Effect of Laurus nobilis on bacteria and human transforming growth factor-ß1.

OBJECTIVE: In this study, we aimed to determine the phenolic compounds, the antibacterial activity of extract from Laurus nobilis leaves, and its possible effect on transforming growth factor-ß1 expression level in peripheral blood mononuclear cells. METHODS: The phenolic components of Laurus nobilis were identified by the high-performance liquid chromatography method. The antibacterial activity of this extract was determined by disk diffusion and broth microdilution methods. The transforming growth factor-ß1 expression was analyzed using the RT-qPCR method. RESULTS: Epicatechin was found in the highest amount and o-coumaric acid in the lowest amount. The half-maximal inhibitory concentration (IC50) was determined to be 55.17 µg/mL. The zones of inhibition and minimum inhibitory concentration for Staphylococcus aureus, Enterococcus faecalis, and Klebsiella pneumoniae were 15, 14, and 8 mm and 125, 250, and 1000 µg/mL, respectively. The change in transforming growth factor-ß1 expression levels was found to be statistically significant compared with the control groups (p<0.0001). CONCLUSION: Laurus nobilis extract was found to be effective against bacteria and altered the expression level of transforming growth factor-ß1 in peripheral blood mononuclear cells.

Molecular epidemiological investigation of carbapenem resistant Klebsiella pneumoniae isolated from intensive care unit patients of six geographical regions of Turkey.

INTRODUCTION: Klebsiella pneumonia causes serious infections in hospitalized patients. In recent years, carbapenem-resistant infections increased in the world. The molecular epidemiological investigation of carbapenem-resistant K. pneumoniae isolates was aimed in this study. METHODOLOGY: Fifty carbapenem-resistant K. pneumoniae isolates from six geographical regions of Turkey between September 2019-2020 were included in the study. The disk diffusion method was used for the antibiotic susceptibility testing. The microdilution confirmed colistin susceptibility. Genetic diversity was investigated by MLST (Multi-Locus Sequence Typing). RESULTS: The resistance rates were as follows: 49 (98%) for meropenem, 47 (94%) imipenem, 50 (100%) ertapenem, 30 (60%) colistin and amoxicillin-clavulanate, 49 (98%) ceftriaxone, 48 (96%) cefepime, 50 (100%) piperacillin-tazobactam, 47 (94%) ciprofloxacin, 40 (80%) amikacin, 37 (74%) gentamicin. An isolate resistant to colistin by disk diffusion was found as susceptible to microdilution. ST 2096 was the most common (n:16) sequence type by MLST. ST 101 (n:7), ST14 (n:6), ST 147 and ST 15 (n:4), ST391 (n:3), ST 377 and ST16 (n:2), ST22, ST 307, ST 985, ST 336, ST 345, and ST 3681 (n:1) were classified in other isolates. In Istanbul and Ankara ST2096 was common. Among Turkey isolates, the most common clonal complexes (CC) were CC14 (n:26) and CC11 (n = 7). CONCLUSIONS: In Turkey, a polyclonal population of CC14 throughout the country and inter-hospital spread were indicated. The use of molecular typing tools will highlight understanding the transmission dynamics.

Evaluation of combination therapies with colistin in an experimental mouse pneumonia model induced by carbapenem-resistant Acinetobacter baumannii strain.

The treatment options are limited in Acinetobacter baumannii infections. In this study, the effectiveness of colistin monotherapy and combinations of colistin with different antibiotics were investigated in an experimental pneumonia model induced by carbapenem-resistant A. baumannii strain. Mice in the study were divided into five groups as control (no treatment), colistin monotherapy, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline combinations. The modified experimental surgical pneumonia model of Esposito and Pennington was applied to all groups. The presence of bacteria in blood and lung samples was investigated. Results were compared. In blood cultures, while there was no difference between the control and colistin groups, there was a statistical difference between the control and the combination groups (P = 0.029). When the groups were compared in terms of lung tissue culture positivity, there was a statistical difference between the control group and all treatment groups (colistin, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline) (P = 0.026, P < 0.001, P < 0.001, and P = 0.002, respectively). The number of microorganisms that grew in the lung tissue was found to be statistically significantly lower in all treatment groups in comparison with the control group (P = 0.001). Both monotherapy and combination therapies of colistin were found to be effective in the treatment of carbapenem-resistant A. baumannii pneumonia, but the superiority of combination therapies over colistin monotherapy has not been demonstrated.

Effectiveness of pediatric rotary, rotary and reciprocating instrumentations on bacterial load reduction in primary molars: an ex vivo comparative study.

This study aimed to evaluate the efficacy of intracanal Enterococcus faecalis reduction using pediatric rotary (EndoArt Pedo Kit Blue, EasyInSmile X-Baby and Denco Kids), rotary (ProTaper Next) and reciprocating (WaveOne Gold) file systems through microbiological analyses in primary molars. Seventy-five mandibular primary second molars were selected and divided into five instrumentation groups and a negative control group. After incubation, five roots were used to confirm biofilm formation on the root canals. Before and after instrumentation, bacterial samples were collected. The bacterial load reduction was statistically analyzed by using Kruskall-Wallis and Dunn post hoc tests at a significance level of 0.05. Denco Kids and EndoArt Pedo Kit Blue promoted higher bacterial reduction than EasyInSmile X-Baby systems. There was no difference in bacterial reduction between ProTaper Next rotary file systems and other groups. Among the single-file techniques, instrumentation with the Denco Kids rotary system showed a more significant bacterial load reduction than WaveOne Gold (p < 0.05). All systems used in the study reduced bacterial counts from root canals in primary teeth. Further studies are required to generate more information about the use of pediatric rotary file systems in clinics.

[Evaluation of In Vitro Efficacy of Ceftazidime-Avibactam, Meropenem, and Colistin Single and Binary Combinations Against Carbapenem Resistant Klebsiella pneumoniae Strains Isolated from Various Clinical Specimens]. / Seftazidim-Avibaktam, Meropenem ve Kolistinin Tek Basina ve Ikili Kombinasyonlarinin Çesitli Klinik Örneklerden Izole Edilen Karbapenem Dirençli Klebsiella pneumoniae Suslarina Karsi In Vitro Etkinliginin Arastirilmasi.

It has been reported that many antibiotics used today, including the carbapenem group, fail to treat Klebsiella pneumoniae infections effectively. Despite many studies in recent years, the definitive treatment for carbapenem-resistant Klebsiella pneumoniae (CRKP) infections is still uncertain. In this study, it was aimed to investigate in vitro activities of colistin (COL) and meropenem (MEM), which are frequently used in the treatment of CRKP infections, and ceftazidime-avibactam (CZA), which is recently used in our country, alone or in combination against different CRKP isolates having different carbapenem resistance mechanisms andto analyze whether the presence of colistin resistance, which is an important problem in CRKP strains, influences the drug interaction results. This study was carried out in 42 K.pneumoniae isolates, which were isolated from various clinical samples as an infectious agent in Süleyman Demirel University Faculty of Medicine, Department of Medical Microbiology, Bacteriology Laboratory and whose carbapenem resistance was confirmed by carbapenemase inactivation test. The carbapenemase genes of the isolates were determined by the polymerase chain reaction (PCR) method. Antimicrobial susceptibilities of CRKP strains to CZA, MEM, and COL were determined by the broth microdilution method and in vitro synergy activities of dual combinations of these drugs were evaluated by checkerboard and time-kill methods. Statistical evaluation of categorical data was performed using Fisher's exact test, and p-value of less than 0.05 was considered statistically significant in terms of difference between the groups. Of the 42 CRKP isolates 34 (81%) were only OXA-48 positive, 5 (11.9%) were OXA-48+NDM and 3 (7.1%) were OXA-48+KPC positive. In the checkerboard test, synergy was detected against 97.6% of the isolates both with CZA+MEM and CZA+COL combinations, whereas this rate was 50% with MEM+COL. In the time-kill test, synergy was detected with CZA+MEM and CZA+COL combinations in the OXA-48 positive isolate and OXA-48+KPC positive isolate, while synergy was detected with CZA+COL and MEM+COL combinations in the OXA-48+NDM positive isolate. There was no significant relationship between whether the isolates were resistant to colistin or not and the checkerboard test results of antibiotic combinations (pCZA+MEM= 0.33, pCZA+COL= 0.11, pMEM+COL= 0.61). Results of our study revealed that the most common carbapenemase type in CRKP isolates was OXA-48 in our hospital, and the combinations of CZA with MEM and COL had high potential for synergism against these isolates.

Investigation of acute effects of topical Alpinia officinarum (galangal) treatment in experimental contact type burns and comparison with topical silver sulfadiazine treatment.

BACKGROUND: It was aimed to determine whether Alpinia officinarum (AO) (galangal), which has been regarded to be effective on wound healing, is healing on experimental contact type burns and compare its effects with silver sulfadiazine (SSD). METHODS: Thirty-five rats were divided into five groups of seven rats each group. Superficial second degree burns were formed by contacting a 1×1 cm copper tip which was kept at 100°C constant temperature to the three shaved areas on the back of rats without applying any pressure for 10 s. All groups were irrigated with a 100 cc saline solution for 2 min. Any procedure or treatment was not applied to Group I (Control). Group II (Burn Control) was only irrigated, Group III (SSD) was applied topical SSD 4 times, with 6-h intervals (at h 0, 6, 12 and 18), Group IV (Galangal) was applied topical AO 4 times, and Group V (Gel) was applied placebo topical material, used for the preparation of topical AO, 4 times. Wound healing findings were evaluated histopathologically. RESULTS: In the galangal group, it was found that collagen discoloration didn't penetrate into deep dermis compared to other groups; epidermis, hair follicles, and sebaceous glands remained protected compared to the burn control group, and there was a thicker layer of epidermis. It was found that the galangal group was the closest group to the control group histologically. In the galangal group, it was determined that the number of vessels and total hair follicles were significantly higher in the 8th h and 4th h respectively (p<0.05), while epidermal thickness and number of degenerated hair follicles were significantly higher in all hours compared to other three groups (p<0.05). It was determined that galangal group had the lowest scores in the evaluation of edema, polymorphonuclear leukocytes infiltration, collagen discoloration, injury of vessels, hair follicles and sebaceous glands in comparisons between groups and within groups' own processes. CONCLUSION: Administrating AO containing gel 4 times a day within the first 24 h is effective in the experimental contact type second degree burn model. It is significantly superior to SSD treatment, especially in the first 8 h of administration.

Preparation of Ethanol Extract of Propolis Loaded Niosome Formulation and Evaluation of Effects on Different Cancer Cell Lines.

Propolis is a candidate for cancer treatment with its activity against different tumor cells and, has a wide spectrum of biological and pharmacological activities due to the diversity of its components. In this study, antitumorigenic activities of ethanol extract of propolis (EEP) and ethanol extract of propolis loaded niosome (PLN) were compared using 2D and 3D cell culture. Niosome formulations were prepared by thin film hydration technique. Cell viability of EEP and PLN was analyzed on MCF7, A549, MDA-MB-231, SK-MEL, SK-BR-3, DU145 and L-929 cell lines using MTT assay. L929, MCF7 and A549 cells were cultured using the 3D petri dish technique and their spherical forms were obtained after 142 h. After 24 h, PLN and EEP application, cell viability analysis was performed on 3D cultures with WST assay. As a result, niosome formulations containing EEP showed higher activity than ethanol extract of propolis in cancer cells. While a slow decrease was observed in cell viability in EEP treated cancer cells, it was observed that the percentage viability rates decreased in a shorter time in PLN treated cancer cells. Also, PLN can be used as an anticancer activity drug such as Doxorubicin, but this is not the case for EEP.

Possibility of Taking an Offensive Stance in Extravasation Injury: Effects of Fat Injection in Vesicant (Doxorubicin) Induced Skin Necrosis Model in Rats.

INTRODUCTION: Extravasation injuries are one of the most feared complications of intravenous drug administration. The most common drugs associated with extravasation injury include chemotherapy agents and contrast media. Natural course of vesicant extravasation is discomfort, pain, swelling, inflammation, and ultimately skin ulceration. While diligence is the principle approach in prevention, immediate bed-side measures are as important in controlling the extent of tissue damage. Various options, either medical or interventional are next steps in treatment of the condition including antidotes, volume dilution, flushing, suction, hyperbaric oxygen therapy, and surgery. MATERIALS AND METHODS: 12 male Wistar albino rats were divided into two groups; one group received fat injections following subdermal doxorubicin infiltration in their right thighs, while other group received saline injection following subdermal doxorubicin infiltration in their right thighs for dilution. Left thighs of both groups were left untreated following subdermal doxorubicin infiltration. Total area of necrosis, as well as resultant epidermal thicknesses were assessed. Histological analyses were conducted using modified Verhofstad scoring system for comparison. RESULTS: Mean necrotic area was significantly smaller in the fat injection group compared to other groups. Median Verhofstad score was lesser in the fat injection group as well. Median epidermal thickness, on the other hand, was greater in the fat injection group. CONCLUSION: Injection of fat grafts following vesicant extravasation might be beneficial in preventing the progression of tissue damage, if employed early.

An Investigation into the Association Between Toxoplasma gondii Infection and Bipolar Disorder

Objective: Studies have implicated Toxoplasma gondii in the etiology of mental disorders because of its neurotropic nature and its ability to modulate neurotransmitter pathways. This study aims to investigate T. gondii seroprevalence in patients with bipolar disorder and in healthy controls living in the Isparta Region of Turkey and to assess the probable relationship between T. gondii and bipolar disorder. Methods: Fourty-eight patients with bipolar disorder and 50 healthy controls were included in the study. Sociodemographic data, possible risk factors for T. gondii infection and clinical characteristics were analyzed. Serum anti-T. gondii IgM and IgG antibody levels were measured by using chemiluminescence immunoassay method (Roche Cobas e601 analyzer, Roche Diagnostics, Mannheim, Germany). Results: Anti-T. gondii IgG seropositivity rates were determined as 18.8% and 20% in the patient group and the control group, respectively. No statistically significant relationship was observed between T. gondii IgG seropositivity and bipolar disorder (p=0.876). In the study population, advanced age, low education level, living in a rural region and consumption of unwashed raw vegetable or fruit were found to be the significant risk factors for T. gondii infection (p<0.05). Conclusion: Our preliminary findings do not support the hypothesis that T. gondii infection is related to bipolar disorder. However, further studies would require larger sample sizes to confirm our results.

Primary Cutaneous Angiosarcoma of the Scalp with Cranial Invasion in a Patient with Metastatic Breast Cancer.

Idiopathic cutaneous angiosarcoma (CA) of the head and neck is a distinct subtype of angiosarcoma most commonly presenting as a single or multiple purple, bruise-like patches that arise de novo and enlarge over several months. In clinical practice, both misdiagnosis and delayed diagnosis are frequently encountered. Here, we present a case of idiopathic CA on the scalp with invasion to the cranium in a patient with breast cancer metastatic to the brain. The patient was initially misdiagnosed and mistreated with herpes zoster and breast cancer metastatic to the skin, which led to a delayed diagnosis by two months until dermatologic evaluation. The diagnosis was then firmly established as CA based on consistent clinical and histological features. Since the tumor was inoperable, radiotherapy and chemotherapy were been considered as the appropriate adjuvant modes of therapy. Despite an initial favorable response, the disease demonstrated a rapidly progressive course and the patient succumbed to the disease within six months. This report briefly reviews the clinical and histological portrait and management options for this aggressive tumor.

Comparison of DNA damage and proliferative capacities in smear samples of HPV positive and negative patients by micronucleus counting and AgNOR staining.

Human papillomavirus (HPV) is believed to cause cervical cancer. Thousands of women develop cancer and other diseases caused by HPV each year. HPV 16 and 18 types are found in approximately 70% of cervical cancers. Micronuclei are small chromosomal fragments that are considered indicators of DNA damage. AgNOR positive dots are useful for assessing proliferation. We investigated the relation between HPV-DNA, micronuclei and AgNOR in smear samples. Three groups were defined: HPV negative, 16/18 positive and other high-risk groups (31, 33, 35, 39, 45, 51, 52, 56, 58, 66 and 68) (HR). After typing, micronuclei were identified by Papanicolaou staining and AgNOR regions were detected by silver staining. Serum reactive protein (CRP) also was measured. We found that the average age of HPV negative patients was significantly greater than for the HPV positive groups. We also found that CRP levels were significantly higher in the HPV 16/18 positive group than HPV negative and other HPV group. We found that the number of micronuclei in the HPV 16/18 group was significantly greater than for the HPV negative group. Also, we found that AgNOR staining for the HPV 16/18 group was significantly greater than for the HPV negative group. We found that CRP level, cell proliferation and genome instability were increased in HPV positive patients. The AgNOR and micronucleus tests were useful for evaluating cell proliferation and DNA damage.

Evaluation of monocyte to HDL cholesterol ratio and other inflammatory markers in patients with psoriasis

Abstract Background Psoriasis is a chronic systemic inflammatory disease frequently associated with serious comorbidities. Objectives To investigate the systemic inflammatory burden in psoriasis and to assess the correlation between traditional and novel inflammatory markers and the severity of the disease. Methods This cross-sectional study was conducted on 60 patients with psoriasis vulgaris and 50 healthy volunteers. Data including demographics, Psoriasis Area and Severity Index scores, and laboratory results were analyzed and compared. Results Compared with the control group, the psoriatic patients had significantly higher high sensitive C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, monocyte to high density lipoprotein (HDL) cholesterol ratio, and aspartate aminotransferase levels, and significantly lower HDL cholesterol levels (p < 0.05). No significant difference was found in procalcitonin, lymphocyte, monocyte, hemoglobin, red blood cell distribution width, platelet, mean platelet volume, platelet distribution width, lymphocyte-to-monocyte ratio, anti-cyclic citrullinated peptide, glucose, alanine aminotransaminase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, and LDL cholesterol levels between the two groups (p > 0.05). The Psoriasis Area and Severity Index score was positively correlated with high-sensitivity C-reactive protein, serum amyloid A, and monocyte to HDL cholesterol ratio, and negatively correlated with lymphocyte-to-monocyte ratio (p < 0.05). Study limitations This was a single-center study with relatively limited numbers of patients and controls. Conclusions The data show that high sensitivity C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and monocyte to HDL cholesterol ratio can be used as markers of systemic inflammation in patients with psoriasis. Moreover, high sensitivity C-reactive protein, serum amyloid A, monocyte to HDL cholesterol ratio and lymphocyte-to-monocyte ratio are closely related to the Psoriasis Area and Severity Index score, and they may be regarded as objective indicators in determining the disease severity.

Evaluation of monocyte to HDL cholesterol ratio and other inflammatory markers in patients with psoriasis.

BACKGROUND: Psoriasis is a chronic systemic inflammatory disease frequently associated with serious comorbidities. OBJECTIVES: To investigate the systemic inflammatory burden in psoriasis and to assess the correlation between traditional and novel inflammatory markers and the severity of the disease. METHODS: This cross-sectional study was conducted on 60 patients with psoriasis vulgaris and 50 healthy volunteers. Data including demographics, Psoriasis Area and Severity Index scores, and laboratory results were analyzed and compared. RESULTS: Compared with the control group, the psoriatic patients had significantly higher high sensitive C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, monocyte to high density lipoprotein (HDL) cholesterol ratio, and aspartate aminotransferase levels, and significantly lower HDL cholesterol levels (p < 0.05). No significant difference was found in procalcitonin, lymphocyte, monocyte, hemoglobin, red blood cell distribution width, platelet, mean platelet volume, platelet distribution width, lymphocyte-to-monocyte ratio, anti-cyclic citrullinated peptide, glucose, alanine aminotransaminase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, and LDL cholesterol levels between the two groups (p > 0.05). The Psoriasis Area and Severity Index score was positively correlated with high-sensitivity C-reactive protein, serum amyloid A, and monocyte to HDL cholesterol ratio, and negatively correlated with lymphocyte-to-monocyte ratio (p < 0.05). STUDY LIMITATIONS: This was a single-center study with relatively limited numbers of patients and controls. CONCLUSIONS: The data show that high sensitivity C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and monocyte to HDL cholesterol ratio can be used as markers of systemic inflammation in patients with psoriasis. Moreover, high sensitivity C-reactive protein, serum amyloid A, monocyte to HDL cholesterol ratio and lymphocyte-to-monocyte ratio are closely related to the Psoriasis Area and Severity Index score, and they may be regarded as objective indicators in determining the disease severity.

The healing effects of Hyperium perforatum (St. John's Wort) on experimental alkaline corrosive eosephageal and stomach burns.

BACKGROUND: The most frequent etiologic cause is alkaline substances. We investigated the protective effects of the plant St. John 's Wort (Hypericum perforatum). METHODS: We included 42 Wistar albino rats weighing between 200-300 grams and divided into six groups as Group 1: Control, Group 2: Burn+Saline (BS), Group 3: Burn+St. John's Wort (BSJW), Group 4: Burn+Plasebo (BP), Group 5: St. John's Wort (SJW), Group 6: Placebo (P). After 15 days of treatment, esophagus, stomach and liver tissue samples were derived by dissection for histopathologic and biochemical markers. The cytotoxic effects of formulation on fibroblasts is evaluated in vitro on human dermoblast fibroblast line (HDFa, Gibco Invitrogen cell culture, C-013-5C). RESULTS: The weight of the rats increased in Group 1, 3, 4, 6, decreased in Group 2 and did not change in Group 5. In the BSJW group, submucosal collagen accumulation, muscularis mucosa damage, tunica muscularis damage and collagen accumulation in esophagus were similar to the control group but lesser than BS and placebo group. In the stomach, mucosal damage, gastric gland dilatation, submucosal polymorphonuclear infiltration were similar to the control group and lesser than the BS group. The lethal concentration of SJW was 2.58 gr/mL. CONCLUSION: SJW substrate is effective in protecting the esophagus and stomach in mild to moderate alcali corrosive burns in the subacute period. We should keep in mind the protective effects of STW substrate in alkaline corrosive burns of the gastrointestinal system.

Evaluation of biochemical, hematological, RIBA and PCR assays in predicting viremia in anti-HCV positive patients.

INTRODUCTION: The detection of HCV-RNA by PCR assays is considered to be the gold standard for confirming the presence of HCV viremia. However, high costs, long and laborious procedures limit their widespread usage. This retrospective study was conducted to assess the predictive performances of biochemical and hematological parameters, anti-HCV signal-to-cutoff (S/CO) ratios and RIBA assay for HCV viremia. METHODOLOGY: Medical records of 210 patients with positive anti-HCV results were analyzed. Samples were tested for anti-HCV by the Roche Elecsys assay. RIBA and PCR assays were performed with Inno-Lia HCV Score test, and Roche Cobas TaqMan HCV test, respectively. RESULTS: Anti-HCV positive patients were categorized into two groups: positive HCV-RNA(viremic) group (n = 94) and negative HCV-RNA(non-viremic) group (n = 116). All viremic patients had positive RIBA results, while in the non-viremic group, 80 (69%) patients had negative/indeterminate RIBA results and 36 (31%) patients had positive RIBA results. Compared with the non-viremic group, the viremic group had significantly higher alanine aminotransaminase (ALT), aspartate aminotransferase, gamma-glutamyl transferase, mean platelet volume, platelet distribution width and anti-HCV levels, and significantly lower platelet count and plateletcrit levels (p < 0.05). With multivariate logistic regression analysis, serum ALT and anti-HCV levels were found to be strong predictive factors for HCV viremia. A S/CO ratio of ≥ 12.34 was identified as the optimal anti-HCV level to predict viremia. CONCLUSIONS: An anti-HCV S/CO ratio of 12.34 can determine the necessity for PCR assay, when carefully evaluated together with the biochemical and hematological evidence. This approach may reduce the cost of diagnosis particularly in low-resource settings.