Evaluation of antibody responses in healthcare workers before & after meningococcal vaccine and determination of meningococcal carriage rates.

The rates of nasopharyngeal meningococcal carriage in healthcare workers are unknown. Meningococcal vaccine is recommended for risk groups but healthcare workers are not included in risk groups for many countries. Herein, we aimed to investigate the nasopharyngeal meningococcal carriage rates, basal and after one dose of Men-ACWY-DT vaccine response on the 30th day by evaluating meningococcus IgG antibody levels and decolonization at month six after vaccination among the detected carriers. Nasopharyngeal swab samples were taken before vaccination to evaluate meningococcal carriage in healthcare workers. All participants received a single dose of Men-ACWY-DT vaccine. Serum samples were collected immediately before vaccination and again on day 30 post-vaccination. Antibodies in the stored sera were analyzed using the ELISA method. Participants who were determined to carry meningococci at the initial visit underwent another round of nasopharyngeal swab tests six months post-vaccination to check for decolonization. Between November 2020 and May 2021, we evaluated samples from 100 physicians [52 % females, 28.28 ± 4.45 (min: 24, max: 49)]. The majority of the physicians worked in the emergency department (45 %), followed by the infectious diseases clinic (14 %). Fifty-eight physicians had a history of at least one contact with a meningococcus-infected patient, and 53 (91.4 %) had used prophylactic antibiotics at least once due to this exposure. None of the study group nasopharyngeal swab cultures were positive for Neisseria meningitidis. Before the Men-ACWY-DT vaccine, anti-meningococcus IgG positivity was detected in the serum samples of only 3 (3 %) participants. By day 30 after vaccination, 48 % of participants showed positive for antibodies. As we didn't detect nasopharyngeal carriage in any participants, we didn't evaluate decolonization among carriers six months post-vaccination. Notably, detection of antibodies was evident in about half of the participants on day 30 after receiving a single dose of the Men-ACWY-DT vaccine.

Prediction of prognostic factors in breast cancer: A noninvasive method utilizing histogram parameters derived from Adc maps.

Objective: The aim of this study is to investigate the relationship between histogram parameters and prognostic factors of breast cancer and to reveal the diagnostic performance of histogram parameters in predicting prognostic factors status. Materials and methods: Ninety-two patients with a confirmed histopathological diagnosis of breast cancer were included in the study. Magnetic resonance imaging (MRI) was performed using a 1.5T scanner and two different b values were used for diffusion-weighted imaging (DWI) (b values: 0 s/mm2, b: 800 s/mm2). For 3D histogram analysis, regions of interest (ROI) were drawn each slice of the lesion on apparent diffusion coefficient (ADC) maps. The following data were derived from the histogram analysis data: percentiles, skewness, kurtosis, and entropy. The relationship between prognostic factors and histogram analysis data was investigated using the Kolmogorov-Smirnov test, Shapiro-Wilk test, skewness-kurtosis test, independent t-test, Mann-Whitney U test, and Kruskal-Wallis test. Receiver operator characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of the histogram parameters. Results: ADCmax, kurtosis, and entropy parameters were statistically significantly correlated with tumor diameter (p = 0.002, p = 0.008, and p = 0.001, respectively). There was a significant difference in ADC90% and ADCmax values, depending on estrogen receptor (ER) and progesterone receptor (PR) status. These values were lower in ER- and PR-positive than ER- and PR-negative patients (p = 0.02 and p = 0.001 vs. p = 0.018, p = 0.008). All ADC percentage values were lower in patients with a positive Ki-67 proliferation index as compared with those with a negative Ki-67 proliferation index (all p = 0.001). The entropy value was high in high-grade lesions and lesions with axillary involvement (p = 0.039 and p = 0.048, respectively). The highest area under the curve (AUC) for ER and PR status was calculated for the ADC90% value with ROC curve analysis. The highest AUC for Ki-67 proliferation index was found for the ADC50%. Conclusion: Histogram analysis parameters derived from of ADC maps of whole lesions can reflect histopathological features of the tumors. Based on our study, it was concluded that histogram analysis parameters were related to the prognostic factors of the tumor.

Investigation Covering the Effect of Boron plus Taurine Application on Protein Carbonyl and Advanced Oxidation Protein Products Levels in Experimental Alzheimer Model.

Alzheimer's disease (AD) is the most common form of dementia that occurs in the brain. This is a chronic neurodegenerative disease which is valid in 60-70% of all dementia patients. Boron, regarded as a potential antioxidant, has the effect of reducing oxidative stress. Taurine, as one of the thiol-containing amino acids, exists at different concentrations in both the neurons and glial cells of the central nervous system. It plays an important role in the protective and adjuvant therapies as an antioxidant due to its characteristics of maintaining the oxidant-antioxidant balance of the body as well as cell integrity and increasing body resistance. Based on this information, our objective was to reveal the effect of boron alone, taurine alone plus co-administration of taurine and boron application on brain tissue protein carbonyls (PC) and serum advanced oxidation protein products (AOPP) levels in the experimental Alzheimer's model. For this purpose, 5 groups were formed in our study which consisted of 30 Wistar albino male rats. The rats were given a single dose of STZ stereotaxically. At the end of this period, the rats were decapitated, plus their brain tissues and blood were removed. Our findings suggested that taurine alone and co-administration of boron and taurine had a decreasing effect on AOPP and PC levels of the experimental Alzheimer model of the rats.

The Impact of Vaccination Among Hospitalized Patients with the Diagnosis of COVID-19.

Objective: We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory-confirmed breakthrough COVID-19 infection inpatients. Materials and Methods: This multi-center point-prevalence study was conducted on inpatients, divided into two groups as 'fully' and 'partially' vaccinated according to COVID-19 vaccination status. Results: Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non-ICU (n=301). Hypertension (p=0.026), DM (p=0.048), and congestive heart failure (CHF) (p=0.005) were significantly higher in ICU patients and the median age was younger among non-ICU patients (p=0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group's need for ICU support was statistically significantly lower (p=0.021). Conclusion: We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post-vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection.

Changes in Hepatitis C Awareness in Different Disciplines During COVID-19.

BACKGROUND: We aimed to determine the awareness of referring hepatitis C virus patients to the relevant departments and the effect of the pandemic period on this subject. METHODS: A total of 65 743 patients with anti-hepatitis C virus requests before and during the COVID-19 pandemic were retrospectively screened. Anti-hepatitis C virus-positive patients were divided into 5 groups according to age distribution. The distribution of patients with anti-hepatitis C virus positivity was compared according to age groups, before and during COVID-19. Anti-hepatitis C virus-pos- itive patients who were not requested hepatitis C virus RNA were evaluated individually according to the departments, and hepatitis C virus awareness was compared before and during COVID-19. RESULTS: Anti-hepatitis C virus positivity rate was 1.54% before COVID-19; this rate was 2.15% during COVID-19. When the anti-hep- atitis C virus positivity rate was compared in terms of age distribution according to before and during COVID-19, it was observed that there was a statistically significant decrease in the >65 age group in the COVID-19 period (P = .004). It was found that 216 (32%) of the patients who had anti-hepatitis C virus (+) before COVID-19 and 231 (48.1%) of the patients during COVID-19 were not requested hepatitis C virus RNA test (P < .0001). The departments with the highest awareness of hepatitis C virus were gastroenterology, infec- tious diseases, hematology, gynecology and obstetrics, and oncology, while the departments with the lowest hepatitis C virus awareness were ophthalmology, psychiatry, and general surgery. It was found that chronic hepatitis C virus awareness decreased in all departments during COVID-19. CONCLUSION: Hepatitis C virus awareness has decreased in all medical departments despite the physician alert system during COVID-19 and also the rate of anti-hepatitis C virus (+) patients decreased in the group aged >65 years during the pandemic.

Could urinary kidney injury molecule-1 be a good marker in subclinical acute kidney injury in mild to moderate COVID-19 infection?

PURPOSE: To evaluate urinary kidney injury molecule-1 (uKIM-1), which is a proximal tubule injury biomarker in subclinical acute kidney injury (AKI) that may occur in COVID-19 infection. METHODS: The study included proteinuric (n = 30) and non-proteinuric (n = 30) patients diagnosed with mild/moderate COVID-19 infection between March and September 2020 and healthy individuals as a control group (n = 20). The uKIM-1, serum creatinine, cystatin C, spot urine protein, creatinine, and albumin levels of the patients were evaluated again after an average of 21 days. RESULTS: The median (interquartile range) uKIM-1 level at the time of presentation was 246 (141-347) pg/mL in the proteinuric group, 83 (29-217) pg/mL in the non-proteinuric group, and 55 (21-123) pg/mL in the control group and significantly high in the proteinuric group than the others (p < 0.001). Creatinine and cystatin C were significantly higher in the proteinuric group than in the group without proteinuria, but none of the patients met the KDIGO-AKI criteria. uKIM-1 had a positive correlation with PCR, non-albumin proteinuria, creatinine, cystatin C, CRP, fibrinogen, LDH, and ferritin, and a negative correlation with eGFR and albumin (p < 0.05). In the multivariate regression analysis, non-albumin proteinuria (p = 0.048) and BUN (p = 0.034) were identified as independent factors predicting a high uKIM-1 level. After 21 ± 4 days, proteinuria regressed to normal levels in 20 (67%) patients in the proteinuric group. In addition, the uKIM-1 level, albuminuria, non-albumin proteinuria, and CRP significantly decreased. CONCLUSIONS: Our findings support that the kidney is one of the target organs of the COVID-19 and it may cause proximal tubule injury even in patients that do not present with AKI or critical/severe COVID-19 infection.

Early predictors of acute kidney injury in COVID-19 patients.

AIM: This study aims to determine the frequency of COVID-19 related AKI and to identify the early predictors of AKI. METHODS: This study is a single-center, retrospective, observational study. Hospitalized COVID-19 patients between 24/03/2020 and 31/05/2020 were included in the study. All patients were evaluated for renal dysfunctions with urine dipstick, protein/creatinine ratio, albumin/creatinine ratio in spot urine, serum cystatin C, serum creatinine level on hospital admission, and 28th day of hospital admission. To assess the utility of these parameters to predict AKI, a receiver-operating characteristic curve was generated and the area under the curve (AUC) was calculated. RESULTS: 348 patients were included. The average incidence of AKI was 4.9% (n = 17). The incidence of AKI in mild, moderate and severe COVID-19 cases was 1.3% (n = 4), 9.0% (n = 3) and 76.9% (n = 10), respectively. Proteinuria was detected in 7.8% (n = 27) of patients with a urine dipstick test. In spot urine analysis, proteinuria was found in 20.1% (n = 70) of patients. The frequency of persistent proteinuria was 5.2% (n = 18). The AUC alue of serum cystatin C, D-dimer and albumin/creatinine ratio to predict COVID-19 related AKI were 0.96 (0.90 to 1.0), 0.94 (0.89-0.98), and 0.95 (0.91-0.98). CONCLUSION: In COVID-19 patients with normal serum creatinine levels on hospital admission, albuminuria, serum cystatin C and D-dimer levels may be an early predictor of COVID-19 related AKI and these patients should be monitored closely for AKI. Since the sample size in the AKI group was small, our study results should be confirmed with larger cohort studies.

The role of fecal calprotectin and lactoferrin in the diagnosis of necrotizing enterocolitis.

BACKGROUND: Early detection of necrotizing enterocolitis can improve the prognosis, however, there is not a reliable laboratory test to detect either newborns at risk for necrotizing enterocolitis development or those at early stages of the disease. Since fecal lactoferrin and fecal calprotectin are inflammatory markers of gastrointestinal diseases, it was hypothesized that both these biomarkers could be successfully used in the diagnosis of necrotizing enterocolitis. METHODS: In a prospective study, fecal lactoferrin and fecal calprotectin concentrations of 14 newborns with necrotizing enterocolitis and consecutively admitted 40 healthy preterm, and 23 healthy full-term newborns were measured with enzyme-linked immunosorbent assay technique. RESULTS: Mean fecal lactoferrin and fecal calprotectin were not different between preterm and full-term newborns (p = .235 and p = .845, respectively), or those who were diagnosed with necrotizing enterocolitis or not (p = .545 and p = .968, respectively). Prevalence of necrotizing enterocolitis was 1.51% (14 of 2734). Stage of the disease did not have a statistical effect on mean levels (p = .694 and p = .267, respectively). Mean fecal lactoferrin and fecal calprotectin levels were not different in the case of breastfeeding (p = .623 and p = .792, respectively). CONCLUSION: Neither fecal lactoferrin nor fecal calprotectin has a role in the identification of necrotizing enterocolitis, especially in early stages of the disease. Further studies on wider necrotizing enterocolitis series are needed for a more definite conclusion.

[Evaluation of tuberculin reactivity in different age groups with and without BCG vaccination]. / BCG asisi olan ve olmayan farkli yas gruplarinda tüberkülin reaktivitesinin arastirilmasi.

Tuberculin skin test (TST) which is used in the diagnosis of tuberculosis disease and evaluation of latent tuberculosis cases, is an easily applied, reproducible and low cost test. This study was carried out to determine the tuberculin reactivity in BCG vaccinated and unvaccinated population, to investigate the variables (BCG vaccination, the number of BCG scars, age, sex) affecting tuberculin reactivity. It was also aimed to determine the annual risk of tuberculosis infection (ARTI). The study which was a cross-sectional epidemiological one, was carried out during July 2006-January 2007 in Antalya district center and the number of objects to be applied with TST was determined by Power analysis method. A total of 408 participants; 147 children aged 5-7, 165 young adults aged 14-25 and 96 elderly people aged over 60, were included to the study. TST was applied by Mantoux method using 0.1 ml of purified protein derivative (PPD) RT 23/tween 80 antigen containing 5 tuberculin unit (TU). Evaluation of the test is done according to the domestic tuberculin skin test evaluation criteria. It was determined that 83.5% (341/408) of the cases were vaccinated with BCG and the diameter of TST was significantly higher in the vaccinated group when compared to the unvaccinated group (p= 0.005). Mean tuberculin reactivity (diameter of the TST induration) was 2.70 +/- 2.96 mm in 5-7 years age group, 6.44 +/- 4.11 mm in 4-25 years age group and 4.48 +/- 3.72 mm in > or = 60 years age group. Mean TST diameter was statistically significantly higher in 14-25 years age groups compared to 5-7 years (p= 0.003) and > or = 60 years (p= 0.002) age groups. Among the BCG unvaccinated group TST positivity was none in 5-7 years, 2% in 14-25 years and 7% in > or = 60 years age group. These rates were none in 5-7 and > or = 60 years age groups and 1% in 14-25 years age group in the BCG vaccinated population. It was also observed that TST diameters increased with increasing number of BCG scars and there was no difference in sex dependent TST reactivity. Average ARTI was determined to be 6%. It was concluded that to determine the risk of tuberculosis, annual variation in the ratio of ARTI has to be determined by nationwide evaluation of tuberculin skin test.

Chanarin-Dorfman syndrome: clinical features of a rare lipid metabolism disorder.

Chanarin-Dorfman syndrome (CDS) is a very rare neutral lipid metabolism disorder with multisystem involvement. In order to not underdiagnose the cases, screening of lipid vacuoles in neutrophils from peripheral blood smears in patients with ichthyosiform erythroderma is needed. Few case reports revealing ultrastructural findings of skin and especially liver in that disorder were observed. Here we discuss clinical and electron microscopic findings of two siblings with CDS.