Surveillance and oseltamivir resistance of human influenza a virus in Turkey during the 2007–2008 season

Monitoring the activity of influenza viruses is important for establishing the circulating types and for detection of the emergence of novel sub‐types and antiviral resistant strains. This is the first report from Turkey on the surveillance and oseltamivir resistance of influenza viruses in 2007–2008. Five hundred twenty‐four nasal swabs were tested from different geographical regions in Turkey during November 2007–April 2008. One hundred sixty‐three (31%) samples were positive for influenza viruses of which 111 (68%) were influenza A, 52 (31%) influenza B using an immuno‐capture ELISA. Forty isolates were selected at random from influenza A positive samples and grown in MDCK cell cultures. The supernatant of the cell cultures was used for RNA extraction followed by RT‐PCR to detect the sub‐types. Sub‐typing revealed all samples as A/H1N1. The N1 gene segment of 30 A/H1N1 samples was sequenced in part, from the 201st to 365th residue, which included the critical region for oseltamivir resistance. Then resulting sequences were analyzed with oseltamivir sensitive and resistant strains obtained from National Center for Biotechnology Information (NCBI) GenBank by CLC Main Workbench Software. H275Y (H274Y according to N2 numbering) mutation, which is known to confer resistance to oseltamivir, was detected in 6 out of 30 (20%) H1N1 isolates from four cities (Istanbul, Bursa, Ankara, and Izmir). The D354G mutation was observed in all oseltamivir resistant H1N1 isolates but not in the oseltamivir sensitive isolates. Assay of neuraminidase activity revealed that these isolates were resistant to oseltamivir, but sensitive to zanamivir. J. Med. Virol. 81:1645–1651, 2009. © 2009 Wiley‐Liss, Inc.     

Cockroach allergy in a group of Turkish children with respiratory allergies

Exposure to cockroach may lead to exacerbations of bronchial asthma and/or allergic rhinitis in sensitized patients. Although there is a widespread belief that cockroach allergy is a common problem in patients with respiratory allergies, little is known in Turkish children. In order to investigate the prevalence and characteristics of cockroach allergy in respiratory allergic children, we performed a study in newly referred children with respiratory allergies. All patients underwent questionnaire-interview and skin prick tested with common inhalant allergens in addition to two cockroach allergens: Blatella germanica (Bg) and Periplaneta americana (Pa). A subgroup of patients was also serologically investigated for specific IgE against Bg and house dust mite. Three hundred- and thirty-seven children aged 2-16 years were recruited for the study and 77.7% of these were atopic, with the most common indoor and outdoor allergens of house dust mite (47.5%) and grass pollens (45.1%), respectively. According to the prick test results, allergies to Bg and Pa were 11.9% and 7.4%, respectively, and there was a weak correlation between size of the prick test and specific IgE levels for Bg allergen. Almost 30% of the cockroach-sensitive patients were allergic to both cockroach antigens. Seventy percent of cockroach-sensitive patients were also sensitive to house dust mite, and only 1% were monosensitive. Dwellings in the Middle Anatolia and Black Sea regions were less commonly infested by cockroach compared to the dwellings in other regions. In conclusion, our preliminary study showed that cockroach sensitization is common among children with respiratory allergies irrespective of infestation history, suggesting that addition of cockroach allergen to the routine allergy screening panel is critical.     

The genotoxic effects of hepatitis B virus to host DNA

Chronic viral hepatitis is the main cause of chronic liver disease, cirrhosis and hepatocellular carcinoma throughout the world. Hepatitis B virus (HBV) has mutagenic effects on somatic cells. HBV may be showing these mutagenic effects through its viral proteins or through integrating into host DNA. The aim of this study was to determine whether HBV has a genotoxic effect on host DNA or not. Peripheral blood lymphocytes of 31 chronic HBV patients and 20 chronic HBV carriers were cultured in order to make cytogenetic evaluation by observing chromosome breakage and cytological evaluation by the micronucleus (MN) test. Their results were compared with 20 healthy controls. For each individual, 100 metaphase chromosome spreads were analysed. Around 190-1091 binucleated cells were observed and MN were scored for each individual. Our results showed significantly higher frequencies of chromosome breaks in chronic HBV patients and in HBV carriers than in the control group. There was no difference in MN scores among HBV patients, HBV carriers and healthy carriers. Based on our data, we conclude that chronic HBV patients and carriers have chromosomal instability and that HBV carriers are as affected as patients because of their same chromosome breakage levels.     

Association of sleep duration with socio‐economic status and behavioural problems among schoolchildren

Aim: In this population‐based study, we aimed to determine the total sleep duration (TSD), its association with socio‐economic status (SES) and behavioural symptoms among schoolchildren. Methods: A cross‐sectional study was performed among schoolchildren in Istanbul. A structured questionnaire evaluating the sleep schedule variables was filled out by their parents. SES was determined according to the Turkish SES scale. Results:  The mean age of 2669 children was 8.2 ± 2.4 years, and 51% of the students were girls. The mean TSD was 10.20 ± 1.04, and the mean bedtime was 21.57 ± 0.56 (both in hours, minutes ± SD). Boys tended to go bed later (p = 0.004) and slept less than girls (p = 0.02). The duration of sleep disruptions increased (p < 0.001), whereas TSD decreased with age (p < 0.001). Multiple linear regression revealed that waking time and TSD decreased significantly (p < 0.05) with higher SES among both girls and boys. Sleep fragmentation was associated with habitual snoring, parasomnias, daytime sleepiness and conduct symptoms. Conclusion: Decreased total sleep duration is more prominent in boys, older children and children among higher socio‐economic status. Insufficient sleep attributed to shortened total sleep duration by age and higher socio‐economic status might have a negative effect on both sleep hygiene and psychological well‐being in schoolchildren.     

External Jugular Vein Catheterization Using 'Intra-Atrial Electrocardiogram'

Purpose

To investigate the reliability of intra-atrial electrocardiogram (ECG) use for external jugular vein (EJV) catheterization.

Materials and Methods

Patients undergoing open heart surgery in Suleyman Demirel University Hospital between February and June 2006 were included in the study. Using a sterile Seldinger technique, a triple lumen polyurethane central venous catheter was introduced (Certofix® Trio V 720, length 20 cm, 7 French) under intra-atrial ECG guidance. The presence of an increase in P-wave size was recorded. Just after the surgery, a portable chest X-ray was taken. The method was considered to be successful when a change in P-wave could be seen and the catheter was in the superior vena cava, as well as when there was no change in P-wave and the catheter was not in the superior vena cava.

Results

In six patients (12%), we were not able to advance the guidewire. In the remaining 44 patients, the catheter was inserted without problem. Eight of these 44 catheters were positioned in the innominate vein, with a malposition ratio of 18%. The success rate of external jugular vein cannulation with intra-atrial ECG was 95%. No complications occured related to the EJV cannulation.

Conclusion

Considering that it is easily accessed without complication, and the malposition is successfully detected by intra-atrial ECG, EJV is a suitable access for central venous cannulation when internal jugular vein (IJV) is not usable.     

Effects of the Histamine H2 Receptor Antagonist Famotidine on the Healing of Colonic Anastomosis in Rats

BACKGROUND:

Failure of anastomotic healing is one of the major complications in colorectal surgery. Because histamine plays an important role in immune and inflammatory reactions, we demonstrate the effects of famotidine on the healing of colonic anastomosis in rats.

METHODS:

Twenty-eight Sprague-Dawley rats were used in the study. Excision and end-to-end anastomosis was performed in the distal colon of the rat. The Famotidine Group received 2 mg/kg/day famotidine; the Control Group received the same amount of saline. Bursting pressure of anastomoses and hydroxyproline content of perianastomotic tissues were evaluated on the third and seventh days following surgery.

RESULTS:

Bursting pressures and hydroxyproline contents for the Famotidine Group were significantly lower than the equivalent parameters for the Control Group on both the third and seventh days post-surgery.

CONCLUSIONS:

According to our findings, famotidine exerts detrimental effects on the anastomotic bursting pressure and hydroxyproline content of perianastomotic tissues in the colon of rats.     

Prolidase Could Act as a Diagnosis and Treatment Mediator in Lung Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease with unknown etiology and pathogenesis. With high mortality risks, most of the IPF cases emerged after a damage of alveolar epithelium, where this situation stimulates the over expression of matrix components. Inflammatory process observed as a reaction to emerged damage. Prolidase as an iminodipeptidase significantly increased during the development of fibrosis. The aim of this study is to measure prolidase activity as a marker of treatment and diagnosis in an experimental lung fibrosis animal model. Thirty male Wistar rats randomly divided into three experimental groups, with ten rats in each group. Group 1, control group; group 2, bleomycin (BLM)-induced lung fibrosis group, and group 3, BLM-induced lung fibrosis treated with palosuran (urotensin-II receptor antagonist). For histopathology, the middle lobes of right lungs were embedded in paraffin, followed by fixation in 10?% buffered formalin, and evaluation of IPF was performed using the Ashcroft scoring method. Prolidase activity was determined by a photometric method based on the measurement of proline levels produced by prolidase. The fibrosis scores and the prolidase activity were significantly enhanced by BLM stimulation. The BLM + palosuran treatment decreased prolidase activity in group 3. There was a positive correlation between prolidase activity and fibrosis scores. Palosuran seems to be effective in the treatment of lung fibrosis, and prolidase activity can be used for the diagnosis and/or for management of the treatment. However, further clinical and experimental studies with animals and/or patients are needed to verify these conclusions.     

Stem Cell Therapy in Spinal Cord Injury: In Vivo and Postmortem Tracking of Bone Marrow Mononuclear or Mesenchymal Stem Cells

Objective

The aim of this study was to address the question of whether bone marrow-originated mononuclear cells (MNC) or mesenchymal stem cells (MSC) induce neural regeneration when implanted intraspinally.

Materials and Methods

The study design included 4 groups of mice: Group 1, non-traumatized control group; Groups 2, 3 and 4 spinal cord traumatized mice with 1 g force Tator clips, which received intralesionally either no cellular implants (Group 2), luciferase (Luc) (+) MNC (Group 3) or MSC (Group 4) obtained from CMV-Luc or beta-actin Luc donor transgenic mice. Following the surgery until decapitation, periodical radioluminescence imaging (RLI) and Basso Mouse Scale (BMS) evaluations was performed to monitor neural activity. Postmortem immunohistochemical techniques were used to analyze the fate of donor type implanted cells.

Results

All mice of Groups 3 and 4 showed various degrees of improvement in the BMS scores, whereas there was no change in Groups 1 and 2. The functional improvement was significantly better in Group 4 compared to Group 3 (18 vs 8, p?=?0.002). The immunohistochemical staining demonstrated GFP⁺Luc⁺ neuronal/glial cells that were also positive with one or more of these markers: nestin, myelin associated glycoprotein, microtubule associated protein or myelin oligodendrocyte specific protein, which is considered as indicator of donor type neuronal regeneration. Frequency of donor type neuronal cells; Luc + signals and median BMS scores were observed 48–64 % and 68–72 %; 44–80 %; 8 and 18 within Groups III and IV respectively.

Discussion

MSCs were more effective than MNC in obtaining neuronal recovery. Substantial but incomplete functional improvement was associated with donor type in vivo imaging signals more frequently than the number of neuronal cells expressing donor markers in spinal cord sections in vitro. Our results are in favor of functional recovery arising from both donor MSC and MNCs, contributing to direct neuronal regeneration and additional indirect mechanisms.     

Trace elements, heavy metals and vitamin levels in patients with coronary artery disease

Aim: In the present study, we aimed to assess serum concentrations of zinc (Zn), copper (Cu), iron (Fe), cadmium (Cd), lead (Pb), manganese (Mn), vitamins A (retinol), D (cholecalciferol) and E (α-tocopherol) in patients with coronary artery disease (CAD) and to compare with healthy controls.Methods: A total of 30 CAD patients and 20 healthy subjects were included in this study. Atomic absorption spectrophotometry (UNICAM-929) was used to measure heavy metal and trace element concentrations. Serum α-tocopherol, retinol and cholecalciferol were measured simultaneously by high performance liquid chromatography (HPLC).Results: Demographic and baseline clinical characteristics were not statistically different between the groups. Serum concentrations of retinol (0.3521±0.1319 vs. 0.4313±0.0465 mmol/I, p=0.013), tocopherol (3.8630±1.3117 vs. 6.9124±1.0577 mmol/I, p<0.001), cholecalciferol (0.0209±0.0089 vs. 0.0304±0.0059 mmol/I, p<0.001) and Fe (0.5664±0.2360 vs. 1.0689±0,4452 µg/dI, p<0.001) were significantly lower in CAD patients. In addition, while not statistically significant serum Cu (1.0164±0.2672 vs. 1.1934±0.4164 µg/dI, p=0.073) concentrations were tended to be lower in patients with CAD, whereas serum lead (0.1449±0.0886 vs. 0.1019±0.0644 µg/dI, p=0.069) concentrations tended to be higher.Conclusions: Serum level of trace elements and vitamins may be changed in patients with CAD. In this relatively small study we found that serum levels of retinol, tocopherol, cholecalciferol, iron and copper may be lower whereas serum lead concentrations may be increased in patients with CAD.     

Which factors affect the likelihood of miscarriage after single euploid blastocyst transfer?

Research questionWhich parameters affect the likelihood of miscarriage after single euploid frozen–thawed blastocyst transfer (FBT)?DesignIn this retrospective study, clinical and laboratory data from 1051 single euploid FBTs were evaluated. Exclusion criteria were endocrine or systemic pathologies, uterine anomalies or pathologies, unilateral or bilateral hydrosalpinx, karyotypic abnormalities (either maternal or paternal) or thrombophilia. Patients were divided into two groups according to pregnancy outcome: live birth and miscarriage.ResultsBody mass index (BMI) (25.98 ± 0.5 versus 24.36 ± 0.21, P = 0.019), duration of infertility (6.62 ± 0.54 versus 4.92 ± 0.18, P = 0.006) and number of previous miscarriages (1.36 ± 0.13 versus 0.79 ± 0.05, P < 0.001) were significantly higher in the miscarriage group (n = 100) than in the live birth group (n = 589). Although the trophectoderm and inner cell mass (ICM) percentage scores were not statistically different among the miscarriage and live birth groups, the percentage of day-6 biopsied embryos was significantly higher in the miscarriage group. Binary logistic regression analysis revealed that BMI (OR 1.083, 95% CI 1.013 to 1.158, P = 0.02) and number of previous miscarriages (OR 1.279, 95% CI 1.013 to 1.158, P = 0.038) were independent factors for miscarriage. Patients with elevated BMI and a higher number of miscarriages were at increased risk of miscarriage.ConclusionAfter a single euploid FBT, BMI and number of previous miscarriages are predictors of miscarriage. Lifestyle interventions before FBT may decrease miscarriage rates.