Prevalence of allergic diseases in Izmir Province, Turkey.

BACKGROUND: The aim of the present study is to determine the prevalence of allergic diseases and related risk factors in Izmir, Turkey, and to assess the positive immunoglobulin E (IgE) levels against common allergens. METHODS: The questionnaires were completed via face-to-face interview with a total of 2937 individuals. Specific IgE was studied in the serum samples by enzyme-linked immunosorbent assay (ELISA). This cross-sectional population-based study comprised adolescents over the age of 15 years and adults of Izmir province. RESULTS: In Izmir, the prevalence of self-reported allergy was 35.5%. Allergy was statistically significantly more common in females, university graduates, in those with high income, with family history for allergy, aged 40-49 years, those living in a flat, keeping pet(s), and in those using central heating. The prevalence of atopy according to the serum IgE levels (Class 3 with any of 3 IgEs) was found 1.6%. CONCLUSION: In conclusion, the prevalence of atopy was found lower in Izmir as compared to the results of other studies.

Seroprevalence of varicella-zoster virus in the prevaccine era: a population-based study in Izmir, Turkey.

PURPOSE: To determine the population-based seroprevalence of varicella zoster virus (VZV) and related risk factors in Izmir. MATERIALS AND METHODS: A population-based household survey was conducted. A representative sample of the population older than 15 years of age was selected using multistage random sampling. A total of 2136 healthy persons participated in this cross-sectional study. The participants completed a questionnaire designed to collect data related to socio-demographic characteristics and risk factors. Blood samples were collected, and VZV-specific IgG was measured using an ELISA. RESULTS: In total, 94.3% of individuals were seropositive for VZV. The difference between VZV seroprevalence in urban and rural populations was significant (OR: 2.6 (95% CI, 1.7-3.8)). No statistically significant differences in seropositivity were observed with respect to other sociodemographic characteristics. CONCLUSION: A large proportion of the participants were found to be immune to VZV.

Virological responses of pegylated interferon alpha-2a treatment in hemodialysis patients infected with hepatitis C.

BACKGROUND: Hepatitis C is the most frequently encountered hepatic disease in dialysis patients. Data related to pegylated interferon alfa-2a (Peg-IFN-α-2a) use in hemodialysis patients with hepatitis C virus (HCV) are limited. The aim of this study was to evaluate the efficacy of Peg-IFN-α-2a among these patients. METHODS: Forty-one IFN-naive hemodialysis patients infected by HCV were assessed. All patients had positive anti-HCV antibody and positive HCV-RNA. Peg-IFN-α-2a 135 mcg/week was given for 48 weeks. Biochemical and virological responses were evaluated at treatment weeks 12, 24, 48, and 72. RESULTS: Thirty-eight of the 41 patients who completed the treatment enrolled in the study. Mean age of the 38 patients was 38.1 (range 23-65) years, and the study group was predominantly male (65.8 %). There was no statistically significant difference in mean age, gender, mean duration of hemodialysis, HCV infection, patient numbers with normal alanine aminotransferase (ALT) values and mean ALT, platelet, and HCV-RNA values between patients who achieved sustained virological response (SVR) and those who did not. Only the Knodell histology activity index correlated with SVR (P = 0.048). Biochemical and virological response rates at the 12th week (early response) were 94.7 % and 60.5 %, respectively. The 34 (89.5 %) patients achieved biochemical response at the end of therapy (48th week); 24 (63.2 %) remained HCV-RNA negative. At the 72nd week, biochemical and virological response rates were 84.2 % and 50 %, respectively. DISCUSSION: According to results of this study, patients achieved good sustained viral and biochemical response rates with Peg-IFN-α-2a treatment. Histology activity index may be a predictor for SVR; but large randomized controlled trials are needed. Weekly 135 mcg dose of Peg-IFN-α-2a for 48 weeks is an effective treatment in HCV-infected hemodialysis patients.

Case report on the development of a brucellosis-related epidural abscess.

Brucellosis is an endemic disease in developing countries. The most commonly observed complications include bone-joint involvement, particularly sacroiliitis and spondylitis. Epidural abscesses caused by brucellosis are a rare complication. We describe the case of a 33-year-old man presenting with high fever, back pain, and weakness. At physical examination, the patient was found to be paraparetic. At thoracic MRI, spondylodiscitis and epidural abscess with significant cord compression were observed. In laboratory examinations, Rose Bengal and tube agglutination tests were positive in patient's serum for brucellosis, and specific antibiotherapy was initiated. Total laminectomy was performed and the abscess was aspirated. The biopsy sample was consistent with chronic non-specific inflammation in acute abscess. No growth was detected in the abscess or blood cultures. Following surgery, medical treatment was initiated and, at six weeks' follow-up, clinical and MRI findings indicated that he had recovered. The diagnosis of spinal epidural abscess due to brucellosis should be considered among differential diagnoses in endemic regions. Early diagnosis and specific treatment are important to prevent later complications. 

Central nervous system aspergillosis in an immunocompetent patient.

Aspergillus sp. is a fungus that is very common in nature and may cause invasive disease with high mortality, especially in immunosuppressed patients. Here we present a case of central nervous system (CNS) aspergillosis in a previously healthy immunocompetent patient. A 23-year-old female was admitted to hospital with the complaints of headache, blurred vision, and double vision. In her cranial magnetic resonance imaging, abscess and paranchymal edema were observed in the left frontal lobe, and biopsy was performed with endoscopic nasal operation. The pathology result was consistent with aspergillus infection. It should be remembered that although CNS aspergillosis generally occurs in immunosuppressed patients, it may also rarely be diagnosed in immunocompetent individuals.

Evaluation of vaccination results in high-risk patients included in hepatitis B vaccination program.

Hepatitis B infection is one of the infectious diseases quite common in Turkey and around the world. Hepatitis B virus infection is a significant health problem which may cause chronic hepatitis, cirrhosis and hepatocellular carcinoma. With the introduction of Hepatitis B vaccine, a significant progress has been made in the prevention of HBV infections. The purpose of the study was to evaluate the characteristics of the individuals included in the risk group who admitted to our vaccination clinic, as well as their immune responses following the vaccination. Among the patients admitted to the vaccination clinic of our hospital between January 2003-December 2005 and that were included in the risk group (patients who have family members with chronic Hepatitis B infection, healthcare workers, hemodialysis patients etc.), those who were included in the vaccination program by examining the results of HBs Ag, anti-HBc and anti-HBs were evaluated in terms of their characteristics (age, gender, smoking etc.) and results of Anti-HBs score. A total of 958 people were included in the vaccination program. Upon evaluation in terms of risk factors, presence of patients with chronic hepatitis B infection in the family was found to be 80.6% (772/958), being healthcare worker was 9.2% (88/958), HCV positivity and chronic liver disease was 3.0% (29/958), being a hemodialysis patient was 2.8% (27/958), and being an oncology patient was 2.1% (20/958). Post-vaccination immune response could be evaluated in 69.8% (669/958) of patients and no responsiveness to vaccine was detected only in 8.1% (54/669) of them. Of the non-responders, 64.8% (35/54) were hemodialysis and oncology patients. Anti-HBs positivity rate following hepatitis B vaccination program was found compatible with the results of previous studies. With this vaccine of considerably high effectiveness, immunization of the entire community including primarily the risk groups should be targeted.

The effectiveness of nucleoside analogues in chronic hepatitis B patients unresponsive to interferon therapy: our clinical trials for one year.

BACKGROUND AND AIMS: We aimed to evaluate the effectiveness of nucleoside analogues such as Lamivudine, Adefovir,Entacavir, and Tenofovir in patients with chronic hepatitis B who failed to respond to interferon therapy and relapsed. MATERIALS AND METHODS: We followed a total of 73 patients with hepatitis B in the hepatitis outpatient clinic in our hospital. The patients subsequently received nucleoside analogues therapy and their treatment data were evaluated retrospectively. The biochemical and virological response rates were evaluated at 3 and 12 months, and we compared these results with the results of treatment-naive patients. RESULTS: There were 29 (39.7%) HbeAg-positive and 44 (60.3%) HbeAg-negative patients, and their mean age was 35.8 (±13.4) years. Of these patients, 33, 18, 13 and 9 received Entacavir, Tenofovir, Lamivudine, and Adefovir treatment,respectively. In HbeAg-negative patients, at 3 months the biochemical and virological response (early response) rates were observed to be 91% and 98%), and at 12 months the two rates were 93% and 73%, respectively. In HbeAg-positive patients, the biochemical and virological response rates at 3 months were 83% and 97%, and the rates at 12 months were 90% and 48%, respectively. CONCLUSIONS: In CHB therapy with treatment-resistent patients, nucleoside analogues may be preferable. There are disadvantages to nucleoside analogues, such as a risk of developing resistance during therapy, reduced HBeAg seroconversion compared to interferons, and the therapy's ambiguous duration. In our study, in HbeAg-negative patients who received nucleoside analogues, a lower biochemical response rate was detected in patients with 1 year of Lamivudine therapy compared to other therapies. For HbeAg-positive patients, the virological response rate was higher in 1 year of Tenofovir therapy than with other therapies.