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Öğe Assessment of Risky Exposures to HBV and HCV in Health Care Workers and Cost Analysis(Galenos Yayincilik, 2005) Yildirim, Mustafa; Sencan, Irfan; Ozdemir, Davut; Yilmaz, Zeynep; Kucukbayrak, Abdulkadir; Cakir, SelmaThe aim of this study is to evaluate the reported situation of exposures to potentially infective biological material and its cost of intervention in health care workers (HCWs). Occupational Health Department (OHD) is composed of one infectious diseases specialist and one nurse at April 2001 and all HCWs have been asked for reporting biologically risky exposures to OHD. All of the reported risky exposures were assessed from the point of epidemiologic and cost analysis between 2002 and 2004. Forty-four risky exposures were reported that consisted of fourty sharp and four splah injuries. Risky exposures were reported most frequently in nurses and the hands were found the most injuried parts of the body. The HCWs were exposed by biological risky materials that belong to 10 patients with anti- HCV positivity, 10 patient HBsAg, 10 patient anti-HBs and three patient had not any marker positivity. Source of biological risky materials were not determined at 12 cases. Cost of serological investigation of the source patients and victims, victims that followed up and postexposure prophylaxy are calculated as 10.684 YTL according to current value of ministry of finance of Turkey. 4388 YTL was saved by owing to preexposure prophylaxis. In conclusion, sufficient protective barrier measure should be applied to decrease the level of occupational injuries and re-move medical wastes with proper methods. Careless of vaccination for the preventible diseases with vaccine should be assumed as a malpractice.Öğe First case of continuous ambulatory peritoneal dialysis peritonitis due to Candida sake(2009) Guclu, Ertugrul; Soypacaci, Zeki; Yildirim, Mustafa; Kucukbayrak, Abdulkadir; Ozdemir, DavutFungal peritonitis is a relatively uncommon complication of peritoneal dialysis that contributes significantly to morbidity, drop out from the continuous ambulatory peritoneal dialysis (CAPD) program, and mortality. Candida sake infections were rarely published in literature. We present the first case of peritonitis due to C. sake. A 41-year-old man was admitted to our hospital with abdominal pain, nausea, vomiting, fever, weakness. Abdominal ultrasonography demonstrated a fistula tract, which has an opening at inferolateral of the umbilicus extending 5 cm from the skin into the abdominal cavity with a foreign body (11 × 10 mm length) inside the fistula. The foreign body was removed by surgery being apparently a part of a previously inserted peritoneal catheter. Postoperative specimens revealed polymorph leucocytes and yeast cells in Gram stain, and culture on Sabouraud dextrose agar (SDA) yielded a growth of a fungus, subsequently identified as C. sake with Api ID 32C. Fluconazole (200 mg/day) therapy was started. He recovered after two weeks of therapy. In conclusion, C. sake, a rare type of Candida species, should be considered as a probable peritoneal pathogen in patients with multiple episodes of bacterial peritonitis, previous broad-spectrum antibiotic therapy and diabetes mellitus. © 2008 Blackwell Publishing Ltd.