Biomedical subjects
Publications and source records attributed to B Besirbellioglu.
Dapsone, a potent antiparasitic and anti-inflammatory compound, is mainly used in the treatment of leprosy and a variety of blistering skin diseases. It may cause a severe adverse drug reaction with multiorgan involvement known as dapsone hypersensitivity syndrome. We report the case of a 21-year-old female patient with dapsone hypersensitivity syndrome. The clinical presentation mimicked a viral exanthema.
BACKGROUND: Gianotti-Crosti Syndrome (GCS) is a characteristic cutaneous eruption following a viral infection. Incidence peaks in early childhood and the syndrome rarely occurs in adulthood. Hepatitis associated with GCS is usually anicteric and acute form. AIM: To report an adult with GCS associated with HBV infection and presenting icteric progress. METHODS: The clinical features of the GCS case associated with HBV infection were evaluated. RESULT: The cutaneous lesions disappeared completely on the 61st day and clearance for HBsAg was also observed. CONCLUSION: GCS may be seen in adults and may be associated with icteric HBV infection.
BACKGROUND/AIMS: This study was initiated to evaluate the role of C. difficile in diarrhea associated with the use of antibiotics, to determine which antibiotics are most often responsible, to characterize the response to several different treatment regimens, and to define the relapse rate as seen in a large teaching hospital in Turkey. METHODOLOGY: Three different patient groups were studied. The first group consisted of 154 individuals with antibiotic-associated diarrhea. The stools of all 154 cases were cultured on cycloserine-cefoxitin-fructose agar (CCFA). If any bacteria grew out, they were identified specifically as C. difficile using a commercially available latex agglutination kit specific for bacterial antigens of C. difficile (MicroScreen C. difficile Latex Slide Test; Merica Diagnostic Limited, Guilford, England). The presence of toxin-A (CDTA) was determined using a MicroScreen CDTA Enzyme Immunoassay kit. RESULTS: The stools of 31 of these patients grew out enteric pathogens. Twenty-eight of these 31 were CCFA positive. Three different drug regimens (Ornidazole, Ornidazole + Cholestyramine, and Vancomycin) were used to treat these 28 C. difficile positive cases. The second group consisted of 37 hospitalized patients who had been in hospital for more than 30 days without any gastrointestinal symptoms. This group was used to identify the in-hospital carrier rate for C. difficile. Stools from these 37 cases were cultured on CCFA and were analyzed for the presence of CDTA by EIA. Colonization with C. difficile was detected in 4 cases. The third group consisted of 40 healthy subjects who served as a population-based control group. The stools obtained from these 40 cases were cultured on CCFA and analyzed for CDTA as were the stools for the other 2 groups. None were CDTA positive. One case was positive for the presence of non-toxigenic C. difficile. CONCLUSIONS: It can be concluded from these data that, in Turkey, C. difficile is responsible for 20% of antibiotic-associated diarrheas. Lincomycin, Azithromycin and Ampicillin were most often associated with the development of antibiotic-associated diarrhea. Ornidazole and Vancomycin were effective agents for C. difficile-associated diarrhea with the latter agent being associated with no relapses.
BACKGROUND/AIMS: The efficacy of alpha interferon therapy in Turkish individuals with chronic hepatitis B virus infection was examined. METHODOLOGY: Sixty-one patients (54 males and 7 females) were studied between 1992 and 1996. Their mean age was 33.4 years (range: 20-57). Each was treated with 4.5 million international units interferon alpha 3 times a week for 24 weeks. Serum alanine aminotransferase (ALT) levels and hepatitis B virus markers (HBsAg, HBeAg, anti-HBe, and HBV DNA) were monitored. A liver biopsy was obtained before and 6 months after the termination of interferon therapy. RESULTS: Before treatment, the serum ALT level was elevated in all 61 subjects. Six months after the termination of therapy, 23 (38%) had a normal serum ALT level. In all patients, before the start of therapy and 6 months after the termination of therapy, HBsAg was detectable. In 36 (59%), HBeAg was present and anti-HBe was not detectable in serum before the initiation of therapy. In 12 (33%), the serum was negative for HBeAg and positive for anti-HBe 6 months after the termination of therapy. HBV DNA was detectable in all serum samples before the onset of therapy and disappeared in 14 (23%) patients, and continued to be undetectable 6 months after the termination of interferon therapy. Histological improvement defined by an improvement in the Knodell score of 2 points or more was observed in 38 (62%). CONCLUSIONS: Interferon therapy eliminates serum markers of active hepatitis B virus infection (eAg and HBV DNA) and is associated with histological improvement in 30-60% of Turkish patients with chronic HBV infection. Interferon therapy did not eliminate sAg from the serum and the histologic improvement achieved was often incomplete.