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

Diagnosis of Toxoplasmosis in Pregnancy

Toxoplasmosis is a common worldwide parasitic infection that caused by Toxoplasma gondii. The clinical progress is generally asymptomatic in patient with normal immune system, on the other hand severe clinical presentations seen in patients with immune deficiency or pregnancy. Congenital toxoplasmosis can emerge due to contamination during pregnancy but 6-8 weeks prior to pregnancy are also at risk. Infants with toxoplasmosis have some clinical semptoms such as chorioretinitis, epilepsia, hypotonia, psychomotor disorders, mental retardation, encephalitis, microcephaly, hydrocephalus, intracranial calcifications, hepatosplenomegaly. Early diagnosis during pregnancy and subsequent treatment. may prevent malformations. Toxoplasmosis diagnosis during pregnancy is mostly based on IgM and IgG antibody screening tests. While IgM indicates the acute infection, it disappears in early period and can be detected in low consantrations through long ages. Therefore IgG avidity test takes more place in the diagnosis of toxoplasmosis during pregnancy. High avidity levels indicate acquired infection prior than 16 weeks, so that it is recommended to perform the test in the first trimester. Low IgG avidity level may indicate a newly onset infection. Amniotic fluid T.gondii PCR, anomaly screening with ultrasonography, Toxoplasma gondii cyst dying with Wright-Giemsa dye in plasental and fetal tissue are the other diagnostic tools can be performed during pregnancy. Avidity test methods during the 16 weeks of pregnancy reduce repeating serum analysis, amniotic fluid PCR reguirement, unnecessary antibiotic treatments and noncompulsory abortus. [TAF Prev Med Bull 2012; 11(6.000): 767-772

May Ursodeoxycholic Acid Significantly Improve Liver Function Tests among Patients with Hepatitis C?

In their relevant study, the authors demonstrated that ursodeoxycholic acid therapy significantly improvedliver function tests either when given alone or combined with silymarin. But, silymarin itself failed to improve liver function tests. We thank to the authors for their valuable contribution. However, there are some concerns that need to be explained in a detailed manner for a better understanding of the results presented in the manuscript. [Med-Science 2015; 4(4.000): 2986-8

The Value of Naproxen Test as a Diagnostic Method to Differentiate Cause of Fever

Objective: Fever of whatever etiology still remains a perplexing problem to both clinicians and investigators. Increasingly, its role in connective tissue diseases, malignancies and other inflammatory disorders is slowly supplanting the exclusivity of the symptom to just infectious conditions. This study aims to determine the sensitivity of the naproxen test and the diagnostic value in patients with a prolonged febrile illness. Methods: We evaluated twenty patients had been administered the naproxen test. Fever lysis after or within the time frame of drug administration was interpreted as a infectious or an infectious condition. Results: Infectious diseases etiology was detected at 15 patients. 12 and 3 of them responded to naproxen test at the first and second days respectively. Two of non-infectious etiology patients remained unanswered. Conclusion: This study clearly showed that the naproxen test cannot be relied upon to guide diagnostic decision making in patients with fever unknown origin. [TAF Prev Med Bull 2012; 11(6.000): 779-782

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

IDENTIFICATION OF CANDIDA SPECIES ISOLATED FROM CLINICAL SAMPLES AND INVESTIGATING ANTIFUNGAL SUSCEPTIBILITY IN TURKEY

WOS: 000344634100002Objectives: The purpose of this study is identify typology of candida species from patients' samples, and determine their in-vitro antifungal susceptibility. Materials and methods: In this study, Candida species isolated from patients who applied to our laboratory between 20092010 were included in order to identify the types of Candida and to carry out their antifungal sensitivity. The Candida species were typed using germ tube test, corn meal Tween-80 and BBL CHROMagar medium, and API ID32C yeast identification system. Antifungal drugs' susceptibility of Candida species for amphotericin B, fluconazole, itraconazole, and voriconazole were conducted through microdilution system. Results: Of the 97 Candida species, 58.76% were identified as Candida albicans, other identified types were as follows: C. parapsilosis (13.4%), C. glabrata (11.3%), C. tropicalis (5.15%) respectively. Antifungal drugs sensitivity tests results revealed 1.03% resistance to fluconazole and 4.12% to itracanazole, whereas no resistance was found to amphotericin B and voriconazole. Conclusion: Target population for Candida has gradually been expanding. Therefore, it may be suggested that determining the type of pathogen and running its susceptibility tests are significant factors that will enhance the success of the treatment before empirical treatment against Candida infections is initiated

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