Increased levels of acute‐phase reactants and lymphopenia are predictors of disease severity in coronavirus disease 2019 (COVID‐19). This study aimed to investigate the role of apoptosis in the etiology of lymphopenia in patients with COVID‐19. This multicentered, prospective, and case‐control study was conducted with polymerase chain reaction (+) severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) patients, and an age–gender‐matched control group. Samples were taken at the time of diagnosis and analyzed via flow cytometry within 24 h. The participants' demographic data and initial laboratory tests were also recorded. In total, 33 patients with COVID‐19 (mean age = 45.4 ± 17.2) and 25 controls (mean age = 43.4 ± 17.4) participated in the study. All patients were identified as having mild (16), moderate (5), or severe (12) disease severity. Both early and late apoptotic cells in B and T lymphocytes were increased in all patients with COVID‐19 (p < .05). Early apoptotic (EA) B and T lymphocytes were also higher in severe cases compared to mild cases (p = .026). There was no significant difference between lymphopenia and apoptosis in patients with COVID‐19. However, patients with lymphopenia (n = 14) and severe COVID‐19 (p = .013) had increased EA T lymphocytes. This study's results show that B and T lymphocytes' apoptosis increases in patients with COVID‐19. In addition, enhanced T lymphocyte apoptosis is associated with disease severity in lymphopenic patients with COVID‐19.

Purpose of the study: The aim of this study was to investigate the relationship of B cell-mediated immunity with disease severity and mortality in patients with COVID-19.Study design: In this retrospective cohort and single-centre study, 208 patients with laboratory-confirmed COVID-19 were recruited. A COVID-19 severity score, ranging from 0 to 10, was used to evaluate associations between various factors. Serum immunoglobulin levels and the number of cells in B lymphocyte subsets were measured and their association with disease severity and mortality in patients with COVID-19 examined.Results: The median age of the patients was 50 (35–63) years and 88 (42%) were female. The number of deceased patients was 17. The median COVID-19 severity score was 8 (6–8) in deceased patients and 1 (0–2) in survivors. Deceased patients had significantly lower levels of total B lymphocytes, naive B cells, switched memory B cells, and serum IgA, IgG, IgG1 and IgG2 than recovered patients (all p<0.05). In addition, a significant negative correlation was found between the number of these parameters and COVID-19 severity scores. Decrease in the number of total B cells and switched memory B cells as well as lower serum IgA, IgG and IgG1 levels were independent risk factors for mortality in patients with COVID-19.Conclusion: In the present study, the prognosis of patients with COVID-19 was shown to be associated with the B cell subset and serum immunoglobulin levels.

Amaç: Son yıllarda vankomisin dirençli enterekok (VRE) enfeksiyonları özellikle yoğun bakım ünitelerinde (YBÜ) sık karşılaşılan nozokomiyal enfeksiyon etkenleri arasındadır. Çalışmamızda hastanemizde yatan hastalardan, hastane enfeksiyonu (HE) etkeni olarak izole edilen enterokokların direnç oranlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Konya Eğitim ve Araştırma Hastanesi’nde beş yıllık süreçte yatan hastalarda enterokoklara bağlı HE’lerinin kaynağı ve direnç oranları retrospektif olarak irdelenmiştir. Bu hastaların belirlenmesinde YBÜ izlem formları, Ulusal Hastane Enfeksiyonları Sürveyans Sistemi verileri dikkate alınmıştır. HE’leri “Hastalık Kontrol ve Önleme Merkezi” (Centers for Disease Control and Prevention) tanı kriterlerine göre tanımlanmış, tüm örnekler konvansiyonel kültür yöntemleri ile değerlendirilmiştir. Bulgular: Hastanemizde kayda alınan tüm nozokomiyal enfeksiyonlarda (2.835) etkenlerin %6,24’ü (177) enterokok spp.’ye bağlı bulundu. Enfeksiyonların %54,8’i (97) YBÜ, %45,2’si (80) servislerde yatmakta idi. Enterokokların %57,63’ü (102) idrarda, %27,11’i (48) kanda, %13,56’sı (24) yaranın sürüntü kültürlerinde üredi. Enterokoklara bağlı nozokomiyal enfeksiyon kabul edilen hastaların 7 tanesinde etken VRE idi. VRE oranı tüm (2.835) nozokomiyal enfeksiyonlar arasında %0,24, enterokoklara bağlı nozokomiyal enfeksiyonlar içinde ise %3,4 olarak bulundu. VRE enfeksiyonlarının 1’i kan dolaşımı, 6’sı idrar yolu enfeksiyonu olarak kaydedilmişti. VRE’lerin tümü Enterococcus feacium (%100) olarak saptandı. Hastalarda en sık rastlanan risk faktörleri ileri yaş, üriner ve santral venöz kateter kullanımı, akut böbrek yetmezliği veya kronik böbrek yetmezliği idi. VRE enfeksiyonu öncesinde glikopeptit kullanımı %42,85 olup, hastaların %100’ü önceden 3. kuşak sefalosporin kullanmıştı. Sonuç: Enterokokların yol açtığı enfeksiyonlarda etkenlerin izolasyonu, doğru tanımlanması ve antibiyotik duyarlılıklarının belirlenmesi ne kadar öncelikliyse, bu bakterilere ilişkin antibiyotik duyarlılık profillerinin izlenmesi de o denli yaşamsal önem taşımaktadır.

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis that can affect all organs and tissues. The clinical forms of primary cutaneous tuberculosis are tuberculosis primary complex (tuberculosis chancre) and tuberculosis cutis miliaris (miliary cutaneous tuberculosis). Secondary cutaneous tuberculosis includes lupus vulgaris, tuberculosis cutis verrucosa, scrofuloderma, tuberculosis cutis orificialis, and metastatic tubercular abscesses. The most common form is lupus vulgaris. Cutaneous tuberculosis is a rare form of tuberculosis presenting with nonspecific lesions. It is difficult to diagnose due to its non-spesific clinical characteristics thus it can be confused with many other diseases. In this paper, we reviewed five patients with cutaneous tuberculosis who presented to our clinic within the past one year and we aimed to emphasize that cutaneous tuberculosis can manifest in different clinical forms.

Objective: Tuberculosis (TB) that can involve all organs is a disease progressing with a wide range of clinical presentations. It is especially difficult to diagnose the cases of extrapulmonary tuberculosis (EPTB) due to the atypical course, and the cases of EPTB constitute approximately 35% of all TB cases in our country. In our study, it was aimed to examine the distribution rates, diagnostic methods, and treatment processes of EPTB in terms of the involved systems. Material-Method: Of 308 patients diagnosed with TB, 119 cases having EPTB were retrospectively analyzed in The Konya Training and Research Hospital of Health Sciences University between 1st January 2015 and 30th June 2019. Results: While 119 (38.6%) EPTB cases of 308 cases diagnosed with TB were included in the study. 63 (52.9%) and 56 (47%) patients were women and men, respectively. The average age was found as 44.42±18.8 years (min: 18- max: 91 years). The distribution of involvement sites of EPTB was as follows: lymphadenitis, 45.3%; pleural tuberculosis, 24.3%; peritonitis, 14.2%; bone-joint tuberculosis, 7.5%; meningitis, 2.5%; miliary tuberculosis, 1.6%; others, 4.2%. In terms of EPTB, 83 (69.7%) cases were diagnosed histopathologically, 28 (23.5%) and nine (7.5%) were found to have culture and acido-resistant bacilli (ARB) positivity, respectively. A total of 29 (24.3%) cases were diagnosed microbiologically, and the purified protein derivative (PPD) positivity was detected in 106 (89%) cases. While the success rate of the treatment was found to be 93.2%, the mortality rate was measured as 3.3%. Conclusion: It should be kept in mind that TB is a common multisystem disease in our country and may present itself with a wide range of symptoms. In the presence of clinical suspicion, supportive tests should be performed; biopsy and culture samples should be obtained from the appropriate tissues; anti-TB treatment should be initiated at once if clinicians have sufficient evidence.

Objective: Coronavirus Disease 2019 (COVID-19) is characterized by high fever, sudden developing respiratory distress, and radiological findings failing to respond to conventional treatments. The purpose of this study is to identify the association of D-dimer levels and lymphocyte counts with poor prognosis and to predict the clinical course in patients with COVID-19. Methods: A total of 118 hospitalized adult patients diagnosed with COVID-19 were included in the study. According to the National Institutes of Health (NIH) COVID-19 treatment guidelines, patients were divided into two groups with severe disease (n= 26) and non-severe (n= 92) disease. Detected at the time of diagnosis, D-dimer levels and lymphocyte counts were compared between severe and non-severe COVID-19 patient groups. Distinctive performance analysis of these values was performed, and cut-off values were determined. Results: The mean age of patients was 62 ± 7 years (range 42-80 years), and 63 (53.4 %) were female. The lymphocyte count was lower (p