Nermin Sakru

Cystic Echinococcosis (CE) is a rare but serious parasitic disease caused by Echinococcus granulosus sensu lato, representing only 1–2% of all hydatid disease cases. Due to its nonspecific clinical presentation, its diagnosis and management pose significant challenges. This study aimed to provide a comprehensive overview of intracranial CE cases reported globally over the past 35 years, focusing on demographic characteristics, clinical presentation, diagnostic approaches, treatment modalities, and outcomes. Methods: A systematic review was conducted in accordance with PRISMA guidelines and was registered in PROSPERO (CRD 42024608624). Relevant studies published between 1990 and 2024 were identified from PubMed, Scopus, and Web of Science databases. Results: After screening and eligibility assessment, 392 studies involving 718 intracranial CE cases were included. The majority of patients were children (65%) and male (59.2%). The most frequent presenting symptoms were signs of increased intracranial pressure (79.4%), followed by motor deficits (37.9%) and visual disturbances (23.2%). Most cysts were located in the supratentorial region (88.9%), predominantly in the parietal lobe, and were solitary (88.4%). Surgical intervention was performed in 95.8% of cases, often combined with albendazole therapy. Complete recovery was observed in 85.5% of patients, while 8.7% died—primarily due to cyst rupture-related complications such as septicemia and anaphylaxis. Recurrence was reported in 26% of cases with follow-up. Conclusions: This review presents one of the most extensive analyses of intracranial CE to date. Despite being a rare manifestation, intracranial CE should be considered in the differential diagnosis of space-occupying brain lesions in endemic areas, particularly in paediatric patients.

Echinococcus granulosus sensu lato (E. granulosus s.l.) is globally distributed and highly prevalent in parts of South America, the Mediterranean, Eastern Europe, the Middle East, Africa, China, and Australia. This systematic review explores the epidemiological and clinical features of urogenital system-cystic echinococcosis (UGS-CE). To systematically review and synthesize available evidence on the epidemiological patterns, clinical presentations, diagnostic methods, and treatment approaches for UGS-CE. Systematic review. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines and was registered in PROSPERO (CRD42024613418). A comprehensive literature search was conducted in the PubMed, Scopus, and Web of Science databases for articles published between 1990 and 2024. Studies based on individual data were included if the UGS-CE diagnosis was confirmed by imaging or laboratory methods. After screening 1976 records, 490 studies were finally included to comprise the following 698 UGS-CE cases: 561 (80.4%) involved the urinary system; 110 (15.8%) involved the female genital system; and 27 (3.9%) involved the male genital system. The kidney (478, 68.5%) was the most commonly affected organ, followed by the adrenal gland (64, 9.2%), the ovary (51, 7.3%), and the uterus (24, 3.4%). Radiological imaging, especially ultrasonography, was the primary diagnostic method used, which is often supported by computed tomography (CT). Treatment was mainly surgical and in combination with antiparasitic therapy. Among the 155 patients who underwent surgical treatment, 134 were initially misdiagnosed with either malignant or benign tumors. Though rare and often non-specific, UGS-CE must be considered in patients with abdominopelvic or flank pain, hydatiduria, urinary symptoms, infertility, or dysmenorrhea, especially in endemic areas. Early detection and appropriate management are crucial to improving the outcomes. A radiological assessment is the primary diagnostic method, with ultrasonography as the most effective, often supported by CT. Treatment is mainly surgical and complemented by antiparasitic therapy to reduce the recurrence/relaps risk.

Background: This systematic literature analysis discusses cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) in Türkiye, emphasizing the increasing importance of species determination studies and epidemiological research due to the emergence of new causative agents post-2010. It highlights the influx of immigrants and refugees into Türkiye, particularly from the neighboring countries where conflict occur. Materials and methods: The study conducted a systematic review of research on leishmaniasis among refugees/immigrants in Türkiye between 2010 and 2022. A search in literature was carried out via English (PubMed, Scopus and Web of Science) and Turkish (TRDizin, and Council of Higher Education Thesis Center) databases published between 1 January 2010 and 31 December 2022. Two reviewers assessed the full-text articles to determine final eligibility. Results: A total of 1,356 studies were identified, and 20 studies for CL, two studies for CL/VL and one study for VL (23 studies, 25 data set) were included in this systematic review. In these 22 studies, a total of 4,337 positive CL cases were reported. Among these positives 1,381 cases were diagnosed in Turkish individuals. The remaining 2,956 positive CL cases were the immigrants from different countries including Syria (n=2,925), Iraq (n=13), Afghanistan (n=7), Somalia (n=4), Iran (n=3) and one case each of Libya, Turkmenistan, Tunisia and Morocco. We also identified the presence of 94 positive visceral leishmaniasis cases, with 75 cases being among Turkish individuals and 19 cases among Syrian refugees in three studies. Conclusions: The systematic review underscores the significance of international epidemiological data sharing and robust health monitoring systems to manage the global public health threat posed by leishmaniasis and other infectious diseases related to population movements.

Peer education is an education model applied to change knowledge, behavior, and attitude in groups equal to each other regarding age, education, and status. This model is preferred in universities to improve teaching skills and reduce the stress level of students. This study aims to apply the peer education model at Trakya University Faculty of Medicine to receive feedback from students and to examine its effect on exam results. This cross-sectional, descriptive, and analytical study was conducted with second-year medical students in parasitology laboratory lessons. Eighteen out of a total of 264 students were selected as peer educators. Peer educators have reached the level of providing education to students by taking the training before the laboratory lessons. At the end of the study, questionnaires were applied to peer educators and students. The students’ of 2021–2022 exam results were compared with the 2018–2019 academic year results. A total of 233 students were surveyed, and 78.5% (183/233) of them believe peer education is helpful, 69.9% (163/233) think it can help them reinforce what they have learned in theoretical lessons, 54.5% (127/233) think it should be used in other practical lessons, and 64.3% think it should be used in the coming years. While there was no significant difference between the exam results of the students in 2021–2022 and the 2018–2019 period (p: 0.462), a significant difference was found between the exam results of peer educators and students (p < 0.05). It is known that with the peer education model, student stress will decrease, and interest and participation in the lesson will increase. Continuing this education model in the coming years and expanding it to other laboratory courses will benefit medical education.

Toxoplasma gondii (T. gondii) is an obligate intracellular parasite distributed worldwide. Serological tests investigating antibodies specific to T. gondii are widely used in diagnosis. The aim of this study was to evaluate the results of anti-T. gondii IgG, anti-T. gondii IgM, and anti-T. gondii IgG avidity tests, which were sent to the Serology Laboratory of Trakya University Health Center for Medical Research and Practice, retrospectively. Anti-T. gondii IgM, anti-T. gondii IgG, and anti-T. gondii IgG avidity tests were studied by enzyme-linked fluorescent assay or electrochemiluminescence immunoassay method between January 2012 and December 2021. The test results were evaluated retrospectively from laboratory records. Of 18,659 serum samples were studied for anti-T. gondii IgG, 5,127 (27.5%) samples were positive, whereas 721 (3.4%) of 21,108 samples were positive for anti-T. gondii IgM. Of the 593 serum samples tested for IgG avidity, 206 (34.7%) samples had low avidity, 118 (19.9%) had borderline, and 269 (45.4%) had high avidity. Our study, compatible with other studies, showed that seropositivity is high in our region, which is not negligible. Especially in women of reproductive age population, T. gondii should be considered in suspected clinical cases.

Background: Parasites of the genus Echinococcus are common worldwide and are important cestodes that cause serious infections in humans and animals. This retrospective study evaluated the indirect hemagglutination (IHA) test results of serum samples obtained from patients with a pre-diagnosis of cystic echinococcosis (CE) within ten years. In addition, the role of the IHA test results of the patients in the follow-up of the treatment and determining possible recurrences was investigated. Methods: The IHA test results of 2426 serum samples of patients with a pre-diagnosed CE admitted to Trakya University Health Center for Medical Research and Practice in Edirne, Turkey, between January 2011 and December 2020 were evaluated retrospectively. The data of 53 patients with CE who had medical treatment and/or postoperative follow-up serological records were evaluated. Results: Of 2426 IHA tests, 376 (15.5%) were seropositive, and 2050 (84.5%) were seronegative. It was determined that 376 serum samples detected as positive belonged to 207 patients with CE. Of 207 CE patients, 109 (52.7%) were female and 98 (47.3%) were male. The most common organ involvement was the liver in 186 (89.9%) cases. Of 53 patients, 16 were considered relapse cases. The median follow-up period for 16 recurrent cases was 31.8 (1-77) months. Our results showed a statistically significant correlation between long-term serological follow-up and recurrence detection (P=0.034). Conclusion: Long-term serological follow-up after treatment is considered useful in determining possible recurrent cases. CE is an important public health problem for endemic regions, including our country, and we think our study results will contribute to the status and follow-up of the disease.

Echinococcus granulosus is the causative agent of cystic echinococcosis in humans and livestock. It is common worldwide. Cystic echinococcosis is still an important public health problem in Turkey, which is an endemic region. To genotype Echinococcus granulosus isolates and investigate antigen B gene polymorphism in Thrace, Turkey. A cross-sectional study. Seventy-five hydatid cyst materials obtained between June 2020 and May 2021 were included in the study. Hydatid cyst materials were collected from 12 humans from various hospitals in Edirne and 63 from slaughterhouse animals during the same period. Cyst materials were localized in 8 livers and 4 lungs in humans, 23 livers and 17 lungs in cattle, and 13 livers and 10 lungs in sheep. In the first step, the 12S ribosomal RNA gene was amplified by polymerase chain reaction for all samples and run on an agarose gel. Band patterns were used for strain typing. Then, the selected samples that represented each of the band patterns obtained by single-strand conformation polymorphism analysis were sequenced for AgB1, AgB2, mt-CO1, and mt-ND1 genes. Three different genotypes in Edirne, Thrace, Turkey, were observed for Echinococcus granulosus: G1 (domestic sheep strain), G2 (Tasmanian sheep strain), and G3 (buffalo strain). G1 was the dominant genotype in Edirne, and G3 was the second most common. Additionally, polymorphism in AgB1 and AgB2 gene regions was found. This study is the first to report on Echinococcus granulosus G2 (Tasmania sheep strain) in Turkey and G3 (buffalo strain) and antigen B polymorphism in Thrace. The study results will contribute to the prevention and control programs for cystic echinococcosis in Turkey and worldwide.

Lysinibacillus massiliensis is an aerobic, endospore-forming, gram-negative staining bacterium with peritrichous flagella belonging to the Bacillaceae family. A few cases of L. massiliensis isolated from the cerebrospinal fluid and tissue have been reported. In this study, we aimed to describe a case of L. massiliensis isolated from the synovial fluid. The synovial fluid from a 74-year-old female patient was inoculated into blood culture bottle. Gram-negative rods were observed in a gram-stained smear from a positive blood culture bottle. The bacterium was identified as Lysinibacillus sphaerkus/Lysinibacillus fusiformis, with a probability of 89% using an automated bacterial identification system (VITEK2; Biomerieux, France). Subsequently, 16S rRNA gene sequencing was performed, and the sequence was analyzed using the Basic Local Alignment Search Tool. The sequence had 99.9% (1426/1427) identity with the strain L. massiliensis (GenBank ID: NR_043092.1). To our knowledge, this is the first reported case of L. massiliensis isolated from the synovial fluid. When an endospore-forming gram-negative staining bacterium can not be identified by phenotypic characterization, L. massiliensis should be considered, and different microbiological methods should be used for identification.