Assessment of adult measles cases followed at a military hospital during a measles epidemic: does forced migration increase infectious diseases such as measles that may affect public health?

In this study, our aim was to review the data of adult patients followed due to a measles diagnosis and the reasons for the measles cases, which has shown an increase because of the events of recent forced migration in our country. Adult patients who referred to the outpatient clinic of infectious diseases and clinical microbiology of our hospital between January and April 2013 and who were diagnosed with measles were retrospectively studied. Patients were diagnosed with measles in accordance with the presence of symptoms described by the World Health Organization (WHO) and in combination with the determination of measles IgM positivity by Enzyme Linked Immunosorbent Assay (ELISA). 16 patients did not have any information about their measles vaccination background. Only one patient reported that he received a single dose vaccination one year previously. Measles IgM positivity by ELISA was determined for all patients. When laboratory findings were assessed we found that leukopenia and thrombocytopenia developed respectively, in 4 and 4 patients. In addition, hepatitis developed in 4 patients, otitis media in 2 patients, pneumonia in 3 patients and a sinusitis complication in 2 patients. Measles is a very contagious disease with a high contagion rate but can be kept under control by maintaining vaccination rates high in the community. However, we must not forget that vaccinations may only provide 95% protection. Measles may become epidemic when sensitive individuals are present in the community at a certain ratio. Therefore, immunity rates must be accelerated in young adults in the community by vaccination campaigns (catch-up) while existing rates of childhood vaccinations are maintained. Especially when the population shows a tendency to increase, due to reasons such as migration or war, it is essential to comply with the mentioned precautions. [Med-Science 2017; 6(2.000): 260-3

Zika virus infections in pregnancy: epidemics and case management

Zika virus is an RNA virus belonging to the Flaviviridae family, and is primarily transmitted by Aedes mosquitoes. Only a small number of cases had been described until 2007 when the first major Zika virus outbreak occurred on Yap Island, Micronesia. Approximately 80% of people infected with Zika virus do not exhibit any symptoms. Symptomatic infections are generally moderate and characterized by acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis. The virus has recently attracted a broad interest due to the emerging cases of microcephaly that are possibly associated with mothers infected by the Zika virus during pregnancy, and the regional increases in the incidence of Guillain-Barre syndrome during the epidemic periods. Although the relationship between Zika virus infection and these abnormalities is not obviously understood yet, Zika virus testing is recommended for infants with microcephaly or intracranial calcifications whose mothers were potentially infected with the Zika virus during pregnancy. Every day, new reports are being published about the outbreaks associated with this virus; nevertheless, no new cases of this virus have been reported in Turkey. Despite this, we cannot currently exclude the possibility of the encounter with the virus because of the presence of Aedes mosquitoes, which are responsible for the spread of the virus, are prevalent in Turkey, and an increasing number of travel-related cases are being reported from different countries. In the light of the current knowledge on this virus, this review aims to discuss the course of Zika virus infections in detail, especially congenital infection, and presenting current information about the case management and preventive measures. [Cukurova Med J 2016; 41(1.000): 143-151

Management of Brucella endocarditis: results of the Gulhane study

Brucella endocarditis (BE) is a rare but life-threatening complication of human brucellosis. The aim of this study was to investigate the course of BE along with the therapeutic interrelations. A total of 53 patients with BE hospitalised in 19 health institutions between 2006 and 2011 were included in the Gulhane study. Diagnosis of brucellosis was established by either isolation of Brucella sp. or the presence of antibodies, and the definition of endocarditis was made according to Duke's criteria. There were four treatment groups: ceftriaxone combined with oral antibiotics (Group 1); aminoglycosides combined with oral antibiotics (Group 2); oral antibiotic combinations (Group 3); and aminoglycoside plus ceftriaxone combined with an oral antibiotic (Group 4). Involvement rates of the aortic, mitral and tricuspid valves were 49.1%, 43.4% and 5.7%, respectively. Thirty-two patients (60.4%) had an underlying cardiac valvular problem, including previous prosthetic valve replacement (n = 18). Medical treatment was provided to 32 patients (60.4%), whilst concordant medical and surgical approaches were provided to 21 patients (39.6%). Mortality in Group 1 was 15% (3/20), whilst in Group 2 it was 5.3% (1/19). In Group 3, 25.0% (3/12) of the cases died, whereas none of the cases in Group 4 died. In conclusion, mortality increased 47-fold with pericardial effusion and 25-fold due to congestive heart failure that developed after BE. Although mortality was lower in the aminoglycoside-containing arm (Groups 2 and 4), statistical analysis could not be performed owing to the small number of patients. (C) 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved

Community-acquired pneumonia in patients with chronic obstructive pulmonary disease requiring admission to the intensive care unit: Risk factors for mortality

Conclusion: Noninvasive ventilation, hypertension, systemic corticosteroid treatment, and shorter ICU stay are associated with reduced mortality, whereas bilateral infiltration and longer duration of invasive mechanical ventilation are associated with increased risk of mortality in patients with COPD and CAP requiring ICU admission. (C) 2013 Elsevier Inc. All rights reserved