Healthcare personnel's attitude and coverage about tetanus vaccination in Turkey: a multicenter study.

The tetanus vaccine is not routinely given to Turkish adults. Protective tetanus immunity decreases with age. Health-care personnel (HCPs), who are role models in the field of health, are a target group in order to achieve a higher rate of tetanus vaccination in the community. This study was designed to evaluate attitudes and coverage regarding tetanus vaccination among a large sample of Turkish HCPs. This cross-sectional epidemiologic study was conducted from July to August 2019. A questionnaire was sent to HCPs using social media. Of the 10,644 HCPs included in the study, 65% were female. Overall, the tetanus vaccination coverage (TVC) among HCPs was 78.5% (95% CI: 77.7%-79.3%). TVC was significantly higher among physicians [83.4% (95% CI: 82%-84.6%); p < .001] compared with all other HCPs except nurses. Older age (≥40 years) and length of professional experience were significantly correlated with TVC. Of the 8353 HCPs who received tetanus vaccines during their lifetime, 73.03% received tetanus vaccination in the past 10 years. The self-vaccination rate for protection against tetanus was 13.1%. Acute injuries (25.42%) and pregnancy (23.9%) were the most common reasons for having the tetanus vaccine. One-third (33.7%) of HCPs did not have information about whether pregnant women could receive tetanus vaccinations. This survey study provided excellent baseline information about HCPs' coverage rates and attitudes regarding tetanus vaccination. The present results suggested that tetanus boosters for HCPs should be established as soon as possible, and revealed that the HCPs younger than 30 years with relatively less professional experience and all other HCPs except nurses and physicians should be identified as the target population for future intervention programs.

The presence of SARS-CoV-2 virus in semen samples of patients with COVID-19 pneumonia.

The SARS-CoV-2 set off a pandemic involving millions of people around the world. The topic of discussion is the possible viral detection in different body fluids than respiratory droplets. Therefore, we evaluated the possible presence of SARS-CoV-2 in semen and urine samples. Thirty patients were included in the study aged 35.67 ± 6.84 years. The day after the pharyngeal and/or nose swab of SARS-CoV-2 was positive, urine and semen samples were taken from patients, and the presence of SARS-CoV-2 was investigated. Laboratory tests and chest CT findings were evaluated simultaneously. SARS-CoV-2 was detected in four (13.3%) patients' semen samples and in seven (23.3%) patients' urine samples. White blood cell (WBC), neutrophil, C-reactive protein (CRP), ferritin, alanine transaminase (ALT), lactate dehydrogenase (LDH) and procalcitonin were significantly higher in patients with SARS-CoV-2 in semen (p < .05), though no statistical difference was found in urine (p > .05). Patients with severe pneumonia findings in Chest CT images are likely to be PCR positive in semen and urine samples (p = .005, p = .001). SARS-CoV-2 was not detected in urine and semen samples of patients after they had recovered (average duration 23 ± 4 days). SARS-CoV-2 can be detected in the urogenital fluids of patients with severe clinical conditions and high viral load.

Effect of serum total testosterone and its relationship with other laboratory parameters on the prognosis of coronavirus disease 2019 (COVID-19) in SARS-CoV-2 infected male patients: a cohort study.

OBJECTIVE: To investigate effect of serum total testosterone and its relationship with other laboratory parameters on the prognosis of coronavirus disease 2019 (COVID-19) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected male patients. METHODS: This prospective cohort study included 221 consecutive male patients (>18 years old) with laboratory confirmed SARS-CoV-2 who had been hospitalized due to COVID-19. The patients were divided into 3 groups: Asymptomatic patients (n: 46), symptomatic patients who were hospitalized in the internal medicine unit (IMU) (n: 129), and patients who were hospitalized in the intensive care unit (ICU) (n: 46). RESULTS: As serum total testosterone level at baseline decreases, probability (%) to be in the ICU significantly increases (p = 0.001). As serum total testosterone level at baseline decreases, probability (%) of mortality significantly increases (p = 0.002). In the patients who had pre-COVID-19 serum gonadal hormones test (n: 24), serum total testosterone level significantly decreased from pre-COVID-19 level of 458 ± 198 ng/dl to 315 ± 120 ng/dl at the time of COVID-19 in the patients (p = 0.003). CONCLUSIONS: COVID-19 might deteriorate serum testosterone level in SARS-CoV-2 infected male patients. Low serum total testosterone level at baseline has a significant increased risk for the ICU and mortality in patients with COVID-19.

Tick-Induced Facial Palsy.

Ticks are obligate blood-sucking arthropods that exist worldwide. Their targets include all vertebrates and humans. Ticks are harmful to people with regard to transmission in many viral, bacterial, and parasitic infections. In addition to these diseases and toxin-induced neurological complications, tick-induced paralysis is a syndrome related to neurotoxin production, and its mortality ratio in the literature is reported to be approximately 10%. Tick-induced isolated facial paralysis is a rare form of the disease developing because of attachment to the external auditory canal or attachment behind the ear. Our country and region are under risk in terms of included tick habitat for tick-induced paralysis that is responsible particularly for hard ticks. In our article, we aimed to present a case with isolated facial paralysis that occurred after the internal auditory canal was bitten by Hyalomma margintum species belonging to the hard ticks group and to probe the management of this disease.

Clinical findings of vertebral osteomyelitis: Brucella spp. versus other etiologic agents.

We aimed to evaluate patients with vertebral osteomyelitis (VO) in our region and to compare the clinical and laboratory parameters of brucellar and non-brucellar VO patients (NBVO). This retrospective study included 80 patients with VO followed in our hospital between August 2004 and September 2010. The distribution of gender was 43 females (53.8%) and 37 males (46.2%) with average age of 52.5. Patients with brucellar vertebral VO (BVO; n = 30) accounted for 37.5% of all patients, and the rest (n = 50) were with NBVO. Co-morbidities existed in 32.5% of patients. In statistical comparison of VO patients who had the Brucella spp. as the infectious agent with patients of VO by non-brucellar pathogens, the following factors were found out to be significantly associated with BVO; low Charlson score (P = 0.0001), lower co-incidence with chronic renal failure (P = 0.001), high frequency of constitutional symptoms (P = 0.006), fever (P = 0.005), low-level inflammatory markers (WBC; Neutrophil; ESR; CRP, P values 0.006; 0.001; 0.022; 0.002, respectively), low-rate surgical treatment (P = 0.02) and culture positivity (P = 0.0001) and higher hemoglobin, total protein, albumin values (P = 0.002; 0.032; 0.016, respectively). VO may be strongly associated with brucellosis in patients presenting with fever and symptoms, low Charlson score and indistinct inflammatory markers.

Brucella melitensis infection within warthin tumor of the parotid gland.

Brucellosis is a zoonotic systemic infectious disease, and multiorgan involvement is commonly seen, but involvement of the neck is a rare presentation of brucellosis. Granulomatous infections of the parotid gland are extremely rare. Warthin tumor is a well-known benign neoplasm of the salivary glands. In this report, we describe a Warthin tumor associated with Brucella melitensis in the same parotid gland.

Multiple cranial nerve involvement caused by Brucella melitensis.

A case of neurobrucellosis complicated by optic, abducens and vestibulocochlear nerve palsies is reported. Brucella melitensis was isolated in the cerebrospinal fluid, and the patient was diagnosed with retrobulbar neuritis. Despite medical treatment, the patient developed optic atrophy. Multiple cranial nerve involvement should be kept in mind in patients presenting with blurred vision and double vision, especially in regions where brucellosis is endemic.

Tumoral mass presenting in the nasomalar region arising from the lateral nasal wall: pleomorphic adenoma.

Pleomorphic adenoma is the most common benign salivary gland tumor. Although the major salivary glands are the most common sites of its origin, it can also occur in the minor salivary glands of the oral cavity and rarely in the neck, ear, nasal cavity and larynx. We report a rare case of intranasal pleomorphic adenoma arising from lateral nasal wall and discuss the clinical presentation, diagnosis and treatment approaches with the review of the literature.

A microdissection study of the facial nerve at the labyrinthine and tympanic segments in adults.

OBJECTIVES: To determine the relationship in detail between the tympanic and the labyrinthine segments of the facial nerve and the relationship between the bony structures and the neighboring nerve. MATERIALS AND METHODS: Measurement of the length of the segment of the facial nerve within the internal auditory canal and the lengths of the labyrinthine and tympanic segments were made on fourteen temporal bones collected from eight fresh cadavers. RESULTS: The minimum distance between the point where the facial nerve leaves the internal auditory canal and the tympanic segment was measured as 4.71+/-0.54 mm. The angle between the labyrinthine and the tympanic segments at the geniculate ganglion was measured as 73 degrees 85' +/-10 degrees 89'. The angle between the labyrinthine and the superior vestibular nerve were measured as 34 degrees 35' +/-5 degrees 51'. CONCLUSION: We believe that the results of our measurements will help the surgeons to minimize the complications who work in this particular anatomic area.

[Coexistence of laryngeal cancer and laryngocele: a radiologic and pathologic evaluation]. / Larenks kanseri ve larengosel birlikteligi: radyolojik ve patolojik arastirma.

OBJECTIVES: We investigated the incidence of laryngocele in patients with laryngeal cancer and in healthy controls and evaluated the role of laryngocele in neck metastasis and thyroid cartilage invasion. PATIENTS AND METHODS: The incidence of laryngocele was investigated by computed tomography (CT) preoperatively in 52 patients (49 men, 3 women; mean age 56 years; range 36 to 79 years) with laryngeal cancer. The findings were compared with those of histopathologic studies; moreover, neck metastasis and thyroid cartilage invasion were sought. In addition, the incidence of laryngocele was examined in 50 normal controls. RESULTS: Histopathologic examination showed laryngocele in 17 patients (32.7%). The incidence of laryngocele by CT was 30.7% (n = 16). Computed tomography showed laryngocele in three cases (6%). Of patients with laryngocele, lymph node metastasis and thyroid cartilage invasion were detected histopathologically in 47% and 23.5%, respectively, whereas lymph node metastasis and thyroid cartilage invasion were found in 22.8% of patients without laryngocele (p > 0.05). CONCLUSION: The association between laryngeal cancer and laryngocele requires a detailed evaluation for laryngeal carcinoma in patients in whom an asymptomatic laryngocele had been detected by CT.

[Four cases of inverted papilloma]. / Inverted papillomlu dört olgunun sunumu.

Inverted papilloma is a benign lesion fo the nasal cavity and paranasal sinuses. Its aggressiveness and association with malignancy have been emphasized in the literature. In this paper, four patients (3 females, 1 male) with inverted papilloma are presented. Their ages ranged between 45 and 68 years. Surgery was performed using the degloving method which enables a wide exposure and radical resection with minimal scar on the face. No recurrences were detected in the postoperative period in patients with regular controls. The importance of postoperative histopathologic examination is addressed with a review of the literature.