Retrospective Evaluation of Hepatitis C Awareness in Turkey Through Two Decades.

BACKGROUND/AIMS: Chronic hepatitis C (CHC) is the only viral infection that can be treated with oral antiviral agents. However, CHC awareness is a major barrier to the World Health Organization's target of eliminating hepatitis C virus (HCV) by 2030. Here, CHC awareness trends were analyzed in Hacettepe University Hospital, Turkey, between January 2000 and December 2017. MATERIALS AND METHODS: Central laboratory data were retrospectively analyzed for HCV test results (anti-HCV, HCV RNA, HCV genotype). After combining 548,141 anti-HCV test results, 395,103 cases were analyzed. The following two parameters were defined for CHC awareness: (1) the presence of HCV RNA results for anti-HCV positives and (2) the presence of a genotype result for HCV RNA positives. RESULTS: Anti-HCV positives were older than negatives (mean age-years ± SD, 59.4 ± 19.0 vs. 44.0 ± 18.9), and the positivity rate was higher in women than in men (1.4% vs. 1.0%). Anti-HCV positivity decreased from 3.1% to 0.6% from 2000 to 2015 and subsequently stabilized. The overall percentage of RNA testing among anti-HCV positives was 53.1% (range, 20%-70%), which stabilized at approximately 50% after 2010. The genotyping rate for RNA positives varied between 40% and 70%. The main genotype identified was genotype 1 (85.7%). CONCLUSION: In an ideal CHC awareness state, all anti-HCV positives should undergo RNA testing, and genotyping should be performed when RNA tests are positive. However, even in our referral center, the combined rate of RNA and genotype testing was only approximately 50% during the last 10 years.

Determination of Helicobacter pylori antibiotic resistance patterns in pediatric gastroenterology patients: the Hacettepe experience.

In this study, our aim was to show the antibiotic resistance patterns of Helicobacter pylori (H. pylori) strains isolated from patients who had undergone esophagogastroduodenoscopy at Hacettepe University. Ninety-three culturepositive patients with no history of H. pylori treatment were included in the study. MIC values against clarithromycin, metronidazole, amoxicillin and tetracycline were evaluated by gradient strips. In the 93 strains, no resistance against tetracycline and amoxicillin was observed. Clarithromycin resistance was detected in 28 (30.1%) and metronidazole resistance in 45 (48.4%) patients' strains. Resistance to clarithromycin and metronidazole, respectively, was observed in three age groups as follows: in 3 (17.6%) and 5 (29.4%) strains in the 5-9 age group; in 13 (30.9%) and 16 (38.1%) strains in the 10-14 age group; and in 12 (35.3%) and 24 (70.6%) strains in the 15-19 age group. Antibiotic susceptibility testing prior to treatment would prevent the administration of useless treatments. It is therefore recommended that such testing be performed before planning the treatment.

Serum selenium concentrations in cirrhotic children.

BACKGROUND/AIMS: Selenium is an essential trace element for humans. Plasma selenium concentration is decreased in adults with cirrhosis. We aimed to investigate the serum selenium concentration in cirrhotic children. METHODS: The serum selenium concentration of 38 patients was determined by spectrofluorometric method. The results of the patients were compared with those of 41 age- and gender-matched healthy children. Correlations between the liver function tests, Child classes and serum selenium concentrations in cirrhotic children were also investigated. RESULTS: The mean serum selenium concentration in cirrhotic children was significantly lower than that of controls (42.4 ± 8.2 µg/L vs 64.4 ± 16.9 µg/L, p<0.05). There was no significant difference between the serum selenium concentrations of cirrhotic children who were in Child-Pugh class A versus B+C (p>0.05). Except for serum aspartate aminotransferase level (Pearson coefficient = -0.34), there was no correlation between serum selenium concentration and liver function tests in cirrhotic children. CONCLUSIONS: Serum selenium concentration in cirrhotic children was found to be low; supportive selenium administration may be beneficial in cirrhotic children in appropriate cases.

Biological activities of Bellis perennis volatiles and extracts.

Different parts of Bellis perennis were subjected to hydrodistillation and the products were subsequently analyzed by GC and GC/MS. Aqueous and methanol extracts were prepared from the aerial parts. Antioxidant [1,1-diphenyl-2-picryl-hydrazyl (DPPH) radical scavenging, reducing activity, total antioxidant] and antimicrobial activity of the plant materials were studied. The aqueous extracts showed higher DPPH scavenging activity (85.8% at 102.5 microg/mL) than the methanol extract. Reducing power was also observed for both tested extracts, where the formation of linoleic acid peroxides was more for the aqueous extract than the methanol extract. Antimicrobial activities of all plant materials were evaluated at varying concentrations against a panel of pathogens, but without pronounced inhibitory effect.

Acute tubular injury associated with mesalazine therapy in an adolescent girl with inflammatory bowel disease.

Mesalazine is a first-line drug in pediatric inflammatory bowel disease, and is effective as primary treatment and maintenance therapy. It's usually well tolerated, but various side effects have been described. A 15-year-old female with ulcerative colitis developed polyuria, polydipsia, vomiting, and fatigue. She was receiving mesalazine (500 mg, thrice daily, p.o.) and prednisolone for 4 months. She was detected as acute tubular injury as she had dehydration, acidosis, hypostenuria, hematuria, proteinuria, low levels of potassium, uric acid and bicarbonate. These findings were attributed to interstitial nephritis as a side effect of mesalazine, however as renal biopsy was disapproved by the parents, it was not confirmed. After discontinuation of mesalazine her renal tubular functions improved. Potassium and phosphorus supplements were stopped after 7 months, although she had to continue bicarbonate supplementation. We conclude that regular renal screening is important in patients receiving 5-ASA therapy to prevent rare but serious complications, such as interstitial nephritis sometimes leading to chronic renal failure.

Serum carnitine and selenium levels in children with celiac disease.

BACKGROUND AND AIM: Celiac disease (CD) is a gluten-induced enteropathy that results in malabsorption of nutrients. We studied the serum levels of carnitine and selenium in children with CD. METHODS: Serum levels of free carnitine and selenium were studied in 30 children (mean age 8.1 [4.4] years) with CD and 30 age- and gender-matched healthy children. All patients had type 3 duodenal lesions. The mean (SD) serum levels of free carnitine and selenium were lower among patients with CD (24.5 [7.7] micromol/mL and 52.1 (12.9) micromol/mL, respectively) than among healthy controls (29.4 [9.2] and 65.1 [17.2] micromol/mL; p < 0.05 each). Levels were similar in children with and without diarrhea. CONCLUSIONS: Serum carnitine and selenium levels are decreased in children with CD, probably due to malabsorption.