Brucella Orshitis That Imitate Testıcular Tumor: Case Report

Brucellosis a disease that can occur with different clinical manifestations affecting all systems, causes difficulties in diagnosis and treatment. The genitourinary tract involvement in brucellosis is found in the ratio of 2-20%, and most often present with epididymoorchitis clinic. Sometimes it can mimic tumor by doing mass in the testicle. In this article; 21 year old patient who applied with pain and swelling in the testicles,diagnosed with testicular tumor according to clinical and radiological findings, and therefore done orchiectomy, then diagnosed Brucella orchitis according to the histopathological and serological evidence is presented. In particular, in endemic areas such as our country, in such cases with testicular mass, brucellosis should be considered in the differential diagnosis of non-specific granulomatous orchitis

Investigation of Febrile Neutropenic Cases and Risk Factors

Introduction: Febrile neutropenia is one of the most important factors responsible for morbidity and mortality in cancer patients. Materials and Methods: In this study, febrile neutropenic attacks seen in 100 patients who were consulted between January 2008 and December 2009 were retrospectively evaluated. Only the first attack of each patient was included in the study. Results: Fifty-eight of the patients were female and 42 were male. Mean age of the patients was 59.4 ± 13.4 years. Primary malignancies were hematologic malignancy in 30 patients and solid tumors in 70 patients. According to the Multinational Association for Supportive Care in Cancer criteria, 29 of the patients were in the low-risk group, whereas 71 patients were in the high-risk group. Mean absolute neutrophil count, mean duration of the neutropenic period and mean duration of hospitalization were 247.8 ± 25.2/mm3, 3.3 ± 1.9 days and 4.4 ± 0.7 days, respectively. Of the 100 neutropenic attacks, 22 were clinically defined infection, 39 were microbiologically defined infection and 39 were fever of unknown origin. The most frequent infection sites were pneumonia and pyelonephritis based on the clinical and microbiological findings. Isolated strains included 44 gram-negative bacilli, four gram-positive cocci and nine Candida spp. Escherichia coli was the most frequently isolated agent in these strains. Empirical treatment of patients included monotherapy (61%) and combined therapy (39%). The most frequently used antimicrobial agents in monotherapy were cefoperazone-sulbactam. Mean fever defervescence time after initiation of empirical treatment was 2.6 ± 0.2 days. Fifteen of the patients died during the febrile neutropenia attack. Conclusion: Clinical and microbiological approaches should be made carefully in order to determine the focus of infection in patients with febrile neutropenia. Early initiation of empiric antimicrobial treatment seems to be important in reducing mortality

The Efficacy of Some Disinfectants to Acinetobacter Species Causing Nosocomial Infections

The most important step for preventing hospital acquired infections is the choice and usage of appropriate disinfectant. For this purpose, the most problematical pathogens and their susceptibility to the disinfectants have to be known in every hospital. In this study, we evaluated the susceptibility of multidrug resistant 10 Acinetobacter spp. against the 10 disinfectants by broth microdilution method. The most effective disinfectants were determined as Chlorispray® (ethanole + chlorhexidine digluconate + glutaraldehyde + formaldehyde + didecyl dimethyl-ammonium chloride), Endex® (cocospropylene diamine diguanidium diacetate/didecyleoxymethyle ammonium propionate) and Savlex® (cetrimide/chlorhexidine), and alcohol (70%), benzalchonium chloride and povidone iodine the mostly used disinfectants were the least effective to the Acinetobacter spp. As a result, we concluded that the susceptibility of the multidrug resistant microorganisms to the disinfectants has to be determined according to the result of the surveillance and the disinfection policies have to be determined in the light of these results

Polymorphisms in the IL-6 and IL-6R receptor genes as new diagnostic biomarkers of acute appendicitis: a study on two candidate genes in pediatric patients with acute appendicitis

WOS: 000367511200002PubMed: 26714766Background: Acute appendicitis (AA) (OMIM: 107700) is an inflammatory disease which is characterized by appendiceal inflammation. Genetic and environmental factors contribute to the development of AA. Especially, multiple genetic factors appear to be promising in the explanation of etiopathogenesis of AA. IL-6 (Interleukin-6) is an inflammatory cytokine and IL-6 receptor (IL-6R) plays an important role in the immune response. IL-6 (-572G/C rs1800796) and IL-6R (1:G.154448302 T > C rs7529229) gene polymorphisms may have an impact on cytokine production, immune response and these gene polymorphisms may be used as inflammatory markers in the diagnosis of appendicitis. Method: A total of 75 children with appendicitis, and 75 healthy children were included in the study. DNA extracts were obtained from peripheral lymphocytes. Single-nucleotide polymorphisms (SNPs) were analysed using an automated SYBR (R) Green RT-PCR system in pediatric patients with appendicitis (n = 75) and healthy controls (n = 75). Results: The allele and genotype frequencies for IL-6 rs1800796 and IL-6R rs7529229 polymorphisms were not different between the study groups (p > 0.05). Any statistically significant differences as for age, sex and other laboratory factors were not detected between the patients with appendicitis for genotype-allele frequencies (p > 0.05). Still in analyses performed to determine correlations among age, and gender of the patients, routine laboratory parameters and allele-genotype frequencies, a statistically significant intergroup difference was not detected. Genotype and allele frequencies were consistent with Hardy-Weinberg equilibrium (HWE) in all groups. Discussion: This is the first study to investigate the effects of functional two polymorphisms on IL-6 and IL-6R genes in a pediatric patient group with AA risk. With this study we investigated the contribution of IL-6 (-572G/C rs1800796) and IL-6R (1:G.154448302 T > C rs7529229) polymorphisms on pathogenesis, and severity of AA in pediatric patients with AA: These results will guide further genetic researches to be performed on the role of IL-6 and IL-6R in AA. Conclusions: Given the putative biological importance of this SNPs, these emerging data can provide a new foundation to stimulate future debate and genetic investigations of AA, focusing on new molecular mechanisms such as other IL gene polymorphisms, particularly in accessible peripheral tissues for novel molecular diagnostics for appendicitis.Firat UniversityFirat University [FUBAP TF.14.73]This study was supported by the intramural research fund of the Firat University (FUBAP TF.14.73). The authors thank the research participants who volunteered their time for this study

Lipocalin 2 as a clinical significance in rheumatoid arthritis

Aim of the study : In this study, serum lipokalin 2 (LCN-2) levels and its clinical and radiological significance in patients with rheumatoid arthritis was evaluated. Material and methods : The study enrolled 37 patients with RA and 34 healthy controls. Serum LCN-2 level was measured using ELISA method. Patients with DAS 28 scores ≤ 3.2, and > 3.2 were allocated into lower and high/moderate disease activity groups, respectively. Additionally patients were divided into 2 groups as early RA (disease duration ≤ 2 years) and established RA (duration of the disease ≥ 2 years). Functional disability was evaluated using Health Assessment Questionnaire (HAQ). Radiographs were scored using the modified Larsen score. Results : Serum LCN-2 (p = 0.029) levels were significantly higher in patients with RA than in the controls. Serum LCN-2 level did not correlate with laboratory and clinical parameters of disease activity like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), DAS 28, Health Assessment Questionnaire Score (HAQ) and Nottingham Health Profile (NHP). Similarly, any correlation could not be found between structural joint damage and serum LCN2 levels. Conclusions : These results indicate that serum LCN-2 levels may be used as an indicator for structural damage like erosions in the early stage of the disease but do not able to be used to monitor disease activity

Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study

Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1%) and TB was isolated in 65 patients (86.6%). PCR were performed to 37 (35.6%) biopsy samples and of these, 35 (94.6%) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9%). Upper gastrointestinal endoscopy was performed to 40 patients (38.5%) and colonoscopy in 74 (71.1%). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3%). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8%) patients died and 2 (1.9%) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery.SCOPUS: ar.jinfo:eu-repo/semantics/publishe