Clinical follow-up of patients with HBeAg positive chronic hepatitis B infection: A long-term observational study

Background and Aim: We aimed to analyze the demographic, laboratory, and clinical characteristics of patients with HBeAg positive chronic hepatitis B infection in tertiary care centers in Istanbul. Materials and Methods: We conducted an observational cohort with >= 18-year-old patients with HBeAg positive chronic hepatitis B infection, who were followed up in three tertiary care centers in Istanbul between January 2000 and August 2018, were evaluated by reviewing electronic and recorded files. The Ethical Committee of Istanbul Medipol University approved this study (Protocol no: 10840098-604.01.01-E.44136). During the polyclinic interview, consent was obtained from patients for analysis and publication. Results: The mean age of the 64 patients was 30 (range 18-39) years, and 50% (32) of them were males. The mean follow-up period of the patients was 67 (18-180) months. Twenty-four patients were treated with at least one antiviral in their follow-up, and only 2 (3.1%) of these patients developed HBeAg seroconversion without antiviral treatment. HBeAg (+) chronic hepatitis B developed in 4 of the patients after the immune-active period. None of the patients and first-degree relatives had hepatocellular carcinoma (HCC). Conclusion: The rationality of antiviral treatment and HCC development risk in these patients still remains elusive

Distribution of Bacteria Isolated from Febrile Neutropenic Cases and Their Antibiotic Susceptibilities

Gram-positive bacteria have recently been increasing in frequency as infectious agents of febrile neutropenic patients in our country as in the world. Bacteria isolated from febrile neutropenic patients who were followed between May 1997 and December 2002 and their antibiotic susceptibilities were investigated in order to find out our data. Of 111 isolates, 61 were from blood, 35 from urine, 17 from wound and others from various materials. Gram-negative organisms were responsible for 70 (63%) isolates and the remaining 41 (37%) were gram-positive organisms. The most common isolate was Escherichia coli (n= 37) followed by Staphylococcus aureus (n= 26) and Pseudomonas aeruginosa (n= 12). Antibiotic susceptibilities were investigated by Bauer-Kirby disk diffusion method according to the National Committee for Clinical Laboratory Standards (NCCLS) recommendations. Of the gram-negative isolates, 100% were susceptible to imipenem and meropenem, 90% to amikacin, 89% to cefepime, 84% to piperacillin-tazobactam, 84% to ciprofloxacin, 80% to ceftazidime, 80% to cefoperazone-sulbactam, 80% to gentamicin and 73% to ceftriaxone. Twelve of 26 S. aureus isolates were methicillin-resistant. None of 10 S. pneumoniae isolates were penicillin-resistant. None of the gram-positive isolates were resistant to glycopeptides. Although the frequency of gram-positive isolates has increased over the years (from 20% to 39%), gram-negative organisms are still the most common isolates. However, the frequency of gram-positive bacteremic isolates has also increased (from 41% to 50%) and became the most common bacteremic isolates. As a result; gram-negative organisms, especially E. coli, are still predominant pathogen in our center, but gram-positive isolates, especially S. aureus, became the most common bacteremic pathogen. These new data will be leading us in decision of proper empirical antibiotic policy and the outcome will be success in treatment

A Case Report Resembling Infectious Mononucleosis: Anticonvulsant Hypersensitivity Syndrome

Anticonvulsant hypersensitivity syndrome (AHS) is a potentially fatal drug reaction with cutaneous and systemic manifestations. This article describes a patient with fever, rash, lymphadenopathy, tonsillopharyngitis, splenomegaly accompanied by atypical lymphocytes in the peripheral smear and elevated transaminase levels resembling infectious mononucleosis

Evaluation of Various Risk Factors for the Emergence of Resistance to Fluoroquinolones

The continuing emergence of resistance to fluoroquinolones together with the widespread use is of great concern. To identify the risk factors associated with fluoroquinolone resistant gram-negative bacilli (GNB) infection, a prospective, unmatched, case-control study during a 16-month-period from November 2002 to March 2004 was conducted. A hundred and thirty patients, from whom fluoroquinolone resistant GNB were isolated, were compared with 50 control patients, from whom fluoroquinolone susceptible GNB were isolated. Potential risk factors were obtained through review of inpatient medical records and evaluated by statistical methods. Risk factors that were significantly associated with fluoroquinolone resistant GNB infection included presence of advanced age (p= 0.009), male sex (p< 0.001; OR 3.927; 95% CI 1.970-7.829), underlying malignancy (p= 0.026; OR 2.809; 95% CI 1.102-7.157), lower urinary system pathology (p= 0.009; OR 8.909; 95% CI 1.163-68.269), prior surgical operation (p= 0.012; OR 2.406; 95% CI 1.200-4.828), prior use of fluoroquinolones (p< 0.001; OR 7.563; 95% CI 3.015-18.970), attendence to urology clinics (p= 0.003; OR 3.039; 95% CI 1.432-6.451), urinary catheterization (p= 0.004; OR 2.649; 95% CI 1.356-5.174), extendedspectrum beta-lactamase (ESBL) producing Escherichia coli or Klebsiella spp. as infecting pathogen (p= 0.001; OR 6.000; 95% CI 1.756-20.501) and the resistance to other antibiotics than carbapenems (p< 0.05). In multivariate analysis, male gender (p= 0.008; OR 0.337; %95 CI 0.151-0.749), history of quinolone usage (p= 0.001; OR 0.170; %95 CI 0.059-0.494) and ESBL positive E. coli or Klebsiella spp. as responsible microorganisms (p= 0.038; OR 0.239; %95 CI 0.062-0.921) were identified as independent risk factors for quinolone resistance

Antitumor and antimetastatic effects of walnut oil in esophageal adenocarcinoma cells

Background: Walnuts contain many components including specific fatty acids, which could be active against cancer. Even though the anticarcinogenic effect of some of the individual fatty acids in walnut oil has been described, the effect of walnut oil itself on esophageal cancer cells hasn't yet been investigated. Objective: We aimed to investigate whether walnut oil affects tumor growth and metastatic potential in esophageal cancer cells. Methods: The human esophageal adenocarcinoma cell line, OE19, was treated with different doses of walnut oil and cell viability, apoptosis/necrosis and cell cycle analyses were performed using WST-1 assay and flow cytometry respectively. Adhesion, colony formation and wound healing assays were performed to assess the antimetastatic effects of walnut oil. NFkB expression was evaluated with western blot analysis. Results: Walnut oil decreased the cell viability of esophageal cancer cells in a dose-dependent manner. 20 mg/mL walnut oil reduced cell viability by similar to 50% when compared with control. The analysis revealed that necrosis and accumulation of cells in G0/G1 phase was induced in the cells treated with high doses of walnut oil. It also down-regulated the protein levels of NFkB. Walnut oil suppressed the adhesion, migration and colony formation of the cells. Conclusions: High-dose short-term administration of walnut oil reduces the cell viability and metastatic ability of esophageal cancer cells, while exhibiting anticarcinogenic effect by inducing necrosis and cell cycle arrest at the G0/G1 phase, probably through suppression of the NFkB pathway. These data indicate that walnut oil, and by extension walnut consumption, may have beneficial effects in esophageal cancer in humans. This should be tested by clinical trials in the future. (C) 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved