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Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The objective is to obtain the seroprevalence of HBsAg, anti-HCV, anti-HIV, RPR and to assess their rates according to time, gender, age and other specifications in blood donors. Methods: HBsAg, anti-HCV, anti-HIV and RPR results of 16 362 blood donors from January 1, 2005 to December 31, 2009 have been evaluated retrospectively. Prevalence of HBsAg, anti-HCV, anti-HIV, and RPR were investigated according to gender, age and other specifications of the donor. Results: 15,479 (94.6%) of the 16,362 donors were male and 883 (5.4%) were female. The age range of the donors was between 18 and 64 years, and the mean age was 31.55±8.94. 611 (3.73%) of the donors were repeat donors and 15,751 (96.27%) were the relatives of patients. HBsAg was positive in 85 (0.52%), anti-HCV in 59 (0.36%), anti-HIV in 16 (0.1%) and RPR in 13 (0.08%) of the donors. Western Blot confirmation test was reported positive in one of the 16 anti-HIV-positive donors. HBsAg positivity was 0.79% in 2005 and it regressed to 0.37% in 2009 (p=0.024). Conclusions: Seropositivity rate of HBsAg was lower than that of Turkey in general and seroprevalence of HBsAg decreased over years. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Medical Sciences is the property of Scientific and Technical Research Council of Turkey and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal disease affecting multiple organ systems. To determine the association between viral load and severity of CCHF infection, quantitative measurement of CCHF virus was performed using 1-step reverse-transcriptase polymerase chain reaction for 36 patients with CCHF infection. Viral loads ranged from copies/mL to copies/mL. 3 9 1.1-10 - 9.9-10 Nine (25%) of 36 patients died. In 8 of the 9 patients with fatal outcomes, viral loads were detected that were - copies/mL, whereas in 25 of the 26 patients with 9 1-10 nonfatal outcomes, viral loads were detected that were ! copies/mL (P < .001). A viral load - RNA 9 9 1-10 1-10 copies/mL can be considered to predict a fatal outcome with a positive predictive value of 80%, with 88.9% sensitivity and 92.6% specificity. We suggest that viral load is a measure of the severity of CCHF. [ABSTRACT FROM AUTHOR]

Objectives: Occupational exposure to bloodborne pathogens continues to be a significant risk for health care workers (HCWs). This study is planned to examine the characteristics of exposures in HCW. Methods: Retrospective surveillance of percutaneous, mucous membrane, and cutaneous contacts was done. A structured survey form was administered to HCWs who sought medical advice following the injury from The Infection Control Comittee (ICC). Results: Twenty-seven HCW applied to ICC following the injury from January 2013 to December 2014. Mean age was 30 (range 18-45) and 18 (66.7%) were female. Most the HCWs (81.5%) described themselves as an experienced staff at their job. All of the HCWs had been previously vaccinated against HBV. Blood was the most common fluid exposed (96.3%). Sharp injuries were accounted 92.6% and 77.8% of the contacts were needle-stick injuries. %32 of the sharp injuries occured while recapping and %36 occured from the needlesticks discarded inappropriately. Of the injured HCW, 74.1% were using personal protective equipment. Conclusion: Most of these injuries caused by devices discarded inappropriately and recapping of the syringes. Training on universal precautions, barrier protection, and safer disposal systems should be implemented. [ABSTRACT FROM AUTHOR]

Ticks are ectoparasites which can't fly or jump, and feed by sucking the blood of animals and also incidentally humans. Tick-borne diseases are seen worldwide and have increasingly become a major problem. The number of diseases transmitted by ticks are considerably high and most of these exist in our country. External auditory canal tick bite is quite a rare condition. In this article, we reported a case of a tick-bite in external auditory canal and aimed to emphasize the importance of careful physical examination of especially rare contact areas of the body in endemic areas for tick-borne diseases. [ABSTRACT FROM AUTHOR]

Hydatidosis is endemic in many Mediterranean countries, the Middle East, South America, Australia, New Zealand and Africa. It is caused by an infection from the Echinococcus granulosus larvae which can lead to the development of cysts. The most frequently affected organ is the liver. Splenic involvement alone is very rare. In this article, a case of an isolated giant splenic hydatid cyst is reported. The patient underwent splenectomy. The diagnosis of a hydatid cyst was confirmed by histopathology. This case suggests that hydatid disease should be considered as a differential diagnosis in every patient with a cystic mass of the spleen in endemic areas. [ABSTRACT FROM AUTHOR]

We evaluated the effect of early use of ribavirin on outcomes of patients at a secondary care hospital. The study included patients who were hospitalized between 2005 and 2010 at the Infectious Diseases Department of Kastamonu Dr. Münif İslamoğlu Hospital in the Kastamonu Province of Turkey. In total, 342 confirmed cases of Crimean-Congo hemorrhagic fever (CCHF) were included in the study. The overall case fatality rate was 2.9%. In multivariate analysis, the patients that were admitted to the hospital within 2 days after onset of symptoms (odds ratio [OR]=5, confidence interval [CI] 0.31-0.86) and received oral ribavirin (OR=0.12, CI 0.05-0.26) were less likely to become more severe cases and less likely to be transferred to the tertiary care centers. Having vaginal bleeding was a significant parameter for transfer.

Trimethoprim-sulfamethoxazole (TMP-SMZ) is recommended as the treatment of choice for Stenotrophomonas maltophilia infections. However, when the administration of TMP-SMZ is not possible, alternative treatment options for S. maltophilia infections has not been clearly established. We compare the efficacy of tigecycline treatment with TMP-SMZ in nosocomial S. maltophilia infections during a 3-year period. For the treatment of S. maltophilia infection, 26 (57.8%) patients received TMP-SMZ and 19 (42.2%) patients received tigecycline. Culture positivity rate was 95.7% in TMP-SMZ group and 70.6% in tigecycline group at the seventh day (P = 0.028), whereas 26.3% versus 18.8% at the fourteenth day (P = 0.700). Clinical improvement was observed 69.2% in TMP-SMZ group and 68.4% in tigecycline group at the fourteenth day (P = 0.954). Mortality rates at the thirtieth day were respectively, 30.8 and 21.1% in TMP-SMZ and tigecycline groups (P = 0.517). There were no significant differences in mortality and clinical response rates between TMP-SMZ and tigecycline treatment. Tigecycline can be considered as an alternative option beyond TMP-SMZ in treatment of S. maltophilia infections.

Despite the relatively recent introduction of propranolol in the treatment of infantile hemangiomas, there can be little doubt of its efficacy. With regard to safety issues, there are no prior data for very low weight infants. In this study, we used propranolol in preterm and very low weight infants. We used clinical criteria to assess the response to the therapy. We noted all side effects expected from beta-adrenergic blocking drugs, and followed the patients' weight gain during propranolol treatment. Objective, clinical evidence of hemangioma regression was seen after two months in all patients. None of the patients required treatment discontinuation due to adverse side effects. During the propranolol treatment, weight gain was normal in all patients. To the best of our knowledge, this is the first report on the use of propranolol in preterm and very low weight infants, and also the first report from Turkey on the use of propranolol in infantile hemangiomas.

Background and Aim of the Study: Despite recent improvements in diagnostic and therapeutic interventions, infective endocarditis (IE) is still associated with high in-hospital mortality rates. The study aim was to determine the clinical, laboratory and echocardiographic features of IE, and to evaluate the risk factors for in-hospital mortality., Methods: A retrospective cohort study design was employed, with a main outcome measure of in-hospital mortality. A total of 107 patients (79 males, 28 females; mean age 45 +/- 16 years) admitted with the modified Duke criteria for definitive IE were included in the study during a five-year period between January 2004 and December 2008., Results: Among the patients, the mitral valve alone was involved in 45% of cases, the aortic valve in 36%, tricuspid valve in 11%, and multiple valves in 8%. Forty-seven patients (44%) had prosthetic valves. Blood cultures were positive in 71 patients (66%). The most common isolated microorganisms were staphylococci, streptococci and Brucella melitensis. The in-hospital mortality rate was 27%. Leading causes of death were multi-organ failure and heart failure. In univariate analysis, factors associated with death were a longer duration of symptoms before hospitalization, previous history of IE, white blood cell count > or = 10,000/mm3, serum creatinine level > or = 2 mg/dl, vegetation size >15 mm, involvement of multiple valves, existence of severe regurgitation, cardiac abscess, and neurologic complications. Multivariate analysis showed that risk factors for mortality were multivalvular involvement (hazard ratio (HR) 4.7; 95% confidence interval (CI) 1.3-17.6; p = 0.021), vegetation size >15 mm (HR 5.5; 95% CI 2.1-14.6; p = 0.001), serum creatinine > or = 2 mg/dl (HR 4.1; 95% CI 1.8-9.4; p = 0.001), and previous history of IE (HR 3.5; 95% CI 1.2-11; p = 0.026)., Conclusion: Multivalvular involvement, vegetation length >15 mm, serum creatinine level > or = 2 mg/dl on admission, and a previous history of IE, were independent predictors for in-hospital mortality in IE.

Objectives: This study examined the association between lymphocyte subgroups and mortality in patients with Crimean-Congo hemorrhagic fever (CCHF) in Turkey., Methods: During the spring and summer of 2007, peripheral blood was collected from hospitalized patients with suspected CCHF. Lymphocyte subgroups were characterized by fluorescence-activated cell sorting. CCHF cases were confirmed by detecting viral RNA by PCR and/or IgM antibodies by ELISA. Lymphocyte subgroups were compared between fatal and non-fatal cases. The correlation between lymphocyte subgroups and viral loads was also investigated., Results: Seventy-seven confirmed cases of CCHF were included in this study (five cases were fatal (6.5 %)). No differences in lymphocyte subgroups were found between fatal and non-fatal cases, except for significantly higher CD3+CD8+ T cells in the fatal cases (p=0.017). A positive correlation between viral load and CD3+CD8+ T cells was also detected (p=0.044). There was no correlation between other lymphocyte subgroups and viral load., Conclusions: Higher levels of CD3+CD8+ T lymphocytes were detected in fatal compared to non-fatal CCHF cases. Despite this cytotoxic immune activation, a fatal outcome could not be prevented. We hypothesize that high viral load and other factors may influence this outcome, although more studies are required to explain the pathogenesis of CCHF.

Apoptosis-related proteins and proliferation activity and their relationship with Epstein-Barr Virus (EBV) are contemporary issues in pediatric non-Hodgkin's lymphoma (pNHL). In this study prognostic or pathogenetic role of EBV latent infection, proliferating activity, and apoptosis-regulating proteins in pNHL were explored. EBV-EBER, lmp-1, ki-67, bcl-2, survivin, bax, fas, c-myc, p53 and apoptotic index by TUNEL method were explored in 70 pNHL cases and evaluated statistically. Of the 70 cases evaluated, 24 were female and 46 were male. Seven cases were stage I/II and 63 cases were stage III/IV. The mean age was 7.16 + or - 3.72(1-15). EBV was positive in (25.7%) cases. Overall survival was 82%, while event free survival was 75%. Bax was expressed in 40% of the cases, while the expression of bcl-2,was 50%, survivin 42.9%, p53 8.6%, fas 18.6% and c-myc in 45.7%. Mean apoptotic index was 131.29 + or - 96.69 per 5,000 cells. Mean proliferation index was 55.97% (12-92%). Fas positivity was high in EBV positive cases (p = 0.0001). EBV positivity was not related with prognosis. Apoptotic index was found to be an independent prognostic factor (p = 0.017). Our results suggest that apoptosis-regulating proteins have a role in the pathogenesis of pNHL. EBV was correlated with apoptotic index and fas, bcl-2. No correlation was observed with proliferation index and studied factors. High apoptotic index was related with good prognosis.

Cryptosporidium spp. is known to cause heavy diarrhea especially in immunosuppressed patients. In this study, eighty nine leukemia and lymphoma patients between the ages of 1 to 14 were studied for the prevalence of Cryptosporidiosis using both ELISA (Cryptosporidium Rida Screen, R-Biopharm, Germany) and the Kinyoun acid-fast staining method. These patients were sent to us by the Hematology-Oncology department where they were diagnosed with leukemia and lymphoma. Cryptosporidium spp. were detected in 11 patients (12.35%) with ELISA and in 7 patients (7.86%) with the Kinyoun acid fast stain. No cryptosporidiosis was detected in the control groups of 60 patients with neoplasia but without diarrhea. The distribution of Cryptosporidium among positive samples were 7 (14.8%) in patients who were diagnosed with ALL, 3 (10%) in patients who were diagnosed with KML, and 1 (8.3%) in patients who were diagnosed with solid tumors. Sixty-five patients (73.03%) had a fever, 43 patients (48.31%) were vomiting and 58 patients (65.16%) had stomach pain. Except for two, all the patients responded positively to paromomycin treatment. Those two patients responded positively to azitromycine treatment. We suggest that when considering cryptosporidiosis in children with cancer, the use of a more sensitive and specific method such as ELISA- in addition to the acid fast stain should be considered.

Background: Epididymoorchitis is the most frequent genitourinary complication of brucellosis., Methods: This prospective study was conducted between February 2001 and January 2004, prospectively. Male patients diagnosed with brucellosis were included in this study and evaluated for testicular involvement., Results: Epididymoorchitis was detected in 17 out of 134 (12.7%) male patients with brucellosis. Mean age of the patients was 36.9+/-7.1 years. Twelve patients (70.6%) had acute, four patients (23.5%) had subacute, and one patient (5.9%) had chronic brucellosis. The most common symptoms were scrotal pain (94%) and swelling (82%). Eleven patients had unilateral epididymoorchitis, four had unilateral orchitis and two had unilateral epididymitis. A testicular abscess was detected in one patient. Sperm analysis was performed on 14 patients. Five patients had aspermia and eight had oligospermia. Combined antibiotic therapy was started and continued for 6-8 weeks. Orchiectomy was required for two patients and granulomatous orchitis was detected in the resected specimens. Relapse occurred in only one patient. Three patients had permanent oligospermia and one patient had permanent aspermia after the antibiotic therapy. Younger age, high C-reactive protein level and blood culture positivity were statistically significant differences between the patients with and without epididymoorchitis., Conclusions: Brucellosis should be considered in the diagnosis of scrotal diseases in endemic areas. A conservative approach is usually adequate for managing brucellar epididymoorchitis. However, infertility problems may develop in these patients. Well-designed further investigations are needed to explain the relationship between brucellar epididymoorchitis and infertility in man.

Possible clinical relevance of Nm23 expression, angiogenesis and proliferative activity were evaluated as prognostic parameters in childhood embryonal rhabdomyosarcoma (RMS). Specimens of 25 RMS cases were studied for Nm23 antigen immunohistochemically. Vascular surface density (VSD) and number of vessels per stroma (NVES) calculated by stereologic methods on labeling sections with CD34 antibody. For evaluation of proliferative activity of tumors, mitotic figures and Ki67 positive cells were investigated. All findings were searched statistically. Five patients were stage 1 (20%), two were stage 2 (8%), 15 were stage 3 (60%) and three were stage 4 (12%). The mean event free survival (EFS) was 20.8 and the mean overall survival (OS) was 25.9 months. Sixteen patients (64%) were alive and without disease. The percentage of Nm23 positivity was 52%. Log rank analysis showed Nm23 as a predictor for survival (p=0.0313). In Pearson correlation analysis, there was statistical significance between OS and presence of Nm23 expression (p=0.044). VSD was also positively related with EFS (p=0.040). Despite the present parameters in use, there is a need for new prognostic markers, especially to predict the outcome of patients. These findings suggested that Nm23 expression and VSD might be useful for follow-up in RMS.

Stool specimens taken from 50 children with malignancy and from 92 healthy children were investigated for intestinal parasites, using the modified formol ethyl acetate concentration method, and native-lugol, trichrome and Kinyoun acid-fast stain methods. Thirty-eight (76.0%) of the 50 patients had lymphoma or leukemia and were considered immunosuppressed. Several different parasites were found in 21 (42.0%) of the 50 patients with malignancy and in 16 (47.3%) of the 38 patients with immune deficiency compared to in only 16 (17.3%) of the 92 healthy children. The incidence of parasites in patients with malignancy or immunosuppression was significantly higher than in the healthy control group (p<0.01, p<0.01).

Thrombocytopenia is one of the rare hematologic complication of brucellosis. Herein a case of brucellosis with severe thrombocytopenia was reported. The patient was admitted to hematology service with epistaxis, ecchymoses, fever, thrombocytopenia (0.6 x 103/μL) and anemia. His initial diagnosis was idiopathic thrombocytopenic purpura. Corticosteroid treatment was started and erythrocyte and platelet suspensions were transfused. Despite this treatment clinical symptoms and laboratory disorders were not improved. No significant pathology was detected in the examination of bone marrow aspiration. On the seventh day, Brucella abortus was yielded from his blood cultures. Steroid was stopped and rifampicin plus doxycycline started. His clinical symptoms were disappeared and laboratory findings improved (thrombocyte count: 205 x 103/μL) at the second week of the antibiotic treatment. This case was interesting showing us that thrombocyte count might decrease to very low levels in brucellosis. So that, especially in the endemic areas, brucellosis should be kept in mind for the etiology of fever and thrombocytopenia.

Objective: To study natural killer cells' spontaneous cytotoxic capacity against tumor cells and their prognostic significance in classical Hodgkin's disease., Study Design: Thirty-eight pediatric mixed cellularity and nodular sclerosing Hodgkin's disease patients were included in the study. Immunohistochemical staining was performed for natural killer cells in the background using the monoclonal antibody CD57 in serial sections of B5-formalin-fixed, paraffin-embedded tissue blocks. CD57-positive cells were counted with an immersion objective among 5,000 cells on representative areas of the tumors. The degree of natural killer cells was classified as low (<150 cells) or high (> or = 150 cells). Multivariate regression analysis was performed to determine the differences between patients with and without relapse., Result: The mean of CD57-positive cell numberfor all the cases was 173.42 +/- 117.34 (range, 20-500). CD57-positive cells were high in 21 cases and low in 17. The mean of CD57-positive cell numbers was 191.85 +/- 115.33 in the disease-free group and 84.44 +/- 57.90 in the relapsing group. Log rank analysis showed statistical significance between event-free survival and number of CD57-positive cells (P = .0207)., Conclusion: In multivariate analysis, CD57 expression proved to be a prognostic factor independent from otherfactors. As a result, CD57 expression by background natural killer cells may be used as a prognostic parameter in mixed cellularity and nodular sclerosing Hodgkin's disease.