Factors Associated with High-grade Smear Positivity Levels in Pulmonary Tuberculosis

ABSTRACT Objective: The high-grade level of smear acid-resistant bacilli (ARB) positivity has been linked to increased infectiousness in pulmonary tuberculosis (TB). The ability to predict infectiousness is important in the management of the disease. The present study aimed to investigate the relationship between smear results, the clinical features, and the levels of radiological involvement of TB. Methods: A total of 245 cases diagnosed with pulmonary TB were admitted to the study. Data including age, sex, case definition, numbers and characteristics of symptoms, smear results, smear positivity grades, and levels of radiological involvement were recorded. Relations between smear results and other data were determined via cluster tree and regression analysis. Results: The group with only coughing had higher rates of both positive smear and high smear positivity levels (p = 0.014 and p = 0.02, respectively) compared to the group without coughing. Similarly, the groups with moderate or high radiological involvement showed significantly higher rates of both positive smear and high smear positivity level when compared to the group exhibiting low radiological involvement (p < 0.001). Conclusion: Patients with coughing and a moderate to high level of radiological involvement should be closely monitored due to their high-level risk of transmission.

The Place of Atopy in the Aetiology of Acute Appendicitis in Children.

OBJECTIVE: Appendicitis, the most common cause of abdominal pain requiring surgery in children, refers to inflammation of the vermiform appendix. The aetiology of appendicitis is multifactorial, although it is affected by several precursor factors. The purpose of this study was to investigate whether allergic diseases cause a predisposition to appendicitis. SUBJECTS AND METHODS: One hundred and sixteen patients who underwent surgery for acute appendicitis and who had a diagnosis of acute appendicitis confirmed pathologically, and a control group of 124 individuals of similar ages and genders, were enrolled. The level of inflammation of appendiceal material in cases diagnosed with acute appendicitis was classified pathologically. The skin prick test (SPT) was used to determine allergic sensitization. RESULTS: A significant difference was determined between the patient and control groups in terms of skin prick positivity (p < 0.05). CONCLUSIONS: While there are several known factors implicated in the causation of acute appendicitis, the cause cannot be identified in some cases. We think that atopy may also be a risk factor in the development of acute appendicitis.

Functional dyspepsia: relationship between clinical subgroups and Helicobacter pylori status in Western Turkey.

The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL), 321 (35.6%), motility disorder-like (ML), 281 (31.2%), and the combination (C) of these symptoms, 298 (33.1%). All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp) density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-alpha (TNF-alpha) and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-alpha and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups.

Functional dyspepsia: relationship between clinical subgroups and Helicobacter pylori status in Western Turkey

The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL), 321 (35.6 percent), motility disorder-like (ML), 281 (31.2 percent), and the combination (C) of these symptoms, 298 (33.1 percent). All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp) density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-alpha (TNF-alpha) and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-alpha and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups

Anticoagulant and antiprotease effects of a novel heparinlike compound from shrimp (Penaeus brasiliensis) and its neutralization by heparinase I.

Heparin is usually obtained from mammalian organs, such as beef lung, beef mucosa, porcine mucosa, and sheep intestinal mucosa. Because of the increased use of heparin in the production of low-molecular-weight heparin (LMWH), there is a growing shortage of the raw material needed to produce LMWHs. A previous report described the structural features of a novel LMWH from the shrimp (Penaeus brasiliensis). In order to compare anticoagulant and antiprotease effects of this heparin, global anticoagulant tests, such as the prothrombin time, activated partial thromboplastin time, thrombin time, and Heptest, were used. Amidolytic anti-Xa and anti-IIa activities were also measured. The relative susceptibility of this heparin to flavobacterial heparinase was also evaluated. The United States Pharmacopeia (USP) potency of shrimp heparin (SH) was found to be 28 U/mg. SH produced a concentration-dependent prolongation of all of the clotting tests and exhibited marked inhibition of FXa and FIIa. Heparinase treatment resulted in a marked decrease of the anticoagulant effects and neutralized the in vitro anti-IIa actions. However, the anti-Xa activities were only partially neutralized. Protamine sulfate was only partially effective in neutralizing the anticoagulant and antithrombin effects of SH. SH also produced marked prolongation of activated clotting time, which was neutralized by heparinase but not by protamine sulfate. These results suggest that SH is a strong anticoagulant with comparable properties to mammalian heparins and can be used in the development of clinically useful antithrombotic-anticoagulant drugs.