Diagnostic Clues For Spondylitis In Acute Brucellosis

Objectives: To determine the diagnostic factors for brucellar spondylitis. Methods: This retrospective study included 227 consecutive brucellosis patients admitted to the Infectious Diseases and Clinical Microbiology clinics of Adiyaman State Hospital and Adiyaman 82nd Year State Hospital, Adiyaman, Turkey between January 2010 and December 2012. Acute brucellosis was diagnosed by standard tube agglutination test, and/or growth of Brucella spp. in appropriately prepared culture media (Bactec). Brucellar spondylitis was diagnosed and followed-up with contrast-enhanced magnetic resonance imaging. Results: Among the 227 brucellosis patients included, 88 (38.8%) were male, and 139 (61.2%) were female. Brucellar spondylitis was detected in 54 patients (23.7%). Brucellar spondylitis patients had higher mean age, higher fever, and higher blood culture positivity rate when compared with brucellosis patients (p=0.001, p=0.001, and p=0.001). Logistical regression analysis determined that male gender (OR: 3.006), older age (OR: 1.025), erythrocyte sedimentation rate (ESR) (OR: 1.067), high fever at the time of admission (OR: 2.550), and positive blood cultures for Brucella spp. (OR: 4.003) values were independently associated with brucellar spondylitis. However, high C-reactive protein (CRP) levels (OR: 0.971) were not found as a risk factor for brucellar spondylitis. Conclusions: The results of this study shows that the risk of developing brucellar spondylitis is high in patients with acute brucellosis, who are at advanced age, who have high fever, that have Brucella spp. growth in their blood culture that has a high ESR value, and who are male.Wo

Impaired Thiol-Disulfide Balance In Acute Brucellosis

The objective of this study was to examine a novel profile: thiol-disulfide homeostasis in acute brucellosis. The study included 90 patients with acute brucellosis, and 27 healthy controls. Thiol-disulfide profile tests were analyzed by a recently developed method, and ceruloplasmin levels were determined. Native thiol levels were 256.72 +/- 48.20 mu mol/L in the acute brucellosis group and 461.13 +/- 45.37 mu mol/L in the healthy group, and total thiol levels were 298.58 +/- 51.78 mu mol/L in the acute brucellosis group and 504.83 +/- 51.05 mu mol/L in the healthy group (p < 0.001, for both). The disulfide/native thiol ratios and disulfide/total thiol ratios were significantly higher, and native thiol/total thiol ratios were significantly lower in patients with acute brucellosis than in the healthy controls (p < 0.001, for all ratios). There were either positive or negative relationships between ceruloplasmin levels and thiol-disulfide parameters. The thiol-disulfide homeostasis was impaired in acute brucellosis. The strong associations between thiol-disulfide parameters and a positive acute-phase reactant reflected the disruption of the balance between the antioxidant and oxidant systems. Since thiol groups act as anti-inflammatory mediators, the alteration in the thiol-disulfide homeostasis may be involved in brucellosis.WoSScopu

Evaluation Of The Relation Between Hepatic Fibrosis And Basic Laboratory Parameters In Patients With Chronic Hepatitis B Fibrosis And Basic Laboratory Parameters

Background: The hepatitis B virus is an important healthcare problem. According to current clinical practice, a liver biopsy is required for the diagnosis and treatment of chronic liver disease. However, a liver biopsy is an invasive, inconvenient procedure, which requires an expert pathologist opinion. Therefore requirement of biochemical tests, which are considered to indicate hepatic fibrosis and may be repeated easily, increases gradually today. Objectives: This study evaluated the correlation between hepatic fibrosis and routine laboratory values in patients with chronic hepatitis B. Patients and Methods: The files of 456 patients with CHB (chronic hepatitis B) who were referred to the infectious diseases and clinical microbiology clinic between January 2009 and March 2012 were screened retrospectively. Liver biopsy samples were examined according to Ishak scoring. Laboratory parameters and histopathology reports were recorded, and correlations between the fibrosis grade and laboratory parameters were analyzed. Results: There were 320 male and 136 female patients, with a mean age 36.7 +/- 12.1 years. According to liver biopsy results, a low fibrosis score (stage 0-2) was detected in 281 patients (61.6%), and a high fibrosis score ( stage 3-5) was detected in 175 patients (38.4%). Patients with a high fibrosis score had significantly higher ALT (alanine amino transferase), AST (aspartate aminotransferase), and HBV-DNA values and a significantly lower platelet count compared with those with a low fibrosis score (P=0.001, 0.001, 0.025, and 0.001, respectively). A positive correlation was detected between the fibrosis score and age, BMI, HAI, ALT, and AST values, and a negative correlation was detected between the fibrosis score and albumin and platelet counts. In the regression analysis performed to evaluate the factors associated with high-stage fibrosis, fibrosis was determined to be associated with thrombosis, ALT, and gender. The results of the regression analysis demonstrated that the risk of fibrosis was 4.6 fold higher in men. Conclusions: According to the results obtained in our study, advanced age, higher BMI, AST, ALT, and HBV-DNA levels, and low albumin and platelet levels are correlated with advanced fibrosis in patients with CHB.WoSScopu

Are Bone Morphogenetic Protein-7 (Bmp-7) Serum Levels Correlated With Development Of Hepatic Fibrosis?

Introduction: Bone morphogenetic protein-7 (BMP-7) is a key protein in organogenesis and liver development. The protein has been studied in the context of liver fibrosis and regeneration. The aim of the present study was to explore any possible association between fibrosis levels (as revealed by liver biopsy) and serum BMP-7 levels. Methodology: A total of 189 patients with chronic hepatitis B and 51 healthy controls were enrolled in the study. Results: The study group contained 120 (63.5%) males and 69 (36.5%) females, and the control group contained 25 males (49.0%) and 26 females (51%). In general, serum BMP-7 values of patients were higher than those of controls (p = 0.001). Serum BMP-7 values of patients with liver fibrosis of stages 1, 2, 3, or 4 were higher than control values (all p values = 0.01), but the serum BMP-7 levels of patients with stage 5 fibrosis were similar to that of controls. Associations between fibrosis stage and the serum levels of BMP-7, ALT, HBVDNA, platelets, and albumin were all statistically significant (p = 0.001). The AUROC for the BMP-7 level in advanced stage fibrosis was found to be 0.23. The data were analyzed using the binary logistic regression analysis (backward stepwise method) and BMP-7, HBVDNA, and platelet levels were found to be risk factors associated with fibrosis (p values 0.031, 0.040, and 0.001, respectively). Conclusions: BMP-7 may play anti-inflammatory and anti-fibrogenic roles in the pathogenesis of chronic hepatitis B infection.WoSScopu

Is Serum High-Mobility Group Box 1 (Hmgb-1) Level Correlated with Liver Fibrosis in Chronic Hepatitis B?

Background: High-mobility group box 1 (HMGB1), identified as an alarmin molecule, was shown to have a role in virus-triggered liver injury. We aimed to evaluate the association between serum levels of HMGB1 and liver fibrosis. Method: This cross-sectional case-control study included 189 chronic hepatitis B (CHB) patients and 51 healthy controls. All patients underwent liver biopsy and modified Knodell scoring system used to determine the fibrosis level in CHB patients. Serum HMGB1 levels were determined with enzyme-linked immunosorbent assay (ELISA). Results: Mean serum HMGB1 levels of patients (58.1 ± 54.7) were found to be higher than those of the control group (7.1 ± 4.3) (P = .001). HMGB1 levels of patients with advanced-stage fibrosis (stage 4 and 5) were detected to be higher than those of patients with early-stage fibrosis (stage 1–3). However, this difference was not statistically significant (P > .05). Albumin levels of fibrosis 3 and 4 patients were lower than fibrosis 1 and 2 patients. ALT, HBV DNA, and AFP levels of fibrosis 5 patients were significantly higher than fibrosis 1 and 2 patients, and their platelet and albumin levels are lower than fibrosis 1 and 2 patients (P < .001). In a logistic regression model, fibrosis levels were correlated with ALT values and inversely correlated with albumin levels. Conclusion: In this study, we demonstrated that serum HMGB1 levels increase in the early course of liver injury and this increase is not correlated with severity of the liver damage.WoSScopusPubMe

Serum Levels of Annexin A2 As a Candidate Biomarker For Hepatic Fibrosis in Patients with Chronic Hepatitis B

Background: Hepatologists have studied serologic markers of liver injury for decades. Annexins are a prominent group of such markers and annexin A2 (AnxA2) is one of the best characterized annexins. AnxA2 inhibits HBV polymerase among other functions. Its expression is up-regulated in regenerative hepatocytes. Objectives: To determine if serum AnxA2 level has a role in estimating liver damage in chronic HBV infection and investigate whether AnxA2 levels correlate with hepatic fibrosis. Patients and Methods: This study included 173 patients with chronic hepatitis B (CHB) and 51 healthy controls. Liver fibrosis was graded histologically on liver biopsy samples. Blood samples were taken from patients during biopsy and serum AnxA2 levels were measured with ELISA. Results: In a group of adult patients with CHB, AnxA2 values were far higher than those of the control group (P = 0.001). When we assessed AnxA2 levels based on fibrosis stages, serum AnxA2 levels of patients with early stage fibrosis (stages 1 - 3) were significantly higher than those of patients with advanced stage fibrosis (stages 4 - 5; P = 0.001). Conclusions: AnxA2 is a useful biomarker for early stage fibrosis in patients with CHB.PubMedWo