Anthrax: The Evaluation of 27 Cases

Twenty seven patients with anthrax applying to Infectious Diseases Department of A¤r› Military Hospital and Internal Medicine Department of State Hospital between 1998-1999 were evaluated prospectively. Twelve of them were males while females made up 15 cases. The mean age was 31.5 (11-59). Excluding one case occupied in the army, all patients were farmers having close relationship with the infected animals. In 5 (18.5%) cases, the lesions were presented as malignant edema distributed to face in one patient, observed at the upper extremity on the other one, and the remaining three cases presented lower extremity findings. In 22 (81.5%) patients, the lesions were in malign pustular form and all were on upper extremities except one lower extremity presentation. The diagnosis was confirmed by bacterial isolation in 13 (48.2%) cases, by direct examination from the lesion material in 8 (29.6%) patients and in remaining 6 (22.2%) cases the diagnosis was established by the lesion presentation. The isolated Bacillus anthracis strains were susceptible to penicillin, eritromycin, cephoxitin, cephotaxim, cephadroxil and imipenem. Three strains were chloramphenicol resistant and two isolates were tetracycline resistant. For the treatment, penicillin was given to 23 patients (92.6%) while 2 cases (7.4%) were administered sulbactam-ampicilline. With emerging respiratory problems of a face restricted lesioned case, that patient was transferred to a more sophisticated center for further investigation and treatment

Lenfomalı hastalarda kemoterapinin yaşam kalitesine etkisi

Amaç: Kemoterapideki gelişmeler lenfomalı hastaların yaşam sürelerini önemli derecede uzatmıştır ve önemli sayıda hasta tedavi edilebilmektedir. Kemoterapi alan hastaların yaşam kalitelerinin değerlendirilmesi giderek daha fazla ilgi çeken bir konu olmuştur. Çalışmamızın amacı, lenfomalı hastalarda kemoterapinin yaşam kalitesine etkilerini değerlendirmektir. Gereç ve Yöntem: Haziran 2000-Ocak 2001 tarihleri arasında Çukurova Üniversitesi Tıp Fakültesi Onkoloji Bilim Dalı’nda Evre I lenfoma tanısı alan 49 hastaya kemoterapi öncesinde ve 2. kür sonrasında yaşam kalitesi anketi (EORTC QLQ C-30) uygulandı. Bulgular: Fiziksel aktivitelerin bazılarında, duygusal fonksiyonlar, ağrı ve halsizlik, dispne, iştahsızlık, uyku ve global yaşam kalitesinde tedavi sırasında anlamlı iyileşme saptandı. Kemoterapi, yaş, cinsiyet ve lenfoma tipi göz önüne alındığında, global yaşam kalitesini etkileyen en önemli faktör hastanın eğitim durumuydu. Sonuç: Çalışmamızın sonuçları, kemoterapi öncesindeki yaşam kalitesine kıyasla tedavi sonrası yaşam kalitesinde iyileşme olması nedeniyle, kemoterapi alma konusunda isteksiz olan hastalara yardımcı olmada kullanılabilir.Aim: Advances in chemotherapy have significantly prolonged survival of patients with lymphoma and a significant percentage of patients may be cured. The assessment of the quality of life in patients undergoing chemotherapy is of growing interest. The aim of this study is to assess the effect of chemotherapy on quality of life in patients with lymphoma. Methods: All patients (n=49) diagnosed with stage I lymphoma in the Cukurova University Oncology Department from June 2000 to January 2001 received a quality-of-life questionnaire (EORTC QLQ C-30) before chemotherapy and after the second cycle of chemotherapy. Results: Significant improvement during treatment was found in some of the physical activities, emotional functioning, relieve from pain and fatigue, dyspnea, anorexia, sleep, and global quality of life. When chemotherapy, age, gender and lymphoma type were taken into account, the most important factor influencing the global quality of life was educational status. Conclusion: The results may be used to reassure the patients who are reluctant to go through chemotherapy that they are likely to experience an improved quality of life compared to their situation before the treatment

Fever of Unknown Origin: Report of 82 Cases

Fever of unknown origin (FUO), is defined as a temperature higher than 38.3ºC that lasts three weeks or longer and remains undiagnosed after one-week of investigation. A total of 82 patients who were hospitalized between 1980-1999 with the diagnosis of FUO were included in this retrospective study. The mean age of the patients was 39 years (range 17-87 years). Thirty eight (46%) patients were females and 44 (54%) males. Infections were found in 49 (59%) patients, neoplasms in 9 (10.9%) patients, collagen vascular diseases in 6 (7%) patients, and miscellaneous diseases in 2 (2.4%) patients. Sixteen (19.5%) of the FUO cases remained undiagnosed. Brucellosis (11 cases, 13%) and tuberculosis (10 cases, 12%) were the most common two causes of infections. Lymphomas were the most common causes of neoplasms. Clinical recovery occured in 47 (57.3%) patients, clinical state remained unchanged in 30 (36.5%) patients and death was observed in 5 (6.2%) patients. In conclusion, the most common cause of FUO is infections in our series. The cases of FUO must be followed up with a multidisciplinary approach for correct diagnosis with in the shortest time and at low cost

Malaria: Investigation of 115 Cases

One hundred and fifteen cases were investigated retrospectively in our clinics during the period of November 1990 and December 1996. The importance of the disease is aimed to be emphasized with this study. Whole cases were diagnosed by examining the blood smears taken in febrile periods of the illness. Signs and symptoms were recorded during the progress and febrile attacks of the disease. Headache (82%) and the increase in erythrocyte sedimentation rate (75%) were determined as the most frequent signs and symptoms. There was a background of going to endemic areas in 97.4% of the whole cases. Among the seasons in summer and autumn, and among the months in August and September, malaria cases were mostly seen. And also an increasing trend about the disease is determined in recent years. Splenic complication (hematoma and rupture) was progressed in 2 cases. Primaquine plus chloroquine therapy was applied and got good results in whole cases

Retrospective Evaluation of Cases with the Diagnosis of Acute Bacterial Meningitis Over a 33-Year Period

Introduction: In this study, we retrospectively evaluated the epidemiological and clinical features, risk factors, laboratory findings, and relations between the therapy duration and mortality rates of cases followed with the diagnosis of acute bacterial meningitis. Materials and Methods: We reviewed data of patients with acute bacterial meningitis admitted to our hospital over a period of 33 years (1977-2010). Clinical, laboratory and demographic data were collected from the official records retrospectively. The data were analyzed through SPSS (Statistical Package for the Social Sciences), version 15.0. Results: One hundred and two of (97.2%) 110 cases were male and 8 (7.3%) were female, and the average age was 22.5 ± 5.93 (minimum 14, maximum 59). Recurrent meningitis had been seen in 10 (9.1%) cases. First admission to the hospital was 3.5 ± 4.1 days after the onset of complaints. While the most important physical examination findings were fever (91.8%), neck stiffness (95.5%) and Kernig’s and Brudzinski signs (84.5%), the most common neurologic sign was confusion (64.5%). In the microbiological analysis of the cerebrospinal fluid, pathogens were determined in 40% of all cases with Gram stain. While 75% of those showed gram-negative morphology, 25% showed gram-positive coccus morphology. Cultivation was detected in 27.3% of cerebrospinal fluid cultures. Conclusion: For acute bacterial meningitis diagnosis, Gram stain examination of cerebrospinal fluid is very important as well as clinical findings and physical examination

Adult Measles: Retrospective Evaluation of 284 Cases

284 adult measles cases hospitalized in Gülhane Military Medical Academy Haydarpafla Teaching Hospital Department of Infectious Diseases between April 1991 and April 1998 were analyzed for the clinical and laboratory findings retrospectively. These cases have also covered two small epidemics occured in different places and at different times with 43 and 30 cases. The diagnosis was established on standard clinical findings in all cases and in 139 of 150 cases (92.7%) the diagnosis was confirmed serologically. All patients had fever and maculopapular rash. Cough (76%), conjunctivitis (63%), koplik spots (38%), cervical lymphadenopaty (36%), pathologic pulmonary auscultation (33%) and hoarseness (19%) were the other clinical findings. Otitis and pneumonia were the most common complications (4.2% and 3.9% respectively). Hepatomegaly in 6 cases (2.1%), bacterial superinfection in 2 cases (0.7%) and acute encephalitis in one case (0.3%) had developed. In 138 cases (48.6%) including 6 cases with hepatomegaly, hepatic dysfunction was found. It must be kept in mind that adolescent and adults, unimmunized or having insufficient antibody levels from rural society can be easily infected as a result of exposure to the virus, and especially in communities such as barracks and schools epidemics can rapidly occur