Engin Araz

Blastocystis subtypes in irritable bowel syndrome and inflammatory bowel disease in Ankara, Turkey

Blastocystis infection has been reported to be associated with irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and chronic diarrhoea. The availability of data on the subtypes of Blastocystis found in these patient groups would be of interest in understanding the significance of Blastocystis infection in chronic illness. In this study, we identify Blastocystis subtypes found in patients presenting with IBS, IBD, chronic diarrhoea and asymptomatic patients in Ankara, Turkey. Blastocystis was detected in 11 symptomatic patients by microscopy and 19 by stool culture. Stool culture was more sensitive than microscopy in identifying Blastocystis. Using standard nomenclature adopted in 2007, Blastocystis sp. subtype 3 was the most common in all groups, followed by Blastocystis sp. subtype 2. Identical subtypes of Blastocystis are found in patients with IBS, IBD and chronic diarrhoea. These particular subtypes show low host specificity and are carried by humans and some farm animals. The subtypes of Blastocystis that are commonly found in rodents and certain wild birds were not found in these patients. We suggest a model in which the severity of enteric protozoan infection may be mediated by host factors.

Saccharomyces boulardii and infection due to Giardia lamblia

Therapy with metronidazole is the recommended option in giardiasis. However, some clinical trial reports suggest the appearance of drug resistance to explain therapeutic failure. Several investigations have been carried out on the effect of probiotic microorganisms for preventing or treating gastrointestinal diseases, but little is known about their efficacy against protozoal infections. The principal objective of our study was to evaluate the efficacy of Saccharomyces boulardii against Giardia lamblia infections. A double-blind, placebo-controlled study was carried out on adult patients with giardiasis. Group 1 (30 patients) included metronidazole 750 mg 3 times daily along with S. boulardii capsules (250 mg b.i.d. orally) for 10 d while group 2 (35 patients) was treated with metronidazole 750 mg 3 times daily and with empty capsules as placebo for 10 d. Patients were re-examined at 2 and 4 weeks after treatment, and stool examinations were performed. At week 2, G. lamblia cysts were detected in 6 cases (17.1%) of group 2 and none in group 1. At the end of the fourth week, presence of the cysts continued in the same 6 cases in group 2 (control group). These findings indicated that S. boulardii may be effective in treating giardiasis when combined with metronidazole therapy.

Maggot Debridement Therapy in the Treatment of Chronic Wounds in a Military Hospital Setup in Turkey

Background: The medicinal use of maggots for the biological debridement of chronic wounds is increasing around the world, due to its efficacy, safety and simplicity. Thousands of patients have been treated in private and governmental hospitals during the last 10 years. Objective: To examine the efficacy of maggot debridement therapy (MDT) in the debridement of chronic wounds in a militaryhospital. Methods: MDT was applied for 1–9 days to 7 male and 4 female soldiers or their family members (21–72 years old) with chronic wounds. Results: Complete debridement was achieved in 10 out of 11 patients, while in 1 patient the wound could be cleaned only partially. A remarkable reduction in the odor emanating from the wound and notable granulation were observed in all debrided wounds. Increased pain was observed in 1 patient with a venous stasis ulcer. Conclusion: We believe that MDT is a rapid and effective method for the debridement of chronic wounds in a military environment especially in times of war in developing countries.

A Special Issue of Dermatology Dedicated to Theo Rufli

Accessible online at: www.karger.com/drm It is hard to believe that Theo Rufli will turn 65 on February 15, 2005, and therefore will step back and retire at the end of the winter term. Beginning over 35 years ago, he had been first coworker and then – for 19 years – director of the Department of Dermatology at the University Hospital of Basel. After 2 years of internal medicine, he received his training as a dermatology resident from 1969 to 1973 as a scholar of Prof. Rudolf Schuppli. He spent some time abroad in dermatology departments at Warsaw and in several institutions in London. After returning, he became ‘Oberarzt’ in 1973 and received the ‘venia docendi’ in 1977. He then served many years as vice-chairman until he was elected Ordinary Professor for Dermatology and Venereology in 1985. This was in a long-standing tradition as his precedessors Wilhelm Lutz (1922–1956) and Rudolf Schuppli (1956–1985) had also been first members of the clinic staff and had then both been elected as ordinary professor and director. All three chairmen were excellent clinicians, histopathologists and allrounders just as it is required in a clinic with few permanent staff members. His first and central interest has always been the patient, his disease but also the care for the person behind, because he had a deep compassionate understanding for the suffering patient. As a director of the clinic, he always had an open heart and office door for the problems of every coworker. Perhaps more than anyone else, Theo Rufli directly supervised the training of residents and always guarded the quality of graduate students and the respect that dermatology gained from other physicians. He is an outstanding teacher; countless medical students have followed his famous lectures spiced with humor and anecdotes. Because of his obvious love for his own specialty and his ability to communicate this commitment to his students, many of them entered the field of dermatology, and residents held him in high regard. He taught clinical dermatology as an essential part of modern medicine and always reminded students and residents of the value of looking, examining and talking to patients. Although

Lucilia sericata Larvalarının Tüm Vücut Ekstrakt Metabolitlerinin Araştırılması ve Potensiyel Antibakteriyel Etkileri

Amac: Yakin donemde, tamamlayici tip uygulamalari modern tibbin ilgi alanina girmistir. Maggot Debritman Tedavisi dunya capinda yaygin olarak kullanilan bir yontemdir. Bu yontem, ozellikle kronik yaralarin tedavisinde tavsiye edilmektedir ve dusuk maliyet, kolay uygulanabilirlik ve nadir yan etkiler gibi avantajlari bulunmaktadir, ancak yontemin etki mekanizmasi henuz tam olarak ortaya konulamamistir. Bu calismanin amaci, Lucilia sericata larvalarinin tum vucut ekstraktinin metabolitlerini ortaya koymak ve bunlarin potensiyel antibakteriyel niteligini arastirmaktir. Gerec ve Yontemler: Antibakteriyel etkinligi arastirmak icin, onceden ozel iklim odalarinda uretilmis larvalarinin tum vucut ekstraktlari, Staphylococcus aureus , Pseudomonas aeruginosa , Escherichia coli ve Enterococcus faecalis bakterileri icin agar difuzyon ve akan hucreolcer ile test edilmistir. Antibakteriyel incelemeyi takiben, iki boyutlu elektroforez ile protein arastirilmasi yapilmistir. Bulgular: S.aureus (16mm), E.coli (22mm) ve E.faecalis (14mm) icin inhibisyon alani gozlenmis ancak P.aeruginosa icinalan olusmamistir. Hucreolcer ile farkli dilusyonlarda farkli oldurme oranlari gozlenmis ve en dusuk dilusyonda (1/64), P.aeruginosa, E.faecalis, E.coli ve S.aureus icin sirasiyla%51,9, %75, %80ve %98,7 oranlari alinmistir. Iki boyutlu elektroforezde farkli molekuler agirlik (<10-260kDa) ve izoelektrik noktada (3-9) proteinler tespit edilmistir. Sonuc: Maggot ekstraklarinin test edilen suslar uzerine antibakteriyel etkisi net olarak gozlenmistir. Farkli molekuler agirlik ve izoelektrik noktada proteinler tespit edilmistir. Antibakteriyel etkinin bu proteinler tarafindan saglanmasi muhtemel olsa da, proteinlerin kutle spektrometrisi ve protein veri bankalari ile ayrica arastirilmasi gerekir.