Evaluation of clinical, diagnostic and treatment aspects in hydatid disease: analysis of an 8-year experience

Background & Objective: Echinococcosis is still a common health problem. The aim of this study was to discuss our 8-year data in terms of diagnosis, treatment and follow-up of cystic Echinococcosis.Methods: A total of 178 patients who had hydatid cyst were analyzed retrospectively from the hospital records. The diagnosis of hydatid cyst was based on clinical-serological and radiological findings. Treatment response was evaluated with clinical, radiological and serological findings.Results: A total of 178 medical records were evaluated; the male:female ratio was 0.73 and mean age 44.6±16.9 years. The most common symptom was abdominal pain (94, 52.8%). The mean cyst size was 9.5±3.9 cm. Eosinophilia was significantly higher in patients with complicated cyst (35.3%) (p=0.002). The average duration of hospitalization in surgical patients was shorter than non-surgical patients (p=0.026). There was no significant correlation between the preference of scolicidal agent (hypertonic saline, H2O2, povidone iodine) and recurrence in patients who underwent surgery (p>0.05). There was no significant difference between the patients who underwent radical and conservative surgery in terms of complication and recurrence (p=0.077, p=0.557). No significant difference was found between percutaneous and surgical treatment in terms of complication and recurrence (p=0.264, p=0.276).Conclusion: Even though considerable progress has been made, uncertainties remain in the diagnosis and treatment of Echinococcosis. Hence, standardized diagnostic and treatment procedures should be established with well-designed studies.Keywords: Echinococcosis, hydatid cyst, diagnosis, treatment

Inactıve hepatitis B surface antigen carriers and intrafamilial tramsmission: results of a 10-year study

Background/AimsThe aims of the present study were to determine the outcomes of inactive hepatitis B virus (HBV) surface antigen (HBsAg) carriers over a 10-year study period and to elucidate the HBV serological profile of their family members.MethodsWe retrospectively analyzed the medical files of inactive HBsAg carriers followed up at the Department of Infectious Diseases of Kocatepe University Medical Faculty Hospital between March 2001 and January 2011.ResultsIn total, 438 inactive HBsAg carriers were enrolled in this trial. The follow-up period was 33.7±22.5 months (mean±SD). Anti-hepatitis-B surface antibody seroconversion occurred in 0.7% of cases, while chronic hepatitis B was found in 0.5%. The anti-hepatitis-D virus (HDV) status was evaluated in 400 patients and anti-hepatitis C virus (HCV) in 430. It was found that 1% and 0.2% were positive for anti-HDV and anti-HCV, respectively. HBV serology was investigated in at least 1 family member of 334/438 (76.3%) patients. The HBsAg positivity rate was 34.6% in 625 family members of 334 patients. A comparison of the HBsAg positivity rates in terms of HBV DNA levels in index cases revealed that HBsAg seropositivity rates were higher in family members of HBV DNA-negative patients than in family members of HBV DNA-positive cases (P=0.0001).ConclusionsThe HBsAg positivity rate was higher in family members of inactive HBsAg carriers than in the general population; these family members therefore have a higher risk of HBV transmission. Furthermore, despite negative HBV DNA levels, transmission risk was not reduced in these patients, and horizontal transmission seems to be independent of the HBV DNA value

Evaluation of clinical, diagnostic and treatment aspects in hydatid disease: analysis of an 8-year experience

Background & Objective: Echinococcosis is still a common health problem. The aim of this study was to discuss our 8-year data in terms of diagnosis, treatment and follow-up of cystic Echinococcosis. Methods: A total of 178 patients who had hydatid cyst were analyzed retrospectively from the hospital records. The diagnosis of hydatid cyst was based on clinical-serological and radiological findings. Treatment response was evaluated with clinical, radiological and serological findings. Results: A total of 178 medical records were evaluated; the male:female ratio was 0.73 and mean age 44.6\ub116.9 years. The most common symptom was abdominal pain (94, 52.8%). The mean cyst size was 9.5\ub13.9 cm. Eosinophilia was significantly higher in patients with complicated cyst (35.3%) (p=0.002). The average duration of hospitalization in surgical patients was shorter than non-surgical patients (p=0.026). There was no significant correlation between the preference of scolicidal agent (hypertonic saline, H2O2, povidone iodine) and recurrence in patients who underwent surgery (p>0.05). There was no significant difference between the patients who underwent radical and conservative surgery in terms of complication and recurrence (p=0.077, p=0.557). No significant difference was found between percutaneous and surgical treatment in terms of complication and recurrence (p=0.264, p=0.276). Conclusion: Even though considerable progress has been made, uncertainties remain in the diagnosis and treatment of Echinococcosis. Hence, standardized diagnostic and treatment procedures should be established with well-designed studies

The epidemiology, Clinical Manifestations, radiology, microbiology, treatment, and prognosis of echinococcosis: Results of NENEHATUN study

Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 +/- 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

Acinetobacter Infections: Microbiological Diagnosis and Resistance

Infections caused by multidrug-resistant Acinetobacter spp. present challenges to infectious diseases physicians worldwide. Acinetobacter spp. emerge as a cause of nosocomial outbreaks and are characterized by increasing multidrug resistance. Described resistance mechanisms include hydrolysis by beta-lactamases, alterations in outer membrane proteins and penicillin-binding proteins, and increased activity of efflux pumps. This article is included as a contribution to the current knowledge of resistance of the microorganism

Clinical significances of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and lymphocyte-to-monocyte ratio in infectious spondylodiscitis

Background: The changes in the rate of leukocytes are simple, rapid and hopeful inflammation parameters in many diseases. Despite the close relationship between spondylodiscitis and inflammation, the roles of leukocyte subtypes in spondylodiscitis have not been previously investigated. Objective: To evaluate the value of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and lymphocyte-to-monocyte ratio in predicting abscess and etiology in spondylodiscitis. Materials and methods: A total of 121 medical records of patients were analyzed retrospectively. The data were obtained from hospital records. The neutrophil-to-lymphocyte, platelet-to-lymphocyte and lymphocyte-to-monocyte ratios were calculated using neutrophil, lymphocyte, monocyte and platelet levels in complete blood count measurements. Patients’ clinical data, and their neutrophil-to-lymphocyte, platelet-to-lymphocyte and lymphocyte-to-monocyte ratio values, were analyzed statistically. Results: A total of 121 medical records were evaluated; the male-to-female ratio was 1:1.2 and mean age was 56.1±16.6 years at the time of diagnosis. The lymphocyte-to-monocyte ratio was lower in patients with abscesses than patients with no abscesses (p=0.040). The ‘area under the curve’ value for lymphocyte-to-monocyte ratio was 0.626, with a cut-off point of ≤3.7 in predicting abscess in patients with spondylodiscitis. The mean neutrophil-to-lymphocyte ratio was higher and lymphocyte-to-monocyte ratio was lower in pyogenic spondylodiscitis compared to granulomatous spondylodiscitis (p=0.001 and p=0.038). The ‘area under the curve’ values for the neutrophil-to-lymphocyte ratio and the lymphocyte-to-monocyte ratio were 0.717 and 0.680, respectively, with cut-off points of ≥4.9 and &lt;2.7, respectively, in discriminating pyogenic spondylodiscitis from granulomatous spondylodiscitis. Conclusions: The neutrophil-to-lymphocyte ratio and lymphocyte-to-monocyte ratio are simple, broadly available and cost-effective parameters, and may be useful in the differential diagnosis of infectious spondylodiscitis. [Ethiop. J. Health Dev. 2020; 34(2):144-121] Key words: Lymphocyte, monocyte, neutrophil, platelet, spondylodisciti