Yakut Akyön

Diagnosis of Helicobacter pylori

Although there are attempts to perform Helicobacter pylori diagnosis directly in vivo using magnification endoscopy, most articles on diagnosis this year concerned non‐invasive tests and molecular methods. For urea breath tests, there are attempts to have a quicker and cheaper test and to evaluate its role in cases of premalignant lesions. For stool antigens tests, evaluation of kits using monoclonal antibodies was carried out. Molecular tests have been applied for typing and detection of resistant mutants.

Helicobacter pylori Infection and Recurrent Abdominal Pain in Turkish Children

Background. Helicobacter pylori infection is primarily acquired in childhood. However, the association between H. pylori infection and recurrent abdominal pain (RAP) remains unclear.

The presence of Helicobacter pylori in the larynx pathologies

OBJECTIVE The well-known relation of Helicobacter pylori to the MALT-lymphoma and gastric carcinoma suggested a possible presence in the laryngeal tissues of patients with squamous cell carcinoma of the larynx by using Polymerase Chain Reaction (PCR) investigations, and PCR results of benign laryngeal pathologies were compared. METHODS Polymerase Chain Reaction investigations were carried out in biopsy samples of 21 patients with squamous cell carcinoma of the larynx and of 19 patients with benign laryngeal pathologies like vocal polyp and nodules. RESULTS The PCR results of 17 out of the 21 samples (80.9%) of the patients with laryngeal squamous cell carcinoma were positive for H. pylori. Moreover, any genomic material of H. pylori was not found in the PCR results of the 19 patients with benign laryngeal pathology. It was also determined that the presence of the H. pylori in the patients with laryngeal squamous cell carcinoma was statistically significant (p=0.0001). In the patients with laryngeal squamous cell carcinoma, the comparison of the H. pylori presence within the normal and tumoral tissues revealed that 16 normal tissue samples (76.19%) were positive, while 9 of the tumoral tissue samples (42.85%) were positive. The ratio of bacterial presence in both the normal and tumor tissue samples was 38.09% (8 patients). The rates of presence revealed a statistically significant difference between the normal and tumoral tissue samples (p=0.039). CONCLUSIONS The presence of the genomic material of H. pylori within the laryngeal tissue of patients with squamous cell carcinoma of the larynx is a proof of the colonization of the bacterium in that tissue. While this may suggest a possible relation of the bacterium to the development of laryngeal squamous cell carcinoma, no conclusion is possible to be drawn about the mechanism of the process.

Comparison of different methods to detect Helicobacter pylori in the dental plaque of dyspeptic patients

The aim of this study was to compare different methods of detection of Helicobacter pylori (H. pylori) in the dental plaque of dyspeptic patients. After recording the clinical indices, culture and polymerase chain reaction (PCR) methods were performed on plaque samples, while rapid urease test in addition to these tests was carried on gastric samples from 67 dyspeptic patients who attended for an upper gastrointestinal endoscopy. Forty-seven of 67 patients were H. pylori-positive in gastric biopsy material whereas the microbial dental plaque from 19 patients demonstrated H. pylori positivity detected by PCR. Among the patients, 25.4% harbored H. pylori both in the stomach and in microbial dental plaque. No significant correlations were found among the presence of H. pylori in the stomach, in plaque, and clinical variables (P > 0.05). Although oral hygiene was observed optimal and the mean of pocket depth was not found to be higher, the prevalence of H. pylori was observed to be higher in dental plaque. According to our results, PCR technique gave the highest detection rate both in gastric biopsy and in dental plaque compared to the other methods used.

Heat shock protein70: a new marker for subsequent atrial fibrillation development?

Atrial fibrillation (AF) is a common arrhythmia, after cardiac surgery, and it is associated with a twofold increase in cardiovascular mortality and morbidity. Reperfusion injury and inflammation associated with cardiac surgery are thought to be involved in its pathogenesis. Heat shock proteins (HSPs) are a family of chaperone proteins which assist in preservation of cellular integrity by maintaining proteins in their correctly folded state. The aim of this study was to investigate pre-postoperative heat shock protein70 (HSP70) and high-sensitivity C-reactive protein in serum from patients in preoperative sinus rhythm. We prospectively screened 45 consecutive patients admitted to the hospital for elective coronary artery bypass surgery (CABG). Electrocardiogram characteristics and cardiovascular risk profile were documented. Pre- and postoperative blood samples were collected. HSP70 value was 8.9 +/- 4.8 ng/mL in Group A (study group) preoperatively and decreased to 7.7 +/- 7.0 ng/mL postoperatively. In contrast, preoperative value of HSP70 was 4.2 +/- 2.2 ng/mL and decreased to 2.7 +/- 2.6 ng/mL postoperatively in Group B (control group). Statistical analysis showed significant difference regarding preoperative HSP70 levels in Group A compared to Group B. To our knowledge, with this study, the association of pre- and postoperative circulating HSP70 with postoperative AF was demonstrated for the first time.

The cagA status of Helicobacter pylori isolates from dyspeptic children in Turkey

There are inconsistent reports regarding cytotoxin-associated gene A (cagA) status of Helicobacter pylori isolates and the severity of the mucosal lesions in children. The aim of this study was to determine the prevalence of cagA(+) strains and to evaluate its correlation with clinic and endoscopic findings. We examined 45 H. pylori strains that were grown on brain-heart infusion agar supplemented with 7% horse blood. Following 72 h of incubation colonies were harvested and bacterial DNA was extracted. Polymerase chain reaction primers F1 and B1 were used to amplify a 348-bp internal fragment of cagA. The prevalence of cagA in Turkish pediatric patients was 55.6%. No association was found between cagA status and the severity of gastro-duodenal lesions.

Kluyvera ascorbata infections in children: a case series.

Kluyvera is a relatively newly described member of the Enterobacteriaceae family that rarely causes infections in humans. In the pediatric population, it is described in association with clinically significant infections ranging from urinary tract infections to sepsis with multiorgan failure. Our aim is to determine the clinical significance of K. ascorbata infections in the pediatric population at our institution. We retrospectively analyzed clinical microbiology data as from 2006 and identified four clinically significant isolates in this period. The isolates were from four cases who presented with sepsis, bacteremia associated with central venous catheter, pyelonephritis and intraabdominal collection. The ages of these patients ranged between seven months to 17 years. All patients received prompt antimicrobial treatment on the basis of susceptibility testing and good clinical response was obtained in all patients. Successful treatment options include third-generation cephalosporins, aminoglycosides, betalactams with beta-lactamase inhibitors and carbapenems. Clinicians should be aware of the spectrum of disease and increasing clinical importance associated with this pathogen.

Detection of parasites in children with chronic diarrhea

The aim of this study was to investigate the frequency of intestinal parasites in patients with chronic diarrhea and clarify the importance of these parasitic pathogens in such cases. A total of 60 pediatric patients with chronic diarrhea between June 2012 and October 2014 were enrolled in the study. Out of 60 stool samples, five were positive for Giardia lamblia, two, Dientamoeba fragilis, and one, Blastocystis hominis. One stool sample was positive for Entamoeba hartmanni and B. hominis, another one was positive for G. lamblia and B. hominis, another, G. lamblia and E. hartmanni and one sample was positive for Enterobius vermicularis, D. fragilis and B. hominis together. Parasitic infection, which decreases quality of life and increases susceptibility to other infections, should not be neglected, particularly in patients with chronic diarrhea. Accurate diagnosis decreases morbidity and mortality in patients with parasite infection.

[The results of Hacettepe University Faculty of Medicine Parasitology Laboratory in 2003-2012: evaluation of 10 years].

OBJECTIVE Parasitic diseases are common throughout the world. Evaluation of regional epidemiological data is needed to determine protective measures and treatment strategies. METHODS This study evaluates the parasites detected in Hacettepe University Faculty of Medicine Parasitology Laboratory. RESULTS Of the 87,100 clinical samples evaluated in the study, 85,707 (98.4%) were from stool samples. Parasites were shown in 3,681 (4.2%) of the samples from 2,906 patients. The most common parasites were Giardia intestinalis (40%), Blastocystis spp. (22%), Entamoeba coli (12%), Dientamoeba fragilis (9%), Enterobius vermicularis (5%), Echinococcus spp. (4%) and Taenia spp. (3%) respectively. When distribution among years was evaluated, G. intestinalis, the most common parasite, had a tendency to decrease after 2004 whereas cases with Blastocystis spp. showed a clear increase in 2011 and 2012. The downward trend in parasite-positive cases also stopped in the last two years, in parallel to the increase of Blastocystis spp. During the study, Leishmania spp. and Plasmodium spp. were detected in four patients each. CONCLUSION This study evaluated the results of a laboratory that scans a large number of patients in our region. Data obtained from different regions will allow to direct strategies to diagnose, treat and implement preventive measures against parasitic diseases in our country.

Does Helicobacter pylori play a role in the pathogenesis of non‐cystic fibrosis bronchiectasis?

The aim of this study was to investigate whether Helicobacter pylori plays a role in the pathogenesis and severity of non‐cystic fibrosis bronchiectasis, and its relationship with gastroesophageal reflux (GER).