Objectives: This study aimed to objectively assess the potential severity of harm associated with erroneous results in 195 laboratory tests by surveying 514 specialist physicians and medical biochemistry experts. Methods: The survey obtained participants’ (75 medical biochemists, 439 clinicians) opinions on severity of harm for the erroneous results of 195 tests. The comprehensive list of errors and their effects on test results were obtained from the literature, and then matched with severity of harm scores, from 1 (negligible effect) to 5 (life-threatening injury/death), obtained from the survey responses. Results: Participants perceived tests such as cardiac biomarkers, blood gases, coagulation parameters (activated partial thromboplastin time, prothrombin time, international normalized ratio, and dimerized plasmin fragment D), critical ions (potassium, sodium), toxic trace elements (lead, mercury), and specific serum drug levels (lithium, digoxin) to have a greater potential for patient harm in case of errors. Medical biochemistry specialists assigned higher severity scores to some laboratory tests, including total bilirubin, pseudocholinesterase, platelet indices, and some drug levels (cyclosporine, methotrexate, vancomycin). Conclusions: A substantial agreement (91%) was observed between medical biochemists and clinicians in terms of the most frequently chosen severity of harm score. The study provided objective severity scores and identified high-risk tests for targeted quality improvement.

Background/Aims: Liver transplantation is a life-saving approach in some cases of mushroom poisoning, which is one of the important causes of acute liver failure. However, debate continues regarding the timing of liver transplantation. The aim of this study is to retrospectively evaluate the results of patients who underwent liver transplantation due to mushroom poisoning. Materials and Methods: In this descriptive and observational study, the demographic and clinical data of 26 patients who presented to emergency units due to clinical features of acute hepatic failure secondary to mushroom poisoning between October 2008 and November 2023 and who underwent emergent liver transplantation were retrospectively reviewed. Results: A total of 26 patients with a median (IQR) age of 39 (36) years were included in this study. The patients were divided into two groups: alive (n = 18) and dead (n = 8). No statistically significant differences were found between groups in terms of age, BMI, blood groups, hepatic encephalopathy grade, biochemical analysis obtained on the first days of hospital admission (AST, ALT, creatinine, ammonia, PTT, INR, albumin, platelets, HGB), ICU stay, cold ischemia time (CIT) and warm ischemia time (WIT), total bilirubin (P = .052), and time from poisoning to admission (P = .051). On the other hand, there were statistically significant differences between the alive and dead groups in terms of MELD score (P = .016; 23 vs. 34), re-transplantation (P = .022; 0% vs. 37.5%), hospital stay (P = .004; 24 vs. 6 days), and follow up (P < .001; 3423 vs. 5 days). Conclusions: This study showed that mortality was higher in patients with high MELD scores and patients who underwent re-transplantation. However, this study needs to be supported by multicenter prospective studies. Cite this article as: Canbaz H, Bestemir A, Akbulut S, Yilmaz S, Yavuz Y. Liver transplantation for acute liver failure due to mushroom poisoning. Turk J Gastroenterol. 2025;36(2):107-113.

Giriş: COVID-19 pandemisinde hastalık, insandan insana bulaşma özelliği nedeniyle aile ve toplum yaşamını olumsuz etkilemiş, hızla yayılarak Acil Servis başvurularında aşırı bir artış oluşturmuştur. Transplantasyon yapılan hastalar gibi hassas hastaların bakımı da zor bir hal almıştır. Hem aile içindeki bulaş hem de toplum içindeki bulaş nedeniyle Acil Servislerde bu hassas hastaların bakımı, değerlendirilmesi, acil tanısı ve yatış kararı kritik öneme haizdir. Bu çalışmada amacımız; Acil servis başvurularının arttığı Covid-19 enfeksiyonu sürecinde Türkiye’de Solid organ nakilli hastaların başvuru sonuçlarının incelenmesidir. Metod: Girişimsel olmayan retrospektif gözlemsel dizayn edilen bu çalışmada; Mart 2020-Ocak 2021 tarihleri arasında Türkiye’de Covid-19 şüphesiyle hastaneye başvuran solid organ nakilli kişiler dahil edilmiştir. 14.463 olgunun Sağlık Bakanlığı bilgi sistemlerine kaydedilmiş klinik ve radyolojik parametreleri, servis ve yoğun bakım yatış ihtiyacı, yatış süreleri ve ölüm oranları incelenmiştir. Bulgular: Olguların %70,39’u (10.180) böbrek nakilli kişiler, %22’si (3245) karaciğer nakilli kişiler, %4,98’i (721) kalp nakli olmuş kişiler, %1,85’i (262) akciğer nakilliler, %0,21’ü (30) ince barsak nakilliler, %0,17’si (25) pankreas nakli olmuş kişilerden oluşuyordu. Tüm solid organ nakilli hastaların ortalama yatış oranı %86,7 idi. Solid organ nakilli hastalar değerlendirildiğinde COVID-19 tanısı konan 4307 hastanın %40,9’unda (1765) pnömoni saptandı, 1691’i (%39,2) hastaneye yatırılırken bu süre ortalama 10,08 gün idi. Yaş ortalamaları ise 48,83 ‘dü. Yoğun bakıma 448 (%10,4) vaka yatırıldı ve kalış süreleri 8,41 gün, ortalama yaşlarının da 57,4 ‘dü. COVID-19 tanısı alıp entübe olan solid organ nakilli hasta oranı %4,3 olup yatış süresi ortalama 7,6 gündü. Solid organ nakli olan tüm vakalarda toplam ölüm sayısı 318 (%2,19), ölenlerin yaş ortalaması 59,64 ‘du. COVID-19 tanısı almış tüm solid organ nakilli hastalarda ölüm oranı ise %7,38 olarak bulundu. Sonuç: COVID-19 pandemisi tibbi sosyal hizmetleri zorlaştırdığı göz önüne alındığında; Acil servislerde Solid organ nakli olan hastalar gibi hassas grupları izole etmenin, hızlı bir şekilde tanı ve yatış-taburcu kararı vermenin önemini ortaya koymaktadır. . Bu kararın; hem COVID-19 enfeksiyonunun sosyal hayatta hassas gruplarda yayılmasını azaltmada hem de enfeksiyon sonrası gelişebilecek pnömoni ve ötesi mortalitenin azaltılmasına katkı sağladığını, acil servislerde sosyal hizmet uygulamasının daha etkin olması için yeni önerilere ihtiyaç olduğunu düşünüyoruz.

Many methods are used in the treatment of coronavirus disease 2019 (COVID-19), which causes acute respiratory distress syndrome (ARDS), and there are conflicting reports in the literature regarding the results of mesenchymal stem cell (MSC) therapy, which is one of those methods. The aim of our study is to evaluate the effect of MSC treatment applied together with standard treatments on survival. This retrospective case-control study evaluates the survival effect of MSC treatment administered to patients treated in intensive care after the development of ARDS due to COVID-19 between March 2020 and March 2021. The age, gender, comorbid disease status, APACHE II score, and overall and comorbidity-based survival rates were compared between patients who received standard medical treatment (SMT) and patients who received MSC treatment together with SMT. There were 62 patients in the group receiving only SMT and 81 patients in the group receiving SMT and MSC. No difference was observed between the groups in terms of age, gender, presence of comorbid diseases, or APACHE II scores. There were also no differences according to Kaplan-Maier analysis for the survival statuses of the groups. There was no serious adverse effect due to MSC treatment among these patients. Our study presents the largest case series in the literature, and it was observed that MSC treatment may not significantly affect overall survival or comorbid disease-based survival, in contrast to many other studies in the literature.

Objective: This study aimed to evaluate the distribution of microorganisms isolated from cerebrospinal fluid (CSF) samples and their antibiotic susceptibility profiles between 2018 and 2024 in a tertiary hospital. Understanding the causative agents of meningitis and their resistance patterns is crucial for guiding empirical therapy and developing effective infection control strategies. Method: A total of 54 CSF samples were retrospectively analyzed. Patient demographics revealed that 46.3% were female and 53.7% were male, with nearly half (46.3%) of the cases occurring in individuals under 18 years of age. Standard microbiological techniques were used for pathogen identification, and antimicrobial susceptibility testing was performed according to routine laboratory protocols. The prevalence of common bacterial isolates and their resistance patterns were documented. Results: The most frequently isolated pathogens were coagulase-negative staphylococci (CoNS), Acinetobacter baumannii, and Klebsiella pneumoniae. Approximately 90% of CoNS isolates were found to be methicillin-resistant. Gram-negative isolates exhibited significant resistance patterns, including carbapenem and colistin resistance, which are particularly concerning due to their role as last-resort antibiotics. Vancomycin maintained complete efficacy against all staphylococcal and enterococcal isolates. A notable finding was the high proportion of pediatric patients, suggesting that children represent a particularly vulnerable group for central nervous system infections. Conclusion: The high rates of multidrug-resistant organisms observed in CSF isolates emphasize the importance of tailoring empirical treatment regimens based on local resistance data. Continuous monitoring of pathogens and their antibiotic susceptibility profiles is essential to improve infection control measures and to support the regular updating of empirical treatment guidelines for meningitis management.