Intraerythrocytic and Intralymphocytic Glutathion Peroxidase Enzyme Activities in Patients with Brucellosis

In this study, the activities of intraerythrocytic and intralymphocytic glutathion peroxidase enzymes (GSH-Px) were determined in 60 patients with brucella infection. There were 4 groups, each containing 20 individuals. In group I (20 patients) enzyme activities were measured before treatment, in group II (20 patients) during treatment and in group III (20 patients) after treatment. Group IV (20 people) served as control group and included healthy individuals. The intraerythrocytic GSH-Px activity was 95.07 ± 16.57, 99.95 ± 16.63, 118.42 ± 33.72, and 128.03 ± 39.53 U/g haemoglobin in groups I to IV, respectively. The intralymphocytic GSH-Px activity was 742.02 ± 14.32, 681.08 ± 9.12, 545.86 ± 8.30, and 558.09 ± 11.73 U/mg protein in groups I to IV, respectively. The GSH-Px activity in erythrocytes were lower in all groups when compared to the control group, there was a statistically significant difference between the patient and the control groups (p< 0.05). The intralymphocytic GSH-Px activities were higher except group III in all groups when compared to the control group. The difference in groups I and II was statistically significant (p< 0.05) except treated group (group III). In conclusion, intraerythrocytic GSH-Px enzyme activities were lower in all patients with brucellosis, and intralymphocytic GSH-Px enzyme activities were higher in all cases. The intralymphocytic GSH-Px plays an important role in both the immune response to brucellosis and the response to the treatment

Tetanus Immunity in Malatya Area

We studied antitoxin levels for tetanus in Malatya area. In this study, we studied the antitoxin levels by ELISA in blood samples of 175 subjects. Of these 175 subjects number of male and female are 89 and 86, respectively; and age of them are arranged between 1-79 years old. We found antitoxin levels in 0-12, 13-20, 21-30, 31-50, 51 and older age group as 14.3%, 5.9%, 25%, 74.3% and 85.7%, respectively, that all of which were under the protective level. There were not statistically significant difference between male and female population for tetanus immunity. We determined more decrease in protective immunity level in 31 and older age groups, especially in women. Tetanus protective immunity level was higher in between 0-30 years age group than 31 and older ones, and, the result was statistically significant (p < 0.05). In conclusion; for elimination of tetanus diseases an effective immunization programme should be provided during all period of life, from birth to death. We consider that the vaccination should be done every 10 years for people who have had enough antitoxin levels after active immunization

The Efficacy of Some Disinfectants to Acinetobacter Species Causing Nosocomial Infections

The most important step for preventing hospital acquired infections is the choice and usage of appropriate disinfectant. For this purpose, the most problematical pathogens and their susceptibility to the disinfectants have to be known in every hospital. In this study, we evaluated the susceptibility of multidrug resistant 10 Acinetobacter spp. against the 10 disinfectants by broth microdilution method. The most effective disinfectants were determined as Chlorispray® (ethanole + chlorhexidine digluconate + glutaraldehyde + formaldehyde + didecyl dimethyl-ammonium chloride), Endex® (cocospropylene diamine diguanidium diacetate/didecyleoxymethyle ammonium propionate) and Savlex® (cetrimide/chlorhexidine), and alcohol (70%), benzalchonium chloride and povidone iodine the mostly used disinfectants were the least effective to the Acinetobacter spp. As a result, we concluded that the susceptibility of the multidrug resistant microorganisms to the disinfectants has to be determined according to the result of the surveillance and the disinfection policies have to be determined in the light of these results

Glutathion Peroxidase and Nitric Oxide Activities in the Lymphocytes of Patients with Hepatitis C Virus Infection

We searched glutathion peroxidase (GSH-Px), and nitric oxide levels in the lymphocytes of patients with hepatitis C virus (HCV) infection. For this purpose we measured intralymphocyte glutathion peroxidase (GSH-Px) and total nitrite levels (nitric oxide metabolites= NO) in 40 patients [10 healthy individuals selected as a control group (group I), 10 patients with acute HCV infection (group II), 10 patients with chronic HCV infection (group III) and 10 patients with chronic HCV infection who were treated with interferon alpha (3 million Ux 3/week) for 6 months (group IV)] in Turgut Özal Medical Center. We found GSH-Px activity to be 548.5 ± 46.96 U/mg, 382.65 ± 42.2 U/mg, 736.01 ± 57.47 U/mg, and 592.03 ± 56.74 U/mg in study groups, respectively. The difference between the groups was statistically significant (p< 0.0001). Total nitrite level in lymphocytes was 25 µmol/dL, 23 µmol/dL, 13µmol/dL, and 23 µmol/dL in study groups, respectively. Nitric oxid levels were similar in groups I, II, and IV; but it was low in untreated patients with chronic HCV infection (group III) (p< 0.0001). In conclusion; intralymphocyte GSH-Px was lower in the patients with acute HCV infection, whereas nitric oxide metabolites were lower in the untreated patients with chronic HCV infection. Both GSH-Px and NO levels were found to be nearly normal, in the patients who received interferon therapy (group IV)

Review of 15 Cases of Neurobrucellosis

Introduction: Brucellosis is a zoonotic disease remaining endemic worldwide and in Turkey. Central nervous system involvement is a rare complication in brucellosis. This study is an overview of 15 neurobrucellosis cases who were followed in our department as inpatients. Patients and Methods: This study is a retrospective analysis of fi fteen cases of neurobrucellosis in the Infectious Diseases and Clinical Microbiology Department of Inonu University Medical Faculty Hospital between the years 2005-2010. Clinical features, laboratory findings, diagnosis, and treatment strategies were recorded retrospectively. Results: Of the fi fteen patients, 6 were females and 9 were males. Mean age of the patientswas 36.2 years (range, 18-68 years). Mean disease duration before diagnosis was 2 months. The most common symptoms were headache and fever, 66 % and 60 %, respectively. Eight patients (53 %) had visual symptoms, 3 patients (20%) had senso-rineural hearing loss, and 2 patients (13%) had ataxia. Two patients had pancytopenia and four patients had abnormal liver function tests. Two patients did not give informed consent for lumbar puncture (LP). The diagnostic LP performed in all thirteen patients revealed high protein levels and pleocytosis in cerebrospinal fl uid (CSF). Seven patients (53.8 %) had low glucose levels in CSF. Twelve patients (80%) had a serum tube agglutination test value 1/160 or higher. Brucella spp. were isolated from the blood culture of six patients and from the CSF culture of three patients. All patients received antibiotic therapy initially with doxycycline, rifampin, ceftriaxone, and trimethoprim-sulfamethoxazole. None of the patients died, but sequelae resulted in two patients. Conclusion: Patients with unexplained fever, headache, and neurological symptoms should be considered for neurobrucellosis in endemic regions

Naturally Occurring Cutaneous Anthrax: Antibiotic Treatment and Outcome

Objectives: Cutaneous anthrax (CA) is the most common clinical presentation in human anthrax, but the duration of antibiotic therapy in naturally occurring CA is controversial. The aim of this study was to compare the clinical outcomes of patients receiving antibiotic treatment for either 3-5 days (group 1) or 7-10 days (group 2) in uncomplicated CA. Methods: A total of 66 patients were enrolled; 29 (44%) in group 1 and 37 (56%) in group 2. Infections were classified as mild (n = 22, 33%) or severe (n = 44, 67%) CA. Results: There were no significant differences between the groups in symptom resolution time, fever clearance time, healing of lesions, development and healing of eschars, requirement for surgical intervention or the development of complications. Both edema resolution time and duration of hospital stay were longer in group 2. There were no therapeutic failures, relapses or deaths in either group. Steroid therapy was used in 32% of patients with severe CA, but a beneficial effect on resolution of edema was not demonstrated. Conclusions: These results suggest that short-course antibiotic therapy is as effective as standard-duration therapy in uncomplicated CA and that steroid therapy may not be effective. Copyright (C) 2012 S. Karger AG, Base

Community Acquired Lower Urinary Tract Infections in Primary Care: Causative Agents and Antimicrobial Susceptibility

Introduction: The aim of this study was to determine the causative agents of community-acquired lower urinary tract infections (CALUTIs) in primary care. We also aimed to evaluate the antimicrobial susceptibility rates of urinary Escherichia coli isolates to various oral antibiotics and to assist primary care physicians with antibiotic selection. Materials and Methods: The study was performed in 55 primary care centers in 13 cities between May and July 2009. Adult patients with at least two of dysuria, pollakiuria, nocturia, suprapubic tenderness, or blurred urine symptoms, but not fever, were included in the study. Urinary samples were obtained and patient data were recorded at the primary care centers. Results: Totally, 400 patients were enrolled. In 175 (43.8%) patients, urine cultures yielded a urinary pathogen. The most frequently encountered pathogen was E. coli (62.8%). Among E. coli isolates, the lowest resistance rates were detected for nitrofurantoin (0.9%) and fosfomycin (3.6%) and the highest for trimethoprim/sulfamethoxazole (43.6%) and amoxicillin/clavulanate (41%). Resistance rates to quinolones were 23.6% for ciprofloxacin and 21% for levofloxacin. Minimum inhibitory concentration (MIC)50 and MIC90 values for ciprofloxacin and levofloxacin were 0.015 and 32 μg/mL and 0.06 and 16 μg/mL, respectively. Quinolone resistance was significantly higher in patients who received an antimicrobial treatment within the last three months (p< 0.001). Extended spectrum beta-lactamase (ESBL) positivity was detected in 15 of 110 (13.6%) E. coli isolates. Quinolone resistance was significantly higher among ESBL positive than ESBL negative strains (53.3% vs. 15.8%, p= 0.002). Conclusion: In conclusion, the most frequent causative agent in CALUTIs was E. coli. The lowest resistance rates among E. coli isolates were detected for nitrofurantoin and fosfomycin. Resistance rates to quinolones were over 20% in our study. Our identifikasyostudy provides important data about the causative agents and their antibiotic susceptibilities and also contains valuable data for rational antibiotic usage in the treatment of CALUTI in Turkey

Occult hepatitis B infection in Turkish HIV-infected patients: A multicentre, retrospective, cross-sectional study, Schindler study

Objective Occult hepatitis B infection (OHBI) appears to have a higher prevalence in populations at high risk for hepatitis B virus (HBV) infection with concomitant liver disease. The aim was to assess the prevalence of OHBI in a sample of human immunodeficiency virus -1 positive and HBV surface antigen-negative (HIV-1+/HBsAg-) Turkish patients

Biologic treatments in Takayasu's Arteritis: A comparative study of tumor necrosis factor inhibitors and tocilizumab

Objective: To compare the treatment outcomes of TNF inhibitors and tocilizumab (TCZ) in patients with Takayasu arteritis. Methods: Takayasu arteritis patients who were refractory to conventional immunosuppressive (IS) drugs and received biologic treatment were included in this multicenter retrospective cohort study. Clinical, laboratory and imaging data during follow-up were recorded. Remission, glucocorticoid (GC) sparing effect, drug survival was compared between TNF inhibitor and TCZ treatments. Also, a subgroup matched comparison was performed between groups. Results: One hundred and eleven (F/M: 98/13) patients were enrolled. A total of 173 biologic treatment courses (77 infliximab, 49 TCZ, 33 adalimumab, 9 certolizumab, 3 rituximab, 1 ustekinumab and 1 anakinra) were given. Tocilizumab was chosen in 23 patients and TNF inhibitors were chosen in 88 patients as first line biologic agent. Complete/partial remission rates between TCZ and TNF inhibitors were similar at 3rd month and at the end of the follow-up. GC dose decrease (<4 mg) or discontinuation of GCs was achieved in a similar rate in both groups (TNF inhibitors vs TCZ: 78% vs 59%, p = 0.125). Drug survival rate was 56% in TNF inhibitors and 57% in TCZ group (p = 0.22). The use of concomitant conventional ISs did not affect the drug survival (HR =0.78, 95% CI =0.42-1.43, p = 0.42). The match analysis showed similar results between groups in terms of relapse, decrease in GC dose, surgery need and mortality. Conclusion: The efficacy and safety outcomes and drug survival rates seem to be similar for TNF inhibitors and tocilizumab in patients with Takayasu arteritis. (c) 2021 Elsevier Inc. All rights reserved