Assessment of Soluble Urokinase-Type Plasminogen Activator Receptor (supAR) in Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) is a disease characterized by a progressive airflow limitation. Soluble urokinase-type plasminogen activator receptor (suPAR) is released from the membrane-bound plasminogen activator, and is positively correlated with the activation of immune system.Aims: Release of inflammatory mediators is increased in chronic obstructive pulmonary disease (COPD), particularly during exacerbations. The objective of this study was to compare plasma levels of suPAR and serum levels of C-reactive protein (CRP) during exacerbation and stable periods in patients with COPD.Study Design: Prospective clinical study. Methods: The patients with COPD were divided into 3 groups for evaluations: those with stable COPD [SCOPD] (n= 54), pre-treatment acute exacerbation COPD [AECOPD] (n= 53), and post-treatment AECOPD (n= 52). Plasma suPARand serum CRP levels were assessed for each patient.Results: Whereas the increased serum CRP levels of the participants were 54.82±56.63 mg/l during acute exacerbation period, during the stable period it was 5.02±6.31 mg/l and statistically significant (p= 0.0001). The suPAR level was 1.28±0.52ng/ml during the acute exacerbation period vs.1.21±0.59ng/ml during the stable period, without a difference (p= 0.49). There was a statistically significant decrease in the CRP serum levels; yet, although not statistically significant  a remarkable decrease was seen in the suPAR levels obtained before and after the management of exacerbations (p= 0.001 and p= 0.06 respectively).Conclusion: These results support the idea that suPAR, a novel biomarker, might be an important indicator if verified with further prospective studies in evaluating COPD exacerbations and treatment response like CRP used for decades

A Diagnostic Algorithm for the Detection of Clostridium difficile-Associated Diarrhea

Conclusion: Tests targeting C. difficile toxins are frequently applied for the purpose of diagnosing CDI in a clinical setting. However, changes in the temperature and reductant composition of the feces may affect toxin stability, potentially yielding false-negative test results. Therefore, employment of a GDH EIA, which has high sensitivity, as a screening test for the detection of toxigenic strains, may prevent false-negative results, and its adoption as part of a multistep diagnostic algorithm may increase accuracy in the diagnosis of CDIs

G����S Duvar�N�N T�Berk�Loz Absesi

Chest wall is a rare involvement localization of tuberculosis, though uncommon are frequently seen in countries endemic to the disease. In this report, a tuberculosis case with chest wall involvement is presented.Hastalığın endemic olarak görüldüğü yerlerde bile göğüs duvarı tutulumu sık değildir, nadir tüberkuloz tutulum lokalizasyonudur. Bu bildiride, göğüs duvarı tutulumu olan bir vaka sunulmuştur

The Effect Of Telithromycin On Inflammatory Markers In Chronic Obstructive Pulmonary Diseases

Aim : To evaluate the anti-inflammatory effect of telithromycin on sputum interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO) levels in patient with chronic obstructive pulmonary diseases (COPD). Methods : Thirty four patients with mild to moderate COPD were enrolled in this prospective, single center, double-blind, placebo controlled study. Subjects received either telithromycin or placebo for 10 days. Before and after treatment period spirometric tests, arterial blood gas analyses were performed, sputum samples were taken for measurement of sputum inflammatory markers, and spu-tum was induced. Results : There was no statistical difference in baseline clinical or laboratory parameters between groups. After the treatment, the induced sputum IL-8, TNF-α, , MPO levels is similar compared with pretreatment levels. Conclusion : In this study, anti-inflammatory effects of telithro-mycin in stable COPD patients were not demonstrated. Further studies are needed to determine the clinical significance of these findings

Comparison of a Newly Developed Automated and Quantitative Hepatitis C Virus (HCV) Core Antigen Test with the HCV RNA Assay for Clinical Usefulness in Confirming Anti-HCV Results

Hepatitis C virus (HCV) is a global health care problem. Diagnosis of HCV infection is mainly based on the detection of anti-HCV antibodies as a screening test with serum samples. Recombinant immunoblot assays are used as supplemental tests and for the final detection and quantification of HCV RNA in confirmatory tests. In this study, we aimed to compare the HCV core antigen test with the HCV RNA assay for confirming anti-HCV results to determine whether the HCV core antigen test may be used as an alternative confirmatory test to the HCV RNA test and to assess the diagnostic values of the total HCV core antigen test by determining the diagnostic specificity and sensitivity rates compared with the HCV RNA test. Sera from a total of 212 treatment-naive patients were analyzed for anti-HCV and HCV core antigen both with the Abbott Architect test and with the molecular HCV RNA assay consisting of a reverse transcription-PCR method as a confirmatory test. The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 96.3%, 100%, 100%, and 89.7%, respectively. The levels of HCV core antigen showed a good correlation with those from the HCV RNA quantification (r = 0.907). In conclusion, the Architect HCV antigen assay is highly specific, sensitive, reliable, easy to perform, reproducible, cost-effective, and applicable as a screening, supplemental, and preconfirmatory test for anti-HCV assays used in laboratory procedures for the diagnosis of hepatitis C virus infection

Effects of Flurbiprofen on CRP, TNF-α, IL-6, and Postoperative Pain of Thoracotomy

Objective: The aims of this study were to evaluate serum levels of acute phase reactants, such as CRP and cytokines (TNF-&#945; and IL-6) in patients who have undergone thoracotomy and to investigate the effects of flurbiprofen on postoperative inflammatory response.Methods: Forty patients undergoing posterolateral thoracotomy were randomly divided into 2 groups of 20 each. Control group received tramadol (4 x 100 mg) intravenously for four days, and flurbiprofen group received both tramadol (4 x 100 mg) and flurbiprofen (2 x 100 mg). Blood samples were collected before surgery and at the 3th and 168th hours after surgical procedure to measure serum CRP, IL-6, and TNF-&#945;. Pain visual analog scales were recorded daily during the first four postoperative days. Spirometric measurement of forced expiratory volume in the first second (FEV 1) was done before and four days after the operation.Results: The serum CRP, IL-6, and TNF-&#945; levels in both groups increased significantly at 3th hour after thoracotomy. Serum TNF-&#945; levels did not differ significantly between the groups at postoperative 4th day. However, IL-6 and CRP were significantly lower in flurbiprofen group than in control group at the same day (p&#60;0.05). Visual analog scale was significantly lower in flurbiprofen group at 6th, 12th, 48th, 72th, and 96th hours postoperatively (p&#60;0.05). The patients receiving flurbiprofen had higher FEV 1 values when compared with control group at postoperative 4th day.Conclusions: Patients undergoing thoracotomy showed reduced postoperative pain, mean additional analgesic consumption, and serum IL-6 and CRP levels, when flurbiprofen was added to systemic analgesic therapy. Analgesia with anti-inflammatory drug may contribute to the attenuation of the postoperative inflammatory response and prevent postoperative pain in patients undergoing thoracotomy.</p