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Antituberculosis drug resistance is a major factor threatening the success of tuberculosis control programmes. The aim of this study was to reveal the patterns of antituberculosis drug resistance in a secondary hospital in Turkey and to compare with national data. The results of BACTEC MGIT 960 system for susceptibility testing were retrospectively analysed on 76 clinical Mycobacterium tuberculosis complex isolates from different patients. The mean age of 48 men (63.2%) and 28 women was 37 and 39, respectively. Overall resistance rate to isoniazid was 14.5%, followed by streptomycin 9.2%, ethambutol 6.9% and rifampin 5.3%. Female sex and diabetes mellitus but not the presence of cavitary lesion or radiological involvement was a risk factor for the development of drug resistance. Anemia, leukocytosis or thrombocytosis was not associated with the drug resistance. In conclusions, further studies should be conducted regularly to monitor drug resistance in Turkey in order to manage effectively national tuberculosis control efforts.

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Bevezetés: A közönséges variábilis immundeficiencia a primer veleszületett immunhiányos állapotok közül a leggyakoribb felnőttkorban manifesztálódó kórkép. A betegséget alacsony immunglobulinszintek, az ellenanyagképzés csökkenése vagy hiánya jellemzi. Klinikai megjelenése változó, visszatérő heveny és krónikus fertőzések dominálnak. Változatos autoimmun betegségek képében is manifesztálódhat, fennállása esetén szolid tumorok és extranodalis B-sejtes lymphomák előfordulása gyakori. A kórkép kezelése rendszeres immunglobulinpótlásból áll. Esetismertetés: A szerzők egy immun thrombocytopenia és autoimmun haemolyticus anaemia miatt évekig gondozott fiatal férfi beteg esetét mutatják be. Osztályos észlelésekor a láz és a thrombocytopenia dominált igen alacsony immunglobulin- és memória-B-sejt- (sejtfelszíni CD27+ antigén jelenléte) szintek mellett. Infekció, malignus betegség nem igazolódott. A közönséges variabilis immundeficiencia diagnózisát a hypogammaglobulinaemia szekunder okainak kizárását követően állították fel. A beteg rendszeres immunglobulinpótlásban részesült. Állapota romlásakor fokozódó hepatosplenomegaliát, pancytopeniát és hemophagocytosis szindróma laboratóriumi jeleit észlelték. Kiterjesztett terápiás erőfeszítése ellenére a beteg elhunyt, a halála előtt megismételt csontvelő-biopsziás minta poszt-mortem igazolta a perifériás T-sejtes lymphoma, tovább nem osztályozható diagnózisát cytotoxikus fenotípussal. A kórboncolás számos szervrendszer súlyos érintettségét írta le. Megbeszélés: A közönséges variábilis immundeficienciához társuló lymphoproliferatív betegségek szinte kivétel nélkül B-sejtes fenotípusúak, T-sejtes lymphoma társulásáról csak elvétve lehet adatot találni az irodalomban.

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Hematológia–Transzfuziológia
Authors: Henrietta Poset, Judit Kárteszi, Tibor Kalmár, Zoltán Maróti, Julianna Fekete, and Miklós Egyed

Összefoglaló. A familiáris mediterrán láz a herediter autoinflammatorikus betegségek közé tartozik. Klinikai tüneteit döntően a savós hártyák akut gyulladása (serositis: peritonitis, pleuritis, synovitis, ritkán pericarditis, meningitis) határozza meg. A betegség hátterében a pyrin fehérjét kódoló MEFV-gén többségében autoszómális recesszív módon öröklődő mutációi állnak. Legfontosabb szövődménye az amyloidosis, amely veseelégtelenséghez vezethet. Kezelésében első vonalbeli terápiaként a colchicin szerepel.

Fiatal nőbetegünket 12 éves kora óta több intézetben vizsgálták intenzív hasi fájdalommal és lázzal járó attakok miatt. A tünettan részeként hányás, hasmenés és mellkasi fájdalom jelentkezett. A gyulladásos epizódok 5–14 napig tartottak, a köztes időszakokban viszont teljesen jól volt. A rohamok alatt készült laboratóriumi vizsgálatok során leukocitózis, valamint emelkedett süllyedés és CRP mutatkozott. Intravazális hemolízisre utalt az anémia, retikulocitózis, magas Sebi, szérum szabad hemoglobin és LDH együttes megjelenése. Az EKG-én inferior és az anteroseptalis elvezetésekben átmenetileg negatív T-hullámok jelentek meg, ami pericarditis lehetőségét vetette fel. Fizikális státuszából kiemelendő a diszkrét, de progrediáló splenomegalia. Kizártuk a porphyriat, glucose-6-phosphat dehydrogenase-hiányt, PNH-t és C1-inhibitorhiányt. Az autoinflammatorikus betegség miatt elvégzett molekuláris genetikai vizsgálat az MEFV-génmutáció homozigóta formáját, a Familiáris mediterrán láz diagnózisát igazolta.

Summary. The familial Mediterranean fever is one of the hereditary autoinflammatory diseases. Its clinical symptoms are mainly determined by acute inflammation of the serous membranes (serositis: peritonitis, pleurisy, synovitis, rarely, pericarditis, meningitis). The background of the disease is mostly represented by autosomal recessively inherited mutations in the MEFV gene encoding the pyrine protein. Its most important complication is amyloidosis, which can lead to renal failure. Colchicine is included in its treatment, as a first-line therapy.

Our young female patient has been examined in several institutions since the age of 12 for attacks of intense abdominal pain and fever. The symptoms included vomiting, diarrhea, and chest pain. The inflammatory episodes lasted 5–14 days, but in the intervening periods she was free of symptoms. Laboratory tests performed during the inflammatory periods showed leukocytosis as well as increased ESR and CRP. Intravascular hemolysis was indicated by anemia, reticulocytosis, co-occurrence of high Sebi, serum free hemoglobin and LDH. On the ECG, transiently negative T waves appeared in the inferior and anteroseptal leads, raising the possibility of pericarditis. Of her clinical status, discrete but progressive splenomegaly should be highlighted. Porphyria, glucose-6-phosphat dehydrogenase deficiency, PNH, and C1 inhibitor deficiency were excluded during our examinations. Molecular genetic testing urged by autoinflammatory disease confirmed a homozygous form of the MEFV gene mutation and established the diagnosis of familial Mediterranean fever.

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anaemia in brown bullhead ( Ameiurus nebulosus ). Comp. Biochem. Physiol. 135 , 165-175. Apparent diffusion limitations on branchial CO 2 transfer are revealed by severe experimental anaemia in brown bullhead ( Ameiurus

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., Schwartz, S., Owen, R. A.: Gastrointestinal blood loss and anemia in runners. Ann. Int. Med. 100 , 843-845 (1984). Gastrointestinal blood loss and anemia in runners. Ann. Int. Med

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Orvosi Hetilap
Authors: Barbara Nagy, Zsuzsanna Nagy-Lőrincz, Márta Bakacs, Éva Illés, Eszter Sarkadi Nagy, Gergő Erdei, and Éva Martos

.] Táplálkozás, Anyagcsere, Diéta. 1995; 1: 31–36. [Hungarian] 10 Breymann C. Iron deficiency anemia in pregnancy. Semin Hematol. 2015; 52: 339–347. 11 Vos T, Flaxman

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Primary immunodeficiency diseases (PIDs) are a heterogeneous group of disorders that genetically affect distinct components of the immune system; thus, predispose individuals to recurrent infections, allergy, autoimmunity, and malignancies. In this retrospective study, autoimmune diseases (ADs), which developed during the course of PID in children, were discussed.Twenty-five patients were included in this study. Symptoms related to ADs, such as autoimmune thyroiditis, type 1 diabetes mellitus, coeliac disease, juvenile idiopathic arthritis, dermatomyositis, autoimmune haemolytic anaemia, leukocytoclastic vasculitis, Henoch-Schonlein purpura, hypoparathyroidism, alopecia areata, Addison’s disease, vitiligo and systemic lupus erythematosus were detected in these patients, who have been followed with diagnosis of PID including common variable immunodeficiency, selective and partial IgA deficiency, Wiskott-Aldrich syndrome, ataxia telangiectasia, hyperimmunoglobulin E syndrome, chronic mucocutaneous candidiasis, Griscelli syndrome, and partial C4 deficiency.Immunodeficiency and autoimmune phenomenon may concomitantly present in an individual, although they seem to be incompatible ends in the spectrum of the clinical immune response. Patients with primary immune deficiency should be closely monitored for development of autoimmune diseases.

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Acta Biologica Hungarica
Authors: Anna Blázovics, Éva Sárdi, Klára Szentmihályi, L. Váli, Mária Takács-Hájos, and Éva Stefanovits-Bányai

Redox homeostasis can be considered as the cumulative action of all free radical reactions and antioxidant defences in different tissues, which provide suitable conditions for life. Transition metal ions are ubiquitous in biological systems. Beta vulgaris var. rubra (table beet root) contains several bioactive agents (e.g. betain, betanin, vulgaxanthine, polyphenols, folic acid) and different metal elements (e.g. Al, B, Ba, Ca, Cu, Fe, K, Mg, Mn, Na, Zn), which act on the various physiological routes. Therefore we studied the effect of this metal rich vegetable on element content of the liver in healthy rats. Male Wistar rats (n = 7) (200 ± 20 g) were treated with lyophilised powder of table beet root (2 g/kg b. w.) added into the rat chow for 10 days. Five healthy animals served as control. We found significant accumulation of Cu, Fe, Mg, Mn, Zn and P in the liver, which was proved by ICP-AES measurements. We suppose that the extreme consumption of table beet root can cause several disturbances not only in cases of healthy patients but, e.g. in patients suffering with metal accumulating diseases, e.g. porphyria cutanea tarda, haemochromatosis or Wilson disease-although moderate consumption may be beneficial in iron-deficiency anaemia and inflammatory bowel diseases.

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Journal of Radioanalytical and Nuclear Chemistry
Authors: M. Durosinmi, J. Ojo, A. Oluwole, O. Akanle, W. Arshed, and N. Spyrou

Abstract  

Instrumental Neutron Activation Analysis (INAA) and Proton-Induced X-ray Emission (PIXE) analysis (employed as a complementary technique) have been used to determine the concentration of 11 elements in blood samples and its components erythrocytes and plasma obtained, from three groups of subjects in Nigeria viz: sickle cell anaemia (SCA) subjects, subjects with sickle cell trait and normal control subjects. The results suggest that SCA subjects have significantly higher concentrations of Na, Cl, Ca and Cu in their whole blood and erythrocytes and a higher concentration, of Cl and Cu in their plasma relative to the control subjects. Furthermore, a significantly lower concentration of K, Fe, Zn, Se, Br and Rb were found in the whole blood and erythrocytes of the SCA subjects as compared to the controls while the concentration of K and Fe in the plasma of the SCA subjects were however, found to be significantly higher than that of the control group. The study also shows that there was no significant differences between the concentration of these 11 elements in the group with sickle cell trait and the normal control group.

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Acta Veterinaria Hungarica
Authors: Darko Davitkov, Milos Vucicevic, Jevrosima Stevanovic, Vanja Krstic, Snezana Tomanovic, Uros Glavinic, and Zoran Stanimirovic

Canine babesiosis is a frequent and clinically significant tick-borne disease. Sixty symptomatic dogs with clinical findings compatible with babesiosis were included in this study conducted in Serbia. After clinical examination, blood samples were taken for microscopic examination, complete blood count (CBC), Canine SNAP 4Dx Test, DNA analyses and sequencing. The main clinical signs included apathy, anorexia, fever, brown/red discoloration of urine, pale mucous membranes, icterus, splenomegaly, and vomiting. The main clinicopathological findings in Babesia infections were a slight to severe thrombocytopenia and a mild to very severe normocytic normochromic anaemia. Microscopic evaluation revealed 58 positive samples with the presence of large and small intraerythrocytic piroplasms in 57 and 1 sample(s), respectively. No co-infections were found using SNAP test. Two Babesia species, B. canis (58/60) and B. gibsoni (2/60), were differentiated by polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). Species identification was further confirmed by sequencing PCR products of B. gibsoni samples and six randomly selected B. canis samples. All dogs were treated with imidocarb dipropionate (6.6 mg/kg of body weight), given intramuscularly twice at an interval of 14 days. This report presents the first molecular evidence of the occurrence of B. gibsoni and B. canis, confirmed by DNA sequencing, in sick dogs from Serbia.

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