Is increased activator protein 1 in cerebrospinal fluid as a potential biomarker that distinguishes idiopathic intracranial hypertension from multiple sclerosis?

OBJECTIVES: To distinguish whether idiopathic intracranial hypertension (IIH) is a condition predisposing to multiple sclerosis (MS) or an isolated disease, the current gene transcription factor Activator Protein-1 (AP-1) was evaluated with its potential to differentiate both diseases. BACKGROUND: The aim of this study was to investigate the use of AP-1 as biomarkers for the discrimination of IIH and MS. METHODS: AP-1, TNF-α, and IL-6 protein values in the CSF of the cases were evaluated by the ELISA method. The numerical measures of the groups and the ability of AP-1 to distinguish the groups were analyzed with the ROC curve. RESULTS: There was no difference between the groups in CSF TNF-α, IL-6, CSF, and serum biochemistry analyses. However, it was determined that the AP-1 concentration (pg/ml) was significantly higher in the IIH group, the sensitivity of AP-1 in separating those with IIH was 75%, and the specificity in separating those with MS was 60% in those with an AP-1 concentration of 606.5 and above. CONCLUSION: According to our results, the fact that CSF TNF-α and IL-6 values did not differ in IIH compared to MS revealed that IIH could not methodologically control MS, and AP-1 was a supportive parameter in differentiating both diseases (Tab. 2, Fig. 1, Ref. 31).

Frequency of lyme disease in patients with tick contact and identification of ticks from Bolu province of Turkey.

BACKGROUND OBJECTIVES: Lyme disease is a multisystemic disease caused by the bacteria in the Borrelia burgdorferi sensu lato complex, which is transmitted by ticks of Ixodes genus. Although there are seroprevalence studies and case reports of Lyme disease from various regions in Turkey, there is no widespread epidemiological research. This study aimed to determine the frequency of Lyme disease in the cases followed-up after tick contact and to examine the isolated ticks to reveal tick population from Bolu province. METHODS: The cases who applied to the emergency department due to tick contact between April and September 2020 were firstly evaluated in our infectious diseases and clinical microbiology outpatient clinic on the third day of exposure and antibodies against Lyme disease were investigated with IFA method to exclude the patients who were previously exposed to B. burgdrorferi. Thereafter, patients were requested to continue outpatient visits at the 1st and 3rd month control. At these controls serum samples were taken to study B. burgdorferi antibodies with ELISA method which was stored at -20°C until the study day. RESULTS: Out of 123 patients who came to first control, 69 patients continued later to at least one of the two controls (either at first or third month). Of these 69 patients, only one (1.4%) was diagnosed with Lyme borreliosis according to clinical and laboratory features. Erythema migrans did not occur in any of the cases. Serum samples were assessed by ELISA method. Asymptomatic infection was detected in 22 cases (30.5%). In addition, we could obtain 46 ticks from our cases and two genera were identified. Forty-two (91.3%) were Ixodes spp, and two (4.3%) were Hyalomma spp. INTERPRETATION CONCLUSION: In this study, which was carried out for the first time in the province of Bolu, it was concluded that the cases presenting with a history of tick contact were most frequently exposed to Ixodes spp ticks and the probability of developing Lyme borreliosis was low (1.4%) during the three-month follow-up. Further studies with a greater number of cases and more extended follow-up period are needed.

Acute toxoplasmosis and antioxidant levels in the liver, kidney and brain of rats

Toxoplasma gondii is a common protozoan parasite which causes toxoplasmosis worldwide. There are limited treatment options against T. gondii infection. Once transmitted, T. gondii can spread to many organs in the body, including the brain, liver and kidneys. One of the most common signs of toxoplasmosis is a rise in oxidative stress. Therefore, our aim was to determine the antioxidant levels in the brain, liver and kidney of rats infected with this parasite. In the present study, 2­4-months old Wistar albino rats were infected intraperitoneally with 1 x 104 mL of RH strain of T. gondii dispersed in 0.9% NaCl. Post-infection after 30 days, the experiment was terminated, the rats were sacrified, and the blood, brain, liver and kidney tissues were collected for analyses. Catalase (CAT), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) levels were determined by ELISA assay. Increased SOD and GSH-Px levels were found in the liver of infected rats compared to controls; however, similar changes were not observed in other tested organs. These results suggest the increased oxidative stress caused by T. gondii infection can be efficiently alleviated, at least in the liver, by increased levels of antioxidant enzymes during post-infection. Further research will be required to determine the potential mechanisms of increasing antioxidant levels in the liver at 30 days post-infection, as well as the potential differences in antioxidant enzyme levels during the acute and chronic phases of toxoplasmosis.

Investigation of a 6-year seropositivity of Toxoplasma gondii in Abant Izzet Baysal University Educational Research Hospital.

OBJECTIVE: The aim of the present study was to determine the prevalence of Toxoplasma gondii IgG and IgM antibodies in patients who were admitted in Abant Izzet Baysal University Education and Research Hospital between January 2010 and December 2016 with a suspicion of toxoplasmosis. METHODS: Anti-T. gondii IgM and IgG antibodies and IgG avidity test determined by ELISA method in 14,262 serum samples belonging to the Abant Izzet Baysal University Education and Research Hospital were retrospectively investigated. RESULTS: IgG was detected in 4079 serum samples with 78% negative, 21% positive, and 0.8% gray zone. IgM was detected in 13,671 cases with 98% negative, 1.2% positive, and 0.5% gray zone. (3.8%, n=540) and neurology (3.4%, n=478) patients who were referred to the Obstetrics and Gynecology Clinic (88.3%, n=12,588) for the majority of the cases requested for the detection of T. gondii antibodies. It has been found that a request has been made. CONCLUSION: The seropositivity of T. gondii has been found to be so large that it should not be ignored. It has come to the conclusion that the events in the risk group should be taken into consideration for this parasite, and awareness should be established. In recent years, this awareness has been observed, especially in neurology clinics.

Determination of Anti-nuclear Antibody Pattern Distribution and Clinical Relationship.

BACKGROUND AND OBJECTIVES: Autoantibodies are immunglobulins occurred directly against autoantigens that are known as endogen antigens. Autoimmune disease is an occasion that the body begins a fight against its own cells and tissues. The antibodies that are created by the body against its own cell nuclei are called as anti-nuclear antibodies (ANA), and one of the methods used for detection and pattern of ANA is indirect immunofluorescence test (IIF). In the present study, it was aimed to determine the rate of ANA positivity and patterns of the positive specimens, and to investigate the relationship between ANA positivity and diseases in patients. METHODS: ANA test results of a total of 3127 patients admitted during March 2010 to December 2012 were evaluated retrospectively. ANA test (HEp 20-10, EUROIMMUN, Germany) was used in dilution of 1:100 in IIF test. RESULTS: A total of 494 (15.8%) resulted as ANA positive. ANA positivity rate was significantly higher in female patients than the male ones (p<0.001). The most frequent ANA patterns were coarse speckled pattern (154 patients, 31.2%), nucleolar pattern (89 patients, 18.0%), fine speckled pattern (57 patients, 11.5%), and speckled pattern (48 patients, 9.7%). ANA positivity was most commonly determined in rheumatoid arthritis (RA) (42 patients, 8.5%), systemic lupus erythematosus (SLE) (29 patients, 5.9%), and rheumatoid vasculitis (RV) (28 patients, 5.7%). The most frequent symptoms or findings were joint pain (127 patients, 26.0%) and anemia (28 patients, 5.7%). ANA positivity rates were found to be significantly higher in patients with RA (p<0.001), with SLE (p<0.001), and with Raynaud phenomenon (p=0.001) in comparison to the controls. Amongst the most frequent diseases evaluated, no significant differences were found between the control groups and the groups of RV (p=0.089), multiple sclerosis (p=0.374), and Sjögren syndrome (p=0.311) in terms of ANA positivity rates. CONCLUSIONS: The present study is the first study reporting the positivity rate and distribution of ANA in Bolu located in northwestern Turkey. Information about the pattern types and the distribution of the patterns according to the diseases and symptoms contribute in diagnosis of autoimmune diseases. It is observed that clinical diagnosis has been supported significantly by ANA test according to data of our study.

Investigation of in-vitro susceptibility of multidrug-resistant Acinetobacter baumannii strains isolated from clinical specimens to tigecycline.

The management of infections due to A. baumannii is difficult because of rapidly developing resistance, however, tigecycline, a glycylcycline antimicrobial, is in use for several years. In the present study, it was aimed to determine the susceptibility rates of A. baumannii to tigecycline. A total of 90 A. baumanni isolates were tested using three methods such as disk diffusion, broth microdilution, and E-test. The MIC50 and MIC90 values and the MIC range were found as 2 µg/ml, 4 µg/ml, and 0.1-8 µg/ml by microdilution; and 2 µg/ml, 6 µg/ml, and 0.1-12 µg/ml by E-test, respectively. There were a few major errors as well as the minor rates were all high as between 35.7%-46.7%. The accuracy rates between the methods were low as 53.3% (48/90) between disk diffusion and E-test, 51.1% (46/90) between disk diffusion and microdilution, and 60.0% (54/90) between E-test and microdilution. In the ROC curve analysis, an inhibition zone diameter of susceptibility breakpoint of 21.5 mm had sensitivity between 68.8%-88.9%; specificity between 81.9%-87.9%; and accuracy between 80.0%-83.33%. An analysis based on EUCAST's non-species breakpoints, the MIC tests showed higher accuracy with a rate of 96.7%, however, performance of disk diffusion got worse as lower than 25%. In conclusion, we showed that the reliability of the methods even did not remain as high as the past. Our study presented that none of three methods revealed reliable results in determination of susceptibility of A. baumanni to tigecycline, so the clinical response should be followed up carefully in such cases.