Correction to: Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study.

In the original version of this article, Mustafa Sunbul was not included in the list of authors for this article. The name has been added accordingly.

Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter Infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study.

Cryptococcal meningitis (CM) is mostly seen in immunocompromised patients, particularly human immunodeficiency virus (HIV)-positive patients, but CM may also occur in apparently immunocompetent individuals. Outcome analyses have been performed in such patients but, due to the high prevalence of HIV infection worldwide, CM patients today may be admitted to hospitals with unknown HIV status, particularly in underdeveloped countries. The objective of this multicenter study was to analyze all types of CM cases in an aggregate cohort to disclose unfavorable outcomes. We retrospectively reviewed the hospitalized CM patients from 2000 to 2015 in 26 medical centers from 11 countries. Demographics, clinical, microbiological, radiological, therapeutic data, and outcomes were included. Death, neurological sequelae, or relapse were unfavorable outcomes. Seventy (43.8%) out of 160 study cases were identified as unfavorable and 104 (65%) were HIV infected. On multivariate analysis, the higher Glasgow Coma Scale (GCS) scores (p = 0.021), cerebrospinal fluid (CSF) leukocyte counts > 20 (p = 0.038), and higher CSF glucose levels (p = 0.048) were associated with favorable outcomes. On the other hand, malignancy (p = 0.026) was associated with poor outcomes. Although all CM patients require prompt and rational fungal management, those with significant risks for poor outcomes need to be closely monitored.

Predictors for limb loss among patient with diabetic foot infections: an observational retrospective multicentric study in Turkey.

We aimed to investigate the predictors for limb loss among patients with diabetes who have complicated skin/soft-tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centres in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total, 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients had used antibiotics within the last month, and 121 (27%) had osteomyelitis. Of the 208 microorganisms isolated, 92 (44.2%) were Gram-positive cocci and 114 (54.8%) were Gram-negative rods (GNR). The most common GNR was Pseudomonas; the second was Escherichia coli, with extended spectrum ß-lactamase positivity of 33%. Methicillin-resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these were major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR 1.75, 95% CI 1.04-2.96, p 0.034), duration of diabetes >20 years (OR 1.9, 95% CI 1.18-3.11, p 0.008), infected ulcer versus cellulitis (OR 1.9, 95% CI 1.11-3.18, p 0.019), history of peripheral vascular disease (OR 2, 95% CI 1.26-3.27, p 0.004), retinopathy (OR 2.25, 95% CI 1.19-4.25, p 0.012), erythrocyte sedimentation rate >70 mm/hr (OR 1.6, 95% CI 1.01-2.68, p 0.05), and infection with GNR (OR 1.8, 95% CI 1.08-3.02, p 0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of diabetes >20 years, infected ulcers, history of peripheral vascular disease and retinopathy, detection of GNR was a significant predictor of limb loss.

HIV-1 subtypes and primary antiretroviral resistance mutations in antiretroviral therapy naive HIV-1 infected individuals in Turkey.

In this study, we determined the subtype distribution and the primary drug-resistant mutations in HIV-1 strains isolated from antiretroviral therapy (ART)-naive patients in Turkey. The study included 117 newly diagnosed HIV-1 positive Turkish patients. HIV-1 subtypes and circulating recombinant forms (CRFs) were identified by phylogenetic analysis (neighbor-joining method), and drug-resistant mutations were analyzed according to the 2009 World Health Organization list of surveillance drug-resistant mutations. Subtype CRFs (CRF 02_AG, CRF 01_AE, CRF 12_BF and CRF 03_AB; 47%, 55/117) and B (33.3%, 39/117) were identified as the most common occurring HIV-1 subtypes in Turkey. The patients had primary antiretroviral resistance mutations to nucleos(t)ide reverse transcriptase (RT) inhibitors (NRTIs) (M41L, T215C, T215D, and K219Q), non-nucleoside RT inhibitors (NNRTIs; K103N), and protease inhibitors (PIs; I47V, G73S). The prevalence of overall primary antiretroviral resistance was 7.6% (9/117) in HIV-1 patients from Turkey and drug-resistant rate for NRTIs, NNRTIs, and PIs were 4.2% (5/117), 1.7% (2/117), and 1.7% (2/117), respectively. In this study, various CRFs of HIV-1 were determined, for the first time, in Turkey. The prevalence of HIV-1 primary drug-resistant mutations in ART-naive patients suggested that resistance testing should be incorporated as an integral part of HIV management, and the choice of a first-line therapy regime should be guided by the results of genotypic resistance in Turkey.

Plasma protein oxidation is correlated positively with plasma iron levels and negatively with hemolysate zinc levels in sickle-cell anemia patients.

INTRODUCTION: Sickle-cell anemia (SCA) is a disease of high oxidative stress. The oxidative medium of SCA was evaluated by protein oxidation parameters and their correlation with lipids and ions were investigated both in the plasma and in the erythrocyte. METHODS: Blood samples were obtained from 15 steady-state patients with SCA, 10 carriers, and 10 controls. Plasma protein carbonyl, total sulfhydryl, total cholesterol, triglyceride, phospholipids, and bilirubin levels were determined by spectrophotometric methods. Plasma copper, zinc, and iron levels were determined by atomic absorption spectrophotometry. Levels of cholesterol, triglyceride, and ions were also determined in the hemolysate lipid extract. RESULTS: Patients had increased protein carbonyl and decreased total sulfhydryl levels compared with controls. Plasma cholesterol levels were lower than controls, and triglyceride levels were higher than carriers in patients with SCA. Plasma iron and hemolysate copper were higher in patients than carriers and controls. Plasma protein carbonyl levels were found to be correlated with plasma iron and hemolysate zinc levels in the patient group. CONCLUSION: Alterations of proteins, lipids, and ions in the plasma and erythrocyte of steady-state patients with SCA were demonstrated. Some of these alterations are related with each other and with the oxidative stress observed in the disease.

Hypocholesterolemia is associated negatively with hemolysate lipid peroxidation in sickle cell anemia patients.

The oxidative stress levels in plasma and hemolysate and cholesterol levels in plasma of sickle cell anemia patients, carriers and controls were evaluated. A total of 40 cases-17 patients, 13 carriers and 10 controls-were involved in the study. Plasma and hemolysate malondialdehyde (MDA) were detected via thiobarbituric acid reaction with a fluorimetric detector by high-performance liquid chromatography system. Plasma cholesterol was determined by enzymatic colorimetric method. Mean MDA levels of SCA patients were higher than those of the carriers' and healthy children's both in plasma and in hemolysate (P < 0.005). The mean plasma and hemolysate MDA levels were 25.3 ± 1.6 nmol/l and 86.7 ± 19.3 nmol/l in patients, 19.1 ± 0.8 nmol/l and 54.1 ± 10.8 nmol/l in carriers and 19.6 ± 0.8 nmol/l and 56.8 ± 9.3 nmol/l in healthy children. Mean plasma total cholesterol levels were 92.1 ± 19.1 mg/dl in patients, 116.2 ± 23.3 mg/dl in carriers and 126.6 ± 16.4 mg/dl in controls (P < 0.005). There was a significant negative correlation of -0.520 between hemolysate MDA and plasma cholesterol levels in patients (P < 0.05). The degree of correlation increased up to -0.782 (P = 0.008) in the patients with HbSS phenotype. This negative correlation between MDA and cholesterol may imply a potential association between oxidative stress and hypocholesterolemia in sickle cell anemia.

Microvesiculation of the microvilli provides a membranous medium within the lumen during digestion.

A hypothesis is presented which states that there is a membranous medium within the intestinal lumen which occurs during digestion. The medium is thought to be generated by the microvesiculation of the microvilli.

Important data in understanding the interaction between the cell and collagen.

In a collagen preparation obtained from rat tail tendon, besides triglycerides, cholesterol, cholesterol esters, and phosphatides whose presence have been reported before, the presence of plasmalogens and glycolipids including gangliosides was observed.