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    Effectiveness of lamivudine and interferon-? combination therapy versus interferon-? monotherapy for the treatment of HBeAg-negative chronic hepatitis B patients: A randomized clinical trial
    (2005) Karabay, Oğuz; Tamer, Ali; Tahtaci, Mustafa; Vardi, Şeref; Çelebi, Harika
    Results comparing the effectiveness of lamivudine used as monotherapy or in combination with interferon-alpha (IFN-?) in the treatment of chronic hepatitis B are not conclusive. This study compared the effects of IFN-? alone or in combination with lamivudine for the treatment of hepatitis B e antigen (HBeAg)-negative patients with chronic hepatitis B. Participation of patients in the IFN-? monotherapy and combination groups was randomized to a 1:1 ratio. Twenty seven HBeAg-negative patients with chronic hepatitis B received IFN-? (13 patients) at 9 million units 3 times weekly for 24 weeks or IFN-? at 9 million units 3 times weekly for 24 weeks plus lamivudine 100 mg/day (14 patients) daily for 1 year. Hepatitis B virus (HBV) DNA was measured quantitatively by real-time polymerase chain reaction at 0, 6, 12 and 18 months after the start of treatment. Sustained virologic response was defined as non-detectable serum HBV DNA 72 weeks after starting treatment. Sustained biochemical response was defined as normalization of alanine aminotransferase (ALT) values 72 weeks after starting treatment. The baseline characteristics of the 2 treatment groups were similar with respect to age, gender, ALT, HBV DNA levels and histologic diagnosis. Sustained biochemical responses were found at week 72 in 7 patients in each group (54% with IFN-? monotherapy and 50% with combination therapy) [p>0.05]. Sustained virologic responses were found at week 72 in 5 patients (38%) in the monotherapy and 7 patients (50%) in the combination therapy group (p>0.05). Combination therapy was not superior to IFN-? alone for the treatment of chronic hepatitis B. Combination treatment was associated with some disadvantages, such as additional cost. Lamivudine, on the other hand, may be more suitable for patients with cirrhosis, non-responders to IFN-? or in cases with contraindication for IFN-?.
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    Impaired immunity against tetanus in Type 2 Diabetes
    (Int Scientific Information, Inc, 2005) Tamer, Ali; Karabay, Oğuz; Ekerbiçer, Hasan; Tahtaci, Mustafa; Selam, Belgin; Çelebi, Harika
    Background: The aim of this study was to compare serum levels of tetanus antibody in diabetic patients over 50 years of age with those of age-and sex-matched non-diabetic controls. Material/Methods: The study population consisted of 115 type 2 diabetic patients and 115 age-and sex-matched nondiabetic patients. Serum levels of tetanus IgG were measured by a commercial ELISA kit, and levels over 0.1 IU/ml were considered protective. Results: Mean serum levels of tetanus antibody in the diabetic and control groups were 0.164 +/- 0.140 IU/ml vs. 0.374 +/- 0.534 IU/ml, respectively (p < 0.001). Mean serum levels of tetanus antibody in the diabetics vs. controls aged 50-64 years were 0.172 +/- 0.141 IU/ml vs. 0.568 +/- 0.653 IU/ml and in those >= 65 years 0.151 +/- 0.139 IU/ml vs. 0.154 +/- 0.193 IU/ml, respectively (p < 0.001, p=1.000). Among patients aged 50-64 years, 38 (55.9%) cases in the diabetic and 45 (73.8%) in the control group demonstrated protective levels of tetanus antibodies (p=0.034). Of patients >= 65 years, 24 (51.1%) cases in the diabetic and 22 (40.7%) in the control group had protective levels of tetanus antibodies (p=0.298). Conclusions: Serum levels of tetanus antibody decreased in diabetic patients older than 50 years of age, whereas this period of time is prolonged to 65 years in healthy individuals. All individuals over 65 years should be vaccinated against tetanus; however, vaccination over 50 years of age might be considered for diabetic patients.
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    Sekonder demir yüklenmesi ile başvuran talasemi minör'lü olgu
    (2004) Tamer, Ali; Çelebi, Harika; Boran, Çetin; Karabay, Oğuz; Tahtaci, Mustafa; Arinç, Hüseyin; Gündüz, Hüseyin
    Demir yüklenmesi; doku hasarı olup olmadığına bakılmaksızın vucut demir depolarında artış olarak tanımlanır. Oral demir alımına bağlı sekonder demir yüklenmesi çok nadirdir. İç hastalıkları polikliniğine halsizlik yakınması ile başvuran, kliniğimizde yapılan tetkikler sonrası ß talasemi minör tanısı alan, 67 yaşında bayan hastaya demir eksikliği düşünülerek uzun süreli demir tedavisi verilmesine bağlı sekonder demir yüklenmesi saptanan olgunun literatür ışığında sunulması amaçlanmıştır. Sonuç olarak özellikle hipokrom mikrositer anemi nedeni dikkatlice irdelenmelidir. Ülkemizde talasemi taşıyıcılığı sıklığı göz önüne alınırsa demir tedavisine cevap vermeyen hipokrom mikrositer anemili hastalarda ayırıcı tanıda talasemi akılda tutulmalıdır.