Hüseyin Çakan

Higher prevalence of toxoplasmosis in victims of traffic accidents suggest increased risk of traffic accident in Toxoplasma-infected inhabitants of Istanbul and its suburbs ☆

Reflexes of drivers who have toxoplasmosis have been shown to deteriorate from the actions of the parasitic cysts. The cysts can change the level of the neurotransmitters such as dopamine in the brain and by doing so extend the muscle response time and change personality profiles. In this study, we aimed to determine the frequency of the latent toxoplasmosis (LT) in the driver population who were either injured or died in traffic accidents reported in Istanbul and its suburbs. We compared the results with a control group and discussed the relationship between the LT and the traffic accidents. We included 218 (89.7%) non-fatal, 25 (10.3%) fatal cases in our study as study groups. A total 243 subjects, 234 (96%) male, 9 (4%) female (who were alcohol negative) compared with 191 (95.5%) male and 9 (4.5%) female subjects (control group) who had a traffic accident before but no history of toxoplasmosis were studied. Serologic tests, enzyme immunoassay (EIA) for IgG and IgM, and microimmunoflorescence (MIF) for IgG were used as the reference test, the Sabin-Feldman Dye test (SFDT) was used. According to serologic test results, LT seroprevalence in the study groups was 130 (53.5%) and in the control group 56 (28%) (p<0.0001). A LT was present in 126 out of 234 (53.8%) males in the study groups, and 54 out of 191 (28.3%) males in the control group (p<0.0001). In the 31-44 year age group, there was a significant difference with regard to toxoplasmosis between the study subjects and control groups (p<0.0001). This difference was statistically very significant in (recent and former) cases with middle-aged men (31-44 years old). The results of this retrospective study suggest that LT in drivers, especially those who are between 31 and 44 years might increase the risk for getting involved in a car accident. In a prospective study, Toxoplasma positive and negative subjects can be monitored before they are involved in a traffic accident to clarify the cause and result relationship.

Do infections trigger juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) is a disease that was prominent with increased inflammation response in immune system, appeared mostly with peripheral arthritis and endogenous and exogenous antigens play a role in the pathogenesis of disease. Two major reasons were thinking to be considerably important. First of them is immunological predisposition and the second one is environmental factors. Infections are considered to be the most important between environmental factors but also stress and trauma are also important in the etiology of the disease. However, the relation between JIA and infections is not clearly defined but the relation between adult chronic arthritis and infections was well-defined. A total of 70 patients, 26 with primer JIA, 20 with recurrent JIA, 24 healthy control were included in this study. Mycoplasma pneumoniae, Chlamydophila pneumoniae and C. Jejuni were detected in 4, 1 and 1 of 10 (38.46%) patients with primer JIA, respectively. Salmonella enteritidis, EBV, M. pneumoniae, C. jejuni and Borrelia burgdorferi were detected in 1, 2, 2, 2, and 1 of the 8(40%) patients with recurrent JIA, respectively. S. enteritidis were isolated in feces culture and also identified by agglutination method. Infection was detected in total 18 (39.13%) of patient groups. C. pneumoniae and C. jejuni were detected in 1 and 1 of 2(8.33) healthy control groups, respectively. Throat culture positivity was not detected in any of the patient and healthy control groups. In conclusion, etiopathogenesis of JIA is not clearly understood and suggested that various factors can trigger the disease and it is the most common rheumatoid disease of childhood. However, there are some studies focusing especially on one infectious agent but this is the first study including such a big range of infectious agents in the literature for the microorganisms that can be suggested to have a role in the etiopathogenesis of JIA. We have a conclusion in the light of our results and suggest that some microorganisms can trigger and increase the intensity of clinical situation according to the case. When we evaluate the primer and recurrent JIA groups; M. pneumoniae and C. jejuni come forward and seen common in JIA cases. We also suggest that the pre-diagnosis of microorganisms, which can play a role as primarily or by intervening in the etiopathogenesis of JIA and adding specific antimicrobial therapy to the standard JIA therapy, it is possible to perform new, extended, especially molecular based serial case studies.

Antimicrobial resistance of Helicobacter pylori strains to five antibiotics, including levofloxacin, in Northwestern Turkey

INTRODUCTION Antibiotic resistance is the main factor that affects the efficacy of current therapeutic regimens against Helicobacter pylori. This study aimed to determine the rates of resistance to efficacy clarithromycin, amoxicillin, tetracycline, levofloxacin and metronidazole among H. pylori strains isolated from Turkish patients with dyspepsia. METHODS H. pylori was cultured from corpus and antrum biopsies that were collected from patients with dyspeptic symptoms, and the antimicrobial susceptibility of H. pylori was determined using the E-test (clarithromycin, amoxicillin, tetracycline, metronidazole and levofloxacin) according to the EUCAST breakpoints. Point mutations in the 23S rRNA gene of clarithromycin-resistant strains were investigated using real-time PCR. RESULTS A total of 98 H. pylori strains were isolated, all of which were susceptible to amoxicillin and tetracycline. Of these strains, 36.7% (36/98) were resistant to clarithromycin, 35.5% (34/98) were resistant to metronidazole, and 29.5% (29/98) were resistant to levofloxacin. Multiple resistance was detected in 19.3% of the isolates. The A2143G and A2144G point mutations in the 23S rRNA-encoding gene were found in all 36 (100%) of the clarithromycin-resistant strains. Additionally, the levofloxacin MIC values increased to 32 mg/L in our H. pylori strains. Finally, among the clarithromycin-resistant strains, 27.2% were resistant to levofloxacin, and 45.4% were resistant to metronidazole. CONCLUSIONS We conclude that treatment failure after clarithromycin- or levofloxacin-based triple therapy is not surprising and that metronidazole is not a reliable agent for the eradication of H. pylori infection in Turkey.

Some samples of weapons and instruments used as weapon in criminal offenses in Turkey

The variety of instruments used for crime of violence is wide. Besides the manufactured legal weapons, there are comparable numbers of purchased instruments, which are used as lethal weapons and significant numbers of comprising home-made ones. The instruments used during the commission of a crime shows similarity throughout the countries. Nevertheless, there are small differences to be seen. The topic of this subject features the types of weapons used in criminal offenses in Turkey.

Assessment of Antibiotic Susceptibility of Ureaplasma urealyticum from Prostitutes and Outpatient Clinic Patients Using the E-Test and Agar Dilution Method

In this study, a total of 647 vaginal discharge samples were examined. Ureaplasma urealyticum growth was seen in 68 samples (10.5%). The antibiotic sensitivity of 30 types of U.urealyticum was determined with the E-test and agar dilution method. With the agar dilution method, all types were sensitive to ciprofloxacin and ofloxacin (MIC 0.94 µg/ml), tetracycline (MIC 0.125 µg/ml) and doxycycline (MIC 0.125 and 0.190 µg/ml). Furthermore, with the agar dilution method, 18 types (60%) were resistant to roxithromycin and 12 (40%) were sensitive (MIC 12 µg/ml); 3 types (10%) were resistant to erythromycin and 27 (90%) were sensitive (MIC 12 µg/ml); 9 types (30%) were resistant to clarithromycin and 21 (70%) were sensitive (MIC 12 µg/ml), and all types were sensitive to azithromycin (MIC 14 µg/ml).

Investigation of the microorganisms decaying bloody evidences

Many biological evidences that submitted to forensic laboratories are not convenient for DNA analysis. Because of they are not collected and packaged correctly and not stored in the appropriate environment. For this reason, DNA test and many other non-DNA tests cannot be performed [1]. In order to protect blood evidence, should be known the reason of the deterioration. For this intention, we investigated the kind of microorganisms which decay the evidences, the effect of temperature, effect of package types and resistance of biological evidence to putrefaction. We aimed to determine the best condition for evidence safety. In our study, evidence modules were prepared using five different grounds, three different temperatures, two different time durations and three different package types. After the waiting periods, packages were opened and microbiological analyzed. At the end of microbiological analyzes, it determined that, as the waiting time of packages increases, microbial reproduction increases. The most decaying was seen on blood drips on the wall. After wall, respectively wood, sponge, fabric and knife are decaying by microorganism. The most putrefaction is seen at 40C, the least putrefaction is seen in the room conditions. Paper envelopes and cloth bags have been found to be better for protecting evidences. However, evidences that were completely dry were found to be better preserved in nylon bags.

Relationship between aneurysm and microorganism: Is Helicobacter pylori a primer agent or has an affinity to the tissue?

1 Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. 2 Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. 3 Medical Faculty, Sifa University, Izmir, Turkey. 4 Faculty of Engineering, Koc University, Istanbul, Turkey. 5 Department of Microbiology, Forensic Sciences Institute, Istanbul University, Istanbul, Turkey.

The diagnostic role of indirect fluorescence antibody in csytic echinococcus and the role of western blot in following-up patients with csytic echinococcus after surgery

Cystic echinococcosis (CE) is a complicated zoonotic infection with diagnosis and treatment. In this study, we aimed to determine the diagnostic performance parameters of Indirect Fluorescence Antibody (IFA) method and also the usability of Western Blot (WB) method for following up CE cases by detecting the antigenic patterns. Cases diagnosed as CE in General Surgery Department of Cerahpasa Faculty of medicine and a selected control group were included in this case-control and cross-sectional study between January 2010 and December 2010. Laboratory studies were performed in Serology/ELISA laboratory of Medical Microbiology Department. Clinically, radiologically and serologically (IHA, ELISA) diagnosed 110 patients with CE, and 80 healthy control group (HCG) individuals were included in the study. Echinococcus granulosus specific antigen IgG test was applied by IFA method in CE cases and HCG. E. granulosus specific antigen patterns were also are detected with WB method in CE cases and HCG. According to the results, performance parameters of IFA test in CE diagnosis were calculated as 100, 93, 95, 100 and 94% for sensitivity, specificity, positive predictive value, negative predictive value and Kappa values, respectively. Ninety six cases were detected positive with WB method. p7 and other accompanying bands were detected in 50 out of this 96 cases and only p39 band was detected in 45 cases. In conclusion, using IFA method in the diagnosis of CE which is a complicated infection disease can be effective in the presence of an appropriate microscope and experienced expert and we also suggest the use of WB method can be useful especially in parasitic treatment or after spontaneous cyst calcification in post-operative period.