Healthcare-associated infections (HAIs) are infections, which are not present at admission or might be in incubating, are acquired in the hospital. HAIs remain a major problem for they increase not only morbidity and mortality but also costs for health care systems.

Background and Objectives: In Turkey, access to adult rheumatology outpatient clinics requires referral from another specialty, mostly internal medicine, and no standardized referral algorithms are in use. We estimated the diagnostic yield of new inflammatory rheumatic disease (IRD) diagnoses among internal medicine referrals who completed rheumatology evaluation and identified referral-stage characteristics associated with a new IRD diagnosis. Materials and Methods: In this retrospective cohort study, 2233 patients referred from internal medicine clinics to rheumatology outpatient clinics between 1 September and 30 November 2022 were screened. Patients with a prior diagnosis of IRD (n = 539) and those who did not attend their scheduled appointment (n = 732) were excluded, leaving 962 patients who completed rheumatology evaluation for analysis. Findings documented at referral were compared between patients with and without a new IRD diagnosis, and associations were examined with a clinically selected multivariable logistic regression model without laboratory variables, because laboratory tests had been ordered selectively. Results: Among the 962 patients who completed rheumatology evaluation, 141 (14.6%) received a new IRD diagnosis, corresponding to 6.3% of all 2233 referrals; the diagnostic status of the 732 patients who did not attend is unknown. In the multivariable model, swollen and tender joints were associated with a new IRD diagnosis (odds ratio [OR] 5.24, 95% confidence interval [CI] 3.17–8.68), whereas sicca symptoms (OR 1.45, 95% CI 0.83–2.55) and constitutional symptoms (OR 1.66, 95% CI 0.76–3.64) were not independently associated. Conclusions: Among patients referred from internal medicine to a tertiary rheumatology clinic who completed evaluation, approximately one in seven received a new IRD diagnosis. Referral appropriateness was not assessed, and the high non-attendance rate limits generalization to all referrals. Swollen and tender joints were the only referral characteristic independently associated with a new diagnosis. Whether structured referral criteria, medical education, or triage strategies improve the yield of referrals is a hypothesis for prospective evaluation.

Gastroenteroloji pratiğinde çoğunlukla gözden kaçan ve hastaların takibinde önemli bir morbidite nedeni olabilen osteoporozun, uzayan yaşam süresi neticesinde sıklığı giderek artmaktadır. Gastroenterolojik hastalıklardan inflamatuar barsak hastalığı, çölyak hastalığı, malabsorbsiyon sendromları, kronik karaciğer hastalıkları gibi klinik durumlarda artmış sıklıkta osteoporoz ve azalmış kemik mineral yoğunluğu gözlenebilmektedir. Bu durumun kronik inflamasyon, bozulmuş kalsiyum metabolizması gibi bir çok nedene bağlı olabileceği düşünülmektedir. Bunun yanında hastalıkların takibinde kullanılan özellikle glukokortikoid gibi ilaçlara sekonder gelişen osteoporozun yönetimi de klinik takibi gerekli durumlardandır. Osteoporoz tanısı alan her hastada yaşam tarzı değişiklikleri, yaşa ve komorbiditelerine uygun yeterli kalsiyum ve D vitamini replasmanı önerilmeli, tedavi seçimleri hasta bazında bireyselleştirilmelidir. Hastanın yaşı, kemik kırık riski, frajilite kırığı olup olmaması ve sekonder osteoporoz nedenlerinin varlığı hasta takibi ve tedavi kararında belirleyici rol oynamaktadır. Özellikle sekonder osteoporozu olan hastalarda tek başına kemik mineral yoğunluğu ölçümünün hasta takibinde yetersiz olabileceği konusunda klinik bilinç oluşturulmalıdır. Osteoporozdan korunma yaklaşımının yaygınlaştırılması, osteoporoz tanısı alan hastaların etkin tedavisi ile osteoporoza bağlı gelişebilecek mortalite ve morbiditelerin önüne geçilmesi temel hedef olarak belirlenmelidir.

Pulmonary nodules are common in ANCA-associated vasculitis (AAV), but their clinical relevance remains unclear. This study assessed the influence of pulmon

Aim: We consider mean platelet volume (MPV), a pointer of platelet activity related to type 2 diabetes mellitus (T2DM) and vascular complications, may have a role in patients using Sodium-Glucose Co-Transporter 2 inhibitors (SGLT2i). Therefore, we aimed to evaluate the MPV change after SGLT2i use in diabetic patients.Matherial and Method: Hemogram parameters such as hemoglobin, hematocrit, and MPV in the 0th and 24th weeks of 102 patients with T2DM that received SGLT2i treatment added to their existing medications and of the control group in which participants are compatible in terms of age and gender factor were compared.Results: A significant increase was observed in the values of MPV and hemoglobin in the 0th and 24th weeks (9.3 (8.2-10.3) to 10.1±1.3, p<0.001, 13.9±1.42 to 14.4±1.5 p<0.001, respectively). Similarly, the hematocrit value increased (42±3.7 to 44.2±3.8, p<0.001). There was also a significant increase in both red blood cell (RBC) and platelet counts (5±0.42 to 5.2±0.47, p<0.001, 252,000 (209,000-304,000) to 262,000 (221,000-322,000), p=0.007, respectively). No correlation was identified in patients with T2DM between MPV and age and gender factors, diabetes duration, body mass index (BMI), fasting and postprandial blood glucose, and insulin use.Conclusion: Contrary to the studies analyzing the relation between MPV and T2DM and its complications, we detected that a 24-week SGLT2i treatment led to an increase in MPV value.