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ABSTRACT: Background. The aim of this study was to evaluate oxidative stress and to determine the activity of paraoxonase and arylesterase in patients with osteomyelitis compared to healthy controls. Method. In total, 30 patients diagnosed with osteomyelitis and 30 healthy volunteers were enrolled in the study. Paraoxonase and arylesterase activities were measured spectrophotometrically. Serum lipid hydroperoxide (LOOH) concentrations were measured by ferrous oxidation with xylenol orange (FOX) assay as markers of oxidative stress. Results. Serum paraoxonase and arylesterase activities were significantly lower in patients with osteomyelitis compared to control individuals (all p < 0.05). Serum LOOH concentrations were significantly higher in patients with osteomyelitis than those in controls (p < 0.05). Arylesterase activity was inversely correlated with triglyceride (r =- 0.49; p = 0.005) and cholesterol concentrations (r =- 0.41; p = 0.025). Conclusion. In light of the findings obtained from the present study, it may be assumed that decreased activity of serum paraoxonase and increased concentrations of LOOH observed in osteomyelitis patients appear to be related to the increased oxidative stress and inflammatory conditions present in these patients, and may cause a much more severe status of the disease.
Scandinavian journal of clinical and laboratory investigation 09/2012; 72(7):513-7. · 1.38 Impact Factor
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ABSTRACT: Neurobrucellosis (NB) is a rare, but important complication of brucellosis. The clinical features vary greatly and, in general, tend to be chronic. Many laboratory procedures are usually employed in the diagnosis of NB. Even though the culture method is the gold standard, growth rate is low and time consuming. Thus the rate of sequelae and mortality increase in case of a delay in treatment. Therefore it is necessary to perform serological tests in both serum and cerebrospinal fluid (CSF) in suspected patients. In this study we aim to evaluate clinical features, diagnosis, and treatment of patients with NB.
We enrolled 17 patients diagnosed with NB. Clinical features, cultures, serological tests, additional laboratory findings, and CSF analyses were recorded for all patients.
There were 14 female and 3 male patients. Ten patients presented with neuropsychiatric symptoms and signs (aphasia, diplopia, hemiparesis, facial paralysis, tremor, ataxia, depression, personality disorder, and hallucinations). Serum standard agglutination test (SAT) was negative in 4 (23.5%) patients and serum Coombs' test was negative in 2 (11.7%). CSF SAT was negative in 4 (23.5%) patients and CSF Coombs was negative in 3 (17.6%) patients. B. melitensis grew in the blood of 6 (35.2%) patients and in the CSF of 3 (17.6%). Treatment protocol for 11 patients consisted of ceftriaxone, rifampicin, and doxycyline for a period of four weeks, followed by rifampicin and doxycyline for an additional four weeks. The remaining patients were given different treatment combinations. One patient died, mild sequelae was present in another patient and the remaining patients recovered without any sequelae.
NB should be considered in the differential diagnosis of neurological and psychiatric cases that are encountered in endemic areas for brucellosis. In order to prevent overlooking this diagnosis, Coombs' test should be performed in both CSF and serum.
Archives of Iranian medicine 08/2012; 15(8):491-4. · 0.97 Impact Factor
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ABSTRACT: Hepatitis C infection represents a common healthcare issue worldwide. The present trial was designed to investigate the role of prolidase, an enzyme that is significantly involved in the biosynthesis of collagen, and of the oxidative stress that is considered to be involved in the pathogenesis of various diseases, in the chronic hepatitis C infection. The trial was performed to assess the serum prolidase enzyme level and the oxidative-antioxidative status and to determine the relation between the serum prolidase activity and the oxidative stress parameters.
A total of 95 individuals, including 55 patients with chronic hepatitis C infection (CHC) and 40 healthy adults, were enrolled in the trial. The values for prolidase, the total antioxidant status (TAS), the total oxidative stress (TOS), the oxidative stress index (OSI), sulfhydryl (SH), lipid peroxidation LOOH, catalase (CAT), and ceruloplasmin were measured and compared between the patient groups.
The prolidase, TOS, LOOH, CAT, and the OSI values were higher in the chronic hepatitis C group compared to the control group (P < 0.001). The TAS, SH, and ceruloplasmin levels were lower in the CHC group relative to the control group (P < 0.001).
We suppose that the values of prolidase and the oxidative stress are increased while the antioxidant levels are decreased in CHC. As a result, prolidase and the oxidative stress seem to be related with the progression of the disease.
Journal of Clinical Laboratory Analysis 07/2012; 26(4):232-7. · 1.38 Impact Factor
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Suda Tekin Koruk,
Hakan Erdem,
Ibrahim Koruk,
Ayşe Erbay,
Yasemin Tezer-Tekce,
Ali Rıza Erbay,
Saim Dayan,
Ozcan Deveci,
Asuman Inan,
Derya Ozturk Engin, [......],
Mucahit Yemisen,
Sema Alp-Cavus,
Serap Gencer,
Gokhan Guzel,
Oral Oncul,
Mehmet Parlak,
Esra Kazak,
Necla Tulek,
Asim Ulcay,
Umit Savasci
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ABSTRACT: Brucella endocarditis (BE) is a rare but life-threatening complication of human brucellosis. The aim of this study was to investigate the course of BE along with the therapeutic interrelations. A total of 53 patients with BE hospitalised in 19 health institutions between 2006 and 2011 were included in the Gulhane study. Diagnosis of brucellosis was established by either isolation of Brucella sp. or the presence of antibodies, and the definition of endocarditis was made according to Duke's criteria. There were four treatment groups: ceftriaxone combined with oral antibiotics (Group 1); aminoglycosides combined with oral antibiotics (Group 2); oral antibiotic combinations (Group 3); and aminoglycoside plus ceftriaxone combined with an oral antibiotic (Group 4). Involvement rates of the aortic, mitral and tricuspid valves were 49.1%, 43.4% and 5.7%, respectively. Thirty-two patients (60.4%) had an underlying cardiac valvular problem, including previous prosthetic valve replacement (n=18). Medical treatment was provided to 32 patients (60.4%), whilst concordant medical and surgical approaches were provided to 21 patients (39.6%). Mortality in Group 1 was 15% (3/20), whilst in Group 2 it was 5.3% (1/19). In Group 3, 25.0% (3/12) of the cases died, whereas none of the cases in Group 4 died. In conclusion, mortality increased 47-fold with pericardial effusion and 25-fold due to congestive heart failure that developed after BE. Although mortality was lower in the aminoglycoside-containing arm (Groups 2 and 4), statistical analysis could not be performed owing to the small number of patients.
International journal of antimicrobial agents 06/2012; 40(2):145-50. · 3.03 Impact Factor
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Hakan Erdem, Suda Tekin-Koruk,
Ibrahim Koruk,
Derya Tozlu-Keten,
Aysegul Ulu-Kilic,
Oral Oncul,
Rahmet Guner,
Serhat Birengel,
Gurkan Mert,
Saygin Nayman-Alpat, [......],
Asim Ulcay,
Halil Kurt,
Bulent A Besirbellioglu,
Haluk Vahaboglu,
Yesim Tasova,
Gaye Usluer,
Dilek Arman,
Husrev Diktas,
Sercan Ulusoy,
Hakan Leblebicioglu
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ABSTRACT: 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.
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.
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.
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.
Annals of Clinical Microbiology and Antimicrobials 12/2011; 10:38. · 2.64 Impact Factor
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Hakan Erdem,
Aysegül Ulu-Kilic,
Selim Kilic,
Mustafa Karahocagil,
Ghaydaa Shehata,
Necla Eren-Tulek,
Funda Yetkin,
Mustafa Kemal Celen,
Nurgul Ceran,
Hanefi Cem Gul, [......],
Serhat Unal,
Saim Dayan,
Levent Gorenek,
Ahmet Karakas,
Yesim Tasova,
Gaye Usluer,
Yasar Bayindir,
Behice Kurtaran,
Oguz Resat Sipahi,
Hakan Leblebicioglu
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ABSTRACT: No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 ± 2.47 months in P1, 6.52 ± 4.15 months in P2, and 5.18 ± 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/117) and P3 (6.1%, n = 3/49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.
Antimicrobial Agents and Chemotherapy 12/2011; 56(3):1523-8. · 4.84 Impact Factor
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ABSTRACT: The aims of this study were to evaluate oxidant and antioxidant status in patients with acute brucellosis before and after therapy, and to determine whether this index could be used to monitor the treatment of brucellosis.
Thirty patients with a diagnosis of acute brucellosis and 37 healthy volunteers were enrolled in the study. Total antioxidant status (TAS) and total oxidant status (TOS) were measured in patients before and after therapy, and an oxidative stress index (OSI) was calculated. These measurements were also taken for the healthy control group and the values were compared.
Plasma levels of TOS and OSI were significantly higher in patients with brucellosis before therapy as compared to the treated group (t: 11.19, p<0.000 and t: 9.91, p<0.000, respectively). After treatment, TOS and OSI levels were lower, whereas in contrast, TAS levels were significantly higher (t: -4.17, p<0.000). TOS and OSI levels were found to be significantly higher in the patients before treatment than in the control group (t: 15.01, p<0.000 and t: 15.00, p<0.000, respectively). TAS levels in patients before treatment were lower than in the controls and the difference was significant (t: -8.03, p<0.000). TOS and OSI levels were significantly higher in the treated group than in the control group (t: 4.58, p<0.000 and t: 9.91, p<0.000, respectively). TAS levels in the treated group were lower than in the control group and the difference was significant (t: -3.02, p<0.004).
Reduced TAS capacity and elevated TOS levels may lead to considerable oxidative stress in brucellosis. Increased oxidative stress may cause severe oxidative damage in the body, and even though this damage ameliorates considerably with 6weeks of treatment, normal healthy levels are not attained. In addition, it appears possible that these oxidant and antioxidant parameters could be used to monitor treatment.
International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 03/2011; 15(5):e346-9. · 2.17 Impact Factor
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ABSTRACT: The aim of this study was to determine and evaluate the activity of paraoxonase and arylesterase enzymes in various clinical forms of hepatitis B infection and to investigate the correlation between these parameters and chronic disease course/fibrosis. Overall, 40 patients diagnosed as hepatitis B carriers (CIHBV), 40 chronic active hepatitis B (CAHBV) patients, and 40 healthy adults (control group) between 18 and 65 years of age were enrolled the study. Serum paraoxonase and arylesterase activities were measured spectrophotometrically. Their activities were significantly lower in patients with CAHBV compared with CIHBV patients or with control group patients (P<0.001). There was a negative correlation between alanine aminotransferase levels and the activity of paraoxonase and arylesterase (r = -0.38, P = 0.001 and r = -0.28, P = 0.002, respectively). A statistically significant negative correlation was found between arylesterase activity in the sera of CAHBV patients and HBV DNA levels (ρ = -0.33, P = 0.03). On the contrary, no correlation was found between paraoxonase levels and HBV DNA levels (P>0.05). The histology activity index of CAHBV patients did not correlate with paraoxonase and arylesterase activities (P>0.05). In light of these findings, it may be assumed that during the progression of an inactive hepatitis B carrier to being actively infected, reduced paraoxonase and arylesterase activities may be observed.
Journal of Clinical Laboratory Analysis 01/2011; 25(5):311-6. · 1.38 Impact Factor
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ABSTRACT: Leptospirosis is an acute generalized infectious disease, caused by spirochaetes, Leptospira interrogans. The severity of the disease ranges from an asymptomatic subclinical course to a fatal outcome. The three cases presented here were diagnosed serologically and had thrombocytopenia and acute renal failure as complication of anicteric leptospirosis. Our first case admitted with clinical presentation of pneumonia but clinical progress and laboratory findings made us to consider leptospirosis. The other two cases presented with aseptic meningitis were diagnosed as anicteric leptospirosis by the serological test results. One of the cases had fatal outcome but could not be strictly correlated with leptospirosis.
The Journal of infection 03/2006; 52(2):e45-8. · 4.13 Impact Factor
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ABSTRACT: Juniper tar (cade oil) is distilled from the branches and wood of Juniperus oxycedrus. It contains etheric oils, triterpene and phenols, and is used for many purposes in folk medicine. A case is reported of a previously healthy man who ingested a spoonful of home-made extract of Juniperus oxycedrus. The poisoning caused fever, severe hypotension, renal failure, hepatotoxicity, and severe cutaneous burns on the face. After supportive and symptomatic treatment, the patient improved and was discharged in a good condition on the eleventh day.
Clinical Toxicology 02/2005; 43(1):47-9. · 2.22 Impact Factor
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Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 25(3):290-1. · 2.10 Impact Factor
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ABSTRACT: Neurobrucellosis is one of the complications of brucellosis. We report a rare case of a 17-year-old girl with seronegative neurobrucellosis and depression and diplopia. Results of agglutination tests for Brucella both in serum and CSF were negative. Diagnosis was made only by positive culture of Brucella mellitensis with inoculation of the patient's cerebrospinal fluid in a BACTEC 9050 System. The patient was successfully treated using ceftriaxone, doxycycline and rifampicin therapy for six months.
Annals of Saudi medicine 30(5):412-4. · 1.07 Impact Factor
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ABSTRACT: The aim of the study was to investigate the mast cell (MC) concentration in the liver tissue of patients diagnosed with chronic hepatitis C and to determine whether there was a correlation with clinical and pathological characteristics of patients.
The study was conducted on liver biopsy samples from 60 patients with chronic hepatitis C. Clinical and laboratory data were obtained from follow-up records. Stained liver biopsies were examined. Immunohistochemical staining was performed by using an anti-c-kit antibody. Patients were divided into four groups (minimal, mild, moderate, and severe) based on the intensity of inflammation and their hepatic activity index scores and into two groups (no-mild, moderate-severe) according to fibrosis grade.
Among patients enrolled, 60.0% (n=36) were men with a mean age of 48.3 ± 12.7 (range 18-64) years. The mean number of mast cells per portal area in the liver was 0.87 ± 0.86 (0-4.0). No correlation was found between alanine aminotransferase (ALT) and hepatitis C virus (HCV). Ribonucleic acid ( RNA ) levels and the degree of inflammation of cases with number of mast cells and liver steatosis (P>0.05). As the degree of fibrosis increased in the liver so did the number of mast cells in portal areas (P=0.001). On the other hand, no correlation was found between the degree of fibrosis and the number of MCs in the sinusoids and steatosis (P<0.05). The increase in the number of MCs in the portal areas correlated with an increase in liver steatosis (t: 0.02, P=0.04).
In light of these findings, it appears possible that MC accumulation in chronic HCV patients may be used as an indicator of fibrosis and possibly be considered in the follow-up of these patients.
Indian Journal of Pathology and Microbiology 54(4):736-40. · 0.68 Impact Factor
