Molecular Detection of Dermatophytes and Nondermatophytes in Onychomycosis in Antalya, Turkey.

BACKGROUND: Onychomycosis is a chronic nail infection, and dermatophytes, yeasts, and nondermatophytic molds may be the causative agents. This study aimed to determine the etiological agents of onychomycosis by using conventional and molecular methods. METHODS: Between June 2020 and July 2021, 37 patients with a presumptive diagnosis of onychomycosis and mycological evidence (culture and/or EUROArray Dermatomycosis assay) were included in the study. Organisms detected in cultured nail specimens were identified by combined phenotypic characteristics and by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). An EUROarray Dermatomycosis assay was used for molecular detection of fungal pathogens. RESULTS: The EUROArray Dermatomycosis assay was positive for a single fungal target in 23 samples, and 14 samples were positive by culture. The most common pathogen was Trichophyton rubrum in both methods. Coinfection was detected in 14 samples by using molecular methods, and Trichophyton rubrum and Fusarium solani (9 samples) were the most common pathogens detected together. Trichophyton spp., nondermatophyte molds, and Candida spp. were detected in 33 (89.2%), 16 (43.2%), and 6 (16.2%) samples, respectively, when the two methods were evaluated together. CONCLUSIONS: Our results revealed that fungal culture allows the diagnosis of onychomycosis, but it is not as sensitive as the EUROArray Dermatomycosis test, especially in patients receiving antifungal therapy.

Exocrine pancreas functions in children with type 1 diabetes mellitus.

BACKGROUND AND STUDY AIM: We evaluated exocrine pancreas functions using a noninvasive indicator in a case-control study conducted on children and adolescents diagnosed with type 1 diabetes mellitus. PATIENTS AND METHODS: Sixty-seven patients who participated in a summer camp were enrolled in this study. Nineteen healthy children in the same age group were assigned to the control group. Fecal pancreatic elastase was assayed using the enzyme-linked immunosorbent assay technique. Values higher than 200 µg/g were considered an indication of sufficient exocrine pancreatic functioning, values between 100 µg/g and 200 µg/g were considered mild exocrine pancreatic insufficiency, and values below 100 µg/g were considered severe exocrine pancreatic insufficiency. RESULTS: The mean concentration of fecal elastase was 158.38 ± 59.67 µg/g. The patients were assigned to three groups according to these values. Thirteen patients (22%) had sufficient fecal elastase levels, whereas 36 patients (62%) had mildly insufficient levels, and nine patients (16%) had severely insufficient fecal elastase concentrations. The levels of fecal elastase, amylase, lipase, and zinc were significantly different between the patients and controls (p < 0.001). Only the duration of diabetes was significantly different between patients with different severities of exocrine pancreatic insufficiency (p = 0.037). Additionally, the group with severe pancreatic insufficiency had more frequent hypoglycemic attacks. CONCLUSION: Exocrine pancreatic insufficiency may develop in children with diabetes, and hypoglycemia attacks are observed more frequently depending on the severity of pancreatic insufficiency.

Evaluation of Aspergillus Lateral-Flow Test in Serum Samples of Pediatric Patients.

BACKGROUND: Diagnosis of invasive aspergillosis (IA) in patients with hematologic malignancies and under the risk of IA may be uncertain or may delay because of nonspecific clinical presentation of the patients and difficult application techniques of conventional methods. Early diagnosis can provide initial antifungal therapy and prevent high mortality. In this study, we investigated the performance of an Aspergillus lateral-flow device (LFD) test (OLM Diagnostics, Newcastle upon Tyne, United Kingdom) for the diagnosis of IA in pediatric febrile neutropenic patients with hematologic malignancies. METHODS: Three hundred and fourty seven serum samples of 26 febrile neutropenic episodes of 21 patients at risk for IA were tested. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the Aspergillus LFD test at episode level and at serum level were calculated. RESULTS: According to the reference diagnostic criteria of IA, one proven and 13 probable IA episodes were defined. Twelve episodes (46.1%) did not meet the criteria for IA. The sensitivity, specificity, PPV, NPV, accuracy of the Aspergillus LFD test at episode level and at serum level were 14.3%, 100%, 100%, 50%, 53.8% and 12.1%, 100%, 100%, 50.8%, 53.9%, respectively. CONCLUSIONS: Aspergillus LFD test is an easy-to-use assay with short hands-on time; however, further study of the clinical utility in children and especially in serum samples are needed. It is a highly specific test for IA on bronchoalveolar lavage (BAL) samples but is not useful as a screening test for serum samples unless combined with galactomannan (GM) antigen test because of its potentially suboptimal sensitivity.

Antibacterial activity of silver nanoparticles activated by photodynamic therapy in infected root canals.

BACKGROUND: Root canal disinfection includes mechanical, chemical and biological struggle against microorganisms (MOs). Photodynamic therapy (PDT) and nanoparticle (NP) agents may be proposed as an alternative for use against intracanal infections due to their ability to disrupt biofilm and prevent bacterial adhesion to dentin. The use of NP agents in combination with light/photosensitizer (PS) agents increases the efficiency of PDT in root canal disinfection. OBJECTIVES: The aim of the study was to evaluate the effect of light application - PDT - on the antibacterial activity of the combination of a PS agent (toluidine blue O -TBO) and an NP agent (silver nanoparticles - AgNPs) for the disinfection of the root canals inoculated with Enterococcus faecalis (E. faecalis). MATERIAL AND METHODS: In this study, concentrations of 20 ppm of TBO and 10 ppm of AgNPs, which showed the highest antibacterial activity against E. faecalis in the TBO/AgNPs combination, were used according to the preliminary studies. After instrumentation, 120 human, single-rooted, straight-canal mandibular premolars of a standard length of 13 mm were contaminated with bacteria, and experimental procedures were conducted against 21-day-old mature biofilm. The teeth were randomly divided into 5 main experimental groups: TBO/light; AgNPs; TBO/AgNPs; AgNPs/light; and TBO/AgNPs/light. Then, these main groups were divided into 2 subgroups each, according to the 2 application time periods (30 s and 60 s) (n = 10). The remaining 20 teeth constituted positive and negative control groups. The data was analyzed with the Kolmogorov-Smirnov test, one-way analysis of variance (ANOVA), Tukey's honestly significant difference (HSD) test, and the Bonferroni correction. RESULTS: The NaOCl group provided a bacterial reduction that was higher than in all other groups in a statistically significant manner. Light application on the TBO/AgNPs combination was the group that provided the highest bacterial reduction after NaOCl. CONCLUSIONS: The photoactivation of the TBO/AgNPs combination led to an increase in the effect of PDT, and it has the potential to be used as an adjunct for disinfection of the root canal system.

Evaluation the oral hygiene conditions, oral Candida colonization and salivary Streptococcus mutans and Lactobacilli density in a group of Beta-thalassemic children and adolescence

BACKGROUND: In this study, the prevalence and distribution of dental caries and oral hygiene conditions in a group of patients with β-TM are evaluated and the results compared to age-and gender-matched healthy patients. In addition, oral candida colonization and the density of Streptococcus mutans (S.mutans) and Lactobacilli in the total saliva are assessed. MATERIAL AND METHODS: This study involved 59 β-TM patients between 6-16 years old (mean: 11.59 ± 3.22), who applied to the Department of Pedodontics, Faculty of Dentistry, Akdeniz University, with ongoing follow-up, treatment and regular blood transfusions. All enrolled patients were diagnosed with β-TM by the Department of Pediatric Hematology and Oncology, Faculty of Medicine, Akdeniz University. As a control group, age-and gender-matched healthy 50 patients were included to the study. RESULTS: Plaque (p = 0.001), DMFT (p = 0.009) and DMFS (p = 0.039) indices were significantly higher in the β-TM patients, whereas, the oral hygiene status was significantly lower (p = 0.004). Saliva buffering capacity average was insignificantly but slightly more in β-TM patients(p= 0.131).While S.mutans values were significantly higher in the β-TM patients (p = 0.002), no significant difference was found in the Lactobacillus (p = 0.131) and Candida values (p= 0.33). CONCLUSIONS: DMFT, DMFS, Plaque and oral hygiene indices and S.mutans values were found significantly differ-ent in β-TM patients than healthy, control group patients, in this study

No disponible

The association of oxidative stress with hypertensive retinopathy.

This study was designed to answer the following questions: (i) Do levels of serum gamma-glutamyl transferase (GGT), a marker of oxidative stress, change in hypertensive retinopathy (HR)? (ii) Is there any relation between degree of HR and GGT levels? This study included 80 hypertensive patients with HR. Group 1 comprised 40 patients with grade I HR, and group 2 comprised 40 patients with grade II HR. We selected 40 healthy subjects for the control group. Level of GGT in group 2 was significantly higher than in group 1 (P = 0.005) and control group (P = 0.001); it was also higher in group 1 than in control group (P = 0.025). Our study suggests that oxidative stress, mechanisms known to be involved in vascular lesions, may promote the development of HR.

Polymorphism in the TNF-alpha gene promoter at position -1031 is associated with increased circulating levels of TNF-alpha, myeloperoxidase and nitrotyrosine in primary Sjögren's syndrome.

OBJECTIVES: Tumour necrosis factor-alpha (TNF-alpha) is a pro-inflammatory cytokine which is associated with the pathogenesis of many inflammatory diseases. The aim of this study was to investigate the effect of TNF-alpha -1031 gene polymorphism on circulating TNF-alpha, myeloperoxidase (MPO) and nitrotyrosine (NT) levels in primary Sjögren's syndrome patients. METHODS: TNF-alpha-1031 T/C gene polymorphism was evaluated in 65 Sjögren's syndrome patients and 58 age and gender matched controls via 5' nuclease PCR analysis. Plasma TNF-alpha and NT levels were analysed by ELISA while MPO activity, total nitrate/nitrite and glutathione (GSH) levels were measured by spectral analysis. RESULTS: TNF-alpha -1031 C carrier genotype frequency was significantly higher (p=0.045) in Sjögren patients compared to controls (23.1 vs. 10.3%, 0R= 2.83, 95% CI=0.27-7.8). Plasma TNF-alpha concentration and NT levels were also significantly higher in Sjögren patients with -1031 C carrier genotype compared to patients with TT genotype. Sjögren patients showed a significant increase in plasma MPO activity which correlated with both TNF-alpha and NT levels in subjects with -1031 C carrier genotype assessed by linear regression analysis. TNF-alpha-1031 T/C gene polymorphism had no effect on plasma nitrate/nitrite and GSH levels which were significantly decreased in Sjögren's syndrome patients compared to controls. CONCLUSIONS: Polymorphism in the TNF-alpha gene promoter at position -1031 is associated with increased circulating levels of TNF-alpha which is correlated with increased plasma MPO activity and protein nitration in Sjögren's syndrome.

Benefits of low dose immunoglobulin in the treatment of refractory CAPD peritonitis and longevity of technical survival on CAPD.

In this study we investigated the long term results of intraperitoneal immunoglobulin (Ig) treatment in continuous ambulatory peritoneal dialyses (CAPD) patients with refractory or relapsing peritonitis. Sixteen CAPD patients (4 female, 12 male) with a mean age of 53 +/- 11 years (40-80), with a mean CAPD duration of 46.2 +/- 4.8 months (17-75) were included in the study. The patients included had a diagnosis of either refractory or relapsing peritonitis unresponsive to appropriate antibiotic therapy. 0.5 g of Ig was added to every exchange bag qid as an adjunctive therapy to the culture based antibiotherapy for 7 days. Intraperitoneal Ig treatment was found to be successful in treating peritonitis in all but one patient. Interestingly, following Ig treatment, long term peritonitis rate decreased significantly compared to the period before treatment (before: 2.2 +/- 0.6 episodes/patient/year vs. after: 0.6 +/- 0.17 episodes/patient/year; P = 0.019). The mean CAPD duration after Ig treatment was 30.5 +/- 5.4 (4-64) months. Out of 16 patients, one patient who was unresponsive, had his catheter removed and was switched to hemodialysis, and four patients with preexisting ultrafiltration failure or inadequate dialysis problems were transferred to hemodialysis after successful treatment of their peritonitis, one patient was transplanted and 10 patients continued on CAPD. We conclude that low dose Ig treatment may be beneficial in the treatment of refractory or relapsing CAPD peritonitis possibly through restoring impaired host defense within peritoneal cavity. This therapy, by preventing further peritonitis attacks, may prolong survival on CAPD.