Evaluation of Blood Culture Results in Patients with Malignancy in Erzurum Province, Turkey.

Background: Bloodstream infections are a serious public health problem that requires follow-up with blood culture; this negatively affects the course of the disease and patient healthcare costs in patients with malignancy. This study aimed to determine the growth frequency of pathogens and their antibiotic resistance profiles in the blood cultures of patients with hematological and oncogenic malignancies. Materials and methods: The results of 7451 blood cultures, obtained from 2926 patients between January 2017 and January 2022, were evaluated retrospectively. Of these cultures, 3969 were obtained from patients with malignancy (diagnostic codes C00-D48 in ICD-10) and 3482 from patients without malignancy. The hospital information management system modules were used to acquire patient data and blood culture results. Results: Various microorganisms grew in 10.1% of blood cultures. Of these organisms, 64.1% were isolated from cases of malignancy. Of the pathogens, 49.2% were gram-negative bacteria, 47.7% were gram-positive bacteria, and 3.1% were fungi. The most frequently isolated bacteria were methicillin-resistant coagulase-negative staphylococci (3.2%), Escherichia coli (2.3%), Klebsiella pneumoniae (1.0%), methicillin-sensitive coagulase-negative staphylococci (0.7%), and Staphylococcus aureus (0.6%). Pathogen positivity was highest in the patient cultures with urinary system cancer (23.9%), thyroid and other endocrine gland cancers (20.6%), female and male genital organ cancers (18.2%/16.9%), and digestive organ cancer (14.2%). Gram-negative bacteria to ampicillin, piperacillin, and sulfamethoxazole-trimethoprim and Gram-positive bacteria to penicillin, erythromycin, and sulfamethoxazole-trimethoprim were highly resistant. Combined resistance to imipenem and meropenem was observed in 25 Gram-negative bacteria. Twelve (48%) of the carbapenem-resistant bacteria were isolated from patients with lymphoid, hematopoietic, and related tissue malignant neoplasia. Conclusion: This study reported microorganisms and their antimicrobial resistance in the blood cultures of malignant patients, a special patient group. It pointed out that the antibiotic resistance of Staphylococcus, Klebsiella pneumoniae, and E. coli is high enough to cause problems in the treatment of patients with malignancy.

Intracerebroventricular injection of kisspeptin in male rats activates hypothalamo-pituitary-gonadal axis, but not hypothalamo-pituitary-adrenal axis.

Kisspeptin is an important hormone involved in the stimulation of the hypothalamo-pituitary gonadal (HPG) axis. The HPG axis can be suppressed in certain conditions such as stress, which gives rise to the activation of the hypothalamo-pituitary-adrenal (HPA) axis. However, the physiological role of kisspeptin in the interaction of HPG and HPA axis is not fully understood yet. This study was conducted to investigate the possible effects of central kisspeptin injection on HPG axis as well as HPA axis activity. Adult male Wistar rats were randomly divided into seven groups as followed: sham (control), kisspeptin (50 pmol), P234 (1 nmol), kisspeptin + p234, kisspeptin + antalarmin (0.1 µg), kisspeptin + astressin 2B (1 µg), and kisspeptin + atosiban (300 ng/rat) (n = 10 each group). At the end of the experiments, the hypothalamus, pituitary, and serum samples of the rats were collected. There was no significant difference in corticotropic-releasing hormone immunoreactivity in the paraventricular nucleus of the hypothalamus, serum adrenocorticotropic hormone, and corticosterone levels among all groups. Moreover, no significant difference was detected in pituitary oxytocin level. Serum follicle-stimulating hormone and luteinizing hormone levels of the kisspeptin, kisspeptin + antalarmin, and kisspeptin + astressin 2B groups were significantly higher than the control group. Serum testosterone levels were significantly higher in the kisspeptin kisspeptin + antalarmin, kisspeptin + astressin 2B, and kisspeptin + atosiban groups compared to the control group. Our findings suggest that central kisspeptin injection causes activation in the HPG axis, but not the HPA axis in male rats.

Does irisin has neuroprotective effect against diabetes induced neuropathy in male rats?

We aimed to investigate the contribution of irisin in the neuroprotective process of exercise training in diabetic rats. Serum irisin levels, thermal and mechanical pain thresholds and intracellular calcium ([Ca2+]i) levels in sensory neurons were measured at different time intervals during the eight weeks of exercise sessions for the control, non-exercise diabetics (3 groups) and exercise performing (low and high intensity groups) diabetic rats (n = 7-10 for all groups). Non-exercise diabetic groups were treated with irisin in different doses (1, 10 and 20 µg/kg respectively). Recovered pain thresholds at the end of the exercise sessions (p < .05), higher serum irisin levels that compared to control and diabetics (p < .05) and insignificant mean [Ca2+]i peak amplitudes in sensory neurons (p > .05) obtained from experiments. Furthermore, irisin injection decreased the thermal pain threshold of diabetics only at 60th minutes (p < .05). Irisin may have a role in the neuroprotective effect of exercise training.

Distribution of bacterial, viral and parasitic gastroenteritis agents in children under 18 years of age in Erzurum, Turkey, 2010-2020.

Introduction: Diarrheal diseases have existed since antiquity, resulting in high morbidity and mortality rates, particularly among children in developing countries. To eradicate these diseases, it is crucial to identify the pathogens that cause them and immediately initiate appropriate treatment. This retrospective study aims to investigate the incidence of childhood gastroenteritis and the epidemiological features of its causative agents. Methods: During an 11-year period (2010-2020), as many as 51159 stool samples were obtained from children aged 0-17 years. These samples were examined for the presence of parasitic, bacterial, and/or viral gastroenteritis agents and evaluated retrospectively. The records obtained from the "ENLIL Hospital Information Management System Modules" were used to collect patient-related information. Results: The most frequently observed pathogens were rotavirus (22.4%), adenovirus (2.2), Giardia lamblia (1.6%), and Campylobacter spp. (3.0%), considering the number of samples examined for each organism. The total incidence of viruses was about 25%, parasites 5% and the rate of pathogenic bacteria was 2%. In one-way ANOVA analysis, pathogen positivity was found to be significantly higher in children aged 3-5 years compared to those aged 15-17 and 0-2 [F (5, 51153, 17,588, p<0.001)]. The highest demand for the investigation of GE factors from stool samples was made in August, September and July. According to the number of samples examined, the highest pathogen positivity was in February, October, May, December and March, respectively. The most common pathogens involved in coinfections, occurring in 0.04% of the studied cases, were rotavirus and Giardia lamblia. Conclusions: Parasitic, viral, and bacterial gastroenteritis maintain their current status with a high prevalence in children under 18 years of age, especially in children aged 0-4 years in Erzurum, Turkey.

Effects of titanium prepared platelet rich fibrin on facial nerve regeneration: an experimental study.

INTRODUCTION: Facial nerve damage is a condition that causes functional, psychological, and cosmetic problems; and treatment methods need to be improved. OBJECTIVE: We investigated the efficacy of titanium-prepared platelet-rich fibrin as a healing enhancer at the region of transection of the facial nerve. METHODS: Twenty-seven New Zealand male rabbits were used in this study, divided into three experimental groups. Group 1, the sham group (n=7); Group 2, the suture group (n=10); and Group 3, the suture+T-PRF group (n=10). In Group 1, the facial nerve trunk was dissected, and no additional surgical intervention was performed. For Group 2, a transection was made to the facial nerve trunk and the nerve endings were sutured together. In Group 3, nerve endings were sutured after transection, and a titanium-prepared platelet-rich fibrin membrane was wrapped in a tube around the damaged area. All animals were followed up weekly for the presence of corneal reflex, whisker movement and low ears. Bilateral facial electromyography was performed both preoperatively and postoperatively at the 1st, 3rd, 5th, 7th, 10th weeks. Tissue samples obtained at the 10th week were histopathologically examined, and intra-group and inter-group comparisons were performed. RESULTS: Subjects in Group showed improvement in whisker movement and ear drop one week earlier than Group 2. In Group 3, the nerve stimulation threshold required to trigger the compound muscle action potential had returned to values similar to the preoperative control values (11.31±2.16V) by 5 weeks postoperatively (12.51±3.97V), (p=0.249). CONCLUSION: Titanium-prepared platelet-rich fibrin administration contributed to partial nerve healing both on a functional and an electrophysiological level.

Volatility spillover around price limits in an emerging market.

The intraday volatility effects of price-limit hits for stocks in the BIST-50 index during a volatile period are examined. Our evidence supports the volatility no-effect, dampening and spillover hypotheses depending on whether the lower or upper price limit is hit and on when the hit begins and ends. Post-hit volatilities tend to be lower for limit hits near the beginning of the first trading session, unchanged for those that transcend a trading session and for upper price-limit hits near the end of either trading session, and higher for lower price-limit hits near the end of either trading session. These results are robust using samples differentiated by cross-listed status, same-day news, equi-distant and trade-by-trade returns and volatility measures accounting for return-series autocorrelations. Our findings have implications for emerging markets planning to impose price-limit bands or to increase their efficacy.

Serological Investigation of Occupational Exposure to Zoonotic Crimean-Congo Hemorrhagic Fever Infection.

OBJECTIVE: Crimean-Congo hemorrhagic fever (CCHF) is an acute and highly fatal disease. In this study, our aim was to compare and evaluate the prevalence of CCHF virus (CCHFV) antibody among occupational high-risk groups by using the enzyme-linked immunosorbent assay and draw attention to the occupational groups that are at high risk for CCHF infection in an endemic region for this zoonotic infection in Erzurum, Turkey. MATERIALS AND METHODS: The antibody levels against CCHFV were surveyed among slaughterhouse workers, animal breeders, and veterinarians. The study population was composed of 72 participants having direct contact with animals and 19 blood donors who were not in direct contact with animals. RESULTS: The overall rate of CCHF immunoglobulin G positivity in risk groups was found to be 6.94% (5/72). CCHFV antibodies were found in 4 (12.5%) individuals of the animal breeder group. This ratio was considered significantly higher compared with the healthy control group. CCHFV antibodies were found in only one person (4.0%) who was an abattoir worker. In the veterinarian group, all people were found negative. CONCLUSION: In our study, the variables showing important associations with the prevalence of anti-CCHFV antibodies were livestock breeding, rural areas, and age. It was concluded that our region is endemic with regard to CCHF infection and persons who had direct contact with animals are at high risk. Thus, these participants must take necessary measures to protect themselves from CCHF and should be trained by health authorities.

A molecular study on the prevalence and coinfections of Rotavirus, Norovirus, Astrovirus and Adenovirus in children with gastroenteritis.

BACKGROUND: Viral gastroenteritides are among the causes of higher morbidity and mortality in the childhood period, especially in infants. Although viral-induced diarrheal diseases are important problems in Erzurum, there have been no studies on the molecular prevalence of viral gastroenteritis agents in this region's children. The aim of the prospective study is to determine the molecular prevalence of the most commonly seen viral etiologic agents and their coinfection rates in children under 5 years of age with gastroenteritis in Erzurum, Turkey. METHODS: Stool samples from 375 children between 0 and 5 years of age who suffered from acute diarrhea were investigated for the presence of Rotavirus, Norovirus, Astrovirus and Adenovirus by reverse transcriptase polymerase chain reaction, followed by conventional PCR techniques. The presence of Rotavirus, Norovirus, Astrovirus and Adenovirus in the specimens was detected by amplification of the VP6, RdRp, ORF-1b and Hexon regions, respectively. Stool samples were also investigated non-viral enteropathogens by conventional techniques. RESULTS: At least one viral pathogen was detected in 59.2% of the stool samples. Rotavirus was the most frequently observed agent (32.3%), followed by Norovirus (20.3%), Adenovirus (9.6%) and Astrovirus (5.6%). All specimens were negative for bacterial pathogens. Twenty seven (7.2%) specimens were positive for intestinal helminths and protozoan. A total of 39 coinfection (10.4%) including 38 dual and 1 triple were detected. The most frequent coinfections were observed between Norovirus plus Rotavirus and Norovirus plus Adenovirus. CONCLUSIONS: Single infections or coinfections of the enteropathogenic viruses occur at a significant rate in Erzurum's children. This study draws attention to the necessity of taking account of multiple viral infections in studies on combined vaccines and the treatment of gastroenteritis.

Investigation of human papillomavirus prevalence in married women and molecular characterization and phylogenetic analysis of the virus.

OBJECTIVE: Human papillomaviruses (HPVs) are among the agents responsible for infection and cancer of the skin and mucous membranes in the human body. The aim of this study was to investigate the frequency and type distribution of HPVs in married female patients with gynecological complaints, who had visited the Maternity Hospital in Erzurum, Turkey. METHODS: In this study, 263 cervical swab samples were taken from married women using the Pap smear method and were investigated for positive reactivity against HPV. The L1 gene region of HPV was investigated using molecular methods. For this purpose, polymerase chain reaction (PCR) assays and sequence analysis of positive samples were performed. Phylogenetic analyses were performed using a bioinformatics approach after sequencing. RESULTS: HPV-DNA was detected in 17 (6.5%) samples. Highest positive reactivity to HPV-DNA was found in the 35-44 age group at 9.2%. Fourteen out of seventeen positive samples were included in the phylogenetic analysis. All isolates clustered in the Alphapapillomavirus genus. Six samples were found to be HPV 70 positive, four were HPV 16 positive, and the rest were HPV 54, 72, 81, and 114 positive. When genotyping data were evaluated according to the risk group, we found that 28.6% of the 14 samples were found to be high risk-HPV, and 71.4% were low risk-HPV. CONCLUSIONS: As per our knowledge, this is the first report on the phylogenetic analysis of HPV genotypes isolated from women in Turkey. The prevalence of low- and-high risk HPV was determined in married women in Erzurum, and these results contribute to the epidemiological data on the distribution of HPV types for this region.

The Prevalence of Mixed Genotype Infections in Turkish Patients with Hepatitis C: a Multicentered Assessment.

BACKGROUND: HCV virus infections are one of the major health problems in the world that can cause cirrhosis and liver cancer at a higher rate than other hepatitis data. The aim of this study was to determine the prevalence of mixed infections with different HCV genotypes in Turkey and also to evaluate the current HCV genotype and sub-type distributions by a multicentered assessment. METHODS: The HCV genotype data of 17,578 hepatitis C patients collected from 23 centers from different geographic regions covering all Turkey were collected. The data included information about the HCV genotypes in the last 10 years (between 2007 and 2016), demographic properties of the patients and the methods/systems used to determine the genotypes. RESULTS: Two hundred twenty-eight of the patients (1.3%) had mixed genotype. The most common mixed genotype combination was 1b + 4 (0.83%) followed by 1a + 1b (0.26%). Genotype distribution varies according to geographical regions. However, genotype 1 (82.92%) was the most common genotype in all regions and all years. This was followed by genotype 3 (7.07%) and genotype 4 (5.43%). A variety of methods were used by the centers including sequencing, pyrosequencing, real-time PCR, in-house RFLP, reverse hybridization (LIPA), and hybridization. CONCLUSIONS: Infection with mixed HCV genotypes in Turkey is uncommon. Genotype distribution varies according to geographic regions; the most common genotype 1 is encountered all over the country, while genotypes 3 and 4 are only in some of the centers. Since there is limited information about mixed HCV infection, further investigations are needed to determine the clinical importance of mixed HCV infection.

Genetic diversity of primate erythroparvovirus 1 between 2009 and 2016: First report from Turkey.

Parvovirus B19 (B19V) is one of the major viral pathogens that infect only human beings. This study's aim is to determine which genotypes of the B19V are present in Turkey and to perform a phylogenetic analysis. Twelve B19V positive serum specimens already diagnosed by real-time PCR amplifying a partial region of the NS gene were included in this study. The serological markers and viral loads of the patients were determined. The positivity of the specimens was confirmed using semi-nested PCR. To determine the genotype of the B19V, PCR-positive amplicons were sequenced directly and compared to GenBank-referenced strain sequences. The phylogeny of the 12 sequenced strains was constructed with the maximum likelihood method. Two different genotypes of B19V were identified in our study. Genotype 2 of B19V was not detected. All of the B19V genotype 1 sequences were clustered in the common genotype 1a cluster (10/12, 83.3%). The average quantification of the B19V strains was determined to be 2.1 × 107 IU/ml. The nucleotide identities between our strains and those isolated in other countries were 85.8%-99.5%. Compared to the Turkish strains identified in our study, at the nucleotide level, the closest strains based on genotypes 3b and 1a were the Germany and Netherlands isolates respectively. This study was the first to provide the genotypic variation of B19V circulated in Turkey. We determined two distinct subtypes of B19V, including subtype 3b and 1a. While the genotype 1 is common all over the world, genotype 3 has begun to spread outside of Africa.

Rotavirus genotypes in children with gastroenteritis in Erzurum: first detection of G12P[6] and G12P[8] genotypes in Turkey.

INTRODUCTION: Rotavirus is one of the leading pathogens which cause acute gastroenteritis in children and is responsible for a substantial proportion of childhood deaths worldwide. AIM: To determine the group A rotavirus (RVA) prevalence and genotypes of circulating RVA strains in 0-5-year-old children with complaints of vomiting and diarrhoea in Eastern Anatolia in Turkey. MATERIAL AND METHODS: RNA extracted from stool specimens of 329 children aged 0-5 years with acute diarrhoea was subjected to reverse transcription polymerase reaction (RT-PCR) and multiplex-nested PCR. The genotypes were identified based on the expected size of the amplicon, which was amplified with a genotype-specific primer. RESULTS: Out of 329 stool samples analyzed, 109 (33.1%) were positive for RVA. G1P[8] was the dominant genotype combination (42.2%), followed by G9P[8] (21.1%) and G12P[6] (11.0%). Mixed infections were identified in 5 cases: G3,9 in 2 cases, G1,9 in 1 case, P[4,8] in 1 case, and P[6,8] in 1 case. The P genotype could not be typed in two patients. CONCLUSIONS: In the study, we detected six different rotavirus G genotypes, 3 different P genotypes, 11 different G-P combinations and 5 different mixed genotypes combinations. G1, G9, G12 and P[8] were found to be the predominant genotypes. G12P[6] and G12P[8] genotypes, showing an increase as new rotavirus genotypes in the world, are reported for the first time for our regions. We determined the dominant genotypes, mixed genotypes and unconventional genotypes of rotavirus in our region.

Frequency and molecular characterization of human norovirus in Erzurum, Turkey.

BACKGROUND/AIM: There are limited studies on genotyping and phylogenetic analysis of norovirus in Turkey, and this has not previously been studied in the Eastern Anatolia region. The aim of the present study was to determine the norovirus profile in this region with genotyping and phylogenetic analysis. MATERIALS AND METHODS: Included in the study were stool samples obtained from 427 people from different age groups in Eastern Anatolia. The nucleic acid samples isolated by the automatic system and nucleic acid sequence reactions and phylogenetic analyses were performed on RNA samples. RESULTS: The presence of norovirus was detected in 86 (20.1%) of the 427 stool samples by RT-PCR analysis. Twenty-six samples selected randomly from norovirus-RNA positive samples were subjected to the sequence reaction. In 24 of the 26 samples, genogroup GII was determined, as well as one each from GI and GIV in sequence reactions. Four different genotypes were detected in genogroup GII, which were determined to be the dominant types. These were GII.1, GII.4, GII.16, and GII.21. The GI.6 and GIV.1 genotypes were determined in genogroups GI and GIV, respectively. CONCLUSION: The high frequency and genetic diversity of these infections are risk factors for disease and so vaccine studies should be undertaken in consideration of this situation.

Comparison of Various Methods in the Diagnosis of Entamoeba histolytica in Stool and Serum Specimens.

OBJECTIVE: Entamoeba histolytica is indistinguishable from Entamoeba dispar in direct microscopic examination. A definitive diagnosis of E. histolytica is important in terms of the treatment of the patient and to avoid unnecessary costs. This study's aim is to determine the prevalence of E. histolytica and to make a comparison of the different diagnostic tests in the patients specimens defined as E. histolytica/E. dispar infection. MATERIALS AND METHODS: Faecal and serum specimens of 90 patients defined as E. histolytica/E. dispar with microscopy (wet mount examination with 0.85% saline and Lugol's iodine) were examined. Stool samples were examined by trichrome staining for trophozoites and cysts and by immunoassay methods for specific adhesin antigens (Wampole (®) E. histolytica II antigen testing) and for specific serine-rich 30 kD membrane protein (Serazym(®) E. histolytica antigen testing). Anti-E. histolytica antibodies were investigated using a latex slide test and indirect hemagglutination methods in serum specimens. RESULTS: Presence of E. histolytica was not confirmed in 31.1% cases with trichrome staining, 62.2% of the Wampole antigen test, 64.4%, of the Serazym antigen test, 73.3% of the indirect hemagglutination test and 75.6%. of the latex agglutination. Considering the common results from Wampole and Serazym antigen testing as a reference standard, the specificity/sensitivity is 100/53.85% for trichrome staining, 75.00/98.11% for the latex agglutination test and 78.57/96.77% for the indirect hemagglutination test. CONCLUSION: It has been shown that investigation of E. histolytica in stools by direct wet-smear microscopy alone can cause significant false positive results. To obtain a reliable diagnosis for E. histolytica and to avoid unnecessary treatment for this parasite, at least one more specific assay, particularly an antigen testing and microscopy, is required.

Serological prevalence of human parvovirus B19 in diseases or disordersrelated to different human body systems.

BACKGROUND/AIM: Human parvovirus B19 is a pathogen that affects different parts of the body. We planned this study because of the lack of data on B19 seroprevalence based on different body-system diseases. MATERIALS AND METHODS: The prevalence of parvovirus B19 antibodies was investigated retrospectively in 1239 patients by review of medical records from 2009-2012, according to their diseases classified under general titles in compliance with the International Classification of Diseases (ICD-10). Parvovirus B19-specific antibodies were detected by quantitative enzyme immunoassays. RESULTS: The positivity rate was 27.8% for only IgG, 8.5% for only IgM, and 2.6% for both IgG and IgM. The highest positivity for IgG alone was found in musculoskeletal system and connective tissue diseases (55.9%), while the highest positivity for IgM was found in neoplasms (16.4%). The highest positivity for IgG was seen in rheumatoid arthritis (72.2%) and pregnancy (52.6%), and the highest positivity for total IgM was found in upper respiratory tract disease (21.0%) and hepatic failure (17.1%). CONCLUSION: Parvovirus B19 seroprevalence was relatively low in northeastern Anatolia compared to most serological studies conducted in other regions. We think that this study has provided the first wide-ranging information on the seroprevalence of B19 in diseases and disorders of the major human body systems.

A childhood case of primary hepatic actinomycosis presenting with cutaneous fistula.

Primary hepatic actinomycosis is extremely rare in children. Although the infection has the capability of extension to surrounding tissues or organs, involvement of the abdominal wall is infrequently reported even in adults. We present a childhood case of primary hepatic actinomycosis infiltrating the anterior abdominal wall and spontaneously draining through the skin.