Explore the vast range of titles available.

ObjectivesPatients diagnosed with chronic hepatitis B virus (HBV) should be tested for hepatitis A virus (HAV) and vaccinated if they are seronegative. However, this test is often neglected. This study aims to investigate the status of HAV testing in chronic HBV patients.Materials and MethodsA multicenter study is being conducted by the Viral Hepatitis Combat Association with 16 centers across the country, including patients who have been receiving treatment for chronic HBV for at least 14 years. The anti-HAV immunoglobulin G (IgG) testing and vaccination status of the patients in this study were evaluated retrospectively. The patients’ data recorded in a web-based program were transferred to an Excel form, and the necessary analyses were performed. Statistical analysis was performed using SPSS for Windows, version 22.0 (IBM Corp., Armonk, NY, USA). Categorical measurements were summarized as numbers and percentages, continuous measurements as mean and standard deviation, and chi-square or Fisher’s exact test statistics were used to compare categorical variables.ResultsThe study group included 2966 individuals, 1832 of whom were male (61.8%) and 1134 of whom were female (38.2%). Of these patients, 1819 individuals (61.3%) were tested for anti-HAV IgG, while 1147 individuals (38.7%) were not. Of the 1819 individuals tested for anti-HAV IgG, 1688 (92.8%) were seropositive, and 131 (7.2%) were seronegative. It was determined that seropositivity increased significantly with age, and seronegativity was 23% among those aged 18-26 and 21% among those aged 27-33 (p=0.00001). According to the obtained data, HAV seronegativity was detected in one-fourth of individuals younger than 26 years and one-fifth of individuals aged 27-33. At 40 and above, seronegativity decreases significantly, falling to 5% and below.ConclusionDue to the changes observed in HAV epidemiology in our country in recent years, HAV seronegativity is high in young adults. According to our study data, anti-HAV IgG should be tested once in all chronic HBV patients, especially patients under the age of 35, and vaccination of seronegative individuals should not be neglected.

Background/Objectives: Highly active antiretroviral therapy (HAART) effectively suppresses viral load and aids immunological recovery in HIV patients, but may still lead to subclinical myocardial dysfunction. This study assesses left and right ventricular functions in patients on HAART containing abacavir, dolutegravir, and lamivudine using Tissue Doppler Imaging (TDI). Methods: This observational cross-sectional study involved 118 HIV-positive adults on HAART and 80 age- and gender-matched healthy controls. Comprehensive echocardiographic assessments, including TDI, were conducted to evaluate myocardial performance index (MPI) and isovolumic acceleration (IVA). Results: Conventional echocardiographic parameters showed no significant differences; however, TDI indicated significant impairments in ventricular functions in the HAART group, with increased MPI and decreased IVA (p < 0.001). Pulmonary artery pressures were also higher in the HIV group (p = 0.012). There was a strong positive correlation between MPI and HAART duration (r = 0.675, p = 0.002), and a negative correlation with CD4 count (r = −0.545, p = 0.006). Conclusions: TDI reveals significant subclinical ventricular dysfunction in HIV patients on HAART, correlating with therapy duration and immune status. These findings underscore the utility of TDI in detecting myocardial deterioration before clinical symptoms appear.

Candidemia is a nosocomial infection mostly found in critically ill patients. Our objectives were to evaluate the change in distribution and resistance profile of Candida spp. isolated from candidemic patients in our intensive care unit over two 5-year periods spanning 15 years and to evaluate the risk factors. Records from the microbiology laboratory were obtained, from January 2004 to December 2008 and from January 2013 to December 2017, retrospectively. Antifungal susceptibility was performed by E-test and evaluated according to EUCAST breakpoints. A total of 210 candidemia cases occurred; 238 Candida spp. were isolated in 197 patients (58.8% male; mean age, 59.2 ± 19.6 years). The most predominant risk factor was central venous catheter use. Species distribution rates were 32%, 28%, 17%, and 11% for C. albicans (n = 76), C. parapsilosis (n = 67), C. glabrata (n = 40), and C. tropicalis (n = 27), respectively. Resistance rate to anidulafungin was high in C. parapsilosis over both periods and increased to 73% in the second period. Fluconazole showed a remarkable decrease for susceptibility in C. parapsilosis (94 to 49%). The prevalence of MDR C. parapsilosis (6%/33%) and C. glabrata (0%/44%) increased in the second period. We observed a predominance of non-albicans Candida spp., with C. parapsilosis being the most frequent and C. glabrata infections presenting with the highest mortality. High level of echinocandin resistance in C. parapsilosis and increasing prevalences of MDR C. parapsilosis and C. glabrata seem emerging challenges in our institution.