Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother.

Background: Contracting COVID-19 during pregnancy can harm both the mother and the unborn child. Pregnant women are highly likely to develop respiratory viral infection complications with critical conditions caused by physiological changes in the immune and cardiopulmonary systems. Asymptomatic COVID-19 in pregnant women may be accompanied by fetal inflammatory response syndrome, which has adverse consequences for the newborn's life and health. Purpose: To conduct an inflammatory response assessment of the fetus due to the effects of COVID-19 on the mother during pregnancy by determining pro-inflammatory cytokines, cell markers, T regulatory cells, T cell response, evaluation of cardiac function, and thymus size. Materials and methods: A prospective study included pregnant women (n = 92). The main group consisted of 62 pregnant women with COVID-19 infection: subgroup 1-SARS-CoV-2 PCR-positive pregnant women 4-6 weeks before delivery (n = 30); subgroup 2-SARS-CoV-2 PCR-positive earlier during pregnancy (n = 32). The control group consisted of 30 healthy pregnant women. In all pregnant women, the levels of circulating cytokines and chemokines (IL-1α, IL-6, IL-8, IL-10, GM-CSF, TNF-α, IFN-γ, MIP-1ß, and CXCL-10) were determined in the peripheral blood and after delivery in the umbilical cord blood, and an analysis was performed of the cell markers on dendritic cells, quantitative and functional characteristics of T regulatory cells, and specific T cell responses. The levels of thyroxine and thyroid-stimulating hormone were determined in the newborns of the studied groups, and ultrasound examinations of the thymus and echocardiography of the heart were also performed. Results: The cord blood dendritic cells of newborns born to mothers who suffered from COVID-19 4-6 weeks before delivery (subgroup 1) showed a significant increase in CD80 and CD86 expression compared to the control group (p = 0.023). In the umbilical cord blood samples of children whose mothers tested positive for COVID-19 4-6 weeks before delivery (subgroup 1), the CD4+CCR7+ T cells increased with a concomitant decrease in the proportion of naive CD4+ T cells compared with the control group (p = 0.016). Significantly higher levels of pro-inflammatory cytokines and chemokines were detected in the newborns of subgroup 1 compared to the control group. In the newborns of subgroup 1, the functional activity of T regulatory cells was suppressed, compared with the newborns of the control group (p < 0.001). In all pregnant women with a severe coronavirus infection, a weak T cell response was detected in them as well as in their newborns. In newborns whose mothers suffered a coronavirus infection, a decrease in thymus size, transient hypothyroxinemia, and changes in functional parameters according to echocardiography were revealed compared with the newborns of the control group. Conclusions: Fetal inflammatory response syndrome can occur in infants whose mothers suffered from a COVID-19 infection during pregnancy and is characterized by the activation of the fetal immune system and increased production of pro-inflammatory cytokines. The disease severity in a pregnant woman does not correlate with SIRS severity in the neonatal period. It can vary from minimal laboratory parameter changes to the development of complications in the organs and systems of the fetus and newborn.

The Relationship between albumin-Bilirubin grade and survival in hepatocelluler carcinoma patients treated with sorefanib.

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common hepatic malignancies and the sixth most common cancer worldwide. Prognosis is affected by tumor stage, hepatic disfunction and patient performance. Albumin - bilirubin grade was developed to assess the hepatic function in patient with HCC. Aims: The purpose of this study was to examine the relationship between albumin-bilirubin (ALBI) grade and survival in HCC patients receiving sorafenib. We also planned to investigate whether ALBI scores in advanced stage patients are prognostic and predictive. PATIENTS AND METHODS: Patients presenting to the Karadeniz Technical University Medical Faculty Medical Oncology Clinic and diagnosed with HCC in 2010-2018 were included in the study. Fifty-six patients using sorafenib with Eastern Cooperative Oncology Group (ECOG) performance scores of 0, 1, or 2, who had not previously received systemic therapy were enrolled. RESULTS: Patients' median age was 64.8 years (range: 23-86), and 80.4% were men. The highest proportion of patients were infected with hepatitis B virus (46.4%), 37 patients were ECOG 1 (66.1%), and 40 were ALBI grade 2 (71.4%). The change occurring in ALBI scores after sorafenib therapy compared to pre-sorafenib values was found to affect progression-free survival. Prognosis was better in the group with decreasing ALBI scores than in the increasing score group (p: 0.028). Multivariate regression analysis revealed that the change occurring in ALBI scores after sorafenib therapy compared to pre-sorafenib values was predictive of progression-free survival independently of alpha-fetoprotein (AFP) levels. CONCLUSION: This study shows that ALBI grade affects survival independently of AFP, Hand-Foot Syndrome (HFS), and other prognostic factors. ALBI grading can be used as a prognostic parameter in patients using sorafenib.

Effects of barrier perch access and early dietary protein and energy dilution on some welfare parameters, tibiotarsus measurements, fear and mobility level in broiler chickens.

1. This experiment determined the effect of increasing mobility in broiler chickens by placing barrier perches between feeders and drinkers. In addition, the limitation of early weight gain by dietary energy and protein dilution on some welfare parameters, tibiotarsus measurements, fear and mobility level was examined.2. A total of 504 male, one-day-old broiler chickens (Ross 308) were randomly allocated to four treatments with three replicate pens per treatment and 42 broiler chickens per pen as a 2 × 2 factorial arrangement. Treatments included feeding the basal control diet between 0-42 days or a diet diluted by 10% energy and 20% crude protein fed between 0-21 d, with the control diet fed between 22-42 d. The second factor was the presence or absence of barrier perches. All treatments were allocated as a completely randomised design. Welfare parameters (foot pad dermatitis, hock burn, gait score, feather score, breast blister), tibiotarsus measurements (bone mineral content, bone mineral density, fluctuating asymmetry and relative fluctuating asymmetry), tonic immobility and mobility level were recorded.3. Results showed that access to a barrier perch and the diluted diet increased the mobility in broiler chickens. However, access to a barrier perch had no significant effect on tibiotarsus and welfare parameters. Broiler chickens had better gait scores (P < 0.05) and lower foot pad dermatitis incidence (P < 0.01) in groups fed the diluted diet. The diluted diet had no significant effect on bone mineral density but reduced the tibiotarsus bone mineral content (P < 0.05).4. In conclusion, the diluted diet provided positive effects in terms of leg health due to weight gain limitations in the early period, thus improving broiler chicken welfare.

Hepatitis B Reactivation in HBsAg-negative Anti-HBc-positive patients receiving cytotoxic chemotherapy for solid tumors.

PURPOSE: The prevalence of hepatitis B virus (HBV) reacti- vation in HBsAg-negative/anti-HBc-positive patients receiving chemotherapy for solid tumors is not fully known. The aim of this study was to investigate the incidence and outcomes of HBV reactivation in these patients. METHODS: Data among 645 HBsAg-negative/ anti-HBc-positive patients who underwent intravenous chemotherapy were retrospectively analyzed. Patients were categorized into two groups, based on received antiviral prophylaxis (n = 43) or not (n = 602). HBV reactivation was defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive, with or without increased liver enzymes. RESULTS: HBV reactivation was detected in 3 patients (0.49%) among non-antiviral prophylaxis group and in none of those with antiviral prophylaxis. Two of the HBV reactivation detected patients were successfully treated with rescue therapy, while the third died due to liver failure. CONCLUSIONS: HBV reactivation is rare in HBsAg-negative and anti-HBc-positive patients receiving chemotherapy for solid tumors. However, considering the fatal outcomes patients must be closely monitored in terms of HBV-DNA positivity and/or HBsAg seroreversion and pre-emptive antiviral therapy must be initiated as soon as HBV reactivation occurs.

Increased ischemia-modified albumin levels in patients with gastric cancer.

Reactive oxygen species (ROS) are found in the development stages of carcinogenesis. Fifty two patients with gastric cancer and 35 controls were enrolled in this trial. IMA, MDA, Total Oxidant Status (TOS), Total Antioxidant Status (TAS) and Oxidative Stress Index (OSI) were evaluated. There was a significant increase in IMA and MDA levels in the patient group (0.405±0.111, 0.271±0.066; p= 0.0001 and 0.207±0.251, 0.077±0.103; p= 0.004 respectively). TOS was also higher in the patient group but it was not statistically different. TAS was statistically lower and there was significant difference in OSI (0.621±0.394, 0.996±0.37; p=0.0001 and 9.68±18.2, 2.9±3.85; p=0.001 respectively). The areas under receiver operating characteristics curves for the determination of gastric cancer were 0.842 for IMA and 0.708 for MDA. Increased levels of IMA, MDA and oxidative stress index were detected and this condition is associated with the impairment of oxidant-antioxidant balance.

Phenytoin- and cranial radiotherapy-induced toxic epidermal necrolysis treated with combination therapy: systemic steroid and intravenous immunoglobulin.

Toxic epidermal necrolysis (TEN) is a rare dermatological disease that causes serious morbidity and mortality. It may be caused by antibiotics, anticonvulsants, nonsteroidal anti-inflammatory agents, allopurinol, infections, autoimmune diseases, and radiotherapy. A 49-year-old man was admitted to our hospital because of skin changes. Prophylactic phenytoin was administered, and cranial radiotherapy was planned for brain metastases. During these treatments, erythematous lesions and blisters were observed on his scalp, face, neck, the front and back of his body, and his arms. Detachment of the skin, especially on the back, was also observed. TEN was diagnosed, and phenytoin was discontinued. Methylprednisolone 80 mg/day IV and intravenous immunoglobulin 1 g/kg/day were applied for treatment. After 10 days, skin recovery and re-epithelialization were established, temperature decreased, and mucosal hemorrhage ceased. The patient was discharged after 2 weeks.

Clinicopathologic characteristics and BRCA-1/BRCA-2 mutations of Turkish patients with breast cancer.

BACKGROUND: BRCA-1 and BRCA-2 are two major susceptibility genes for breast cancer. Between 30-70 % of hereditary breast cancers are thought to be attributed to mutations in BRCA-1 or BRCA-2. The aim of our study was to investigate the clinicopathologic characteristics and BRCA mutations of patients with breast cancer living in the northeast region of Turkey. MATERIALS AND METHODS: Two hundred eleven patients diagnosed with breast cancer were enrolled in the present study. All patients provided their demographic, environmental, family, and reproductive traits. Patients were screened for mutations of BRCA-1 and BRCA-2 with multiple ligation-dependent probe amplification (MLPA) test. RESULTS: In the present study, the mean age of breast cancer patients was 50.7 years and the mean age at first delivery was 21.8 years. Large genomic rearrangements in BRCA-1 were detected in 4 (1.9 %) patients; 2 of them had exon 21 deletions and the remaining 2 patients had exon 18 and 19 deletions. No BRCA-2 rearrangements were detected in the study population. CONCLUSIONS: Different mutation analyses results were detected in different countries by using different testing techniques. The characteristics and sensitivities of patients as determined by all methods were different in these studies. Due to these factors, BRCA mutation rates were different. This is the first study where MLPA was used to screen BRCA-1 and BRCA-2 mutations in Turkish population (Tab. 1, Ref. 10).

Bilateral breast cancer: a male patient.

Bilateral breast cancer represents less than 2% of male patients with breast cancer. A 63-year old male presented with a mass at right breast and modified radical mastectomy was performed. Pathology was reported as invasive ductal carcinoma. Radiotherapy and tamoxifen was administered following chemotherapy. At the 5th month, a mass was detected at left breast and modified radical mastectomy was performed. Chemotherapy was started postoperatively. BRCA1 and BRCA2 were reported negative. Although male breast cancer is rare, male patients with breast cancer may have cancer at the other breast (Fig. 1, Ref. 5).

The effect of prenatal factors on the development of colon cancer.

BACKGROUND: There is some evidence that prenatal factors can play a role in the development of colon cancer. Children with an old parent age at the time of birth were observed to develop certain childhood cancers more frequently. OBJECTIVE: This trial was designed to investigate the effects of some prenatal factors on colon cancer risk. Particularly, investigation of the effect of advanced parent age on colon cancer development risk was targeted. MATERIALS AND METHODS: In this study 117 in or out patients diagnosed with colon cancer and 234 control subjects were included. Definitive diagnostic results and dates of diagnosis were determined from pathological reports. Groups were asked for the parent age, smoking habits, sociodemographic, environmental, familial and reproductive traits. The results were compared between the patients and the control group. RESULTS: It was determined that children may have higher risk if mother and father are more than 30 at birth (p = 0.018, p = 0.020). While the mean mother age at birth was 25.6 +/- 5.72 in patients, it was 24.7 +/- 6.90 in the controls. The difference was not statistically significant (p < 0.056). The mean father age at birth was 29.4 +/- 6.58 in patients and 27.4 +/- 7.47 in the controls. The difference was statistically significant (p < 0.001). Smoking of mother was one of the important risk factors of colon cancer (p = 0.044). CONCLUSION: Our data supports that some prenatal factors such as high parental age at birth and mother -smoker may be risk factors for some cancers in children. This is the first study to report that high parental age at birth and exposure to smoke prenatally increase the risk or colon cancer (Tab. 7, Ref. 28).

Bolus fluorouracil induced syncope and pulseless ventricular tachycardia: a case report.

5-fluorouracil is an anti-cancer drug commonly used in oncology practice. Typical side effects are myelosupression, nausea, vomiting, diarrhea and stomatitis. Cardiotoxicity is the other toxicity. Cardiac side effects are ST segment changes, rhythm abnormalities, supraventricular and ventricular dysrhytmias. Pulseless ventricular tachycardia and ventricular fibrillation releated with bolus fluorouracil were not detected in the literature. Here we discussed a 46 year-old male patient that has no known cardiac history. After bolus fluorouracil administration, syncope and pulseless ventricular tachycardia developed in this patient. There are a few explanations about the cardiotoxicity of fluorouracil. One of these is the effect on nitric oxide. It causes a reduction in the levels of endothelial NO and this leads coronary vasospasm. Another explanation is protein kinase C mediated vasospasm. In animal studies toxic myocarditis like lesions were detected with fluorouracil infusions. Finally both myocardit and vasospasm may lead cardiac problems like sudden cardiac deaths. Bolus 5-fluorouracil is as cardiotoxic as 5-fluorouracil infusion and we must be careful about the arrhytmia after the bolus administration.

The effects of E-cadherin and bcl-2 on prognosis in patients with breast cancer.

BACKGROUND: Breast cancer is the most common malignancy in women. Axillary lymph node involvement and tumor size are the most significant prognostic factors in breast cancer. However, more factors are needed for evaluating the prognosis and individualizing the treatment in these patients. Intracellular adhesion molecule E-cadherin, antiapopitotic protein bcl-2, and p53 might have predictive and prognostic properties in breast cancer. OBJECTIVE: We have investigated the effects of E-cadherin, bcl-2, and p53 on disease free survival and overall survival in patients with breast cancer. METHODS: Positivity of aforementioned genes was detected with immunohistochemistry staining. Seventy-six women patients with invasive ductal and lobular breast cancer who had received adjuvant therapy were included in the study. RESULTS: Bcl-2, E-cadherin, and p53 expression in tumor tissue specimens were found in 26.31%, 35.52%, and 9.21%, respectively. Mean duration of follow-up was 93.58 +/- 3.40 months. In multivariate analyses, axillary lymph node presence and C-erb-B2 overexpression were a strong negative prognostic factor of disease free survival and overall survival. E-cadherin and bcl-2 failed to have an effect on disease free survival and overall survival in our study. In addition, p53 overexpression was determined in a limited number of patients. CONCLUSIONS: The results of this study showed that E-cadherin, bcl-2, and p53 did not have any significant prognostic value for our patients. In order to arrive at a decision, we need studies, which include more patients and long follow-up periods (Tab. 2, Fig. 2, Ref. 24).

Sexing of newly-hatched chicks using DNA isolated from chorio-allantoic membrane samples by polymerase chain reaction in Denizli chicken.

1. The aim of the present study was to determine the sex of newly-hatched chicks of Denizli chicken, a local Turkish breed, by polymerase chain reaction (PCR) using DNA extracted from the chorioallantoic membrane (CAM). 2. Fertilised eggs were incubated individually and a total of 20 CAM samples were collected following the hatching process. DNA was isolated from the CAM samples and PCR was performed using W-repeat (W) and 18 S ribosomal gene (R) primers. 3. Screening of the PCR products by agarose gel electrophoresis revealed that males have a single band (256 bp) and females have an extra second band (415 bp) as expected. 4. The present study describes a reliable, rapid, and simple multiplex PCR protocol that can be put into use to sex local breeds of chicken in which phenotypic sexing is impossible, using DNA isolated from the CAM that is discarded and remains attached to the egg shell following the hatching process.