Hamza Bozkurt

Change in Serum Concentrations of Interleukin-2 and Interferon-γ during Treatment of Tuberculosis

We aimed to investigate changes in serum concentrations of the cytokines interleukin (IL)-2 and interferon (IFN)-γ during the clinical course of active tuberculosis, to establish the presence of cellular immunity before and after treatment. Blood samples were taken from 18 patients with active tuberculosis before and 2 months after therapy; IL-2 and IFN-γ concentrations were evaluated. The mean serum IL-2 concentration before therapy was 164.5 pg/ml (range 12–980 pg/ml) and the concentration 2 months after therapy was 92.11 pg/ml (range 1–490 pg/ml). The mean serum IFN-γ concentrations were 10.83 pg/ml (range 1–22.2 pg/ml) and 4.64 pg/ml (range 1–28.5 pg/ml), respectively. The decrease in concentrations of both cytokines after therapy was statistically significant. Further studies investigating the benefits of adding cytokines to drug treatment for tuberculosis are needed.

Correlation of Slime Production Investigated via Three Different Methods in Coagulase-Negative Staphylococci with Crystal Violet Reaction and Antimicrobial Resistance

This study investigated slime production by coagulase-negative staphylococci (CNS) using the standard tube (ST), Congo red agar (CRA) plate and Christensens tube (CT) methods, and compared the results with those of the crystal violet reaction (CVR) test. The potential correlation between slime production and antimicrobial resistance was also evaluated. In total, 205 CNS strains were isolated from biological samples: 92 (44.9%) were shown to produce slime by the ST method; 96 (46.8%) by the CRA plate method; 90 (43.9%) by the CT method; and 89 (43.4%) strains were CVR positive. Eighty-three (40.5%) CNS strains were positive for slime production by the ST, CRA and CT methods. The findings of the ST, CRA and CT test methods were consistent with each other but were not related to CVR positivity. Based on the ST method, rates of antibiotic resistance to several antimicrobial agents were higher in slime-positive strains than in slime-negative strains and, in some cases, this was statistically significant.

Distribution of hepatitis C prevalence in individuals according to their age level in Eastern Turkey.

Hepatitis C virus (HCV) belongs to the Flaviviridae virus family. Its reservoir is the human being. HCV is highly transmittable and is usually transmitted through blood transfusion, use of the same syringe between drug users, during sexual interaction and from mother to child. The course of HCV infection can develop subclinically without any clear symptoms. More than 50% of patients, however, develop chronic hepatitis, and subsequently a high percentage of these patients develop cirrhosis [1,2].

The Effect of Colchicine on the Peritoneal Membrane

Peritoneal dialysis (PD) is a treatment modality for patients with renal failure. Peritoneal fibrosis is one of the most serious complications after long-term continuous ambulatory peritoneal dialysis (CAPD). Histological studies in both humans and animals show that chronic peritoneal dialysis results in fibrosis of the peritoneal membrane. In our study, we investigated the effect of colchicine on peritoneal alterations induced by hypertonic PD solution in rats. Sprague-Dawley rats intraperitoneally received saline (control group) once daily, for 28 days, or 3.86% glucose (PDF group), or 3.86% glucose plus colchicine (colchicine group). Animals from each group were sacrificed after 28 days with anesthetized ketamine (60 mg/kg BW). For the PD fluid assessment, 1 h before the sacrifice of animals, 10 mL PD fluid of 2.27% glucose was given, and this fluid was obtained after the sacrifice. The levels of transforming endothelial growth factor β (TGF-β), tumor necrosis factor α (TNF-α) and albumin were investigated both in the peritoneal dialysate and blood, and the levels of malondialdehyde (MDA) were investigated only in peritoneal dialysate. The peritoneal membrane was evaluated histologically by light microscopy. When groups were compared in terms of body weight change, the colchicine group significantly lost weight compared to controls and PDF group (−4.7% ± 4.5, 3.5% ± 7.2, 3.0% ± 1.3, respectively, p = 0.018). Also, the blood albumin level was significantly lower for these in the colchicine group compared to those in the PDF group (2.7 ± 0.35 versus 3.2 ± 0.3 g/dL, respectively, p = 0.048). The blood TGF-β level was significantly lower in the control group, and no difference was observed between the PDF and colchicine groups (294.4 ± 67.5 versus 787.4 ± 237.4 versus 615.3 ± 235.1 pg/mL, respectively, p = 0.004). The mesothelial thickness found in groups was as follows: control group 102 ± 18.9 µm, PDF group 128.33 ± 33.1 µm, colchicine group 117 ± 35.6 µm (p = 0.34). In conclusion, a rat model for peritoneal dialysis associated peritoneal derangement without fibrosis could be induced. Colchicine could not prevent peritoneal derangement in this model.

Distribution, Optimum Detection Time and Antimicrobial Susceptibility Rates of the Microorganisms Isolated from Blood Cultures over a 4-Year Time Period in a Turkish University Hospital and a Review of the International Literature

This study retrospectively examined 8986 blood cultures from patients over a 4-year time period in an eastern Turkish university hospital to determine the detection times and distribution of isolated microorganisms using the automated BACTEC™ 9050 and BACTEC™ 9120 systems. A total of 1914 (21.3%) blood cultures contained pathogenic microorganisms and 252 (2.8%) positive cultures were considered contaminated. Of all the cultures, 18 (0.2%) were false positives and 224 (2.5%) were false negatives. In cultures containing pathogenic microorganisms, Gram-positive and Gram-negative bacterial isolation rates were 436 (22.8%) and 1440 (75.2%), respectively, and yeasts (all Candida sp.) were found in 38 (2.0%) cultures. Coagulase-negative staphylococci occurred in 936 (48.9%) cultures and Staphylococcus aureus occurred in 302 (15.8%) cultures. The mean detection time for all of the pathogens was 21 h and Brucella spp were isolated within 10 days. This study helps in understanding the epidemiology of the region and in providing positive therapeutic approaches. A review of the international literature helps to place this understanding into a global context.

Asymptomatic bacteriuria in infants in eastern Turkey.

In this study, the prevalence of asymptomatic bacteriuria (ABU) was investigated in the 146 infants without symptoms suggesting urinary tract infection, age ranged from 29 days to 15 months (mean 4.56 +/- 3.30 months). Our purpose was to determine the prevalence ofABU in infants living in Eastern Turkey and to define the relationship between pyuria and ABU in infants. Of 146 infants, 77 (52.7%) were males, and 69 (47.3%) were females. Although we would like to select randomized healthy infants for the study, 47 (32.1%) infants had a mild to severe malnutrition. While various microorganisms were cultured in 41 (28%) infants in the first urinary culture, only 18 (12.3%) infants had a positive culture in the second urinary culture. The prevalence of ABU was 12.3%. Although ABU prevalence was higher in the infants with malnutrition than those without malnutrition (14.8% 1 vs. 11.1%), there was not a difference between the groups (p>0.05). There was a positive relation between urinary culture positiveness and pyuria (p < 0.001). The prevalence of ABU was much higher (12.3%) than the literature data, which was probably related to very low socioeconomic status of our region where malnutrition and its related disorders are commonly seen. The high ratio might also be related to the method of urine collection, because we used sterile collecting bag, but not suprapubic aspiration method.

Septicaemia And Meningitis In An Infant

We read with interest the review article on necrotizing enterocolitis (NEC) in full-term neonates.1 Although the author mentioned various risk factors that are associated with NEC in term neonates, we call your attention to some of the more recent data we have published on this topic. First of all, NEC in term infants is a rare event, at least in this part of the world. The incidence quoted as 5–25% of NEC infants came from the studies published in the 1970s and 1980s. We published more recent figures derived from a detailed population-based study on the incidence and aetiology of NEC in full-term neonates born in New South Wales and Australian Capital Territory in Australia.2 The incidence in our region was 0.05 per 1000 live births which was similar to the crude estimation (0.06 per 1000) in > 2500 g infants based on the CDC hospital diagnosis information in the United States. With regards to risk factors, one important message is missing in this article. There is a great difference in aetiological factors between full-term and premature infants. Earlier institutional studies suggested the association of congenital diseases in term infants.3 The major finding in our recent regional study was that about two-thirds of the 29 NEC neonates had an underlying congenital disease, which included congenital heart lesions in 35% and endocrine lesions in 17%. This contrasts with prematurity being the major underlying risk factor in premature infants, who have an inherent gastrointestinal immaturity and other illnesses associated with prematurity. The role of T-cryptantigen screening in the management of NEC was discussed in this review. We would like to caution that the literature on antigen screen was derived primarily from the preterm population. NEC aetiological factors appear very different between the preterm and term infants. The mortality of our series is low and both deaths were not associated with haemolysis (circulatory collapse with panhypopituitarism and the other due to congenital anomaly). Furthermore, in the largest series of T-cryptantigen reported in preterm infants (27 antigen positive cases in 200 NEC infants) we have not been able to demonstrate reduced mortality since the introduction of routine screening,4 so the benefit of screening is yet to be proven in preterm infants, let alone in term infants. The author’s suggestion of exploring cytokine modulation therapy in the prevention of NEC in term infants is unlikely to be effective given the different aetiological factors, in particular the high incidence of associated congenital diseases in term infants. Furthermore, with the rarity of disease and low mortality in term neonates, even if we restrict the preventive therapy to high-risk term neonates such as infants with congenital heart disease it is extremely difficult to justify the expenditure involved. For example, during our study period of 6.5 years with over 539 000 live births, we would expect about 1300 cases born with major heart defects based on National Perinatal Statistics Unit data.5 Only 10 of these developed NEC! In short, NEC in term and preterm infants are very different in many aspects and the knowledge derived from preterm infants may not be applicable in term infants.