Virulence properties and characterization of aeromonads isolated from foods of animal origin and environmental sources.

Aeromonas species are increasingly recognized as enteric pathogens, and they possess several virulence factors that may contribute to illness. In this work, the biochemical, enzymatic, and some virulence properties of 73 potentially pathogenic strains of Aeromonas spp. isolated from food and environmental sources were investigated to compare strains from different sources and establish the possible relationships between some phenotypic characters and pathogenicity. Virulence factors (hemolysin and siderophores), biochemical properties (Voges-Proskauer and lysine decarboxylase reactions), and enzymatic properties (lipase, phospholipase, protease, and DNase activities) were examined in these strains. Results indicated that 57% of the strains from environmental sources produced siderophores and hemolysin, whereas 39.0% of strains from food produced siderophores and 60.5% produced hemolysin. Protease, lipase, DNase, and phospholipase activities in strains isolated from food and environmental sources were 69.5 to 94.3, 73.6 to 68.5, 52.6 to 68.6, and 71.0 to 68.4%, respectively. A higher percentage of strains of environmental origin (94.3%) had protease activity, and higher lipase activity (73.6%) was observed in food isolates. For all antimicrobials tested, all strains had the least resistance to meropenem, and high levels of resistance were found to amoxicillin-clavulanic acid and cephalothin. These findings demonstrate the presence of potentially pathogenic and multidrug-resistant Aeromonas spp. in environmental and food sources, thereby indicating a significant risk to public health.

Diagnostic value of combined serum biomarkers for the evaluation of liver fibrosis in chronic hepatitis C infection: A multicenter, noninterventional, observational study.

BACKGROUND/AIMS: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. MATERIALS AND METHODS: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest®, aspartate aminotransferase-to-platelet ratio index(APRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. RESULTS: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. CONCLUSION: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further.

Effects of low back massage on perceived birth pain and satisfaction.

AIM: The aim of the study was to evaluate the effect of low back massage on perceived birth pain and delivery. METHOD: This study was designed as a study-control experimental type. The study sample consisted of 62 pregnant women (massage group = 31, control group = 31). Massage was applied to the study group in three phases during intrapartum period. The massages were done at the end of latent, active and transition phases (at cervical dilatation 3-4 cm, 5-7 cm, 8-10 cm) correspondingly. The VAS scores were evaluated three times during all phases. RESULTS: The first mean VAS score was 5.2 ± 0.9 and 7.3 ± 1.3 for massage and control groups, respectively. Second VAS score was found as 6.6 ± 1.6 in massage group and 8.8 ± 1.0 in control group. The third VAS score was significantly higher in the control group than massage group during third evaluation (9.2 ± 2.4 vs 6.7 ± 2.7) (p < 0.05). The mean duration of second stage was 24.6 ± 12.7 min in massage group and 31.7 ± 20.9 min in control group (p > 0.05). The mean scores of satisfaction about delivery were found as 8.8 ± 0.7 in massage group and 6.9 ± 0.8 in control group (p < 0.05). CONCLUSION: It was determined in the study that lower back massage has a significant impact on reducing labor pain and increasing the satisfaction with birth. Health professionals, who work in the delivery unit, can use massage intervention for decreasing pain, shortening delivery time and increasing satisfaction with birth experience.

The association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C: an observational, multicenter study in Turkey.

BACKGROUND/AIMS: To evaluate the association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C. MATERIALS AND METHODS: A total of 104 chronic hepatitis C patients were included in this non-interventional, open-label, observational, multicenter, cross-sectional study conducted at 20 gastroenterology clinics in Turkey. The primary end point was the correlation between stage of hepatic fibrosis and insulin resistance evaluated via the homeostasis model of assessment-insulin resistance index. Confounders of hepatic fibrosis and insulin resistance were the secondary end points. RESULTS: The mean age of patients was 52.8 years; 65.4% were female. Type 2 diabetes was present in 6.8% and insulin resistance noted in 38.0% of patients. Further, 45.7% of the patients had mild (A0/A1) and the remaining had moderate/severe (A2/A3) hepatic necroinflammatory activity. Patient distribution according to Metavir fibrosis stage was as follows: F0/F1 (57.0%); F2 (6.5%); F3 (23.7%); and F4 (12.9%). A univariate analysis revealed significant positive correlations between Metavir fibrosis stage and insulin resistance (r=0.297; p=0.007). Logistic regression analysis showed that significant predictors of insulin resistance were high alanine transaminase levels (odds ratio, 0.97; 95% confidence interval, 0.944-0.997) and liver fibrosis stage (odds ratio, 0.114; 95% confidence interval, 0.021-0.607). CONCLUSION: Our findings revealed significant associations between insulin resistance and hepatic fibrosis.

Association of insulin resistance, viral load, and adipokine levels with liver histology in patients with chronic hepatitis C: an observational, multicenter study in Turkey.

OBJECTIVE: To evaluate the association of insulin resistance (IR), viral load, and adipokine levels with liver histology in patients with chronic hepatitis C (CHC). PATIENTS AND METHODS: In this noninterventional, multicenter study carried out at 11 infectious diseases clinics in Turkey, 103 CHC patients [mean (SD) age: 50.2 (11.0) years, 60 (58.3%) women] planned to be treated by ribavirin and peginterferon-α2a were included. Data on hepatic fibrosis and steatosis, IR, viral load, and hepatitis C virus-RNA genotyping, adipokine, and cytokine levels were collected. RESULTS: The mean (SD) Knodell score was 8.1 (3.6); grade I steatosis was evident in 46 (44.7%) patients and IR was identified in 56 (54.9%). There was a significant positive correlation of the homeostasis model assessment-IR index with Knodell fibrosis (r=0.235; P=0.027) and hepatic steatosis (r=0.435; P<0.001). There was a significant positive correlation of leptin levels with Knodell fibrosis (r=0.265; P=0.013) and hepatic activity index (r=0.218; P=0.041). Hepatic steatosis was correlated negatively with adiponectin (r=-0.320; P=0.001) and positively with leptin (r=-0.368; P<0.001) levels. Logistic regression analysis showed that increase in age [odds ratio (OR), 1.056; 95% confidence interval (CI), 1.005-1.110; P=0.030] was the only significant predictor of hepatic fibrosis (OR, 1.056; 95% CI, 1.005-1.110; P=0.030), whereas increase in age (OR, 1.066; 95% CI, 1.006-1.130; P=0.030), the presence of IR (OR, 5.621; 95% CI, 1.547-20.425; P=0.009), and decrease in adiponectin levels (OR, 0.808; 95% CI, 0.682-0.957; P=0.013) were the significant predictors of hepatic steatosis. CONCLUSION: Our findings indicate a significant relationship of hepatic fibrosis and hepatic steatosis with IR and leptin levels, but not with the viral load in Turkish patients with CHC.