in patients with comorbidities, pregnant women, and those receiving immunosuppressive therapy. Identifying and informing individuals in risk groups, raising their awareness. The near-total absence of vaccination in our cohort underscores the urgent need for national health policies to improve vaccine accessibility.

Objective: In this study, we aimed to examine the relationship between Prostate-Specific Antigen (PSA) level and mortality and morbidity of COVID-19 disease. Methodology: Demographic characteristics, PSA levels, comorbidities and clinical outcomes of male patients hospitalized at Bozyaka Training and Research Hospital between May 2020 to October 2021 due to COVID-19 and who had PSA measurements within the last one year were retrospectively analyzed. Exclusions included recent urologic intervention androgen deprivation therapy and five alpha reductase inhibitors. Mortality and morbidity rates were compared between patients with high PSA levels and those with normal PSA levels according to age. Age-specific PSA values followed the Oesterling guideline. Statistical analysis used T-test, Mann-Whitney U and chi-square tests, with significant set at p < 0.05 Results: Of 664 patients, 42.2% had normal PSA levels, 57.8% had high PSA levels. Overall mortality was 32.0%. Mortality was higher in high PSA patients than normal PSA patients. (38.0% vs. 26.1%, p=0.0012). Intubation rates were higher in the high PSA group than normal PSA group (50.5% vs. 36.8%, p=0.0004). Hospital stays were longer and SOFA and APACHE II scores were higher in high PSA patients. Conclusions: PSA elevation is linked to increased mortality and morbidity in COVID-19 patients. PSA level may serve as a biomarker for risk assessment in COVID-19 patients.

The study is aimed to investigate the association between different corticosteroid treatment regimens and clinical status, complications, mechanical ventilation requirement, and intensive care unit (ICU) mortality in individuals diagnosed with Coronavirus Disease of 2019 (COVID-19). This is a descriptive retrospective study. Patients admitted to the ICU for COVID-19 and treated with low- or medium-dose corticosteroid therapy (methylprednisolone at a dose of 0.5-1 mg/kg for 7-10 days) were compared with patients treated with high-dose pulse corticosteroid therapy (methylprednisolone at varying doses of 250 mg, 500 mg or 1000 mg for 3-7 days) in addition to standard therapy because of increased pulmonary infiltrate and elevated inflammatory markers during clinical monitoring. All demographic and clinical data, including age, sex, clinical course, laboratory findings, discharge status, 28-day mortality, intubation status, acute physiological assessment and chronic health evaluation II score, Charlson Comorbidity Index, and sequential organ failure assessment score, were recorded. Corticosteroid treatment was administered to 689 (88.3%) of 780 COVID-19 ICU patients between April 2020 and October 2021. The overall mortality rate was 45.1% (n= 352). When the mortality rates of patients were compared according to the corticosteroid dose, the mortality rate in the low-to-medium-dose group (40%) was significantly lower than that in the high-dose group (76%). In addition, significant deterioration in laboratory and clinical parameters was observed in the high-dose corticosteroid group. High mortality, adverse effects, and complications were significantly increased when high-dose corticosteroids were administered. Corticosteroid therapy should be used cautiously according to the patient's clinical condition, disease stage, comorbidities, and systemic or organ reserves.

To determine effective risk factors on mortality in febrile neutropenic cases with hematologic malignancy. Patients with hematologic diseases are more prone to infections and those are frequent causes of mortality. This retrospective study was performed using data of 164 febrile neutropenic cases with hematologic malignancies who were followed up in a hematology clinic of a tertiary health care center between 2011-2015. The relationship between descriptive and clinical parameters rates and rates of mortality on the 7th and the 21st days were investigated. Patients with absolute neutrophil count less than 100/mm3, duration of neutropenia longer than 7 days, pneumonia or gastrointestinal foci of infection, central catheterization (p=0.025), isolation of Gram (-) bacteria in culture, carbapenem resistance, septic shock, and bacterial growth during intravenous administration of antibiotic treatment were under more risk for mortality on both the 7th and the 21st days. The final multivariate logistic regression results showed that pneumonia (p less than 0.0001), septic shock (p=0.004) and isolation of Gram-negative bacteria (p=0.032) were statistically significant risk factors. Early diagnosis and appropriate treatment of serious infections, which are important causes of morbidity and mortality, are crucial in patients with febrile neutropenia. Thus, each center should closely follow up causes of infection and establish their empirical antibiotherapy protocols to accomplish better results in the management of febrile neutropenia.

This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-risk Multinational Association for Supportive Care in Cancer (MASCC) index score (92.6% vs. 57.4%; p < 0.001), pneumonia (38% vs. 19.2% p < 0.001), and infection due to multidrug-resistant P. aeruginosa (MDRPA) (33.8% vs. 21.1%, p < 0.001) were statistically significantly higher in patients with septic shock compared to those without. Patients with septic shock were more likely to receive inadequate empirical antibiotic therapy (IEAT) (21.7% vs. 16.2%, p = 0.020) and to present poorer outcomes, including a need for ICU admission (74% vs. 10.5%; p < 0.001), mechanical ventilation (49.1% vs. 5.6%; p < 0.001), and higher 7-day and 30-day case fatality rates (58.2% vs. 12%, p < 0.001, and 74% vs. 23.1%, p < 0.001, respectively). Risk factors for 30-day case fatality rate in patients with septic shock were orotracheal intubation, IEAT, infection due to MDRPA, and persistent PABSI. Therapy with granulocyte colony-stimulating factor and BSI from the urinary tract were associated with improved survival. Carbapenems were the most frequent IEAT in patients with septic shock, and the use of empirical combination therapy showed a tendency towards improved survival. Our findings emphasize the need for tailored management strategies in this high-risk population.

Telbivudine has potent antiviral activity against hepatitis B virus. Although there are several reports concerning the safety profile of telbivudine, most adverse events are described as mild and transient in nature. In this paper, we report a case of reversible telbivudine-induced myopathy. To detect this adverse event, monitoring of serum creatine kinase level and recognition of myopathic signs and symptoms are necessary.