Mete Eyigor

Detection of Helicobacter pylori in adenotonsiller tissue specimens by rapid urease test and polymerase chain reaction

In recent studies, there have been many arguments concerning Helicobacter pylori being reservoir in adenotonsillar tissue. In this study, our objective was to detect whether adenoid and/or tonsillar tissue of patients diagnosed with chronic adenotonsillitis was a reservoir for H. pylori. This study was performed with 47 patients with the diagnosis of chronic tonsillitits and adenoid hypertrophy. Helicobacter pylori was searched by rapid urease test (RUT) and polymerase chain reaction (PCR). Presence of H. pylori glmM gene (formerly named as ureC gene) was tested using ureC and ureC2 primers. Fifty-five specimens used in the study were made up of 35 adenoid and 20 tonsil tissues. Rapid urease test was positive in three (5.5%) specimens. Helicobacter pylori was not detected in any of the patients by PCR. Further studies are needed to clarify the possible role of H. pylori in upper aerodigestive tract diseases such adenotonsillitis.

Characterization of fungi in chronic rhinosinusitis using polymerase chain reaction and sequencing

The role of fungi in chronic rhinosinusitis (CRS) remains unknown. Fungi were also determined as one of the responsible agents in the etio-pathogenesis, while several studies found fungi in 6–93% of the cases. The aim of this study is to test the presence of fungi in samples taken from the middle meatus of patients with CRS, using traditional culture methods and polymerase chain reaction (PCR), and to compare the efficacy of these methods. Thirty patients diagnosed with CRS, with or without nasal polyposis, undergoing an operation in the Otorhinolaryngology Clinic, were prospectively included in the study. Nasal mucosa samples from ten patients, who were operated for pathologic evaluation, and without CRS, were used as controls. Nasal samples were taken from each patient by swabbing with a cytology brush. Middle meatus culture samples were taken by using nasal cotton swab, and the polyp and/or sinus mucosa samples were taken during endoscopic sinus surgery. Fungal specific PCR, using 18S rRNA primers and standard cultures, were performed on every sample. All amplicons were sequenced. There was no fungal growth in the Sabouraud dextrose agar (SDA) medium from middle meatus samples and tissue parts. Of 30 tissue and brush samples, 3 and 2 were positive for fungal DNA, respectively. Sequence analysis showed that four amplicons were homologus to Cladosporium herbarum and one to Aspergillus amstelodami. We concluded that fungal etiology is overestimated and fungi rarely play a role in patients with CRS. Large-scale studies should be done using molecular methods.

Evaluation of resistance mechanisms and serotype and genotype distributions of macrolide-resistant strains in clinical isolates of Streptococcus pneumonia in Aydın, Turkey

Macrolide resistance mechanisms in 89 Streptococcus pneumoniae strains isolated from several clinical samples between February 2007 and May 2009 were investigated. Erythromycin resistance was noted in 35 (40%) S. pneumoniae strains. In these strains, the most frequent resistance phenotype was cMLSB (74%), and the most frequent resistance genotype was ermB (82%). Both ermB and mefA genes were positive in 20% of macrolide-resistant strains. While no resistance to vancomycin, linezolid and telithromycin was noted in 89 S. pneumoniae strains, 12 (13%) strains were penicillin resistant, 26 (30%) strains were clindamycin resistant, 35 (40%) were azithromycin resistant, 32 (36%) strains were tetracycline resistant, and 1 (1%) strain was levofloxacin resistant. The serotype distribution of 35 macrolide-resistant S. pneumoniae strains revealed that the most frequent serotype was serogroup 19 (45%). Multidrug resistance was present in 19 (86%) of 22 strains carrying only the ermB resistance gene. No clonal dissemination was noted in the macrolide-resistant pneumococcal strains. These findings suggest that macrolide resistance rates, resistance phenotype and genotype, as well as resistant serotypes of S. pneumoniae strains should be continuously monitored in our country.

Confirmation of anti-DFS70 antibodies is needed in routine clinical samples with DFS staining pattern

Background Recognition of nuclear dense fine speckled (DFS) pattern by indirect immunofluorescence (IIF) is not easy. Thus, confirming the presence of these antibodies might be needed. In this study, we aimed to determine the frequency of DFS pattern in our diagnostic laboratory and to investigate the presence of anti-DFS70 antibodies in samples showing DFS pattern by two commercially available research kits retrospectively. Material and methods Seventy-four sequential serum samples with DFS pattern on HEp2010 cell substrates by IIF were included in this study. The semiquantitative DFS70 ELISA Kit (MBL International Corporation, Woburn, UK) was used for detection of anti-DFS70 antibodies in these samples. Twenty selected samples were tested for the presence of anti-DFS70 antibodies using ANA Line Immunoassay (LIA) (Immco Diagnostics, New York, USA). Results Sixty-two (83.8%) of 74 serum samples were found positive with ELISA, when 15 U/ml was taken as a reference value. Among 18 samples that were found positive by ELISA, five were negative for anti-DFS70 antibodies by LIA, while 13 were found positive. The lowest ELISA result of the sample that was positive by LIA was found to be 45.3 U/ml. When 45.3 U/ml was considered as a reference value, 45 (60.8%) of 74 serum samples were positive by ELISA. Nineteen of 20 patients had no SARD, while one had systemic lupus erythematosus (SLE). Conclusions DFS pattern should be confirmed with an objective method such as ELISA, LIA, or IB. We think that confirmation tests for detection of anti-DFS70 antibodies should be included in diagnostic algorithms.

Can we use serum copeptin levels as a biomarker in obstructive sleep apnea syndrome

OBJECTIVE The aim of this study was to compare serum copeptin levels in patients with obstructive sleep apnea syndrome (OSA) and simple snorers without sleep apnea; and to investigate relationships between copeptin levels and polysomnographic parameters. METHODS Serum copeptin levels were determined using enzyme-linked immunosorbent assay in 47 patients with OSA and 12 patients without OSA (control group). Full-night polysomnography was performed in each patient. Patients with OSA were divided into three groups according to their Apnea Hypopnea Index (AHI) scores: mild OSA (5 < AHI < 15), moderate OSA (15 < AHI < 30), and severe OSA (AHI > 30). RESULTS A total of 59 patients were included in the study. There were 23 female (39.0%) and 36 male (61.0%) subjects. The range of ages of study subjects was between 27 and 63 (mean 44.75 ± 9.64) years. According to the AHI values, patients were classified into four groups: simple snoring (n = 13), mild OSA (n = 10), moderate OSA (n = 15), and severe OSA (n = 21). Statistically significant differences between AHI groups in terms of age, Epworth score, and neck circumference. According to multiple comparison results for age, the difference between simple snoring and moderate OSA was statistically significant. According to multiple comparison results for Epworth score, the difference between simple snoring and severe OSA was statistically significant. According to multiple comparison results for neck circumference, a similar result was found like Epworth Sleepiness Scale score. The difference between AHI groups by gender was tested by a Pearson χ(2) test and was found to be statistically significant. There was no statistically significant difference among AHI groups in terms of copeptin. There was a statistically significant correlation of copeptin with AHI during rapid eye movement (REM) sleep; however, the correlation coefficient was not sufficiently large. CONCLUSIONS Increased serum copeptin concentration may reflect a response to stress in some diseases. This is well documented especially in cardiovascular diseases; however, we could not find any difference in OSA groups in terms of copeptin levels.

Substance P and vasoactive intestinal peptide levels in middle ear effusions of children.

Abstract Conclusion: This is the first report demonstrating high levels of substance P (SP) that inversely correlate with vasoactive intestinal peptide (VIP) levels in middle ear effusions (MEEs) of patients with otitis media with effusion (OME). Increased SP and decreased VIP levels might play a role in the pathogenesis of chronic OME. Objective: The etiology of OME is multifactorial, and neurogenic inflammation may play a significant role. SP and VIP levels were not evaluated previously in MEEs of children with OME. Methods: Fifty patients aged 2–12 years (mean age 5.24 ± 2.64) were included in the study. MEEs were classified as mucoid or serous based on the gross appearance. SP and VIP levels were determined using ELISA. Results: High levels of SP were detected in MEEs. In addition SP levels were significantly higher in serous samples (2910.55 ± 307.96 vs 2218.55 ± 262.30 pg/ml). There were also age-dependent changes, such that SP levels were significantly higher in children aged 2–3 years compared with those who were 4–5 and 6–12 years old. VIP levels were undetectable in 30% of patients and the mean level of VIP was 50.91 ± 16.01 pg/ml in serous middle ear effusions and 54.86 ± 15.91 pg/ml in mucoid MEEs.