HBsAg, Anti-HBs and Anti-HCV Seropositivity Rates among Pregnant Women Attending a University Hospital in Zonguldak

Objective: To explore the HBV and HCV seroprevalence rates among pregnant women attending the Obstetric Outpatient Unit at the Medical Faculty of Zonguldak Bulent Ecevit University and to provide contributory data to the already existing data from the other geographical regions of Turkey. Materials and Methods: HBsAg, anti-HBs and anti-HCV seropositivity rates were retrospectively investigated among a total of 1084 pregnant women attending the Obstetric Outpatient Unit at the Medical Faculty of Zonguldak Bulent Ecevit University between January 2012 and January 2014 Serum assays were performed using a chemiluminescence immunoassay method according the manufacturer's instructions (Cobas e 411 Analyzer, Roche Diagnostics, Mannheim, Germany). Statistical analyses of the study data were performed using SPSS 18.0 software package (SPSS Inc., Chicago IL, USA). Results: The mean age of the 1084 pregnant participants was 29.12 +/- 5.48 years (min: 17, max: 46 y) and the average gestational age was 10.7 +/- 4.64 weeks. HBsAg, anti-HBs, and anti-HCV detection rates were 4% (n= 43), 7.3% (n= 79), and 0.6% (n= 7), respectively. With regard to age groups, HBsAg was positive in 3.1%, 3.7%, 4.4%, and 5.9% of the women who were below 20 years of age, between 21 and 30 years of age, between 31 and 40 years of age, and over 40 years of age, respectively. Conclusion: While similar rates of seroprevalence for HBsAg and anti-HCV were found as compared to the previous reports from Turkey, anti-HBs positivity rates were lower than that in most of the previous reports

Plasmodium falciparum Malaria of Foreign-Origin in Kocaeli Province: Assessment of 16 Cases

WOS: 000389267200008Objective: This paper intends to underline that malaria should be borne in mind in the differential diagnosis of patients with history of visiting endemic regions and of malaria prophylaxis for those intending to travel to these regions. Methods: 16 cases of P. falciparum malaria that were followed in the clinic between 2009 and 2015 were included in our study. Diagnosis was based on plasmodia seen under light microscope in thick and thin smears prepared from peripheral blood samples obtained from febrile patients and stained with Giemsa method. Results: Out of 16 patients, one was female and 15 were males. 14 of these patients, whose average age was 32 years, did not receive prophylaxis. Complaints of all patients were fever with chills, rigor, weakness, and anorexia; other accompanying complaints were headache, nausea, abdominal pain, diarrhea, cough and sore throat. Body temperatures over 38 degrees C were detected in all patients. 11 patients were treated with artemether-lumefantrin and 5 patients treated with combination of quinine and doxycycline. Ertapenem was added in the treatment of a patient due to Serratia marcescens isolation in his blood culture obtained during his febrile period. Acute hepatitis A as a co-infection was detected in a patient and he was followed with symptomatic treatment. Somnolence, bleeding, bilateral pleural effusion and pulmonary infiltrates were observed in two patients diagnosed as severe malaria. Conclusions: Malaria chemoprophylaxis for the people intending to travel endemic regions is crucial

Mediastinal lymphadenopathy may predict 30-day mortality in patients with COVID-19

Purpose: There is scarce data on the impact of the presence of mediastinal lymphadenopathy on the prognosis of coronavirus-disease 2019 (COVID-19). We aimed to investigate whether its presence is associated with increased risk for 30-day mortality in a large group of patients with COVID-19

Protease Inhibitors Drug Resistance Mutations in Turkish Patients with Chronic Hepatitis C

WOS: 000388326300001PubMed: 27401586Background: 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 DiseasesThis study was funded by Department of Scientific Research Project of Kocaeli University and Turkish Society of Clinic Microbiology and Infectious Diseases

Liver histology of patients with hepatitis C virus infection and normal alanine aminotransferase levels Alanin aminotransferaz düzeyi normal kronik hepatit C infeksiyonlu hastaların karaciǧer histolojileri

Objective: In this study, our objective is to evaluate histological changes in livers of hepatitis C virus (HCV)-infected patients with normal alanine aminotransferase (ALT) levels. Methods: 72 patients over 16 years old, with chronic hepatitis C (CHC) and normal ALT levels were evaluated in this multicenter retrospective study. Persistently normal ALT level was defined as 2 or 3 normal ALT levels at intervals of at least 1 month during 6 months. Demographic data, year of diagnosis, at least 2 ALT values within 6 months, hepatitis markers, results of HCV RNA and the liver biopsy were all evaluated. Serological markers have been tested with different kits. HCV RNA has been studied by RT-PCR with dynamic range and sensitivity of different kits. All biopsies were evaluated again by the same pathologist. Results: The mean age was 44±13 years and 61.1% were female. HCV RNA levels were between 1.53x102-1.13x108 IU/ml. The mean ALT levels were 30.3±9.6 IU/lt. The mean grade of necroinflammation was 4.67±1.96 and mean staging of fibrosis was 1.03±1.13. The ratios of minimal, mild and moderate activity in the liver biopsies were 48.6%, 45.3% and, 2.8%, respectively. Rate of portal-periportal fibrosis, bridging fibrosis and incomplete cirrhosis were 51.4%, 6.9%, and 1.4%, respectively. Conclusions: ALT level is a poor indicator of liver disease activity in patients with CHC. Patients with indication for treatment should be evaluated for liver biopsy

Protease Inhibitors Drug Resistance Mutations in Turkish Patients with Chronic Hepatitis C

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-naïve 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