Changes in acute viral hepatitis epidemiology in the Turkish adult population: A multicenter study.

BACKGROUND/AIMS: The present study aimed to determine the changes in the epidemiology of hepatitis in recent years in an adult Turkish population. MATERIALS AND METHODS: Overall, 852 patients with acute viral hepatitis from 17 centers were included in this study. Their sociodemographic characteristics, clinical courses, treatments, and laboratory findings were retrospectively analyzed. RESULTS: The most commonly found microorganisms were the hepatitis B virus (55.2%) and hepatitis A virus (37.6%), and the types of acute viral hepatitis differed significantly according to the age group (p≤0.001). The most frequently reported symptom was fatigue (73.7%), and the most common complications were cholecystitis (0.4%) and fulminant hepatitis (0.4%). The median hospital stay was 9 days (range 1-373). In total, 40.8% patients with acute hepatitis B virus developed immunity. CONCLUSION: In Turkey, there are significantly large adolescent and adult populations susceptible to acute viral hepatitis. Therefore, larger vaccination programs covering these age groups should be implemented.

A rare cause of dyspnea in a patient presenting to the emergency department: a case report and review of the literature of laparoscopic cholecystectomy complication.

UNLABELLED: In recent years, there has been an emerging preference by patients for emergency services due to the efficiency of transactions and the increased quality of service. As a result, emergency departments have experienced an extreme density of patients. Nevertheless, patients require the same standard of care and should be evaluated carefully. The emergency physician should evaluate the patient as a whole in light of the findings and not merely according to the recommendations of the consultant. We describe in this case report a rare complication occurring after laparoscopic cholecystectomy, shortness of breath, which could easily be disregarded. KEYWORDS: Laparoscopic cholecystectomy complication; Dyspnea; Intrahepatic subcapsular hematoma.

Long-term efficacy of pegylated interferon alpha-2a in HCV-positive hemodialysis patients.

BACKGROUND AND AIM: Hepatitis C virus (HCV) is prevalent in hemodialysis (HD) patients. The current "best therapy" for HCV-positive hemodialysis patients is not known. The aim of the present study was to evaluate the long-term efficacy of pegylated interferon (PEG-IFNalpha-2a) in HCV-positive hemodialysis (HD) patients. MATERIALS AND METHODS: Twenty-five HCV-RNA-positive hemodialysis patients were included into the study. Twelve patients were allocated to the PEG-IFN treatment group (group 1). Six refused the therapy, and seven were not candidates for kidney transplantation and were allocated to the control group (group 2). All patients underwent chronic hemodialysis treatment for end-stage renal disease during the study period. Group 1 patients received PEG-IFN alpha-2a at a dose of 135 mug weekly for 48 weeks. The patients were prospectively followed up for a period of 192 weeks. Biochemical and virological responses were evaluated at 144 weeks after the completion of therapy. Results. Two patients in group 1 and five patients in group 2 died during 144 weeks of follow-up. SVR was observed in six patients (50%) in group 1 and one patient (1/13) (7.7%) in group 2. ALT levels were normal in 8/10 (80%) in group 1 and in 5/7 (70%) in group 2. CONCLUSION: In summary, our data showed that treatment of chronic HCV infection in dialysis patients with PEG-IFN alpha-2a at a dose of up to 135 mug weekly was well tolerated. Furthermore, SVR was achieved in half of patients at the end of 144 weeks of follow-up. Our results are encouraging for the administration of PEG-IFN alpha-2a in HCV-positive HD patients waiting for kidney transplantation.