Inducible nitric oxide synthase and histopathological correlation in chronic viral hepatitis

PubMedID: 17553719Background: Chronic liver disorders represent a serious health problem. Nitric oxide (NO) synthesized by inducible nitric oxide synthase (iNOS) can function as an antimicrobial agent able to kill or reduce replication of microorganisms, and plays an important role in immune regulation. This study was undertaken to evaluate the expression of iNOS in chronic viral hepatitis and its relation to histopathology. Methods: This study included 56 patients with chronic viral hepatitis (38 hepatitis B, 18 hepatitis C). There were 35 men and 21 women with a mean age of 38.6 ± 21.731 years. A modified form of the histology activity index (HAI) designed by Ishak and colleagues was used to assess grading and staging of chronic viral hepatitis. The needle biopsy specimens were fixed in 10% formalin and routinely processed. Routine hematoxylin-eosin, periodic acid-Schiff, and reticulin staining, and iNOS immunoperoxidase technique were performed on paraffin-embedded tissues. Results: We demonstrated that all liver samples had a marked iNOS expression, with a diffuse distribution pattern. iNOS consistently labeled mononuclear cells infiltrating portal tracts in all samples. Statistical evaluation of data showed that the iNOS expression correlated with the HAI and fibrosis. Furthermore a correlation between iNOS and severity of disease was detected (r = 0.772, p = 0.000). Conclusions: Further investigations are required to determine whether iNOS-related treatment protocols could be useful in reducing disease severity. © 2007 International Society for Infectious Diseases

Probable montelukast-induced hepatotoxicity in a pediatric patient: Case report [3]

PubMedID: 18059126[No abstract available

Nosocomial Urinary Tract Infections: Micro-organisms, Antibiotic Sensitivities and Risk Factors

Objective: Although urinary tract infections (UTIs) are the most common hospital-acquired infections, the epidemiology of these UTIs is not well defined in Turkey. The aim of this surveillance study was to determine micro-organisms responsible for UTI, their antibiotic sensitivities and to describe the incidence and risk factors of nosocomial urinary tract infections (NUTI). Subjects and Methods: This was a prospective surveillance study including cases of NUTI in intensive care units and various inpatient clinics. This study was carried out between November 2000 and January 2002. The following information was recorded: patients’ age, gender, type of infection (hospital-acquired), presence of urinary catheter, intensive care unit admission, duration of hospital stay, type of organisms isolated and their antimicrobial susceptibility. The diagnosis of NUTI was based on criteria established by the Centers for Disease Control, Atlanta. Mini Api and conventional culture methods were used to determine the causative agents. The agents were isolated on eosin methylene blue agar and 5% sheep blood agar. Statistical analyses of data were by chi-square test and logistic regression. Results: In this study, 618 (2.1%) nosocomial infections (NIs) were determined in 29 778 patients, and 178 of these infections were NUTI (28.8%, 178/618). The mean age of NUTI patients was 61.0 ± 19.4 years (0–91 years) and 82 NUTI patients (46.1%) were male and 96 (53.9%) were female. The most frequently isolated micro-organism was Escherichia coli (31.4%) followed by Candida spp (21.3%), Klebsiella spp (10.6%) and Enterococcus spp (6.9%). Compared to the rate of other NIs, the rate of NUTI increased by 1.011 times per year of age, by 2.052 times in females and by 3.83 times in patients with urinary catheters (p < 0.05). The most effective antibiotics against Gram-negative bacteria were found to be imipenem and meropenem. Conclusions: Important factors to prevent NUTI are to avoid unnecessary urethral catheterization, to choose narrow spectrum antibiotics according to antibiotic sensitivities, to investigate regularly the causative micro-organisms and their resistance patterns and to update the treatment protocols. "Infecciones Nosocomiales del Tracto Urinario: Microorganismos, Sensibilidades Antibióticas y Factores de Riesgo" RESUMEN Objetivo: Aunque las infecciones del tracto urinario (ITU) son las que con mayor frecuencia se adquieren en los hospitales, su epidemiología no se halla bien definida en Turquía. El objetivo de este estudio de vigilancia fue determinar los microorganismos responsables de la ITU, sus sensibilidades antibióticas, y describir la incidencia y los factores de riesgo de las infecciones del tracto urinario nosocomiales (ITUN). Sujetos Y Métodos: Este fue un estudio prospectivo de vigilancia que incluyó casos de ITUN en unidades de cuidados intensivos y en varias clínicas de ingreso. El estudio se llevó a cabo entre noviembre de 2000 y enero de 2002. Se registró la siguiente información: edad del paciente, sexo, tipo de infección (adquirida en el hospital), presencia de catéter urinario, ingreso a la unidad de cuidados intensivos, duración de la estadía hospitalaria, y el tipo de organismo aislado así como su susceptibilidad antimicrobiana. El diagnóstico de ITUN se basó en criterios establecidos por los Centros de Control de Enfermedades, Atlanta. El sistema Mini Api y métodos de cultivo convencionales fueron usados con el propósito de determinar los agentes causantes. Los agentes causantes fueron aislados sobre agar-eosina-azul de metileno y agar sangre de oveja a 5%. El análisis estadístico de los datos se realizó usando la prueba de chi-cuadrado y regresión logística. Results: En este estudio, se determinaron 618 (2.1%) infecciones nosocomiales (IN) en 29 778 pacientes, y 178 de estas infecciones resultaron ser INTU (28.8%, 178/618). La edad media de los pacientes de INTU fue 61.0 ± 19.4 años (0–91 años) y 82 pacientes de INTU (46.1%) fueron varones y 96 (53.9%) fueron hembras. El micro-organismo más frecuentemente aislado fue Escherichia coli (31.4%), seguido por Candida spp (21.3%), Klebsiella spp (10.6%) y Enterococcus spp (6.9%). En comparación con la tasa de otras IN, la tasa de INTU aumentó 1.011 veces por año de edad, 2.052 veces en las hembras, y 3.83 veces en pacientes con catéteres urinarios (p < 0.05). Se halló que los antibióticos más efectivos contra las bacterias Gram-negativas fueron imipenema y meropenema. Conclusions: Factores importantes para prevenir las INTU son: evitar cateterizaciones innecesarias de la uretra; escoger antibióticos de espectro estrecho de acuerdo con las sensibilidades antibióticas; investigar con regularidad los micro-organismos causantes y sus patrones de resistencia; y actualizar los protocolos de tratamiento

Knowledge, attitude and sources of information regarding aids of high school students in Antakya (Antioch) City

Aim: The aim of the current study was to investigate the knowledge of senior High school students, sources of their knowledge, and the socio-economical facts acting on their knowledge about AIDS. Methods: A cross sectional, descriptive study, included a total of 2838 students (1368 females and 1470 males) from 16 high schools of 4 different types (State, Anatolian, Trade, and Private high schools). A questionnaire composed of 5 different sections was used to analyze the knowledge level separately "what kind of disease is AIDS", "how AIDS can be transmitted", "risk factors for AIDS", "ways of protection from AIDS", and "the sources of their knowledge about AIDS" in sections from 1 to 5 respectively. In the first 4 sections the right answers were graded with a score of 2, wrong answers were graded with a score of 0, and a score of 1was given when the student did not have an idea. The maximum score for the first 4 sections of the questionnaire were 12, 38, 14, and 14 respectively. In the 5th section the probable sources of knowledge of AIDS, such as school, friends, family, newspapers, books, and TV, were questioned. Results: The mean score received from the questionnaire were 49.50±6.50 (minimum: 27, maximum: 69). The mean score for the females was 49.69±6.46, it was 49.32±6.66 for the males (p&gt;0.05). The mean score for the first 4 sections were 8.2±2.15, 24.7±4, 16, 9.70±2.30, and 6.90±1.79, respectively. Statistically, there was no significant difference observed between the 15-16, 17-18, and 19-20 age groups on knowledge about "risk factors for AIDS" (p&gt;0.05). However, there were meaningful differences in "what kind of disease is AIDS", "how AIDS can be transmitted", and "ways of protection from AIDS" (p&lt;0.05). In aspect of type of high school the knowledge levels of students about AIDS obtained from the questionnaire were statistically different. Concerning the total score of the questionnaire, the students from trade schools received the lowest score, while the highest score of "risk factors for AIDS." were received by Anatolian high school students. The highest score for "what kind of illness is AIDS", "how AIDS be can transmitted", and "ways of protection from AIDS" were received by private high school students. Conclusion: High school students in this region do not have enough knowledge on AIDS. They need education especially on ways of protection and spread of AIDS. © 2011 Versita Warsaw and Springer-Verlag Berlin Heidelberg

Association of insulin resistance, viral load, and adipokine levels with liver histology in patients with chronic hepatitis C: An observational, multicenter study in Turkey

PubMedID: 23114743OBJECTIVE: To evaluate the association of insulin resistance (IR), viral load, and adipokine levels with liver histology in patients with chronic hepatitis C (CHC). PATIENTS AND METHODS: In this noninterventional, multicenter study carried out at 11 infectious diseases clinics in Turkey, 103 CHC patients [mean (SD) age: 50.2 (11.0) years, 60 (58.3%) women] planned to be treated by ribavirin and peginterferon-?2a were included. Data on hepatic fibrosis and steatosis, IR, viral load, and hepatitis C virus-RNA genotyping, adipokine, and cytokine levels were collected. RESULTS: The mean (SD) Knodell score was 8.1 (3.6); grade I steatosis was evident in 46 (44.7%) patients and IR was identified in 56 (54.9%). There was a significant positive correlation of the homeostasis model assessment-IR index with Knodell fibrosis (r=0.235; P=0.027) and hepatic steatosis (r=0.435; P<0.001). There was a significant positive correlation of leptin levels with Knodell fibrosis (r=0.265; P=0.013) and hepatic activity index (r=0.218; P=0.041). Hepatic steatosis was correlated negatively with adiponectin (r=-0.320; P=0.001) and positively with leptin (r=-0.368; P<0.001) levels. Logistic regression analysis showed that increase in age [odds ratio (OR), 1.056; 95% confidence interval (CI), 1.005-1.110; P=0.030] was the only significant predictor of hepatic fibrosis (OR, 1.056; 95% CI, 1.005-1.110; P=0.030), whereas increase in age (OR, 1.066; 95% CI, 1.006-1.130; P=0.030), the presence of IR (OR, 5.621; 95% CI, 1.547-20.425; P=0.009), and decrease in adiponectin levels (OR, 0.808; 95% CI, 0.682-0.957; P=0.013) were the significant predictors of hepatic steatosis. CONCLUSION: Our findings indicate a significant relationship of hepatic fibrosis and hepatic steatosis with IR and leptin levels, but not with the viral load in Turkish patients with CHC. © 2012 Wolters Kluwer Health / Lippincott

Effectiveness and safety of direct-acting antiviral therapies in chronic hepatitis C infections patients with cirrhosis in Turkey

International Liver Congress (ILC) -- APR 11-15, 2018 -- Paris, FRANCEWOS: 000461068601206…European Assoc Study Live

Effectiveness and safety of direct-acting antiviral therapies in chronic hepatitis C infections patients with cirrhosis in Turkey

International Liver Congress (ILC) -- APR 11-15, 2018 -- Paris, FRANCEWOS: 000461068601206European Assoc Study Live

The characteristics of patients with chronic hepatitis B in Turkey

Aim To evaluate the characteristics of patients with hepatitis B virus (HBV) infection and summarize the treatment modalities. Methods By September 30, 2011 the data of 7871 HBsAg (+) patients were complied and analysed according to demographic and medical records (age, sex, laboratory tests, treatment with antiviral agents) in thirty centres of Turkey. Results Of the 7871 patients 3078 (39.1%) were females; mean (standard deviation) age was 35 (14) years, 3180 (40.4%) were HBsAg positive (+) after admission to a hospital, 1488 (18.9%) after blood donation and 967 (11.9%) were found during routine screening. The HBV prevalence among relatives of HBsAg (+) patients was 1764 (22.4%), and most frequently infected family members were siblings and mothers, 4961 (63.0%) and 2149 (27.3%), respectively). Anti-HDV was negative in 7407 94.1% of patients. Three-fourths of the patients 6383 (81.1%) were HBeAg negative (-). Mean (SD) ALT was 85.8 (266.4) U/L. Majority of patients, 5588 (71.0%) were chronic hepatitis-B patients under treatment, while 2283 (29.0%) were asymptomatic carriers without treatment and only 165 (2.1%) of patients were cirrhotic and 6612 (84.0%) of those were compensated. One-third of the patients 2983 (37.9%) were under a combined treatment, while others were under monotherapy. Lamivudine, entecavir and adefovir were the most frequently used oral therapies, used for 2583 (32.8%), 11.6% and 787 (10.0%) of patients, respectively), while 2975 (37.8%) of patients were under interferon treatment. Conclusion Hepatitis B is still a problem in our country. First task of the physicians and our state should be to prevent the development and spread of the disease with education and vaccination programs, safe blood transfusions, and control of barbers