Custody and prison deaths autopsied in Istanbul between 2010 and 2012.

The occurred death of a convict in prison, police custody cell or in a hospital always attracts public attention and can be considered as a complex phenomenon. The aim of this study is to evaluate the data obtained from autopsies performed to the custody and prison deaths in Istanbul and to discuss the possible solutions by comparing with the literature. It is also aimed to discuss the postponement of the sentence and presidential amnesty facts in Turkey. Deaths of inmates, which occurred in hospitals, prisons, prison medical rooms, police vans and police custody cells between 2010 and 2012 in Istanbul, Turkey were included in the study. Totally 125 cases were found and 98.4% of them were male. Natural deaths accounted for a great majority of deaths (83.2%). The most common natural cause was cardiovascular diseases. Unnatural deaths accounted for 15.2% of the deaths. Death reason cannot be determined for 1.6% of the cases. More than half of the cases (56%) were died at the hospital, 34.4% were died at the prison, 4% of them at the police van, 3.2% were died under police custody and 2.4% were died at the prison medical room. Moreover, twelve of these cases had applied to Third Specialization Board previously for postponement of the sentence or Presidential amnesty. Totally five of these cases found suitable for postponement of the sentence. Prison conditions should be improved, prisoners with chronic diseases should be examined periodically and if appropriate their sentences should be postponed until they heal.

Is the extraction by Whatman FTA filter matrix technology and sequencing of large ribosomal subunit D1-D2 region sufficient for identification of clinical fungi?

Although conventional identification of pathogenic fungi is based on the combination of tests evaluating their morphological and biochemical characteristics, they can fail to identify the less common species or the differentiation of closely related species. In addition these tests are time consuming, labour-intensive and require experienced personnel. We evaluated the feasibility and sufficiency of DNA extraction by Whatman FTA filter matrix technology and DNA sequencing of D1-D2 region of the large ribosomal subunit gene for identification of clinical isolates of 21 yeast and 160 moulds in our clinical mycology laboratory. While the yeast isolates were identified at species level with 100% homology, 102 (63.75%) clinically important mould isolates were identified at species level, 56 (35%) isolates at genus level against fungal sequences existing in DNA databases and two (1.25%) isolates could not be identified. Consequently, Whatman FTA filter matrix technology was a useful method for extraction of fungal DNA; extremely rapid, practical and successful. Sequence analysis strategy of D1-D2 region of the large ribosomal subunit gene was found considerably sufficient in identification to genus level for the most clinical fungi. However, the identification to species level and especially discrimination of closely related species may require additional analysis.

Can Helicobacter pylori cause inflammation in the middle ear?

OBJECTIVES: To investigate whether Helicobacter pylori causes inflammation in the normal middle ear and in the middle ear with effusion. METHODS: Sixteen adult New Zealand white rabbits were divided into two gropus equally. Group I was representing histamine-induced middle ear inflammation and Group II was representing normal middle ear. While H. pylori was inoculated in the right ears, physiologic saline was inoculated in the left ears of the rabbits in both groups. Results were evaluated clinically, histopathologically and microbiologically. Fisher's exact test was used for statistical analysis. RESULTS: In Group I, clinical scores of the inflammation in the right ears were higher than the left ears scores at the 7th day. Histopathological scores of the inflammation in the right ears were higher than the left ears scores at the 7th day. Also, H. pylori was isolated in 6 of the 8 right ears of the rabbits. In Group II, while clinical scores of the inflammation in the right ears scores were higher than the left ears scores at the 7th day, histopathological scores were not significantly different between both ears. Also, no H. pylori was isolated in right ears of the rabbits. CONCLUSIONS: Effusion in the middle ear induced by histamine is an appropriate medium for H. pylori reproduction and it also aggravates the inflammation process. In contrary, H. pylori did not cause inflammation in the normal middle ear. We suggest that H. pylori does not play a role in the etiology of otitis media with effusion alone, but it contributes to the inflammation process in the presence of an effusion.

The probable relation between Toxoplasma gondii and Parkinson's disease.

Parkinson's disease (PD), a chronic progressive neurodegenerative disorder, has a mainly unknown multifactorial etiology. Neuroinflammatory mechanisms might contribute to the cascade of events leading to neuronal degeneration. Toxoplasmosis can be associated with various neuropsychiatric disorders. The most commonly affected central nervous system (CNS) region in toxoplasmosis is the cerebral hemisphere, followed by the basal ganglia, cerebellum and brain stem. Therefore, in this study, we aimed to investigate the possible association between Toxoplasma infection and PD by evaluating the serum anti-Toxoplasma gondii IgG antibodies. There were no difference between the socioeconomic status of the patients and control subjects and magnetic resonance images of the patients were normal. Serum anti-T. gondii IgG levels were measured using ELISA. There was no statistically significant differences among the patients and control subjects with respect to age (66.01+/-12.14 years, 62.42+/-5.93 years, p=0.089; respectively) and gender. The sero-positivity rate for anti-T. gondii IgG antibodies in PD patients and control groups were 42.3 and 22.5%, respectively, and they were statistically significant (p=0.006). These results suggest that Toxoplasma infection may be involved in the pathogenetic mechanisms of PD. If confirmed, this hypothesis would represent a valuable advancement in care of patients with Parkinson's disease.

Prevalence of cagA and vacA genotypes of Helicobacter pylori isolated from Turkish patients with active or non-active chronic gastritis.

Several virulence factors of Helicobacter pylori may contribute to gastric mucosal damage. In this study, the prevalence of cagA and vacA genotypes of H. pylori was examined in different patterns of chronic gastritis. Oesophagogastroendoscopy was performed in 147 dyspeptic patients. Antrum biopsies were obtained for isolation of H. pylori and for histopathological assessment. H. pylori vacAs1 and cagA genes were directly genotyped in the gastric biopsy specimens by polymerase chain reaction (PCR). A total of 102 dyspeptic patients, all H. pylori-positive by PCR, were included in the study. Of these, 59 had active chronic gastritis and 37 had non-active chronic gastritis. The prevalence of cagA and vacAs1 was higher among patients with active chronic gastritis than among those with non-active chronic gastritis (45.8% vs 21.6% (p = 0.02) and 78.0% vs 40.5% (p < 0.001), respectively). In conclusion, both cagA and vacAs1 genotypes are associated with the activity of chronic gastritis.

The effects of caspofungin and voriconazole in an experimental fungal infection of the ear due to Aspergillus.

The purpose of the study was to evaluate the effectiveness of caspofungin and voriconazole in the treatment of experimental Aspergillus otitis media in an experimental rabbit model. A total of 30 New Zealand white rabbits were divided into four treatment groups and one control group. The rabbits were immunosuppressed by cyclophosphamide and triamcinolone acetonide. The right ear of each rabbit was infected by an injection of the inoculum of 0.1 ml (8.6 x 103 CFU/0.1 ml) of Aspergillus fumigatus into the middle ear cavity. At 72 h after the inoculation, amphotericin B 1 mg/kg per day (n = 6), itraconazole 10 mg/kg per day (n = 6), voriconazole 10 mg/kg per day (n = 6) and caspofungin 5 mg/kg per day (n = 6) were injected to each treatment group. No antifungal drug was administered to the control group (n = 6). Clinical and histopathological examination scores and microbiological analysis of middle ear mucosa were compared.There was statistically significant difference in the clinical scores, histopathological scores, and mean CFU/g between the treatment and control groups (P < 0.05). There was no statistically significant difference among the treatment groups in the clinical and histopathological scores, whereas there was statistically significant difference in the mean CFU/g (P < 0.05). The mean CFU/g of amphotericin B and caspofungin groups were similar and both were lower than the itraconazole and voriconazole groups. Also, the mean CFU/g of voriconazole group was lower than the itraconazole group (P < 0.05). Caspofungin and voriconazole were demonstrated at least as effective as amphotericin B and itraconazole. We suggest that caspofungin and voriconazole may be considered for the treatment of fungal infection of the ear.

In vitro anti-Helicobacter pylori activity of usnic acid.

Eradication of Helicobacter pylori is an important objective in overcoming gastric diseases. Many regimens are currently available but none of them could achieve 100% success in eradication. Medicinal lichen is used in the treatment of gastric ulcer in local folk medicine in Anatolia (Turkey). The present study was performed to assess the in vitro effects of usnic acid from Usnea dasypoga against clinical isolates and standard H. pylori strains and their minimum inhibitory concentrations (MICs). A total of 38 strains was assayed for anti-H. pylori activity. The agar dilution method was used for the determination of usnic acid and clarithromycin resistance.Six (16.2%) clinical isolates were resistant to usnic acid and five (13.5%) were resistant to clarithromycin. Dual susceptibility to usnic acid and clarithromycin rate was detected as very high (97.3%). Usnic acid has a strong and dose-dependent activity against H. pylori strains. The synergism between usnic acid and clarithromycin may be effective in the treatment of H. pylori infection.

[Cystic echinococcosis in Turkey from 2001-2005]. / Türkiye'de 2001-2005 Yillari Arasinda Kistik Ekinokokkozis.

Cystic echinococcosis (CE) caused by the metacestode form of Echinococcus granulosus is a major public health problem especially in animal-raising regions of the world. In the present study, CE cases were determined during 2001-2005 by investigating different hospital and health directorship documents and Health Ministry documents, retrospectively. Our results show that there were 2534 (13.13%) cases in the Marmara region; 2114 (16.94%), in the Aegean region; 2578 (16.09%), Mediterranean region; 5404 (38.57%), in the Middle Anatolian region; 428 (5.70%), in the Black Sea region; 844 (6.80%), in the eastern Anatolian region; and 887 (2.75%), in the southeastern Anatolian region making a total of 14,789 CE cases. Finally, it has been determined that the patients were hospitalized for a total of 149,464 days.

[Short communication: Determination of methicillin resistance in staphylococci with different methods and detection of multiple antibiotic resistance]. / Kisa bildiri: Stafilokoklarda metisilin direncinin farkli yöntemlerle arastirilmasi ve coklu antibiyotik direncinin saptanmasi.

The aims of this study were to determine the methicillin resistance of a total of 256 staphylococcus strains [213 Staphylococcus aureus and 43 coagulase negative staphylococci (CNS)], isolated from different clinical samples and hospital environmental specimens by different methods and to detect multiple antibiotic resistance in these isolates. Methicillin resistance of staphylococci was investigated by using oxacillin agar screening (OAS), oxacillin disk diffusion (ODD), cefoxitin disk diffusion (CDD), PBP2a latex agglutination (LA) and microdilution tests. The resistance of the strains against penicillin G, amoxycillin/clavulanate, cephalothin, tetracycline, erythromycin, fusidic asid, ofloxacin, vancomycin, co-trimoxazole and gentamicin was investigated by standard disk diffusion method. As a result, 152 (71.3%) S. aureus and 30 (69.7%) CNS isolates were found to be methicillin-resistant with the use of OAS and PBP2a LA tests, respectively. The numbers of the isolates which were detected as methicillin-resistant and methicillin-susceptible were 182 and 74 by OAS; 183 and 73 by ODD; 181 and 75 by SDD; 180 and 76 by PBP2a LA; 183 and 73 by microdilution tests, respectively. There was no statistically significant differences-between the results obtained by all of the methods (p > 0.05), however the sensitivity of PBP2a LA test was lower in the detection of methicillin resistance in S. aureus strains. CDD test which was found to be as sensitive as ODD test, may be preferred in the detection of methicillin resistance in staphylococci. In our study staphylococci which were sensitive to methicillin, were also found generally sensitive to the other antibiotics, whereas staphylococci which were resistant to methicillin were also resistant to the other antibiotics. The difference between methicillin sensitive and resistant staphylococci in terms of the rates of resistance against other antibiotics was found statistically significant with the exception of fusidic acid (p < 0.05). The resistance rates of isolates for fusidic acid were very low and all of the strains were susceptible to vancomycin. In conclusion, for better determination of methicillin resistance, agar screening test which is proposed as a confirmatory test by CLSI, should be used when necessary.

Clinical importance of Demodex folliculorum in patients receiving phototherapy.

BACKGROUND: Patients with immunodeficiency are prone to infestation with Demodex folliculorum mites. Ultraviolet (UV) radiation can lead to immunosuppression and sebaceous gland hyperplasia. Although some cases of demodicidosis related to UV radiation exposure have been reported, no studies have been performed on the incidence of D. folliculorum and its clinical characteristics in patients receiving phototherapy. Objective To investigate the effects of phototherapy on the density of D. folliculorum infestation and its clinical characteristics. METHODS: This was a cross-sectional study. Forty-five patients receiving phototherapy and 43 age- and sex-matched healthy controls were enrolled to the study. The sociodemographic characteristics, occupational information, and skin types (2, 3, 4, or 5) of both patients and controls were carefully recorded. The dermatologic diseases requiring phototherapy, type and number of phototherapy treatments, and cumulative UV doses of all patients were noted. The clinical findings that may relate to demodicidosis were recorded. Standardized skin surface biopsies were taken from three anatomic regions (forehead, cheek, and nasal dorsum) and suspected lesions; five or more D. folliculorum mites per square centimeter of skin was defined as demodicidosis. RESULTS: Twelve (26.7%) patients received psoralen plus UV-A (PUVA) and 33 (73.3%) received narrow-band UV-B. Demodicidosis was detected in 13 (28.9%) patients and three (7%) controls. The difference in the demodicidosis rate between patients and controls was statistically significant (P = 0.01). In eight of the 13 patients (61.5%) with demodicidosis, clinical demodicidosis was present. Demodicidosis was present in seven of the 12 patients (58.3%) receiving PUVA and in six of the 33 patients (18.2%) receiving narrow-band UV-B. The difference in demodicidosis rates between patients receiving PUVA and those receiving narrow-band UV-B was statistically significant (P = 0.02). A statistically significant difference was also found between the mean D. folliculorum densities of patients and controls in all anatomic regions. CONCLUSION: Demodicidosis should be included in the differential diagnosis of facial eruptions in patients receiving phototherapy.

Etiology of foot intertrigo in the District of Afyonkarahisar, Turkey: a bacteriologic and mycologic study.

BACKGROUND: Foot intertrigo, occurring in the interdigital space, is mostly caused initially by dermatophytes and yeasts and less frequently by gram-negative and gram-positive bacteria. With time, a "complex" may develop in the setting of moisture and maceration that contains multiple fungal and bacterial organisms. METHODS: We examined and sampled 84 patients with toe web intertrigo for bacteriologic and mycologic studies. RESULTS: In the culture media, the prominent isolated pathogens as single agents were coagulase-negative staphylococci in 17.9% of patients, which is assessed as contamination from skin flora; Pseudomonas aeruginosa in 16.7%; dermatophytes, Corynebacterium minutissimum, and Staphylococcus aureus each in 11.9%; beta-hemolytic streptococcus in 2.4%; and Proteus mirabilis in 1.2%. However, we recovered double pathogens from patients with foot intertrigo as mixed infection in 19 patients (22.6%). The most common predisposing factors were exposure to spa pools and ablutions. CONCLUSIONS: Several pathogens and factors might play a role in toe web infections. Therefore, clinical and microbiologic studies are suggested to assist in the selection of appropriate treatment and the prevention of important complications of toe web infections.

Antifungal efficacy of voriconazole, itraconazole and amphotericin b in experimental fusarium solani keratitis.

PURPOSE: To evaluate the efficacy of topical voriconazole in an experimental rabbit model of Fusarium keratitis. METHODS: Fungal keratitis was induced in the right eyes of 24 New Zealand rabbits. 8.6 x 10(3) CFU/0.1 ml F.solani spore suspension was injected midstromally into the central cornea. Group 1 received topical amphotericin B 0.15%, group 2 received topical itraconazole 1% and group 3 received topical voriconazole 1% hourly between 08:00 to 22:00 on days 1 and 2; 4 times daily on days 3-5. Control group received topical balanced salt solution at identical intervals. The eyes were examined clinically with a scoring system before treatment (day 0), on day 3 and on day 5. Cultures were taken from the lesion by scraping at the end of the treatment. Clinical scores and microbiologic results were analyzed statistically. RESULTS: In the control group, keratitis progressed clinically and colony level was 2 x 10(3) CFU at day 5. In all treatment groups, progression of keratitis was inhibited clinically. Culture was sterile in the group receiving amphotericin B. Colony level was 0.3 x 10(2) CFU in the itraconazole group and 2 x 10(2) CFU in the voriconazole group at day 5. CONCLUSION: Progression of keratitis was inhibited clinically in all treatment groups. Colony level decreased significantly in all treatment groups. As a result, itraconazole 1% and voriconazole 1% were found to be effective in Fusarium keratitis clinically and microbiologically, although their activity was not as effective as amphotericin B 0.15%.

Caffeic acid phenethyl ester reduces mortality and sepsis-induced lung injury in rats.

OBJECTIVE: Sepsis and ensuing multiorgan failure continue to be the major causes of mortality in intensive care units. Nuclear factor (NF)-kappaB activation is supposed to be one of the targets in the treatment of sepsis. We studied the effectiveness of caffeic phenethyl ester (CAPE), a known NF-kappaB inhibitor, in cecal ligation and puncture (CLP)-induced sepsis and lung injury. DESIGN: Randomized, controlled animal study. SETTING: Research laboratory of an academic institution. SUBJECTS: Female Sprague-Dawley rats. INTERVENTIONS: CLP was performed in all rats except the rats in control and sham+CAPE groups. CAPE was administered to rats at the time of operation in sham+CAPE and CAPE+sepsis 0 groups. CAPE was administered to rats in the CAPE+sepsis12 group 12 hrs after CLP. Eight rats from each group were killed 24 hrs after CLP. Blood was taken for assessment of interleukin-1, interleukin-6, interleukin-10, and tumor necrosis factor-alpha; the right lung was removed for histopathologic examination and the left lung for biochemical examination. Apoptosis, inducible nitric oxide synthase, heat shock protein 70, malondialdehyde, catalase, superoxide dismutase, and glutathione peroxidase were studied. The rest of the rats were observed for mortality. MEASUREMENTS AND MAIN RESULTS: Mortality was significantly decreased in groups that received CAPE compared with the sepsis group. All cytokine levels were similar to control levels only in the CAPE+sepsis12 group. Apoptosis, inducible nitric oxide synthase, and heat shock protein 70 evaluation were significantly changed between all groups in the following order: control < sham+CAPE< CAPE+sepsis12 < CAPE+sepsis 0 < sepsis. Malondialdehyde and catalase were increased in the sepsis group. CONCLUSIONS: CAPE reduced mortality in sepsis and improved histopathologic variables best when it was administered after the onset of sepsis.

Evaluation of bacteremias in a Turkish university hospital: 3-year outcomes.

In this retrospective study, the investigators examined blood cultures from patients that had been diagnosed with bacteremias over a 3-y period. The study was conduced at Kocatepe University Hospital (Middle Anatolia, Turkey). Blood samples that arrived at the university's microbiology laboratory between 2002 and 2005 were evaluated retrospectively. These samples were classified as contamination, false positivity, community-acquired bacteremia (CAB), or hospital-acquired bacteremia (HAB). Patient age and sex, foci of bacteremia, present comorbidities, predisposing factors, pathogens, and mortality rates were evaluated. A total of 1783 blood cultures that had been drawn from 1441 patients during this 3-y period were examined retrospectively. Of 354 positive isolates, 61 (17.2%) were CABs and 293 (82.8%) were HABs. In HABs, the most commonly isolated microorganisms were Staphylococcus aureus (37.5%), coagulase-negative staphylococci (29.7%), and Escherichia coli (10.2%); in CABs, the most commonly isolated microorganisms were S aureus (29.5%), Brucella spp (26.2%), and E coli (24.6%). Crude mortality rates were determined to be 15.2% for HABs and 12.7% for CABs. This study yielded data on the most common foci of bacteremia, microbiologic factors, and the epidemiology associated with HABs and CABs. It is hoped that these data will enhance empirical antibiotic therapeutic approaches, thereby preventing delays in treatment and decreasing mortality rates associated with bacteremias.

[Investigation of hemodialysis patients in terms of the presence of occult hepatitis B]. / Hemodiyaliz hastalarinin gizli hepatit B varligi yönünden arastirilmasi.

The presence of hepatitis B virus (HBV) DNA in case of negative HBV surface antigen (HBsAg) in serum is known as "occult hepatitis B". There are many reports indicating that occult HBV infections are more frequently encountered in case of hepatocellular carcinoma, hemodialysis practice and co-infections with hepatitis C virus (HCV). The aim of this study was to investigate the presence of HBV-DNA in HBsAg negative hemodialysis. patients and subjects who had never experienced hemodialysis. A total of 226 HBsAg negative sera were included to the study, of which 153 were from hemodialysis patients (97 male, 56 female; mean age: 41.3 +/- 5.8 years), and 73 were from non-hemodialyzed individuals (46 male, 27 female; mean age: 36.5 +/- 6.9 years) who had serological evidence of previous HBV and HCV infections. Of these 73 subjects, 41 were anti-HCV positive, 22 were "anti-HBc IgG positive alone", seven were anti-HBc IgG and anti-HBs positive, and three were anti-HBc IgG and anti-HBe positive, while 40 of 153 (26.1%) hemodialysis patients were anti-HCV positive. HBV and HCV markers were detected by commercial enzyme immunoassays (bioMerieux, France and Murex, UK, respectively), and HBV-DNA testing was performed by a commercial real-time polymerase chain reaction (PCR; 5700 and 7700 Sequence Detection System, Applied Biosystems, UK) assay. Nineteen (12.4%) of HBsAg-negative hemodialysis patients and five (6.8%) of the non-hemodialyzed subjects were found positive for HBV-DNA (viral loads were > or =10(4) copies/ml, and 10(3)-10(4) copies/ml, repectively). The rates of occult HBV infection in the anti-HCV positive hemodialysis patients and anti-HCV positive non-hemodialyzed subjects were detected as 27.5% (11/40) and 2.4% (1/41), respectively. These rates in the other groups were found as follows; 7.1% (8/113) in the anti-HCV negative hemodialysis patients, 9.1% (2/22) in the "anti-HBc positive alone" subjects, and 20% (2/10) in the subjects positive for anti-HBc+anti-HBs or anti-HBe. The results of this study indicated that the prevalence of HBV viremia (12.4%) in hemodialysis patients being more prominent in those of anti-HCV positive patients (27.5%) should not be overlooked. In conclusion, the hemodialysis patients should be screened by sensitive PCR-based methods for occult HBV infections, even if they were negative for HBsAg, in order to prevent or at least to decrease the transmission risk of HBV infection which is still an important health problem in dialysis units.

Efficacy of topical caspofungin in experimental fusarium keratitis.

PURPOSE: To evaluate the efficacy of caspofungin in an experimental rabbit model of Fusarium keratitis and to compare it with amphotericin B. METHODS: Eighteen New Zealand white rabbits were randomly divided into 2 treatment groups and 1 control group. One cornea of each rabbit was inoculated with Fusarium solani spores. The first group received topical amphotericin B 0.15%, the second group received topical caspofungin 1%, and the control group received topical balanced salt solution hourly for 2 days and then 4 times daily for 3 additional days. Treatment effects were evaluated by clinical assessment at days 3 and 5 and by fungal culture after 5 days of treatment. RESULTS: In the treatment groups, progression of keratitis was inhibited, and cultures were sterile at the end of the study. In the control group, keratitis progressed, and cultures were positive for F. solani. CONCLUSIONS: Topical caspofungin is effective in Fusarium keratitis, and clinical efficacy studies seem justified.

Nasal carriage of Staphylococcus aureus in 4-6 age groups in healthy children in Afyonkarahisar, Turkey.

AIM: Staphylococcus aureus is a common cause of disease, particularly for colonized persons. Although methicillin-resistant S. aureus (MRSA) infection has frequently reported, population-based S. aureus and MRSA colonisation estimates are lacking. Our objective in this report is to present the prevalance of S. aureus carriage among 4-6 age groups healthy children in our region. METHODS: Nasal samples for S. aureus culture were obtained from healthy children. Sociodemographic features and the data related with risk factors were obtained from the parents of the children. Nasal swabs were inoculated on to a variety of bacteriological culture media, which were then incubated at 35 +/- 1 degrees C for 16-18 h. Antimicrobial susceptibility testing of the isolates was determined according to Clinical and Laboratory Standard Institute (CLSI, 2005) guidelines. RESULTS: In this study 1134 children between 4 and 6 years old age were evaluated; 607 (53.5%) of the subjects were boys and 527 (46.5%) were girls. S. aureus was isolated in 322 (28.4%) subjects and MRSA was isolated in 3 (0.3%) subjects of them. All of the MRSA isolates were found in healthcare workers' children. CONCLUSIONS: This first assessment of this study is that nearly one third of the 4-6 age group healthy children population present nasal carriage of S. aureus in Turkey. However, it also shows that the rate of MRSA carriage remains low. In addition, it is considered that MRSA colonization may be a risk factor for healthcare workers' children.

Anti-Toxoplasma gondii antibodies in patients with schizophrenia--preliminary findings in a Turkish sample.

Schizophrenia is a serious neuropsychiatric disease of uncertain etiology. We investigated the seropositivity rate for anti-Toxoplasma IgG and IgM antibodies by enzyme-linked immunosorbent assay (ELISA) in patients with schizophrenia to ascertain a possible relationship between Toxoplasma gondii and schizophrenia. We selected 100 patients with schizophrenia, 50 with depressive disorder, and 50 healthy volunteers to investigate the seropositivity rate of anti-Toxoplasma antibodies by ELISA. The seropositivity rate for anti-Toxoplasma IgG antibodies among schizophrenia patients (66%) was significantly higher than among patients with depressive disorder or healthy volunteers (P < .01). Thus, there might be a causal relationship between toxoplasmosis and the etiology of schizophrenia.

[Investigation of the presence of Clostridium difficile in antibiotic associated diarrhea patients by culture and toxin detection methods]. / Antibiyotige bagli ishal olgularinda Clostridium difficile varliginin kültür ve toksin saptama yöntemleriyle arastirilmasi.

Clostridium difficile-associated disease can be observed especially in hospitalized patients who use broad-spectrum antibiotics. The aim of this study was to investigate the presence of C. difficile as the causative agent of diarrhea in outpatients and inpatients. During January-December 2005, 45 outpatients and 46 inpatients (of them 11 were intensive care unit patients) who had developed diarrhea due to antibiotic use, were included to the study. In addition 7 intensive care unit personnel and 20 food handlers were also included to the study in order to detect their carrier states. The age range of patients was 16-80 years, and of them 45 (49.5%) were male, while the age range of the personnel was 25-55 years, and of them 21 (78%) were male. Stool samples collected from the study groups were cultivated in C. difficile agar media (C. difficile Agar Base, Oxoid) as well as on routine bacteriologic media, and C. difficile growth was confirmed by latex agglutination test with the use of specific antisera. The presence of C. difficile toxin A was investigated by latex method (Oxoid, UK), and toxin A and B was searched by enzyme-linked immunoassay (ELISA; Seramun GmbH, Serazym C. difficile Toxin A+B), in the stool samples. While C. difficile was isolated from 13 (14.3%) of the 91 samples, no positive result was detected in the personnel. There was no statistically significant difference between outpatient and inpatient groups by means of C. difficile culture positivity (15.5% and 17.1%, respectively) (p>0.05). All of the culture positive samples were also found positive by ELISA Toxin A+B method (100%), but only 4 of them (30.7%) yielded positive result by Toxin A latex test. It was detected that 84.6% (11/13) of the patients had used ampicillin/sulbactam, 7.7% (1/13) used cotrimoxazole-SXT, and 7.7% (1/13) used macrolide antibiotics. The use of ampicillin/sulbactam was found statistically significant in development of diarrhea (p<0.05). Our data indicated that ELISA Toxin A+B is a reliable method with 100% specificity and sensitivity in the rapid diagnosis of C. difficile until the culture results were obtained, however, although specificity of Toxin A latex test is 100%, its use alone as a primary rapid diagnostic test was not recommended because of its low (30.7%) sensitivity.

[Short communication: determination of hepatitis C virus genotypes by INNO-LIPA and sequence analysis methods]. / Kisa bildiri: hepatit C virus genotiplerinin INNO-LIPA ve sekans analizi yöntemleri ile belirlenmesi.

The detection of genotypes of hepatitis C virus (HCV) which exhibit very high genetic variability, has a great impact for the therapy and follow-up of the chronicity of infections. The aim of this study was to detect the genotypes of HCV strains by using two different methods. Thirty patients (5 hemodialysis patients, 9 chronic hepatitis C patients, 5 blood donors, 1 hospital staff) who were positive for both anti-HCV (Vitros, Ortho-Clinical Diagnostics) and HCV-RNA (Rotorgene, Artus) were included to the study. The serum samples were studied by Inno-LIPA (Inno-LIPA HCV-II, Innogenetics, Belgium) and sequence analysis (9700 Sequence Detection System, and ABI PRISM 310 Genetic Analyzer, Applied Biosystems, USA) methods. For Inno-LIPA, 5'non-coding region (5'NCR) of HCV-RNA was amplified by reverse transcriptase polymerase chain reaction (RT-PCR) and genotyped by line probes. For sequence analysis (SA), NS5B and 5'NCR regions were amplified by RT-PCR, and genotypic variations were assessed by Cycle Sequencing system (Applied Biosystems, USA). As a result, one strain was found as 1a, and 28 strains were found as 1b with both Inno-LIPA and SA methods, however, one strain was genotyped as 1b/3a by Inno-LIPA, but as 1b by SA method. Our data have indicated that the results obtained by Inno-LIPA and sequence analysis methods were in concordance for the detection of HCV genotypes, considering that they have similar sensitivities.