Baş biti enfestasyonlarının etkin kontrolü için uluslararası tavsiyeler

Baş biti enfestasyonları, en gelişmiş olanlar da dâhil olmak üzere çoğu ülkede halk sağlığını ilgilendiren bir sorun olmaya devam etmektedir. Makalede sunulan tavsiyeler, bu parazitin prevalansını azaltmak amacıyla baş biti kontrolünde farklı otoritelerin, kurumların, endüstrinin ve kamunun rollerini ve etkilerini vurgulamayı ve bilgilendirmeyi amaçlamaktadır. Sağlık yetkililerini, bu tür enfestasyonların doğru şekilde tespit edilmesi; mevcut ve yeni pedikülositler, tıbbi cihazlar, repellentler, bit ve yumurta giderici ürünlerin değerlendirilmesi amacıyla daha etkili yöntemler iz açıklamalara sahip olmalı ayrıca aktif bileşenlere ve formüle ürünlere karşı bitlerin direnç seviyelerinin mevcut durumunu belgelemek için periyodik olarak test edilmelidir. Bit yaygınlığının salgın düzeyine ulaştığı iddiaları ortaya atıldığında, gerçek yaygınlık düzeyinin kanıtlanması amacıyla çocuklar periyodik aralıklarla objektif olarak değerlendirilmelidir. Sağlık hizmeti sunanlar ve toplum geneli için düzenlenen sürekli eğitimlerle bitlerin biyolojisi, önlenmesi ve kontrolü konusundaki yanlış bilgilerin düzeltilmesi sağlanabilir. Ebeveynler, çocuklarını baş biti açısından düzenli olarak kontrol etmeli ve gerektiğinde tedavi etmelidir. Sağlık yetkilileri, vakaları ve yaygınlığı azaltmada bir araç olarak kullanılan ancak bilimsel gerekçesi olmadığı gibi çocukların sağlığı ve huzuruna da ters etki yapan “sirkeye geçit yok- no-nit politikası” tarzında çocukları okuldan uzaklaştırmaya dayalı politika ve uygulamaların ortadan kaldırılması için mücadele etmelidir.lemeye teşvik etmeyi umuyoruz. Pedikülositler ve tıbbi cihazlar, kullanım talimatlarında doğrulanabilirHead louse infestations continue to be a concern of public health in most countries, including the most developed ones. The present recommendations are intended to inform and stress the role and impact of the different authorities, institutions, industry, and the public in the control of head lice in order to reduce the prevalence of this parasite. We encourage health authorities to pursue more effective methods to correctly identify such infestations, and evaluate existing and new pediculicides, medical devices, louse repellents, and louse and nit-removal remedies. Pediculicides and medical devices must have verifiable claims in the instructions for use and should be tested periodically to document current levels of resistance by lice to the active ingredients and to the formulated products. Where the prevalence of lice is claimed to be epidemic, children should be periodically evaluated objectively to document the actual level of prevalence. Continuing education for health providers and the general population promises to correct misinformation regarding the biology, prevention, and management of lice. Parents should regularly inspect their children for head lice and treat as necessary. Health authorities are encouraged to eliminate policies and practices that rely upon school exclusion as a means to reduce incidence and prevalence, e.g., the ‘no-nit’ policy which lacks scientific justification, and are countFil: Mumcuoğlu, Kosta Y.. The Hebrew University; IsraelFil: Pollack, Richard J.. Harvard University. Harvard School of Public Health; Estados UnidosFil: Reed, David. University Of Florida. Florida Museum Of History. Departamento Of Biology; Estados UnidosFil: Barker, Stephen. The University of Queensland; AustraliaFil: Gordon, Shirley. Florida Atlantic University (fau);Fil: Toloza, Ariel Ceferino. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Picollo, Maria Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Taylan Özkan, Ayşegül. Tobb University Of Economics And Technology; TurquíaFil: Chosidow, Olivier. Hopital Henri Mondor; FranciaFil: Habedank, Birgit. German Environment Agency; AlemaniaFil: Ibarra, Joanna. Community Hygiene Concern; Reino UnidoFil: Meinking, Terri L.. Global Health Association Of Miami; Estados UnidosFil: Stichele, Robert Vander. University of Ghent; Bélgic

Helminthotherapy

Helminthotherapy is the stimulation of the host immune system using certain helminths, especially nematodes, to aid in the treatment of inflammatory and autoimmune diseases. The relationship between the development status of countries and the assocaited health profile is extremely complex. The prevalence of autoimmune diseases is extremely low in underdeveloped countries where helminth infections are common. On the other hand, in developed countries, the frequency of autoimmune and chronic inflammatory diseases has increased significantly in the last century. The rise in hygiene standards causing reduction in helmintic infections, is thought to play a role in the increased incidences of inflammatory diseases. This observation has led to “hygiene” and “old friend” hypotheses claiming that some organisms in abundant amounts in the human microenvironment are necessary for the development of a healthy immune system and are associated with immunomodulatory or immune-repressive effects. According to these hypotheses, a decrease in exposure to certain organisms, especially parasites, has caused an increase in immune-mediated diseases. Helminths use a range of immunomodulatory mechanisms that affect the host immune responses, in all aspects, to maintain their persistence within the host. Helminth can skew immune response from TH1 to TH2 phenotype, increase both T- and B-regulatory cell levels, and decrease inflammatory cytokines release. This broad-spectrum modulation of the host immune system has both intended and undesirable consequences. Thanks to this modulation, the host benefits from the suppression of allergic, autoimmune and inflammatory reactions as well as suppression of parasitic damage. The suppressive and regulatory effects of helminths on both acquired and innate immune systems have led to many investigations on their use for treatment purposes. In addition to studies showing the effects of anti-helminthic treatment in enhancing atopic manifestations and inflammatory diseases, helminths have also been shown to have protective effects in animal models of allergy and autoimmune disease. Many studies following this data obtained from animal studies still continue today to both identify helminthic immunomodulatory molecules and to test implementability of helmintotherapy for human diseases

Interdiginal Myiasis Caused By Lucilia sericata in a Diabetic Patient

Cases of myiasis in humans are usually seen in agricultural areas and during the warm months of the year. The most common myiasis cases are caused by the members of the Calliphoridae family, especially by Lucilia and Phormia spp. We present the case of a 66-yearold male farmer from Çankırı suffering from diabetes. During the examination of his wound in the interdigital area between the fourth and fifth toe of his right food, a large number of the third larval stage of Lucilia sericata could be seen. The larva were treated with 2% prilocain and removed with the help of a forceps. In addition, cryotherapy was applied, and the patient was treated with antibiotics in order to prevent any secondary infections

Investigation of Giardia intestinalis in Fresh Stool Specimens By Using Microscopy and EIA

Giardia intestinalis is one of the most common intestinal protozoan parasite, having a worldwide distribution. Its transmission is by fecal-oral route and is directly related to lack of sanitation and personal hygiene. Giardiasis prevalence is reported to range between 2% and 30% in the world and between 1.9% and 37.7% in different regions of Turkey. The most practical and economic method for the diagnosis of giardiasis is the microscopic examination of the fecal samples. On the other hand, this method needs experienced personnel and its sensitivity in single specimen is reported to be low. As an alternative to microscopy, antigen detection methods such as EIA (Enzyme Immunoassay) and DFA (Direct Fluorescent Antibody) tests have been developed. Our aim in this study was to investigate the presence of G. intestinalis in fresh fecal specimens by using both microscopic method and EIA. The fresh fecal samples of one hundred and eighty patients who applied to Turkish National Institute of Public Health, National Parasitology Reference Laboratory were included in this study. Initially, the samples were examined by microscopy both with native/lugol method and after formol-etyl acetate sedimentation method. The fresh samples separated for EIA were studied according to the manual of the commercial kit and the results were compared. According to the microscopic examination results of 180 fecal specimens examined, while seven samples were positive for G. intestinalis, 22 samples were found to be positive for other protozoa consisting Blastocytis hominis (n= 17), Entamoeba histolytica/ dispar (n= 4) and Entamoeba coli (n= 1). EIA examination revealed that nine of the samples, including the ones detected by microscopy, contained antigens of G. intestinalis. EIA in giardiasis diagnosis is a reasonable choice since it does not require experienced personnel, many samples could be tested simultaneously and it has a high sensitivity and specificity. However, in order not to miss the diagnosis of other possible intestinal parasites, it should be done together with microscopic examination

Report of a rare case of severe allergic reaction due to nasal myiasis and a brief review of the literature in Turkey

Myiasis is defined as infestation of a mammal by fly larvae. It may occur on either living tissues (primary myiasis) or dead tissues (secondary myiasis). In this report, we present a patient with myiasis with an extremely rare clinical manifestation and severe allergic reaction, and we review the literature in order to reveal the current status. A 20-year-old female patient was admitted to our emergency department due to rush on face, cough and shortness of breath. The maggot came out of her nose was identified as Oestrus ovis . With a diagnosis of severe allergic reaction due to myiasis, she was treated diphenhidramine, prednisone and inhale albuterol in the emergency department. After treatment and further investigation, she was discharged with full recovery. Myiasis is a rare cause for severe allergic reaction in patients with definite diagnosis. Immediate diagnosis and treatment are milestones in preventing bad outcomes

Evaluation of serological tests for the diagnosis of visceral leishmaniasis

Aim: Visceral leishmaniasis (VL) is a zoonosis that affects both animals and man. VL is seen sporadically in the Aegean, Mediterranean, Black Sea and central Anatolian regions of Turkey. The aim of this study was to evaluate serological tests for the diagnosis of VL. Materials and Methods: The performance of two agglutination tests based on freeze-dried whole promastigote Leishmania antigen, i.e. Fast Agglutination Screening Test (FAST) and Direct Agglutination Test (DAT), an Indirect Immunofluorescent Antibody Test (IFAT), and an Enzyme-Linked Immunosorbent Assay (ELISA) using soluble antigen were compared to parasitological diagnosis in the serum specimens of 59 patients with the clinical suspicion of VL presenting at a tertiary care center in Ankara. Results: Twenty-four patients had a parasitologically proven VL infection and 35 VL suspects had a negative parasitological work-up. DAT and IFAT were positive in all parasitologically positive patients whereas FAST and ELISA were positive in 23 (95.8%) out of 24 of the cases. Out of 35 clinically suspected but parasitologically negative VL cases, four showed a positive reaction in DAT, five in FAST and IFA and six in ELISA. The agreement between the tests was excellent (agreement: 90-96.6%; κ value: 0.82-0.93). Conclusions: The present study shows that the FAST is a rapid and cost-effective screening test. DAT, IFAT and ELISA tests are all very sensitive tests, but on grounds of simplicity and low cost, the DAT is considered the most suitable test for the sero-diagnosis of VL in our region

BARTONELLA VİNSONİ SUBSP. BERKHOFFİ’NİN KAN KÜLTÜRÜ İLE İSTANBUL’DAKİ BARINAK KÖPEKLERİNDE TARANMASI

Amaç: Bartonella vinsoni subsp. berkhoffii zoonotik potansiyele sahip olup, köpeklerde endokardit başta olmak üzere çeşitli semptomlara yol açmaktadır. Bu çalışma, İstanbul’daki barınak köpeklerinde B. vinsoni subsp. berkhoffii’nin varlığının belirlenmesi amacıyla yapılmıştır. Yöntem: Üç farklı köpek barınağındaki 100 köpekten alınan kan örnekleri, tavşan kanlı beyin kalp infüzyon agara inokule edilerek mikroaerofilik ortamda inkübe edilmiştir. Kültürdeki üremeler, üreme zamanı, koloni morfolojisi ve biyokimyasal özelliklerine göre değerlendirilmiştir. Bulgular: Alınan 100 kan örneğinin 31’inin kan kültürü kontaminasyona bağlı olarak değerlendirilememiştir. Değerlendirmeye alınan 69 örnekte ise Bartonella spp. üremesi gözlenmemiştir. Sonuç: Bu çalışmada İstanbul’daki barınak köpeklerinde B. vinsoni subsp. berkhoffii’nin varlığı belirlenememesine karşın bakterinin zoonotik potansiyeli nedeniyle daha ileri incelemeler yapılması gerektiği düşünülmektedir