Effect of fentanyl and remifentanil on neuron damage and oxidative stress during induction neurotoxicity.

Opioids can be used for medical and non-medical purposes. Chronic pain such as cancer, as well as the frequent use of such drugs in places such as operating rooms and intensive care units, and in non-medical areas like drug abuse the effects and side effects of these drugs need to be examined in more detail. For this purpose, the effects of fentanyl and remifentanil drugs on neuroinflammation, oxidative stress and cholinesterase metabolism were investigated. Neuron cells (CRL-10742) were used for the evaluation of the toxicity of fentanyl and remifentanil. MTT, PON1 activity and total thiol levels for its effect on oxidative stress, AChE and BChE activities for its effect on the cholinergic system, and TNF, IL-8 and IL-10 gene levels for its neuroinflammation effect were determined. The highest neurotoxic dose of fentanyl and remifentanil was determined as 10 µg/mL. It was observed that the rate of neuron cells in this dose has decreased by up to 61.80% and 56.89%, respectively. The IL-8 gene expression level in both opioids was down-regulated while IL 10 gene level was up-regulated in a dose-dependent manner compared to the control. In our results, the TNF gene expression level differs between the two opioids. In the fentanyl group, it was seen to be up-regulated in a dose-dependent manner compared to the control. Fentanyl and remifentanil showed an inhibitory effect against PON1, while remifentanil showed an increase in total thiol levels. PON1, BChE and total thiol activities showed similarity with MTT.

Comparison of the performance of TK system with LJ and MGIT methods in the diagnosis of tuberculosis.

Tuberculosis is a common infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis (TB). Various liquid or solid media are used for the diagnosis of tuberculosis. TK Rapid Mycobacterial Culture System has been developed recently. In our study, we aimed to compare TK Rapid Mycobacterial Culture System with LJ and MGIT systems in the diagnosis of tuberculosis. 200 clinical specimens (152 sputum, 41 Bronchoalveolar lavage fluid (BAL), 4 gastric aspirations, 2 urine and 1 wound) obtained from 192 patients from different clinics were included for the diagnosis of TB. All specimens were decontaminated by using the same-common procedure in all the methods. The obtained sediment was used for inoculation for the BACTEC MGIT 960, TK and LJ. Additionally, smears were prepared from the residual suspension for Ehrlich-Ziehl-Neelsen (EZN) staining for microscopic examination. Contamination was observed in 23 sputum and 4 BAL samples. Contamination rates for TK, LJ, and BACTEC MGIT 960 systems were determined as 3 (1.5%), 13 (6.5%), and 18 (9%) respectively. Mycobacterium tuberculosis growth was determined as 15 (7.5%), 14 (7%) and 13 (6.5%) by TK culture system, MGIT and LJ, respectively. In our study, the total mean detection times of Mycobacterium tuberculosis by the LJ, TK, and MGIT method were 20.1, 17.1, and 8.3 days, respectively. TK system showed a dramatically lower contamination rate than the others. There was no difference in growth rates for each of the three methods. We concluded that the TK culture system is disadvantageous in terms of turnaround time.

[Microscopic examination of vaginal discharge specimens for Trichomonas vaginalis and other micro-organisms in 18-45 age group women]. / 18-45 Yas Grubu Kadinlarda, Trichomonas vaginalis ve Diger Mikroorganizmalarin Vajinal Akinti Örneklerinden Mikroskobik Olarak Incelenmesi.

OBJECTIVE: Trichomonas vaginalis is a protozoon that causes trichomoniasis which is characterised by a foamy yellowish odorous discharge and superficial defects and necrotic ulcers in vaginal mucosa. Trichomoniasis is transmitted from human to human by sexual contact and can be seen in almost every part of the world. The aim of this study was to determine the incidence of Trichomonas vaginalis in 18-45 years age group women with vaginal discharge complaints who applied to the Gynaecology Outpatient Clinic of Konya Social Insurance Instution Hospital during September 1-December 15 2003. METHODS: Samples were taken from posterior fornix of the vagina with the aid of a speculum and sterile cotton swabs. All the samples were examined by wet mount preparations, Gram and Giemsa staining method under the light microscope. RESULTS: Of seventy samples 6 (9%) were positive for Trichomonas vaginalis, 9 (13%) for Gardnerella vaginalis, one for Mobiluncus spp. and 11 (16%) for Candida spp. CONCLUSION: It is possible to say that, in spite of a definite diagnosis of trichomoniasis made by cultivation method, examining the vaginal smear by direct microscope also has an important role in the diagnosis of infection. Direct microscopic examination will help in deciding whether to begin the treatment of trichomoniasis.

A rare cause of bacteremia in a pediatric patient with Down syndrome: Sphingomonas paucimobilis.

Sphingomonas paucimobilis, is a yellow-pigmented, aerobic, non fermentative, gram negative motile bacillus. S. paucimobilis which is widely found in nature and hospital environments rarely cause serious or life threatening infections. In this report, a case of hospital acquired bloodstream infection due to S. paucimobilis in a patient with Down syndrome who was on treatment for presumed pneumonia is presented. A one year-old child patient who was a known case of Down syndrome and had previously experienced cardiac surgery was hospitalized and treated for pneumonia. On the 12th day of hospitalization, blood cultures were taken because of a high body temperature. One of the blood cultures was positive for gram-negative rods. After 48 hour of incubation, the sub-cultures on blood agar medium yielded pure growth of a yellow, non-fermentative, gram-negative, rod-shaped bacterium. The microorganism was positive for oxidase, and esculin hydrolysis, while negative for urea and nitrate reduction, citrate utilisation and motility. The isolate had been identified as S. paucimobilis by using Vitek 2 system. The antibiotic susceptibility test was also performed with the same system and the strain was found to be susceptible to piperacillin-tazobactam and other antibiotics. Treatment with intravenous piperacilin-tazobactam (150 mg/kg/day) was initiated. He responded well to the treatment and was discharged after 10 days. This case is reported to emphasize that S. paucimobilis should be kept in mind as a nosocomial infectious agent in patients with Down syndrome and immunosuppressive patients and the infections should be treated according to the sensitivity test results.

Mechanical intestinal cleansing and antibiotic prophylaxis for preventing bacterial translocation during the Pringle maneuver in rabbits.

PURPOSE: We investigated the effectiveness of mechanical intestinal cleansing and antibiotic prophylaxis in preventing bacterial translocation (BT) during the Pringle maneuver in rabbits. METHODS: Forty-eight rabbits were allocated to one of the following four groups: a control group (group 1); an antibiotic group, given 100 mg/kg intravenous ceftizoxime (group 2); a mechanical intestinal cleansing group, given a Fleet enema (group 3); and a mechanical intestinal cleansing plus antibiotic group (group 4). After performing laparotomy, we dissected the portal region and turned the portal triad, using tape. Pringle maneuver was applied for 30 min in all groups. Blood samples were collected from the portal vein for blood culture before the Pringle maneuver. All groups underwent relaparotomy 30 min after the Pringle maneuver, to obtain portal blood, mesenteric lymph nodes (MLNs), and splenic tissue for culture. RESULTS: All cultures from the portal vein specimens taken before the Pringle maneuver were negative. The rate of bacterial isolation in the portal vein (P < 0.001), MLNs (P < 0.01), and splenic (P < 0.001) cultures was significantly lower in group 4 than in the other groups. It was also lower in group 3 than in groups 1 and 2 (P < 0.05 for all). CONCLUSIONS: The combination of mechanical intestinal cleansing and preoperative broad-spectrum antibiotics was most effective for preventing BT during the Pringle maneuver.

[Investigation of parvovirus B19 seroprevalence in various age groups in Central Anatolia Region, Turkey]. / Konya bölgesinde çesitli yas gruplarinda parvovirus B19 seroprevalansinin arastirilmasi

Human parvovirus B19 is a small, non-enveloped, icosahedral symmetric, single-stranded DNA virus that can cause a number of diseases, notably erythema infectiosum in children and aplastic crisis in patients with chronic hemolytic disorders. There have been limited data on the epidemiological pattern of parvovirus B19 infection in Turkey. The objective of this study was to investigate the seroprevalence of parvovirus B19 in Konya province (Central Anatolia), Turkey. Parvovirus B19 IgG antibodies were investigated by a commercial ELISA kit (RIDASCREEN, R-Biopharm AG, Germany) in 631 adults (age range: 18-> 60 years) and 542 children (age range: 0-17 years). The overall prevalence of parvovirus B19 IgG antibodies was 28.9%. The rate of parvovirus B19 IgG positivity was 20.7% (112/542) in the 0-17 years age group and was 36% (227/631) in the adult population. No significant difference in seropositivity rates were detected in terms of sex in children and adult group (p>0.05 in both groups). The rates of parvovirus B19 IgG seropositivity were 15.8% in 0-4 years age group, 16% in 5-9 years, 24.2% in 10-14 years, 40.9% in 15-19 years, 34.7% in 20-29 years, 35.5% in 30-39 years, 32.2% in 40-49 years, 37.5% in 50-59 years and 53.8% in > 60 years age group. The seropositivity rates in 0-4 and 5-9 years age groups were lower than the other age groups and the difference was statistically significant (p< 0.05). To determine the prevalence of parvovirus B19 in different age groups in different geographical areas is necessary since this will provide important information about the epidemiology of such infections.

[Comparison of commercial IFA, IHA and in-house IFA tests in the diagnosis of cystic echinococosis]. / Kistik ekinokokkozis tanisinda ticari indirekt floresan antikor (IFA), indirekt hemaglutinasyon (IHA) testleri ve laboratuvarimizda hazirladigimiz IFA testinin karsilastirilmasi.

Hydatidosis is an endemic illness in many regions of world. Several serodiagnostic techniques have been evaluated for the diagnosis of cystic hydatid disease caused by Echinococcus granulosus. The aim of this study was to assess the efficiency of the commercial fluorescent antibody test (IFAT), indirect hemaglutination test (IHAT) and in-house IFA tests. For this purpose sera from one hundred patients who had been given a diagnosis of hydatid cyst by surgery were used. In-house IFA was developed using the germinal membrane of Echinococcus granulosus and sera were studied by the three different methods. As a result, the specificity of commercial IFA, IHA and in-house IFA was found to be 100% and sensitivities of these tests were 87.7%, 74.6% and 83.3% respectively. In conclusion, in-house IFA test is a useful and cost effective but difficult test to prepare for the routine laboratory.

Determination of hepatitis B virus DNA incidence, viral load, and mutations in blood donors with HBsAg and anti-HBs-negative serology and antibodies to hepatitis B core antigen.

BACKGROUND: The aim of the present study was to determine hepatitis B virus DNA incidence, viral load, and mutations in blood donors with HBsAG and anti-HBs negative serology and antibodies to hepatitis B core antigen. METHODS: Blood samples were collected from 1000 blood donors with HBsAg-negative test results. Anti-HBc total screening was performed using the ELISA method. HBsAg-negative/anti-HBc total-positive samples were tested for anti-HBs, anti-HBc IgM, HBeAg, and anti-HBe. Samples with isolated anti-HBc were determined for viral load of HBV DNA using real-time PCR. RESULTS: Anti-HBc total was established as positive in 200 (20%) of the 1000 blood donors. While anti-HBs was negative in 59 (29.5%) of the 200 anti-HBc-positive samples, it was found to be positive in 141 (70.5%) of them. All of the other hepatitis B markers were negative in all of the anti-HBs-negative samples. HBV DNA was not detected in the sera of the isolated anti-HBc-positive blood donors with real-time PCR. CONCLUSION: Although we could not detect HBV DNA in the sera of the isolated anti-HBc-positive blood donors, findings in the literature suggest that anti-HBc testing should be used in combination with HBsAg for the screening of blood donors to reduce risk. After that, the most appropriate algorithm to follow can be HBV DNA screening of donors.