Levent Tabak

Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey

BackgroundTuberculosis (TB) is an established occupational disease affecting health care workers (HCWs). Determining the risk of TB among HCWs is important to enable authorites to take preventative measures in health care facilities and protect HCWs. This study was designed to assess the incidence of TB in a teaching hospital in Istanbul, Turkey. This study is retrospective study of health records of HCWs in our hospital from 1991 to 2000.ResultsThe mean workforce of the hospital was 3359 + 33.2 between 1991 and 2000. There were 31 cases (15 male) meeting the diagnostic criteria for TB, comprising eight doctors, one nurse and 22 other health professionals. Mean incidence of TB was 96 per 100,000 for all HCWs (relative risk: 2.71), 79 per 100,000 for doctors (relative risk: 2.2), 14 per 100,000 for nurses and 121 per 100,000 (relative risk: 3.4) for other professionals. The mean incidence of TB in Turkey between 1991 and 2000 was 35.4 per 100,000. Incidence of TB was similar in the Departments of Chest Diseases and Clinical Medicine but there were no TB cases in the Basic Science and Managerial Departments.ConclusionHCWs in Turkey who work in clinics have an increased risk for TB. Post-graduate education and prevention programs reduce the risk of TB. Control programs to prevent nosocomial transmission of TB should be established in hospitals to reduce risk for HCWs.

HEREDITARY THROMBOPHILIC RISK FACTORS AND VENOUS THROMBOEMBOLISM IN ISTANBUL, TURKEY: THE ROLE IN DIFFERENT CLINICAL MANIFESTATIONS OF VENOUS THROMBOEMBOLISM

The aim of this study was to investigate the hereditary thrombophilic risk factors in patients with venous thromboembolism (VTE) and whether these risk factors play a different role in patients with isolated pulmonary embolism (PE) as compared with patients with deep vein thrombosis (DVT) and patients with PE + DVT. The protein C (PC), protein S, antithrombin activities, homocysteine levels, and factor V Leiden (FVL) G1691A and prothrombin G20210A mutations were evaluated in 191 patients with VTE and 191 controls. The prevalence of FVL and PC deficiency were higher in patients (P = .003 and P = .02, respectively). There was no significant difference for the other risk factors. The combination of thrombophilic risk factors was significantly higher in patients with DVT + PE as compared with patients with isolated PE or DVT (P = .04). In conclusion, the most important hereditary risk factors for VTE in this study were the FVL mutation and PC deficiency.

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.

Platelet glycoprotein Ia 807C/T and 873G/A polymorphisms in patients with venous thromboembolism.

Two silent polymorphisms (807C/T and 873G/A) within glycoprotein Ia (GPIa) gene have been implicated in increased risk of developing thrombosis and myocardial infarction in affected individuals. The aim of this study was to investigate the GPIa gene polymorphism in patients with venous thromboembolism (VTE). A multiplexed allele specific-polymerase chain reaction (AS-PCR)–based method was used to determine the GPIa 807T/873A allele frequency in 77 patients with VTE and 106 healthy controls. The allelic frequency for 807T/873A was 33% in the patient group and 38% in the control group. The allelic frequency for 807C/873G was 66% in the patient group and 62% in the control group. The genotypic frequencies were 8% for 807TT/873AA, 42% for 807CC/GG, and 50% for 807CT/GA in the patient group. In the control group, the frequencies were 12% for 807TT/873AA, 35% for 807CC/873GG, and 52% for 807CT/873GA. As a result, the glycoprotein Ia 807C/T and 873G/A dimorphisms were not shown as risk factors for VTE.

The Value of Labial Biopsy in the Differential Diagnosis of Sarcoidosis and Sjögren's Sydrome and Immunohistochemical Analysis

ABSTRACT The aim of this study was the evaluation of the value of labial biopsy in the differential diagnosis of sarcoidosis and Sjögrens Syndrome and the value of immunohistochemical markers such as CD3, CD4, CD8, and CD20 at the immunopathogenesis. Fifteen labial salivary gland biopsies from patients affected by primary Sjögrens syndrome, and 15 labial salivary gland biopsies from patients affected by sarcoidosis, were included in the study. In all patients, biopsies were carried out as a diagnostic procedure either for sicca syndrome or sarcoidosis. Sarcoidosis and Sjögrens Syndrome were compared according to immunohistochemical markers. It was found that CD3 and CD4 immunreactiviy were statistically higher in sarcoidosis patients, and CD 20 immunreactivity was statistically higher in SS patients. CD8 did not show any significance between groups. We also compared labial biopsy with radiological stage, and could not find any significant correlation. When the microscopic methods are not enough to differentiate between sarcoidosis and Sjögrens Syndrome, or when they are seen together, then obtaining the subgroups of lymphocytes with immunohistochemical methods can be helpful for diagnosis.