Investigation of Obesity-Related HAdV-36 in NAFLD Patients: a Case-Control Study.

BACKGROUND: HAdV-36 leads to adipocyte proliferation of adipose tissue through E4orf1 gene, leading to the development of obesity and related diseases. We aimed to investigate the presence and any association of HAdV-36 in non-alcoholic fatty liver disease (NAFLD) patients Methods: The patient group was composed of 116 patients; 30 obese patients with NAFLD (BMI > 30 kg/m2), 30 patients with Diabetes Mellitus (DM)+NAFLD (BMI > 30 kg/m2), 16 patients with NAFLD (BMI < 30 kg/m2), and operated obese group with NAFLD (BMI > 30 kg/m2). The control group comprised 81 non-obese healthy adults. Liver adipose tissue samples were obtained in 30 operated NAFLD patients. HAdV-36-DNA, HAdV-36 neutralizing antibodies, serum lipid, and adipokine levels were analyzed. RESULTS: HAdV-36 neutralizing antibodies (HAdV-36 Ab-positive) were detected in 10/116 and 2/81 participants in the study and control groups, respectively; the difference was statistically significant (p < 0.005). LDL, total cholesterol but not adipokine levels were found to be significantly higher in HadV-36 Ab-positive patients (p < 0.05). While HAdV-36 was identified as a risk factor with OR = 4.11 in univariate analyses, there was no significant difference in binary logistic regression analysis. HAdV-36-DNA was detected in the adipose tissue samples of two patients. CONCLUSIONS: We suggest that the presence of HAdV-36 may lead to the development of obesity with the increase in adipose tissue, and diseases such as hyperlipidemia, NAFLD, DM, and metabolic syndrome may develop on the basis of chronic inflammation caused by obesity. Thus, HAdV-36 may be a plausible risk factor for the development of NAFLD.

Association of SARS-CoV-2 IgG Antibody Levels with Clinical/Laboratory Characteristics in COVID-19 Patients: Data from a Turkish Study.

BACKGROUND: COVID-19 causes clinical manifestations ranging from asymptomatic infection to multi-organ failure. It is reported that those with severe disease have higher anti-SARS-CoV-2 antibody titers compared to asymptomatic or mild cases. We evaluated the correlation of antibody responses with laboratory and clinical indicators in COVID-19 patients. METHODS: Seventy-nine male and 66 female patients (mean age: 39) with at least one positive SARS-CoV-2 RT-PCR test and SARS-CoV-2 IgG antibody result after acute infection were included. RESULTS: Seventy-six (52%), 45 (31%), and 24 (17%) patients had mild, moderate, and severe clinical findings, respectively. Patients with high body mass index and advanced age had significantly more severe disease (p < 0.001). A significant correlation was found between the increase in lymphopenia, C-reactive protein, ferritin, D-dimer, and lactate dehydrogenase and the severity of clinical findings (p = 0.0001). SARS-CoV-2 IgG antibody test was positive in 128 (88.3%) patients. A significant correlation was found between disease severity and antibody levels in the comparison of all groups (p < 0.001). CONCLUSIONS: Long-term monitoring of immune responses will be required to determine the appropriate time for the administration of new vaccines.

The Effect of Bacterial Colonization and Maggot Debridement Treatment on Wound Healing in Chronic Venous Leg Ulcers.

BACKGROUND: The debridement of necrotic and infected tissues, which prolong the wound healing process, is important for the preparation of the wound bed. Therefore, wound-bed preparation and debridement are vital components of venous leg ulcer management. We aimed to present a perspective to evaluate the clinical and microbiological efficacy of Maggot Debridement Therapy (MDT) in the treatment of chronic leg ulcers caused by venous insufficiency. METHODS: Thirty-eight patients with chronic venous leg ulcers who were referred to our unit with an MDT request were included in the study. Lucilia sericata larvae were applied to the wounds two days a week until the necrotic tissue was cleared. Swab samples were regularly taken before and immediately after each larval application for wound culture. Changes in the percentage of wound surface area and growing pathogenic microorganisms were recorded during the follow-up period. RESULTS: The sample consisted of 38 patients with 55 venous leg ulcers. The mean initial ulcer surface area was 99.1 cm2 (range 3 - 500). Complete debridement was achieved in all ulcers in the 2nd week, on average. Twenty-five ulcers (45.5%) were completely debrided with two one-week MDT sessions. Complete wound healing occurred in 42 ulcers (76.4%) after an average of seven MDT sessions. Microorganisms isolated from the wounds significantly decreased immediately after the first MDT session. CONCLUSIONS: Although many methods are used in the treatment of venous leg ulcers, they are often not effective. MDT, which is coming into widespread use today, is a simple and effective method in the treatment of these ulcers. Its effects such as biodebridement, disinfection, and growth stimulation can encourage the rapid healing of chronic venous leg ulcers.

[Evaluation of the Diagnostic Performance of Different Principles of SARS-CoV-2 Commercial Antibody Tests in COVID-19 Patients]. / SARS-CoV-2 ile Ilgili Farkli Prensipli Ticari Antikor Testlerinin COVID-19 Hastalarindaki Tanisal Performanslarinin Degerlendirilmesi.

Following the emergence of severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) and using only PCR for diagnosis, antibody tests have been rapidly developed by various commercial companies. There are differences between the sensitivity and specificity of these tests due to the usage of different viral target proteins and antibody subclasses. In order to evaluate the diagnostic use of these tests, we aimed to examine the diagnostic performance, especially sensitivity and specificity, of SARS-CoV-2 IgM, IgA and IgG tests of various companies (Abbott, Roche, Euroimmun, Dia.Pro, Anshlabs, Vircell, UnScience and RedCell), which have different principles (ECLIA/CLIA, EIA, LFA). Current (n= 180) and past (n= 180) COVID-19 patients with clinical and molecular diagnosis of COVID-19 admitted to Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine Hospital, Pandemic Polyclinic with suspected COVID-19 infection, were included in our study. The patients admitted within the first 3 weeks after the onset of symptoms were included in the current patient group, and those admitted at the third and after the third week were included in the past patient group. Serum samples (n= 180) obtained from Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Blood Center between April and June 2018 before the COVID-19 pandemic were included in the study as a control group. All the tests included in our study were studied with the recommendations of the manufacturer companies. Between the IgG detection tests with different principles in patients with past COVID-19, the sensitivity and specificity values of the most effective tests were; 86.7%/99.4% (Abbott), 86.1%/98.9% (Dia.Pro), 91.3%/95% (RedCell). Between the IgM detection tests with different principles in current COVID-19 patients, the sensitivity and specificity values were; 67.8%/99.4% (Abbott), 68.9%/98.6% (Vircell), 50%/97.5% (RedCell). Abbott IgM with a kappa coefficient of 0.67 and Vircell IgM + IgA test with a kappa coefficient of 0.65 showed the best fit in patients with current COVID-19 infection. In patients with past COVID-19, Abbott IgG with 0.86 kappa coefficient and Dia.Pro IgG test with 0.85 kappa coefficient showed the best match. Due to the low sensitivity of IgM detection antibody tests, they should not be preferred instead of real-time reverse transcriptase polymerase chain reaction in routine diagnosis. IgG detection tests may be preferred to detect the antibody response and the titers in people who have had COVID-19 for population seroprevalence and especially therapeutic immune plasma production. However, it is thought that the combined use of both ECLIA/CLIA-based and EIA/ELISA-based tests together may be more effective in routine use for SARS-CoV-2 IgG tests.

The Relationship between Pre-Pandemic Interferon Gamma Release Assay Test Results and COVID-19 Infection: Potential Prognostic Value of Indeterminate IFN-γ Release Assay Results.

OBJECTIVE: To reveal the relationship between interferon-gamma release assay (IGRA) test (Standard ETB-Feron ELISA (TBF)) results performed within 12 months before the COVID-19 pandemic and the frequency of COVID-19 infections and the severity of COVID-19. METHODS: The retrospective TBF test results and contact information of 684 patients aged over 18 years who underwent TBF testing between March 11th, 2019, and March 10th, 2020, were obtained. Of the 684 patients contacted by phone, 365 agreed to participate in the study and were enrolled. The patients were divided into three groups (TBF test positive, negative, and indeterminate). The data obtained from the questionnaire were compared statistically. RESULTS: According to the TBF test results, positive (n = 51, 14%), negative (n = 286, 78.3%), and indeterminate (n = 28, 7.7%) groups were compared. The frequency of COVID-19 infections in the indeterminate group was found significantly higher than that in the positive and negative groups (p=0.005). When the group with COVID-19 (n = 46, 12.6%) was compared with the group without (n = 319, 87.4%), no difference was found in terms of age, sex, body mass index, smoking history and number of cigarettes smoked, TB history, diabetes mellitus, hypertension, coronary artery disease, and biologic and corticosteroid therapy use. Only the frequency of obstructive pulmonary disease was significantly higher in the group without COVID-19 (p=0.033). CONCLUSION: The frequency of COVID-19 infection was increased in patients with indeterminate TBF test results. Indeterminate TBF test results may be a guide in terms of risk stratification in groups at risk for COVID-19.

Evaluation of knowledge, attitudes and practices of health services vocational schools' students with regard to COVID-19.

INTRODUCTION: The most critical intervention to control SARS-CoV-2 infection requires appropriate knowledge and attitude towards the virus. OBJECTIVE: To determine the level of knowledge, attitudes and practices of students of a health services' vocational school with regard to COVID-19. METHODS: Cross-sectional study carried out between May and June 2020 in a university of the Turkish region. Data were collected through an online survey portal. RESULTS: Four hundred and fifty-four questionnaires were completed and returned. Students of medical laboratory techniques and first aid and emergency medicine had significantly higher knowledge scores (p < 0.001). More than 43 % of the students (n = 201) used the TV as their main source of information on COVID-19. There was a positive attitude towards preventive measures such as avoiding crowded places and maintaining hand hygiene and social distance. CONCLUSIONS: Health services vocational school students have good knowledge and positive attitude towards COVID-19. The main sources of information were the TV and social media. For this reason, more attention should be given to these issues in the curriculum in order for science-based information sources to be used.

INTRODUCCIÓN: La intervención más crítica para controlar la infección por SARS-CoV-2 requiere el conocimiento y la actitud correctos hacia el virus. OBJETIVO: Determinar el conocimiento, las actitudes y las prácticas de los estudiantes de una escuela vocacional de servicios de salud respecto a COVID-19. MÉTODOS: Estudio transversal realizado entre mayo y junio de 2020 en una universidad de la región de Turquía. Los datos se recopilaron mediante un portal de encuestas en línea. RESULTADOS: Se completaron y devolvieron 454 cuestionarios. Los estudiantes de técnicas de laboratorio médico y primeros auxilios y emergencias tuvieron puntuaciones de conocimiento significativamente más altas (p < 0.001). Más de 43 % de los estudiantes (n = 201) usaron televisores como su principal fuente de información sobre COVID-19. Se manifestó una actitud positiva hacia las aplicaciones, así como evitar lugares concurridos y mantener la higiene de las manos y la distancia social. CONCLUSIONES: Los estudiantes de la escuela vocacional de servicios de salud tienen buen conocimiento y actitud positiva hacia COVID-19. Las principales fuentes de información fueron la televisión y las redes sociales, por lo que se debe prestar más atención a estos temas en el plan de estudios para utilizar fuentes de información basadas en la ciencia.

Real-time PCR using high-resolution melting analysis technology for diagnosis of Leishmania and determination of types of clinical samples

Background/aim: Leishmaniasis is a disease group carried by Phlebotomus and Lutzomyia sand flies infected with Leishmania and is mostly observed in rural areas. In this study, using high-resolution melting analysis (HRMA), we aim to identify the active types of leishmaniasis, which are inadequately identified by classical methods. Materials and methods: Samples of 85 patients were examined in the study. Six of the patients were suspected of having visceral leishmaniasis (VL) and 79 cutaneous leishmaniasis (CL). The slides prepared from the samples were stained with Giemsa stain and examined under a light microscope. The results were compared with those determined in real-time PCR. When the real-time PCR result was positive for Leishmania , we determined the type by HRMA. Results: Among 85 Leishmania amastigote samples, 28 (32.9%) of them were detected and accepted as positive by microscopic examination. On the other hand, 25 (29.4%) of the 85 samples were found as positive using real-time PCR. In addition, when 25 Leishmania-positive samples were examined by HRMA, the results showed that 21 (84%) were L. tropica, 3 (12%) were L. major, and 1 (4%) was L. infantum. Conclusion: Based on our findings, we conclude that using real-time PCR and HRMA is useful in determining the cause of the disease in leishmaniasis.

Evaluation of Adenovirus-36 (Ad-36) antibody seropositivity and adipokine levels in obese children.

Adenovirus 36 (Ad-36) has recently been suggested as a possible contributor to the current obesity epidemic. The aim of this study was to investigate the prevalence of Ad-36 antibodies in obese children, as well as investigate the role of serum leptin and lipid levels in Ad-36-obesity. Seventy-one obese children and 62 non-obese children were included as the patient group (PG), including the healthy control group (HCG), respectively. Simultaneously, Ad-36 antibodies and adipokine levels were assessed with serum neutralization assays (SNA) and ELISA. Ad-36 antibody was detected in 9 patients (12.7%) and 1 patient (1.6%) in both the PG and HCG, respectively, while a significant difference was detected between groups (p < 0.05). Although serum LDL, total cholesterol, triglycerides and leptin levels were detected significantly higher, adiponectin level was detected paradoxically lower in the PG. However, a significant difference was not detected for lipids and leptin levels; adiponectin levels were found to be significantly lower in Ad-36 antibody-positive PG (p < 0.05). In conclusion, we suggest there is an association between Ad-36 and obesity in children, including IL-6 levels increasing in obese children with Ad-36 seropositivity. Conversely, adiponectin levels in obese children with Ad-36 seropositivity were higher. As such, there is a need for studies to understand the mechanisms underlying this observation.

Morphological Changes of Trichomonas vaginalis Treated by Ornidazole: An In-Vitro Study.

BACKGROUND: Nitroimidazoles, which are drugs that are used to effectively treat Trichomonas vaginalis, alter the structure of the T. vaginalis cell membrane, penetrate into its cytoplasm and nucleus and block cellular metabolism. In this study, we observed the morphological changes that occurred in T. vaginalis during in vitro exposure to 1.3 µg/mL of ornidazole at various time intervals ranging from 10 minutes to 10 hours. METHODS: Vaginal and urethral secretion samples from suspected T. vaginalis cases were inoculated into Cysteine Peptone Liver Maltose medium. In 18 sterile tubes, 9.5 mL of this solution were mixed with 0.5 mL of ornidazole. The periods of contact between ornidazole and T. vaginalis ranged from 10 minutes to 10 hours. RESULTS: The first change was vacuolization, which started in the 10th minute of exposure. The glycogen particles started to diminish in the 20th minute. CONCLUSIONS: During exposure to 1.3 mg/L of ornidazole, cell lysis began in the 30th minute and accelerated towards the 60th minute (p < 0.001). Cytoplasmic matrix integrity was impaired in the 60th minute (p < 0.001).

The role of adenovirus 36 as a risk factor in obesity: the first clinical study made in the fatty tissues of adults in Turkey.

Obesity which developes due to multifactorial reasons, was associated recently with human Adenovirus-36 (Ad-36). The aim of this study was to investigate the prevalence of Ad-36 antibodies in obese adults and also to investigate the DNA of Ad-36 in their adipose tissue. In this cross-sectional and case-control based study, 49 obese adults, with BMI ≥ 30 kg/m(2), and 49 non-obese adults, with BMI ≤ 25 kg/m(2), applied for esthetic purposes and were included in this study as patient and control groups, respectively. Adipose tissue samples, obtained by the lipoaspiration method, were studied by single-step PCR and nested-PCR methods. Simultaneously, the presence of Ad-36 antibodies and serum leptin and adiponectin levels were assessed by serum neutralization assay (SNA) and ELISA, respectively. Serum samples which didn't cause a cytopathic effect at ≥ 1:8 were accepted as positive. Ad-36 antibody was detected in 6 (12.2%) of 49 patients by SNA and was statistically significant (p < 0.05). Ad-36 DNA was not detected in any of the adipose tissue samples of the patient or control groups. Mean BMI and leptin levels were higher in the Ad-36-positive group, while adiponectin levels were found to be lower in the Ad-36-positive group. Although no statistically significant difference was found in cholesterol and triglyceride levels between the two groups (p > 0.05), lower mean serum cholesterol and triglyceride levels were found in the Ad-36-positive patients. In conclusion, we couldn't detect Ad-36 DNA in adipose tissue; however, we detected significantly higher Ad-36 antibody levels in the obese group compared to the non-obese group, according to the both univariant and multivariant analyses, suggesting that Ad-36 may play a role in obesity. There is a need for new and extended serial, particularly cohort and human-based, studies in order to have a clear understanding of the Ad-36-obesity relationship.

The epidemiological and molecular characterization of vancomycin-resistant enterococci isolated from rectal swab samples of hospitalized patients in Turkey.

BACKGROUND: Vancomycin-resistant enterococci (VRE) are a serious problem all over the world. The present study was conducted to investigate antimicrobial resistance patterns, genotypes, clonal relationship, and virulence fac- tors of VRE species isolated from rectal swab samples of hospitalized patients, patient's relatives, and medical staff at Istanbul University Cerrahpasa Medical School hospital. METHODS: The VRE isolates were typed with an automated VITEK system and their antibiotic sensibilities were analysed by disc diffusion and Etest® method. The molecular characterization and clonal relationships were per- formed using a PCR method and virulence genes by sequence typing. RESULTS: A total of 100 (10.3%) of the 971 patients were colonized with VRE. None of the investigated 25 patient's relatives and 45 medical staff carried VRE. All VRE strains were identified as E. faecium. They were vanA genotype and originated from a single clone. VRE strains exhibited multi-drug resistance. High-level gentamicin-resistance was 93%. However, lower resistance rates were found for linezolid (40%) and quinopristin-dalfopristin (11%). The enterococcal surface protein gene esp was found positive in 87 of 100 isolates, and four strains were positive for the cylB (cytolysin) gene. CONCLUSIONS: The identification of VRE strains to the species level and detection of virulence genes will assist in infection control practices.

The relationship between bifidobacteria and allergic asthma and/or allergic dermatitis: a prospective study of 0-3 years-old children in Turkey.

Bifidobacteria are beneficial bacteria for humans. These bacteria are particularly effective at protecting against infectious diseases and modulating the immune response. It was shown that in newborns, the fecal distribution of the colonizing Bifidobacterium species influences the prevalence of allergic diseases. This study aimed to compare the faecal Bifidobacterium species of allergic children to those of healthy children to detect species level differences in faecal distribution. Stool samples were obtained from 99 children between 0 and 3 years of age whose clinical symptoms and laboratory reports were compatible with atopic dermatitis and allergic asthma. Samples were also obtained from 102 healthy children who were similar to the case group with respect to age and sex. Bifidobacteria were isolated by culture and identified at the genus level by API 20 A. In addition, 7 unique species-specific primers were used for the molecular characterization of bifidobacteria. The McNemar test was used for statistical analyses, and p < 0.05 was accepted as significant. Bifidobacterium longum was detected in 11 (11.1%) of the allergic children and in 31 (30.3%) of the healthy children. Statistical analysis revealed a significant difference in the prevalence of B. longum between these two groups (X(2): 11.2, p < 0.001). However, no significant differences in the prevalence of other Bifidobacterium species were found between faecal samples from healthy and allergic children. (p > 0.05). The significant difference in the isolation of B. longum from our study groups suggests that this species favors the host by preventing the development of asthma and allergic dermatitis. Based on these results, we propose that the production of probiotics in accordance with country-specific Bifidobacterium species densities would improve public health. Thus, country-specific prospective case-control studies that collect broad data sets are needed.

Evaluation of the Diagnostic Performance of a SARS-CoV-2 and Influenza A/B Combo Rapid Antigen Test in Respiratory Samples.

This study aimed to evaluate the performance characteristics of a rapid antigen test developed to detect SARS-CoV-2 (COVID-19), influenza A virus (IAV), and influenza B virus (IBV) (flu) compared with those of the real-time reverse transcription-polymerase chain reaction (rRT-PCR) method. One hundred SARS-CoV-2, one hundred IAV, and twenty-four IBV patients whose diagnoses were confirmed by clinical and laboratory methods were included in the patient group. Seventy-six patients, who were negative for all respiratory tract viruses, were included as the control group. The Panbio™ COVID-19/Flu A&B Rapid Panel test kit was used in the assays. The sensitivity values of the kit were 97.5%, 97.9%, and 33.33% for SARS-CoV-2, IAV, and IBV, respectively, in samples with a viral load below 20 Ct values. The sensitivity values of the kit were 16.7%, 36.5%, and 11.11% for SARS-CoV-2, IAV, and IBV, respectively, in samples with a viral load above 20 Ct. The kit's specificity was 100%. In conclusion, this kit demonstrated high sensitivity to SARS-CoV-2 and IAV for viral loads below 20 Ct values, but the sensitivity values were not compatible with PCR positivity for lower viral loads over 20 Ct values. Rapid antigen tests may be preferred as a routine screening tool in communal environments, especially in symptomatic individuals, when diagnosing SARS-CoV-2, IAV, and IBV with high caution.

Detection of anti-leishmanial effect of the Lucilia sericata larval secretions in vitro and in vivo on Leishmania tropica: first work.

It is known that some of the enzymes and substances secreted by 2nd and 3rd stages of the Lucilia sericata larvae to have bacteriostatic and bactericidal effects. From this point of view, we investigated the anti-leishmanial effect of larval secretions of the L. sericata on the Leishmania tropica both in vitro and in vivo conditions. In vitro: It was observed that promastigotes of L. tropica had undergone lyzis within 1 min in the larval secretions of L. sericata. However, larval secretion was ineffective on the promastigotes within Novy-MacNeal-Nicolle (NNN) cultures and RPMI 1640 medium. In vivo: Seven groups of male Balb/C mice (6 study groups and 1 control group), each composed of eight weeks old 10 mice were formed. L. tropica promastigotes were injected subcutaneosly to the soles of the SG mice' feet. In study groups, cutaneous lesions were developed Limoncu et al., 1997 in 2 (20%) and 1 (10%) of the SG-1 and SG-2, respectively after 15 days. There were L. tropica in the smears prepared from the lesions and L. tropica was observed in the cultures. Cutaneous lesions were not developed in 8 (80%), 9 (90%) and 10 (100%) of the SG-I, SG-II and SG-III, respectively. There were no cutaneous lesions developed in the soles of the feet. There were no L. tropica in the smears prepared from the infected soles of the feet neither L. tropica was observed in the cultures. Larval secretions were given into the cutaneous lesions to the feet soles of the SG-IV, V and VI mice after 6 months. No healing was observed in the cutaneos lesions of 4 (40%), 5 (50%) and 1 (10%) of SG-IV, SG-V and SG-VI, after 6 months, respectively. There were L. tropica in the smears prepared from the lesions and L. tropica was observed in the cultures. On the other hand, the lesions of 6 (60%), 5 (50%) and 9 (90%) of SG-IV, SG-V and SG-VI were diminished in size and disappeared completely after 6 months. There were L. tropica observed in the smears prepared from the infected soles of the feet and no growth was observed in the cultures. In the smears prepared from the cutaneous lesions developed in the soles of the feet of the control group mice, L. tropica was visualized and observed in the cultures. A statistical significant difference was observed between study groups and control group (p<0.001). In our study we demonstrated for the first time that the secretions of the 2nd and 3rd stages sterile and pure larvae of L. sericata had effects on promastigotes of L. tropica in in vitro and very effective on amastigote forms in in vivo conditions.

Comparison of Larval Therapy and Vacuum-Assisted Closure Therapy after Revascularization in Peripheral Artery Disease Patients with Ischemic Wounds.

Objective: Even for very successful peripheral revascularization therapy, treatment is not complete until the ulcerative, gangrenous, and infected wound is closed. This study was performed and compared the outcomes of vacuum-assisted closure (VAC) and maggot debridement therapy (MDT) following peripheral revascularization to accelerate the wound healing process. Methods: We did a prospective randomized clinical trial between January 1, 2014, and June 21, 2019. This study included 72 patients (63 males and nine females). Balloon angioplasty was performed in 21 patients (29.2%), peripheral bypass in 39 (54.2%), and both balloon angioplasty and revascularization (hybrid) surgery in 12 (16.7%). Thirty-three patients (45.8%) received 15 VAC therapy sessions for a month. Therapy progress was monitored at 48 h intervals, and wound debridement was performed. Thirty-nine patients (54.2%) received an average of six larval therapy sessions for a month. Groups were compared with the X 2 test, and a statistically significant difference was found (P < 0.001). Results: In the VAC therapy group (n = 33), 14 patients (42.4%) had their feet amputated, 5 (15.1%) had a toe amputated, and 4 (12.1%) had all of their toes amputated. A skin graft was performed on four patients (12.1%) who developed granulation tissue. The wounds of six patients (18.2%) undergoing VAC therapy healed. In the larval therapy group (n = 39), the wounds healed in 36 patients (92.3%), and 3 (7.7%) had a toe amputated. Conclusion: Larval therapy was shown to be more effective than VAC therapy for the treatment of postrevascularization ischemic wounds. Thus, larval therapy can be used as an effective biological treatment method when major amputation is not required.

Anti-SARS-CoV-2 IgG and Neutralizing Antibody Levels in Patients with Past COVID-19 Infection: A Longitudinal Study

Background: Monitoring the longevity of immunoglobulin G (IgG) responses following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections is vital to understanding the role of antibodies in preventing infection. Aims: To determine the quantitative IgG responses specific to the Spike-S1 (S1) receptor-binding domain (S1/RBD) region of the virus in serum samples taken between 4 weeks and 7 months after polymerase chain reaction (PCR) positivity in patients who are diagnosed with coronavirus disease-2019 (COVID-19). Study Design: A longitudinal study. Methods: This study included 113 patients with a clinical and molecular diagnosis of COVID-19. The first and second serum samples were taken 1 and 7 months, respectively, after the PCR positivity. S1/RBD-specific IgG antibody response was assayed using anti-SARS-CoV- 2 QuantiVac ELISA (IgG) kit (Euroimmun, Lübeck, Germany). The neutralizing antibodies were investigated in 57 patients whose IgG test results were above the cut-off value. Results: In 57 patients with SARS-CoV-2 IgG, the anti-SARS-CoV-2 IgG quantitative antibody levels significantly decreased after 7 months (Z = −2.197, p = 0.028). A correlation was detected between the anti-SARS-CoV-2 IgG and nAb percent inhibition (IH%) levels detected in 1 month (rs = 0.496, p < 0.001), but without significant correlation in serum samples taken on 7 months. The nAb IH% levels of the first and second were compared for COVID-19 severity and revealed no statistical difference (p = 0.256). In the second serum sample, the nAb IH%s of patients with moderate COVID-19 showed a statistically significant difference from patients with mild COVID-19 (p = 0.018), but without significant differences between severe and moderate or mild COVID-19. Conclusion: SARS-CoV-2 quantitative IgG antibody titers are significantly reduced at long-term follow-up (> 6 months). Due to the limited information on seroconversion, comprehensive studies should be conducted for long-term follow-up of the immune response against SARS-CoV-2.

A Retrospective Study of Cutaneous and Visceral Leishmaniasis in Istanbul, Turkey.

INTRODUCTION: Leishmaniasis is a vector-borne disease caused by flagellated protozoans of the genus Leishmania. This study aimed to evaluate the epidemiological status of Visceral Leishmaniasis (VL) and Cutaneous Leishmaniasis (CL) among patients admitted to a university hospital in Istanbul, located in western Turkey. METHODOLOGY: This study included 160 and 77 patients with a pre-diagnosis of VL and CL, respectively, between January 2001 and December 2017. Detailed demographic data, including age, gender, nationality and the number and location of lesions were collected and recorded from the patient registries. RESULTS: Among 160 bone marrow specimens that suspected as VL, 22 (13.7%) of the specimens that were evaluated with both culture and Giemsa staining detected as positive. Furthermore, 29 (37.7%) of the 77 patients suspected for CL showed evidence of Leishmania. CONCLUSIONS: The increase in human immigration from neighbouring countries (with a high incidence of leishmaniasis) to Turkey might increase the risk of spreading the disease. This situation could result in a higher prevalence in metropolitan cities like Istanbul, where the country's population is concentrated.

In Silico Analysis of Common Long Noncoding RNAs in Schistosoma mansoni and Schistosoma haematobium.

BACKGROUND: Schistosomiasis caused by Schistosoma parasites is one of the most common parasitic infections worldwide. Genetic regulation of the genus Schistosoma, which has different developmental stages throughout its life, is quite complex. In these parasites, thousands of long noncoding RNAs (lncRNAs) estimated to be functional were identified. Identifying the transcripts expressed in common and detecting their functions for better understanding of the role of these lncRNAs require a comparative study. METHODS: Assembled RNA-seq datasets belonging to S. mansoni and S. haematobium were obtained from the National Center for Biotechnology. A basic local alignment search tool (BLASTN) analysis was conducted against previously constructed lncRNA library to identify the common lncRNAs between two species. LncRNAs target genes and their gene ontology annotation was performed. RESULTS: In S. mansoni and S. haematobium, 5132 and 3589 lncRNA transcripts were detected, respectively. These two species had 694 lncRNAs in common. A significant number of lncRNAs was determined to be transcribed from sex chromosomes. The frequently expressed lncRNAs appear to be involved in metabolic and biological regulation processes. CONCLUSIONS: These two species share similar lncRNAs; thus, this finding is a clue that they might have similar functions. In sexual development, they especially might play important roles. Our results will provide important clues to further studies about interactions between human hosts and parasites and the infection mechanisms of Schistosoma parasites.

The Distribution of Intestinal Parasites in Patients Presenting to a University Hospital in Istanbul: A Seven-year Retrospective Analysis

Objective: The purpose of this study was to determine the intestinal parasite distributions in patients who applied to the Parasitology Laboratory of Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, by evaluating the parasites retrospectively. Methods: Normal saline and stool lugol were applied for direct examination of stool samples that were sent for parasite examination; cellophane band samples were evaluated microscopically. The samples suspected to have protozoa were evaluated using modified acid fast and trichrome staining methods. We evaluated the parasitological examination results of patients who applied to our laboratory between January 2012 and December 2018. Results: A total of 2.96% of the 20,948 patients who applied had parasites in their faeces. Blastocystis spp. was detected at the highest rate (63.23%), followed by Giardia intestinalis (17.26%), Enterobius vermicularis (12.58%), Taenia saginata (2.42%), Cryptosporidium spp. (1.94%) and Entamoeba histolytica/dispar (1.45%). Conclusion: Although the prevalence of intestinal parasitic infections has decreased when compared to previous years, it still remains important. For this reason, solving infrastructure problems, providing information on personal hygiene and sanitation rules are among the most important tasks needed to reduce the prevalence of intestinal parasites.

A Case of Cutaneous Leishmaniasis Caused by Leishmania infantum

Leishmania is a disease that is transmitted via Phlebotomine sand flies. Two clinical forms of leishmaniasis are observed in humans: Visceral and cutaneous leishamniasis. The latter is very widespread in our country and may resolve by itself with scar formation. Whereas visceral leishmaniasis can be lethal if left untreated. Recently, molecular studies have shown that agents causing visceral leishmaniasis may cause cutaneous leishmaniasis and vice-versa.

A 34-year-old female patient from Kahramanmaras was sent to the microbiology laboratory with a pre-diagnosis of leishmaniasis. The smear taken from the patient was stained with Giemsa and was viewed by using a light microscopy. The materials taken via swab were examined with Real Time PCR and High Resolution Melting Analysis (HRMA).

Leishmania amastigotes were viewed by using microscopy and diagnosis was confirmed. Real Time PCR was positive for Leishmania and HRMA showed that the agent was L. infantum.

As our county has a bridging role between Asia and Europe, we should be aware of the recent epidemiological changes about Leishmania infections. We wanted to present this case becasue the causative agent of cutaneous leishmaniasis was L. infantum in this case and the disease resolved without treatment.