Sensitivity to House Dust Mites Allergens in Patients with Allergic Asthma in Erzincan Province, Turkey

OBJECTIVE

To investigate the sensitivity of allergic asthma (AA) patients to house dust mites (HDM) by conducting skin tests, measuring total and specific IgE antibodies to Dermatophagoides pteronyssinus and D. farinae mites, and examining HDM fauna in patients' homes.

METHODS

The study included 25 patients with AA and 31 healthy controls, who were challenged with Der p and Der f allergens; serum levels of allergen-specific lgE and total IgE were measured. Dust samples were collected from the homes of all participants, and mite species and the number of mites per gram of dust were investigated.

RESULTS

D. pteronyssinus was found in the homes of 94.7% patients with positive Der p reactions in the skin test (p<0.001). D. farinae was found in the homes of 22.2% patients with positive Der f reactions in the skin test (p>0.05). D. pteronyssinus-specific IgE was detected in 75% patients in whose homes D. pteronyssinus was also found, while D. farinae-specific IgE was detected in 16.6% patients in whose homes D. farinae was also found.

CONCLUSION

A part of AA patients residing in Erzincan are sensitive to HDM allergens, and high numbers of mites leading to allergic sensitization are found in their homes.

[Measles outbreak in the adult age group: evaluation of 28 cases]

Nowadays, the age group affected from measles has widened and the disease has become more common among adolescents and young adults. The number of measles case reports have increased in our country, particularly from 2010-2011, and measles outbreaks occurred in various regions in 2012 and 2013. The aim of this study was to analyze the demographical and epidemiological characteristics, clinical and laboratory findings, and complications of adult patients with measles who were affected during the outbreak. A total of 28 patients (25 male, 3 female; age range: 19-39 years, median age: 24) who were hospitalized and followed-up in our clinic between January 2013 and June 2013, were evaluated. In the serum sample of the index case, measles-specific IgM antibodies were detected by ELISA, and measles virus RNA by real-time polymerase chain reaction (RT-PCR), then genotyping was performed to detect the epidemiological relationship. In all of the other cases, measles IgM and IgG antibodies were screened by ELISA. The most common symptoms on admission included high fever (n= 28, 100%), malaise (n= 25, 89%), sore throat (n= 25, 89%), headache (n= 20, 71%) and cough (n= 18, 64%). At physical examination, rash (n= 28, 100%), lymphadenopathy (n= 11, 39%) and conjunctivitis (n= 10, 36%) were in the foreground, and Koplik spots were detected in five (18%) cases. The most common laboratory findings were; increased level of C-reactive protein (n= 15, 54%), leukopenia (n= 12, 43%) and increased serum levels of aminotransferases (n= 12, 43%), and thrombocytopenia was detected in five (18%) patients. One or more complications (secondary bacterial pneumonia in 5, diarrhea in 4, hepatitis in 3 and otitis in 2 cases) developed in the eight (29%) patients. Measles RT-PCR and IgM tests yielded positive results for the index case, and the isolate was identified as D8 strain by genotyping. Measles lgM antibodies were also positive in all of the other cases. The hospitalization period was estimated as 3-7 days (median: 5 days), while all the patients were discharged with recovery. It appeared that, our index case had come from a troop in Amasya province three days ago and he had a history of contact with suspected measles patients. In addition, the D8 strain determined in the index case was found to be related with the strain that caused the outbreak in Amasya province. Of the cases, 20 (71.4%) were military personnel, and eight (28.6%) were civilian who had histories of contact with military personnel. Regardless of immunity status in the outbreak period, all of the healthcare staff in our hospital, especially in risky departments, was recommended to be vaccinated. Personnel vaccination was provided at a high rate, however nosocomial transmission occurred in two unvaccinated cases. In conclusion, measles is an important health problem, especially in the adult age group, because of the complications and labour loss. For outbreak management; the awareness of health personnel should be increased following the identification of index case, proper isolation measures should be taken for the hospitalized patients, and routine reporting should be carried out timely and accurately.

[A case of brucellosis presenting with suppurative parotitis involvement]

Brucellosis is a common zoonotic infection caused by Brucella bacteria. Brucella infections are usually presented with various clinical manifestations, and often accompanied by multiple organ involvements. In this article, we present a case of brucellosis with suppurative parotitis involvement accompanied by parotid abscess and fistula in a 60-year-old male patient. According to the literature review we conducted regarding complications of brucellosis, our case is the first case reported in the literature. Significant improvement in patient's suppurative parotitis and clinical findings was observed at the fifth week of combination antibiotic therapy. Patient's complaints resolved completely after eight weeks of treatment.

Comparison of Living and Bedrooms in Terms of House Dust Mites in the Province of Erzincan, Turkey

The most important factors in development of symptoms such as allergic asthma, rhinitis, conjunctivitis, and dermatitis in atopic persons are the allergens of house dust mites. The objective of this study was to compare living rooms and bedrooms, and woolen and spring mattresses in terms of the number and species of mites in houses in the province of Erzincan, Turkey. In total, 74 dust samples were collected from living rooms and bedrooms of 37 randomly selected houses from various districts of the city. All examined houses were positive for house dust mites. In total, 5,210 mites were isolated, 1,058 from the living rooms and 4,152 from the bedrooms, and the differences were statistically significant (P < 0.05). Of 4,152 mites detected in bedrooms, 1,330 (32%) were isolated from 31 spring mattresses and 2,822 (68%) from 6 woolen mattresses (P < 0.001). The study identified 14 families, 17 genera, and 16 species belonging to Astigmata, Prostigmata, and Oribatida. Of these, Dermatophagoides pteronyssinus (Trouessart) was the dominant species: living rooms, 63.3%; bedrooms, 74.4%; woolen mattresses, 84.6%; and spring mattresses, 52.8%. This was followed by Lepidoglyphus destructor (Schrank) (9.8%), Dermatophagoides farinae Hughes (5.1%), Tyrophagus putrescentiae (Schrank) (4.3%), and Acarus siro L. (2.5%) in living rooms; L. destructor (11.2%), Euroglyphus maynei (Cooreman) (4.2%), D. farinae (3.8%), and T. putrescentiae (1.0%) in bedrooms; L. destructor (11.8%), D. farinae (2.1%), E. maynei (0.3%), and T. putrescentiae (0.2%) in woolen mattresses; and E. maynei (12.5%), L. destructor (9.9%), D. farinae (7.5%), and T. putrescentiae (2.7%) in spring mattresses.

Genotoxic evaluation of two oral antidiabetic agents in the Drosophila wing spot test

In this study, two sulfonylureas—glimepiride and glipizide—commonly used in type 2 diabetes mellitus were investigated for genotoxicity in the Drosophila wing spot test. For this purpose, three-day-old transheterozygous larvae were treated with three mutagenic compounds, and the results obtained were compared with the control group. Mutational or recombinogenic changes were recorded in two recessive genes— multiple wing hairs ( mwh) and flare ( flr3). Two recessive markers were located on the left arm of chromosome 3, mwh in map position 0.3, and flare-3 ( flr3) at 38.8, while the centromere was located in position 47.7. Wing spot tests are targeted on the loss of heterozygosity, which may be grounded in different genetic mechanisms such as mutation, mitotic recombination, deletion, half-translocation, chromosome loss, or nondisjunction. Genetic changes formatting in somatic cells of the imaginal discs cause nascence different mutant cloning in different body parts of adult flies. Our in vivo experiments demonstrated that glimepiride and glipizide show the genotoxicity, which is especially dependent on homologous somatic recombination.