[Investigation of ganciclovir resistance in CMV UL54 and UL97 gene regions in immunocompromised patients receiving gancyclovir treatment]. / Gansiklovir tedavisi alan immün yetmezlikli hastalarda, CMV UL54 ve UL97 gen bölgelerinde gansiklovir direncinin arastirilmasi.

Cytomegalovirus (CMV) is a main cause of severe morbidity and mortality in immunocompromised patients. Ganciclovir (GCV) is used for both prophylaxis and treatment of CMV disease with successful results, however GCV resistance has been increasingly reported. The aim of this study was to investigate the GCV resistance in patients whose viral loads did not decline (≥1000 copies/mL) despite of receiving GCV treatment, by using sequence analysis method. A total of 30 patients, 25 of them were bone marrow transplant (BMT) and five who were followed in hematology clinics (non-Hodgkin lymphoma, lung cancer, diffuse large B cell lymphoma, combined immune deficiency, chronic lymphocytic leukemia) were included in the study. CMV-DNA levels were monitored by real-time polymerase chain reaction (QIAsymphony, Artus® CMV QS-RGQ kit, Qiagen, Germany), and DNA sequence analysis (ABI 310 Genetic Analyzer, Applied Biosystems, USA) was performed to detect the mutations leading to CMV antiviral drug resistance in following gene regions: 420-664 codons in UL97 gene region and 261 to 588 and 740 to 987 codons in UL54 gene region. Of 30 patients included, M460V mutation in CMV UL97 gene region was detected in one (3.3%) (1st case) and L802M mutation in UL54 gene region, in addition to P887S and S897L variant sequences in another patient (3.3%) (2nd case). The first patient was a 20-year-old male with acute myeloid leukemia who underwent BMT. The blood sample for the investigation of antiviral drug resistance was taken on the 117th day of transplantation (with simultaneous viral load 4470 copies/mL) and the patient has been using GCV for 70 days when the sample was taken. Valganciclovir (VGCV) and foscarnet (FOS) were used for the therapy of the first patient and monitored. The second patient was a 19-year-old male with acute lymphoblastic leukemia who underwent BMT. The blood sample for the investigation of antiviral drug resistance was taken on the 109th day of transplantation (with simultaneous viral load 4830 copies/mL) and the patient received GCV for 26 days and VGCV for 40 days when the sample was taken. FOS and cidofovir were used for the therapy of the second patient but the patient was lost due to the underlying diseases. In conclusion, mutations responsible for GCV resistance was detected in 6.6% (2/30) of immunocompromised patients receiving GCV, indicating that the determination of CMV antiviral drug resistance may help clinicians for planning the antiviral therapy.

[Investigation of intestinal parasites among primary school students in Kayseri-Hacilar]. / Kayseri-Hacilar'da Ilkögretim Okulu Ögrencilerinde Bagirsak Parazitlerinin Arastirilmasi

OBJECTIVE: Parasitic infections are an important health problem which affect children more than adults. Especially in growth-age children, this leads to problems such as malnutrition, malabsorption, growth retardation and learning disabilities. In this study, 328 students who were investigated in two primary schools between the ages of 6 and 14 in Kayseri-Hacilar region were analyzed for intestinal parasites. METHODS: Stool samples were analyzed by light microscopy for the detection of helminths and protozoon using the native-lugol method. Cellophane tape samples were also analyzed by light microscopy for the detection of Enterobius vermicularis and Taenia spp. RESULTS: At least one or more intestinal parasite species were found in 116 (35.4 %) children. The distribution of parasites which were detected in stool samples was as follows; Blastocystis hominis, 77 (23.5%); Enterobius vermicularis, 35 (10.7%); Giardia intestinalis, 14 (4.3%); Entamoeba coli, 15 (4.6%); Endolimax nana, 6 (1.8%); Hymenolepis nana, 1 (0.3%); Iodamoeba butschlii, 1 (0.3%). CONCLUSION: Parasitic diseases are a major public health problem and we believe that education about personal hygiene, sanitation rules and parasitic diseases is important to overcome this problem.

The prevalence of Pediculus humanus capitis in two primary schools of Hacilar, Kayseri.

OBJECTIVE: Pediculosis capitis is a worldwide public health concern, and today, head lice are seen in all socio-economic levels. The infestation usually occurs by head-to-head contact and children, primarily girls, aged 3-12 years are mostly affected. In the present study a total of 405 pupils (214 boys and 191 girls) from two pre- and primary schools in the Kayseri-Hacilar region were examined for pediculosis capitis during March 2010. METHODS: Lice and/or eggs were detected by visual examination of the children's hair. RESULTS: Out of 405 children, 44 (10.9%) were infested with head lice. There were significant differences between the schools and the gender while no significant differences could be found between infestation and child's age, education of the parents, income of the family, housing type, source of water, and the presence or absence of a bathroom. CONCLUSION: Head lice remain a public health problem and more emphasis should be given to the education of parents regarding their biology and control.