[Investigation of the cases presenting to Dokuz Eylül University Hospital with tick bites]. / Dokuz Eylül Üniversitesi Hastanesi'ne Kene Tutmasi Yakinmasi ile Basvuran Olgularin Arastirilmasi.

OBJECTIVE: Determination of the properties of ticks, which are the vectors of many infectious diseases and the patients with tick bites are important for the prevention of these diseases. For tist reason, the purpose of this study is to determine the important properties of the cases presenting with tick bites to Dokuz Eylul University Hospital and of the removed ticks from the cases. METHODS: Two hundred seventy three of 294 patients, who presented with tick bites to Dokuz Eylül University Hospital, Izmir, were included in the study. Demographic parameters, symptoms related to tick borne diseases of the patients and the species and other characteristics of ticks removed from humans, also the tick population in the related habitat were investigated. RESULTS: Removed ticks were classified into five genera. The overwhelmingly dominant genera were Hyalomma and it comprised 52.4% of the collection. The majority of these ticks were nymphs. The majority (11.4%) of removed adult ticks were Rhipicephalus sanguineus (R. sanguineus). In most cases (60.7%) the ticks were removed from the patients by medical staff. CONCLUSION: There was no significant difference in removing ticks without damage between the health personnel and the patient or relatives (p=0.133).

[The epidemiology research of Blastocystis hominis in the Dokuz Eylül University Medical Faculty Hospital between 2005 and 2009]. / Dokuz Eylül Üniversitesi Hastanesi'ne 2005-2009 Yillari Arasinda Basvuran Olgularda Blastocystis hominis Epidemiyolojisinin Arastirilmasi

OBJECTIVE: An investigation of Blastocystis hominis (B. hominis) prevalance in 17756 patients with gastrointestinal system complaints who presented at the parasitology laboratory of the Dokuz Eylul University Medical Faculty Hospital between January 2005 and December 2009 was carried out. METHODS: Fecal samples of all patients were examined using the native-Lugol and trichrome and Kinyoun acid-fast staining method after sedimentation in fecal concentration tubes. RESULTS: One or more parasites were detected in 1510 (8.50%) of the patients. The distribution of the intestinal parasites was as follows: B. hominis 778 (4.38%), nonpathogenic amoebas 343 (1.93%), Giardia intestinalis (G. intestinalis) 205 (1,15%), Enterobius vermicularis (E. vermicularis) 46 (0.25%), Entamoeba histolytica/Entamoeba dispar (E. histolytica/E. dispar) 34 (0.19%), and other rare parasites 104 (0.58%). The most frequently seen parasite was B. hominis in fecal samples of patients with gastrointestinal complaints in our study. Distribution of 778 patients with B. hominis due to parasite forms was determined as: vacuolar in 525 (67.49%), granular in 115 (14.78%), both vacuolar and granular in 138 (17.73%) cases. CONCLUSION: As B. hominis was the most frequently seen parasite in patients with gastrointestinal complaints, we suggest that the parasite should be considered as pathogenic and sufficient attention must be paid in routine stool examinations.

[The distribution of intestinal parasites detected in The Dokuz Eylul University Medical Faculty Hospital between 2005 and 2008.]. / Dokuz Eylül Universitesi Tip Fakültesi Arastirma ve Uygulama Hastanesi'nde 2005-2008 Yillari Arasinda Saptanan Bagirsak Parazitlerinin Dagilimi.

A retrospective evaluation of the data from 14,246 patients with gastrointestinal complaints who presented at the parasitology laboratory of the Dokuz Eylul University Medical Faculty Hospital between January 2005 and December 2008 was carried out. Fecal samples of all patients were examined using native-Lugol and the trichrome and Kinyoun acid-fast staining method after sedimentation in fecal concentration tubes. One or more parasites were detected in 1320 (9.3%) of the patients. The distribution of the intestinal parasites was as follows: Blastocystis hominis, 689 (4.83%); nonpathogenic amoebas, 108 (21.82%); Giardia intestinalis, 320 (2.24%); Enterobius vermicularis, 23 (0.16%); Entamoeba histolytica/Entamoeba dispar, 34 (0.24%); and other rare parasites, 78 (0.54%). The results of this study emphasize the fact that intestinal parasitic infections are still an important public health problem.

[Contribution to one world, one health: a dog with demodicosis.]. / Tek Tip, Tek Saglik Konseptine Katki: Demodicosisli Bir Köpek.

Dogs are the most preferred pet animal in the world. Canine demodicosis is a skin disease of dogs in which there is proliferation of Demodex canis, an acarine parasite of canine hair follicles, and is typically manifested by alopecia as well as inflammation of hair follicles and sebaceous glands. Secondary bacterial infection often induces pustule and a crusting dermatitis. Two years ago, a police dog eight years old, without any previous health problem, was brought to a private veterinary clinic for edematous and inflammatory lesions on the soles of its feet. In the clinic, antibacterial and antimicotics were applied for treatment of the lesions, but ten months after completion of the therapy the lesions relapsed and the treatment was repeated. But again six months after the last treatment, the lesions spread widely and the general health status of the dog began to worsen. Finally the dog was brought for treatment to the Izmir Bornova Veterinary Research Institution. Microscopic examination of all the skin scrapings revealed the presence of 10-15 adult Demodex mites per cm(2) and the diagnosis was pododemodicosis. Treatment was performed with ivermectin, antibacterial drugs and beta-glucan. The density of Demodex was reduced after two months of therapy and there was clinical and microscopical improvement. Six months after completion of the therapy the lesions disappeared completely.

Diagnosis and treatment of demodectic blepharitis.

The aim of this study was to investigate the prevalence of Demodex spp. in the eyelash follicles obtained from patients seen in our ophthalmology clinic, to define the symptoms of this infestation, and to examine the effectivity of the therapy. This study was conducted in Department of Ophthalmology and Parasitology, Dokuz Eylül University, School of Medicine. Our study included 82 cases that were seen in the Ophthalmology Department and Parasitology Department for various reasons. We have also observed that the presence of Demodex spp. provokes itching and redness in the eyes and that using baby shampoo for cleansing the face reduces the risk of infestation. After the treatment of 32 cases with 4% pilocarpin HCl gel, we achieved a total cure in 12 eyes (37.5%), partial improvement in 13 eyes (40.6%), (making a total of 25 eyes, 78.1%). The treatment was unsuccessful in 7 eyes (21.9%). In patients with Demodex spp. cleansing with baby shampoo and treating by pilocarpin gel may be used in treatment.

An outbreak of gastroenteritis associated with intestinal parasites.

Intestinal protozoa are one of the leading causes of waterborne outbreaks. Stool samples of 196 residents from a village of Izmir, using the public water supply, were collected during an outbreak of gastroenteritis. Patients were asked to fill out a questionnaire reporting on gender, age, gastrointestinal symptoms, whether or not there was a toilet in the house, their hygiene practices, and similar symptoms in the household members. Of the patients who had gastrointestinal symptoms (74.5%), diarrhea was observed in 69.5% whereas bloody and mucoid stools were observed in 20.4 %. The stool samples were examined for intestinal parasites by wet mount and trichrome stain and were also cultured in the Robinson medium. Pathogenic parasites were detected in 11 samples (5.6%) as follows: Giardia intestinalis in 7, Hymenolepis nana in 1 and Blastocystis hominis in 4. Entamoeba histolytica/dispar was not detected by direct wet mount in any of 8 patients who had E. histolytica/E. dispar in culture whereas it was detected in the trichrome stained slides of 3 patients. Amoeba prevalence in the 15-44 age-group was significantly high when compared with the 0-14 age group. The prevalence of pathogenic parasites was high among the people who had a toilet outdoors. Drinking water was thought to be a principal source of this outbreak.

[The evaluation of the techniques used for diagnosis of Entamoeba histolytica in stool specimens]. / Diskida Entamoeba histolytica'nin saptanmasinda kullanilan yöntemlerin birlikte degerlendirilmesi.

In this study, stool samples of 9378 patients from different clinics, who presented at the laboratory of the department of parasitology of the Dokuz Eylul University, Faculty of Medicine with several gastrointestinal complaints from January 2004 to May 2006, were examined. All stool samples were examined with the saline-Lugol method and, in suspicious cases, by trichrome staining, cultivation in Robinson's medium and/or antigen detection in stool with the Entamoeba CELISA Path kit. Forty-one cases (0.44%), in which Entamoeba histolytica/Entamoeba dispar cysts and/or trophozoites were detected by at least one method, were found to be positive. Out of these 41 cases, four methods were used in 24 cases, three methods in 14 cases, whereas only saline-Lugol and trichrome staining methods were used in 3 cases. Even though all 41 positive cases had been examined with the saline-Lugol method, only 25 cases were found to be positive with this method for E. histolytica/E. dispar cysts and/or trophozoites. The remaining 16 cases were diagnosed by the other three methods. Today it is necessary to distinguish E. histolytica from E. dispar because the patient does not need to be treated if E. dispar is identified whereas if E. histolytica is identified the patient needs urgent treatment. That's why it is necessary to get reliable results using diagnostic methods together and, when needed, by ELISA specific for E. histolytica.

[The distribution of intestinal parasites detected in the Dokuz Eylul University Medical Faculty Hospital between 2003 and 2004]. / Dokuz Eylül Universitesi Tip Fakültesi Arastirma ve Uygulama Hastanesi'nde 2003-2004 yillari arasinda saptanan bagirsak parazitlerinin dagilimi.

A retrospective evaluation of the data from 7,712 patients with gastrointestinal complaints who presented at the parasitology laboratory of the Dokuz Eylul University Medical Faculty Hospital between January 2003 and December 2004 was carried out. Fecal samples of all patients were examined using native-Lugol and the trichrome staining method after sedimentation by the fecal concentration tube. One or more parasites were detected in 495 (6.41%) of the patients. The distribution of the intestinal parasites was as follows: Blastocystis hominis 218 (44.04%), nonpathogenic amoebas 108 (21.82%), Giardia intestinalis 82 (16.57%), Enterobius vermicularis 50 (10.10%), Entamoeba histolytica 17 (3.43%) and other rare parasites 20 (4.04%). The results of this study were similar to those of other cities in the western part of Turkey and emphasize the fact that intestinal parasitic infections are still an important public health problem.