Results of Nucleos(t)ide Analog Treatment Discontinuation in Hepatitis B e-Antigen-Negative Chronic Hepatitis B: NUCSTOP Study.

BACKGROUND/AIMS: This study aims to investigate the effects of nucleos(t)ide analogs (NAs) discontinuation in eligible patients in accordance with the Asian Pacific Association for the Study of the Liver hepatitis B guideline and the factors affecting clinical and virological relapses. MATERIALS AND METHODS: In this prospectively designed study, hepatitis B e antigen (HBeAg)-negative chronic hepatitis B patients who were followed up between 2012 and 2019 were evaluated and 57 patients were included. All participants enrolled the study were HBeAgnegative status at NA initiation. RESULTS: The median age of the patients was 49 (29-72) years and 24 (42%) were females. The median treatment duration was 96 (36- 276) months and patients were followed for a median duration of 27 months. Sixteen patients had a previous history of NA switch, and thirteen of these patients had a history of lamivudine resistance. Thirty-eight of 57 patients (66%) developed an elevated hepatitis B virus deoxyribonucleic acid level of >2000 IU/mL at least once, defined as virological relapse and 23 (60%) of them, experienced clinical relapse. Thirty-one of 57 patients were re-treated during the follow-up, and hepatitis B surface antigen (HBsAg) loss occurred among 4 (7%) patients. All patients who experienced HBsAg loss had a history of lamivudine resistance (P = .002). CONCLUSION: Despite receiving NAs suppression therapy for a long time, HBsAg loss occurs rarely. Although it was not life-threatening, most patients experienced relapses and treatment should be restarted. In our study, whether it is a coincidence that all patients with HBsAg loss are patients in whom NAs are used sequentially due to lamivudine resistance is an issue that needs to be further investigated.

Comparative analysis of different loop types for urine culture collection: Implications for quantitative bacterial growth and culture results.

We hypothesized that the loop material and size could affect the results of the culture when compared to the calibrated pipette. A total of 484 urine samples were included in the study, and each sample was plated by using different loop types and the calibrated pipette. The bacterial counts per milliliter were calculated and compared, with a focus on the important cutoff values of 10³ and 104 CFU/ml for further identification. When considering the 10³ CFU/ml as cutoff value, 1 µl and 10 µl plastic loops gave the highest sensitivity (86.8 %), whereas the 10 µl metal loop had the lowest sensitivity (64.2 %). For the 104 CFU/ml cutoff value, 1 µl plastic loop inoculation demonstrated the highest sensitivity (75.9 %), while the 10 µl metal loop provided the lowest sensitivity (26.5 %). These results suggest that the single use plastic loops are functional, sensitive, useful especially for critical sample.

One-year follow-up evaluation of radiological and respiratory findings and functional capacity in COVID-19 survivors without comorbidities.

The aim of this study was to assess clinical findings, radiological data, pulmonary functions and physical capacity change over time and to investigate factors associated with radiological abnormalities after coronavirus disease 2019 (COVID-19) in non-comorbid patients. This prospective cohort study was conducted between April 2020 and June 2020. A total of 62 symptomatic in non-comorbid patients with COVID-19 pneumonia were included in the study. At baseline and the 2nd, 5th and 12th months, patients were scheduled for follow-up. Males represented 51.6% of the participants and overall mean age was 51.60 ±â€…12.45 years. The percentage of patients with radiological abnormalities at 2 months was significantly higher than at 5 months (P < .001). At 12 months, dyspnea frequency (P = .008), 6-minute walk test (6MWT) distance (P = .045), BORG-dyspnea (P < .001) and BORG-fatigue (P < .001) scores was significantly lower, while median SpO2 after 6MWT (P < .001) was significantly higher compared to results at 2 months. The presence of radiological abnormalities at 2 months was associated with the following values measured at 5 months: advanced age (P = .006), lung involvement at baseline (P = .046), low forced expiratory volume in 1 second (P = .018) and low forced vital capacity (P = .006). Even in COVID-19 patients without comorbidities, control computed tomography at 2 months and pulmonary rehabilitation may be beneficial, especially in COVID-19 patients with advanced age and greater baseline lung involvement.

Humoral Response to BNT162b2 and CoronaVac in Patients Undergoing Maintenance Hemodialysis: A Multicenter Prospective Cohort Study.

INTRODUCTION: Data regarding inactivated vaccines for SARS-CoV-2 in patients undergoing maintenance hemodialysis (MHD) are limited. We aimed to investigate humoral responses induced by CoronaVac compared to BNT162b2 in this population. METHODS: In this multicenter prospective cohort study, adult patients undergoing MHD who lacked a history of COVID-19 and decided to get vaccinated with BNT162b2 or CoronaVac were enrolled. Participants provided serum samples before, 1 and 3 months after 2 doses. Anti-SARS-CoV-2 IgG antibodies against receptor-binding domain of the virus were measured, and levels ≥50 AU/mL were considered as positive. Breakthrough infections and adverse events were recorded. RESULTS: Ninety-two patients were included, 68 (73.9%) of whom were seronegative at baseline. BNT162b2 and CoronaVac were administered in 38 (55.9%) and 30 (44.1%) patients. At 1 month, seropositivity was 93.1% in BNT162b2 and 88% in CoronaVac groups (p = 0.519). Quantitative antibody levels were significantly higher in BNT162b2 (p < 0.001). At 3 months, both seropositivity (96.4% and 78.3%, p = 0.045) and antibody levels (p = 0.001) remained higher in BNT162b2 compared to CoronaVac. Five patients (7.4%) experienced breakthrough COVID-19. Adverse events were more frequent with BNT162b2, although all of them were mild. Multiple linear regression model showed that only vaccine choice (BNT162b2) was related to the humoral response (ß = 0.272, p = 0.038). Seropositive patients at baseline (n = 24) had higher antibody levels at any time point. CONCLUSIONS: BNT162b2 and CoronaVac induced humoral responses in naïve patients undergoing MHD, which were more robust and durable for 3 months after BNT162b2. Both vaccines created high antibody levels in patients who were seropositive at baseline.

Altered gut microbiota in patients with idiopathic Parkinson's disease: an age-sex matched case-control study.

OBJECTIVE: The investigations related to how gut microbiota changes the brain-gut axis in idiopathic Parkinson's disease (PD) attract growing interest. We aimed to determine whether gut microbiota is altered in PD patients and whether non-motor symptoms of PD and disease duration had any relation with alterations of microbiota profiles among patients. METHODS: Microbial taxa in stool samples obtained from 84 subjects (42-PD patients and 42-healthy spouses) were analyzed using 16S rRNA amplicon-sequencing. RESULTS: We observed a significant decrease of Firmicutes and a significant increase of Verrucomicrobiota at the phylum level. At the family level, Lactobacillaceae and Akkermansiaceae were significantly increased and Coriobacteriales Incertae Sedis were significantly decreased in the PD patients compared to their healthy spouses. Genus level comparison inferred significant increase in abundance only in Lactobacillus while the abundance of Lachnospiraceae ND3007 group, Tyzzerella, Fusicatenibacter, Eubacterium hallii group and Ruminococcus gauvreauii group were all decreased. We determined that the abundance of Prevotella genus decreased, but not significantly in PD patients. In addition, we found differences in microbiota composition between patients with and without non-motor symptoms. CONCLUSION: We observed differences in gut microbiota composition between PD patients and their healthy spouses. Our findings suggest that disease duration influenced microbiota composition, which in turn influenced development of non-motor symptoms in PD. This study is the first in terms of both gut microbiota research in Turkish PD patients and the probable effect of microbiota on non-motor symptoms of PD.

Examination of antimicrobial effect of fluoxetine in experimental sepsis model: An in vivo study.

Since most infectious diseases can develop into sepsis, it is still a major medical problem. Some in-vivo studies showed promising properties of fluoxetine in the treatment of infections. This study aims the antimicrobial effect of fluoxetine on the inflammatory process used in the treatment of sepsis-modeled rats. Besides, to investigate the efficacy of fluoxetine on modifying the antibiotic effect of imipenem in the inflammatory response. An experimental sepsis model was divided into negative control, positive control, fluoxetine 5 mg/kg, imipenem 60 mg/kg, and combined (fluoxetine; imipenem). Procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), lactate, myeloperoxidase activity (MPO), the inflammation markers interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-alfa (TNF-α), and monocyte chemoattractant protein-1 (MCP-1) levels were measured by enzyme-linked immunosorbent assay method. Oxidative stress markers, total oxidant status (TOS), total antioxidant status (TAS), total thiol (TT), and native thiol (NT) were measured using photometric methods. Oxidative stress index (OSI) was calculated according to TAS and TOS levels. The statistical analysis was performed by Statistical Package for Social Sciences version 22.0. After treatment with fluoxetine, imipenem, and combined groups, IL-1ß, IL-6, TNF-α, MPO activity, MCP-1, hs-CRP, PCT, lactate, and the oxidative stress markers OSI, and disulfide levels were decreased (p < 0.05). The TT, NT, and TAS levels significantly statistically increased (p < 0.05). This research demonstrates that fluoxetine has effects as anti-inflammatory and antioxidant, and the combined treatment with antibioticum imipenem indicates positive synergistic effects in the experimental sepsis model.

Thorax computed tomography findings and anti-SARS-CoV-2 immunoglobulin G levels in polymerase chain reaction-negative probable COVID-19 cases.

OBJECTIVE: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negative but assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings. METHODS: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngeal swabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodies were analyzed. The cutoff value for negative and positive serology was defined as <1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, the patients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as <5% lung involvement versus ≥5% lung involvement. RESULTS: The patients' mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgG positive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases (p<0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p<0.001 and OR=2.19, p=0.010, respectively). CONCLUSION: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgG antibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lung parenchymal involvement.

Sonication of explants enhances the diagnostic accuracy of synovial fluid and tissue cultures and can help determine the appropriate antibiotic therapy for prosthetic joint infections.

PURPOSES: This study aimed to evaluate the sensitivity and specificity of the sonication cultures according to the International Consensus Meeting 2018 criteria and to evaluate the effect of sonication on the antibiotic treatment of patients. METHODS: Sixty-four patients who were scheduled for revision hip or knee arthroplasties were included in the study. Aspiration fluid, tissue, and sonication cultures were performed from all patients and compared in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Other targets of the study were to investigate the rate of change in the antibiotic treatment. RESULTS: The sensitivity, specificity, PPV, NPV, and overall accuracy of the fluid culture obtained by the sonication method were 71.4%, 96.6%, 96.2%, 73.7%, and 82.8%, respectively. The sensitivity, specificity, PPV, NPV, and overall accuracy of the fluid culture obtained after tissue sampling were 68.6%, 100%, 100.0%, 72.5%, and 82.8%, respectively. There was no statistically significant difference between the sonication method and tissue culture in terms of sensitivity and specificity (p = 1.0). The sensitivity, specificity, PPV, NPV, and overall accuracy of the fluid culture obtained by the aspiration method were 28.6%, 93.1%, 83.3%, 51.9%, and 57.8%, respectively. Treatment change was applied in 10 (15.6%) patients. CONCLUSION: Our prospectively collected data revealed that sonication of the explants alone did not increase the sensitivity, and we found that sonicate culture sometimes changed the antibiotic therapy strategy in patients with periprosthetic joint infection because different microorganisms were detected. TRIAL REGISTRATION: This study was prospectively registered in a public trials registry ( https://clinicaltrials.gov/ , NCT04304885).

Efficacy and safety profile of COVID-19 vaccine in cancer patients: a prospective, multicenter cohort study.

Aim: To compare the seropositivity rate of cancer patients with noncancer controls after inactive SARS-CoV-2 vaccination and evaluate the factors affecting seropositivity. Method: Spike IgG antibodies against SARS-CoV-2 were measured in blood samples of 776 cancer patients and 715 noncancer volunteers. An IgG level ≥50 AU/ml is accepted as seropositive. Results: The seropositivity rate was 85.2% in the patient group and 97.5% in the control group. The seropositivity rate and antibody levels were significantly lower in the patient group (p < 0.001). Age and chemotherapy were associated with lower seropositivity in cancer patients (p < 0.001). Conclusion: This study highlighted the efficacy and safety of the inactivated vaccine in cancer patients. Clinical Trials Registration: NCT04771559 (ClinicalTrials.gov).

Cancer patients are at high risk for infection with SARS-CoV-2 and of developing the associated disease, COVID-19, which therefore puts them in the priority group for vaccination. This study evaluated the efficacy and safety of inactive SARSCoV-2 vaccination, an inactivated virus vaccine, in cancer patients. The immune response rate, defined as seropositivity, was 85.2% in the cancer patient group and 97.5% in the control group. The levels of antibodies, which are blood markers of immune response to the vaccine, were also significantly lower in the patient group, especially in those older than 60 years and receiving chemotherapy. These results highlight the importance of determining the effective vaccine type and dose in cancer patients to protect them from COVID-19 without disrupting their cancer treatment.

Thorax computed tomography findings and anti-SARS-CoV-2 immunoglobulin G levels in polymerase chain reaction-negative probable COVID-19 cases

SUMMARY OBJECTIVE: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negative but assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings. METHODS: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngeal swabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodies were analyzed. The cutoff value for negative and positive serology was defined as <1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, the patients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as <5% lung involvement versus ≥5% lung involvement. RESULTS: The patients' mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgG positive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases (p<0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p<0.001 and OR=2.19, p=0.010, respectively). CONCLUSION: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgG antibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lung parenchymal involvement.

Usefulness of oxidative stress marker evaluation at admission to the intensive care unit in patients with COVID-19.

OBJECTIVE: Two critical processes in the coronavirus disease 2019 (COVID-19) pandemic involve assessing patients' intensive care needs and predicting disease progression during patients' intensive care unit (ICU) stay. We aimed to evaluate oxidative stress marker status at ICU admission and ICU discharge status in patients with COVID-19. METHODS: We included patients in a tertiary referral center ICU during June-December 2020. Scores of Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and clinical severity, radiologic scores, and healthy discharge status were noted. We collected peripheral blood samples at ICU admission to evaluate total antioxidants, total oxidants, catalase, and myeloperoxidase levels. RESULTS: Thirty-one (24 male, 7 female) patients were included. At ICU admission, patients' mean APACHE II score at ICU admission was 17.61 ± 8.9; the mean SOFA score was 6.29 ± 3.16. There was no significant relationship between clinical severity and oxidative stress (OS) markers nor between radiological imaging and COVID-19 data classification and OS levels. Differences in OS levels between patients with healthy and exitus discharge status were not significant. CONCLUSIONS: We found no significant relationship between oxidative stress marker status in patients with COVID-19 at ICU admission and patients' ICU discharge status.

Relationships Between Bronchoscopy, Microbiology, and Radiology in Noncystic Fibrosis Bronchiectasis.

Background: Published data on the correlations of bronchoscopy findings with microbiological, radiological, and pulmonary function test results in children with noncystic fibrosis (CF) bronchiectasis (BE) are unavailable. The aims of this study were to evaluate relationships between Bronchoscopic appearance and secretion scoring, microbiological growth, radiological severity level, and pulmonary function tests in patients with non-CF BE. Methods: Children with non-CF BE were identified and collected over a 6-year period. Their medical charts and radiologic and bronchoscopic notes were retrospectively reviewed. Results: The study population consisted of 54 female and 49 male patients with a mean age of 11.7 ± 3.4 years. In the classification according to the bronchoscopic secretion score, Grade I was found in 2, Grade II in 4, Grade III in 9, Grade IV in 17, Grade V in 25, and Grade VI in 46 patients. When evaluated according to the Bhalla scoring system, 45 patients had mild BE, 37 had moderate BE, and 21 had severe BE. Microbial growth was detected in bronchoalveolar lavage fluid from 50 of the patients. Forced expiratory volume in 1 s (FEV1) and functional vital capacity decreased with increasing bronchoscopic secretion grade (P = 0.048 and P = 0.04), respectively. The degree of radiological severity increased in parallel with the bronchoscopic secretion score (P = 0.007). However, no relationship was detected between microbiological growth rate and radiological findings (P = 0.403). Conclusions: This study showed that bronchoscopic evaluation and especially scoring of secretions correlate with severe clinical condition, decrease in pulmonary function test, worsening in radiology scores, and increase in microbiological bacterial load in patients. Flexible endoscopic bronchoscopy should be kept in mind in the initial evaluation of non-CF BE patients.

Is there a link between pre-existing antibodies acquired due to childhood vaccinations or past infections and COVID-19? A case control study.

BACKGROUND: There is growing evidence indicating that children are less affected from COVID-19. Some authors speculate that childhood vaccinations may provide some cross-protection against COVID-19. In this study, our aim was to compare the circulating antibody titers for multiple childhood vaccine antigens, as an indicator of the state of immune memory between patients with COVID-19 and healthy controls, with a specific aim to identify the association between disease severity and antibody titrations which may indicate a protective function related to vaccine or disease induced memory. METHODS: This study is a case-control study including 53 patients with COVID-19 and 40 healthy volunteers. COVID-19 severity was divided into three groups: asymptomatic, mild and severe. We measured the same set of antibody titers for vaccine antigens, and a set of biochemical and infection markers, in both the case and control groups. RESULTS: Rubella (p = 0.003), pneumococcus (p = 0.002), and Bordetella pertussis (p < 0.0001) titers were found to be significantly lower in the case group than the control group. There was a significant decline in pneumococcus titers with severity of disease (p = 0.021) and a significant association with disease severity for Bordetella pertussis titers (p = 0.014) among COVID patients. Levels of AST, procalcitonin, ferritin and D-dimer significantly increased with the disease severity. DISCUSSION: Our study supports the hypothesis that pre-existing immune memory, as monitored using circulating antibodies, acquired from childhood vaccinations, or past infections confer some protection against COVID-19. Randomized controlled studies are needed to support a definitive conclusion.

A Snapshot of Pediatric Patients with COVID-19 in a Pandemic Hospital.

AIM: Reports describing coronavirus disease 2019 (Covid-19) in children are fewer than adult studies due to milder clinical picture. We aimed to share our experience at a single center with an emphasis on collective decision making. MATERIALS AND METHODS: A suspected case was defined as the presence of symptoms suggestive of COVID-19 and/or positive contact history. SARS-CoV-2 PCR positive patients were defined as confirmed COVID-19. Between March 12, 2020, and May 15, 2020, all children presenting with fever, cough, or respiratory difficulty were investigated for COVID-19. A total of 719 children were examined at outpatient clinics, and 495 were tested with polymerase chain reaction (PCR) for suspicion of COVID-19. A team was organized for monitoring and treating patients either as outpatients or hospitalization. Patients were evaluated in terms of age, gender, travel history, epidemiological history, clinical symptoms and signs, laboratory and radiological findings, treatment, and outcome. RESULTS: Sixty patients were hospitalized for suspicion of COVID-19. Forty-three patients were diagnosed as probable or confirmed COVID-19. 21 of 43 patients (48.8%) were PCR confirmed. The remaining 22 were diagnosed by epidemiologic history, clinical assessment, and computerized thorax tomography (CT) findings. The median age was 126 and 78.5 months in PCR positives and PCR negatives, respectively and the youngest patient was a 28 days old baby. Nineteen of the patients had an upper respiratory infection (44.1%). Although five patients had no clinical signs, chest X-ray, or CT revealed pneumonia. CONCLUSIONS: As previously reported, the clinical manifestations of COVID-19 in children are mostly mild. Even very young kids can become infected following exposure to sick family members. International and local guidelines are valuable for decision making since it is a new disease. A combination of chest disease, infectious diseases, and emergency care physicians approach will aid the appropriate management of cases.

Discordance between Serum Neutralizing Antibody Titers and the Recovery from COVID-19.

The recent pandemic of COVID-19 has caused a tremendous alarm around the world. Details of the infection process in the host have significant bearings on both recovery from the disease and on the correlates of the protection from the future exposures. One of these factors is the presence and titers of neutralizing Abs (NAbs) in infected people. In the current study, we set out to investigate NAbs in the recovered subjects discharged from the hospital in full health. Serum samples from a total of 49 documented consecutive COVID-19 subjects were included in the study. All the subjects were adults, and serum samples collected during the discharge were tested in viral neutralization, enzyme immunoassay (EIA), and Western immunoblot tests against viral Ags. Even though a majority of the recovered subjects had raised significant NAb titers, there is a substantial number of recovered patients (10 out of 49) with no or low titers of NAbs against the virus. In these cohorts as well as in patients with high NAb titers, viral Ag binding Abs were detectable in EIA tests. Both NAb titers and EIA detectable Abs are increased in patients experiencing a severe form of the disease, and in older patients the Ab titers were heightened. The main conclusion is that the recovery from SARS-CoV-2 infection is not solely dependent on high NAb titers in affected subjects, and this recovery process is probably produced by a complex interplay between many factors, including immune response, age of the subjects, and viral pathology.

Association between Consumption of Cow's Milk and Iron Deficiency Anemia in Children: Are There Roles for Hepcidin-25/Ferroportin? A Case-Control Study.

Systemic iron homeostasis is regulated by the interaction of the peptide hormone, hepcidin and the iron exporter, ferroportin. The objective was to investigate the relationship between the consumption of cow's milk and iron deficiency anemia in children 2-10 years old and its association with the hepcidin-25 and ferroportin concentrations. The study population consisted of 187 prepubescent children of similar ideal body weight (IBW:90-120%); 82 children with iron deficiency anemia (37girls and 45boys; 4.27 ± 0.28 years) and 105 (47girls and 58boys; 4.25 ± 0.34 years) healthy age-sex-matched controls. Serum fasting hepcidin-25/ferroportin concentrations were measured by enzyme immunoassay in all subjects. Mean cow's milk consumption in the anemic group (373 ± 248 mL/d) tended to be higher than that in the control group (320 ± 226 mL/d), but the result was not statistically significant (p = 0.063).The mean hepcidin-25 level was significantly higher in the anemic group (19.5 ± 18.4 ng/mL) than in the healthy controls (11.0 ± 10.7, p < 0.001). The mean ferroportin level was lower in the anemic group (21.04 ± 5.74 ng/mL) than in the healthy controls (22.68 ± 4.77 ng/ml, p = 0.037). Consuming cow's milk was not associated with IDA in prepubertal children, provided that it was adequately supplemented with iron-enriched foods. We observed a significant increase in hepcidin-25 levels and a decrease in ferroportin levels in children with iron deficiency anemia compared with healthy controls. Children who consumed more cow's milk had higher levels of hepcidin-25. Iron deficiency anemia is not a concern when cow's milk is given to children if the complementary foods are rich in iron.

A Current Microbiological Picture of Mycobacterium Isolates from Istanbul, Turkey.

Despite advances in diagnosis and treatment, tuberculosis (TB) continues to be one of the essential health problems throughout the world. Turkey is considered to be endemic for TB. In this study, we analyzed the distribution of Mycobacterium species, compare the diagnostic methods, and susceptibilities to anti-tuberculosis drugs of TB isolates. The aim was to document the current status and to provide a frame of reference for future studies. In this study, 278 Mycobacterium species isolated from 7,480 patients between September 2015 and June 2019 were included. Löwenstein-Jensen medium (LJ) and MGIT 960 were used for the isolation of strains. Susceptibility to 1st-line anti-tuberculosis drugs was determined. Positivity rates in clinical samples were as follows: 1.4% for direct microscopic acid-fast bacilli (AFB) detection, 3.4% for growth on the LJ, and 3.7% for growth on MGIT-960. Two hundred thirty-three isolates were identified as Mycobacterium tuberculosis complex (MTBC) and 45 were non-tuberculous mycobacteria (NTMs). Eleven of the NTMs (24.4%) were Mycobacterium fortuitum group isolates, and eight NTMs (17.7%) were Mycobacterium abscessus complex isolates. A number of patients diagnosed with tuberculosis peaked twice between the ages of 20-31 and 60-71. A hundred and eighty-two MTBC isolates (78.1%) were susceptible to all 1st-line anti-tuberculosis drugs, while 51 isolates (21.9%) were resistant to at least one drug tested. The multidrug-resistant tuberculosis rate was 13.7% among resistant strains and 3% in all strains. The liquid cultures were better for detection of both MTBC and NTMs isolates. The data demonstrate that MTBC continues to be challenge for this country and indicates the need for continued surveillance and full-spectrum services of mycobacteriology laboratory and infectious diseases.Despite advances in diagnosis and treatment, tuberculosis (TB) continues to be one of the essential health problems throughout the world. Turkey is considered to be endemic for TB. In this study, we analyzed the distribution of Mycobacterium species, compare the diagnostic methods, and susceptibilities to anti-tuberculosis drugs of TB isolates. The aim was to document the current status and to provide a frame of reference for future studies. In this study, 278 Mycobacterium species isolated from 7,480 patients between September 2015 and June 2019 were included. Löwenstein-Jensen medium (LJ) and MGIT 960 were used for the isolation of strains. Susceptibility to 1st-line anti-tuberculosis drugs was determined. Positivity rates in clinical samples were as follows: 1.4% for direct microscopic acid-fast bacilli (AFB) detection, 3.4% for growth on the LJ, and 3.7% for growth on MGIT-960. Two hundred thirty-three isolates were identified as Mycobacterium tuberculosis complex (MTBC) and 45 were non-tuberculous mycobacteria (NTMs). Eleven of the NTMs (24.4%) were Mycobacterium fortuitum group isolates, and eight NTMs (17.7%) were Mycobacterium abscessus complex isolates. A number of patients diagnosed with tuberculosis peaked twice between the ages of 20­31 and 60­71. A hundred and eighty-two MTBC isolates (78.1%) were susceptible to all 1st-line anti-tuberculosis drugs, while 51 isolates (21.9%) were resistant to at least one drug tested. The multidrug-resistant tuberculosis rate was 13.7% among resistant strains and 3% in all strains. The liquid cultures were better for detection of both MTBC and NTMs isolates. The data demonstrate that MTBC continues to be challenge for this country and indicates the need for continued surveillance and full-spectrum services of mycobacteriology laboratory and infectious diseases.