Determination of Serum Differential Carnitine Ester Levels in HIV(+) Patients: A Cross-Sectional Study.

OBJECTIVE: It has been reported that carnitine deficiency is observed in various viral infections and in the follow-up of the prognosis of some diseases. In this cross-sectional study, we aimed to determine how carnitine ester derivatives change in HIV-positive patients. MATERIALS AND METHODS: In this study, 25 HIV-infected patients who applied to Harran University Faculty of Medicine Education Research and Practice Hospital Infectious Diseases and Clinical Microbiology Outpatient Clinic and who did not receive any antiretroviral treatment, as well as 25 healthy volunteers were included in the study. Carnitine ester levels in serum samples were measured by Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (LC-MS/MS) method (Shimadzu North America, Columbia, MD, USA). RESULTS: While suberoylcarnitine (C8DC), myristoleylcarnitine (C14:1), tetradecadienoylcarnitine (C14:2), palmitoleylcarnitine (C16:1), and linoleylcarnitine (C18:2) levels in HIV(+) patients were quite low compared to the control group, tiglylcarnitine (C5:1) levels were high (p ≤ 0.05). In addition, C5:1 and C14:2 index parameters according to VIP score, and C5:1 and C14:1/C16 index parameters according to ROC analysis were determined as markers with high potential to distinguish HIV(+) patients from healthy volunteers. CONCLUSION: This study showed that levels of acylcarnitine derivatives might be altered in HIV(+) patients, and the results obtained may contribute to a better understanding of carnitine metabolism.

Plasma Free Amino Acid Profile in HIV-Positive Cases.

BACKGROUND: Increasing the sensitivity and availability of liquid chromatography tandem mass spectrometry (LC-MS/MS) devices may provide advantages in terms of revealing the changes in metabolic pathways in HIV-positive patients and elucidating the physiopathology. INTRODUCTION: The aim of this study was to determine the difference in amino acid levels between HIV-positive patients and healthy individuals by using LC-MS / MS and investigate its relationship with HIV infection. MATERIAL AND METHODS: Concentrations of 36 different amino acids and their derivatives were measured and compared in venous plasma samples from 24 HIV-positive patients and 24 healthy individuals by using the LC-MS/MS method (Shimadzu North America, Columbia, MD, USA). RESULTS: HIV-positive subjects had significantly lower alanine, 1-methyl-L-histidine, valine, aspartate, cysteine, cystine, methionine, lysine, glutamine, imino acid, tyrosine, tryptophan, threonine, sarcosine, and argininosuccinic acid and significantly higher 3-methyl-L -histidine, asparagine, glutamate, and carnosine levels as compared to healthy controls. No significant differences were detected in other amino acids. CONCLUSION: The significant differences in amino acid profile between HIV-positive and healthy subjects may represent an auxiliary biomarker of cellular damage in asymptomatic HIV-positive patients that may be examined in more detail in further studies. It may also provide guidance for symptomatic cases in terms of the association between symptoms, clinical manifestations, and deficiency or excess of certain amino acids in the context of the complete metabolomics record of HIVpositive patients.

Single Nucleotide Polymorphism Analysis in HIV and Kaposi's Sarcoma Disease by Microarray Technique.

BACKGROUND: Emergence of Kaposi's Sarcoma in the cases other than HIV, following the use of immunosuppressant drugs, demonstrates that it is related to weak immunity. The fact that this malignancy does not occur in every HIV-positive patient suggests that genetic predisposition may also be effective. Replacement of one of the base pairs of adenine, guanine, cytosine, and thymine that constitute the DNA sequence in the human genome with another base pair can affect susceptibility to disease, response to treatment, and immunity. OBJECTIVE: The purpose of this study is to analyze the Single Nucleotide Polymorphism that could predispose to Kaposi's sarcoma of an HIV-infected patient and to identify which nucleotides such SNPs correspond to, using the microarray technology. MATERIALS AND METHODS: The blood samples of individuals, one of whom was diagnosed with Kaposi's Sarcoma HIV (+) visiting the outpatient clinic of infectious diseases polyclinic of Harran University Research and Practice Hospital and of a healthy individual with no Kaposi's Sarcoma, were used in the study. Following the DNA isolation of the blood samples taken from the respective individuals, a SNP analysis was conducted on the microarray device. 204,000 SNPs obtained were scanned later on in the databases in an attempt to identify the SNPs related to Kaposi's Sarcoma. RESULTS: In the 204,000 SNP screenings, we scrutinized the SNPs that differ in the case of Kaposi's Sarcoma [KS (+) and HIV (+)] on the basis of Control [KS(-) and HIV(-)] and HIV+ [KS(-)], and two SNPs of the ENDRA gene, three SNPs of the ADRA1A gene, six SNPs of the STIM1 gene, four SNPs of the EFNB2 gene, and one SNP of the CD209 gene were found to be different. However, when it comes to all SNPs (all the 204.000 SNPs) screened in terms of allele, it was observed that the AA and BB alleles were lower in the patient with Kaposi's Sarcoma [KS (+) and HIV (+)] compared to other groups and AB alleles were found to be higher than others in the patient with Kaposi's sarcoma [KS] (+) and HIV (+)]. CONCLUSION: In the microarray study we have conducted, 204,000 SNPs were screened for Control (HIV-) HIV (+) and HIV (+) patient with Kaposi's Sarcoma. It was found that 32,362 of those SNPs had different alleles in the Kaposi's Sarcoma [KS + HIV (+)] patient, while they had the same ones in the control [KS (-) and HIV (-)] and HIV + [KS (-)] group. 16 of the 32,362 SNPs took place among the genes related to Kaposi's Sarcoma. In the cases of Kaposi's Sarcoma with suspected diagnosis, it can be used as a beneficial laboratory test.

Oxidant and antioxidant parameters in people who fast during Ramadan, and those who do not.

BACKGROUND: Objectives: The main aim of this study was to compare, by a new automated colorimetric method, oxidant and anti-oxidant status of those who fast during Ramadan and those who do not. For this purpose, total oxidant status (TOS), total anti-oxidant capacity (TAC) levels and oxidative stress index (OSI) were analysed. By doing this, we hope to examine whether fasting has any beneficial effect on human health. MATERIALS AND METHODS: Fifty seven people were included in this study. Of these, 30 people had been fasting during the month of Ramadan for at least ten years, but 27 had never fasted in their life. On the 15th day of Ramadan, blood samples were obtained from both groups after 12 hours of fasting. RESULTS: The TAC levels of the fasting group (1.29±0,19) was quite higher than the non-fasting group (1,09±0,16) [EIC2][ICD3] [ICD4](p< 0.001). Similarly, in the fasting group TOS level and the OSI (respectively 12,77±2,23 and 1,01±0,25) was quite lower [EIC5][ICD6][ICD7] than in the non-fasting group (respectively 14,15±2,04 and 1,33±0,30), (p<=0.019 and p<0.001, respectively).These findings show that the TOS level of non-fasting group was high. This oxidative stress might cause various illnesses. Therefore, fasting could play a significant part in health-protection by increasing total anti-oxidant capacity.

Evaluation of 257 extra pulmonary tuberculosis cases at the Tuberculosis Control Dispensary, Van, Turkey.

OBJECTIVE: To determine whether there were any changes in demographic and clinical features of extrapulmonary tuberculosis cases. METHODS: This retrospective study was conducted at Yuzuncu Yil University, Van, Turkey, and comprised records of extrapulmonary tuberculosis patients treated between January 2009 and July 2014 at the tuberculosis control dispensary. Descriptive and clinical data, including age, gender, site of involvement, diagnostic method and coexisting systemic diseases, were noted. Any changes in terms of these parameters were investigated on a year-on-year basis. SPSS 20 was used for data analysis. RESULTS: There were 257 cases detected. Of them, 50(19.45%) related to 2009, 61(23.75%) to 2010, 24(9.33%) to 2011, 50(19.45%) to 2012, 47(18.28%) to 2013 and 25(9.72%) to 2014. Although lymph nodes were by far most frequently affected in 2009, 2010, 2011 and 2013; pleura was most commonly involved in 2012 and 2014. Age and gender distribution displayed no changes between 2009 and 2014 (p>0.05). However, diagnostic method of choice and frequency of co-existent systemic disorders displayed remarkable alterations in this period (p<0.05). CONCLUSIONS: Improved insight of clinicians for atypical demographic and clinical features at presentation may provide reduction of rates of morbidity and mortality due to extrapulmonary tuberculosis.

Could soluble urokinase plasminogen receptor (suPAR) be used as a diagnostic biomarker for ventilator-associated pneumonia?

BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker that is increasingly used for evaluation of systemic inflammation. This study was performed to investigate whether suPAR may possess a diagnostic value in patients with ventilator-associated pneumonia (VAP). METHODS: This clinical study was performed in the anesthesia intensive care units (ICUs) of our university. In addition to descriptive data, WBC, serum levels of C-reactive protein (CRP) and suPAR prior to and after development of VAP were noted and compared in 31 patients (22 men, 9 women) diagnosed with VAP (Study Group) and 19 patients without VAP (Control Group) in ICU (14 men, 5 women). RESULTS: The suPAR (P = 0.023), CRP (P = 0.037), WBCs (P = 0.024) in patients with VAP were significantly higher than patients without VAP. There was no remarkable difference in terms of WBCs (P = 0.052) and suPAR levels (P = 0.616) between groups on the first day of connection to mechanical ventilator. The suPAR and CRP levels in patients with VAP were significantly higher than prior to development of VAP (P = 0.001 for both). Area under curve value after diagnosis of pneumonia was found 0.248 (P = 0.002). CONCLUSION: To conclude, our results suggest that suPAR can be a useful diagnostic biomarker in patients with VAP. However, clinical trials on larger series are warranted to explore the clinical significance more accurately.

Comparative analysis of pulmonary and extrapulmonary tuberculosis of 411 cases.

BACKGROUND: Tuberculosis is a disease that can involve every organ system. While pulmonary tuberculosis is the most common presentation, extrapulmonary tuberculosis (EPT) is also an important clinical problem. The current study aimed to outline and compare the demographic and clinical features of pulmonary and extrapulmonary tuberculosis cases in adults. METHODS: Medical records of 411 patients (190 women, 221 men) treated between January 2010 and July 2014 in provincial tuberculosis control dispensary was retrospectively reviewed. Demographic and clinical characteristics were compared for pulmonary and extrapulmonary tuberculosis cases. RESULTS: Of these 411 cases, 208 (50.6%) had pulmonary tuberculosis (PTB) and 203 were diagnosed with extrapulmonary tuberculosis (EPTB) (49.4%). The average ages for PTB and EPTB groups were 33.00-27.00 and 31.00-29.75, respectively (p = 0.513). Men were more frequently affected by PTB (59.6%), while EPTB was more commonly detected in women (52.2%) (p = 0.016). Main diagnostic modalities for PTB were sputum/smear analyses (72.7%), clinical-radiological data (21.7%) and biopsy (6.1%); while biopsy (71.5%), sputum/fluid analysis (18.8%) and clinical-radiological data (4.9%) were used for confirming EPTB (p < 0.0019). The most common sites of EPTB involvement were lymph nodes (39.4%), followed by pleura (23.6%), peritoneum (9.9%) and bone (7.4%). CONCLUSIONS: Extrapulmonary involvement of tuberculosis is common and females are more likely to be affected. Increased clinical awareness is important since atypical presentations of the disease may constitute diagnostic and therapeutic challenges.

[Can mannose-binding lectin and plasma level of soluble urokinase receptor be used in diagnosis and treatment monitorization of brucellosis patients?]. / Brusellozlu Hastalarda Mannoz-Baglayan Lektin ve Plazma Çözünür Ürokinaz Reseptör Düzeyi Tani ve Tedavi Izleminde Kullanilabilir mi?

The aim of this study was to evaluate the diagnostic value of serum mannose-binding lectin (MBL) and plasma soluble urokinase plasminogen activator receptor (SuPAR) levels in monitoring the treatment in patients with brucellosis, by comparing their levels before and after treatment with the values obtained from healthy control group. Thirty brucellosis patients (mean age: 25.8 ± 12.2 years; 15 were male) and 28 healthy controls (mean age: 29.3 ± 12.3 years; 15 were male) were included in the study. Patients were diagnosed with brucellosis according to the characteristic clinical findings and by brucella standard tube agglutination test (SAT) titer ≥ 1/160 and/or blood culture positivity. Serum MBL (Antibodyshop, Denmark) and plasma SuPAR (Virogates, Denmark) levels were investigated with commercial ELISA kits. In our study, no statistical significance was observed between the pre-treatment (13.8 ± 13.4 ng/ml) and post-treatment (12.4 ± 13.1 ng/ml) MBL levels of the patient group and MBL levels of the control group (16.5 ± 14.8 ng/ml) (p> 0.05). Moreover, the mean SuPAR levels measured in pre-treatment and post-treatment plasma samples of the brucellosis patients was 5.1 ± 1.9 ng/ml and 2.9 ± 1.3 ng/ml, respectively, while the mean SuPAR level was 1.8 ± 0.5 ng/ml in the control group. The difference between mean SuPAR levels of patients in pre- and post-treatment samples was found statistically significant (p< 0.001). In addition SuPAR levels were significantly higher in patients before and after treatment than the control group (p> 0.001). In conclusion, plasma SuPAR level would be a useful marker for the diagnosis and treatment follow up of the patients with brucellosis.

Severe thrombocytopenia and hemorrhagic diathesis due to brucellosis.

BACKGROUND: We aimed to examine cases of brucellosis that presented with severe thrombocytopenia and hemorrhagic diathesis. METHODS: A total of 10 brucellosis cases with severe thrombocytopenia were included in this case-series study. Patients' files were reviewed for their clinical and laboratory findings, as well as clinical outcomes and complications. Platelet counts of < 20,000/mm³ were diagnosed as severe thrombocytopenia. RESULTS: The lowest thrombocyte count was 3000/mm³ while the highest was 19,000/mm³ (mean: 12,000/mm³). Patients had the following symptoms: epistaxis (7 cases), petechia with epistaxis (4 cases), bleeding gums (3 cases), ecchymosis with epistaxis (2 cases), melena and renal failure (2 cases), and hematuria (1 case). Patients were given rifampicin and doxycycline along with supportive hematological therapy. All were treated successfully with no evidence of recurrence at follow-up visits. CONCLUSION: Since brucellosis is endemic in developing countries, it must be considered in the differential diagnosis of cases that present with severe thrombocytopenia and hemorrhagic diathesis.

[Case report: two Plasmodium vivax malaria cases in the Van Province]. / Olgu Sunumu: Van Ilindeki Plasmodium vivax Sitmasi.

Malaria is an important parasitic infection which is endemic in the Eastern Mediterranean and Southeastern Anatolia regions and sporadic in other regions of Turkey, while Plasmodium vivax is the most common cause. Two patients who were admitted to our hospital in October with complaints of high fever, chills, nausea-vomiting, generalized body pain and fatigue and diagnosed as P. Vivax malaria are presented, because they were two brothers with no history of travel outside of Van city.