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    BRUCELLOSIS IS A MAJOR PROBLEM: A FIVE YEARS EXPERIENCE
    (Carbone Editore, 2013) Dal, Tuba; Celen, Mustafa Kemal; Ayaz, Celal; Dal, Mehmet Sinan; Kalkanli, Sevgi; Mert, Duygu; Yildirim, Necmettin
    Brucellosis is a chronic granulomatous infection which is endemic in Mediterranean countries and Turkey. The aim of this study is to analyze the clinical, laboratory findings and therapeutic features in patients with brucellosis. A retrospective study was conducted with 91 patients who developed brucellosis between 2005 to 2009. The diagnosis was based on clinical findings compatible with brucellosis, serological tests positive, and/or isolation of Brucella species from blood, or other tissues. The mean age was 33 years (16-67 years). Sixty-threes of patients (69.2%) were male. Forty (44%) cases had an occupational history relevant for Brucella exposure and 85 (93%) cases consumption with contaminated animal product. The mean diagnostic delay was 15 days, much longer in focal brucellosis. A total of 77 (85 %) cases had acute brucellosis. The focal brucellosis complications were observed in 39 (42.8%) cases: osteoarticular involvement 32 (82%), epididymo-orchitis 4 (10%), and central nervous system involvement 3 (8%). Chronic brucellosis occurs in 3 (3.3%) cases. Clinical manifestations included non-specific symptoms such as fever (95%). sweats (90%), arthralgia and lower back pain (63%). Of the patients 84 (92%) had serological titre =1/160 and 28 (31%) blood cultures were positive. All of the patients were cured by antibiotic therapy (Doxycycline+rifampicin/streptomycine, streptomycine+rifampicin/Doxycycline, ceftiraxone/rifampicin). Relapse was observed in 5 (5.4%) patients. Brucellosis is an infection with multiple presentations. Its early diagnosis was mandatory to avoid severe complications.
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    Efficacy and safety of tenofovir disoproxil fumarate in pregnancy for the prevention of vertical transmission of HBV infection
    (Baishideng Publishing Group Inc, 2013) Celen, Mustafa Kemal; Mert, Duygu; Ay, Muzeyyen; Dal, Tuba; Kaya, Safak; Yildirim, Necmettin; Gulsun, Serda
    AIM: To evaluate the effects of tenofovir disoproxil fumarate (TDF) use during late pregnancy to reduce hepatitis B virus (HBV) transmission in highly viremic mothers. METHODS: This retrospective study included 45 pregnant patients with hepatitis B e antigen (+) chronic hepatitis B and HBV DNA levels > 10(7) copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation (n = 21). Untreated pregnant patients served as controls (n = 24). All infants received 200 IU of hepatitis B immune globulin (HBIG) within 24 h postpartum and 20 mu g of recombinant HBV vaccine at 4, 8, and 24 wk. Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28. RESULTS: At week 28, none of the infants of TDF-treated mothers had immunoprophylaxis failure, whereas 2 (8.3 %) of the infants of control mothers had immunoprophylaxis failure (P = 0.022). There were no differences between the groups in terms of adverse events in mothers or congenital deformities, gestational age, height, or weight in infants. At postpartum week 28, significantly more TDF-treated mothers had levels of HBV DNA < 250 copies/mL and normalized alanine aminotransferase compared with controls (62% vs none, P < 0.001; 82% vs 61%, P = 0.012, respectively). CONCLUSION: TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.