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Amaç: Sistemik sklerozda (SSk) oto-antikorlar hastalığın tanısında, alt tiplerinin ve prognozun belirlenmesinde ve organ tutulumlarının öngörülmesinde kullanılmaktadır. SSk hastalarında hastalığa spesifik oto-antikorlar (anti-sentromer antikor, anti-Scl-70 antikor ve anti-RNA polimeraz II antikor) yanında spesifik olmayan oto-antikorlar da saptanmaktadır. Çalışmamızın, erken SSk hastalarında genişletilmiş bir profilde oto-antikorların sıklığını, erken dönem ve takipte gelişen organ tutulumları ile ilişkisini araştırmaktır. Yöntem: Çalışmaya ACR/EULAR 2013 sınıflama kriterlerini karşılayan ve hastalık süresi <3 yıl olan erken SSk hastaları alındı. Hastaların ANA ölçümleri HEp-20-10/primat karaciğer mozaiği indirekt immünofloresan (IIF) ve geniş panel oto-antikor ölçümü için SSc (Nucleoli) Profile EuroLine (Euroimmun, Lübeck, Almanya) kitleri kullanıldı. Bulgular: Yüz hastadan 93'ü IIF ile ANA için pozitifti. Anti-Scl70 ab en sık saptanan (%41) oto-antikor olurken, bunu %27 ile anti-sentromer ab (ACA) ve %15 sıklıkla RNAPIII izledi. Otuz iki hastada çoklu otoantikor pozitifliği ve 53 hastada tek pozitiflik (26'sı anti-Scl70, 16'sı ACA, 6'sı anti-RNAPIII, 1 anti-Ku ab, 1 anti-PM/Scl100, 2 anti-PM/Scl75 ve 1 anti-Ro52) saptandı. SSk'ye özgü otoantikorlar arasında, anti-Scl70 ve anti-RNAPIII antikorları en yüksek birliktelik gösterdi ve 4 hastada pozitifti. SSk'ye özgü otoantikorlar için tek veya çoklu boyaması olan hastalar arasında majör organ tutulumları açısından fark yoktu (tümü için p>0,05). Hastaların 4 yıllık takibi sonucunda 80 hastanın verilerine ulaşıldı. Hastaların 3'ünün takipten çıktığı ve birinin öldüğü saptandı. Daha önce organ tutulumu saptanmayan hastaların takip sırasında 5'inde İAH, 1'inde PAH ve 3'ünde dijital ülserin yeni geliştiği bulundu. İAH gelişen yaygın deri tutulumlu hastalarda Scl-70 saptanırken, İAH gelişen sınırlı deri tutulumlu hastalarda CENPA/B, Ro52 ve anti-ku antikorlarının ikili pozitiflikleri saptandı. Sonuç: Çalışmamızın sonuçlarına göre SSk'da spesifik otoantikorlar nispeten sık olmasına rağmen, hastaların çoğunluğunda çoklu otoantikor pozitiflikleri görülmüştür. Çoklu oto-antikor pozitiflikleri SSk-spesifik oto-antikorların beklenen organ tutulumlarında farklılığa farklılığa yol açabilir. [ABSTRACT FROM AUTHOR]

Objective: Hand washing is not only the simplest universal method to prevent healthcare related infections, it is also very important for the protection and development of general public health. In this study, it was aimed to investigate the hand washing habits and load of microorganisms in the hands of healthcare professionals and non-healthcare participants, so to raise the awareness in terms of hand hygiene. Methods: The study group consisted of patients and their relatives over 18 years of age, medical staff and medical school students. A questionnaire consisting of 17 questions regarding their personal characteristics and hand washing habits were applied to all participants. Swab samples were taken by sterile swabs from 1 cm2 areas of four different regions of the hands that were predominantly used by the participants, and were inoculated on blood agar plates and evaluated after 48 hours of incubation. Results: A total of 194 participants were reached, including 77 patients and patient relatives, 85 medical staff and 32 medical school students. A hundred and thirty- five of the participants were women and 59 were men. Bacteria that are members of normal skin flora (coagulase negative staphylococci, viridans streptococci, coryneform bacteria, micrococci) were isolated from almost all samples and more than 100 CFU bacterial load was detected in 53 participants. In 59 (30.4%) participants, microorganisms not included in normal skin flora (Gram negative enteric bacteria, Bacillus spp., Pseudomonas spp., Enterococcus spp., Staphylococcus aureus, mold and yeast fungi) were isolated. The proportion of these was calculated as 23% in patient/patient relatives, 33% in medical staff and 41% in students (p> 0.05). Women had a significantly lower bacterial load than men, 40-49 age group had a significantly lower bacterial load than participants over 60, and intensive care unit staff had a significantly lower bacterial load than patient/patient relatives and medical staff other than intensive care unit. Some hand washing habits of the participants were evaluated by scoring; 2 points before eating, 1 after eating, 1 before restroom, 2 after restroom, 2 after money contact, 2 when entering home from outside. As the hand washing score increased, the bacterial load on the hands decreased, but it was not statistically significant. It was observed that factors such as smoking, long nails, liquid/solid soap, paper/fabric towel, having a pet did not affect the microorganism load on the hands. The presence of any wound/lesion, prolonged time after hand washing and use of moisturizer were found associated with increased load. Conclusion: Being aware of the importance of hand hygiene in the community and especially among healthcare professionals is extremely important for the correct application of hand washing practices. In this study, it was aimed to emphasize the importance of hand washing by demonstrating the microorganism load on hands with the hand washing habits in a group of hospital related participants. [ABSTRACT FROM AUTHOR]

Aim Insulin resistance ( IR) plays an important role in the development of cardiovascular events in rheumatoid arthritis ( RA) patients. Adiponectin influences insulin sensitivity but its impact on IR in RA patients remains unclear. The present study aims to investigate the role of methotrexate ( MTX) and low doses of prednisolone ( LDP) on IR and adiponectin levels in RA patients who are naïve to disease-modifying antirheumatic drugs ( DMARDs), as well as determining the relationship between disease activity, acute phase response, IR and adiponectin levels in patients with RA. Methods Sixty-five RA patients naïve to DMARDs and prednisolone were involved in this study. The medication for RA patients was standardized for MTX and prednisolone. Body mass index, acute phase response reactants, 28-joint-count disease activity score, fasting blood glucose, serum cholesterol levels, insulin levels and adiponectin levels were measured in all RA patients both at the baseline and 3 months after the onset of the study. Results Adiponectin levels in the third month of the therapy with MTX and LDP were significantly increased in patients with RA ( P = 0.03). Insulin resistance tended to decrease in the third month of the treatment, which achieved no statistical significance. Conclusion Increased levels of adiponectin due to MTX and LDP could be related to the decrease in homeostasis model assessment insulin resistance ( HOMA- IR) in RA patients. This, in turn, could prove advantageous for cardiovascular conditions in RA. [ABSTRACT FROM AUTHOR]

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Objective: The aim of the study was to determine the HPV prevalance and its relation to Pap smear, colposcopy and colposcopy directed biopsy in our region of Eskisehir, Turkey., Material and Methods: A total of 615 women who applied to the outpatient clinic between December 2009 and December 2010 constituted our study population. All patients underwent pelvic examination and Pap smear sampling. Patients who had pathological cervical appearance or Pap smear results of ASCUS, AGUS, LSIL or HSIL were referred to colposcopy. Cervical samples for HPV DNA were taken from the patients before Pap smear sampling during the routine examination or before the colposcopic evaluation., Results: Twenty six of 615 patients (4%) were HPV positive. Of these 26 patients, 12 were positive for HPV type 16, 3 for type 18, 3 for type 51, 2 for type 6, 1 for type 52, 1 for type 33, 1 for type 16 and type 31, 1 for type 6 and 52, 1 for type 56 and 90, 1 for type 39 and 66. In 4 patients with cervical cancer, and in 3 of 4 CIN III cases both HPV DNA and Pap smear were positive. In the Pap smear examination of 615 patients, cytology revealed 35 ASCUS (5.6%) 4 AGUS (0.6%), 2 CIN I (0.3%) results who were negative for HPV DNA. These patients with abnormal cytology (n=41) underwent colposcopy directed biopsy, there were 3 CIN I and 1 CIN III and all the other cervical biopsy results of these patients were benign (inflammation, chronic cervicitis)., Conclusion: HPV positivity in our hospital setting is low which is compatible with other studies in Turkey. In positive HPV cases there is a good correlation between HPV type and positive cervical biopsy results.

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) which are autoimmune diseases usually questioned for their association with many infectious agents have etiopathogenesis related to genetic, immunologic, hormonal and even environmental factors. The most commonly attributed etiologic agents are herpes group viruses. The aim of this study was to investigate the role of Epstein-Barr virus (EBV) and herpes simplex (HSV) viruses in the etiology of RA and SLE. A total of 137 patients (87 RA and 50 SLE; mean age: 33 ± 12 years) who were admitted to Eskisehir Osmangazi University Medical Faculty Rheumatology Department between January 2007-January 2008 and diagnosed according to 1987 ACR (American College of Rheumatology) criteria have been included in the study, together with 50 healthy blood donors (mean age: 35 ± 14 years) as control group. Serum samples obtained from all of the cases were tested for EBV VCA-IgG, VCA-IgM, EA/D-IgG and EBNA-IgG (Trinity Biotech, USA); IgM and IgG antibodies against HSV-1 and HSV-2 by ELISA method (Dia-Pro Diagnostic, Italy), and the presence of viral nucleic acids in blood samples were investigated by real-time quantitative polymerase chain reaction (RTPCR; Qiagen, USA). EBV VCA-IgM was negative in all of the RA, SLE and control group patients. VCA-IgG positivity were 98% and 96%, and for EBNA-IgG 98.5% and 100%, in patient and control groups, respectively. There was no statistically significant difference between the groups regarding VCA-IgG and EBNA- IgG positivity (p> 0.05). On the other hand, EBV EA/D-IgG positivity rate found in the SLE group (34%) was significantly higher than RA (7%) and control (12%) groups (p< 0.001 and p< 0.05, respectively). There was no significant difference between RA and control groups in terms of EA/D-IgG positivity (p> 0.05). Regarding herpes simplex virus serology, HSV1-IgG seropositivity were 99% and 94% and HSV2-IgG positivity were 8% and 12% in the patient and control groups, respectively. There was no statistically significant difference between the groups according to the positivity rates of IgM and IgG specific for HSV-1 and HSV-2 (p> 0.05). All of the cases were found negative in terms of EBV, HSV-1 and HSV- 2 DNAs according to double-checked RT-PCR results. In conclusion, no significant difference was determined for EBV and HSV serologic markers in RA and SLE patients compared to the control group. However, significantly higher rate of EBV EA/D-IgG positivity in SLE patients might have indicated a possible association between SLE and EBV infection. Larger scale, prospective studies including examination of the synovial fluid/tissue samples are required to enlighten the association between SLE and EBV.

In this retrospective study, the data of hepatitis C virus (HCV) markers (anti-HCV and HCV-RNA) obtained from the patients who were prediagnosed and/or diagnosed as HCV infection have been comparatively evaluated and the relationship between these markers and transaminase (ALT and AST) levels have been analysed. A total of 690 sera from patients who were followed-up between January 2002 to December 2004 in Eskisehir Osmangazi University Medical Faculty Hospital were included to the study. Anti-HCV (Axsym System HCV version 3.0, Abbott Laboratories, USA) and HCV-RNA (Real-time Taqman Technology, Roboscreen kit and ABI Prism 7700 Perkin Elmer) tests were studied simultaneously and the results were examined together with the levels of ALT and AST of patients. In our study group, 455 (65.9%) of 690 samples were found positive for anti-HCV, while 235 (34.1%) were negative. Of anti-HCV positive patients, 51.6% (235/455) yielded positive and 48.4% (220/455) yielded negative results for HCV-RNA. The rate of anti-HCV negative but HCV-RNA positive sera was detected as 8.5% (20/235). When liver enzyme levels were taken into consideration, of 690 sera 338 (49%) showed normal transaminase levels, while 352 (51%) had elevated ALT and/or AST levels (23 with increased AST, 57 with increased ALT, and 272 with increased ALT and AST). Of the patients who exhibited increased ALT+AST levels (n=272), 50% were found positive for both markers (anti-HCV and HCV-RNA), 17% were only positive for anti-HCV, 3.6% were only positive for HCV-RNA, and 29% were negative for both markers. As a result, since anti-HCV negativity may be detected in viremic patients, molecular methods should be applied especially for the diagnosis of suspected cases and cases without seroconversion.

The relationship between the airborne contaminants obtained from operating theatres and intensive care units and the colonizing and infecting microorganisms isolated from patients were investigated. Air samples were obtained with the biocollector air IDEAL (BioMerieux, France). During the study period (19 weeks), a total of 77 air samples and 870 clinical specimens (swabs from throat, nose, conjunctiva and skin) from 174 patients were collected weekly. Microorganisms were identified by using Vitek system (BioMerieux, France) and conventional methods. According to the criteria of Federal Standard 209E (FD 209E) on cleanrooms, the conventionally ventilated operating- and general surgery rooms, and the anesthesia intensive care unit have been ranked as less than class 3.5 and 3, respectively. The frequency of nosocomial infection related to air-colonization was higher in patients of anestesia intensive care unit (16.4%), than in those of general surgery intensive care unit (4.9%). In general surgery rooms and anesthesia intensive care unit, the most frequent air-colonization related nosocomial infections were surgical wound infections and bacteremia, respectively. The most frequently isolated microorganisms were methicillin resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii. It can be concluded that, total number of airborne viable particles in the critical areas such as operating theatres and intensive care units, seems to be a significant risk factor for the development of nosocomial infections in immunocompromised patients.