Clinical Features and Risk Factors for Mortality in Patients with Stenotrophomonas maltophilia Infection

Introduction: It is important to know the risk factors for death in reducing mortality in patients with Stenotrophomonas maltophilia infections. The purpose of this study was to examine the risk factors associated with mortality in hospitalized patients with S. maltophilia infections. Material(s) and Method(s): Patients with S. maltophilia infections aged 18 years and older who were hospitalized in Haseki Research and Training between January 1, 2017, and April 30, 2022, were included in the study. The patients were divided into two groups, non-survivors and survivors, and the clinical features and laboratory parameters of the groups were compared. Mortality risk factors were analyzed by logistic and Cox regression analyses. Result(s): A total of 75 patients with S. maltophilia infections were included. The mortality rate was 38.6% (n= 29). Advanced age (OR= 1.05, 95% CI= 1.012-1.085, p= 0.009), COVID-19 pneumonia (OR= 9.52, 95% CI= 1.255-72.223, p= 0.029), and presence of central venous catheter (CVC) (OR= 18.25, 95% CI= 2.187-152.323, p= 0.007) were risk factors for death. Conclusion(s): Physicians should be aware of the potential risk of S. maltophilia infections for mortality, particularly in patients with predefined risk factors such as advanced age, the presence of CVC, and COVID-19. Performing CVC care in accordance with infection prevention and control measures and timely removal of CVC may be beneficial in reducing deaths due to S. maltophilia infection.Copyright © 2023 Bilimsel Tip Yayinevi. All rights reserved.

Effects of the COVID-19 pandemic on neovascular age-related macular degeneration and response to delayed Anti-VEGF treatment.

OBJECTIVES: To investigate the effects of the COVID-19 pandemic on the treatment course of neovascular age-related macular degeneration (nAMD) patients who received anti-VEGF injection therapy with real-life data. METHODS: This retrospective study consisted of 116 eyes of 106 patients. Ophthalmic examination, assessment of best-corrected visual acuity (BCVA), optical coherence tomography (OCT) findings and data of last two visits before restrictions (V-2 and V-1) and the first visit (V0) after the release of national lockdown and subsequent visits (V1 and Vlast) were recorded. The lockdown period was determined by the time interval between March 11 and June 1, 2020. MAIN RESULTS: The injection interval before V-1 was significantly longer than the interval after V0 (2.56±0.9 vs. 2.14±0.8 months, P=0.02). While the median central macular thickness (CMT) was significantly increased at V0 compared to V-1 [274(132-711) vs. 238(136-628), P<0.001], the median CMT was significantly lower at V1 compared to V0 [256 (136-591) vs. 274(132-711), P=0.003]. The median BCVA was 0.67(0.1-1.1) logMAR at V-1 and significantly worsened to 0.78 (0.1-1.2) logMAR at V0 (P=0.003). Although the median BCVA improved to 0.69 logMAR (0.1-1.2) at Vlast, the difference did not reach statistical significance compared to V0 (P=0.08). CONCLUSION: Treatment delay due to the COVID-19 pandemic cause progression of nAMD and visual impairment. To plan more frequent anti-VEGF treatments and visits may be an appropriate approach until the disease stabilizes. However, it should be kept in mind that despite the improvement in OCT findings, the desired success in VA could not be achieved in the short term.

Neurological manifestations of SARS-CoV-2 infection among hospitalized patients

Introduction: Neurological symptoms in SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infected patients and the course of COVID-19 in patients with neurological findings are determined. Material and methods: Inpatient cases aged =18 years, followed-up in clinical services for COVID-19 diagnosis are studied. Patients were visited on 04.20.2020 and examined for central nervous system (CNS), peripheral nervous system (PNS) manifestations and muscular injury, from onset of symptoms to hospitalization. Risk factors associated with the severity of COVID-19 and the comparison of variables in terms of existence of neurological findings including CNS and PNS findings were performed. Results: Overall, 133 (54%) of the 242 patients of the study were male, mean age was 56.82±16.35 (18-91) years. Of these, 128 (52%) cases were defined as severe COVID-19. Outstanding symptoms at the onset were cough (62.8%), fever (46.7%), dyspnea (45.9%), and tiredness (31%). Further, 82 (33.9%) cases showed neurological findings at the first admission. Of those with neurological symptoms, 25.6% had CNS, 16.1% had PNS, 1.7% had muscular symptoms. In patients with CNS manifestations, the most common symptoms were headache (20.6%) and dizziness (7.4%). Impaired taste was the most common manifestation of PNS (11.2%). Neurological symptoms showed no significant difference between severe and non-severe COVID-19 groups except impaired taste (significantly higher in non-severe group). During follow-up, 17 (7%) patients needed intensive care unit. Nine (3.6%) patients died. Conclusion: Frequency and variety of neurological findings in COVID-19 cases is too high to underestimate. Early diagnosis of these findings may prevent spread of COVID-19.