Brucellosis diagnosis remains challenging in resource-limited endemic settings. This retrospective case–control study evaluated the diagnostic utility of mean platelet volume (MPV) and hematological inflammatory ratios in brucellosis. Fifty patients with confirmed brucellosis and 50 age-matched healthy controls were included at a university hospital in Turkey (2015–2018). Complete blood count parameters, hematological ratios (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR]), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured at diagnosis. Receiver operating characteristic (ROC) curve analysis evaluated diagnostic performance; multivariate logistic regression developed a combined model. Brucellosis patients showed significantly lower MPV (8.04 ± 0.95 vs. 8.56 ± 0.69 fL, p = 0.002), higher platelet counts (305.0 ± 116.0 vs. 246.0 ± 55.2 × 10³/μL, p = 0.002), lower NLR (median: 1.69 vs. 2.07, p = 0.013), and higher LMR (median: 5.28 vs. 4.12, p = 0.008). ESR demonstrated the best individual diagnostic performance (area under the curve [AUC] = 0.842). The combined model (MPV + ESR + CRP) achieved superior performance (AUC = 0.891, sensitivity 84%, specificity 86%). Limitations include the single-center retrospective design, lack of internal validation, and comparison with healthy controls only. Notably, healthy controls were deliberately selected to establish baseline hematological profiles associated with brucellosis rather than to differentiate it from other infections. Brucellosis presents a unique hematological profile with decreased MPV and altered inflammatory ratios. The combined model offers a potentially cost-effective screening approach for endemic settings, pending external validation.

Background/Objectives: Central line-associated bloodstream infections (CLABSIs) remain a leading healthcare-associated infection in intensive care units (ICUs), yet independent risk factors and evidence-based catheter duration thresholds have not been defined through analytical study designs in settings with endemic multidrug-resistant organisms (MDROs). Methods: A retrospective case–control study was conducted in the ICU of a tertiary teaching university hospital in western Türkiye (January 2019–December 2024). Cases (n = 74) were patients with confirmed CLABSIs per CDC/NHSN criteria; controls (n = 148) were randomly selected central venous catheter (CVC)-bearing patients without CLABSIs. A reduced multivariate logistic regression model (seven variables; events-per-variable ratio 10.6) identified independent risk factors. Results: In multivariate analysis, catheter duration (adjusted OR: 1.19 per day; 95% CI: 1.13–1.24; p < 0.001), renal replacement therapy (aOR: 3.66; 95% CI: 1.68–7.95; p = 0.001), vasopressor support (aOR: 3.04; 95% CI: 1.50–6.17; p = 0.002), APACHE-II score (aOR: 1.07 per point; 95% CI: 1.02–1.11; p = 0.002), lower Glasgow Coma Scale (aOR: 0.86 per point; 95% CI: 0.78–0.94; p = 0.002), mechanical ventilation (aOR: 2.48; 95% CI: 1.24–4.95; p = 0.010), and total parenteral nutrition (aOR: 2.33; 95% CI: 1.12–4.86; p = 0.024) were independently associated with CLABSI. The model demonstrated good discrimination (C-statistic: 0.864) and calibration (Hosmer–Lemeshow p = 0.425). Kaplan–Meier analysis showed CLABSI-free survival declining from 98.9% at day 7 to 42.9% at day 21 (log-rank p < 0.001); these within-study estimates reflect relative risk patterns given the artificial 1:2 case-to-control ratio. Receiver operating characteristic (ROC) analysis identified day 13 as an exploratory optimal cutoff (AUC: 0.818; 95% CI: 0.762–0.874; sensitivity: 77.0%; specificity: 74.3%). CLABSI-attributable ICU mortality was 20.3% (47.3% vs. 27.0%; p = 0.004). Late-onset CLABSIs (>10 days) were dominated by Gram-negative pathogens (68.3%) versus 35.7% in early-onset infections (Fisher’s exact p = 0.012), with Acinetobacter baumannii as the predominant organism (27.0%; 83.3% carbapenem-resistant). Conclusions: Each additional catheter-day is independently associated with a 19% increment in CLABSI odds, with an exploratory critical threshold at day 13 beyond which enhanced surveillance measures should be considered, pending external validation.

Aims: Respiratory tract infections are leading causes of morbidity and mortality in the geriatric population. The COVID-19 pandemic has reinforced the critical importance of vaccination against preventable respiratory diseases in elderly individuals. This study aimed to assess awareness levels, vaccination rates, and factors influencing vaccine acceptance for COVID-19, influenza, and pneumococcal vaccines among individuals aged ≥65 years. Methods: This cross-sectional study was conducted between January 08, 2025, and February 28, 2025, involving patients aged ≥65 years who presented to the hospital for any reason. Structured interviews assessed vaccination history and awareness levels. Unvaccinated participants received standardized educational information about vaccine benefits and risks, followed by assessment of vaccination willingness. Demographic characteristics, educational level, and reasons for vaccine hesitancy were recorded. Statistical analysis was performed using SPSS v30.0, with Chi-square tests for categorical variables and p

Background: Up to one-third of brucellosis patients develop focal organ involvement, contributing to increased morbidity and therapeutic failure, yet no clinically validated instrument exists to stratify risk at presentation. Methods: In this three-center retrospective cohort from Türkiye (2015–2025), 355 adults with confirmed brucellosis were enrolled. Thirty-two candidate variables spanning demographics, comorbidities, symptoms, routine laboratory values, and composite inflammation indices underwent LASSO-penalized regression with 10-fold cross-validation for predictor selection, after which a nomogram was constructed and internally validated via 1000-iteration bootstrap resampling. Results: Ninety-two patients (25.9%) developed focal complications. Five predictors were retained by LASSO—prognostic nutritional index (PNI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), chronic disease stage, and hypertension—and combined with age and sex (retained a priori) into a seven-predictor nomogram. PNI was the strongest contributor (OR = 0.901, 95% CI: 0.857–0.948). Apparent C-statistic reached 0.782 (optimism-corrected 0.762), with a calibration slope of 0.894 and Brier score of 0.154. Decision curve analysis indicated net clinical benefit over the 5–55% threshold probability range. Conclusions: This PNI-anchored LASSO nomogram offers a practical bedside risk stratification instrument for brucellosis-related focal involvement. Prospective external validation across geographically diverse endemic regions is warranted before clinical adoption.

Background: Human brucellosis is a widespread zoonotic febrile illness in livestock-rearing endemic regions, including Türkiye (pooled human seroprevalence approximately 4.5%). Age-stratified item-level knowledge profiles paired with information-source patterns are rarely reported in adult populations. We aimed to describe age-stratified brucellosis knowledge and information-source ecosystems in a hospital-attending adult sample from an endemic Turkish province. Methods: A hospital-based cross-sectional survey enrolled 397 adults in Balıkesir, Türkiye. A 17-question instrument assessed demographics, prior awareness, a 26-item composite knowledge score among aware respondents, and information sources. Item-level recognition was compared across four age strata, with multivariable logistic regression identifying independent predictors. Results: Of 397 adults (mean age 36.1 years; 62.7% male), 233 (58.7%) reported prior awareness, increasing with age (51.8% in 18–29 vs. 74.5% in ≥60 years; p < 0.001). Among aware respondents, composite knowledge declined with age (mean 8.52 vs. 5.94; p < 0.001). Raw dairy transmission and treatment availability were uniformly recognized (>80% across all strata). Recognition of clinical symptoms (fever 68.9% vs. 34.3%; p = 0.005) and veterinary signs (decreased milk yield 36.9% vs. 8.6%; p = 0.001) was substantially lower in older respondents. Internet citation declined with age (41.7% to 17.1%), while older respondents relied more on interpersonal networks. Conclusions: Brucellosis knowledge was not uniformly distributed across the adult age spectrum. Dominant transmission and treatment messages were near-universally recognized, while clinical-symptom and veterinary-sign recognition showed substantial age-related deficits, accompanied by generational divergence in information-source ecosystems. These findings suggest that age-tailored, channel-specific reinforcement of less-recognized clinical and veterinary knowledge, delivered through trusted healthcare-worker channels, may strengthen brucellosis education in endemic Turkish settings. Community-based replication is required before broader policy translation.

Aims: This study aimed to evaluate changes in human papillomavirus (HPV) knowledge, attitudes toward HPV vaccination, and vaccination intentions following a structured HPV educational intervention among medical students.Methods: This single-group, uncontrolled pretest-posttest study was conducted among 312 medical students in years 1-5 at Balıkesir University Faculty of Medicine between February and June 2026. HPV knowledge was assessed using the validated Turkish 33-item HPV Knowledge Scale (HPV-KS). Attitudes toward HPV vaccination were evaluated using a 20-item Likert-type section, and vaccination intentions were assessed using matched pre- and post-intervention questions. Participants received a standardized face-to-face HPV educational intervention between the pretest and posttest assessments.Results: The total HPV-KS score increased from 19.37±5.89 to 23.57±4.08 (mean change, 4.20; 95% CI, 3.70-4.70; p