Tracking the footsteps of Burkholderia mallei: determination of the molecular differences and potential resistance genes.

Background/aim: Chemical biological radiological nuclear threats are at an important point in the agenda of world health today, as they can cause mass deaths. B. mallei attracts attention as a potential biological warfare agent due to its features such as multidrug resistance, a rapid transmission mechanism via aerosol, the absence of a complete treatment protocol for the infection it causes, and the absence of an approved vaccine for protection against the bacteria. B. mallei suspect samples must be studied by experienced personnel in biosafety level III laboratories. B mallei is a difficult and troublesome pathogen to diagnose and many unknowns about B. mallei today. Therefore, the aim of the study was to determine the molecular differences and potential resistance genes of B mallei strains. Materials and methods: Determination of the molecular differences and potential resistance genes of B mallei strains with new bioinformatics approaches by comparatively examining the data of 29 B mallei strains, 10 of which were isolated from Türkiye, on the genome list of the National Biotechnology Information Center (NCBI). Results: According to the genome annotations of the origins, the origin containing the highest number of CDS which is 5172 was found as the 11th strain obtained in Türkiye in 1949. The origin with the highest number of pseudogenes was determined as 23,344 (China 7) origin. Two hundred and eighty-five pseudogenes found in this strain were obtained from a knee effusion in Myanmar. According to chromosome 2 data, B. mallei strain was determined as the most similar strain to ATCC 23344, line 11 with NCTC 10229 strain, and SAVP1 strain was determined as the least similar strain. When the antimicrobial resistance gene markers of the isolates included in the study were examined, amrA and amrB, qacG ade, Burkholderia pseudomallei Omp38 were found to be carrying. Conclusion: In terms of public health, it was thought that the data obtained as a result of our study about B mallei, which is defined as a biological weapon, is very valuable for creating treatment protocols to be applied to possible epidemics in the future. In addition, the available genetic epidemiological data of these strains belonging to a category that is dangerous to work with in a laboratory environment were reviewed.

History repeats itself: horse originated hyperimmune sera production against SARS CoV-2

Background/aim/AIM: SARS-CoV-2 disease was announced as a pandemic by The World Health Organization in early 2020. It is still threatening the world population. Here, we aimed to produce hyperimmune sera that contain immunoglobulin G and F(ab')2 fragments sourced from horse antibodies as an urgent response to the pandemic. Materials and methods: SARS-CoV-2 was produced and inactivated with three different methods [formaldehyde (FA), formaldehyde, and binary ethylene amine (FA + BEI), and heat treatment]. After in vitro inactivation control, immunogens were mixed with Freund's adjuvant, thereafter horses (n: 2 for FA, 4 for FA + BEI, 2 for heat inactivation) and New Zealand rabbits (n: 6 for FA, 6 fo r FA + BEI, 6 for heat inactivation) were immunized four times. Neutralizing antibody levels of the sera were measured at the 4th, 6th, and 8th weeks. When the antibodies were detected at the peak level, plasma was collected from horses and hyperimmune sera procured after the purification process. Results: Horses and rabbits produced highly neutralizing antibodies against the SARS-CoV-2 in FA and FA + BEI inactivation groups, foreign proteins were removed effectively after purification. Conclusion: This study presents a profitable practice to develop specific antisera in horses against SARS-CoV-2 for emergency and low-cost response. In further studies, new purification methods can be used to increase the efficiency of the final product.

Risk indices that predict in-hospital mortality of elderly patients

Background/aim: Mortality in the elderly population tends to be higher than in all other age groups; the risk factors that predict mortality among those in this age cohort are not fully understood. This large-scale clinical study aimed to identify effective risk factors that predict mortality in the elderly population with a particular focus on age and hospitalization status. Material and methods: We retrospectively analyzed outcomes from patients with clinical follow-up between July 2015 and January 2020 at 29 Mayis State Hospital, Ankara, Turkey. Patient records with missing or ambiguous data were excluded. Age, sex, length of hospital stay, comorbidities, consultation requests and diagnoses that include infectious diseases were evaluated for their role in predicting in-hospital mortality using binary logistic regression analysis. Primary outcomes focused on factors that had an impact on overall in-hospital mortality in the elderly population. Results: Our study included 11,430 patients; of this group, 39.9% were elderly, which we defined as 65 years of age or older. Risk factors for in-hospital mortality in this cohort included consultation requests (AOR = 1.95, CI (1.53­2.49), P < 0.001) and length of hospital stay of ≥4 days (AOR = 2.49, CI (1.90­3.26), P < 0.001). Conclusion: Elderly patients are at significantly higher risk for in-hospital mortality than are younger patients. Among the factors that may be used to predict the risk of in-hospital mortality in the elderly patient cohort, the most important factor is the length of hospital stay.

The importance of the injury severity scores and revised trauma scores for moderate traumas: A state hospital experience.

BACKGROUND: The degree of damage presents a pressing issue in determining trauma severity. Various trauma-scoring systems, such as the injury severity and revised trauma scores, are used worldwide. In this study, we aimed to evaluate the functionalities of these two trauma scoring systems, which are presently used frequently and have scientifically evolved at the state hospital level. METHODS: Following approval from the ethics committee to conduct clinical studies with retrospective archive screening, data between January 1, 2012, and December 31, 2017, were retrospectively analysed for determining the factors affecting mortality in all patients diagnosed with traumatic injury in 29 Mayis State Hospital. Incomplete or unclear data were excluded from this study. Mean and standard deviation were used for continuous variables; percentage and frequency values were used for binary variables. For evaluating continuous variables, Student's t-test or Mann-Whitney U-test was used in independent groups based on their distribution status. Dichotomous variables were evaluated using the chi-square test. The results and significant in univariate analyses were evaluated again by the linear and binary logistic regression model. RESULTS: Mean age of all patients was 37.53±14.47 years [male (35.68±13.9) versus female (40.61±15.1) (p=0.116)]. Mean injury trauma score for the general population was 3.18±8.46. No dissimilarity was noted regarding gender for the injury severity score (ISS) [(3.93±10.49 versus 1.91±2.34) (p=0.727)]. Regarding age, for revised trauma score (RTS), no statistical significance was noted [(7.60±0.91 versus 7.81±0.16) (p=0.207)]. Regarding the injury mechanism, we detected a difference between the two trauma scores; both ISS and RTS also had statistical significance. The results were found for ISS [penetrant (6.56±6.47) versus blunt (2.45±8.68) (p=0.002)] and for RTS [penetrant (7.41±0.54) versus blunt (7.74±0.79) (p=0.001)]. After the final statistics with logistic linear regression, the respiratory rate was statistically significant for penetrant injury [AOR 0.22 (0.001, 0.47) (p≤0.05)]. In the detailed subanalysis for RTS score components, respiratory rate was also significant in moderate traumas [AOR 0.22 (0.001, 0.47) (p=0.004)]. CONCLUSION: Both ISS and RTS are nonsignificant in all moderate injury types. On the other hand, respiratory rate is an important marker, especially in penetrant moderate injuries.

Effects of B2O3 (boron trioxide) on colon cancer cells: our first-step experience and in vitro results.

Boron oxide (B2O3) is derived from dehydration of boric acid and is a colorless, semitransparent, crystalline compound that is moderately soluble in water. On the other hand, boron oxide is chemically hygroscopic. This gives the molecule the ability to soak up water and adhere to tissues. Boron oxide can be used locally after tumor debulking in inoperable tumors and especially when the tumor-free margin distance cannot be provided. For all these reasons we aimed to evaluate the in vitro test results of B2O3 in terms of cytotoxicity, genotoxicity, apoptosis, and necrotic effects on L929 fibroblast cells and DLD-1 colorectal adenocarcinoma cells. Our studies demonstrated that boron oxide compounds appear to be highly cytotoxic for both cell lines according to WST cell viability assay (44.22% and 18.36% on DLD-1 and L929, respectively). Although no genotoxic effects were observed, boron oxide compounds showed antiproliferative effects for both cell lines. The prepared boron oxide compounds may hold the potential to be applied locally to the remaining tissue after surgery and further research and evaluation will be needed to determine its effectiveness.