The first serological detection of West Nile virus infection among residents living in northern Turkey.

BACKGROUND & OBJECTIVES: West Nile virus (WNV) is transmitted by a mosquito-borne virus whose natural reservoir is birds. Humans and horses are considered accidental hosts. Even if the vast majority of WNV infections in humans have asymptomatic or mild disease settings, serious neurological disorders with lethal outcomes can also be observed in around 1% of the cases. We aimed to serologically investigate the presence of WNV in humans living in Black sea of Turkey, and to obtain epidemiological data that will contribute to the implementation of public health policies to control and prevent potentially other life-threatening arboviral infections. METHODS: In the current study, a total of 416 human sera were collected from native patients of Samsun and its boroughs attending Samsun Training and Research Hospital; these sera were tested for WNV with pooling method, using anti-IgM and IgG ELISA commercial kits. All pools that were found positive for both IgM and IgG were individually retested for the detection of positive WNV sera. After that, all positive samples were tested using real-time PCR to detect the presence of WNV-RNA particles. RESULTS: Total seropositivity rates of WNV in terms of IgM and IgG were found as 0.96% and 0.72%, respectively. No presence of WNV-RNA could be detected in positive samples. INTERPRETATION & CONCLUSION: According to the data, further studies should be conducted to better understand the epidemiological dynamics of WNV in Turkey. It is recommended that other antigenically related flaviviruses which can give cross-reaction with WNV should also be investigated.

Incidence of Coronavirus-2 in cerebrospinal fluid in pregnant Coronavirus Disease 2019 (COVID-19) patients with neurological symptoms.

BACKGROUND: The aim of this prospective cohort study was to investigate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the cerebrospinal fluid (CSF) of pregnant women with neurological symptoms due to coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: This research was carried out in the Samsun University. Department of Anesthesiology and Reanimation from December 2021 to May 2022. Pregnant women exhibiting neurological symptoms linked to COVID-19 were assigned to one of the two groups, depending on the severity of the disease-mild (Group 1) and severe (Group 2). Specimens were collected from patients' CSF, and the presence of SARS-CoV-2 was investigated using the reverse transcription-polymerase chain reaction (RT-PCR) method. SARS-CoV-2 was also investigated using RT-PCR by collecting oropharyngeal swab specimens from infants in the first 6 h after birth. RESULTS: One hundred fifty patients were enrolled, 75 in both groups. The most frequent neurological symptoms were dizziness in Group 1 (52%) and headache in Group 2 (32%). No significant differences were determined in neutrophils, lymphocytes, hemoglobin, leukocytes, platelets, ferritin, D-dimer, C-reactive protein, prothrombin time, aspartate aminotransferase, alanine aminotransferase, creatinine, sedimentation, or fibrinogen values. SARS-CoV-2 was identified in the CSF of only one patient, from Group 2. Infant oropharyngeal swab specimens tested negative for SARS-CoV-2 using RT-PCR. CONCLUSION: This study indicates that the detection of SARS-CoV-2 in CSF via RT-PCR is rare. We suggest that neurological symptoms linked to SARS-CoV-2 are not caused by direct invasion and that other etiologies represent more likely mechanisms.

A prevalence study of COVID-19 among healthcare workers in a pandemic hospital in the Samsun province of Turkey.

Among populations globally, many healthcare workers have been disproportionally impacted by the COVID-19 pandemic because of their above average exposure to people infected with SARS-CoV-2. Exposure to asymptomatic or pre-symptomatic individuals is particularly challenging, if those individuals continue to work, not knowing that they are potentially infectious. This study aimed to measure the level of asymptomatic infection in a cohort of workers in a healthcare setting in Turkey during the second major wave of infection in late 2020. Blood samples were collected and tested by electrochemiluminescence immunoassay for SARS-CoV-2 IgM and IgG antibodies. Nasal and throat swabs were performed in a subset of this cohort and RT-qPCR was used to search for the presence of SARS-CoV-2 RNA. The results showed that approximately 23% of the cohort were positive for anti-SARS-CoV-2 IgM antibodies and approximately 22% were positive for anti-SARS-CoV-2 IgG antibodies despite no reported history of COVID-19 symptoms. Just less than 30% of a subset of the group were positive for the presence of SARS-CoV-2 RNA indicating the likelihood of a current or recent infection, again despite a lack of typical COVID-19 associated symptoms. This study indicates a high rate of asymptomatic infection and highlights the need for regular testing of groups such as healthcare workers when community prevalence of disease is high and there is a desire to limit entry of virus into settings where vulnerable people may be present, because symptoms cannot be relied on as indicators of infection or infectiousness.

Genotype Distribution and Prevalence of High-Risk Human Papillomavirus Infection among Women in Samsun Province of Turkey.

BACKGROUND: The human papillomavirus (HPV) is an important public health problem that can cause cervical cancer. HPVs were classified into high-risk (HR-HPV) and low-risk (LR-HPV) types. In this study, we aimed to determine the prevalence and genotype distribution of HR-HPV infection in Samsun province in Turkey. METHODS: Cervical smear samples taken from 5406 women over a 23-month period were evaluated for the presence of HPV infection. The detection of HPV genotypes was performed using RT-PCR technology. HPV detection and genotyping were performed using RT-PCR method. HR- HPV types are divided into 3 groups as type 16,  type 18 and other types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, with or without type 16 and 18).  The results were evaluated statistically. RESULTS: The mean age of HR-HPV positive patients was 39.56 years (20-68 years). The prevalance of HR-HPV types did not differ between different age groups (p˃0.05). Overall, 9.17% of women (496/5406 samples) were found to be positive at least one type of HR-HPV. HPV type 16 was detected in 28.62%, type 18 in 9.67%, and other types in 78.83%. The most common HR-HPV type was other types (p˂0.001). Type 16 was most common than type 18 (p˂0.001). The patients were evaluated by dividing them into 6 age groups. Type 16 positivity was higher in 30-39 ages while type18 and other types positivity were higher in the 40-49 age group. When the 23-month period of HPV test was evaluated according to months and seasons, the highest prevalance was seen in June 2021 and Summer 2021. CONCLUSION: To our knowledge, this is the first large-scale study of HR-HPV prevalence and genotype distribution among women in Samsun Province of Turkey.  The other types containing one or more types made up the majority of the studied population.

[Evaluation of Patients Diagnosed with COVID-19 in Terms of Risk Factors]. / COVID-19 Tanili Hastalarin Risk Faktörleri Açisindan Degerlendirilmesi.

Coronaviruses are RNA viruses that can cause disease in the upper and lower respiratory tract in humans and animals. Lately, a new coronavirus causing pneumonia cases was detected in Wuhan, China in December 2019. Soon after, the name of the virus was identified as the "severe acute respiratory syndrome coronavirus-2", and the World Health Organization named the disease coronavirus disease-2019 (COVID-19). In our country, the first cases began to appear in the second week of March. In this study, we aimed to investigate the demographic characteristics and risk factors of patients with the diagnosis of COVID-19. A total of 100 patients (53 female and 47 male) were included in our study. The patients included in the study were randomly selected from the registration system and their information was evaluated retrospectively. The mean age of the patients was 54.42 (Age range= 20-90). When the risk factors for catching the disease were evaluated; it was determined that there was at least one risk factor in 46 patients; 30 patients had close contact with the COVID-19 patient in the social environment (30%) and 16 patients had a travel history outside the city in the last 14 days (16%). The most common symptoms in our patients were; cough (93%), fever (42%), dyspnea (22%), weakness (8%), sore throat (7%), diarrhea (6%), headache (5%) and sputum (2%). The most common comorbid conditions in our patients were detected as hypertension (42%), diabetes mellitus (DM) (21%), congestive heart failure (10%), allergic asthma (7%), chronic obstructive pulmonary disease (6%), rheumatoid arthritis (3%), coronary artery disease (2%), solid organ tumour (2%), depression (1%) and epilepsy (1%). The mean age of our 15 patients who were monitored in intensive care unit was 65 y (± 11.46), the mean age of 85 patients followed in the service was 52.55 (± 16.35) and this difference was statistically significant (p= 0.006). When these two groups were compared in terms of comorbid diseases, the presence of DM was 40% higher (n= 6) in intensive care patients, and this difference was statistically significant (p= 0.05). In addition, the majority [11 patients (73%)] of the patients hospitalized in the intensive care unit were male (p= 0.03). When smoking was evaluated as a risk factor for serious illness, 4 of 11 patients (26%) in intensive care unit had a smoking history, while none of the patients who have died due to COVID-19 had a smoking history. These findings suggested to us that smoking does not increase the severity of COVID-19 disease. As a result, knowledge about the disease should be increased rapidly by sharing the studies on risk factors, transmission routes and clinical features of COVID-19 infection, which affects the whole world.

Clinical Value of CXCL5 for Determining of Colorectal Cancer

Background: Several studies indicate that chemokines play important roles in colorectal mucosal immunity. The chemokine CXCL5 which is expressed by epithelial cells within colorectal mucosa is a promoter of cell proliferation, migration and invasion, is a novel serum prognostic marker in patients with colorectal cancer. The purpose of this study was to investigate whether serum and tissue CXCL5 levels is altered in colorectal carcinomas (CRC) compared to colonic adenoma and normal mucosa.It also aimed to compare colon adenoma and colorectal cancer for blood CXCL5 and CEA levels, their sensitivity, and specificity. Methods: CXCL5 expression was assessed with immunohistochemistry staining in biopsy samples taken during colonoscopy in 22 colonic adenomas, 23 colorectal carcinomas and 23 normal colonic tissue samples. Also all patients' serum CXCL5 and CEA levels were measured. This stduy was prospective observational study. Results: The number of cases who were stained positive with immunohistochemistry was found to be higher in the group with CRC. When compared with the other groups, both levels of serum CXCL5 and CEA were significantly high in the group CRC. Sensitivity and specificity of serum CXCL5 were found to be low as a result of the ROC analysis. Conclusion: Although the level of CXCL5 is high in CRC, its level in serum is not significant enough to support the early diagnosis of the disease.

[Brucellosis as a cause of hemophagocytic syndrome]. / Hemofagositik sendrom sebebi olarak bruselloz.

Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of excessive inflammation and tissue destruction due to abnormal immune activation and inflammation. HLH can occur primarily due to genetic etiology, or secondarily associated with malignancies, autoimmmune diseases or infections. There are a number of reports that revealed the relationship of hemophagocytosis with brucellosis. In this report, we described a brucellosis-related HLH case. A 73-year-old male who work as farmer was admitted to our hospital with the complaints of fever continuing for 10 days, loss of appetite and back pain. Physical examination revealed right upper quadrant tenderness and hepatomegaly. Since the patient exhibited five of the diagnostic criteria for HLH (fever, hepatosplenomegaly, bicytopenia, hypertriglyceridemia and high ferritin level), he was diagnosed as secondary HLH. PCR, microscopic agglutination and indirect fluorescent antibody tests gave negative results for the diagnosis of Crimean-Congo hemorrhagic fever, leptospirosis and Q fever, respectively. On the other hand, Rose Bengal test for brucellosis was positive, while standard tube agglutination test (STA) was negative. The patient's serum yielded a very high positive (1/1280) result when Coombs' test was performed in terms of the possibility of blocking antibodies or prozone phenomenon. Additionally, B.melitensis was isolated from his blood culture on the sixth day. The patient was treated with doxycycline and rifampicin, and on the 10th day of antibiotic therapy the patient was discharged and recommended to complete his treatment up to 6 weeks. In conclusion, in patients with secondary HLH symptoms especially in the endemic areas, brucellosis should be considered as a predisposing infection.