Candan Öğüş

Evaluation of the ICT Tuberculosis test for the routine diagnosis of tuberculosis

BackgroundRapid and accurate diagnosis of tuberculosis (TB) is crucial to facilitate early treatment of infectious cases and thus to reduce its spread. To improve the diagnosis of TB, more rapid diagnostic techniques such as antibody detection methods including enzyme-linked immunosorbent assay (ELISA)-based serological tests and immunochromatographic methods were developed. This study was designed to evaluate the validity of an immunochromatographic assay, ICT Tuberculosis test for the serologic diagnosis of TB in Antalya, Turkey.MethodsSera from 72 patients with active pulmonary (53 smear-positive and 19 smear-negative cases) and eight extrapulmonary (6 smear-positive and 2 smear-negative cases) TB, and 54 controls from different outpatient clinics with similar demographic characteristics as patients were tested by ICT Tuberculosis test.ResultsThe sensitivity, specificity, and negative predictive value of the ICT Tuberculosis test for pulmonary TB were 33.3%, 100%, and 52.9%, respectively. Smear-positive pulmonary TB patients showed a higher positivity rate for antibodies than smear-negative patients, but the difference was not statistically significant. Of the eight patients with extrapulmonary TB, antibody was detected in four patients.ConclusionOur results suggest that ICT Tuberculosis test can be used to aid TB diagnosis in smear-positive patients until the culture results are available.

Doppler ultrasonography versus venography in the detection of deep vein thrombosis in patients with pulmonary embolism

In patients with acute pulmonary embolism (PE) the frequency of deep vein thrombosis (DVT) varies between 13–93%. The aim of this study was to compare Doppler ultrasonography (DUSG) and venography in the detection of DVT in patients with PE. Fifty-one patients who were clinically diagnosed as having PE from January 1st 2001 to January 31st 2005 were entered into the study and comorbid conditions and risk factors were noted. The diagnosis of PE was confirmed by ventilation-perfusion (V/Q) scintigraphy, spiral tomography and angiotomography while the diagnosis of DVT was made by DUSG and venography. DVT was confirmed by both DUSG and venography in 19 (37,3%) patients. In the remaining 32 patients DUSG was negative. Venography confirmed DVT in 6 of these patients while in 26 no DVT was found. The sensitivity and specifity of DUSG in the diagnosis of DVT were 76% and 100% respectively and the negative and positive predictive values were 81% and 100% respectively. The mean d-dimer concentration was 1187 in patients with DVT and 641 in patients without DVT (p > 0.05). Aquired risk factors were found in 4 of 6 patients with DVT, CRP was elevated in 5 (83%) and ALT-AST were elevated in 2 (33%). Although DUSG alone is considered sufficient for the diagnosis of DVT, venography still remains the gold standard in the diagnosis of DVT. Especially in patients with PE, where the diagnosis of DVT may increase the success of treatment, venography or other diagnostic tools may be used instead of a second DUSG if the first DUSG is negative.

Extrapulmonary involvement in patients with sarcoidosis in Turkey

Background and objective:  Extrapulmonary sarcoidosis is common, and is almost always associated with concomitant thoracic involvement. Extrapulmonary manifestations vary on the basis of gender, age at presentation and ethnicity. The aim of this study was to investigate extrapulmonary involvement in patients with sarcoidosis in Turkey.

Takayasu’s Arteritis Presenting with Bilateral Parenchymal Consolidations and Severe Respiratory Failure

This is a report of an unusual case of Takayasu’s arteritis presenting with bilateral parenchymal infiltrations and severe respiratory failure caused by pulmonary hemorrhage. The patient was initially diagnosed and treated as protracted pneumonia. After the diagnosis of Takayasu’s arteritis, she was successfully treated with high-fractioned oxygen and corticosteroid therapy.

Asthma phenotypes in Turkey: a multicenter cross-sectional study in adult asthmatics; PHENOTURK study.

To evaluate asthma phenotypes in patients with asthma from different regions of Turkey.

A case of allergic bronchopulmonary aspergillosis following active pulmonary tuberculosis.

Allergic bronchopulmonary aspergillosis usually occurs in children with underlying airway disease such as asthma and cystic fibrosis. While the colonization and infection of pre‐existing tuberculosis lesions by aspergillus species is well known, occurrence of allergic bronchopulmonary aspergillosis following pulmonary tuberculosis in children has not been reported yet. Here, an 11‐year‐old girl who developed allergic bronchopulmonary aspergillosis following active pulmonary tuberculosis is reported and the mechanisms of causality are also speculated. Pediatr Pulmonol. 2009; 44:86–89.

Right Hilar Mass in a Patient with β-Thalassemia major

Accessible online at: www.karger.com/journals/res A 55-year-old man was admitted to hospital because of atrial fibrillation and dilated cardiomyopathy. He had no respiratory problems except for dyspnea, which was controlled by cardiotonic and diuretic drugs. His medical history included regular blood transfusions for ß-thalassemia major and a splenectomy for hypersplenism in 1965. On physical examination, vital signs were normal. He had arrhythmia and hepatomegaly. A chest radiogram showed a regular-shaped mass at the right hilar region apart from the cardiac contour which was later found to be located in the posterior mediastinum by right lateral radiography (fig. 1). A CT scan of the thorax revealed a regular-shaped mass localized in the right hemithorax, arising near the 6th thoracic vertebral body and extending to the paravertebral space inferiorly with a length of 6 cm (fig. 2). It was observed that the mass was in contact with the spine and ribs, but neither an erosion in the bone structure nor an invasion into the neural foramen was observed. In addition, at the edge of the mass, soft tissue densities were detected, which were located bilaterally in the paravertebral space extending inferiorly. A CT scan demonstrated no pathologic findings at the level of the carina and hilus (fig. 3). Based on the patient’s medical history and the clinical, radiographic and laboratory findings, what is your diagnosis? What is your next step in the diagnostic workup?

Antineutrophil Cytoplasmic Antibody-Positive Vasculitis Associated with Propylthiouracil Therapy

1. Case Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 817 2. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 819 3. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 820

A 22-year-old woman with pleural effusion.

Accessible online at: www.karger.com/res A 22-year-old nurse was admitted to our emergency department with complaints of right-sided pain and high fever. The anamnesis revealed that she had been hospitalized at another health center with complaints of fatigue, high fever and diarrhea. Her diarrhea ceased on the day after her admission. She was operated on for appendicitis because of right lower quadrant pain and tenderness; however, she developed leukocytosis (21,280/mm3) during the follow-up. On pathological examination, her appendix was found to be normal; however, the patient’s general condition did not improve after surgery; the fever and right-sided pain persisted and did not respond to ceftriaxone-clarithromycin. She was referred to our hospital for further investigation. At physical examination, her body temperature was 39.4°C; chest examination with percussion revealed dullness in the right lower hemitho-