The importance of transmission time in HIV infections and an epidemiological prospective follow-up study for 1 year in the Marmara Region of Turkey

It is important to detect recent and new HIV/1 infections and to take preventative measures in order to prevent rapid disease progression in AIDS and to decrease the incidence of infection. We aimed to detect long standing or recent HIV infections by determining transmission times for the cases in which first-time HIV/1 seropositivity were detected. The serum samples of 323 cases which were found to be seropositive by ELISA and Western-blotting were included in this study. The discrimination between long-term and recent HIV/1 infection was made by determining transmission-time with the Aware BED-EIA, HIV-1 incidence test (IgG capture HIV-EIA) tests. Ninety-six healthy blood donors who did not have a positive anti-HIV test and a chronic infectious disease for at least 1 year were included in this study as a negative healthy control group. In the discrimination of long-term and recent HIV/1 infections, only in vitro ODn values were used. The cases with normalized optical density (OD) (OD(specimen)/OD(calibrator))<0.8 by commercial kit were accepted as recent HIV infection (155 days history or seroconversion less than 6 months). The cases with ODn >1.2 were accepted as long-term HIV/1 infections (more than 155 days history or more than 6 months). The cases with ODn between 0.8 and 1.2 were accepted as "additional tests needed" cases. We detected recent HIV/1 infections (<6 months) in 60 (18.5%) out of 323 cases and long-term HIV/1 infections (>6 months) in 263 (81.5%) out of 323 cases. The most frequently encountered transmission route in long-term and recent HIV/1 infections was heterosexual sexual intercourse as 54 (50%) and 257 (97%), respectively. 63.3% of newly infected patients were married females and 65.3% of recently infected patients were males. In conclusion, the detection of the high ratio of long-term HIV/1 infection cases (81.5%) compared to recent infections (18.5%) suggested to us, that the long standing cases may have some activities related with transmission of HIV/1 in the past. The detection of higher HIV/1-infections in individuals which had heterosexual sex and also in married males suggested that this situation poses a very great threat for the health of society.     

Evaluation of Cytotoxic and Mutagenic Effects of Coriolus versicolor and Funalia trogii Extracts on Mammalian Cells

This study examined the in vitro cytotoxic activities of standardized aqueous bioactive extracts prepared from Coriolus versicolor and Funalia trogiiATCC 200800 on HeLa and fibroblast cell lines using a MTT (3-[4,5-dimetiltiazol-2-]-2–5-difeniltetrazolium bromide) cytotoxicity assay. F. trogii and C. versicolor extracts were cytotoxic to both cell lines. At 10 μL treatment level, F. trogii and C. versicolor extracts inhibited proliferation of HeLa cancer cells by 71.5% and 45%, respectively, compared with controls. Toxicity was lower toward normal fibroblasts. In the latter case, treatment at 10 μL level with F. trogii and C. versicolor extracts reduced cell proliferation by 51.3% and 38.7%, respectively. In separate experiments, the mitotic index (MI) obtained with 3 μL treatment level of unheated extracts of the two fungi was comparable to the MI value obtained by treatment with 4 μg/mL MMC (anticancer agent mitomycin-C). A significant induction of sister chromatid exchange (SCE) was observed in normal cultured lymphocytes treated with MMC (4 μg/mL). MMC treatment reduced replication index compared with treatment with unheated F. trogii extract and negative controls (p < 0.001). In contrast to MMC, F. trogii extracts did not affect the proliferation of human lymphocytes compared with controls (p > 0.05). Laccase and peroxidase enzyme activities in F. trogii extract were implicated in their inhibitory effect on cancer cells. F. trogii extract was concluded to have antitumor activity.     

Association of low maternal levels of salusins with gestational diabetes mellitus and with small-for-gestational-age fetuses

Objectives

To evaluate maternal and cord serum concentrations of salusin-α and salusin-β in women with gestational diabetes mellitus (GDM) and with small-for-gestational age (SGA) fetuses.

Study design

Pregnant women with GDM (n = 25), women with SGA (n = 20) and maternal age-matched normal healthy pregnant subjects (n = 25) participated in the study. Maternal serum and cord blood salusin-α and salusin-β levels at the time of birth were measured using ELISA, and their relation with metabolic parameters was also assessed.

Results

Mean concentrations of maternal and fetal serum salusin-α in the GDM and SGA groups were significantly lower than those of the controls (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). Mean concentrations of maternal and cord blood salusin-β also decreased in both the GDM and the SGA groups in comparison to the control group (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). The concentrations of maternal serum salusin-α and salusin-β were strongly positively correlated with the concentrations of cord blood salusin-α and salusin-β (R = 0.92, P < 0.001 and R = 0.94, P < 0.001, respectively).

Conclusions

The low levels of maternal serum salusin-α and salusin-β may have negative impact on metabolic disorders and vascular dysfunction.     

Comparison of “sandwich chemo-radiotherapy” and six cycles of chemotherapy followed by adjuvant radiotherapy in patients with stage IIIC endometrial cancer: a single center experience

Objective

To compare “sandwich chemo-radiotherapy” with six cycles of chemotherapy followed by adjuvant radiotherapy with respect to tolerability and acute toxicity.

Materials and methods

Twenty-five women with surgically staged IIIC endometrial cancer were included. Treatment consisted of either three cycles of paclitaxel (175 mg/m²) and carboplatin (AUC 6) on a q21-day schedule followed by irradiation (45–50.4 Gy) or six cycles of the same chemotherapy followed by radiotherapy. Acute toxicity related to either chemotherapy or radiotherapy was evaluated.

Results

Median age was 61.5 years (range 36–83 years). Eleven patients had sandwich chemo-radiotherapy, and the other 14 patients had 6 cycles of chemotherapy followed by radiotherapy. Three out of the five patients who could not complete all the cycles in the sandwich chemo-radiotherapy group had pelvic and para-aortic radiotherapy. Acute radiotherapy related grade 1–2 gastrointestinal system (GIS) and genitourinary system (GUS) toxicities were observed in 72.8 and 63.6 % of patients, respectively, for sandwich group. Undesired treatment breaks in the course of radiotherapy were observed in six patients for sandwich chemo-radiotherapy and in one patient receiving six cycles of chemotherapy followed by radiotherapy. All the patients who had undesired treatment breaks in the sandwich chemo-radiotherapy group had pelvic and para-aortic radiotherapy.

Conclusion

Sandwich chemo-radiotherapy seems to be more toxic particularly for patients who had pelvic and para-aortic irradiation. Therefore, it might be more convenient to delay radiotherapy after six cycles of chemotherapy for patients with the indication of pelvic para-aortic radiotherapy.     

Risk factors for postmenopausal osteoporosis: anthropometric measurements,age, age at menopause and the time elapsed after menopause onset

Objectives.?The aim of this study was to determine, how much the anthropometric measurements and age affect the femur and vertebra T-scores by using correlation and regression analysis in postmenopausal women.

Methods.?Data of 540 healthy postmenopausal women were included in this analysis. Bone mineral density was determined by dual energy X-ray absorptiometry (DXA). The data of the patients related to height, weight, age, age at menopause were obtained from records, and body mass index (BMI) was calculated (BMI = W (kg)/H(m²)). Statistical analyses were performed with SPSS 15.0 for Windows (SPSS, Chicago, IL).

Results.?Mean age and standard deviation of 540 postmenopausal women was 59.3 ± 8.4 years. The correlation coefficients among femur, vertebra T-scores, weight, the time elapsed after the menopause onset, age, BMI and height were found as follows, from higher to lower values with 0.465, 0.453, 0.411, 0.382, 0.232, respectively, and were statistically significant (p < 0.001).

Conclusions.?We determined the effects of the anthropometric measurements on osteoporosis from higher to lower influence as follows: weight, menopause age, age, BMI and height. Weight and menopause age of the patients were the major determinants for osteoporosis.     

Brain abscess in childhood: a 28-year experience

Brain abscess is an uncommon intracranial suppurative infectious disease, especially in children. The clinical presentation, treatment and outcome of 75 children with brain abscesses admitted to the Department of Pediatric Infectious Diseases at Hacettepe University Faculty of Medicine were retrospectively analyzed. Seventy-five cases of brain abscess within a 28-year period were included in this study. Fever and headache were the most common presenting symptoms. Cyanotic congenital heart disease was the most common predisposing factor. The most common pathogen was Streptococcus spp. Although congenital heart disease remained the most common predisposing factor for development of intracerebral abscess, the rate of immunocompromised diseases as a predisposing factor of brain abscess has increased in recent years, and better management of otogenic infections also influences the prevalence of the disease.     

Outcome of ventilator-associated pneumonia due to multidrug-resistant <Emphasis Type="Italic">Acinetobacter baumannii</Emphasis> and <Emphasis Type="Italic">Pseudomonas aeruginosa</Emphasis> treated with aerosolized colistin in neonates: a retrospective chart review

Multidrug-resistant (MDR) gram-negative bacteria-related nosocomial infections and ventilator-associated pneumonia (VAP) presents an emerging challenge to clinicians. Older antimicrobial agents such as colistin have become life-saving drugs because of the susceptibility of these pathogens. We report our experience with aerosolized colistin in two preterm and one term neonate with Acinetobacter baumannii and Pseudomonas aeruginosa-related VAP who were unresponsiveness to previous antimicrobial treatment. All pathogens were isolated from tracheal aspirate. We used 5 mg/kg (base activity) aerosolized colistin methanesulfonate sodium in every 12 h as an adjunctive therapy for VAP. VAP was treated by 14, 14, and 16-day courses of aerosolized colistin in these patients, respectively. No adverse effect such as nephrotoxicity or neurotoxicity was observed. We found that aerosolized colistin was tolerable and safe, and it may be an adjunctive treatment option for MDR gram-negative bacterial VAP in neonates. Further studies are needed to determine appropriate doses for aerosolized colistin and its eligibility as an alternative treatment choice in newborns.     

Cerebral and mesenteric tissue oxygenation by positional changes in very low birth weight premature infants

Aim

There has been no clear consensus of the appropriate positioning in preterm infants. We aimed to evaluate the changes of cerebral and mesenteric tissue oxygenation in three different positions, by near infrared spectroscopy (NIRS), in stable very low birth weight (VLBW) infants of postnatal > 30 days.

Methods

NIRS monitoring of cerebral and mesenteric tissue oxygenation in three different positions was performed in 29 stable preterm newborns in neonatal intensive care unit (NICU). The patients were observed in three different positions consecutively, each lasting for 4 h. The demographic features, cerebral and mesenteric tissue oxygenation with positional changes and feeding periods were recorded.

Results

Mean gestational age, mean birth weight and mean postnatal age of the patients were 27.6 ± 1.7 weeks, 1046 ± 308 g and 42.4 ± 15.7 days, respectively. There were no statistically significant differences in cerebral and mesenteric tissue regional SO₂ values in each position (p = 0.954 and p = 0.151, respectively). The values of cerebral and mesenteric tissue regional SO₂ before and after feeding did not show any statistically significant difference in each position.

Conclusions

Clinically stable very low birth weight infants are able to maintain a stable cerebral and mesenteric tissue oxygenation in different positions, both before and after feeding. Positional changes seem to be safe in VLBW stable infants and this influence should be considered in care of these patients in the NICU.Clinical Trials Identification Number: NCT01255189.