Efficacy of accelerated hepatitis B vaccination program in patients being actively treated for hematologic malignancies.

BACKGROUND: The goal of this study was to conduct an accelerated vaccination program and to determine its efficacy in patients susceptible to hepatitis B virus (HBV) receiving chemotherapy because of their hematologic malignancies. METHODS: Over a one-year period, a total of 327 patients who were diagnosed as having a hematologic malignancy were serologically analyzed in terms of HBV infection. Of those found to be susceptible to HBV infection, a total of 42 patients consisting of 16 females and 26 males were enrolled in the accelerated vaccination program. All the patients were administered a 20-microg yeast-derived recombinant hepatitis B vaccine on days 0, 14, and 28. Anti-HBs titers above 10IU/l at 1 and 3 months after the final dose were accepted as protective. RESULTS: A total of 146 (44.6%) patients were susceptible to HBV, while 13 (4.0%) were carriers, 28 (8.6%) were vaccinated, and 113 (34.5%) had had a previous HBV infection. A total of 42 patients (16 females and 26 males, mean age 34.5+/-10.9 years) were enrolled in the vaccination program. Overall, 23.8% (10/42) of the patients in the program had developed anti-HBs at one month after the last vaccination. CONCLUSIONS: Poor results obtained by different vaccination programs suggest the need for alternative strategies to prevent the disease.

Attitudes towards HIV/AIDS and other sexually transmitted diseases in secondary school students in Izmir, Turkey: changes in time.

The aim of this study was to evaluate the changes in the sexual attitudes of young people in a period of 7 years (1997-2004). The participants in the first and the second surveys were 633 and 654 grade 10 students from six high schools located in the central district of Izmir, Turkey, chosen randomly according to the stratified sampling method. The rate of having had sexual experience was 11.3% and 22.8% in the first and second surveys, respectively (chi(2) P < 0.001).

Sexual knowledge, attitudes, and risk behaviors of students in Turkey.

This survey produced baseline information about student knowledge of sexually transmitted diseases (STDs), their sexual attitudes, and their behavior to help establish control and education programs. The study was conducted at Ege University, Izmir, Turkey, during the 1999-2000 academic year. A total of 2,217 first- and fourth-year students determined by stratified sampling constituted the study group. All students who volunteered to participate completed a questionnaire assessing sociodemographic and knowledge factors, sexual attitudes, behavior, and history of STDs. The rate of students having had sexual experience was 36.6%. Males were more sexually active than females. Most students (71.4%) began sexual activity at ages 15-19 without any difference by gender. Males reported significantly more sexual partners than females. Similarly, the rate of male students never using condoms was significantly higher than females. Condom was the most frequent contraception method, followed by oral contraceptives and withdrawal. Mean score on the knowledge questions was 16.29 (highest score 30). The most widely known STD was HIV infection and AIDS. Students' knowledge of transmission routes, signs and symptoms, and risk groups of STDs was insufficient. Main sources of knowledge were visual and print media, and friends. Most students (84.7%) viewed prevention from STDs as a person's own responsibility. Young people in Turkey are sexually active and tend to engage in high-risk behavior. However, their knowledge on sexual health and sexually transmitted diseases is insufficient. Study results suggest a need for implementation of STD control programs and provision of school sexuality education for adolescents and young adults.

Brucellosis: a retrospective evaluation.

One hundred and sixty-six presumed brucellosis patients were included in the study. These patients were classified as primary (91), relapse (18) and suspected (57) cases according to their clinical presentations, and serologic and microbiologic test results. Primary and relapse cases were evaluated retrospectively according to age, sex, residence, routes of transmission, clinical and laboratory findings, treatment regimens, duration of treatment, and relapse rates. Of the 109 primary and relapse patients, 57 were male and 52 female. The ages of the patients ranged between 16-75 (mean age 40.2). The percentages of the urban and rural residence of the patients were 41.3% and 58.7%, respectively. The most common mode of transmission was consumption of unpasteurized milk and milk products (67.9%). Malaise, fever and sweating were the most frequently observed symptoms (96.3%, 95.4%, 91.7%, respectively). The most common signs were fever (97.2%), splenomegaly (59.6%), and hepatomegaly (37.6%). The liver was the most frequently involved organ (21.1%). Almost all (99.1%) patients were serologically positive. However, the positivity rate of culture was low (15.6%). The most frequently preferred antimicrobial regimen was rifampin and doxycycline combination. The relapse rate was 8.3%. Brucellosis is still prevalent in Turkey as in many other countries in the Mediterranean basin. The clinical presentation of the disease may show regional variations. Patients with a history of occupational or nutritional contact with the bacterium and with a compatible clinical picture should be examined using appropriate diagnostic techniques before any attempt to prescribe an antimicrobial.