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Leblebicioglu, Hakan/0000-0002-6033-8543; WOS: 000369680000004 PubMed: 26695860 Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease of humans that affects a wide geographic area of Africa and Eurasia, including Turkey, Iran, Pakistan, Afghanistan and Russia. Since the first detection of CCHF cases in Turkey in 2002, more than 9700 patients have been reported, with an overall mortality rate just under 5%. This article assesses the present epidemiological situation of CCHF in Turkey, with an updated literature review, describes national practices and summarizes lessons learned in preparation for future outbreaks. (C) 2015 Elsevier B.V. All rights reserved.

Adult onset Still’s disease is rare syndrome consisting of recurrent fever, rash, artralgia or arthritis. A sixty-five years old female was admitted to the hospital for high fever with one month duration, accompanied with fatique and lack of appetite. Findings of physical examination, laboratory test results and radioghraphic evaluations were negative for infectious diseases, malignancy and immunological disorders. The diagnosis of Still’s disease was made on the clinical findings and exclusion of other possible diseases. High serum ferritin value was a key factor in making the diagnosis. The patients with Still’s disease can apply to the infectious diseases department because of the fever of unknown origin (FUO) and this disorder can be the cause of FUO in the elderly as well as in the younger population.

Hepatitis B virus (HBV) infection may progress to liver failure and liver cancer, for this reason it is a serious health problem. The mechanisms of chronicity are poorly understood. The balances in cytokine production profiles may play a crucial role in determining the resolution or persistence of infection. In this study, we aimed to determine various cytokine levels in patients with chronic HBV infection and to reveal the relationship between levels of cytokines and different clinical phases. HBsAg positive patients with a duration of positivity longer than six months who applied to outpatient clinic of Infectious Diseases and Clinical Microbiology Department of Ankara Training and Research Hospital between October 2005 and June 2006 were included to the study. There were 57 patients in chronic hepatitis B group. There were 24 healthy individuals in the control group. Serum interleukin (IL)-6 and IL-10 levels were detected and compared between patients and controls. There were 25 chronic hepatitis and 32 inactive carrier patients in the patient group. Serum IL-6 levels in patients with chronic HBV infection (8.496 pg/mL) were higher than those of the control group (6.850 pg/mL) and the difference was statistically significant (p= 0.022). Serum IL-10 levels were 0.784 pg/mL and 0.052 pg/mL in patient and control groups, respectively. There was a statistically significant difference between these groups (p= 0.019). Correlation between serum alanin aminotransferase (ALT) levels and cytokine levels were also examined. There wasn’t any correlation between the levels of IL-6 and IL-10, and ALT in patients. As a conclusion, increased IL-10 levels may be associated with persistence of hepatitis B infection. Testing the level of serum IL-6 may be helpful to determine the liver inflammation in patients with chronic hepatitis B infection.

Amaç: Bu çalışmada, klinik ve laboratuvar bulgularıyla kesin pandemic influenza A (H1N1) enfeksiyonu tanısı konan yatan hastalar, üst solunum yolu enfeksiyonu enfeksiyonu tanısı konan poliklinik hastlarında serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma solubl ürokinaz plazminojen aktivatör reseptörü (suPAR) düzeyinin klinik öneminin belirlenmesi amaçlandı. Yöntem: Çalışmaya influenza A (H1N1) enfeksiyonu tanısı klinik ve laboratuvar testiyle (polimeraz zincir reaksiyonu: PZR) tanısı konan 26 yatan hasta, üst solunum yolu enfeksiyonu (akut sinüzit, akut tonsillofarenjit, akut nazofarenjit vb.)tanısı konan 30 poliklinik hastası ve hiçbir yakınması olmayan 24 sağlıklı birey dahil edildi. Serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma suPAR düzeyi ELISA yöntemiyle üretici firmanın önerileri doğrultusunda belirlendi. İstatistiksel değerlendirmede Kruskal- Wallis, Mann-Whitney U testi ve Ki-kare testleri kullanıldı.Bulgular: İnfluenza A (H1N1) enfeksiyonu olan yatan hastalarda serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ile plazma suPAR düzeyleri median değeri sırasıyla; 27,8 ng/ml, 9,29 ng/ml, 11,04 ng/ml, 8,82 ng/ml ,5,64 ng/ml olarak belirlendi.Üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarında serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma suPAR düzeyi median (ortanca) değeri sırasıyla; 7,24 ng/ml, 1,9 ng/ml, 19,74 ng/ml, 4,37 ng/ml, 3,33 ng/ml idi.Sağlıklı bireylerde ise serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma suPAR düzeyi median değeri sırasıyla; 0,97 ng/ml, 0,16 ng/ml, 4,46 ng/ml, 2,38 ng/ml, 1,65 ng/ml olarak belirlendi.İnfluenza A (H1N1) enfeksiyonu tanısı konan yatan hastalarda serum IL-6, IL-10, neopterin düzeyleri, üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarınkınden istatistiksel olarak anlamlı yüksekti. Üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarında serum TNF-alfa düzeyleri H1N1 tanısı konan yatan hastalardan daha yüksekti. Üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarında, serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ile plazma suPAR düzeyleri kontrol grubundan anlamlı oranda yüksekti.İnfluenza A (H1N1) enfeksiyonu tanısı alan yatan hastalarda serum IL-6, IL-10,neopterin ve plazma suPAR düzeyi sağlıklı bireylere göre anlamlı yükseklik gösterdi.Sonuç: Serum IL-6, IL-10, neopterin, TNF-alfa düzeyleri ve plazma suPAR düzeyi influenza A (H1N1) enfeksiyonu olan hastaların klinik izleminde kullanılabilir, Objective: This study aims to investigate the clinical importance of serum interleukin (IL) 6, IL-10, tumor necrosis factor alpha (TNF-alpha), neopterin, and plasma soluble urokinase plasminogen activator receptor (suPAR) levels in patients with pandemic H1N1 influenza infection and outpatients diagnosed with upper respiratory infections. Materials and Methods: Twenty-six inpatients with H1N1 infection confirmed by clinical findings and polymerase chain reaction (PCR) test 30 outpatients diagnosed with upper respiratory infections, and 24 healthy individuals without any complaints were included. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were compared between the patients groups and the 24 healthy controls. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were determined through the enzyme-linked immunosorbent assay (ELISA) as per manufacturer’s instructions.Results: The median serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 27.8 ng/ml, 9.29 ng/ml, 11.04 ng/ml, 8.82 ng/ml and 5.64 ng/ml, respectively in inpatients with H1N1. In 30 outpatients diagnosed with upper respiratory infections, the median serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 7.24 ng/ml, 1.9 ng/ml, 19.74 ng/ml, 4.37ng/ml and 3.33 ng/ml, respectively. In healthy individuals, the mean IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 97 ng/ml, 0.16 ng/ml, 4.46 ng/ml, 2.38 ng/ml, 1.65 ng/ml, respectively. In inpatients with H1N1, serum IL-6, IL-10, neopterin levels were significantly higher than those of outpatients diagnosed with upper respiratory infections. In outpatients with upper respiratory infections, serum TNF-alpha levels were higher than in inpatients with H1N1 infection as confirmed by laboratory findings (PCR). In outpatients, serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were significantly higher from those in the control group. In patients with influenza A (H1N1) infection, serum cytokine levels and plasma suPAR levels were significantly higher from healthy individuals.Conclusion: Serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels may be used as clinical follow-up markers in patients with H1N1 infection. J Microbiol Infect Dis 2015;5(3): 119-124 Key words: Pandemic influenz A (H1N1), cytokines, soluble urokinase plasminogen activator receptor (suPAR), diagnostic value.

Objectives: Crimean-Congo hemorrhagic fever (CCHF) is a tick borne zoonotic infection. Up till now knowledge about pathogenesis of the disease is limited. Cytokine response is quite important during this infection. The aim of this study was to determine the serum tumor necrosis factor-alpha (TNF-α) and the interleukin-4 (IL-4) levels in patients with CCHF and compare with those of healthy controls. Materials and methods: Forty-two adult CCHF patients and 40 healthy subjects were included in this study. The diagnosis of CCHF was based upon anti-CCHF virus IgM positivity (ELISA method), and/or positivity in real time-polymerase chain reaction (RT-PCR) in acute phase serum samples. Serum TNF-α and IL-4 levels were determined by ELISA method. Results: In patients with CCHF the mean serum TNF-α level was significantly higher than the control group (15.01 vs. 7.69 pg/ml; p

An 18- year old female patient was admitted to the Emergency Department with complaints of fever and fatigue beginning 15 days ago associated with headache, weakness, palpitation, abdominal pain, and diarrhea a week later. The patient who apathic confused and discordant was transferred to the Department of Infectious Diseases. There was also hypocalcemia, hypopotassemia, pancytopenia, intestinal hemorrhage, and hepatic involvement. S. typhi was grown in the blood culture. The patient was discharged with full recovery after ciprofloxacin treatment in addition to electrolyte replacement. Typhoid fever is a widespread infectious disease in our country and should be taken into consideration in differential diagnosis of many diseases because it may involve a number of systems and may present with a variety of complications

Leptospirosis is a widespread zoonosis manifesting itself in various types all over the world. A 23-yearold male patient, who referred to the Emergency Unit of Yüzüncü Y›l University Medical Faculty, suffered from fever, sweats, anorexia, fatigue, headache, myalgia, hiccups, nausea and vomiting, oliguria and darkening of the urine beginning 15 days before. Leptospiras were seen by dark field examination of the preparations from urine samples of the patient that we were informed to be a building worker in Istanbul. In the serum samples taken from pre-treatment period, we have found a positiveness against Leptospira icterohaemorrhagiae Wijnberg strain at a titer of 1/3200 by method of microscopic agglutination test (MAT) in Etlik Veterinary Control and Investigation Institute. The patient who was determined to have acute renal failure and hepatic function disorder was discharged from the hospital after treatment with a complete recovery.

WOS: 000307199900012, Objective: The aim of this study was to determine the frequency of metallobeta-lactamase (MBL) enzyme in Pseudomonas aeruginosa strains resistant to carbapenem (imipenem or/and meropenem) in seven regions of Turkey and to assess the minimal inhibitory concentration (MIC) levels of drugs used in treatment such as colistin, aztreonam, polymyxin B and rifampin. Overall 186 Pseudomonas aeruginosa (P.aeruginosa) strains resistant to carbapenem from 8 provinces (Ankara, Konya, Antalya, Istanbul, izmir, Diyarbakir, Van and Trabzon) representing 7 different geographical regions of Turkey were included in the study. Material and Methods: The presence of MBL in P.aeruginosa strains resistant to carbapenem was investigated by combined disk methods with imipenem and EDTA absorbed imipenem disk. The MBL positivity was determined in the strains. Additionally, susceptibility to aztreonam, colistin, polymyxin B, and rifampin was established by the E-test method. Results: MBL enzyme positivity was detected in 58 out of 186 strains (31.2%). There was statistically significant difference between regions in terms of MBL positivity, with the highest rates in Antalya (52%), and Istanbul (50%) and the lowest in Diyarbakir (6%). Aztreonam sensitivity was detected in 134 (72%) strains; 155 (83.3%) were sensitive to colistin and 148 (79.6%) to polymixine. No strain (0%) was sensitive to rifampin. Conclusion: In conclusion, the overall mean rate of MBL positivity was 31.2%, which is quite high. Therefore, it will be beneficial to confirm the MBL positivity of strains with molecular methods, to review regional antibiotic surveillance data at certain intervals and to share the obtained data with relevant institutions in order to prevent the regional spread of these strains. Thus, it is essential to record and monitor systematically the antibiotic surveillance data., Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [SBAG-HD-62], We are grateful to The Scientific and Technological Research Council of Turkey (TUBITAK) for their support of this project (SBAG-HD-62).

Anthrax is essentially a disease of grazing herbivorous animals. The most common form of the disease is cutaneous anthrax, which accounts for 95% of all cases. We report here 39 cutaneous anthrax cases in humans that were seen in Eastern Anatolia over a six-year period. The clinical presentation was malignant edema in 16 of the cases (41%) and malignant pustule in 23 (59%). A secondary bacterial infection was present in 13 patients (33.3%) in the vicinity of the lesions. The agent was observed using Gram-stained smears in 25 patients (64%), and Bacillus anthracis was isolated from 15 patients (38.5%). All of the patients were treated with penicillin G or penicillin procaine, except one patient who had a penicillin allergy. One patient with cervical edema (2.5%) died as a result of laryngeal edema and sepsis syndrome. In conclusion, we found that the appearance of the skin lesion of cutaneous anthrax may vary, and this fact, combined with the rarity of this disease, which contributes to a general lack of experience among medical personnel, may make diagnosis difficult in nonagricultural settings

Summary Background Crimean-Congo hemorrhagic fever (CCHF) is a serious disease caused by the CCHF virus of the Bunyaviridae family. The disease has been reported in 30 countries in Africa, Asia, Eastern Europe, and the Middle East. It has been present in Turkey since 2002. In this study we present and discuss the epidemiological features, clinical and laboratory findings, treatment, and outcome of cases diagnosed with CCHF between 2002 and 2007 from the surveillance results of the Turkish Ministry of Health (MoH). Methods According to the surveillance system of the MoH, data for patients with clinical, laboratory, and epidemiological findings compatible with CCHF are recorded on case reporting forms. These forms are submitted to the General Directorate of Primary Health Care of the MoH by the city health directorates. All the surveillance data regarding CCHF were recorded on a database (SSPS 11.0) established in the Communicable Diseases Department of the MoH. Results According to the surveillance reports of the Turkish MoH, between 2002 and 2007, 1820 CCHF cases occurred (150 in 2002–2003, 249 in 2004, 266 in 2005, 438 in 2006, and 717 in 2007). The crude fatality rate was calculated to be 5% (92/1820). Two thirds of the CCHF cases were reported from five cities located in the Mid-Eastern Anatolia region; 69.4% of the cases were from rural areas. The male to female ratio was 1.13:1. Of all the reported cases, 68.9% had a history of tick-bite or tick contact and 84.1% were seen in the months of May, June, and July. Of 1820 CCHF cases, three (0.16%) were nosocomial infections. Conclusions CCHF appears to be a seasonal problem in the Mid-Eastern Anatolia region of Turkey. The possible risk factors for transmission and the clinical and laboratory findings of patients with a diagnosis of CCHF were found to be similar to those reported in the literature. The mean fatality rate for Turkey is lower than the rate reported for other series from other parts of the world.

This work presents a dynamically reconfigurable architecture for Neural Network (NN) accelerators implemented in Field-Programmable Gate Array (FPGA) that can be applied in a variety of application scenarios. Although the concept of Dynamic Partial Reconfiguration (DPR) is increasingly used in NN accelerators, the throughput is usually lower than pure static designs. This work presents a dynamically reconfigurable energy-efficient accelerator architecture that does not sacrifice throughput performance. The proposed accelerator comprises reconfigurable processing engines and dynamically utilizes the device resources according to model parameters. Using the proposed architecture with DPR, different NN types and architectures can be realized on the same FPGA. Moreover, the proposed architecture maximizes throughput performance with design optimizations while considering the available resources on the hardware platform. We evaluate our design with different NN architectures for two different tasks. The first task is the image classification of two distinct datasets, and this requires switching between Convolutional Neural Network (CNN) architectures having different layer structures. The second task requires switching between NN architectures, namely a CNN architecture with high accuracy and throughput and a hybrid architecture that combines convolutional layers and an optimized Spiking Neural Network (SNN) architecture. We demonstrate throughput results from quickly reprogramming only a tiny part of the FPGA hardware using DPR. Experimental results show that the implemented designs achieve a 7× faster frame rate than current FPGA accelerators while being extremely flexible and using comparable resources.