Seroprevalence of Asymptomatic Leishmania spp. Carriage Among Blood Donors in Leishmaniasis Endemic Area in Turkey

Introduction: Transfusion-related infections are usually caused by a microbial pathogen transmitted to the recipient by the donated blood. Plasmodium spp., Trypanosoma cruzi, Babesia microti, Toxoplasma gondii and Leishmania spp. are listed as the most widely reported transfusion-transmitted parasites. Leishmaniasis is well known as an endemic in Mediterranean countries including Turkey. Accordingly, detection of asymptomatic Leishmania infantum carriage in blood donors is an important issue in Turkey. In endemic teretories, research on blood donors is under-represented in Turkey. Likewise, Mersin province is also endemic for Leishmaniasis. Up to date, no studies have been conducted to detect Leishmaniasis in healthy blood donors in our region. Therefore, the main objective of the current study was to reveal the seroprevalance of asymptomatic Leishmania carriage among the blood donors in Mersin province

Is L-glutamine really effective in reducing painful crisis and hospitalization for sickle cell anemia patients in real life?

9th International Eurasian Hematology Oncology Congress (EHOC) -- OCT 17-20, 2018 -- Istanbul, TURKEYWOS: 000447176600085

Seasonal Association of Immune Thrombocytopenia in Adults

Saydam, Guray/0000-0001-8646-1673; GURKAN, EMEL/0000-0002-3060-4054WOS: 000362846400002PubMed: 26740892Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8 +/- 16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen

The Clinical Characteristics and Therapeutic Outcomes of Elderly Patients with Chronic Lymphocytic Leukemia: A Retrospective Multicenter Study

56th Annual Meeting of the American-Society-of-Hematology -- DEC 06-09, 2014 -- San Francisco, CASaydam, Guray/0000-0001-8646-1673; Kaynar, Leylagul/0000-0002-2035-9462; KAYA, Emin/0000-0001-8605-8497WOS: 000349233802125…Amer Soc Hemato

Therapeutic Plasma Exchange in Patients with Neurologic Disorders: Review of 63 Cases

TOMBAK, ANIL/0000-0002-7195-1845WOS: 000398084800017PubMed: 28194064Therapeutic plasma exchange (TPE) is a procedure that reduces circulating autoantibodies of the patients. TPE is commonly used in neurological disorders where autoimmunity plays a major role. We report our experience with regard to the indications, adverse events and outcomes of plasma exchange in neurological disorders. Sixty-three patients were included to this retrospective study. Median age was 48 years (range 1-85), there was a predominance of males. Neurological indications included Guillain-Barre syndrome (n = 22), myasthenia gravis (n = 21), chronic inflammatory demyelinating polyneuropathy (n = 7), polymyositis (n = 3), multifocal motor neuropathy (n = 2), acute disseminated encephalomyelitis (n = 2), neuromyelitis optica (n = 2), multiple sclerosis (n = 2), limbic encephalitis (n = 1) and transverse myelitis (n = 1). TPE was frontline therapy in 57 % of the patients (n = 36). Total number of TPE sessions was 517; median number of sessions per patient was 8 (range 1-66). TPE was done through a central venous access in 97 % and through a peripheral venous access in 3 % of the patients. Human albumin was used as replacement fluid in 49 %, hydroxyethyl starch (HES) in 49 % and fresh frozen plasma in 2 % of the cases. Adverse reactions were recorded in 60 % of the patients. Total ratio of complications in 517 TPE procedures was 10.8 % and these were mild and manageable such as allergic reactions and hypotension. Overall response rate was 81 %. Interestingly, complication and response rates were similar in both HES and human albumin groups. We conclude that TPE is an effective treatment in neurologic diseases in which autoimmunity plays an important role in the pathogenesis and HES can be used instead of albumin as replacement fluid in these disorders, since it is cost-effective, has similar efficacy and complication rates

Flavivirus Seroepidemiology In Blood Donors In Mersin Province, Turkey

Among the vector-borne flaviviruses, West Nile virus (WNV), tick-borne encephalitis virus (TBEV) and Dengue virus (DENV) constitute the most frequently-observed pathogens with significant public health impact in endemic regions throughout the globe. This seroepidemiological study was undertaken to investigate human exposure to DENV, WNV and TBEV, as well as other flaviviruses via various serological assays in the Mediterranean province of Mersin, Turkey, where scarce data is currently present for the circulation of these agent. A total of 920 sera were collected after informed consent from asymptomatic blood donors (all were male; age range: 18-63 yrs, mean age: 35.17 +/- 9.56 yrs) were taken between August 2010 and April 2011. All samples were initially screened via a commercial ELISA kit for DENV IgM and IgG. Reactive samples were further evaluated via commercial indirect immunofluorescence tests (IIFTs) for yellow fever virus (YFV) IgG, TBEV IgG and via ELISA for WNV IgG. Moreover, presence of neutralizing antibodies were investigated in all reactive samples via plaque reduction neutralization (PRNT) assay for WNV, whose activity has been detected previously in the region. Samples interpreted as positive for TBEV IgG were further evaluated for specificity by TBEV PRNT assay. DENV IgM reactive samples were also assessed for NS1 antigens and IgM/IgG antibodies via a commercial immunochromatographic assay (ICA). DENV IgM and IgG antibodies were detected in 0.9% (8/920) and 16.6% (153/920) of the samples, respectively. One sample was simultaneously positive for IgM and IgG. WNV PRNT revealed positive results in 85.6% (137/160) of the reactive samples, which indicated frequent WNV exposure and frequent development of cross-reactions in the screening assay. Positive or borderline DENV IgM reactivity was identified in 0.43% (4/920) of the samples, which remained negative for NS1 antigen and antibodies in the ICA. Antibody specificity in two samples, positive for DENV and TBEV IgG in IIFT could not be confirmed by TBEV PRNT. A total of 19 reactive samples (19/920, 2.1%), that comprise seven borderline and six positive DENV IgG positivities as well as six samples with IgG positivity for different virus combinations remained negative after DENV confirmatory and WNV/TBEV PRNT assays. When the samples with borderline results were omitted from the evaluation, 12 samples (12/920, 1.3%) were considered to represent exposure to DENV or an antigenically-similar flavivirus. These findings indicated the activity of and frequent exposure (137/920, 14.9%) to WNV, as previously suggested in the study region. In 1.3% of the samples, probable exposure to DENV or other flaviviruses was revealed and this requires further serosurveillance efforts. WNV must be considered in the etiology of febrile diseases or viral neuroinvasive infections of unexplained etiology in the study area.WoSScopusTr-Dizi

Ege Üniversitesi ve Mersin Üniversitesi Tıp Fakültelerinin kan merkezlerine başvuran HBsAg negatif kan vericilerinde HBV-DNA varlığının araştırılması

Aim: Hepatitis B virus (HBV) remains important among the agents of blood transmitted infections. Although increased sensitivity of serological tests, detection of HBV-DNA by nucleic acid tests (NAT) techniques, especially by the individual NAT (ID-NAT) techniques for safe blood transfusion came into question. Materials and Methods: A total of 4352 HBsAg negative volunteer-donors in ages of 18-65 years admitted to the Blood Transfusion Centers of Ege University Faculty of Medicine and Mersin University Faculty of Medicine Hospital were included in the study between April 2010 and January 2011. The samples of the donors were tested with real- time polymerase chain reaction (RT-PCR) in order to detect HBV-DNA. Results: Following HBV-DNA screening, only two positive serum results were found. Test was repeated on two positive samples with both the same and an alternative method. Repeated tests resulted negative; therefore all samples were assessed as HBV-DNA negative. In all samples of HBsAg negative donors from two different centers, HBV-DNA was found to be negative. Conclusion: The number of blood donors included in the study and low seroprevalence of the centers could be the reason for no detection of occult HBV. Turkish Red Crescent routine NAT studies that began in 2014 will give appropriate data for occult HBV in our regionAmaç: Kan yoluyla bulaşan enfeksiyon etkenleri arasında hepatit B virüsü (HBV) önemini korumaktadır. Serolojik testlerin duyarlılığının arttırılmasına rağmen güvenli kan transfüzyonu için kanda HBV-DNA varlığını saptayan nükleik asit testi (NAT) uygulamaları, özellikle de tek tek örneklere uygulanan NAT (ID-NAT) uygulamaları gündeme gelmiştir. Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi Kan Merkezi ve Mersin Üniversitesi Tıp Fakültesi Sağlık Araştırma Uygulama Hastanesi Kan Merkezi’ne Nisan 2010 ile Ocak 2011 tarihleri arasında başvuran 18–65 yaşları arasındaki 4352 HBsAg negatif kan vericisinin serum örnekleri incelenmek üzere çalışmaya alındı. Kan vericilerinin örneklerinde HBV-DNA’yı saptamak amacıyla gerçek zamanlı polimeraz zincir reaksiyonu (RT-PCR) testi uygulandı. Bulgular: Çalışılan örneklerden sadece 2 serumda HBV-DNA şüpheli pozitif olarak saptandı. İki pozitif sonuç aynı yöntemle iki kez ve farklı alternatif yöntemlerle doğrulamak amacıyla tekrarlandı. Tekrarlanan örneklerin negatif bulunması sonucunda örneklerin tümünde HBV-DNA negatif olarak değerlendirildi. İki ayrı merkezden alınan HBsAg negatif kan vericilerinin tüm örneklerinde HBV-DNA negatif bulundu. Sonuç: Çalışmaya alınan kan vericilerin sayısı ve merkezlerdeki düşük seroprevalans gizli HBV görülmemesinin nedeni olabilir. Türk Kızılayı’nın 2014’de başlayan rutin NAT çalışmaları bölgemizdeki gizli HBV verilerini daha net ortaya çıkaracaktı