Leptospirosis: twelve Turkish patients with the Weil syndrome

Twelve cases of leptospirosis followed by the Infectious Diseases Clinic of the Cukurova University Medical School, Adana, Turkey, between January 1994 and November 1995 are reported. Included are their clinical manifestation, laboratory findings and serotype. Nine men and three women with an average age of 40.4 years were studied. Symptoms, clinical manifestations, laboratory findings and treatment of the disease are evaluated. All of the patients had fever and chills and the following symptoms: nausea and vomiting (91.6%), lower back pain and myalgia (58.3%), headache (50%), epistaxis (16.6%) and confusion (25%). The predominant clinical findings were jaundice (91.6%), hepatomegaly (41.6%), dyspnea (25%), conjunctival suffusion (33%), and nuchal rigidity (33%). Diagnosis was based on dark-field examination of the blood, cerebrospinal fluid and urine specimens. Also, microscopic agglutination tests (MAT) were carried out for serodiagnosis. MAT showed L. inter-rogans serovar icterohaemorrhagiae in 11 cases and L. interrogans serovar grippomosocova in one case. There was cross reaction with L. biflexa patoc in all cases. Agglutinations were tested in the same specimens twice and confirmed in the Microbiology Laboratory of the Etlik Veterinary Research Institute in Ankara. All cases were treated with penicillin and doxycycline. In the end; 83.3% of the patients were cured and 16.6% died due to hepatorenal failure.</p

The Relationship of the Peroxisome Proliferator Activated ReceptorGamma 2 Exon 2 and Exon 6 Gene Polymorphism in Type 2 Diabetic Patients with and without Diabetic Foot Ulcers

We aims investigate Turkish type 2 diabetic patients with/without diabetic foot ulcers and healthy group and examined the contribution of the G/C exon 2 and T/C exon 6 of the PPARgamma gene polymorphism to the development of diabetic foot ulcers. The PPARgamma genotypes were determined prospectively in 50 patients with diabetic foot ulcers and 50 without diabetic foot ulcers and a control group of 50 healthy individuals. Genotyping of the G/C exon 2 and T/C exon 6 of the PPAR-gamma gene polymorphism for all individuals was performed by melting curve analysis of the generated amplicons after real-time online PCR. The genotype exon 2 and exon 6 distribution did not differ between the control group and the type 2 diabetes mellitus patients (with and without diabetic foot) (P&gt;0.05). The frequency of the polymorphic G allele in exon 2 was no similar for the groups (6% and 1%, respectively) (p0.05). The evaluation of exon 2 and exon 6, genotype and haplotype did not show statistically significant difference between the patient diabetic foot and without diabetic foot (p&gt;0.05). The G/C exon 2 and T/C exon 6 of the PPARgamma gene polymorphism is not an independent risk factor for diabetic foot in Turkish type 2 diabetes mellitus patients. Genetic factors in the pathogenesis of diabetic foot may also show any changes in different populations. [Med-Science 2014; 3(4.000): 1582-94

Evaluation of Doxorubicin Cardiomyopathy by Signal Averaged Electrocardiography

BACKGROUND: Signal-averaged electrocardiography detects low-amplitude signals designated as late potentials which are strongly related to myocardial damage. We aimed to search for the possible relation between the myocardial effects of doxorubicin and signal-averaged electrocardiographic parameters. METHODS: Fortyeight patients who received doxorubicin included chemotherapy were enrolled. Signal-averaged electrocardiographic parameters were detected by using 3 parameters; filtered QRS (fQRS), the square root of the voltage obtained during the last 40 milliseconds of the duration of fQRS (RMS40), the duration starting from the last 40 miliseconds of fQRS till the decrease of voltage under 40 microvolts. (HFLA40). Ejection fractions of the patients were measured by echocardiographic evaluation. RESULTS: Median age was 44 (27-70) years. Mean cumulative doxorubicin dosage was 475.56&#177;98.45 mg. Mean values of the measured signal-averaged electrocardiographic parameters were as follows; fQRS: 78.27&#177;10.74 miliseconds, RMS40:115.10&#177;50.23 and HFLA was 21.95&#177;8.39 microvolts . The doses of doxorubicin showed a positive correlation with fQRS (r=0.28, p=0.02) and a negative correlation with RMS40 (r=-.31,p=0.03). There was no correlation between the doxorubicin dosage and the ejection fraction of the patients (r=.18, p=0.22). CONCLUSION: Our results suggested that significant correlations are present between fQRS and RMS40 and cumulative doxorubicin dosages. Therefore, signal-averaged electrocardiographic parameters may be of value for predicting the prognosis of the patients who have received doxorubicin included chemotherapy. [Cukurova Med J 2013; 38(2.000): 241-249

beta-Thalassemia mutations and hemoglobinopathies in Adana, Turkey: results from a single center study

WOS: 000306150200004PubMed ID: 22851993Introduction: beta-Thalassemia and hemoglobinopathies are common genetic disorders in Turkey and in this retrospective study our aim was to determine the frequency of beta-thalassemia and hemoglobinopathies in Adana, which is one of the biggest cities located in the southern part of Turkey. Material and methods: Data from 3000 individuals admitted to Seyhan Hereditary Blood Disorders Center in Adana were evaluated. The blood samples were collected into EDTA-containing tubes and hematological parameters were analyzed using an automatic cell counter. High performance liquid chromatography technique was used to determine the type, of hemoglobin. Molecular screening of the beta-globin gene was performed with beta-Globin StripAssay. Results: Of 3000 cases, 609 were diagnosed as beta-thalassemia or hemoglobinopathy. We have found that the rates of occurrence of beta-thalassemia and hemoglobinopathies are 13.46% and 6.83% respectively in this area. We have identified 18 different beta-thalassemia mutations and three separate abnormal hemoglobins: HbS, HbD Los Angeles, and HbE. In molecular analyses, beta-thalassemia gene mutations of IVSI.110 (G>A), codon 8 (-AA), IVSI.1 (G>A), IVSI.6 (T>C), -30 (T>A), IVSII.1 (G>A), codon 39 (C>T), codon 44 (-C), IVSI.5 (G>C), codon 5 (-CT), codon 8/9 (+G), IVSII.745 (C>G), codon 22 (7bp del), -101(C>T), codon 36/37 (-T), IVSI.15 (T>G), codon 6 (-A), 88 (G>A) were detected. Conclusions: Considering the high incidence of mutations that we have found, beta-thalassemia and hemoglobinopathies still seem to be a public health problem in Adana