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Background We investigated the role of European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for the prediction of LN among children with SLE. Methods The data of the patients with childhood-onset SLE diagnosed based on 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were retrospectively evaluated. Based on 2019 EULAR/ACR classification criteria, the scoring was done at the time of renal biopsy. Results Fifty-two patients (12 with LN, 40 without LN) were included. The mean score was higher in patients with LN than those without (30.8±6.14, 19.8±7.76, respectively, p=0.000). The score value had indicative value for LN (area under curve [AUC]:0.863±0.055, cut-off value:22.5, p=0.000). Lymphocyte counts had a predictive value for LN (cut-off value:905/mm3, AUC:0.688±0.087, p=0.042). The score was positively associated with SLE disease activity index (SLEDAI) and activity index (r=0.879, p=0.000; r=0.811, p=0.001, respectively). There were significant negative associations between score value and GFR (r=-0.582, p=0.047). The patients with renal flare had higher the mean score than those of without renal flare (35±2/25.4±5.57, respectively, p=0.019). Conclusions The EULAR/ACR criteria score could reflect the activity of disease and severity of nephritis in childhood-onset SLE. A point of 22.5 as score value might be an indicator for LN. During scoring, it should be taken into account that lymphopenia might guide the prediction of LN.

Objective This study aims to compare the frequency of respiratory viruses using real-time and multiplex polymerase chain reaction technology and nasopharyngeal swabs taken during exacerbation of patients aged 0-18 years followed for febrile neutropenia (FN) with non-FN children. Methods This prospective study included a total of 40 patients with FN and malignancies followed at Eskisehir Osmangazi University, Department of Pediatric Hematology and Oncology. The control group (n=76) consisted of age-matched patients with upper respiratory tract infections (URTIs) or lower respiratory tract infections (LRTIs) who were admitted to the emergency service due to fever. Results Viral agents were detected in 16 of 53 FN attacks (30.1%). The most commonly isolated viruses were coronavirus (23.7%, n=9), influenza B (18.4%, n=7), and adenovirus (18.4%, n=7). Of 76 children diagnosed with URTI with fever (52.6%) had viral agents, and only 28 of them had a single agent. The most commonly isolated virus was adenovirus (28.6%, n=14). Viral factors were found in 32 of 42 patients (76.1%) patients diagnosed with LRTI, while respiratory syncytial virus was the most common virus in 27 patients (21.7%, n=5). Conclusion Our study results show that viral agents play an important role in the etiology of FN. This is the first study to show that viral agents play an important role in the etiology of this disease and viral factors in non-neutropenic febrile children at the same time period by detecting respiratory viruses in 30% of FN cases. More similar studies provide antiviral therapy in selected patients, as well as these studies lead to reduce the use of antimicrobial agents or allow more selective use of antibiotics and/or the earlier discontinuation of these antibiotics in febrile neutropenic children who have been shown to have viral cause of respiratory tract infection based on clinical and microbiological/molecular diagnostic criteria.

IntroductionHeart-type fatty acid-binding protein (H-FABP) is a novel indicator of myocardial damage. The aim of the study was to compare the levels of H-FABP in off-pump and on-pump coronary artery bypass grafting (CABG).Material and methodsThirty non-randomised 30 patients who underwent CABG between January 2009 and January 2010 were enrolled in the study. Patients were divided into two equal size (n = 15) groups as group A (off-pump CABG group) and group B (on-pump CABG group). Three arterial blood samples were obtained for H-FABP after sternotomy (H-FABP 1), after the last distal anastomosis in group A and immediately after the cross clamp was removed from the aorta in group B (H-FABP 2) and 24 h after the operation (H-FABP 3). Renal and liver functions and circulating fatty acid binding protein (FABP) levels were also assessed in blood samples obtained 24 h before and 1 h after the operation.ResultsAt all three assessment points patients in group B had significantly higher H-FABP values when compared with group A. Preoperative renal and liver functions were similar in both groups and they did not differ significantly in group A and group B when preoperative and postoperative values were compared. In both groups circulating FABP levels increased in the postoperative period, and the increase was more pronounced in the on-pump CABG group.ConclusionsOn-pump surgery resulted in higher levels of H-FABP as an ischaemic marker in patients receiving coronary artery bypass surgery.

Changes in microbiota composition affect the aetiology and patho-genesis of chronic diseases, including Behçet's disease (BD). However, no studies have analysed the potential gut microbiota changes among different clinical forms of BD. This study evaluated the intestinal microbiota composition of patients with BD and healthy controls and also compared differences between patients with BD with respect to eye, mucocutaneous, and vascular involvement.In this prospective cohort study, 27 patients diagnosed with BD according to the International Study Group criteria and 10 age- and sex-matched healthy controls were included. Detailed intestinal microbiota analysis was performed.There were no differences between the BD group and the control group in terms of alpha and beta microbial diversity and abundance indices (p0.05). Actinomyces, Libanicoccus, Collinsella, Eggerthella, Enetrohabdus, Catenibacterium, and Enterobacter were significantly higher in the BD group than in the control group. In addition, Bacteroides, Cricetibacter, Alistipes, Lachnospira, Dielma, Akkermansia, Sutterella, Anaerofilum, Ruminococcease-UCG007, Acetanaerobacterium, and Copropaacter were lower in the BD group than in the control group. When we compared three different system involvement (eye, mucocutaneous, and vascular), the linear discriminant analysis effective size revealed a difference for the following genera: Lachnospiraceae NK4A136 in the uveitis group; Dialister, Intestinomonas, and Marvinbryantia in the mucocutaneous group; and Gemella in the vascular group.The composition of intestinal microbiota was significantly different in patients with BD compared with healthy adults. Ours is the first study to show differences in microbiota composition in isolated mucocutaneous, eye, and vascular involvement. These findings should be evaluated in a larger series.

Background:Although Familial Mediterranean Fever (FMF) is a monogenic disease, microbiota composition may play role in the pathogenesis or phenotypic expression.Objectives:We aim to evaluate the intestinal microbiota composition in patients with FMF and to compare with healthy controls.Methods:In this prospective cohort study, a group of 10 adult patients with FMF and 10 age-appropriate healthy controls, for which there was strict inclusion/exclusion, were enrolled. Fecal samples were stored at -80°C until DNA extraction. A region of the 16S rRNA gene (V3-V4) was selected and sequencing was performed on the Illumina MiSeq platform at the Sequencing and Bioinformatics Service of FISABIO foundation.Results:Alpha and beta diversity tests were similar between FMF and control groups except that Chao1 index. Chao1 index was modestly decreased in FMF group comparing the healthy controls (pEggerthella, at genus level. At species level,Eggerthella sinensisandEggerthella lentawere more abundant in patients with FMF.Conclusion:Eggerthella lentawas previously shown to be higher in type II diabetes, multiple sclerosis, rheumatoid arthritis and some disseminated infections. In this study we firstly showed abundance ofEggerthellain patients with FMF, especially inE. sinensisandE. lenta;in addition to. Whether any of observed associations are causal, or the direction of causality is unclear yet and further studies with patients with FMF at the first diagnosis might clarify this issue.Disclosure of Interests:None declared

Background:Serum autoantibodies closely reflect patterns of organ involvement and disease progression in systemic sclerosis (SSc). The entire autoantibody profile is less well defined in many cohorts and the data regarding their clinical associations and frequencies is limited.Objectives:To determine the autoantibody profile of patients with SSc, as well as their clinical associations, in well-characterized inception- cohort with disease duration less than 3 years.Methods:Serum samples of 100 patients out of 105 enrolled in the study were analyzed for ANA patterns with indirect immunofluorescence (IIF) assay using HEp-20-10/primate liver mosaic IIFT kit. Sera of 96 patients were subjected to commercial line immunoassay to quantify autoantibodies against 13 different autoantigens.Results:92 (92%) out of 100 patients were positive for ANA by IIF (Table 1). The speckled staining was the most pattern followed by nucleolar in 10 patients, centromere in 4, reticular in 1, nuclear in 2 and homogenous in 1. All patients (n= 96) patients were positive for at least 1 autoantibody by immunoblotting (Table 2). Twenty-two (49%) of patients with antiTopo I, 12 (44%) of the patients with antiCENP and 4 (22%) of the patients with antiRNAPIII were single positive. There was no difference in terms of the clinical findings when the patients with single and coexpression of these antibodies were compared. The distributions of the most frequent autoantibodies are shown in Figure 1. Interstitial lung disease was more frequent in the patients positive for anti-Topo I (78.8%) and anti-RNAPIII (27.3%). One of the two patients with breast cancer was anti-RNAPIII positive and none of the patients have diagnosed scleroderma renal crisis. Anti-Topo I was more common in patients with dcSSc (75%) and anti-CENP in lcSSc (46.4%).Table 1.Demographic, clinical and laboratory characteristics of the SSc patients.Sex Female N, %91 (86.7%) Male N, %14 (13.3) Female-to-male ratioAge, mean±SD years48.6±12.7Disease duration, mean±SD years2±1.4Disease classification N, % Diffuse39 (36.5%) Limited65 (62.5%) Sine scleroderma1 (1%)Interstitial lung disease37 (34.3%)Pulmonary arterial hypertension3 (2.8%)Scleroderma renal crisis0Digital ulcer14 (13.3%)Raynaud phenomenon105(100%)Telengiectasia31 (28.8%)Calcinosis1 (1%)Malignancy3 (2.9%)Antinuclear antibody profile N*, % Positive92 (92%)Staining pattern Speckled65 (65%) Nucleolar13 (13%) Centromere29 (29%) Homogeneous3 (3%) Reticular3 (3%)Table 2.Numbers and combinations of autoantibodies identified in the 96 SSc patients.Topo-ICENPRNAP IIIFibrillarinNOR90Th/ToPm/SclKuPDGFRRo52Topo-I22170159507CENP12202222011RNAPIII40121307Fibrillarin0000000NOR90011002Th/To04202Pm/Scl4306Ku102PDGFR00Ro522Single positive221240004102Total452718058179024Figure 1.Diagram of disease-related antibodies against the four main autoantibodies [anti-centromere (antiCENP) anti-Topoisomerase I (antiTopo I), anti-RNA polymerase III (antiRNAP III) and anti-Ro52).Conclusion:We presented the clinical and serologic features of the Turkish SSc patients from a new inception cohort. Clinical features of the SSc patients with single or multiple antibody positivity were not different.References:NoneDisclosure of Interests:None declared

Aim Insulin resistance (IR) plays an important role in the development of cardiovascular events in rheumatoid arthritis (RA) patients. Adiponectin influences insulin sensitivity but its impact on IR in RA patients remains unclear. The present study aims to investigate the role of methotrexate (MTX) and low doses of prednisolone (LDP) on IR and adiponectin levels in RA patients who are naive to disease-modifying antirheumatic drugs (DMARDs), as well as determining the relationship between disease activity, acute phase response, IR and adiponectin levels in patients with RA. Methods Sixty-five RA patients naive to DMARDs and prednisolone were involved in this study. The medication for RA patients was standardized for MTX and prednisolone. Body mass index, acute phase response reactants, 28-joint-count disease activity score, fasting blood glucose, serum cholesterol levels, insulin levels and adiponectin levels were measured in all RA patients both at the baseline and 3 months after the onset of the study. Results Adiponectin levels in the third month of the therapy with MTX and LDP were significantly increased in patients with RA (P = 0.03). Insulin resistance tended to decrease in the third month of the treatment, which achieved no statistical significance. Conclusion Increased levels of adiponectin due to MTX and LDP could be related to the decrease in homeostasis model assessment insulin resistance (HOMA-IR) in RA patients. This, in turn, could prove advantageous for cardiovascular conditions in RA.

Oz: Santral sinir sistemi (SSS) enfeksiyonlari hizli ilerleyen, olume veya kalici sekellere neden olabilen hastaliklardandir. Bu nedenle hizli tani buyuk onem tasimaktadir. Akut menenjit ve ensefalit etyolojisinde en sik karsilasilan etken viruslerdir. Bu etkenler arasinda Herpes simpleks virus (HSV) onemli bir yere sahiptir. MSS enfeksiyonu tanisinda, HSV DNA’nin beyin omurilik sivisi (BOS)’nda polimeraz zincir reaksiyonu (PZR) ile tespit edilmesi altin standart olarak kabul edilmektedir.Bu calismada 2008-2015 yillari arasinda, MSS enfeksiyonu on tanili hastalarin, ESOGU Tip Fakultesi Tibbi Mikrobiyoloji Anabilim Dali Laboratuvari’na gonderilen BOS orneklerinin Real time PZR sonuclari retrospektif olarak degerlendirilmistir. Bu BOS orneklerinde DNA izolasyonu yapildiktan sonra Artus HSV1/2 RG PCR ( Qiagen, Almanya) kitleri kullanilarak Gercek zamanli polimeraz zincir reaksiyonu ile Rotor Gene (Corbett Research 6000, Avustralya) cihazinda HSV1/2 DNA varligi arastirilmistir. Kullanilan kitin analitik duyarliligi HSV-1 ve HSV-2 icin sirasiyla 120 ve 160 kopya/mL’dir. Toplam 176 BOS ornegi degerlendirilmis olup; bu orneklerin 93’u (%52.8) erkek, 83’u kadin (%47.2) hastalara aittir. Hastalarin yas araligi 1-74 arasinda degismektedir. Gonderilen 176 BOS orneginin 9’unda (%5.1) HSV-1 DNA pozitif saptanirken hicbir BOS orneginde HSV-2 DNA saptanmamistir. HSV-1 DNA’si pozitif saptanan hasta orneklerinden 4’u Enfeksiyon Hastaliklari, 3’u Noroloji, 2’si ise Anestezi ve Reanimasyon kliniklerinden gonderilmistir. SSS enfeksiyonlari nadir gorulmekte ancak insidanslari tam olarak bilinmemektedir. HSV’ye bagli SSS enfeksiyonlarinda, etkili antiviral tedaviye baslama ve mortalitenin azaltilmasi acisindan etkene yonelik erken tani cok onemlidir. Bu grup hastada gercek zamanli PZR gibi molekuler yontemlerin uygulamaya girmesi, tedavinin belirlenmesi acisindan klinisyen hekimlere onemli oranda katki saglamaktadir.

Aim:Chronic Hepatitis C is a serious disease than can result in long-term health problems. It is known that different genotypes in HCV infections account for differences in disease courses and treatment responses. Our study aimed to determine the HCV genotype distribution of patients with chronic hepatitis C infection. Material and Method: This study investigated the anti-HCV, HCV RNA viral loads, and HCV genotypes of 203 patients who were followedup in Eskisehir Osmangazi University Medical Faculty from 2009-2014. Anti-HCV was tested by microparticle ELISA (Abbott AxSYM System HCV 3.0). HCVRNA viral loads were determined by Artus HCV RG PCR kit (QIAGEN) on a Rotor-Gene 6000 (Corbett Research) instrument between 2009-2011, and by Cobas TaqMan 48 (Roche) between 2011-2014 by Real Time PCR. Genotyping of HCV RNA positive patients was performed by HCV genotype Pyrosequencing test and PCR based assay Abbott Real Time Genotype II (USA). Results: The distribution of HCV genotypes was as follows: In 151 (74.4%) patients genotype 1; in 36 genotype 1b (17.7%), in 5 type 1a (2.4%), in 3 genotype 2(1.4%); in 4 genotype 3(1.9%); and in 4 genotype 4(1.9%). HCV viral loads were between 1.25x10(3)-8.35x10(7). In 191 (94.0%) patients, anti-HCV was positive and in 12 (6.0%), anti-HCV was negative. Discussion: The most common HCV genotype in the Eskisehir region was genotype 1, and the most common subtype in this group was genotype 1b. Treatment protocols should be reevaluated by taking into consideration that sustained viral response in these patients might be weak. In Turkey, approximately 90% of HCV infections are of type 1 (most are type 1b), although types 2, 3, and 4 HCV infections are also seen.

PubMedID: 27118199 Systemic sclerosis (SSc) is an autoimmune connective tissue disease with multisystem involvement. An increased incidence of cancer in SSc patients compared with the general population has been reported in several reports. Our aims in this study were to determine the most common malignancies and to investigate the possible risk factors for the development of malignancy in patients with SSc. Three hundred forty SSc patients from 13 centers were included to the study. Data of the patients were obtained by evaluating their medical records retrospectively. A total of 340 patients with SSc were evaluated. Twenty-five of the patients had 19 different types of malignancy. Bladder cancer was the most common type of cancer with four patients and was followed by breast cancer with three patients, and cervix cancer and ovarian cancer with two patients each. Other types of cancers such as squamous cell skin cancer, adenocancer with an unknown origin, multiple myeloma, chronic myeloid leukemia, papillary thyroid cancer, larynx cancer, non-small cell lung cancer, follicular type non-Hodgkin lymphoma (NHL), endometrium cancer, colon cancer, uterus cancer, neuroendocrine tumor, glioblastoma multiforme, and soft tissue sarcoma were diagnosed in one patient each. The only cancer type that showed an association with cyclophosphamide dose was bladder carcinoma. Other malignancies did not show a correlation with age, sex, smoking, type and duration of the disease, autoantibodies, organ involvement, and dose and duration of cyclophosphamide therapy. Cancer may develop in any organ in patients with SSc. Continuous screening of the patients during a follow-up period is necessary for the early detection of the tumor development. © 2016, International League of Associations for Rheumatology (ILAR).

Candida glabrata is one of the most frequent organisms isolated from superficial and invasive fungal infections, after Candida albicans. This organism also exhibits intrinsically low susceptibility to azole antifungals and treatment often fails. The microdilution method is not very practical for use in routine susceptibility testing in the clinical laboratory, thus necessitating the use of other methods. In this study, we compared the in vitro activity of five antifungal agents in three different groups (echinocandin, polyene and azole) against 50 C. glabrata isolates by broth microdilution and disk diffusion methods recommended by Clinical Laboratory Standards Institute CLSI M27-A3 and CLSI M44-A, respectively. All the isolates were susceptible to amphotericin B (100%) and 98% of the isolates were susceptible to caspofungin by the broth microdilution method. Within the azole group drugs, voriconazole was the most active followed by fluconazole and itraconazole in vitro. The highest rate of resistance was obtained against itraconazole with a high number of isolates defined as susceptible-dose dependent or resistant. Although the disk diffusion method is easy to use in clinical laboratories, it shows very poor agreement with the reference method for fluconazole and itraconazole against C. glabrata (8% and 14%, respectively).

Human papillomavirus (HPV) infections have a broad range of clinical spectrum from subclinical or asymptomatic infection to anogenital carcinoma. The detection of HPV-DNA and determination of the risk groups in cervical cancer (CC) screening is very important because CC is considered to be a preventable illness which is the third most common cancer type of women in the world. The aims of this study were to investigate the presence of HPV-DNA in women by two different molecular methods and to compare their results together with the results of cytology, in Eskişehir, Central Anatolia, Turkey. A total of 1081 women aged between 30-65 years, who applied to Eskişehir Early Diagnosis, Screening and Training of Cancer Center (KETEM) for screening were included in the study. Three separate cervical samples were collected simultaneously from the participants for cytologic examination and molecular studies. In the first step of the study, all cervical samples were investigated for the presence of HPV-DNA by Hybrid Capture 2 (HC2; Qiagen, Germany) method. In the second part of the study, consensus real-time polymerase chain reaction (RT-PCR) (Takara Bio Inc., Japan) was performed in 152 samples which included HC2 positive and randomly selected negative samples, and then the HPV genotypes were detected by using a commercial kit based on pyrosequencing method (Diatech Pharmacogenetics S.R.L, Italy). In the first part of the study, HC2 test was found positive in 3% (32/1081) of the women, while in 4.4% (47/1081) Pap smear was positive alone or with HC2 test. Five (0.5%) samples yielded positive results with both of the methods, and four of them were positive for high risk HPV types. Cytology results were negative in 19 out of 23 (23/1081, 2.1%) samples that were reported as high risk HPV by HC2 test. On the other hand, 42 (42/1081, 3.9%) samples that were positive by cytology yielded negative results by HC2 test. In the second part of the study, 32 (21.1%) of 152 selected samples were positive by HC2 test, 40 (26.3%) were positive by Pap smear, and 53 (34.9%) were positive by consensus RT-PCR. All of the 32 samples that were positive by HC2 were also positive by RT-PCR, however 21 samples that were positive by RT-PCR were negative by HC2 test. Among 40 samples that were positive (abnormal) by Pap smear, HPV-DNA was positive in nine (22.5%) by RT-PCR and in five (12.5%) by HC2 test, but HPV-DNA was not detected in 31 (77.5%) samples by both of the tests. Genotyping of the strains could be performed in 44 samples, and the most common type detected was HPV type 16 (n=15, 34.1%), followed by type 90 (n=11, 25%) and type 18 (n= 4, 9.1%). In our study, the sensitivity, specificity, positive and negative predictive values of Pap smear method were estimated as 16.1%, 96%, 10.6% and 97.5%, respectively, based on the HC2 results which was approved by U.S. Food and Drug Administration (FDA). In addition, a significant degree of concordance was detected between HC2 and concensus RT-PCR methods (Cohen's kappa: 0.665). In conclusion, regarding the insufficient number of cytopathologists in our country and according to the recommendations of American Society for Colposcopy and Cervical Pathology (ASCCP) and FDA, it was once again demonstrated that, the implementation of molecular diagnostic methods in addition to the Pap smear for effective screening of CC are needed.

Cytomegalovirus (CMV) infections continue to cause significant morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. Successful pre-emptive therapy in transplant patients depends on the availability of reliable diagnostic tests for CMV infections. The purpose of this retrospective study was to evaluate CMV DNA viral load, incidence of CMV disease and CMV seropositivity, risk factors and correlation between CMV DNA positivity and clinical course in HSCT patients.Two hundred and twenty-five patients who underwent peripheral blood stem cell or bone marrow transplantation between June 2003 and April 2010 were included. A real-time polymerase chain reaction (RT-PCR) assay was used for CMV monitoring.Recipient median age was 42.5 years. CMV seropositivity was 95.6%. CMV DNA positivity determined by RT-PCR was 24.9% among the entire patient group. CMV DNA positivity with RT-PCR was found to be significantly higher in allogeneic transplant recipients than autologous transplant recipients (46.7% vs 14.0%; P0.0001). Gender, age, conditioning regimen, stem cell source, underlying disease and recipient and donor seropositivity (alone or paired) were not significant risk factors for CMV DNAemia. We did not observe any CMV end-organ disease.CMV DNAemia was significantly higher in allogeneic transplant recipients than in autologous transplant patients. End-organ disease could be prevented with appropriate pre-emptive therapy.

The aim of the study was to determine the HPV prevalance and its relation to Pap smear, colposcopy and colposcopy directed biopsy in our region of Eskisehir, Turkey.A total of 615 women who applied to the outpatient clinic between December 2009 and December 2010 constituted our study population. All patients underwent pelvic examination and Pap smear sampling. Patients who had pathological cervical appearance or Pap smear results of ASCUS, AGUS, LSIL or HSIL were referred to colposcopy. Cervical samples for HPV DNA were taken from the patients before Pap smear sampling during the routine examination or before the colposcopic evaluation.Twenty six of 615 patients (4%) were HPV positive. Of these 26 patients, 12 were positive for HPV type 16, 3 for type 18, 3 for type 51, 2 for type 6, 1 for type 52, 1 for type 33, 1 for type 16 and type 31, 1 for type 6 and 52, 1 for type 56 and 90, 1 for type 39 and 66. In 4 patients with cervical cancer, and in 3 of 4 CIN III cases both HPV DNA and Pap smear were positive. In the Pap smear examination of 615 patients, cytology revealed 35 ASCUS (5.6%) 4 AGUS (0.6%), 2 CIN I (0.3%) results who were negative for HPV DNA. These patients with abnormal cytology (n=41) underwent colposcopy directed biopsy, there were 3 CIN I and 1 CIN III and all the other cervical biopsy results of these patients were benign (inflammation, chronic cervicitis).HPV positivity in our hospital setting is low which is compatible with other studies in Turkey. In positive HPV cases there is a good correlation between HPV type and positive cervical biopsy results.Çalışmanın amacı Türkiye’nin Eskişehir bölgesinde HPV prevalansı ve bunun Pap smear, kolposkopi ve kolposkopik biopsi ile ilişkisini belirlemektir.Aralık 2009 ile Aralık 2010 tarihleri arasında polikliniğimize başvuran 615 hasta çalışma grubumuzu oluşturdu. Bütün hastalara pelvik muayene yapılıp, hastaların hepsinden Pap smear alındı. Serviksinde patolojik görünüm olan hastalara veya Pap smear sonucu ASCUS, AGUS, LSIL veya HSIL olan hastalara kolposkopik inceleme yapıldı. Hastalardan ya rutin değerlendirme sırasında Pap smear alınmadan önce ya da kolposkopik muayene öncesinde HPV DNA için servikal örnek alındı.Altıyüzonbeş hastanın 26’sı (%4) HPV pozitifti. Bu 26 hastanın 12’sinde HPV tip 16, 3 tanesinde tip 18, 3 tanesinde tip 51, 2 tanesinde tip 6, 1 tanesinde tip 52, 1 tanesinde tip 33, 1 tanesinde tip 16 ve tip 31, 1 tanesinde tip 6 ve 52, 1 tanesinde tip 56 ve 90, 1 tanesinde tip 39 ve 66 mevcuttu. Serviks kanseri olan 4 hasta ve CIN III olan 4 hastanın 3’ünde hem HPV DNA hem de Pap smear pozitifti. Altıyüzonbeş hastanın Pap smear sonuçlarına bakıldığında HPV DNA negatif olan 35 ASCUS (%5.6), 4 AGUS (%0.6), 2 CIN I (%0.3) olan hasta vardı. Anormal sitolojisi olan bu 41 hastaya kolposkopik biopsi yapıldı ve sonuçta sadece 3 hastada CIN I, 1 hastada CIN III varken kalan hastaların biopsi sonuçları benigndi (inflamasyon, kronik servisit).Hastanemizde yapılan bu çalışmada elde edilen HPV oranları Türkiye’de yapılan diğer çalışmalarla uygun olarak düşük bulundu. HPV pozitif olan vakalarda HPV tipi ile pozitif servikal biopsi sonuçları arasında kuvvetli bir korelasyon mevcuttur.

The aim of this study was to determine the frequency of tinea pedis and manuum (dermatophyte infections of the hands and feet) in adults in rural areas of Turkey, the risk factors and self-administered treatment options. A total of 2,574 people living in a rural area were enrolled in the study. Participants were asked demographic data, hygienic habits in a questionnaire. KOH preparations and culture were performed from suspicious lesions. Medical and alternative therapy methods and former dermatophytosis diagnosis history were taken from the respondents with suspicious lesions. Microbiological samples were taken from 285 (11.1%) participants. Culture was positive in 109 (4.2%) of those. The most common agent was Trichophyton rubrum. The predisposing factors were found as age older than 40, male gender and obesity. Forty-nine (44.9%) of patients had taken a medical therapy, 56 (51.4%) had performed non-medical methods (cologne, Lawsonia inermis-Henna and softener creams). Patient's education about the treatment compliance is important.

Background: Influenza infection is a significant cause of morbidity and mortality in general population. Hemodialysis patients are considered at high risk of influenza infection given their altered immune status. Pandemic influenza virus is new for human beings, so it is hard to predict the response to infection or vaccination. We aimed to evaluate the response to pandemic H1N1 vaccination in hemodialysis patients. Methods: A total of 70 patients on chronic hemodialysis and 20 controls who had been vaccinated against the pandemic influenza virus 5 weeks before the time of blood sampling were included into this study. The anti-H1N1 immunoglobulin G (IgG) antibodies of the patients were studied with enzyme immune assay (EIA) method. Our cut-off optical density (OD) value was 1.503. If the patient’s OD value was equal or higher than this value, it was considered as positive. If it was lower, it was considered as negative. Results: The mean OD value was 2.22 ± 0.42 in the patient group and 1.99 ± 0.34 in the control group (p < 0.05). Two of 70 patients and 1 of the controls had negative OD values and they were considered as nonresponsive to vaccination. There was also a negative correlation between the age and OD values in the patient group (r = −0.277, p < 0.05). Conclusion: H1N1 vaccine can be performed safely and cost effectively with a single dose to the risk groups especially to the hemodialysis patients. Evaluation of H1N1 IgG antibody with enzyme-linked immunosorbent assay (ELISA) may be a safe, easy, and cost-effective assay.

Combinations of voriconazole, fluconazole, and itraconazole with caspofungin were evaluated against 50 Candida glabrata isolates by the time-kill, disk diffusion, and Etest methods. The majority of antifungal combinations were indifferent. By the time-kill method, synergistic activity was detected with eight (16%) of the caspofungin-voriconazole and seven (14%) of the caspofungin-fluconazole combinations, but synergy was not seen with the caspofungin-itraconazole combination. Further comparisons of the Etest and disk diffusion synergy techniques with the time-kill method are warranted.

The aim of this study is to determine the knowledge, beliefs, and practices of a population living in a rural area in regards to tick bites and Crimean-Congo hemorrhagic fever (CCHF). The study was conducted in a rural area located in Central Anatolia in the region of Eskisehir. A total of 1,500 individuals aged 20 years and older chosen by a stratified random sample were enrolled. A questionnaire was administered in person. In 264 (17.4%) participants, there was a history of being bitten by a tick. This rate was higher in older persons, males, married persons, and farmers. The most commonly reported protective behavior was wearing long sleeves and long pants when wandering in rural areas (65.1% of participants). The least commonly reported behavior was using insect repellent on skin or clothes (3.3% of participants). Only 799 participants (54%) had heard about CCHF as a disease associated with ticks. Females, those with primary school education, housewives, and male farmers had a high frequency of having heard about CCHF. Tick bites and CCHF are important public health problems, yet the current knowledge of these problems is not sufficient in populations living in rural areas of the Middle Anatolian Region of Turkey.

The in vitro activities of caspofungin plus amphotericin B against 50 Candida glabrata isolates were evaluated by the time-kill, disk diffusion, and Etest methods. In vitro experiments showed a positive interaction. Even though each of these methods uses different conditions and endpoints, the results of the different methods frequently agreed.

Parvovirus B19 has a marked tropism for erythroid progenitor cells. This may lead to chronic anemia in predisposed individuals. The purpose of the study was to investigate the frequency of parvovirus B19 infections in patients with diagnosis of haematological disorders. In order to determine the diagnostic use of different markers of parvovirus B19 infection, serum specimens obtained from 79 patients with haematological disorders were tested for specific antibodies and viral DNA through the use of ELISA and PCR techniques. Evidence of parvovirus B19 infection was found in 23/79 (29.1%) patients by demonstrating viral DNA and/or specific IgM antibody. B19 infection was established in 3 of 11 patients with chronic myeloid leukemia, in 3 of 11 acute myeloid leukemia, in 2 of 11 patients with multiple myeloma, in 3 of 8 patients with Hodgkin's lymphoma, in 5 of 10 patients with non-Hodgkin's lymphoma, in 1 of 6 patients with myelodysplastic syndrome, in 4 of 11 patients with chronic lymphocytic leukemia, and in 2 of 11 patients with acute lymphocytic leukemia. In 4 of 23 positive patients, only parvovirus B19 DNA could be detected, while 7 patients were tested positive for both parvovirus B19 DNA and specific IgM. Nine patients were tested positive for both B19 DNA and specific IgG. In the remaining 3 positive patients only specific IgM could be detected. Due to the discrepancies between DNA and IgM results, the diagnostic procedures should include a search for specific DNA by PCR methods if specific IgM has been found to be negative.

Aim: The aim of this study was to define the prevalence of HPV DNA in females aged 30-65 years who presented for scanning at Eskisehir Training Centre for Early Cancer Diagnosis and Scanning (KETEM) and to research the effect of potential risk factors on HPV DNA positivity. Method: The study comprised 1081 females aged 30-65 years who presented for scanning at Eskisehir Training Centre for Early Cancer Diagnosis and Scanning (KETEM). All participants completed a questionnaire with demographic information and data on potential risk factors then cervical smear samples were taken according to the kit manufacturer's instructions. The testing to determine the presence of HPV DNA in the samples was applied at the Microbiology Laboratory of Eskisehir Osmanagazi University Medical Faculty using the Hybrid Capture 2 kit (HC 2: Qiagen, Hilden, Germany). The SPSS 20.0 statistical software was used for the molecular method results and the statistical analysis of the questionnaire data. Results: The high risk and low risk subjects included in the study were examined separately for the presence of HPV. In a total of 32 samples (3.0%), HPV was determined to be present with the HC 2 test. In the statistical analysis of the results of a survey applied to the participants for evaluating the risk factors; significant effection HPV DNA positivity was determined on the variables such as, a higher number of births, protection with oral contraception (OCS) method and smoking. Conclusions: In addition to the prevention of cervical cancer, scanning programs are also important in protection against HPV infection. Applications which could be implemented on this subject can be considered as defining the potential risk factors and taking precautions against them. More detailed studies should be conducted in Turkey to research the relationship between HPV infections and social groups, the frequency of HPV infection,results, follow-up, treatment, control and prevention. Communities must be made aware of this subject throughpublic health education. [TAF Prev Med Bull 2015; 14(3.000): 222-228]

Background Rheumatoid Arthritis (RA) is a chronic, inflammatory, autoimmune disease (1). Adiponectin is an adipocytokin which has anti-atherogenic, anti-angiogenic, anti-inflammatory and anti-tumor effects (2). Adiponectin also increases the sensitivity to insulin (3). Objectives The aim of this study was to investigate the relationship between disease activity, acute phase response, insulin resistance and adiponectin levels, known to have antiinflammatory effects in RA. Methods Sixty-five patients with RA and thirty patients with osteoarthritis (OA) who fulfilled the American College of Rheumatology (ACR) classification criteria for each disease were included for this study. Patients who have a previous history of diabetes mellitus or recieving oral anti-diabetic agents, insulin, anti-obesity drugs or disease modifying anti-rheumatismal drugs were excluded. Body mass index, acute phase reactants, DAS-28, fasting blood glucose, insulin levels and adiponectin levels were measured at the beginning (0. month) and 3th month of the therapy in RA patients. Results Adiponectin levels at the third month of the therapy were significantly increased compared with baseline levels. However there was no correlation between adiponectin levels and disease activity or acute phase reactans in both baseline and third month of the therapy. Acute phase response and DAS-28 decreased at the end of the 3rd month, as expected. The decrease in insulin resistance was statistically non-significant.There was no correlation between adiponectin levels and insulin resistance at the begining of the therapy but there was an inverse correlation at the end of 3rd month. Conclusions We believe that the cause of elevation in adiponectin levels and the decrease in insulin resistance are the results of immunsupresive therapy used in treatment of RA. References Scott DL, Wolfe F, Huizinga TWJ. Rheumatoid arthritis. Lancet 2010; 376: 1094-1108 Diez JJ, Iglesias P. The role of the novel adipocyte-derived hormone adiponectin in human disease. Eur J Endocrinol 2003; 148:293-300 Kadowaki T, Yamauchi T. Adiponectin ve adiponectin receptors. Endocrine Reviews 2005; 26(3): 439-451 Disclosure of Interest None Declared

This study was conducted to investigate the role of serum procalcitonin and CRP levels in determining etiology, treatment and prognosis in COPD patients with acute exacerbation.