2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe

A very rare pathogen in peritoneal dialysis peritonitis: Serratia liquefaciens

Peritoneal dialysis (PD) peritonitis has been decreasing in frequency in recent years. However, it still causes significant morbidity and mortality. Nearly 1%-6% of all peritonitis attacks result in death. Hospitalizations, loss of PD access, and intravascular catheter insertion for hemodialysis are some examples of morbidity. Approximately 15%-20% of the infectious mortality of PD patients is attributed to peritonitis. The responsible pathogens are usually Gram-positive bacteria, but unusual pathogens may be present. Prognosis is worse when Gram-negative and fungal pathogens are involved. We report a case of Serratia liquefaciens peritonitis due to defiance of hygienic practices which presented with severe abdominal pain and fever and led to loss of PD access

Molecular identification and DNA sequencing of Trichomonas vaginalis strains from agean region of Turkey

The aim of this study is to compare the presence of Trichomonas vaginalis (T. vaginalis) in symptomatic and asymptomatic women through microscopic examination, culture in Trypticase-Yeast Maltose (TYM) medium and PCR methods. In addition, T. vaginalis strains were analysed for genotyping with 18S rRNA-DNA and phylogenetic analysis. Axenized strains of T. vaginalis isolated from urine culture samples taken from symptomatic and asymptomatic women with clinical signs. Molecular characterization of the isolated strains of T. vaginalis was performed by using PCR. To evaluate molecular diagnosis and genotypic identification of T. vaginalis strains, 14 samples were analysed. Of the 14 samples, T. vaginalis was positive in 14 samples by microscopy, 6 in culture(TYM medium) and 14 by PCR, respectively. Although the sample size is very small, PCR was shown to be high sensitivity and specificity, and seems to be a promising diagnostic tool. 18S rRNA-DNA PCR results also confirmed with real time PCR method. In conclusion, it is considered that two strains of T. vaginalis isolated from samples, 5-TV1G and 13-TV1G, are subtypes of T. vaginalis as a result of 18S rRNA-DNA sequencing analysis. To best of our knowledge this is the first analysis of phylogenetic positions on T. vaginalis from Turkey. © 2017, Malaysian Society for Parasitology. All rights reserved

Prognostic factors in glomerular diseases with crescents

INTRODUCTION: More than 50% of glomerular crescent formation is required for a diagnosis of crescentic glomerulonephritis in a kidney biopsy. Although treatment protocols have been established for diffuse crescentic glomerulonephritis, there is no standard treatment for patients with fewer crescents in renal biopsies. In this study the importance of crescent percentage and clinical features on renal survival independent of underlying disease was investigated. METHODS: This retrospective observational study was conducted between 2013 and 2017. Forty-nine patients with crescent formation in their kidney biopsies were evaluated. We compared clinicopathological features and renal survival. We evaluated the factors affecting the course of end stage renal disease (ESRD). RESULTS: A total of 49 patients (57% male and median age 49 years) were enrolled in this study. 39% of patients developed ESRD at follow-up. Logistic regression analysis showed that the requirement for renal replacement treatment on admission (p < 0.001), serum creatinine level above 2.7 mg/dL (p < 0.001), the presence of more than 50% glomerulosclerosis (p = 0.04) and more than 34% crescent formation (p = 0.002) were significantly associated with ESRD. Kaplan-Meier survival analysis revealed that patients with less than 34% crescent in kidney biopsy and a serum creatinine level less than 2.7 mg/dL had increased kidney survival (log-rank test p: 0.01 and p: 0.002). CONCLUSION: Patients with crescent formation in kidney biopsy more than 34% should be evaluated for more aggressive treatment modalities regardless of the underlying disease, especially if the serum creatinine level is above 2.7 mg/dL

Molecular Identification and DNA Sequencing of Trichomonas vaginalis Strains from Agean region of Turkey

The aim of this study is to compare the presence of Trichomonas vaginalis (T. vaginalis) in symptomatic and asymptomatic women through microscopic examination, culture in Trypticase-Yeast Maltose (TYM) medium and PCR methods. In addition, T. vaginalis strains were analysed for genotyping with 18S rRNA-DNA and phylogenetic analysis. Axenized strains of T. vaginalis isolated from urine culture samples taken from symptomatic and asymptomatic women with clinical signs. Molecular characterization of the isolated strains of T. vaginalis was performed by using PCR. To evaluate molecular diagnosis and genotypic identification of T. vaginalis strains, 14 samples were analysed. Of the 14 samples, T. vaginalis was positive in 14 samples by microscopy, 6 in culture(TYM medium) and 14 by PCR, respectively. Although the sample size is very small, PCR was shown to be high sensitivity and specificity, and seems to be a promising diagnostic tool. 18S rRNA-DNA PCR results also confirmed with real time PCR method. In conclusion, it is considered that two strains of T. vaginalis isolated from samples, 5-TV1G and 13-TV1G, are subtypes of T. vaginalis as a result of 18S rRNA-DNA sequencing analysis. To best of our knowledge this is the first analysis of phylogenetic positions on T. vaginalis from Turkey

Formation, distribution and chemical properties of saline and alkaline soils of the Çukurova Region, southern Turkey

The salinity and alkalinity changes over the last 30 years in the Çukurova Region were studied using LANDSAT images, field trials and data obtained from earlier studies. Three categories of reclaimed land were determined for the region as follows: 1. 1. Totally reclaimed soils, including the Bajadas, River Terraces and Bottom Lands. 2. 2. Partially reclaimed soils, in the Delta and Saline Marshy areas. 3. 3. Soils with increased salinity, in the Sand Dunes and the Salinity Marshy areas. © 1991

Can Calcium, Phosphate, Calcium Phosphate Product and Intact Parathyroid Hormone Levels Be Appropriately Controlled in Dialysis Patients?

Objective: To review the target levels of calcium (Ca), phosphate (P), calcium phosphate products (Ca x P) and intact parathyroid hormone (iPTH) levels in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) and compare them with the Kidney Disease Outcome Quality Initiative (K/DOQI) recommendations. Subjects and Methods: Three hundred and fifty-seven patients who had been undergoing dialysis for more than 3 months were included. Patients who had undergone a parathyroidectomy were excluded. The levels of Ca, P, iPTH and Ca x P were monitored for the last 3 months. The Ca and P levels were measured by standard techniques, and iPTH was assessed by the intact molecule assay. Results: Between HD and PD patients, there was no statistically significant difference for age, duration of dialysis or primary disease causing end-stage renal disease. The percentage of patients whose serum Ca, P, Ca x P product and iPTH were within K/DOQI recommended target ranges were 61.2, 66.4, 82.2 and 28.3% in HD patients, and 56.3, 60.6, 85.9 and 22.5% in PD patients, respectively. When all results for each group - HD and PD - were analyzed, 12.8% of patients had all 4 markers within the target range. Conclusion: Achieving target ranges of mineral markers is important in dialysis patients, but reaching K/DOQI target levels is difficult. Hence, physicians should be careful in using P binders and vitamin D analogs to achieve the normal ranges. Copyright (C) 2010 S. Karger AG, Base