Treatment of brucellosis in a young child with trimethoprim/sulfamethoxazole anaphylaxis

SummaryBrucellosis is a common zoonotic disease throughout the world. Brucella spp. transmit to humans through contact with fluids of infected animals, especially sheep, cattle, and goats. It is also transmitted by ingestion of fluid-derived products of infected animals, such as unpasteurized milk and cheese. Brucella spp. changes pH level of intracellular environment, so the first treatment approach is to administer antibiotics that have activity in acidic conditions. Anti-brucellosis treatment regimens include doxycycline for children older than eight years old and rifampicin and trimethoprim/sulfamethoxazole (TMP-SMX) combination therapy for children under eight years old, which may be able to act intracellularly under acidic conditions. A TMP-SMX allergy causing anaphylaxis has been reported previously. No alternative anti-brucellosis treatments have been reported in the literature for patients under eight years old with a TMP-SMX allergy. Here, we report a case of a child with brucellosis and a TMP-SMX allergy who was under eight years old at the time of diagnosis and was successfully treated with rifampicin, ciprofloxacin, and gentamicin

An Exploratory study into the manufacturing strategies in the Turkish machine manufacturing industry

This study has been accomplished to determine the current status of the machine manufacturing industry in Turkey to evaluate different manufacturing strategies employed by the companies operating in that industry. The study is based on data from a joint project of Machine Manufacturer's Industrialists' and Businessmen's Association (TÜSİAD) and Sabancı University. The data is obtained from a survey targeting all the members of MIB. There are three basic components comprising a manufacturing strategy. There are competitive priorities, that enable the differentiation of the firm from its competitors; manufacturing objectives consistent with the competitive priorities; and action plans for supporting the manufacturing objectives and thus the competitve priorities at the operational level. The companies participatin in the survey have evaluated 15 competitive priorities, 16 manufacturing objecives and 35 action plans on a 1-5 Likert scale. Competitive priorities and manufacturing objectives have been evaluated with respect to their relative importance for the company for the next two years. Action plans have been evaluated through two questions: one asking for the assesment of the companies concerning the emphasis they have placed on the action plans within the past two years and the other asking about the ranking of the most important 7 action plans for the next two years. The variables representing these components of the manufacturing strategy are grouped using factor analysis for each component. Competitive priorities are grouped into 4 factors, manufacturing objectives into 5 factors and action plans into 6 factors. For the first two components, companies are grouped into clusters according to their responses to the same questions. Differences between company clusters within a component are explored using multivariate data analysis techniques. Mean scores of the questions in a particular component are used to determine a statistically significant difference between company groups. Different company groups spplying different manufacturing strategies have been defined. To asses whether companies'selection of manufacturing objectives are consistent with their competitive priorities, clusters achieved by analyzing competitve priorities are fixed and manufacturing objectives are used to determine the differences between these clusters. Results indicate to a certain level of consistency