The role of neutrophil-lymphocyte ratio and red blood cell distribution width in the classification of febrile seizures.

OBJECTIVE: Most febrile seizures occur outside of hospitals, and in most cases, information about the characteristics of the seizures is obtained from the parents. This makes it difficult to differentiate between simple and complex seizures. The aim of this study is to evaluate the significance of the Neutrophil-Lymphocyte Ratio (NLR) and the red blood cell (erythrocyte) distribution width (RDW) in distinguishing between simple and complex febrile seizures. PATIENTS AND METHODS: The files of 142 patients between the ages of 6 months and 5 years who were admitted to the Emergency Department with the diagnosis of first febrile seizure were reviewed retrospectively. Complete blood count and C-reactive protein (CRP) parameters obtained from the venous blood samples collected from the patients at admission were evaluated. RESULTS: The average values of NLR for simple and complex seizure groups were 2.38 ± 1.60 and 3.42 ± 1.77 respectively, and the difference was statistically significant (p < 0.001). The average values of RDW for simple and complex seizure groups were 16.15 ± 1.37 and 16.27 ± 1.53, respectively; the difference was not significant (p = 0.631). We used receiver operating characteristic (ROC) analysis and chose a cutoff value of 2.315 for the NLR, and we found that the sensitivity and specificity were 62.7% and 53.8%, respectively (area under the curve [AUC]: 0.665, p = 0.001, confidence interval [CI] 0.573-0.756). CONCLUSIONS: We suggest that NLR may provide clinicians with an insight into differentiating between simple and complex febrile seizures; however, it does not produce a clear-cut distinction. We found that the RDW ratio is not useful in this differentiation.

Prevalence of several herpesviruses and human papillomavirus in acute apical abscesses.

AIM: To investigate and compare the radiographic size of acute apical abscess lesions for the presence of Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human herpesvirus-6 (HHV-6) and human papillomaviruses (HPV) DNA by means of the real-time polymerase chain reaction (PCR) method. METHODOLOGY: According to the radiographic size of acute apical abscess lesions, 11 lesions were categorized as large (≥5 mm) and 10 lesions as small (<5 mm). DNA extracts from purulent exudate aspirates of 21 cases of acute apical abscess and 10 control samples were evaluated for the presence of viral loads using real-time PCR methods following the kit protocols recommended by the manufacturers. Statistical analysis was performed using chi-squared test with Yates's correction and Fisher's exact test. RESULTS: HCMV DNA was detected in 27% of large and in 10% of small abscess lesions. EBV was identified in 18% of large and in 10% of small abscess lesions. HPV and HHV-6 DNA were found in 9% of large abscess lesions. None of the small abscess lesions contained HPV or HHV-6 DNA. Viral coinfections were found in two samples as the pair of HCMV/EBV and HCMV/HHV-6 from large abscess lesions. No significant associations were found between any of the target viruses and size of periapical lesions. As for the healthy pulps used as noninflamed controls, no control specimens contained viral DNA. CONCLUSIONS: HCMV was the most frequent herpesvirus amongst the target viruses in samples from both large and small apical abscess lesions. In large lesions, EBV and HHV-6 tended to occur in coinfection with HCMV. Additional studies are required to elucidate the role of herpesviruses in the pathogenesis of periapical abscess.

Estimation of human heat loss in five Mediterranean regions.

This study investigates the effects of seasonal weather differences on the human body's heat losses in the Mediterranean region of Turkey. The provinces of Adana, Antakya, Osmaniye, Mersin and Antalya were chosen for the research, and monthly atmospheric temperatures, relative humidity, wind speed and atmospheric pressure data from 2007 were used. In all these provinces, radiative, convective and evaporative heat losses from the human body based on skin surface and respiration were analyzed from meteorological data by using the heat balance equation. According to the results, the rate of radiative, convective and evaporative heat losses from the human body varies considerably from season to season. In all the provinces, 90% of heat loss was caused by heat transfer from the skin, with the remaining 10% taking place through respiration. Furthermore, radiative and convective heat loss through the skin reached the highest values in the winter months at approximately between 110 and 140W/m(2), with the lowest values coming in the summer months at roughly 30-50W/m(2).

Modest correlation between serum neopterin levels and Gensini scores in a cohort of patients undergoing coronary angiography.

OBJECTIVE: We initially tried to study the possible correlation between the severity of coronary artery disease (CAD) and serum neopterin levels in stable coronary artery disease patients. Also we tried to investigate the neopterin as an indicator for the extent of CAD using the Gensini score. METHODS: A total of 40 patients with stable angina pectoris who are chosen for coronary angiography were selected for the study. Before the angiography procedure, blood samples were taken for the measurement of serum neopterin levels and the results of the coronary angiography were scored according to the Gensini scoring system. RESULTS: Neopterin levels were correlated with the Gensini scores [p = 0.010, ρ = 0.401] and a correlation between the age of patient population and Gensini score was also observed in the study [p = 0.016, ρ = 0.380]. CONCLUSION: By the guidance of our results, we can confidently state that there is a correlation between serum neopterin levels and the severity and extent of CAD in stable coronary artery disease patients.

A new diagnostic approach for Turkish speaking populations DAWBA Turkish Version.

Aims. Turkey has the youngest population in Europe with about 25 million people aged below 19 years and Turkish-speaking people comprise the biggest migrant group in Europe with 2.5 million people dispersed in different countries, but conducting epidemiologic surveys on Turkish people is challenging due to the lack of a suitable diagnostic tool. The Development and Well-Being Assessment (DAWBA) is one of the most widely used diagnostic interviews in child and adolescent psychiatry. In this study, we aimed at translating the DAWBA into Turkish and then examined its validity and reliability. Methods. The validity of the Turkish version was examined in clinical (n = 50) and community (n = 104) samples. The interrater reliability was also evaluated on 20 cases. Results. The translation method used in the study achieved semantic, conceptual, content, technical, item and criterion equivalence between the Turkish and original forms. The validity of the Turkish DAWBA was good or excellent for different diagnostic categories (κ: 0.43-0.84); the interrater reliability was also excellent (κ: 0.85-1). Conclusions. The Turkish DAWBA may be useful for future prevalence studies in Turkey. European clinicians and researchers who work with Turkish-speaking families can use the online Turkish DAWBA to gather structured information from Turkish-speaking informants and review the answers in their own language.

Microarray-based gene expression analysis of an animal model for closed head injury.

OBJECTIVE: Traumatic brain injury (TBI) is a major cause of death and disability in both children and the elderly. Mortality from TBI is said account for 1-2% of all deaths. One-third to one-half of all traumatic deaths is due to head injury. Of those who survive, the majority is left with significant disabilities, including 3% who remain in a vegetative state and only approximately 30% who make a good recovery. Microarray studies and other genomic techniques facilitate the discovery of new targets for the treatment of diseases, which aids in drug development, immunotherapeutics and gene therapy. Gene expression profiling or microarray analysis enables the measurement of thousands of genes in a single RNA sample. METHODS: In this study, adult Wistar-albino rats underwent TBI using a trauma device. Brain tissues and blood samples were taken for gene expression at 1, 12 and 48 h post-trauma and were then analysed via microarray. Total RNA was isolated using an RNeasy Mini Kit (QIAGEN-Sample & Assay Technologies, Hilden, Germany) and tested using a 2100 Bioanalyzer (Agilent Technologies, Palo Alto, CA). Overall changes in gene expression were evaluated using Agilent Whole Rat Genome 4 × 44 K oligonucleotide arrays and analysed with GeneSpring (GeneSpring 6.1, Silicon Genetics, Redwood City, CA) software. Only genes with a signal-to-noise ratio of above 2 in the experiments were included in the statistical analysis. RESULTS: ANOVA (p<0.05) was performed to identify differentially expressed probe sets. Additional filtering (minimum 2-fold change) was applied to extract the most differentially expressed genes based on the study groups (Control vs. 1st hour, Control vs. 12th hour, Control vs. 48th hour). Differentially expressed genes were detected via microarray analysis. A gene interaction-based network investigation of the genes that were identified via traditional microarray data analysis describes a significantly relevant gene network that includes the C1ql2, Cbnl, Sdc1, Bdnf, MMP9, and Cd47 genes, which were differentially expressed compared with the controls. CONCLUSIONS: In this study, we will review the current understanding of the genetic susceptibility of TBI with microarrays. Our results highlight the importance of genes that control the response of the brain to injury as well as the suitability of microarrays for identifying specific targets for further study.

Nerve conduction studies of the axillary, musculocutaneous and radial nerves in elite ice hockey players.

AIM: The peripheral nerves of the upper extremity are exposed to acute and chronic mechanical injuries in ice hockey players, because of the high repetition of motions, high muscular forces and extreme shoulder positions. This study was performed to evaluate the effect of ice hockey playing on the axillary, musculocutaneous and radial nerves crossing the upper arm region. METHODS: The ice hockey group consisted of 20 first-division male ice hockey players and the control group consisted of 20 non-active males. The neurophysiological study consisted of motor nerve conduction latency of the axillary, musculocutaneous and radial nerves. RESULTS: The values of distal motor latency (DML) of the axillary, radial and musculocutaneous nerves were significantly prolonged in the ice hockey players compared with the controls. Ice hockey can repetitively stress the upper extremity during shooting, because of forceful throwing to move the puck from the stick blade to the opponent's net. The mechanism of prolonged DML in the axillary nerve may both tract and compress as the axillary nerve stretches across the humerus during movement. From this study it emerged that using the biceps and coracobrachialis muscles can create notable muscle compartment pressure on the musculocutaneus nerve. The significant differences detected in the neurophysiologic study of the musculocutaneous nerve between the ice hockey players and controls may reflect the fact that the forces acting on the shoulder and the elbow during ice hockey matches can effectively influence DML. CONCLUSIONS: The authors suggest two plausible causes for prolonged radial nerve DML: direct compression by the hypertrophied triceps muscle and stretching of the arm. The study suggests it is likely that a combination of skeletal muscle hypertrophy and excessive biomechanical demands on neurological structures during ice hockey matches may be a major etiologic factor in compression of the axillary, musculocutaneous and radial nerves.

Comparison of the bacterial flora of the nasal vestibule and cavity in haemodialysis patients.

Staphylococcal infections are the major causes of morbidity in haemodialysis patients. The source of the staphylococci is the anterior nares. Elimination of nasal carriage of staphylococci could result in a remarkable decrease in the infection rate. The aim of this study was to investigate if there was a difference in the bacterial flora between the nasal vestibule and cavity as well as their antibiotic susceptibility in haemodialysis. Swab samples obtained from 35 haemodialysis patients were subjected to conventional microbiological methods. The antimicrobial susceptibility test was performed for Staphylococcus spp. using cephazolin, cephaclor, trimetoprim + sulfamethoxazole, amoxicillin, oxacillin, clindamycin, erythromycin, tetracycline, ampicillin + sulbactam and amoxicillin + clavulanic acid. Staphylococcus spp. was found more often in the vestibule than in the cavity (88.5 vs. 77.1%). The effectiveness of clindamycin, erythromycin and tetracycline was particularly striking for the methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococci isolates. In conclusion, existence of difference in bacterial flora between the nasal cavity and vestibule and their responsiveness to antibacterial agents may require reconsideration of elimination of secondary infections in haemodialysis patients.

Nerve conduction study of ulnar nerve in volleyball players.

Ulnar neuropathy at the elbow is a common disorder seen in the throwing athlete. The purpose of our study was to determine whether asymptomatic physically active volleyball players and non-actives demonstrate distinct differences in nerve conduction of the ulnar nerve at the elbow. Nerve conduction studies were performed on both arms of 24 male volleyball players and 24 male non-actives. Nerve conduction velocity at the above to below elbow segment of the ulnar motor nerve were slower in the volleyball players compared with controls and their non-dominant arms. There were no statistical differences in latencies and conduction velocity of the ulnar nerve on the forearm, both in volleyball players and in the controls. In the evoked responses of the ulnar nerve, the amplitude was the same as corresponding normal values in both sensory nerve and muscle action potentials. We conclude that abnormal ulnar (motor) nerve conduction at the elbow segment may suggest a subclinical entrapment neuropathy as a result of strenuous elbow movements in volleyball players.

The accelerating effects of the microorganisms on biodeterioration of stone monuments under air pollution and continental-cold climatic conditions in Erzurum, Turkey.

The aim of this research was to determine the accelerating effects of microorganisms on the biodeterioration of stone under air pollution and continental-cold climatic region in Erzurum, Turkey. Studies have been carried out on specimens of the Rustempasa Bazaar, the Lalapasa Mosque, the Erzurum Castle Mosque, the Double Minarets-Madrasah, the Great Mosque and the Haji Mehmet Fountain aged from 441 to 823 years old. The results showed that vegetative and reproductive (generative) forms of the microorganisms could develop during the winter months when the night time average temperature was even -25 degrees C. Also the reproductive forms had developed and the whole stone surface was covered with a biofilm caused by the microorganisms. Silicon, aluminum, calcium, potassium, titanium, magnesium, zinc, sulfur, iron, sodium, and niobium were found in the stones of the historical buildings with varying amounts through the SEM-EDS analysis. Some of these elements could be used as an energy resource for the microorganisms together with the air pollutants such as sulfur dioxide, nitrogen oxides and particles on the stone surfaces. Of 21 isolates, 15 species from 6 bacterium genera and 5 species from 5 fungi genera plus 1 fungi genera were identified on the deteriorated stone surfaces even during the coldest months by microbial identification system (MIS) and these findings were tested by SEM investigations.

Histopathological effects of dietary Fusarium graminearum on rat duodenum.

Microscopic pathology of duodenum in rats exposed to Fusarium graminearum, a fungus infecting small-grain cereals, was investigated. Intestinal haemorrhage was observed macroscopically in one of the rats. Light microscopy demonstrated detachments between the surface epithelium and the lamina propria and severe interstitial oedema in the lamina propria in the test group. Electron microscopy identified epithelial absorptive cells with highly expanded endoplasmic reticulum tubules, abundant cytoplasmic vesicles containing electronlucent materials, swollen mitochondria with spongiform appearance, and prominent cellular swelling. Other observations included opening of junctional complexes between epithelial cells lining the duodenum, highly enlarged intercellular spaces in duodenal epithelium, and numerous eosinophilic granulocytes and mast cells in the lamina propria. These findings indicate that dietary F. graminearum causes epithelial cell and connective tissue damage in rat duodenum. This is the first histopathological study showing that F. graminearum ingestion is associated with duodenal damage.

Comparison of nerve conduction velocities of lower extremities between runners and controls.

Peripheral nerve injuries can occur in runners, but large numbers of nerve injuries remain subclinical. Identification of nerve injuries needs an understanding of common sites of entrapment in running. Fourteen asymptomatic male middle-distance runners and 14 non-active subjects participated in this study. The neurophysiologic study consisted of motor and sensory nerve conduction of medial and lateral plantar nerves, sensory nerve conduction of sural and superficial peroneal nerves, and motor nerve conduction of common peroneal nerve. Active range of motion and muscle strength assessment (dorsi flexion/plantar flexion; inversion/eversion) as measured using a Biodex System3 Dynamometer were observed to be within normal limits for both groups. The medial plantar (sensory) nerve and sural nerve distal latencies were significantly prolonged and sensory conduction velocities were significantly delayed in the runners compared with the control subjects. Many of the asymptomatic runners with abnormal nerve conduction tests in this study may represent presymptomatic or asymptomatic neuropathy similar to the type of subclinical entrapment neuropathy.

Nerve conduction studies of upper extremities in tennis players.

OBJECTIVES: The influence of regular and intense practice of an asymmetric sport such as tennis on nerves in the elbow region was examined. METHODS: The study included 21 male elite tennis players with a mean (SD) age of 27.5 (1.7) years and 21 male non-active controls aged 26.4 (1.9) years. Anthropometric measurements (height, weight, limb length, and perimeters of arm and forearm) were determined for each subject, and range of motion assessment and radiographic examination carried out. Standard nerve conduction techniques using constant measured distances were applied to evaluate the median, ulnar, and radial nerves in the dominant and non-dominant limb of each individual. RESULTS: The sensory and motor conduction velocities of the radial nerve and the sensory conduction velocity of the ulnar nerve were significantly delayed in the dominant arms of tennis players compared with their non-dominant arms and normal subjects. There were no statistical differences in the latencies, conduction velocities, or amplitudes of the median motor and sensory nerves between controls and tennis players in either the dominant or non-dominant arms. However, the range of motion of the upper extremity was significantly increased in tennis players when compared with control subjects. Tennis players were taller and heavier than control subjects and their dominant upper limb lengths were longer, and arm and forearm circumferences greater, than those of the control subjects. CONCLUSIONS: Many of the asymptomatic tennis players with abnormal nerve conduction tests in the present study may have presymptomatic or asymptomatic neuropathy similar to subclinical entrapment nerve neuropathy.

Microscopic pathology of the liver in rats fed a Fusarium graminearum-inoculated diet.

Fusarium graminearum is a fungus frequently isolated from cereal grains. This study investigates the histopathological effects of dietary F. graminearum on rat liver. Treatment and control group rats were fed F. graminearum-inoculated and non-inoculated rice, respectively. After 14 days, all rats were sacrificed, and their livers analysed by electron and light microscopy. Electron microscopy of treatment group livers identified hepatocytes with well-developed smooth endoplasmic reticulum, swollen mitochondria, lipid accumulation, numerous vesicles containing electron-lucent materials and increased lysosomes. Many Kupffer's cells containing apoptotic bodies were also seen. Light microscopy identified hepatocytes from the treatment group with: cytoplasmic and nuclear pleomorphism; foci of necrosis; mononuclear cell infiltration; and presence of apoptotic bodies. These changes were absent in control rat livers indicating that dietary F. graminearum causes inflammation and parenchymal damage in the rat liver. This is the first histopathological study showing the association between F. graminearum and liver damage.

Effect of oral zinc supplementation on agents of oropharyngeal infection in patients receiving radiotherapy for head and neck cancer.

We aimed to investigate the effect of zinc supplementation on oropharyngeal infections in immunocompromised patients. Thirty patients receiving radiotherapy for head and neck cancer received 150 mg/day zinc or placebo, orally, during radiotherapy and for a further 6 weeks. None received antibiotics during this period. Oropharyngeal samples were collected 1 day before the first course and 1 day after the last course of radiotherapy, and 1 week and 6 weeks after radiotherapy. Samples were cultured and pathogens identified using microbial diagnostic and gas chromatography methods. Coagulase-positive and -negative staphylococci, group A beta-haemolytic streptococci, Streptococcus pneumoniae, and Candida species were detected in both groups, but some infections, especially with Candida species and staphylococci, were prevented by zinc supplementation. We therefore suggest use of low-dose antibiotics and oral zinc supplementation in patients with these infections. No effects of zinc supplementation were observed on group A beta-haemolytic streptococci and Streptococcus pneumoniae, making it essential to start antimicrobial chemotherapy before radiotherapy.

Prevalence and in-vitro antimicrobial susceptibility patterns of Acinetobacter strains isolated from patients in intensive care units.

Fifty-six Acinetobacter species strains (49 Acinetobacter baumanii, 5 Acinetobacter calcoaceticus, 2 Acinetobacter iwoffii) were detected using both conventional methods and gas chromatography of bacterial fatty acids with the MIDI Sherlock Microbial Identification System. The susceptibilities of these strains to 16 antimicrobial agents were investigated by the disc-diffusion method according to the National Committee for Clinical Laboratory Standards. The production of extended-spectrum beta-lactamases (ESBLs) and inducible beta-lactamases (IBLs) by the strains were investigated by the double-disc-synergy and disc-approximation methods, respectively. Imipenem was the most effective agent for Acinetobacter baumanii strains (95.9% of strains were sensitive), while meropenem and netilmicin showed moderate activity (87.7% and 79.6% of strains, respectively, responded). Acinetobacter baumanii strains were less sensitive to cefoperazone-sulbactam (53.1%), ofloxacin (51.0%), ciprofloxacin (42.8%), and amikacin (36.7%). Acinetobacter calcoaceticus and Acinetobacter iwoffii strains were sensitive to imipenem, meropenem and netilmicin. IBLs and ESBLs were produced, respectively, by 8.9% and 7.1% of all bacterial strains. The strains isolated were sufficiently sensitive to imipenem, but not to ofloxacin or ciprofloxacin, and were very resistant to amikacin.

Identification of three strains of Mycobacterium species isolated from clinical samples using fatty acid methyl ester profiling.

The cellular fatty acid profiles of 67 strains belonging to three different species of the genus Mycobacterium were determined by gas chromatography of the fatty acid methyl esters, using the MIDI Sherlock Microbial Identification System (MIS). The species M. tuberculosis, M. xenopi and M. avium complex were clearly distinguishable and could be identified based on the presence and concentrations of 12 fatty acids: 14:0, 15:0, 16:1 omega 7c, 16:1 omega 6c, 16:0, 17:0, 18:2 omega 6.9c, 18:1 omega 9c, 18:0, 10Me-18:0 tuberculostearic acid, alcohol and cyclopropane. Fatty acid analysis showed that there is great homogeneity within and heterogeneity between Mycobacterium species. Thus the MIS is an accurate, efficient and relatively rapid method for the identification of mycobacteria.

Kidney damage by dietary Fusarium graminearum in rats: a microscopic study.

Fusarium graminearum is a fungus frequently isolated from cereal grants. In this study, the histopathological effects of dietary F. graminearum on rat kidneys were examined. Treated rats and controls were fed F. graminearum-inoculated and non-inoculated rice, respectively. After 14 days, all the rats were killed and their kidneys were removed and examined using light microscopy. The kidneys of the rats in the treatment group were characterized by the following histopathological findings: patch-like mononuclear cell infiltrations in the cortex; prominent necrosis of proximal tubules; debris areas containing mononuclear cells and degraded renal tubules; shrunken and densely eosinophilic apoptotic cells in the proximal tubule epithelium; karyorrhexis and mitotic figures in the epithelium of both proximal and distal tubules; and many apoptotic bodies in the areas between the renal tubules. It was concluded that dietary F. graminearum caused inflammation and tubular damage in the rat kidney. This is the first microscopic study showing that F. graminearum ingestion is associated with renal damage.

Nerve conduction studies of lower extremities in pes planus subjects.

Pes planus is a condition in which the medial longitudinal arch is depressed. Pedoscop, eyeball visualization, ink mat and roentgenography were used in clinical evaluation. We performed nerve conduction studies on both feet of 28 pes planus subjects. Our results demonstrated mild prolongation distal latency of the medial and lateral plantar sensory nerves, and delayed sensory conduction velocity of the medial plantar sensory nerve. The presence of electrodiagnostic abnormalities in this study population helps to substantiate the presence of compression neuropathy of the medial or lateral plantar nerve in pes planus subjects.