Effects of N-acetyl-cysteine and acetylsalicylic acid on the tonsil bacterial biofilm tissues by light and electron microscopy.

OBJECTIVE: The present study aimed to investigate the effects of the bacterial biofilm formation on the tonsil surface exposed N-acetyl-cysteine (NAC) and acetylsalicylic acid (ASA) of patients undergoing tonsillectomy by light and electron microscopy. The general process of biofilm formation comprises adhesion of free-living or planktonic bacteria to a surface, which subsequently develop into microcolonies and form a biofilm. Based on studies that have shown the presence of biofilms in common sites of chronic infections, it has become clear that bacteria may persist on mucosal surfaces through formation of biofilms. PATIENTS AND METHODS: Ten patients between 4 and 39 years of age (mean, 11.9 ± 11.2 years). In all cases, periodic acide Schiff (PAS) staining was found to be an accurate predictor of the presence or absence of biofilm using light microscopy as a control standard. Therapeutic doses of NAC and ASA were identificated as the effective on the tonsil bacterial biofilm using light and electron microscopy. RESULTS: Biofilm formation was detected on all samples. Tonsils removed from patients with ASA-10 had showed higher-grade inhibitory effect at the biofilm formation than the other group (p ≤ 0.0001). The correlation was found between drug dose and decrease at the biofilm formation. CONCLUSIONS: In chronic or recurrent tonsillitis patients, decrease on the tonsils surface biofilm formation may be associated with ASA dose. Whether effect on the tonsils surface biofilm formation of other agent have a role is not known. Key Words: Acetylsalicylic acid, Chronic tonsillitis, In vitro, Mucosal biofilm, N-Acetyl-cysteine.

Comparison of diagnostic methods for evaluation of postmenopausal bleeding.

OBJECTIVE: To determine and compare diagnostic accuracy parameters of saline infusion sonohysterography (SIS), transvaginal ultrasonography (TVUSG), and hysteroscopy (H/S) based on histopathologic results which are accepted to be the gold standard in patients with postmenopausal bleeding (PMB). MATERIALS AND METHODS: Forty-seven patients who applied to Gynecology clinic of Adnan Menderes University, School of Medicine with PMB complaint aged between 43-76 years were included to the study. Fractioned curettage (F/C) and H/S guided biopsy were used for endometrial sampling. Diagnostic accuracy parameters (sensitivity, specificity, and positive and negative predictive values) of different methods; TVUSG, SIS, and H/S based on histopathologic findings were investigated. RESULTS: Specificity and sensitivity values calculated based on histopathologic results for all endometrial cavity lesions were found, respectively: 44.4% and 25% for TVUSG, 88.8% and 60.7% for SIS, and 100% and 77.7% for HIS. CONCLUSION: SIS is superior to TVUSG and as effective as H/S for assessment of endometrial cavity lesions in patients with PMB.

Seroprevalence of serum HBsAg positivity and hepatitis delta virus infection among blood donors in Southeastern Turkey.

AIMS: HBV and HDV infection is still a serious health problem in Southeastern Turkey. In this study, we aim to investigate the prevalence serum HBsAg along with HDV infection among volunteer blood donors. MATERIALS AND METHODS: This single centre and prospective study was performed in 6200 consecutive volunteer blood donors admitted to the Central Blood Bank of Dicle University Hospital. All adult blood donors included males and females were screened for HBsAg positivity. The positive serum samples for HBsAg were assessed for total anti-delta antibodies using the micro-ELISA method. Serum samples of anti-delta antibody positive cases were then examined for the presence of serum HDV RNA by real time, reverse transcription PCR method. RESULTS: Six thousand two hundred adult volunteer blood donors were enrolled to the study. Of all analyzed blood donors, 6004 (96.8%) were men and 196 (3.2%) were women. Serum HBsAg positivity was found in 3% (186/6200) of 6200 blood donors. The mean age and female/male ratio of HBsAg positive cases (n=186) were 32.85±10.04 years and 12/174, respectively. Serum anti-delta antibodies were detected in 6.98% (13/186) of HBsAg positive cases. The mean age of anti-delta antibody positive cases (n=13) was 44.5±13.61 years and female/male ratio was 1/12. Moreover, 2 cases, (15.39%, 2/13) that were positive for anti-delta antibody, had serum HDV RNA positivity. CONCLUSIONS: It would be appropriate for HBsAg positive volunteer blood donors to be assessed regarding concurrent HDV infection as well. The magnitude of the contribution and benefit that this screening would provide to our region, which is endemic for HDV infection, is the early diagnosis and management of this devastating disease. The real viremia in these cases can be best shown by using sensitive real time PCR method for the presence of serum HDV RNA.

Posterior reversible encephalopathy syndrome in obstetric patients. Report of three cases with literature review.

Posterior reversible encephalopathy syndrome (PRES) is a serious clinico-neuroradiological maternal complication in pregnancy. Although it has various etiologies such as hypertensive encephalopathy, renal failure, autoimmune disorders, sepsis, multiple organ failure, and treatment with immunosuppressant or cytotoxic agents, pregnancy and postpartum complicated by hypertensive disorders more frequently lead to this condition. PRES is clinically characterized by headache, confusion, seizures, vomiting, and visual disturbances with radiographic vasogenic edema especially affecting symmetrical parietal and occipital lobes. The underlying pathophysiology is still a matter of debate. Prompt recognition and early intervention greatly improve the prognosis, so that obstetricians should be well aware of this rare entity. Timely imaging is of crucial importance especially in patients with an uncertain diagnosis for determining the appropriate treatment and preventing the possible development of neurologic deficits. In the present report, three cases of PRES are presented with clinical and radiological findings in pregnancies complicated by severe pre-eclampsia and eclampsia. The latest literature in the field is also carefully reviewed.

Determination of serological profiles and avidity of specific antibodies in the sera of patients with potential Epstein-Barr virus (EBV) infection.

BACKGROUND: Epstein-Barr Virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. OBJECTIVES: The purpose of this study was to investigate the serological profiles of specific antibodies among the sera of suspected EBV infection patients along with VCA-IgG avidity. METHODS: A total of 522 patient's sera were sent to The Clinical Microbiology Laboratory for EBV specific antibody detection and were studied by IFA method during a two year period. The serum samples were tested for EBV specific VCA IgG, VCA IgM, EA, EBNA antibodies and VCA IgG aviditity. RESULTS: Among 33 patients those who had low avidity for VCA IgG, 27 (81.8 %) of them had a serologic profile as follows; positive VCA IgG, negative VCA IgM, negative EA and negative EBNA. CONCLUSION: While this profile is considered as a primary infection, the frequency of the coexistence of VCA IgG low avidity with this profile is interpreted that avidity may lead to detect primary infection (Tab. 2, Ref. 25)

Folate and vitamin B12 levels in abnormal pap smears: a case control study.

OBJECTIVE: This study aimed to explore the risk of abnormal cervical cytology in relation to serum folate and vitamin B12 levels, and demographic characteristics. PATIENTS AND METHODS: A case-control study was carried out among women attending the gynecology clinic for cervical cytology screening. At the follow-up clinic visit, fasting blood samples were collected from 103 cases with abnormal cervical cytology of the cervix and 175 controls with cytological normal smears and serum folate and vitamin B12 levels were measured. Data from cases and controls were compared. Logistic regression analysis was used to estimate the relative odds of abnormal cytology with increasing vitamin B12 levels. RESULTS: There were no significant differences between cases and controls in demographic characteristics and mean folate levels (p > 0.05). The mean vitamin B12 level of cases was significantly lower than that of controls (p < 0.001). Dichotomized logistic regression analyses of vitamin B12 levels were significantly different (p < 0.001). The predicted percentages at a cut-off value of 0.5 were as follows: sensitivity 70.0%, specificity 74.6%, positive predictive value 71.8% and negative predictive value 72.6%. The logistic regression analysis of the 1st and the 4th quartiles of vitamin B12 levels showed a significant difference p < 0.001, OR: 1.525 (CI, 1.175-1.875). CONCLUSION: The results of this study suggest that lower vitamin B12 levels are associated with abnormal cervical cytology. It is recommended that women should consume not only folate-rich foods such as fruits and vegetables but also vitamin B12-rich foods such as meat, fish, milk products and eggs in a balanced way.