Effect of acetylsalicylic acid and dipyridamole in primary membranoproliferative glomerulonephritis type I.

Primary membranoproliferative glomerulonephritis (MPGN) has a poor long-term prognosis, with 40 per cent of patients reaching end-stage renal failure after 10 years of observation. Approximately 35 per cent of patients die due to complications of the nephrotic syndrome. This study investigates the effect of acetylsalicylic acid (ASA) combined with dipyridamole on proteinuria and renal function in nephrotic MPGN patients with normal/moderately reduced glomerular filtration rate (GFR). Fourteen patients with biopsy-proven type I MPGN received ASA (1000 mg/day) and dipyridamole (300 mg/day) for 24 months. Proteinuria was reduced from 6.8 +/- 2.4 g/day to 1.1 +/- 0.6 g/day (p < 0.001). Serum albumin levels increased from 2.2 +/- 0.5 g/dL to 3.7 +/- 0.4 g/dL (p < 0.001) during the study period after 24 months compared to baseline. Serum creatinine and GFR did not significantly change in patients treated with acetylsaliclylic acid and dipyridamole during the observation period (p < 0.05). Our study suggests that ASA combined with dipyridamole significantly reduces proteinuria without impairing renal function in patients with MPGN.

High-level disinfection with 2% alkalinized glutaraldehyde solution for reuse of laparoscopic disposable plastic trocars.

The reusability of disposable plastic trocars after high-level disinfection by alkalinized 2% glutaraldehyde solution was examined in a prospective study from the point of view of infection risk in order to determine the safety and economic benefits. For this purpose, 45 laparoscopic cholecystectomy cases were analyzed microbiologically and clinically. In 30 cases, trocars subjected to 15 min of disinfection by glutaraldehyde were used. In the remaining 15 cases, new trocars were used and a control group was established. In total, eight culture samples were taken from trocars, laparoscope (as it is disinfected by the same method), glutaraldehyde solution and umbilicus of the patients preoperatively; and from the bile in the gallbladder, peritoneal lavage fluid, and epigastric and umbilical incisions postoperatively. Only one of the disinfected trocars yielded a culture-positive result. No culture-positive results were found in the samples taken from laparoscope, glutaraldehyde, and epigastric incisions. Culture-positive results were obtained in 11 cases at the umbilicus, in one case at the peritoneal lavage and in one case at the umbilical incision. None of the patients had infection at the wound site or intra-abdominally. In conclusion, we have shown that disposable plastic trocars subjected to high-level disinfection can be reused safely without infection risk and that cost can be reduced.

Bloodstream, respiratory, and deep surgical wound infections after open heart surgery.

Nosocomial infections are one of the most feared complications after open heart surgery. A large retrospective study was conducted to evaluate the nature and scope of the problem. Between 1992 and 1998, 9352 patients who had undergone open heart surgery were evaluated. Bloodstream infections, pneumonia, and deep sternal wound infections were included. Univariate and logistic regression analyses were conducted to identify the high-risk patients that were likely to become infected. Three hundred forty-six infections in 276 patients were diagnosed. Age, preoperative albumin level, banked blood requirement, duration of operation, diabetes mellitus, previous open heart surgery, moderate or severe pericardial adhesions, obesity, postoperative low cardiac output, and postoperative cerebrovascular accident were found to be significant in univariate and logistic regression analyses for infectious outcome. Univariate analysis also revealed additional significant factors: fresh frozen plasma requirement, duration of cardiopulmonary bypass and cross-clamp, preoperative high levels of blood urea and glucose, presence of occlusive peripheral arterial disease, preoperative history of hypertension, and nasal carriage of Staphylococcus aureus. Methicillin resistant S. aureus was involved in 58.4% of the infections. Risk factors should be individualized for patients and every effort should be carried out to minimize infectious outcome.

Campylobacter jejuni gastroenteritis in Turkish children.

Four hundred children between the ages of 1 month and 14 years with the complaint of diarrhea were studied to assess Campylobacter jejuni isolation rates in childhood acute gastroenteritis in Turkey and to clarify clinical presentations of C. jejuni enteritis. C. jejuni was found to be the second most common isolate with a rate of 8.3%, the first being Shigella strains. The highest isolation rate was in the 6 to 14-year age range at 12%. The most frequent symptoms in patients with C. jejuni enteritis were abdominal pain (51.5%), vomiting (36.4%) and fever (30.3%). Stool examination revealed bloody mucous stool in 51.5% of the patients, and erythrocytes and/or leucocytes were detected in 42.4%. Only 12.1% of the patients with C. jejuni enteritis were hospitalized in this study.

[Mannose-resistant hemagglutination (MRHA), type 1 fimbriae and hemolysin production of urinary and fecal Escherichia coli strains]. / Uriner ve fekal kaynakli Escherichia coli suslarinda mannoz-rezistan hemaglütinasyon (MRHA), tip 1 fimbriya ve hemoliz yapma özelliklerinin arastirilmasi.

The prevalence E.coli bearing Mannose-Resistant Hemagglutinating (MRHA) adhesin, Type 1 fimbriae and hemolytic activity was assessed in 103 E.coli strains isolated from 43 male and 60 female adult patients with urinary tract infection. For comparison 83 faecal E.coli strains were also examined for the same properties. MRHA adhesins were present in 58% (60/103) of the urinary strains, and 31% (26/83) of the faecal strains of E.coli. All faecal and 95% (98/103) of the urinary strains of E.coli expressed Type 1 fimbriae. Hemolytic activity was more frequent among urinary strains than among faecal strains (21%, 12%, respectively). The presence of MRHA adhesin and hemolytic activity was found correlated in 13.5% (14/103) of urinary strains whereas only one (1.2%) strain showed these properties together among the faecal isolates.

[Staphylococcus aureus nasal carriage in the normal population and hospital laboratory personnel]. / Normal populasyonda ve hastane laboratuvar personelinde Staphylococcus aureus burun tasiyiciligi.

Hospital personnel may be nasal carriers of S.aureus in a higher percentage of cases than in the general population. The aim of the present study was to compare the rate of nasal carriage of S.aureus in general population and hospital laboratory personnel. 144 of patients sent to our Microbiology laboratory for other reasons (i.e., Urine Culture, serology, etc.) were taken as general population, and 38 person from Microbiology, Biochemistry, Hematology, Immunology and Pathology Laboratories of our hospital were included the study as hospital laboratory personnel. S.aureus nasal carriage rates were found 28% (41/144) in normal population, and 31.5% (12/38) in hospital laboratory personnel. These figures are between normal population range. Therefore the rate of nasal carriage of S.aureus in our hospital, reflects probably normal population carrier rate, not the hospital colonization.

[A comparison of the frequency of hepatitis B surface antigen and antibody in hospital and nonhospital personnel]. / Hastane personeli ve hastane disindan kisilerde hepatit B Yüzey antijeni ve antikoru sikliginin karsilastirilmasi.

HBsAg and Anti-HBs positivity was determined in hospital personnel and volunteer blood donors (controls) by using Enzyme Immuno Assay (EIA) method. The combined prevalence of antigen-antibody positivity among hospital personnel was 40.52% (HBsAg 5.57%, Anti-HBs 34.94%) while it was present 37% (HBsAg 6% Anti-HBs 31%) in controls. The frequency of the antigen and antibody in hospital personnel and controls did not differ significantly.

[Streptococcal pharyngitis]. / Streptokokal faranjit.

Streptococcal sore throat is a common illness during childhood. The causative agent is generally Group A Streptococci. Group C and G streptococci also cause the same disease. In streptococcal pharyngitis a number of factors become important including speed and accuracy of diagnosis, appropriate treatment, treatment failure problems, possible serious complications and the carrier state.

[Postoperative wound infections]. / Postoperatif yara infeksiyonlari.

Between July 1987 and October 1988, 400 postoperative wound infection material sent to Microbiology Laboratory from various surgery clinics were examined bacteriologically. Staphylococcus aureus was the predominant organism. E. coli and coagulase negative Staphylococci were second and third in frequency respectively.

[Monoclonal antibodies]. / Monoklonal antikorlar.

Monoclonal antibodies have the capability to bind specifically to the antigens to which they are targeted, and hybridoma technology makes the production of these antibodies possible. Now, it is used in diagnosis and treatment of various diseases.