Selçuk Kaya

Infective endocarditis is a very rare clinical form caused by Erysipelothrix rhusiopathiae. It is rarely seen in immunocompetent individuals. Even after surgery it may entail mortality rates as high as 30–40 %. This report describes a case of native valve endocarditis caused by E. rhusiopathiae and cured with crystallized penicillin G and surgery.

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The aim of this study was to investigate the predictive factors which contribute to diagnosis of hantavirus infection. One hundred patients from rural areas hospitalized with a preliminary diagnosis of hantavirus infection from different hospitals in Turkey were investigated. Hantavirus infection was confirmed in 20 patients (Group 1) using immunofluorescence and immunoblot assays at the Refik Saydam National Public Health Agency. Hantaviruses were not detected in the serum of the remaining 80 patients, other infectious and non‐infectious diseases being diagnosed in this group (Group 2). Patients' demographic characteristics and clinical and laboratory data on admission were examined and compared between the two groups. Fever, proteinuria, hematuria, lethargy‐weakness, and nausea‐vomiting were the most frequent symptoms and findings in Group 1, seen in almost all patients. Proteinuria, hematuria, muscle pain, diarrhea/abdominal pain, hypotension, shock, and sweating were observed at significantly higher levels in Group 1 compared to Group 2. Serum urea, creatinine, uric acid, lactate dehydrogenase (LDH), aspartate transaminase (AST), alkaline phosphatase (ALP), and C‐reactive protein (CRP) were significantly higher, but serum platelet counts were lower in Group 1 patients. Area beneath the receiver operating characteristics (ROC) curve analysis was used to calculate the discriminative ability of various laboratory values to identify patients with hantavirus infection. This analysis revealed that, serum CRP had a 100% negative predictive value, whilst, platelet, and creatinine had 75% and 70% positive predictive values for the diagnosis of hantavirus infection. In summary, laboratory markers used in clinical practice are of great importance predicting hantavirus infections. J. Med. Virol. 84:1790–1796, 2012.

Sepsis continues to be a very important cause of morbidity and mortality despite advances in modern medicine. It is the cause of mortality in approximately 28-50% of the patients, with the risk increasing particularly in patients with multiple organ dysfunctions. Although anti-infective treatment and securing hemostasis form the cornerstone in the management of this condition, studies to develop new drugs are expected to reduce mortality in severely septic patients. Recombinant human activated protein C (rhAPC) was known as an anti-inflammatory agent with proven efficacy in severe sepsis patients and had a critical effect in the reduction of mortality when administered in the right dose and duration so far, but unfortunately current studies indicate that it was unable to show favorable effects of rhAPC on patients with severe sepsis. For this reason, interests are becoming focused on some other new approaches such as antioxidant treatments, stem cells, computer-implemented sepsis alerting systems, endotoxin removal devices. These attempts may reduce the incidence of mortality due to sepsis in the near future. Some patents on sepsis have also been reviewed in this article.

OBJECTIVES: To determine predictive fatality criteria based on clinical and laboratory findings on admission to hospital in patients diagnosed with pandemic influenza A (H1N1) virus infection. METHODS: The study was conducted at the School of Medicine, Karadeniz Technical University, Trabzon, Turkey. Demographic, clinical, and laboratory data for hospitalized cases with a diagnosis of A (H1N1) virus infection between October 2009 and May 2010 were analyzed retrospectively. Patients were divided into 2 groups: fatal (group I) and non-fatal (group II). The 2 group9s demographic, clinical, and laboratory data were compared on admission. RESULTS: Ten (20%) of the 50 patients included in the study died. The average age of group I was significantly higher than that of the group II. No significant difference was observed between the groups in terms of underlying chronic diseases and pregnancy. Fever, phlegm, shortness of breath, tachypnea, cyanosis were observed at significantly higher levels in group I compared to group II. Serum hemoglobin, glucose, albumin levels, arterial oxygen saturation were significantly lower in group I compared to group II; aspartate transaminase, alanine aminotransferase, C-reactive protein, procalcitonin, blood urea nitrogen levels, time between onset of symptoms and commencement of antiviral treatment were all significantly higher in group I. CONCLUSIONS: This study shows that in addition to demographic characteristics and clinical findings, prognosis of patients with A (H1N1) virus infection can be determined beforehand with various laboratory tests. But these parameters, which can guide the clinician in the prior identification of potentially fatal A (H1N1) cases will contribute to the provision of supporting treatment and, when necessary, intensive care services for such patients.