Klimik Dergisi\/klimik Journal 

About: Klimik Dergisi\/klimik Journal is an academic journal published by Doc Design and Informatics Co. Ltd.. The journal publishes majorly in the area(s): Medicine & Internal medicine. It has an ISSN identifier of 1301-143X. Over the lifetime, 401 publications have been published receiving 809 citations. The journal is also known as: Klimik journal & Journal of klimik.

Contact tracing in the context of covid-19: Ethical issues and assessment

Abstract: The COVID-19 outbreak spread like a forest fire in the first quarter of 2020. Until September, more than 26 million people were affected by this epidemic. It has been 9 months since the first case was seen. However, a curative treatment method or vaccine has not been developed yet. Today, the only approach that can prevent the outbreak is classical epidemic control approaches such as hygiene, case isolation, contact tracing and quarantine. Contact tracing aims to reduce the spread of the epidemic by trying to analyze the potential transmission routes of the infection at the individual level. In addition, it will be possible to prevent official measures such as the curfew taken to prevent the epidemic from spreading. However, when considering ways of communication between people, the epidemic knows no boundaries. Mobile applications and artificial intelligence can be successful in analyzing this contact chain. Even if protecting human life is the highest degree moral duty, these methods contain many ethical problems. The most violated ethical values because of these practices are privacy, confidentiality of information, civil freedom and autonomy. In this study, we will try to analyze the ethical problems that arise with contact tracing mobile applications in the context of COVID-19. © 2021, DOC Design and Informatics Co. Ltd.. All rights reserved.

Diagnosis, Treatment and Prevention of Diabetic Foot Wounds and Infections: Turkish Consensus Report

Abstract: Study Group for Diabetic Foot Infections of the Turkish Society of Clinical Microbiology and Infectious Diseases has called for collaboration of the relevant specialist societies and the Ministry of Health to issue a national consensus report on the diagnosis, treatment and prevention of diabetic foot (DF) wounds and diabetic foot infections (DFIs) in Turkey. In the periodical meetings of the assigned representatives from all the parties, various questions as to pathogenesis, microbiology, assessment and grading, treatment, prevention and control of diabetic foot were identified. Upon reviewing related literature and international guidelines, these questions were provided Özet Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Diyabetik Ayak İnfeksiyonları Çalışma Grubu, ülkemiz koşullarında diyabetik ayak (DA) yarasının ve DA infeksiyonu (DAİ)’nun tanısı, tedavisi ve önlenmesine yönelik bir ulusal uzlaşı raporu hazırlamak üzere ilgili ulusal uzmanlık derneklerine ve Sağlık Bakanlığı’na işbirliği çağrısında bulunmuştur. Görevlendirilen temsilcilerin periyodik olarak yaptığı toplantılarda ilgili literatür ve uluslararası kılavuzlar gözden geçirilerek, patogenez, mikrobiyoloji, değerlendirme ve derecelendirme, tedavi, korunma ve kontrol konularında yanıt verilmesi gereken sorular saptanmış ve bu sorulara üzerinde uzlaşılan yanıtlar verilmişSaltoğlu N et al. Diyabetik Ayak Yarası ve İnfeksiyonunun Tanısı, Tedavisi ve Önlenmesi 3 with consensus answers. Several of the answers provided in the report are listed below: [1] Although there are many reasons for the development of DF wounds, the main reason is the combined effect of diabetes-related vascular disease and neuropathy. [2] Aerobic Gram-positive cocci are mostly responsible for superficial DFIs in patients with cellulitis and no history of antibiotic use. [3] Pseudomonas aeruginosa is one of the commonly encountered agents when between the toes of the patient are moist. [4] When the other potential reasons are eliminated, DFIs should be considered in presence of at least two of the classical signs of inflammation including redness, warmth, swelling, tenderness, and pain, or purulent discharge in the foot lesion. [5] Infections are classified into mild, moderate, or severe groups according to some criteria such as the depth and width of the wounds, and the presence of systemic findings of infection. [6] PEDIS system should be preferred as a classification system for its high predictive value in diabetes-related foot complications. [7] Culture samples from the DF wound should only be obtained when infection is clinically considered and, where possible, before starting antibiotic treatment. [8] Inflammatory biomarkers such as leukocyte count, C-reactive protein, erythrocyte sedimentation rate, and procalcitonin may be useful in distinguishing between colonization with infection. [9] Magnetic resonance imaging is a sensitive and specific method in patients unresponsive to treatment when osteomyelitis and deep soft tissue abscesses are considered. [10] The gold standard in the diagnosis of osteomyelitis is histopathological examination. [11] To provide wound healing and to save the limb, removal of dead and infected tissue with urgent and aggressive debridement, appropriate antibiotic therapy, metabolic control, and off-loading of pressure, the diagnosis and proper treatment of peripheral arterial disease, and restoration of the foot function are necessary. [12] A lot of different factors playing a role in etiopathogenesis complicate the approach to be developed in this type of lesions, and therefore it requires a team concept. [13] In the empirical treatment, the objective should be treating only the potential agents. Adequate tissue levels, low side effects and patient compliance must be observed; effective drugs should be used in specified doses and duration. [14] Debridement is an essential and integral part of wound treatment and is an important tool allowing the formation of healthy granulation tissue. [15] When the infected tissue cannot be completely cleared with the debridement and in cases when the patient could not cope with the remaining infection load, performing a limb amputation on a safe level of infection would be lifesaving. [16] If an arterial insufficiency is considered in a patient with a DF wound, early diagnosis and interventional treatment is necessary. [17] Hyperbaric oxygen therapy is used as an adjunctive treatment in combination with other treatments in DFI patients. [18] Topical negative pressure therapy is a useful adjunctive measure in selected patients. [19] Growth factors can be used in selected patients other than wounds that can be treated with cheaper and safer methods. [20] Maggot therapy may be considered as a debridement method in DF wound cases. [21] Patients with more than ten years of diabetes history have an increased risk of wound development or amputation. [22] DF problem is the only complication of diabetes that can be prevented through education. Klimik Dergisi 2015; 28(Suppl. 1): 2-34.

Management of Chronic Hepatitis C Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases-2017 Update

Abstract: Previously a consensus report about management of hepatitis C virus (HCV) infection, a major health problem all over the world had been prepared by Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases. It was first published in the Klimik Journal in 2014. Özet Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu tarafından, ilk olarak 2014 yılında tüm dünyada önemli bir sağlık sorunu olan hepatit C virusu (HCV) infeksiyonunun yönetimine ilişkin bir uzlaşı raporu hazırlanmış ve Klimik Dergisi’nde yayımlanmıştır. Kronik hepatit Aygen B et al. Kronik Hepatit C Virusu İnfeksiyonunun Yönetimi 3 Recently, we needed to update this report considering the new developments in treatment of chronic hepatitis C (CHC). This new consensus report is based on review of current literature and international guidelines. Agreed recommendations are presented at the end of each section such as epidemiology and natural history of HCV infection, diagnosis of acute hepatitis C (AHC) and CHC, treatment of AHC, goals of CHC therapy and pre-therapeutic assessment of CHC therapy, indications for treatment, contraindications to therapy, direct-acting antivirals (DAA) in the treatment of CHC and drug-drug interactions in the treatment of DAA, resistance problem in DAA treatment and clinical assesment of resistance, monitoring and managing treatment safety and side effects, post-treatment follow-up of patients who achieve a sustained virological response (SVR), follow-up of patients who didn’t achieve an SVR and prevention of HCV infection. Klimik Dergisi 2017; 30(Suppl. 1): 2-36.

HIV Infection in Turkey: How Close Are We to the Target?

Abstract: The Joint United Nations Program on HIV/AIDS (UNAIDS) “9090-90” target aims to decrease the annual number of new HIV infections and AIDS related deaths to <200 000 by 2030. The aim of this article is to define the HIV epidemic and the response to the epidemic in Turkey within the context of UNAIDS target and to discuss how close we are to achieve this target. The number of new HIV diagnoses has increased by 2.5-fold between 2012 and 2016, which is most likely an underestimation. While heterosexual transmission rates started to decline recently, transmissions between men who have sex with men increased significantly. However, real life data are not in accordance with reported numbers. The 25-34 years age group has the highest number of new diagnoses with a recent decrease among 35-44 years and increase among 20-24 years. In Turkey, 48-52.4% of people living with HIV are diagnosed late and 24-30.6% with advanced disease. This may be due to the lack of targeted testing strategies for key populations and the diagnosis being made during the differential diagnosis of symptomatic cases (3548.8%). Access to antiretroviral drugs in Turkey is better than it is in Central and Eastern European countries, and antiretroviral treatment is initiated for all people living with HIV regardless of the CD4 T cell count after publication of an official guideline on HIV diagnosis and treatment in 2013. Virologic success rates are high (76.6-90%) among those who start using antiretroviral treatment. Turkey has good standards for and better access to HIV treatment and management compared to many neighboring countries. Collaborative work of all stakeholders is crucial to control the HIV infection in the country. Klimik Dergisi 2018; 31(1): 4-10.