Search

WOS:000648816400007 PMID: 33960939 Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. Methods: Data from patients with chronic hepatitis C treated with SOF/LDV +/- RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 +/- 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV +/- RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV +/- RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.

Purpose Restless leg syndrome (RLS) is a movement disorder which constitutes the most common and major risk group during pregnancy. The purpose of this study was to determine prevalence and severity of RLS during pregnancy and to investigate the effect of RLS on quality of life in pregnant women. Methods This cross-sectional study was conducted in antenatal clinics of four different public hospitals. Data collected were pregnancy assessment form, RLS diagnostic criteria form, RLS severity scale, and SF-12 quality of life scale. Results Among 718 pregnant women, mean age was 28.3 +/- 5.9 years (range 19 to 45). According to the diagnostic criteria of RLS, RLS prevalence was 22% (n=159). of the 159 women with RLS, 41% had moderate severity and 40% had severe RLS. Prevalence of RLS in pregnant women increased with gestational week, working time during pregnancy, weight before pregnancy, total weight gain during pregnancy, and pre-pregnancy body mass index. Physical health scores, physical functioning scores, pain scores, emotional role difficulty scores, and social function scores were significantly lower in the pregnant women with RLS than without RLS (p, Ege University Scientific Research Project FundEge University [16-ASYO-006], This research was funded by the Ege University Scientific Research Project Fund through grant number 16-ASYO-006.

Aim: The aim of this study was to determine the effects of sacral massage and heat application on the perceptions of labor pain and comfort level in pregnant women. Methods: This was a quasi-randomized controlled experimental study. The data were collected under three groups in 2016: the heat application group (HAG), the massage group (MG), and the control group (CG). Each group included 30 primiparous pregnant women (range of age: 17–35) whose cervix was dilated to 4–5 cm. At 4–5 cm, 6–7 cm, and 8–9 cm cervical dilation, sacral massage was applied to MG, and sacral heat application was applied to HAG. Each group received standard midwifery care during labor. The data were collected using the Childbirth Comfort Questionnaire (CCQ) and the Numerical Rating Scale (NRS). The data were analyzed by using the Chi-square test, the Friedman test, Paired sample t-test, ANOVA, the Kruskal-Wallis test, and Wilcoxon signed-ranks test Results: The mean pain score in HAG (4.56±0.67) during 4–5 cm of cervical dilation was significantly lower than those in MG (5.03±1.06) or CG (5.23±0.72) (p < 0.05). The mean pain scores in HAG (6.80±0.7) and MG (7.30±0.8) during 6–7 cm of cervical dilation were significantly lower than that in CG (7.70±0.5) (p < 0.001). Moreover, a statistically significant difference was found between the mean CCQ total scores (HAG: 31.06±3.46, CG: 27.66±3.85, p < 0.05), mean CCQ physical comfort scores (HAG: 13.16±1.89, CG: 11.03±1.80, p < 0.001), mean CCQ relief comfort level score (HAG: 11.23±1.43, CG: 10.00±2.01, p < 0.05) and mean CCQ transcendence comfort level scores (HAG: 19.83±2.37, CG: 17.66±2.15, p < 0.05) and both HAG and CG during 8–9 cm of cervical dilation. Conclusions: Heat application and massage can be used as a safe and effective midwifery intervention to reduce the perception of pain in pregnant women and provide comfort during labor. © 2020 Elsevier Inc., The authors express thanks to the pregnant women for participation in the study. Place or institution where the work was developed, city and country: Bal?kesir Atat?rk City Hospital in Turkey.

WOS: 000503180500033, PubMed: 31603126, Introduction: Following the diagnosis and treatment of breast cancer, women may experience some emotions such as anxiety, uncertainty, andhopelessness, and these experiences may vary from person to person. Many patients, along with conventional treatments, can resort to traditional methods to support the treatment, prevent recurrence of cancer, cope with the side effects of the treatment, and strengthen physically and mentally. Aims: the study was aimed at determining the relationship between hopelessness level and use of complementary and alternative medicine (CAM) methods in women with breast cancer. Materials and Methods: in this descriptive and cross-sectional study, 336 women with breast cancer who presented to the mammography unit were contacted. Among the CAM methods used, herbal treatment methods rank first. of the reasons, women prefer these methods; "CAM provides psychological comfort" takes the first place. Results: the mean scores obtained from the Beck Hopelessness Scale by the women who used and who did not use CAM were 5.45 +/- 5.18 and 4.44 +/- 4.10, respectively. the difference between the two groups was statistically significant (P < 0.05). Conclusion: in conclusion, women with breast cancer may attempt to use CAM due to hopelessness. Therefore, in the course of medical treatment of patients, CAM practices should be questioned, they should be provided counseling and if necessary, referred for psychological support., Ege University Scientific Research Project FundEge University; Rectorship of Ege University; Scientific Research Fund, We would like to extend our sincere thanks to the staff of the Ege University Medical Faculty Radiology Department's Mammography Unit where the research was held and to the women who participated in the research for their great support. This work was supported by the Ege University Scientific Research Project Fund. We would also like to thank the Rectorship of Ege University which supported the research with Scientific Research Fund.

WOS: 000388326300001, PubMed: 27401586, Background: Drug resistance development is an expected problem during treatment with protease inhibitors (PIs), this is largely due to the fact that Pls are low-genetic barrier drugs. Resistance-associated variants (RAVs) however may also occur naturally, and prior to treatment with Pls, the clinical impact of this basal resistance remains unknown. In Turkey, there is yet to be an investigation into the hepatitis C (HCV) drug associated resistance to oral antivirals. Materials and methods: 178 antiviral-naive patients infected with HCV genotype 1 were selected from 27 clinical centers of various geographical regions in Turkey and included in the current study. The basal NS3 Pls resistance mutations of these patients were analyzed. Results: In 33 (18.5%) of the patients included in the study, at least one mutation pattern that can cause drug resistance was identified. The most frequently detected mutation pattern was T54S while R109K was the second most frequently detected. Following a more general examination of the patients studied, telaprevir (TVR) resistance in 27 patients (15.2%), boceprevir (BOC) resistance in 26 (14.6%) patients, simeprevir (SMV) resistance in 11 (6.2%) patients and faldaprevir resistance in 13 (7.3%) patients were detected. Our investigation also revealed that rebound developed in the presence of a Q80K mutation and amongst two V55A mutations following treatment with TVR, while no response to treatment was detected in a patient with a R55K mutation. Conclusion: We are of the opinion that drug resistance analyses can be beneficial and necessary in revealing which variants are responsible for pre-treatment natural resistance and which mutations are responsible for the viral breakthrough that may develop during the treatment. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases., Department of Scientific Research Project of Kocaeli University; Turkish Society of Clinic Microbiology and Infectious Diseases, This study was funded by Department of Scientific Research Project of Kocaeli University and Turkish Society of Clinic Microbiology and Infectious Diseases.

WOS: 000429311800001, Background: Hepatitis B virus (HBV) has a high mutation rate due to its unusual replication strategy leading to the production of a large number of virions with single and double mutations. The mutations, in turn, are associated with the development of drug resistance to nucleos(t)ide analogs (NUCs) in patients before and during NUCs therapy. Objectives: The current study aimed at investigating the molecular characterization of HBV in Turkish patients with chronic hepatitis B (CHB) infection. Methods: Polymerase chain reaction (PCR) amplification and direct sequencing procedures were used to analyze mutations. The detected drug resistance mutations were divided into the nucleos(t) ide analogs primary, partial, and compensatory resistance groups. The amino acid substitutions of hepatitis B surface antigen (HBsAg) were categorized into antiviral drug - associated potential vaccine-escape mutations (ADAPVEMs) and typical HBsAg amino acid substitutions, which included hepatitis B hyperimmunoglobulin (HBIg) - selected escape mutation, vaccine escape mutation, hepatitis B misdiagnosis, and immune - selected amino acid substitutions. Results: The number of patients included in the study was 528 out of which 271 (51.3%) were treatment - naive and 351 (66.3%) were hepatitis B e antigen (HBeAg) - negative. Moreover, 325 (61.6%) were males with a mean age of 38 years (range: 18 - 69). Primary, partial, and compensatory resistance to NUCs was reported in 174 (32.9%) patients. Six different ADAPVEM motifs were determined in both treatment - naive and treatment - experienced patients, namely, sF161L/rtI169X, sE164D/rtV173L, sL172L/rtA181T, sL173F/rtA181V, sS195M/rtM204V, and sS196L/rtM204I. The prevalence of ADAPVEMs and typical HBsAg escape mutations was 5.3% (n = 28) and 34.8% (n = 184), respectively. Conclusions: The analysis of drug resistance should constitute a fundamental part of the follow - up period of patients with CHB undergone treatment with NUCs. The surveillance of development of drug resistance mutations, while receiving treatment for hepatitis B is of paramount importance to monitor and control the emerging resistance.

WOS: 000357330600005, PubMed: 26185714, Background: The use of pegylated interferon alpha and ribavirin (PegIFN/RBV) for the retreatment of chronic hepatitis C virus (HCV) infection without a sustained virological response (SVR) prior to PegIFN/RBV treatment has resulted in low success rates. Aims: To investigate the efficacy and safety of telaprevir (TVR) in combination with PegIFN/RBV in patients infected with HCV genotypes 1 and 4 who were previously treated with PegIFN/RBV and failed to achieve SVR. Study Design: Multi-center, retrospective, cross-sectional study. Methods: The study included 111 patients: 80 prior relapsers, 25 prior null responders, and six prior partial responders to PegIFN/RBV treatment. The patients were given TVR/PegIFN/RBV for 12 weeks, followed by a 12-week PegIFN/RBV treatment; virological response results were assessed at weeks 4, 12, and 24. Treatment was discontinued in patients with HCV RNA >1000 IU/mL at week 4 or with negative RNA results at week 4 but >1000 IU/mL at week 12. Rapid virological response (RVR), early virological response (EVR), extended rapid virological response (eRVR), and virological response at 24th week of treatment were evaluated. The side effects of combination therapy and the rates of treatment discontinuation were investigated. Results: The mean age of the patients was 56.02 +/- 9.96 years and 45.9% were male. Ninety-one percent of the patients were infected with viral genotype 1, 69.6% with the interleukin (IL) 28B genotype CT and 20.2% were cirrhotic. The RVR rate was 86.3% in prior relapsers, 56% in prior null responders, and 50% in prior partial responders (p=0.002). EVR rates in those groups were 91.3%, 56%, and 83.3%, respectively (p

Objectives: We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms. Methods: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. Results: In total, 791 patients with DFI were included, 531(67%) were male, median age was 62 (19-90). Severe infection was diagnosed in 85 (11%) patients. Osteomyelitis was diagnosed in 291(36.8%) patients. 536 microorganisms were isolated, the most common microorganisms were S. aureus (20%), P. aeruginosa (19%) and E. coli (12%). Methicillin resistance (MR) rate among Staphylococcus aureus isolates was 31%. Multidrug resistant bacteria were detected in 21% of P. aeruginosa isolates. ESBL (+) Gram negative bacteria (GNB) was detected in 38% of E. coli and Klebsiella isolates. Sixty three patients (8%) were rehospitalized. Of the 791 patiens, 127 (16%) had major amputation, and 24 (3%) patients died. In multivariate analysis, significant predictors for fatality were; dialysis (OR: 8.3, Cl: 1.82-38.15, p = 0.006), isolation of Klebsiella spp. (OR:7.7, Cl: 1.24-47.96, p = 0.028), and chronic heart failure (OR: 3, Cl: 1.01-9.04, p = 0.05). MR Staphylococcus was detected in 21% of the rehospitalized patients, as the most common microorganism (p < 0.001). Conclusion: Among rehospitalized patients, methicillin resistant Staphylococcus infections was detected as the most common agent, and Klebsiella spp. infections were found to be significantly associated with fatality. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Introduction Back pain is commonly experienced by pregnant women. Evidence suggests that progressive muscle relaxation (PMR) therapy, a complementary therapy widely used by pregnant women, may improve the physical and psychological outcomes of pregnancy. The aim of this study was to investigate the effects of PMR training accompanied by music on perceived pain and quality of life (QOL) in pregnant women with low back pain (LBP). Methods This was a prospective randomized controlled trial. The study was designed to examine the effects of PMR accompanied by music on pregnant women with LBP. In total, 66 pregnant women were assigned randomly to a PMR group or a control group (33 women in each). A personal information form was used as a data collection tool; a visual analog scale was used for measuring pain; and the Short Form-36 was used to evaluate QOL. Results The control and intervention groups were comparable at baseline. Significant differences were observed between the 2 groups after 4 and 8 weeks of intervention. The intervention group showed significant improvement in all QOL subscales after the intervention. The intervention group, but not the control group, showed significant improvement in perceived pain after the intervention. The intervention group experienced a greater decrease in perceived pain and improved QOL than the control group. Discussion Our findings show that PMR accompanied by music may be an effective therapy for improving pain and QOL in pregnant women with LBP. Large randomized studies are recommended to confirm these results.

Eriskin Still Hastaligi (ESH) yuksek ates, dokuntu, yaygin kas ve eklem agrilariyla seyreden, nadir gorulen bir hastaliktir. Bu yazida, benzer klinik ve laboratuar bulgulari olan ve antienflamatuar tedaviye yanit alinan dort ESH olgusu literatur esliginde sunulmustur.

Conference of the Asian-Pacific-Association-for-the-Study-of-the-Liver (APASL) -- MAR 12-15, 2014 -- Brisbane, AUSTRALIA, WOS: 000370967500005, PubMed: 26966614, Background: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. Aims: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naive. Study Design: A multicenter, retrospective observational study. Methods: The study was conducted retrospectively on 1214 treatment naive-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients' data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient's demographic characteristics, baseline viral load, genotype, and fibrosis scores. Results: The mean age of the patients was 50.74 (+/- 0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early virological response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%). Conclusion: Our findings showed that the rate of SVR to dual therapy was higher in treatment-naive Turkish patients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients., Asian Pacific Assoc Study Liver

Lung nodules/masses under suspicion of malignancy are a clinical problem frequently encountered in patients with or without known cancer. Percutaneous transthoracic needle biopsy (PTNB) has been a minimal invasive diagnostic approach to patients with cancer in whom routine clinical and radiological diagnostic efforts have failed. Nursing care of patients before, during, and after the PTNB is not complex, but it is a new concept. Patients and their family members need to be educated about the intent and outcomes of the procedure, as well as its complications. The purpose of this article is to review the theoretical aspect of the procedure and outline basic steps of computed tomography-guided PTNB. Preoperative patient education and preparation, intraoperative nursing interventions, and postoperative patient care are discussed.

We aimed to investigate the predictors for limb loss among patients with diabetes who have complicated skin/soft-tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centres in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total, 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients had used antibiotics within the last month, and 121(27%) had osteomyelitis. Of the 208 microorganisms isolated, 92 (44.2%) were Gram-positive cocci and 114 (54.8%) were Gram-negative rods (GNR). The most common GNR was Pseudomonas; the second was Escherichia coli, with extended spectrum beta-lactamase positivity of 33%. Methicillin-resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these were major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR 1.75, 95% Cl 1.04-2.96, p 0.034), duration of diabetes >20 years (OR 1.9, 95% Cl 1.18-3.11, p 0.008), infected ulcer versus cellulitis (OR 1.9, 95% Cl 1.11-3.18, p 0.019), history of peripheral vascular disease (OR 2, 95% Cl 1.26-3.27, p 0.004), retinopathy (OR 2.25, 95% Cl 1.19-4.25, p 0.012), erythrocyte sedimentation rate >70 mm/hr (OR 1.6, 95% Cl 1.01-2.68, p 0.05), and infection with GNR (OR 1.8, 95% Cl 1.08-3.02, p 0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of diabetes >20 years, infected ulcers, history of peripheral vascular disease and retinopathy, detection of GNR was a significant predictor of limb loss. Clinical Microbiology and Infection (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Ertugrul Guclu, Nazan Tuna, Oguz Karabay Anthrax is a zoonotic disease caused by Bacillus anthracis. cutaneous anthrax is the most commonly seen form of anthrax. Skin lesions usually occur on the most exposed areas of the body, such as the face, neck, hand or upper extremity. The aim of this paper is to report a case of cutaneous anthrax form which was occurred on an unexpected area of the body of a slaughter-house worker.

It is known that immunotherapy and cancer chemotherapy may cause hepatitis B virus (HBV) reactivation in hepatitis B surface antigen carriers and inactive chronic hepatitis B patients. Guidelines recommend antiviral prophylaxis regardless of HBV DNA levels to prevent reactivation. We read from the article written by Liu et al that Lamivudine was given inadequate time for antiviral prophylaxis.

Geyik, Mehmet Faruk/0000-0002-0906-0902; demirdal, tuna/0000-0002-9046-5666; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Gunduz, Alper/0000-0001-9154-844X WOS: 000352106600012 PubMed: 25500658 Introduction: Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. Methodology: Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy Results: SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log(10) IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). Conclusions: Detection of a 1 log(10) decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR.

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases set up a task force to develop a consensus report focused on chronic hepatitis B in pregnancy, a complex issue for both the mother with an advanced liver disease and the unborn child who is under the risk of hepatitis B virus (HBV) transmission. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented in the report. An algorithm adapted from actual publications is also proposed for management of chronic hepatitis B in the pregnant patient. Since many women of childbearing age are in the immune tolerant phase of infection, there is generally no need for therapy and no indication to start therapy during the early stages of pregnancy. Initiation of antiviral therapy in the beginning of the third trimester in highly viremic (HBV DNA > 200 000 IU/mL) pregnant women can prevent mother-to-child-transmission of HBV despite postnatal passive and active immunoprophylaxis provided. Given its potency and its high genetic barrier to resistance, tenofovir might be an appropriate option for mothers who might need to continue their treatment for active hepatitis B after delivery.

Pain is a problem frequently encountered by patients with cancer. For more than 30 years, the percutaneous chordotomy procedure has been a nonpharmacological approach to the management of intractable cancer pain. Nursing care of patients before, during, and after the percutaneous chordotomy procedure is challenging. Patients and their family members need to be educated about the intent and outcomes of the procedure, as well as its complications. The purpose of this article is to review the theoretical aspect of pain perception and outline the anatomical background and basic steps of the percutaneous chordotomy procedure. Preoperative patient education and preparation, intraoperative nursing interventions, and postoperative patient care are discussed.

Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF) in terms of clinical and laboratory findings.

If virologic breakthrough is observed during chronic hepatitis B treatment, drug resistance or compliance problem should be considered. But in some cases, breakthrough depends on drug preservation conditions. We report the case of a 30-years-old man, who experienced viral breakthrough due to wrong preservation conditions of the drug.

Stenosis of the internal carotid artery due to atherosclerosis can cause embolic stroke or cerebral ischemia, both of which may result in significant morbidity, mortality, and long-term disability. Although the endovascular technique with balloons and stents to relieve arterial (i.e., coronary) stenosis has allowed a nonsurgical approach to the management of atherosclerotic disease for many years, its use in carotid vessels has only recently gained popularity. In addition, improvements in endovascular access systems have extended the use of carotid angioplasty and stenting (CAS), especially since the advent of cerebral emboli protection devices. Nowadays, CAS is emerging as an intervention for high-risk surgical patients with high-grade carotid artery stenosis. Nursing care of these patients before, during, and after CAS is challenging. Patients and family need to be educated about the aim and consequences of the procedure and its complications. To care for these patients, the nurse must understand the techniques of CAS. The purpose of this article was briefly to review the etiology of stroke, the current treatments to relieve carotid stenosis, and the basic steps of CAS. The nursing management throughout the procedure, the patient preparation before the procedure, and most importantly, the postprocedure nursing care are discussed.

SUMMARY A prospective analysis was conducted comparing dysfunction attributable to catheter thrombosis in subjects who received a heparin catheter lock three times a week (n = 15) to those who received a heparin lock six times a week (n = 15) immediately after the insertion of a temporary haemodialysis catheter. Thrombus related catheter removal occurred in two patients in control but no patients in the experiment group. Heparin locking six times a week was found to be effective in prolonging the mean of the first day where difficulty was experienced in aspiration. It also prevented any possible difficulty in catheter flushing. Increased locking frequency prevents any thrombus accumulation within the temporary catheter, while it has limited but significant preventive effect on thrombus accumulated around the catheter.

The aim of the study was to determine the quality of life (QOL) of nursing staff working in oncology units in Turkey. The study was a descriptive study and included 89 oncology nurses from 12 different cities in Turkey who participated in the course "Basic Chemotherapy Courses for Oncology Nurses" in Izmir. This course was organized by Ege University Faculty of Medicine and the Turkish Ministry of Health. Quality of life was assessed with the Questionnaire for Socioeconomic Status and the World Health Organization QOL Scale (WOQOL-BREF). Data were analyzed using descriptive statistics including Student t tests, analysis of variance, and the Scheffe test for post hoc analysis. Mean scores for QOL were 14.52 for the physical health domain, 14.3 for the psychologic domain, 13.57 for the social relationships domain, and 11.78 for the environment domain. It has been concluded that providing care for patients with cancer has a negative impact on the QOL of oncology nurses.

Objective: In this study, it was aimed to investigate the influence of prenatal risk indicator scores of pregnant women on mental symptoms. Methods: This cross-sectional study was carried out with 142 pregnant women who were admitted to obstetrics clinic of a state hospital in Izmir province and who stated that they were not diagnosed with any psychiatric diseases. A form questioning socio-demographic and obstetric characteristics of pregnant women, prenatal risk indicator aiming at determining risk of pregnant women and brief symptom inventory (BSI) aiming at screening mental symptoms were used for data collection. Results: The most common risk factors according to risk indicator were detected as experiencing urinary tract infection during the current pregnancy, being nulliparous, receiving late or insufficient prenatal care and inadequate weight gain and almost half of the pregnant women were found to be high risk. In addition, it was found that BSI scores were low, paranoid thought scores were high in high risk women and there was a positive correlation and phobic anxiety scores of all pregnant women were equal. Conclusion: High risk pregnant women were detected to have paranoid thoughts and all pregnant women found to experience phobic anxiety equally.

Background: The consumption of carbapenems has increased worldwide, together with the increase in resistant gram negative bacilli. Subsequently, the prevalence of carbapenem-resistant Acinetobacter infections has increased rapidly and become a significant problem particularly in intensive care unit patients. The aim of the present study was to evaluate the changes in the prevalence of Acinetobacter infection by restricting the consumption of carbapenems in intensive care unit patients. Methods: This study was conducted between May 1, 2011 and February 28, 2013. The amount of carbapenem consumption and the number of patients with multi-drug resistant Acinetobacter baumannii (MDRAB) isolates during the study period were retrospectively obtained from the records of the patients, who were hospitalized in the intensive care unit. The study period was divided into two periods named as: Carbapenem non-restricted period (CNRP) and carbapenem-restricted period (CRP). During CNRP, no restrictions were made on the use of carbapenems. During CRP, the use of carbapenems was not allowed if there was an alternative to carbapenems. Primary Endpoint: MDRAB infection after ICU admission. The definition of nosocomial infections related to Acinetobacter spp. was based on the criteria of the Center for Disease Control (CDC). The correlation between the amount of carbapenem consumption and the number of infections with MDRAB strains between the two periods were evaluated. Results: During the study period, a total of 1822 patients' (1053 patients in CNRP and 769 patients in CRP) records were evaluated retrospectively. A total of 10.82 defined daily dose (DDD/100 ICU days) of anti-pseudomonal carbapenem were used in CNRP, and this figure decreased to 6.95 DDD/100 ICU days in CRP. In the 8-month CNRP, 42 (3.98%) MDRAB-related nosocomial infections were detected, and 14 (1.82%) infections were detected in CRP (p = 0.012). Conclusion: The prevalence of MDRAB strains isolated in the CNRP was 2.24-fold higher than the prevalence in the CRP. The prevalence of Acinetobacter infections can be reduced by taking strict isolation measures as well as by implementing good antibiotics usage policy.

KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X WOS: 000309553900009 PubMed: 22825647 Introduction Interferons, pegylated interferons (PegIFN), and oral antivirals are used in the treatment of chronic hepatitis B (CHB) virus infection. The number of studies comparing the efficacy of PegIFNs in the treatment of HBe antigen-negative CHB is rather limited. In this trial, the efficacy of two PegIFN products used in the treatment of CHB is compared. Methods Study data were obtained from 16 tertiary healthcare service centers located in various areas of Turkey. Data of patients who were consecutively treated with PegIFN alpha-2a or alpha-2b for CHB were recorded retrospectively. Hepatitis B virus DNA and liver enzymes were analyzed at the beginning of the treatment and during weeks 12, 24, 48, and 72. A P-value less than 0.05 was considered to be significant. Results A total of 155 patients were enrolled in this trial. Two cases were excluded because of insufficient data. Among the remaining 153 patients, 81 (53%) patients were in the PegIFN alpha-2a group and 72 (47%) patients were in the alpha-2b group. Treatment success was found to be 17.2% for the PegIFN alpha-2a group and 18.0% for the PegIFN alpha-2b group (P>0.05). In terms of efficacy (weeks 24, 48, and 72), there were no significant differences between the groups (P>0.05). Conclusion According to our results, for HBe antigen-negative CHB cases, the response rate during the sixth month after the treatment with PegIFN was determined to be similar to 17%. No difference was found between the efficacy rates of the two PegIFN products used in the treatment of HBe antigen-negative CHB. Eur J Gastroenterol Hepatol 24: 1296-1301 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. HEP-NET Turkey; Gliad science The authors thank the HEP-NET Turkey project for support. Planning the study: K. Oguz. Conducting the study: K. Oguz, T. Nazan. Collecting data: K. Oguz, T. Nazan, E. Saban and the PEG-HBV study group (arranged in alphabetical order: A. Sila, B. Hurrem, C. Bahadir, D. Kutbettin, D. Tuna, D. Nese, E. Serpil, E. Omer, G. Faruk, G. Alper, K.K. Mustafa, F.K. Omer, O. Resat, O. Davut, O. Nail, S. Fatma, T. Ediz). Interpreting data: K. Oguz and T. Nazan. Drafting the manuscript: K. Oguz, T. Nazan, E. Saban.; K. Oguz and T. Nazan received travel and manuscript preparation (statistical analysis) grants from Gliad science. For the remaining authors there are no conflicts of interest.

Aim: In 2009, a flu pandemic caused panic worldwide. Oseltamivir and zanamivir were widely used in this pandemic. Currently, there are a limited number of studies comparing the efficacy and tolerability of these two drugs. This study aimed to compare the efficacy and tolerability of these two drugs in the treatment of influenza. Materials and Methods: Patients diagnosed with influenza at our infectious disease outpatient clinic during the influenza season between October 1, 2009 and February 1, 2010 were included in the study. Study data were obtained retrospectively from files for consecutive patients. A total of 136 subjects were selected. After exclusion criteria were applied, 56 subjects were discarded. The information for 80 patients in whom oseltamivir or zanamivir therapy was initiated (40 for each therapy) was compiled, and the efficacy and tolerability of the drugs were compared. Results: There was no significant difference in efficacy for the two drugs (P > 0.05). Temperature normalization was significantly faster in patients taking zanamivir (P = 0.0157). Drowsiness was the most frequent adverse event for both drugs (38% for the oseltamivir group, and 22% for the zanamivir group). Respiratory distress was observed in five patients in the zanamivir group, whereas it was not observed in patients in the oseltamivir group (P < 0.05). One patient had to discontinue therapy in the zanamivir group due to respiratory distress. Conclusion: Efficacy (in terms of symptom relief and duration to resumption of work) and adverse events were similar for zanamivir and oseltamivir, but temperature normalization was much more rapid in patients using zanamivir. Patients using zanamivir should be monitored for respiratory distress.

Legionella pneumophila is a cause of both community- and hospital-acquired pneumonia and might cause high morbidity and mortality. Therefore, early diagnosis and treatment with appropriate antibiotics is crucial. Many clinical and laboratory abnormalities can be observed in the course of Legionella pneumonia. In this study, we aimed to present simultaneously increased serum ferritin and myoglobin level in a legionella case with reference to the relevant literature.

Brucellosis is one of the most important zoonotic diseases. Several complications may be seen during its clinical course. Here, we describe a patient who presented with complaints of fatigue, malaise, and intensive lumbar pain. He had been suffering from these complaints for nearly 1 month. It was learned that he lived in rural area, made and ate his own cheese. The Rose Bengal test was positive and Brucella standard tube agglutination was positive at 1/320 titer. Pedro Pons′ sign, an osteoarticular complication of brucellosis, was revealed with the aid of radiologic imaging. Osteoarticular involvement is common in the course of brucellosis. Deformation in vertebrae formerly known as Pedro Pons′ sign should be thought in brucellosis patients suffering from lumbar pain.