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Objective and background: Light-based antimicrobials, mainly ultraviolet C (UVC) and laser light irradiation, have a potential to inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of our study was to evaluate the effect of transbronchial and intravenous application of UVC and laser light irradiation on treatment of patients with severe COVID-19. Methods: The clinical outcome of six patients (age 42-69 years) with severe COVID-19 infection who were directly applied UVC (254 nm) transbronchially, and UVC plus green (630 nm) and red laser (535 nm) lights to the blood circulation in addition to standard pharmacotherapy (UVC group) were prospectively evaluated in comparison to six patients (age 50-69 years) treated only with pharmacotherapy (standard treatment group). Results: The patients in UVC group had shorter stay in intensive care unit (median length of stay 1 vs. 8.5 days; p=0.015), more negative PCR results after treatment (5/6 vs. 0/6 patients; p=0.003), higher discharge rate (5/6 vs. 3/6 patients), and lower mortality (1/6 vs. 3/6 patients), as compared to patients in standard treatment group. Serum D-dimer level, which reached up to 2500 ng/mL (six times of baseline value) seven days after treatment in standard treatment group, was much lower in UVC group (1000 ng/mL). Serum ferritin level was 1.5 to 1.9-fold higher and CRP level was up to 1.7-fold higher in standard treatment group during ten days after treatment as compared to UVC group. No adverse effects have been observed. Conclusions: Combined transbronchial and intravenous UVC and laser irradiation may improve outcome of severe COVID-19 cases.

OZ Objective: The study was designed to evaluate the relationship between the methods of circumcision procedures used in the past and hepatitis B surface antigen (HBsAg), anti-HBs and anti-hepatitis C virus (HCV) positivity. Materials and Methods: Within the scope of “Public Hepatitis Awareness Activities” executed by the Viral Hepatitis Society, volunteer participants who were admitted to primary healthcare centers across the Turkey, were screened for HBsAg, anti-HBs and anti-HCV positivity. A standard questionnaire form regarding their circumcision procedure in the past was applied via face-to-face interview method to each participant while their blood samples were collected for the analysis of hepatitis B virus and HCV positivity. Results: HBsAg, anti-HBs and anti-HCV positivity rates were 3.6%, 9.9% and 0.6% respectively. HBsAg positivity was significantly higher in group of participants who have been circumcised by a traditional non-medical person than in the other group of subjects who have been circumcised by a health professional (3.3% vs 5.3%, p=0.003). Conclusion: Circumcision is a widespread practice based on the existing cultural and religious traditions in islamic countries like Turkey. Mass circumcision and circumcision performed by traditional nonmedical persons like barbers is still one of the important health-care problems with the risk of transmission of viral infections in Turkey. The results will help to take measures for preventing viral hepatitis transmission.

Background/aims To evaluate the effectiveness of tenofovir in patients with chronic hepatitis B infection in a real life setting. Materials and methods We performed a retrospective analysis of data from 164 patients with chronic hepatitis B who were treated with Tenofovir. Eighty-six patients (52.4%) were naive. Seventy-seven (46.9%) patients were previously treated with anti-viral drugs, including standard interferon (n=4), pegylated (PEG) interferon (n=14), standard interferon together with lamivudine (n=13), lamivudine alone (n=41), adefovir (n=2), lamivudine together with adefovir (n=1), and entecavir (n=2). Six patients (3.7%) had liver cirrhosis before treatment of tenofovir. Results The patients who have hepatitis B viral DNA>104 copy/mL with chronic hepatitis B infection were included in the treatment of Tenofovir. Average follow up time was 30.31±14.33 months. HBV DNA negativity and alanine aminotransferase (ALT) normalization were 86.5% and 71.3%, respectively, at the last visit. Hepatitis B e-Antigen (HBeAg) seroconversion occurred in 11 (19.6%) out of 164 patients. During the follow-up period, 4 (2.4%) patients developed liver cirrhosis and in 5 (3%) patients hepatocellular carcinoma (HCC) occurred out of 164 patients. HBsAg seroconversion occurred in one patient (0.6%). Conclusion Tenofovir can be used safely and successfully in those patients that were naive, experienced with immune modulators and/or antivirals, HBeAg-positive, and HBeAg-negative patients.

Hepatitis C virus (HCV) infection is a significant health problem. The aim of this study is to evaluate the cost-effectiveness of HCV treatment and estimate its economic burden in Turkey. An Excel-based disease progression model was used to estimate the HCV-infected population for 2015–2030. Direct costs in US dollars (USD) including diagnostic, laboratory, and healthcare costs were provided by experts in the country. Indirect costs were estimated as lost productivity using the World Health Organization (WHO) disability-adjusted life years (DALYs) metric from the Global Burden of Disease study. Three scenarios were developed to estimate the cost-effectiveness of HCV treatment through 2030: Base 2016, Increase Treatment and SVR (where SVR is sustained virological response), and WHO Targets. Additionally, the WHO Targets scenario was assessed at three different treatment price points: 10,900 USD, 16,730 USD (base cost), and 27,285 USD. Cumulative total direct and indirect costs (2015–2030) for the WHO Targets scenario were estimated to be 10.8 billion USD, or a 1.5 % increase compared with Base 2016. However, by the following decade, due to a marked decline in DALYs, cumulative direct and indirect costs were estimated to be 45 % less when compared with Base 2016. At a threshold of 9125 USD, all scenarios were cost-effective. By implementing the WHO Targets scenario, Turkey would be able to lower HCV prevalence by 80 % and reduce the total number of liver-related deaths by >65 % by 2030. Treating HCV infection in the country is cost-effective if healthcare and indirect costs are taken into consideration.

Giriş: Birçok ülkede olduğu gibi ülkemizde de pandemik grip geçtiğimiz kış aylarının en çok tartışılan konusu olmuştur. Bu çalışmada Ankara Üniversitesi İbn-i Sina Hastanesinde kliniğimiz bünyesinde salgın sırasında açılan grip polikliniğimize başvurular incelenmiş, İnfluenza A H1N1 (2009) pandemisinin genel özellikleri poliklinik verileri ile ortaya konmaya çalışılmıştır. Bulgular: Erişkin hasta grip polikliniğimize, 23.10.2009 ve 14.01.2010 tarihleri arasında toplam 2787 hasta başvurmuştur. Açıldığı tarihten itibaren başvuru sayısı her hafta bir öncekine göre artmış, 2009 yılı 47. haftasında en yüksek değere ulaşmıştır. Hastaların 1544’ü (% 55.40) bayan olup bu vakaların ortalama yaşı 31.7 olarak hesaplanmıştır. En sık görülen başvuru şikayetleri olarak; öksürük (% 78.75), ateş (% 62.46) ve kas ağrısı (% 41.11) saptanmıştır. Grip polikliniğimize başvuran hastalardan, 23’ü bayan 6’sı erkek olmak üzere toplam 35 hasta servisimize yatırılarak takip edilmiştir. Pandemik influenza A H1N1 için örnek gönderilen 23 vakadan 9’unda PCR pozitifliği saptanmıştır. Sağlık Bakanlığı ‘Vaka Tanımlaması’ göz önünde bulundurularak başvuran tüm hastalar arasından 1681 kişiye (% 60.31) klinik olarak H1N1 infeksiyonu, 614 hastaya ise (% 22.03) soğuk algınlığı tanısı konmuştur. Klinik olarak grip tanısı konan hastalardan (1681 hasta) 432’sine (% 25.69) oseltamivir tedavisi başlanmıştır. Sonuç: Salgın sırasında; tüm verilerin düzenli kayıt altına alınması, salgın sonrası ise tüm sağlık merkezleri deneyim ve verilerinin paylaşılması gelecek salgınların yönetimi açısından oldukça önemlidir.

Son yillarda Streptococcus pneumoniae suslarindapenisilin ve makrolid direncinde artis gozlenmektedir. Bucalismada, bir yil icerisinde solunum yolu orneklerindenizole edilen 77 pnomokok susunun, cesitli antibiyotiklereduyarliliklari disk difuzyon yontemi ile arastirilmistir.Izolatlarin %57.1'inin oksasilin tarama testi ile penisilineduyarli oldugu bulunmustur. Eritromisin, klindamisin,tetrasiklin ve levofloksasin duyarlilik oranlari ise sirasiyla,% 75.3, %85.7, %68.8 ve %96.1 ‘dir. Eritromisine duyarliolmayan 19 susun 11'i (%57.9) klindamisine duyarli (Mtipi direnc), 8 tanesi ise klindamisine direncli (MLSB tipidirenc) bulunmustur. Suslarin tamaminin vankomisin vetelitromisine duyarlidir. Buna gore, telitromisin ve levofloksasin,penisilin direncli pnomokok soz konusuoldugunda toplum kokenli pnomoninin tedavisinde alternatifajanlar olarak kullanilabilirler.

Gilead Sciences Chronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. for some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. the largest viremic populations were in Egypt, with 6358000 cases in 2008 and Brazil with 2106000 cases in 2007. the age distribution of cases differed between countries. in most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level. Arud Ctr Addict Med, CH-8005 Zurich, Switzerland Univ Leipzig, D-04109 Leipzig, Germany Odense Univ Hosp, Dept Infect Dis, DK-5000 Odense, Denmark Univ Libre Brussels, Erasme Univ Hosp, Brussels, Belgium Univ Fed Rio de Janeiro, Dept Gastroenterol, Rio de Janeiro, Brazil Hop Henri Mondor, Dept Sante Publ, F-94010 Creteil, France Hosp Santa Maria, Ctr Hosp Lisboa Norte, Dept Gastroenterol, Lisbon, Portugal Univ Toronto, Toronto Gen Hosp, Univ Hlth Network, Toronto, ON M5G 1L7, Canada Nottingham Univ Hosp NHS Trust, Nottingham, England Biomed Res Unit, Nottingham, England Inst Clin & Expt Med, Dept Hepatogastroenterol, Prague, Czech Republic Ege Univ, Izmir, Turkey Ankara Univ, TR-06100 Ankara, Turkey Osped Cantonale, Dept Gastroenterol, Bellinzona, Switzerland Univ Montreal, Dept Med, Liver Unit, Montreal, PQ H3C 3J7, Canada Adv Tech Hlth Serv Res TAISS, Madrid, Spain Hosp Valle de Hebron, CIBERehd, Barcelona, Spain Hosp Santo Antonio Capuchos, Dept Gastroenterol, Ctr Hosp Lisboa Cent, Lisbon, Portugal Hosp Puerta Hierro, Madrid, Spain Univ Fed Rio Grande do Sul, Hosp Clin, Porto Alegre, RS, Brazil Region Hosp Hovedstaden, Region Hovedstaden, Denmark Univ Fed Rio de Janeiro, Dept Clin Med, Rio de Janeiro, Brazil Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, Hannover, Germany German Liver Fdn, Hannover, Germany Univ Plymouth, Peninsula Schools Med & Dent, Plymouth PL4 8AA, Devon, England Univ New S Wales, Kirby Inst, Sydney, NSW, Australia Cairo Univ, Cairo, Egypt Orebro Univ Hosp, Dept Infect Dis, Orebro, Sweden Univ Orebro, Sch Hlth & Med Sci, SE-70182 Orebro, Sweden Ain Shams Univ, Cairo, Egypt Dokuz Eylul Univ, Izmir, Turkey Ctr Dis Anal CDA, Louisville, CO USA Karolinska Inst, Infect Dis Unit, Dept Med Huddinge, Stockholm, Sweden Exigo Consultores, Alhos Vedros, Portugal Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Hosp Carlos III, CIBERehd, Madrid, Spain Univ Copenhagen, Copenhagen, Denmark Direccao Geral Saude, Lisbon, Portugal Univ Estadual Campinas, Fac Ciencias Med, UNICAMP,Dept Clin Med, Grp Estudo Hepatites,Disciplina Doencas Infeccios, São Paulo, Brazil Wilhelminenspital Stadt Wien, Dept Internal Med 4, Vienna, Austria Univ São Paulo, Sch Med, Div Gastroenterol & Hepatol, São Paulo, Brazil Hop Henri Mondor, Serv Hepatogastroenterol, F-94010 Creteil, France Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Vienna, Austria Masaryk Univ, Univ Hosp Brno, Clin Infect Dis, Brno, Czech Republic Ankara Univ, Dept Gastroenterol, Sch Med, TR-06100 Ankara, Turkey Univ Manitoba, Dept Internal Med, Sect Hepatol, Winnipeg, MB, Canada Hlth Sci Ctr, Viral Hepatitis Invest Unit, Winnipeg, MB, Canada European Liver Patients Assoc, St Truiden, Belgium Istanbul Univ, Istanbul, Turkey Univ British Columbia, British Columbia Ctr Dis Control, Vancouver, BC V5Z 1M9, Canada Aalborg Univ Hosp, Dept Med Gastroenterol, Aalborg, Denmark Aalborg Univ Hosp, Sect Mol Diagnost, Aalborg, Denmark Katholieke Univ Leuven, Univ Hosp Leuven, Louvain, Belgium Univ Western Ontario, Div Gastroenterol, London, ON, Canada Univ Dusseldorf, Dusseldorf, Germany Univ São Paulo, Sch Med, São Paulo, Brazil Univ Zurich Hosp, Swiss HPB Hepatopancreatobiliary Ctr, CH-8091 Zurich, Switzerland Univ Zurich Hosp, Dept Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland Univ Calgary, Liver Unit, Div Gastroenterol & Hepatol, Calgary, AB, Canada Univ Hosp, Div Gastroenterol & Hepatol, Geneva, Switzerland Univ Hosp, Div Clin Pathol, Geneva, Switzerland Natl Inst Publ Hlth, Natl Reference Lab Hepatitis, Prague, Czech Republic Univ Southhampton, Southampton, England Dalhousie Univ, Dept Med, Halifax, NS, Canada Dalhousie Univ, Dept Surg, Halifax, NS B3H 4H2, Canada Capital Dist Hlth Author, Serv Hepatol, Queen Elizabeth II Hlth Sci Ctr, Halifax, NS, Canada Univ British Columbia, Dept Gastroenterol, Vancouver, BC V5Z 1M9, Canada Assembleia Republ, Lisbon, Portugal Alfred Hosp, Melbourne, Vic, Australia Monash Univ, Melbourne, Vic 3004, Australia UCL, UCL Inst Liver & Digest Hlth, Div Med, London, England Ctr Hosp Porto, Dept Infect Dis, Oporto, Portugal JW Goethe Univ Hosp, Frankfurt, Germany Cantonal Hosp St Gallen, Div Gastroenterol & Hepatol, St Gallen, Switzerland Egyptian Liver Res Inst & Hosp ELRIAH, Dakahliah, Egypt Monash Hlth, Melbourne, Vic, Australia Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium Med Univ Graz, Dept Internal Med, Div Gastroenterol & Hepatol, Graz, Austria St Vincents Hosp, Dept Gastroenterol, Melbourne, Vic, Australia Univ Melbourne, Melbourne, Vic, Australia Charles Univ Prague, Dept Internal Med, Fac Med 1, Prague, Czech Republic Cent Mil Hosp, Prague, Czech Republic Deutsch Leberhilfe eV, Cologne, Germany Ghent Univ Hosp, Ghent, Belgium Univ Ghent, B-9000 Ghent, Belgium Hasselt Univ, Dept Hlth Econ & Patient Safety, Diepenbeek, Belgium Med Univ Innsbruck, A-6020 Innsbruck, Austria Natl Liver Inst, Menoufia, Egypt Copenhagen Univ Hosp, Hvidovre, Denmark Univ New S Wales, St George Hosp Clin Sch Med, Sydney, NSW, Australia Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia Univ Antwerp, B-2020 Antwerp, Belgium Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden Karolinska Univ Hosp, Dept Gastroenterol & Hepatol Infect Dis, Stockholm, Sweden Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Web of Science

Gilead Sciences The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. the largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical. Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, D-30625 Hannover, Germany German Liver Fdn, Hannover, Germany Orebro Univ Hosp, Dept Infect Dis, Orebro, Sweden Univ Orebro, Sch Hlth & Med Sci, SE-70182 Orebro, Sweden Hosp Valle de Hebron, CIBERehd, Barcelona, Spain UCL, Div Med, UCL Inst Liver & Digest Hlth, London, England Inst Clin & Expt Med, Dept Hepatogastroenterol, Prague, Czech Republic Cairo Univ, Cairo, Egypt Ankara Univ, TR-06100 Ankara, Turkey Ghent Univ Hosp, Ghent, Belgium Wilhelminenspital Stadt Wien, Dept Internal Med 4, Vienna, Austria Ege Univ, Izmir, Turkey Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden Karolinska Univ Hosp, Dept Gastroenterol & Hepatol Infect Dis, Stockholm, Sweden Univ Leipzig, D-04109 Leipzig, Germany Osped Cantonale, Dept Gastroenterol, Bellinzona, Switzerland Univ Montreal, Dept Med, Liver Unit, Montreal, PQ H3C 3J7, Canada Adv Tech Hlth Serv Res TAISS, Madrid, Spain Fed Univ State Rio de Janeiro, Dept Gastroenterol, Rio de Janeiro, Brazil Arud Ctr Addict Med, Zurich, Switzerland Hosp Santo Antonio Capuchos, Ctr Hosp Lisboa Cent, Dept Gastroenterol, Lisbon, Portugal Hosp Puerta Hierro, Madrid, Spain Univ Fed Rio Grande do Sul, Hosp Clin, Porto Alegre, RS, Brazil Odense Univ Hosp, Dept Infect Dis, DK-5000 Odense, Denmark Region Hosp Hovedstaden, Region Hovedstaden, Denmark Univ Fed Rio de Janeiro, Dept Clin Med, Rio de Janeiro, Brazil Univ Plymouth, Peninsula Sch Med & Dent, Plymouth PL4 8AA, Devon, England Univ New S Wales, Kirby Inst, Sydney, NSW, Australia Ain Shams Univ, Cairo, Egypt Dokuz Eylul Univ, Izmir, Turkey Ctr Dis Anal CDA, Louisville, CO USA Karolinska Inst, Dept Med Huddinge, Karolinska Univ Hosp, Infect Dis Unit, Stockholm, Sweden Exigo Consultores, Alhos Vedros, Portugal Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Hosp Carlos III, CIBERehd, Madrid, Spain Univ Copenhagen, Copenhagen, Denmark Direccao Geral Saude, Lisbon, Portugal Univ Estadual Campinas, Fac Ciencias Med, Disciplina Doencas Infecciosas, Grp Estudo Hepatites,Dept Clin Med, São Paulo, Brazil Univ São Paulo, Sch Med, Div Gastroenterol & Hepatol, São Paulo, Brazil Hop Henri Mondor, Serv Hepatogastroenterol, F-94010 Creteil, France Med Univ Vienna, Div Gastroenterol & Hepatol, Dept Internal Med 3, Vienna, Austria Masaryk Univ, Clin Infect Dis, Univ Hosp Brno, Brno, Czech Republic Ankara Univ, Dept Gastroenterol, Sch Med, TR-06100 Ankara, Turkey Univ Manitoba, Dept Internal Med, Sect Hepatol, Winnipeg, MB, Canada Hlth Sci Ctr, Viral Hepatitis Invest Unit, Winnipeg, MB, Canada European Liver Patients Assoc, St Truiden, Belgium Istanbul Univ, Istanbul, Turkey Univ British Columbia, British Columbia Ctr Dis Control, Vancouver, BC V5Z 1M9, Canada Aalborg Univ Hosp, Dept Med Gastroenterol, Aalborg, Denmark Aalborg Univ Hosp, Sect Mol Diagnost, Aalborg, Denmark Katholieke Univ Leuven, Univ Hosp Leuven, Louvain, Belgium Univ Western Ontario, Div Gastroenterol, London, ON, Canada Univ Dusseldorf, Dusseldorf, Germany Univ São Paulo, Sch Med, São Paulo, Brazil Univ Libre Brussels, Erasme Univ Hosp, Brussels, Belgium Univ Zurich Hosp, Swiss HPB Hepatopancreatobiliary Ctr, CH-8091 Zurich, Switzerland Univ Zurich Hosp, Dept Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland Univ Calgary, Div Gastroenterol & Hepatol, Liver Unit, Calgary, AB, Canada Natl Inst Publ Hlth, Natl Reference Lab Hepatitis, Prague, Czech Republic Univ Southhampton, Southampton, England Dalhousie Univ & Hepatol Serv, Queen Elizabeth II Hlth Sci Ctr, Capital Dist Hlth Author, Dept Med, Halifax, NS, Canada Dalhousie Univ & Hepatol Serv, Queen Elizabeth II Hlth Sci Ctr, Capital Dist Hlth Author, Dept Surg, Halifax, NS, Canada Univ British Columbia, Dept Gastroenterol, Vancouver, BC V5Z 1M9, Canada Assembleia Republ, Lisbon, Portugal Alfred Hosp, Melbourne, Vic, Australia Monash Univ, Melbourne, Vic 3004, Australia Hop Henri Mondor, Dept Sante Publ, F-94010 Creteil, France Nottingham Univ Hosp NHS Trust, Nottingham, England Biomed Res Unit, Nottingham, England Ctr Hosp Porto, Dept Infect Dis, Oporto, Portugal JW Goethe Univ Hosp, Frankfurt, Germany Cantonal Hosp St Gallen, Div Gastroenterol & Hepatol, St Gallen, Switzerland Univ Toronto, Toronto Gen Hosp, Univ Hlth Network, Toronto, ON M5G 1L7, Canada Egyptian Liver Res Inst & Hosp ELRIAH, Dakahliah, Egypt Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium Med Univ Graz, Div Gastroenterol & Hepatol, Dept Internal Med, Graz, Austria St Vincents Hosp, Dept Gastroenterol, Melbourne, Vic, Australia Univ Melbourne, Melbourne, Vic, Australia Charles Univ Prague, Dept Internal Med, Fac Med 1, Prague, Czech Republic Cent Mil Hosp, Prague, Czech Republic Univ Antwerp, B-2020 Antwerp, Belgium Deutsch Leberhilfe eV, Cologne, Germany Univ Ghent, Dept Hlth Econ & Patient Safety, B-9000 Ghent, Belgium Hasselt Univ, Diepenbeek, Belgium Med Univ Innsbruck, A-6020 Innsbruck, Austria Natl Liver Inst, Menoufia, Egypt Copenhagen Univ Hosp, Hvidovre, Denmark Univ New S Wales, St George Hosp Clin Sch Med, Sydney, NSW, Australia Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia Univ Hosp, Div Gastroenterol & Hepatol, Geneva, Switzerland Univ Hosp, Div Clin Pathol, Geneva, Switzerland Monash Hlth, Melbourne, Vic, Australia Division of Gastroenterology, Federal University of São Paulo, São Paulo, Brazil Division of Infectious Disease, Federal University of São Paulo, São Paulo, Brazil Web of Science

Seventy isolates of enterococci with species identification were collected from clinical specimens between August 1996-June 1997 and antimicrobial susceptibility tests were performed. Using conventional tests, 67.2% of the isolates were identified as Enterococcus faecalis, 28.6% of the isolates as E. faecium and 2.8% of the isolates as E. gallinarum. Penicillin and ampicillin resistance were present in 21.4% of the isolates and there was no β-lactamase producer. High-level resistance to gentamicin and streptomycin were detected in 31.4% and 22.8% of the isolates, respectively. While there was no vancomycin and teicoplanin resistance in E. faecalis and E. faecium strains, E. gallinarum strains were moderately susceptible to vancomycin but susceptible to teicoplanin. Ciprofloxacin resistance was present in 20% of the isolates. Penicillin, ampicillin, ciprofloxacin and gentamicin resistance were significantly higher in E. faecium strains than that in E. faecalis strains (p < 0.001). Streptomycin resistance was also higher in E. faecium strains but the difference was not statistically significant (p > 0.05).

To evaluate the characteristics of patients with hepatitis B virus (HBV) infection and summarize the treatment modalities.By September 30, 2011 the data of 7871 HBsAg (+) patients were complied and analysed according to demographic and medical records (age, sex, laboratory tests, treatment with antiviral agents) in thirty centres of Turkey.Of the 7871 patients 3078 (39.1%) were females; mean (standard deviation) age was 35 (14) years, 3180 (40.4%) were HBsAg positive (+) after admission to a hospital, 1488 (18.9%) after blood donation and 967 (11.9%) were found during routine screening. The HBV prevalence among relatives of HBsAg (+) patients was 1764 (22.4%), and most frequently infected family members were siblings and mothers, 4961 (63.0%) and 2149 (27.3%), respectively). Anti-HDV was negative in 7407 94.1% of patients. Three-fourths of the patients 6383 (81.1%) were HBeAg negative (-). Mean (SD) ALT was 85.8 (266.4) U/L. Majority of patients, 5588 (71.0%) were chronic hepatitis-B patients under treatment, while 2283 (29.0%) were asymptomatic carriers without treatment and only 165 (2.1%) of patients were cirrhotic and 6612 (84.0%) of those were compensated. One-third of the patients 2983 (37.9%) were under a combined treatment, while others were under monotherapy. Lamivudine, entecavir and adefovir were the most frequently used oral therapies, used for 2583 (32.8%), 11.6% and 787 (10.0%) of patients, respectively), while 2975 (37.8%) of patients were under interferon treatment.Hepatitis B is still a problem in our country. First task of the physicians and our state should be to prevent the development and spread of the disease with education and vaccination programs, safe blood transfusions, and control of barbers.

We often see type-2 diabetes mellitus (DM) in the patients admitted to our clinics for chronic hepatitis C. Thereforey, we decide to examine the patients with chronic viral hepatitis (B and C) for DM and the patients with type-2 DM for HBsAg and anti-HCV antibodies. Group-1 was consisted of 72 patients with chronic hepatitis B and 38 patients with chronic hepatitis C between 1990 and 1995 (n=110). The patients who admitted to hospital for type-2 DM second half of 1995 consisted of group-2. In these two group, we searched the transaminases, other biochemical tests and viral hepatitis markers with ELISA method. We found type-2 DM in 34.2% of patients with chronic hepatitis C and 2.7% of chronic B hepatitis group (p

In the last year (1995), a new hepatitis agent that transmissible via blood has been found out by the Genelabs laboratories and it has been named as hepatitis G virus (HGV). In the same year, the Abbott laboratories have presented three new viral agents named with GB prefix and have defined them as GBV-A, GBVB and GBV-C. The hepatitis G virus as a member of the Flaviviridae is a RNA virus and closely related with HCV. It has been shown that it is an agent of both acute and chronic hepatitis. According to the results of the studies limited number, statistically important HGV-RNA positivity has been found among the multiple transfused patients, iv. drug addicts, haemophilic patients. In healthy blood donor population, the HGV-RNA positivity ranges from 0.5% to 1.7%. Besides the GBV-A one of the GB agents has not the replication state on the liver of the tamarin, it has been shown that GBV-B causes hepatit disease in the tamarins. It has not been provided yet whether or not the GBV-B causes a disease in man. However, GBV-C is a hepatitis agent of human being and there are strong evidence that the disease would end to be chronic. According to the present data, there is a close similarity between the GBV-C and HGV and the mentioned two viruses may be the same virus. Next studies will clearly demonstrate the relationship between the GBV-C and HGV. In the paper, the information related to HGV and GB agents to be the new agents of hepatitis has been reviewed in the light of the literature.

Purpose: Antimicrobial resistance among microorganisms is a global concern. In 2003, a nationwide antibiotic restriction program (NARP) was released in Turkey. In this study we evaluated the effect of NARP on antibiotic consumption, antimicrobial resistance, and cost. Materials and Methods: The data obtained from all of the four university hospitals, and one referral tertiary-care educational state hospital in Ankara. Antimicrobial resistance profiles of 14,233 selected microorganisms all grown in blood cultures and antibiotic consumption from 2001 to 2005 were analyzed retrospectively. Results: A negative correlation was observed between the ceftriaxone consumption and the prevalence of ceftriaxone resistant E.coli and Klebsiella spp. (rho:-0.395, p:0.332 and rho:-0.627, p:0.037, respectively). The decreased usage of carbapenems was correlated with decreased carbapenems-resistant Pseudomonas spp. and Acinetobacter spp (rho:0.155, p:0.712 and rho:0.180, p:0.668, respectively for imipenem). Methicillin resistance rates of S.aureus were decreased from 44% to 41%. After two years of NARP 5,389,155.82 USD saving occurred. Conclusion: NARP is effective in lowering the costs and antibiotic resistance.

WOS: 000341082000199

Chronic infections that caused by hepatitis B and C viruses, are important all of the world as a public health problem. Despite intensive control measurements, the incidences of chronic hepatitis B and C virus infections in our country are estimated as 5-7% and 3%, respectively. There are accumulating data of especially autoimmune mediated extrahepatic manifestations of hepatitis B and C virus infections, such as Diabetes Mellitus (DM), Behçet's Disease (BD), hypo- or hyper-thyroiditis and autoimmune diseases. The aim of this study was the retrospective evaluation of 400 chronic B hepatitis (CBH) and 35 C hepatitis (CCH) patients by means of the presence of extrahepatic manifestations. As a result, the positivity rates of extrahepatic manifestations detected in CBH and CCH patients were as follows respectively; 1.5% and 8.5% for DM, 1.5% and 5.7% for hypothyroiditis, 0.75% and 2.8% for hyperthyroiditis, 2% and 20% for nodular goitre, 0.25% and 5.7% for BD, 1% and 0% for systemic lupus, 1% and 5.7% for Rheumatoid Arthritis (RA), and 22% and 11.4% for iron deficiency anemia. DM, thyroid diseases and RA were the most common extrahepatic manifestations detected in both of the patient groups, while the rates of DM, BD and nodular goitre were found higher in CCH patients than CBH patients (p0.05). As a result, the extrahepatic manifestations should be carefully followed in patients with chronic hepatitis B and C infections, for an early diagnosis and appropriate treatment.

WOS: 000182584000009, PubMed ID: 12803374, A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study. The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were reviewed using a standardized protocol. The diagnosis of TMB was established with the clinical and laboratory findings and/or microbiological confirmation in cerebrospinal fluid (CSF). The non-microbiologically confirmed cases were diagnosed with five diagnostic sub-criteria which CSF findings, radiological findings, extra-neural tuberculosis, epidemiological findings and response to antituberculous therapy. A total of 469 patients were included in this study. Majority of the patients were from Southeast Anatolia (164 patients, 35.0%) and (108 patients, 23.0%) from East Anatolia regions. There was a close contact with a tuberculous patient in 88 of 341 patients (25.8%) and with a tuberculous family member in 53 of 288 patients (18.4%). BCG scar was positive in 161 of 392 patients (41.1%). Tuberculin skin test was done in 233 patients and was found to be negative in 75. Totally 115 patients died (24.5%) of whom 23 died in 24 hour after admittance. The diagnosis was confirmed with clinical findings and CSF culture and/or Ziehl-Nelson staining in 88 patients (18.8%). Besides clinical criteria, there were three or more diagnostic sub-criteria in 252 cases (53.7%), two diagnostic sub-criteria in 99 cases (21.1%), and any diagnostic sub-criteria in 30 patients (6.4%). Since TBM is a very critical disease, early diagnosis and treatment may reduce fatal outcome and morbidity.

In this study, between the period of September 2000 to July 2001, hepatitis A virus (HAV) IgG antibodies and hepatitis E virus (HEV) total (IgG + IgM) antibodies have been searched by using commercially provided enzyme immunoassay kits (Axsym, Abbott USA), in 1046 adults aged between 15-75 years old (mean age: 32.3 years), who were admitted to the outpatient clinics of Internal Medicine and Infectious Diseases Department of Ankara University Medical School, with no acute hepatitis signs and symptoms. As a result, anti-HAV and anti-HEV seropositivities were detected in 914 (87.4%) and 40 (3.8%) subjects, respectively. The seropositivity rate for anti-HAV was 72.7% at the ages of 15-30 years, while anti-HEV was negative in this age group. Anti-HAV and anti-HEV seropositivity rates were found to be the highest between the ages of 30-60 years.

Kaygusuz, Arif/0000-0002-1404-1933; Leblebicioglu, Hakan/0000-0002-6033-8543; VAHABOGLU, Haluk/0000-0001-8217-1767 WOS: A1997XY74700033 PubMed: 9333059 We studied the prevalence and molecular epidemiology of PER-1-type beta-lactamases among Acinetobacter, Klebsiella, and Pseudomonas aeruginosa strains isolated over a 3-month period id eight university hospitals from distinct regions of Turkey, A total of 72, 92, and 367 Acinetobacter, Klebsiella, and P. aeruginosa isolates were studied, respectively, The presence of bla(PER) aas determined by the colony hybridization method and later confirmed by isoelectric focusing, We detected PER-1-type beta-lactamases in 46% (33/72) of Acinetobacter strains and in 11% (40/367) of P. aeruginosa strains but not in klebsiella strains. PER-1-type enzyme producers were highly resistant to ceftazidime and gentamicin, intermediately resistant to amikaein, and susceptible or moderately susceptible to imipenem and meropenem, Among PER-1-type-beta-lactamase-positive isolates, five Acinetobacter isolates and six P, aeruginosa isolates from different hospitals were selected for ribosomal DNA fingerprinting with EcoRI and SalI, The EcoRI-digested DNAs were later hybridized with a digoxigenin-labelled PER-1 probe, The ribotypes and the lengths of bla(PER)-carrying fragments were identical in four Acinetobacter strains. A single isolate (Ac3) harbored a PER gene on a different fragment (approximately 4.2 kbp) than the others (approximately 3.4 kbp) and showed a clearly distinguishable ribotype, Ribotypes of P. aeruginosa strains obtained with EcoRI showed three patterns. Similarly, in Pseudomonas strains two different EcoRI fragments harbored bla(PER) (approximately 4.2 kbp in five isolates and 3.4 kbp in one isolate), PER-1-type beta-lactamases appear to be restricted to Turkey, However, their clonal diversity and high prevalence indicate a high spreading potential.

Kırım-Kongo Kanamalı Ateşi (KKKA), viral hemorajik ateş sendromları arasında yer alan zoonoz karakterli bir enfeksiyondur. Hayvanlarda insanlara nazaran daha yaygın olmakla birlikte sporadik vakalar veya salgınlar halinde insanlarda da görülebilmektedir. Akut olarak ortaya çıkan; yaygın vücut ağrısı, ateş, bulantı, kusma, karın ağrısı, ishal, ekimoz ve kanama semptomları, AST, ALT ve LDH yüksekliği, trombositopeni ve lökopeni laboratuvar bulguları ile seyreder. Tanı virüsün üretilmesi, virüse karşı oluşan antikorların saptanması ya da moleküler yöntemlerle konulur. Destek tedavisinin yanında antiviral bir ajan olan ribavirin tedavide kullanılır. Sunulan yazıda KKKA ile izlenen bir olgu sunulmuştur.