Role of migratory birds in spreading Crimean-Congo hemorrhagic fever, Turkey.

We investigated migratory birds' role in spreading Crimean-Congo hemorrhagic fever virus (CCHFV) through attached ticks. We detected CCHFV RNA in ticks on migratory birds in Turkey. Two isolates showed similarity with CCHFV genotype 4, suggesting a role for ticks in CCHFV epidemics in Turkey and spread of CCHFV by birds.

Effect of free creatine therapy on cisplatin-induced renal damage.

Abstract Cisplatin is one of the commonly used anticancer drugs and nephrotoxicity limits its use. The aim of this study is to investigate the possible protective effect of creatine supplementation on cisplatin-induced nephrotoxicity. Sixty male Sprague-Dawley rats were divided into three groups: Group I: Cisplatin (n=20) (7 mg/kg cisplatin intraperitoneal (i.p.) single dose), group II: Cisplatin+creatine monohydrate (n=20) (7 mg/kg cisplatin i.p. single dose and 300 mg/kg creatine p.o. daily for 30 days starting on first day of cisplatin injection), group III: Control group (n=20) (Serum physiologic, 2.5 mL/kg i.p.). Sacrifications were performed at first week and 30th day. Blood urea nitrogen (BUN) and serum creatinine levels, histopathological evaluation, mitochondrial deoxyribonucleic acid (mtDNA) common deletion rates, and body weights of rats were evaluated. A significant decrease in body weight, higher values of kidney function tests, histopathological scores, and mtDNA deletion ratios were observed in group I compared to control group at days 7 and 30 (p<0.05). In group II, there was a slight decrease in body weight at same days (p=0.931 and 0.084, respectively). Kidney function tests, histopathological scores, and mtDNA common deletion ratios were statistically better in group II than group I at 7th and 30th day (p<0.05). Although creatine significantly reversed kidney functions and pathological findings, this improvement was not sufficient to reach normal control group's results at days 7 and 30. In conclusion, the present study demonstrates that creatine administration is a promising adjuvant protective drug for reducing nephrotoxic effect of cisplatin.

Cryptosporidiosis: a rare and severe infection in a pediatric renal transplant recipient.

Cryptosporidium is an intracellular protozoan parasite that causes gastroenteritis in human. In immunocompromised individuals, cryptosporidium causes far more serious disease. There is no effective specific therapy for cryptosporidiosis, and spontaneous recovery is the rule in healthy individuals. However, immunocompromised patients need effective and prolonged therapy. Here, we present our clinical experience in a six-yr-old boy who underwent living-related donor renal transplantation and who was infected with Cryptosporidium spp. Our patient was successfully treated with antimicrobial agents consisting of spiramycin, nitazoxanide, and paromomycin. At the end of second week of therapy, his stool became negative for Cryptosporidium spp. antigen and spiramycin was discontinued. Nitazoxanide and paromomycin treatment was extended to four wk. With this case, we want to emphasize that cryptosporidiosis should be considered in the differential diagnosis of severe or persistent diarrhea in solid organ transplant recipients where rigorous antimicrobial therapy is needed.

Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis and bronchial asthma: a case report.

OBJECTIVE: Strongyloides stercoralis is a soil-transmitted intestinal nematode that has been estimated to infect at least 60 million people, especially in tropical and subtropical regions. Strongyloides infection has been described in immunosupressed patients with lymphoma, rheumatoid arthritis, diabetes mellitus etc. Our case who has rheumatoid arthritis (RA) and bronchial asthma was treated with low dose steroids and methotrexate. METHODS: A 68 year old woman has bronchial asthma for 55 years and also diagnosed RA 7 years ago. She received immunusupressive agents including methotrexate and steroids. On admission at hospital, she was on deflazacort 5 mg/day and methotrexate 15 mg/week. On her physical examination, she was afebrile, had rhonchi and mild epigastric tenderness. She had joint deformities at metacarpophalengeal joints and phalanges but no active arthritis finding. RESULTS: Oesophagogastroduodenoscopy was performed and it showed hemorrhagic focus at bulbus. Gastric biopsy obtained and showed evidence of S.Stercoralis infection. Stool and sputum parasitological examinations were also all positive for S.stercoralis larvae. Chest radiography result had no pathologic finding. Albendazole 400 mg/day was started for 23 days. After the ivermectin was retrieved, patient was treated with oral ivermectin 200 µg once a day for 3 days. On her outpatient control at 15th day, stool and sputum samples were all negative for parasites. CONCLUSION: S.stercoralis may cause mortal diseases in patients. Immunosupression frequently causes disseminated infections. Many infected patients are completely asymptomatic. Although it is important to detect latent S. stercoralis infections before administering chemotherapy or before the onset of immunosuppression in patients at risk, a specific and sensitive diagnostic test is lacking. In immunosupressed patients, to detect S.stercoralis might help to have the patient survived and constitute the exact therapy.

Assessment of genotoxicity in rats treated with the antidiabetic agent, pioglitazone.

Pioglitazone (PIO), a member of the thiazolidinedione class of antidiabetic agents, specifically targets insulin resistance. Drugs of this class act as ligands for the gamma subtype of the peroxisome proliferator-activated receptor. Although troglitazone, another drug in this class, displayed unacceptable hepatotoxicity, PIO was approved for human use by the U.S. Food and Drug Administration. To our knowledge, there are no published reports on the genotoxicity of PIO; however, the package insert indicates that it has minimal genotoxicity. In this study, we used the comet assay to investigate the DNA damage in the peripheral blood and liver cells of rats treated with PIO. Sixteen male Sprague-Dawley rats were randomly distributed into four groups, and dosed daily for 14 days by oral gavage with 0, 10, 20, and 40 mg/kg/day PIO. A dose-dependent increase in DNA damage, as assessed by % tail DNA, was observed in both hepatocytes and blood lymphocytes of the PIO-treated groups, with significant increases detected between the rats treated with all the doses of PIO and the control, and between the rats treated with different PIO doses (P < 0.005 to P < 0.0001). Treating nuclei from the exposed animals with an enzyme cocktail containing Fpg and Endonuclease III prior to performing the comet assay increased the level of DNA damage, which reflects oxidized purine and pyrimidine. Taken together, our data indicate that PIO is able to dose-dependently induce DNA damage in both the liver and blood lymphocytes of rats, which is partially due to the generation of oxidative lesions.

Osteoarthritis models after anterior cruciate ligament resection and medial meniscectomy in rats. A histological and immunohistochemical study.

OBJECTIVE: To compare the amount of degeneration based on the time spent, using 2 different methods of surgically induced osteoarthritis (OA) that frequently used in treating OA. METHODS: We undertook this research in Ondokuz Mayis University, Surgical Research Center between April 2006 and July 2006. In this study, 55 rats were used, 7 as the control group, and 12 in each of 4 groups. We compared the amount of OA formed by the medial meniscectomy (MMx) and anterior cruciate ligament transection (ACLT) at 8 and 16 weeks according to the Modified Mankin Score and histologically and immunohistochemically due to their response to Matrix metalloproteinase 13 expression (MMP13). RESULTS: We observed the highest degeneration in the MMx model at 8 weeks, and this situation continued until 16 weeks. However, the degeneration in the ACLT model was lower at 8 weeks compared with the MMx group, however, it reached the same amount as the MMX group at 16 weeks. CONCLUSION: The OA model formed by the ACLT method was better than the MMx model when degeneration and time were taken into consideration and should be used when researching drugs on an experimental basis in OA.

Detection and identification of cutaneous leishmaniasis isolates by culture, Polymerase chain reaction and sequence analyses in Syrian and Central Anatolia patients.

OBJECTIVES: To characterize the cutaneous leishmaniasis (CL) isolates of Syrian and Central Anatolia patients at species levels. Methods: Skin scrapings of 3 patients (2 Syrian, 1 Turkish) were taken and examined by direct examination, culture in Novy-MacNeal-Nicole (NNN) medium, internal transcribed spacer polymerase chain reaction and sequence analysis (PCR). Results:According to microscopic examination, culture and PCR methods, 3 samples were detected positive. The sequencing results of all isolates in the study were identified as Leishmania tropica. The same genotypes were detected in the 3 isolates and nucleotide sequence submitted into GenBank with the accession number: KP689599. Conclusion: This finding could give information about the transmission of CL between Turkey and Syria. Because of the Syrian civil war, most of the Syrian citizens circulating in Turkey and different part of Europe, this can be increase the risk of spreading the disease. So, prevention measurements must be taken urgently.

Genotoxicity in rats treated with the antidiabetic agent, rosiglitazone.

Rosiglitazone (RSG), a member of the thiazolidinedione class of antidiabetic agents, improves glycemic control by increasing insulin sensitivity. The therapeutic mode of action of RSG involves its activity as a highly selective and potent agonist for peroxisome proliferator-activated receptor-gamma. Although other drugs in this class have displayed unacceptable hepatotoxicity, RSG was approved for human use. The package insert indicates that RSG has minimal genotoxicity, but information on the genotoxicity of RSG is not available in the published literature. In this study, we used the single cell gel electrophoresis (SCGE)/Comet assay to investigate the DNA damage in peripheral blood and liver cells of rats treated with RSG. Sixteen male Sprague-Dawley rats were randomly distributed into four groups, and dosed daily by oral gavage with 0.0, 0.5, 1.0, and 2.0 mg/kg/day RSG. The rats dosed with 2.0 mg/kg/day RSG received an approximately 10-times the area under the curve concentration of the maximum recommended human daily dose. After 14 days of treatment, the rats were euthanized, and peripheral blood and liver were collected and processed for the Comet assay. A dose-dependent increase in DNA damage (as assessed by % tail DNA and Olive Tail Moment) was observed in the hepatocytes of RSG-treated groups, with significant increases detected between rats treated with all the doses of RSG and the control, and between rats treated with different RSG doses (P < 0.05 - P < 0.0001). In contrast, DNA damage was detected in peripheral blood lymphocytes only in rats treated with the higher RSG doses (1.0 and 2 mg/kg/day). Taken together, the data indicate that RSG is able to induce primary DNA damage in rats, with greater damage being detected in liver cells than lymphocytes.

Effects of acetic acid on the viability of Ascaris lumbricoides eggs. Is vinegar reliable enough to clean the vegetables?

OBJECTIVES: To investigate the effects of acetic acid on durable Ascaris lumbricoides (A. lumbricoides) eggs to determine the effective concentration of vinegar and the implementation period to render the consumption of raw vegetables more reliable. METHODS: This experimental study was performed in May 2015 in the Parasitology Laboratory, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey. The A. lumbricoides eggs were divided into 2 groups. Eggs in the study group were treated with 1, 3, 5, and 10% acetic acid concentrations, and eggs in the control group were treated with Eosin. The eggs' viability was observed at the following points in time during the experiment: 0, 10, 15, 20, 30, 45, and 60 minutes. RESULTS: The 1% acetic acid was determined insufficient on the viability of Ascaris eggs. At the 30th minute, 3% acetic acid demonstrated 95% effectiveness, and at 5% concentration, all eggs lost their viability. Treatment of acetic acid at the ratio of 4.8% in 30 minutes, or a ratio of 4.3% in 60 minutes is required for full success of tretment. CONCLUSION: Since Ascaris eggs have 3 layers and are very resistant, the acetic acid concentration, which can be effective on these eggs are thought to be effective also on many other parasitic agents. In order to attain an active protection, after washing the vegetables, direct treatment with a vinegar containing 5% acetic acid for 30 minutes is essential.

In Vivo Efficacy of Drugs against Toxoplasma gondii Combined with Immunomodulators.

The aim of this study is to evaluate the effects of pyrimethamine (PYR) and sulfadiazine (SDZ) combined with levamisole and echinacea on the survival of mice infected with Toxoplasma gondii. For this, we used 99 specific pathogen-free BALB/c mice. All the mice were infected intraperitoneally with 10(5) T. gondii tachyzoites and were divided into 11 groups, each including 9 mice. Except for the control group, oral treatment was initiated in all groups 24 h post infection and was continued for 10 days. The treatment regimen included dual combinations of PYR (dose, 6.25 and 12.5 mg/kg/day) and SDZ (dose, 100 and 200 mg/kg/day), triple combinations of PYR + SDZ, and levamisole (dose, 2.5 mg/kg/day) or echinacea (dose, 130 and 260 mg/kg/day) and echinacea alone (dose, 130 and 260 mg/kg/day). We observed that an effective dose of the combination of PYR + SDZ and levamisole resulted in a statistically significant increase in the survival rate from 33.3% to 88.9%. Similarly, half the dose of this combination resulted an increase in the survival rate from 0% to 44.4% (p < 0.05). Survival rate also increased in the groups treated with the combinations including echinacea; however, the difference did not reach statistical significance. The triple combination of PYR-SDZ-levamisole could be an alternative treatment option in case of infections caused by T. gondii.

Intrabiliary rupture: an algorithm in the treatment of controversial complication of hepatic hydatidosis.

AIM: Intrabiliary rupture (IBR) is a common and serious complication of hepatic hydatid cyst. The incidence varies from 1% to 25%. The treatment of IBR is still controversial. We aimed to design an algorithm for the treatment of hepatic hydatidosis with IBR by reviewing our cases. METHODS: Eight cases of IBR were analyzed retrospectively. Patients were evaluated according to age, sex, clinical findings, cyst number and stage, abdominal ultrasonography and CT-scan, surgical methods, complications, results and coincidental diseases. RESULTS: Female/male ratio was 1/7. Mean age was 52.12+/-18.26 years (range 24-69 years). Right upper quadrant pain, flatulence, palpable hepatic mass were symptoms common in all patients. Cholestatic jaundice was found in four cases. In all patients, cyst evacuation and omentoplasty were performed, followed by either choledochoduodenostomy, T-tube drainage, intracavitary suturing of the orifice, two cases in each. Whereas in two patients diagnosed post-operatively percutaneous drainage of biliary collection or ERCP and sphincteroplasty were added. Morbidity and hospital stay were higher in these cases. CONCLUSION: When the diagnosis of IBR can be done pre- or intra-operatively, morbidity decreases. If a biliary fistula is seen post-operatively, endoscopic procedures such as ERCP, sphincteroplasty or nasobiliary drainage can be applied.

Videolaparoscopic treatment of hepatic hydatid cyst.

BACKGROUND/AIMS: Unroofing, cystopericystectomy, or cystic evaluation and omentoplasty have been used in videolaparoscopic treatment in hepatic hydatidosis since 1992. Currently it is shown that videolaparoscopic treatment has been carried out successfully in selected cases. METHODOLOGY: Fifteen hepatic hydatid cysts in 12 cases were treated by videolaparoscopic methods. Formerly in the 5 cases, the cysts were aspirated with a needle designed for a 5-mm trocar, leaving a cystic cavity that was tension-free, then scolicidal solution was injected and aspirated. In the last 7 patients an aspirator-grinder apparatus was used. Intraoperative ultrasonography was applied in all patients. RESULTS: All the cysts were treated by drainage and omentoplasty. In one case cystic cavity infection was diagnosed in the 2nd postoperative month (morbidity rate 8.33%). Another patient died due to cerebral hydatid cyst and multiple organ failure after the postoperative first month (mortality rate 8.33%). Operative mortality was not seen. CONCLUSIONS: Videolaparoscopic treatments of hepatic hydatid cysts may be carried out successfully in selected cases.

A case of severe babesiosis treated successfully with exchange transfusion.

Babesiosis is a zoonotic disease that may be asymptomatic or result in severe clinical conditions, with severe hemolysis, hepatic, and renal failure, in humans. Clinical symptoms depend on the species and immune status of the host. The disease is especially severe in those of advanced age, those with an immune deficiency, and the splenectomized. A severe case of babesiosis that developed in a splenectomy patient is presented here; the patient was admitted from a rural region with severe anemia and a deterioration in her general condition, with an initial diagnosis of malaria. In such situations, an exchange transfusion (ET), in addition to antimicrobial treatment, could be lifesaving.

[Evaluating of Plasmodium species isolated from peripheral blood samples in a non-endemic region]. / Endemik Olmayan Bir Bölgede Periferik Kan Örnegi Incelemesinde Saptanan Plasmodium Türlerinin Degerlendirilmesi.

OBJECTIVE: Malaria is a parasitic disease, caused by Plasmodium species, which transmitted to humans through genus Anopheles mosquitoes. This disease widely spreaded in tropical and subtropical areas. The aim of our study is to evaluate malaria cases diagnosed by peripheral blood examination. METHODS: Peripheral blood samples sent to Parasitology Laboratory between 2001 and 2013 years, were examined using thick and thin blood smear techniques. RESULTS: A total of 102 blood samples obtained from suspected patients were examined and eight of them were found to be positive. All cases were male and Plasmodium falciparum and Plasmodium vivax was detected in seven (87.5%) and one (12.5%) of them, respectively. Blood samples were mainly sent from Departments of Infectious Diseases. All P. falciparum cases had a history about work or travel to different African countries. CONCLUSION: We think that patients who has fever and travel history to endemic countries especially in Africa, blood examination for malaria parasites should be taken into account in differential diagnosis.

Should intraoperative ultrasonography be used routinely in hepatic hydatidosis?

BACKGROUND/AIMS: Recurrent or secondary hydatidosis are the most important problems of hepatic hydatidosis in the late postoperative period. The spread of cystic liquid, overlooked centrally located or pericystic satellite cysts that are inconspicuous during operation are the basic reasons for the problem. METHODOLOGY: In order to prevent the risk of recurrent or secondary hydatidosis, 22 liver hydatid cystic patients were taken for a prospective study. Beyond the routine investigations and researches, after the completion of conventional surgical procedures, intraoperative ultrasonography was applied to all patients. RESULTS: In three patients the existence of cysts were not found by conventional research (13.63%), in another patient (4.54%) cysto-biliary communication which had been determined clinically but was invisible due to difficulty in anatomic localization was verified by means of intraoperative ultrasonography. CONCLUSIONS: Intraoperative ultrasonography has been thought to be beneficial to find centrally localized cysts which may be inconspicuous especially in cases of multiple cysts.

[A practical volume controlled bleeding method in animal hemorhagic shock model]. / Deneysel hemorajik sok modelinde hacim kontrollü pratik bir kanatma yöntemi.

The bleeding method is the most widely used technique in volume controlled hemorrhagic shock model that was described as withdrawing blood by an heparinized syringe from veins of laboratory animals. However the difficulty in establishing a constant bleeding rate and volume at a desired time is the major disadvantage of this technique. This disadvantage may also lead to the mortality during the exsanguinating phase due to inconstant bleeding rate. Reversely connected infusion pump that was described in this report is a useful and practical method to withdraw blood with predetermined bleeding volume and rate. The described method can easily be applied to various pathophysiological and metabolic studies on acute blood loss.

[Giardia muris infection in laboratory rats (Rattus norvegicus) and treatment with metronidazole]. / Laboratuvar Siçanlarinda (Rattus norvegicus) Giardia muris Enfeksiyonu ve Metronidazol ile Sagaltimi.

OBJECTIVE: This study was conducted to determine the effectiveness of metronidazole for treatment of Giardia muris infection in laboratory rats. METHODS: The feces of rats was yellow watery diarrhea and brought to the surgery research center of University of Ondokuz Mayis in order to be a study. Stool samples were examined by native examination, evaluation of infection rates was done with an X40 lens, and results were recorded as positive from 1 to 4. Metronidazole was administered to infected animals orally for 5 days with a 20 mg/kg dose. RESULTS: As a result of fecal examination of 64 rats held in groups of four in cages, 15 of the cages (60 rats) were found to be infected with G. muris. While agents were not observed in collected stool samples following 5, 7, and 14 days of drug administration of 14 groups, trophozoite density in one cage was decreased (75%), and adverse effects were not seen in rats. CONCLUSION: Metronidazole was found to be an effective drug for the treatment of giardiasis.

The beneficial effects of Momordica charantia (bitter gourd) on wound healing of rabbit skin.

Momordica charantia (MC; bitter gourd) is a traditional herbal commonly used for its antidiabetic, antioxidant, contraceptive and antibacterial properties. In the current study, the authors aim to observe the topical effect of MC cream on the wound-healing process in rabbits. Moreover, they compare the healing potential with conventional creams used therapeutically. Towards this aim, 28 New Zealand rabbits were divided into four groups and excision wounds (7 cm²) were made on their backs. Open wound dressing was carried out daily for 28 days among the experimental groups with the application of dekspanthenol (Bepanthen®; BP group, n = 7), nitrofurazon (Furacin®; FR group, n = 7) and olive oil extract of MC (MC group, n = 7). No application was made to the control group. At the end of day 28, areas of the skin with initial wound area were en bloc dissected and prepared for histopathological and stereological analysis. Inflammatory cells were abundant in the control group and cream application led to a decrease in the number of these cells, especially in the MC group. The highest number of fibroblasts was detected in the MC group. Furthermore, the MC group displayed the highest fractions of epidermis to papillary dermis, fibroblasts to reticular dermis and collagen fibres to reticular dermis. The MC group also presented a high density of blood vessels, moderate density of collagen fibres and mature fibroblasts. The BP group showed better epithelialisation compared with the FR group, but the latter provided more effective reorganisation of the dermis. Different cream supplements caused healthy and fast wound healing according to untreated controls and the results show that administration of the MC extract improves and accelerates the process of wound healing in rabbits in comparison with the BP and FR extracts.

In Vitro Effects of Ivermectin and Sulphadiazine on Toxoplasma gondii.

OBJECTIVE: Ivermectin and sulphadiazine were tested individually to determine their in vitro effects on Toxoplasma gondii grown in human epidermoid larynx carcinoma (Hep-2) cell culture. STUDY DESIGN: In-vitro study. MATERIAL AND METHODS: Toxoplasma growth was quantities by an enzyme immunoassay performed directly on the fixed cultures, using a rabbit anti-T. gondii immunoglobulin G as the first antibody and a phosphatase-labeled anti-rabbit immunoglobulin G as the second antibody. For each drug, regression models were used to quantify the relationship between optical density values and antimicrobial agent concentrations in the cultures. RESULTS: The 50% inhibitory concentrations (IC50) of ivermectin and sulphadiazine were found to be 0.2 µg/mL and 7.3 µg/mL after 48 h of exposure, respectively. None of the concentrations tested for each drugs demonstrated toxicity to Hep-2 cells after 72 h of incubation. CONCLUSION: These results indicate that ivermectin significantly inhibited replication of the tachyzoites of T. gondii RH strain.

[Evaluation of materials sent due to suspected cystic echinococcosis to the parasitology laboratory of Ondokuz Mayis University Medical School between the Years 2005-2011]. / Kistik Ekinokokkozis Süphesi ile 2005-2011 Yillari Arasinda Ondokuz Mayis Üniversitesi Tip Fakültesi Parazitoloji Laboratuvarina Gönderilen Örneklerin Degerlendirilmesi.

OBJECTIVE: Cystic echinococcosis (CE) is an important health problem common in our country. In this study, anti-Echinococcus granulosus IgG antibodies were investigated in the serum samples of 454 patients who attended the Ondokuz Mayis University, Faculty of Medicine, Department of Parasitology between 2005 and 2011. METHODS: IHA (Fumouze, France) and ELISA (R-Biopharm, Germany) tests were performed at the same time. RESULTS: While serum samples from 328 patients (72%) were negative with both tests, 81 samples (18%) were found to be positive with both tests. Forty (49%) cases were female, 41 (51%) cases were male who were positive by both tests. 25 (31%) positive cases were between 31 and 50 years old. While IHA was negative for 33 patients (7%) ELISA was positive for the same samples. In 2 patients (0.4%), both tests revealed low-positivity. CONCLUSION: Using these two tests together for serologic detection of cystic echinococcosis could be recommended because of the high sensitivity and specificity ratios.