Temporal Trends in the Epidemiology of HIV in Turkey.

OBJECTIVE: The aim of this study was to analyze the temporal trends of HIV epidemiology in Turkey from 2011 to 2016. METHODS: Thirty-four teams from 28 centers at 17 different cities participated in this retrospective study. Participating centers were asked to complete a structured form containing questions about epidemiologic, demographic and clinical characteristics of patients presented with new HIV diagnosis between 2011 and 2016. Demographic data from all centers (complete or partial) were included in the analyses. For the cascade of care analysis, 15 centers that provided full data from 2011 to 2016 were included. Overall and annual distributions of the data were calculated as percentages and the Chi square test was used to determine temporal changes. RESULTS: A total of 2,953 patients between 2011 and 2016 were included. Overall male to female ratio was 5:1 with a significant increase in the number of male cases from 2011 to 2016 (p<0.001). The highest prevalence was among those aged 25-34 years followed by the 35-44 age bracket. The most common reason for HIV testing was illness (35%). While the frequency of sex among men who have sex with men increased from 16% to 30.6% (p<0.001) over the study period, heterosexual intercourse (53%) was found to be the most common transmission route. Overall, 29% of the cases presented with a CD4 count of >500 cells/mm3 while 46.7% presented with a CD4 T cell count of <350 cells/mm3. Among newly diagnosed cases, 79% were retained in care, and all such cases initiated ART with 73% achieving viral suppression after six months of antiretroviral therapy. CONCLUSION: The epidemiologic profile of HIV infected individuals is changing rapidly in Turkey with an increasing trend in the number of newly diagnosed people disclosing themselves as MSM. New diagnoses were mostly at a young age. The late diagnosis was found to be a challenging issue. Despite the unavailability of data for the first 90, Turkey is close to the last two steps of 90-90-90 targets.

Efficacy of levamisole on experimental endometriosis.

OBJECTIVE: To investigate the efficacy of levamisole on experimental endometriosis. METHODS: After the implantation of endometrial tissue on abdominal peritoneum, 40 rats were randomized to 1 of 4 equal intervention groups. Levamisole (2 mg/rat) was applied subcutaneously to group "L" once a week. Depot medroxyprogesterone acetate (3 mg/kg) was applied intramuscularly to group "M" twice at 4-week intervals. Leuprolide (0.075 mg/kg) was applied subcutaneously to group "G" twice at 4-week intervals. Saline (0.1 cm(3)/rat) was applied subcutaneously to group "C" once a week for 8 weeks. The efficacy of levamisole was determined by volume measurement and characterizing the histological structure of the implants. RESULT: Volume increase of the implants in group C (P<0.05), and volume decrease in groups M, G, and L was found (P<0.05, P<0.01, and P<0.01, respectively.) Stromal tissue and glandular activity were not different between groups L and G. CONCLUSION: Levamisole was found to be as effective as leuprolide in regression of the volume of endometriotic implants.

Correlation of proliferating cell nuclear antigen and bcl-2 expression with tumor front grading and metastasis in laryngeal squamous cell carcinoma.

This study was designed to examine the immunohistochemical expression of proliferating cell nuclear antigen (PCNA) and bcl-2 protein in 45 cases with advanced laryngeal squamous cell carcinoma who had undergone total laryngectomy with unilateral modified radical neck dissection, and the relation of this expression to some prognostic factors such as tumor front grading and neck lymph node metastases. Sections were reevaluated for routine histologic grade, tumor front grading and neck lymph node metastases, and were stained with monoclonal antibodies against PCNA and bcl-2. Significant correlation was present between the severity of PCNA expression and incidence of lymph node metastasis (p<0.05). No correlation was found between the severity of PCNA expression and tumor front grading. Bcl-2 expression did not associate with either parameters. In conclusion, PCNA is important in predicting prognosis and no association is present between the bcl-2 protein expression and prognostic factors.

Cathepsin B, p53 expression and AgNORs in transitional cell carcinoma.

The aim of this study was to assess the relation between silver-strained nucleolar organizer regions (AgNOR), tumor stage, tumor grade and p53 expression with cathepsin B staining in transitional cell carcinoma of bladder. Tissue sections from 64 transitional cell carcinomas of the bladder were evaluated for the relation between AgNOR, tumor stage, tumor grade and p53 expression with cathepsin B staining in the neoplastic and stromal cells. Mean AgNOR values were significantly higher and the presence of p53 expression were different in cathepsin B positive and negative tumor and stromal cells. Although the number of cases is limited, this pilot study shows that cathepsin B staining may have a prognostic value in transitional cell carcinoma, but more studies are needed for a definite conclusion.

A massive calcified left ventricular aneurysm with normal coronary arteries and without myocardial infarction. A case report.

Most cardiac aneurysms develop after myocardial infarction. Calcification in the aneurysmal wall is seen rarely. In this case report the authors present a thirty-nine-year-old man, who had been free from symptoms until eight months before, when he began to experience palpitations due to monomorphic sustained ventricular tachycardia. A chest roentgenogram disclosed an oval calcification on the left ventricular apex. Coronary angiography and left ventriculography revealed normal epicardial coronary arteries and a massive calcified and ossified left ventricular apical aneurysm. He had no chest pain, nor were there electrocardiographic findings of myocardial infarction. Attacks of ventricular tachycardia disappeared after aneurysmectomy was performed. To the author's knowledge there is no case report in the literature of a calcified left ventricular aneurysm with normal epicardial coronary arteries and without clinical and electrocardiographic findings of infarction. They discuss the possible etiology of this case.

Early detection of left ventricular aneurysm rupture by two-dimensional echocardiography and surgical salvage.

A 52-year-old man was admitted to hospital emergency room with cardiogenic shock. The electrocardiogram showed normal tracing. Left ventricular aneurysm rupture at the posterolateral wall and haemopericardium was diagnosed with two-dimensional and colour Doppler echocardiography. The patient was operated on immediately and the defect was repaired. The patient made a good recovery. Four months later coronary angiography and left ventriculography were performed. The coronary vessels were found patent and there was minimal stenosis (lesser than 50%) at the proximal 1/3 portion of left anterior descending (LAD) artery. Left ventriculography showed anterolateral and posterolateral hypokinesis. The patient was symptom free and leading an active life 4 months later.

Primary-adenocarcinoma of Bartholin's gland: a case report.

Up to now, about 300 primary adenocarcinoma carcinomas of Bartholin's gland have been reported in the literature. A new case of a 57-year-old woman with primary carcinoma of Bartholin's gland is reported. The patient underwent radical vulvectomy and has been healthy for 18 months.

The effect of wood dust on the nasal cavity and paranasal sinuses.

The effect of wood dust on the mucous lining of the nose and paranasal sinuses is investigated experimentally in 20 rats. Our short-term study revealed that wood dust is a chronic irritative agent for these tissues.

An experimental study on the use of fibrin sealants in strabismus surgery.

Fibrin sealants were used in place of the classical suture materials in strabismus surgery. Classical recession operations were performed on the right eyes of ten albino rabbits, while the recessed anterior rectus muscles of the left eyes were fixed to the sclera with the tissue sealant. Better histopathological results were obtained with the fibrin sealant than with the classical sutures, but the functional results were worse.

Intracranial tuberculoma mimicking metastasis from renal tumor--case report.

A 63-year-old female presented with intracranial tuberculoma manifesting as severe headache. Systemic examination found a mass in the left kidney. The histological diagnosis was tuberculoma after kidney biopsy. Cranial computed tomography found two lesions, in the right frontal and occipital lobes. The intracranial lesions were considered to be tuberculomas. Tuberculosis chemotherapy was continued for 15 months. Her neurological deficit was resolved. Cranial computed tomography showed the lesion in the frontal lobe had disappeared and the lesion in the occipital lobe was reduced in size.

Hepatitis C in haemodialysis and nonuraemic patients: a histopathological study.

Hepatitis C virus (HCV) is the major cause of posttransfusion non-A, non-B hepatitis. Haemodialysis patients carry the risk of HCV infection. The aim of this study is to compare the morphological changes related to chronic HCV infection found in haemodialysis and nonuraemic patients. Liver biopsies from nine haemodialysis patients and 37 patients with normal renal function were studied. This study shows that haemodialysis patients may have less active and progressive chronic hepatitis C than patients with normal renal function. The number of patients in this study is limited, therefore further studies are needed for definite conclusion.

Intraobserver and interobserver reproducibility of WHO and Gleason histologic grading systems in prostatic adenocarcinomas.

In this study a total of 96 patients with prostatic carcinoma were evaluated retrospectively. Sections prepared from paraffin blocks were examined and all cases were scored according to the World Health Organization (WHO) and Gleason grading systems. We investigated intraobserver and interobserver reproducibility of two grading systems in prostatic adenocarcinomas. In our study the intraobserver reproducibilities of the WHO and Gleason systems were 75.0% and 78.1%, respectively. The interobserver reproducibilities of the WHO and Gleason grading systems were 60.4% and 70.8%, respectively. While there was no difference between intraobserver and interobserver variations in the Gleason system (p > 0.05), there was significant difference between intraobserver and interobserver variations in the WHO system (p < 0.05).

The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study.

We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-γ release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Löwenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p <0.05 for both). Accordingly, CSF L-J culture was superior to CSF-PCR (p <0.05). Combination of L-J and ACS was superior to using these tests alone (p <0.05). There were poor and inverse agreements between EZNs and L-J culture (κ = -0.189); ACS and L-J culture (κ = -0.172) (p <0.05 for both). Fair and inverse agreement was detected for CSF-ADA and CSF-PCR (κ = -0.299, p <0.05). Diagnostic accuracy of TBM was increased when both ACS and L-J cultures were used together. Non-culture tests contributed to TBM diagnosis to a degree. However, due to the delays in the diagnosis with any of the cultures, combined use of non-culture tests appears to contribute early diagnosis. Hence, the diagnostic approach to TBM should be individualized according to the technical capacities of medical institutions particularly in those with poor resources.

Possible formation of chiral polarons in graphene.

A theoretical investigation of the possible existence of chiral polaron formation in graphene is reported. We present an analytical method to calculate the ground-state of the electron-phonon system within the framework of the Lee-Low-Pines theory. On the basis of our model, the influence of electron-optical phonon interaction on the graphene electronic spectrum is investigated. We considered only the doubly degenerate optical phonon modes of E(2g) symmetry near the zone center Γ. It is analytically shown that the energy dispersions of both valence and conduction bands of the pristine graphene differ significantly from those obtained through the standard electron self-energy calculations arising from the electron-optical phonon interactions. In this paper, we also show for the first time that the degenerate band structure of the graphene promotes the chiral polaron formation. Furthermore, due to the k-dependent nature of the polaronic self-energy, in analogy with quantum chromodynamics, we also propose a running electron-phonon coupling constant as a function of energy.