Effects of clinoptilolite on heavy metal levels in milk, proinflammatory cytokine responses (IL-1ß and IL-6) and oxidative stress in dairy cows.

The effects of clinoptilolite on milk copper (Cu), lead (Pb), zinc (Zn), cadmium (Cd) and iron (Fe) concentrations, proinflammatory cytokine responses, oxidative stress status, whole blood cell counts and liver and kidney functions were investigated in dairy cows exhibiting no signs of any kind of toxicity. Clinoptilolite was added to the feed at a dose of 200 mg kg-1 body weight in the clinoptilolite-treated group (n = 14), but was not added to the feed in the control group (n = 7). In the milk samples (n = 21) collected before the experiment, the Cu, Pb, Zn, Cd and Fe values were 0.021 ± 0.020, 0.104 ± 0.01, 3.42 ± 0.32, <0.000, 0.56 ± 0.34 ppm, respectively. At the end of the experiment (30th day), among the elements measured in milk samples collected from the clinoptilolite-treated group, only the Pb value (0.076 ± 0.01) was lower than the 0-day value of the clinoptilolite-treated group (0.104 ± 0.01) and the 30th-day value of the control group (0.105 ± 0.01) was found to be statistically lower. Changes determined at the end of clinoptilolite application in serum superoxide dismutase (SOD), malondialdehyde (MDA), albumin, glucose, urea and urine creatinine/urine total protein (uCr/uTP) values, which were interpreted as the effect of lead exposure before the trial, were evaluated as the positive effect of clinoptilolite. It was concluded that the addition of clinoptilolite to the feed in dairy cows caused a significant decrease in the amount of Pb in milk, and positive changes in the parameters related to oxidative stress in serum and in parameters related to renal function.

The relationship between platelet indices and ABO blood groups in healthy adults.

BACKGROUND: ABO blood groups have been suggested to have a high correlation with cardiovascular diseases (CVDs). It has also been postulated that platelet indices, including mean platelet volume (MPV) and platelet distribution width (PDW), are very important in the development and progression of CVDs. However, despite these common associations with CVDs, as far as we know, there are no studies investigating platelet indices in ABO blood groups. Thus, the aim of this study was to investigate whether platelet indices are associated with ABO blood groups. METHODS: The study included 301 healthy volunteers (99 women and 202 men; mean age: 32.59 ± 7.52 years) whose blood groups were determined by the gel column method using agglutination techniques. Platelet indices were studied by an automated blood counter. RESULTS: No considerable differences in age, gender, or Rh factors were observed among ABO blood groups. MPV was detected to be considerably lower in O and A blood group subjects than in AB and B blood group subjects. Similarly, PDW was significantly lower in O and A blood group subjects than in B blood group subjects. Additionally, MPV in the O blood group subjects was significantly lower than in the non-O blood group subjects. CONCLUSIONS: Because MPV and PDW are used as markers of CVDs, individuals with O and A blood groups in this study may be considered to have a lower risk of CVDs than AB and B blood group subjects. However, prospective cohort studies involving a greater number of volunteers are needed to elucidate these relationships.

Clinical and Laboratory Features of CD5-Negative Chronic Lymphocytic Leukemia.

BACKGROUND Chronic lymphocytic leukemia (CLL) usually expresses CD5 antigen. However, 7-20% of patients are CD5 negative. We report here a series of 19 CD5-negative B-CLL cases. MATERIAL AND METHODS We reviewed 19 consecutive CD5-negative B-CLL cases seen in our medical center from 2009 to 2015 and compared them with 105 CD5-positive B-CLL cases. The two groups were compared in terms of clinical parameters, laboratory parameters, and survival characteristics. RESULTS Lymphadenopathy was present in 31.5% of the CD5-negative group and 51.4% of the CD5-positive group (p=0.029). Splenomegaly was present in 42.1% of the CD5-negative group and 16.1% of the CD5-positive group (p=0.029). There was no difference between the groups in terms of Binet A, B, and C stages (p=0.118, p=0.051, and p=0.882, respectively). The median thrombocyte count was 144×109/L and 160×109/L in the CD5-negative and CD5-positive groups, respectively (p=0.044). There was no difference between the two groups in terms of median neutrophil count (p=0.169). The mean lymphocyte count was 43.2±4.0×10^9/L and 36.7±3.2×10^9/L in the CD5-negative and CD5-positive groups, respectively (p=0.001). There was no difference between the groups in terms of autoimmune hemolytic anemia and autoimmune thrombocytopenia. In five-year follow-up, 84.2% of CD5-negative patients and 90.5% of CD5-positive patients were alive (p=0.393). CONCLUSIONS We found more isolated splenomegaly, less lymphadenopathy, a higher lymphocyte count, and a lower thrombocyte count in the CD5-negative group. There was no difference between the groups in terms of clinical stage, autoimmune phenomena, hemoglobin and neutrophil count, and survival.

The impact of low molecular weight heparin on obstetric outcomes among unexplained recurrent miscarriages complicated with methylenetetrahydrofolate reductase gene polymorphism.

OBJECTIVES: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism. MATERIAL AND METHODS: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively. From among them, 68 patients were treated only with folic acid and iron. The remaining 53 patients were treated with folic acid, iron and prophylactic doses of low molecular weight heparin. The subsequent pregnancy outcomes of these patients were noted. RESULTS: The live birth rate was higher in patients with anticoagulant therapy than in patients without anticoagulant therapy (48.5% vs. 69.8%, respectively, p: 0.015) and the congenital anomaly rate was lower in anticoagulant therapy group (17.6% vs. 3.8%, respectively, p: 0.022). The other obstetric outcomes were found to be similar between the two groups. CONCLUSIONS: The current study demonstrated that low molecular weight heparin improved the live birth rates among unex-plained recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphisms. How-ever, the routine use of low molecular weight heparin did not improve the late pregnancy complications in these selected patients in the eastern region of our country. Further studies are needed to discriminate the effect of anticoagulation on the live birth rate of each of methylenetetrahydrofolate reductase gene polymorphism type.

The prevalence of Hymenoptera venom allergy in adults: the results of a very crowded city in Euroasia.

BACKGROUND: There are scarce data about the prevalence of Hymenoptera venom allergy in the general population. The aim of this study was to determine the prevalence of Hymenoptera venom allergy in the general adult population of Istanbul. METHODS: A total of 17,064 randomly selected telephone numbers were contacted and 11,816 (69.25%) individuals who agreed to participate completed a questionnaire. Those who disclosed hypersensitivity reactions due to Hymenoptera stings in this initial survey were called again and given another questionnaire. Those who were suspected of experiencing hypersensitivity reactions to Hymenoptera stings were invited for a clinical investigation with in vivo and in vitro diagnostic tests. RESULTS: According to the first questionnaire, a total of 1171 (9.9%; 95% CI: 9.38-10.47%) were suspected of having a hypersensitivity to Hymenoptera stings. 51.75% (n: 606) answered the second questionnaire and 21% (n: 128) of these were still suspected of having a hypersensitivity to Hymenoptera stings (1.1%; 95% CI: 0.9-1.29%). The confirmed prevalence of hypersensitivity to Hymenoptera stings according to skin tests and in vitro sIgE levels was 0.2% (95% CI: 0.14-0.30%). Nearly all of the participants with systemic reactions were admitted to the emergency department, although only one tenth of them received adrenaline in the emergency room. 2.3% carried an adrenaline injector, whereas none of the patients received venom immunotherapy. CONCLUSIONS: The prevalence of Hymenoptera sting reactions in our geographical region is comparable with other European studies. There is a need to increase the awareness of adrenaline in the emergency management of insect sting anaphylaxis and venom immunotherapy in the prophylaxis.

Investigation of the prophylactic and therapeutic effectiveness of oral thyme extract in rats experimentally infected with cryptosporidium parvum.

In this study, the prophylactic and therapeutic activities of thyme extract at different concentrations against experimental Cryptosporidium parvum infection in immunosuppressed rats were investigated. Thyme extract was prepared at four different concentrations (10%, 30%, 50%, and 100%) and administered as a single oral dose of 1 mL for evaluation of its prophylactic efficacy. Five consecutive days after infection was detected in all rats, therapeutic evaluations were also performed. According to the results obtained by daily counting of oocysts in stools, the prophylactic and therapeutic effects of thyme extract administration were significant in comparison to the control group (P˂0.01). Oocyst shedding continued in the control group at high numbers from the beginning to the end of the study, while oocyst counts in the prophylaxis groups remained low throughout the study. On the other hand, oocyst excretion rates were high in the therapeutic groups and decreased rapidly after thyme extract administration. At the end of the study, oocyst excretion had completely stopped for some rats administered thyme extract. There was no group in which oocyst shedding ceased for all rats. No significant differences were observed in the therapeutic or prophylaxis groups regarding the doses administered (P > 0.01). Renal and hepatic functions were monitored by measuring urea, creatinine, alanine transaminase, and aspartate transaminase levels ​​before and after thyme extract administration. As a result, it was concluded that oral thyme extract administration at the doses applied in this study is effective and safe in the prophylactic and therapeutic treatment of experimental cryptosporidiosis in rats.

Tuberculous meningitis together with systemic brucellosis.

We present a case of a 57-year-old woman admitted with findings of meningitis. Cerebrospinal fluid (CSF) tests revealed a pleocytosis together with a low CSF glucose concentration. Empirically, antituberculosis treatment was started. Rose Bengal and Wright tests were performed to exclude brucellosis with central nervous system involvement. These tests were positive in serum but not in CSF. Antibrucellosis treatment with doxycycline and ceftriaxone was started without withdrawing the antituberculosis treatment because of the possibility of simultaneous infection with both tuberculosis and brucellosis agents. Finally, this approach was shown to be correct when tuberculosis was isolated from the culture of CSF. Clinicians in endemic regions for brucellosis should be careful while diagnosing subacute/chronic meningitis. Other possible similar etiologies such as Mycobacterium tuberculosis must be ruled out before attributing the meningitis to brucellosis.

A Rare Presentation of Transfusional Hemochromatosis: Hypogonadotropic Hypogonadism.

Hemochromatosis is a disease caused by extraordinary iron deposition in parenchymal cells leading to cellular damage and organ dysfunction. ß-thalassemia major is one of the causes of secondary hemochromatosis due to regular transfusional treatment for maintaining adequate levels of hemoglobin. Hypogonadism is one of the potential complications of hemochromatosis, usually seen in patients with a severe iron overload, and it shows an association with diabetes and cirrhosis in adult patients. We describe a patient with mild transfusional hemochromatosis due to ß-thalassemia major, presenting with central hypogonadism in the absence of cirrhosis or diabetes. Our case showed an atypical presentation with hypogonadotropic hypogonadism without severe hyperferritinemia, cirrhosis, or diabetes. With this case, we aim to raise awareness of hypogonadotropic hypogonadism in patients with intensive transfused thalassemia major even if not severe hemochromatosis so that hypogonadism related complications, such as osteoporosis, anergia, weakness, sexual dysfunction, and infertility, could be more effectively managed in these patients.

Development of Agranulocytosis after Discontinuation of Methimazole: An Unusual Case.

Agranulocytosis is a rare and critical adverse effect of antithyroid drugs (ATD). The occurrence of agranulocytosis in continuous ATD treatment patients is well known; however, a case of ATD agranulocytosis occurring following the discontinuation of methimazole (MMI) treatment is not a usual situation. We herein describe a case of a 41-year-old woman who was previously administered methimazole (MMI) for ten days and developed ATD-induced agranulocytosis and symptoms of an upper respiratory tract infection after three weeks following discontinuation of MMI treatment. A thorough hematologic and serological evaluation did not disclose an alternative cause for the agranulocytosis. After receiving empirical antibiotic treatment, she responded successfully with clinical improvement of her symptoms and resolved neutropenia on the seventh day. This case is atypical because agranulocytosis developed after discontinuation of MMI, which strengthens the importance of remaining alert for signs of agranulocytosis even after discontinuation of ATD treatment.

Successful management of pulmonary hemorrhage and aspergillosis in a patient with acute myeloid leukemia (AML-M3).

A 35-year-old man presented with a one month history of gingival bleeding. He was diagnosed with Acute Myeloid Leukemia (AML-M3). During treatment he developed alveolar hemorrhage for which he was treated with a steroid. After the steroid treatment he developed a nodule, a cavitary lesion and atelectasia in the left lung. He was treated with voriconazole. After therapy with voriconazole his lesion significantly decreased. This case illustrates the efficacy and safety of antifungal therapy with voriconazole for aspergillosis complicated by AML.

On how environmental stringency influences adoption of best management practices in agriculture.

There are relatively few Federal environmental regulations that influence agricultural production in the US. However, many local and state environmental rules may influence the management practices on US farms as might interactions between urban population centers and agricultural producers. Detailed analysis of corn farms gives insight into these relationships and suggests that stringent environmental regulations could increase the likelihood of adoption of certain conservation practices, all else being constant, but that the interaction between urban populations has less of an effect on the adoption decisions.