[Genotype distribution of chronic hepatitis B and hepatitis C patients and investigation of the resistance patterns in hepatitis B cases]. / Kronik hepatit B ve hepatit C'li hastalarda genotip dagilimi ve hepatit B olgularinda direnç paterninin arastirilmasi.

The high genetic diversity in hepatitis B and C viruses (HBV and HCV, respectively), and the presence of differences in pathogenicity and response to therapy, necessitates continous monitorization of the genotypes and antiviral resistance patterns. The aims of this study were to investigate the genotype distribution of HBV and HCV in chronically infected patients and to detect the resistance patterns of HBV strains in treatment-naive patients and those under lamivudine (LAM) treatment. A total of 44 chronic hepatitis B (CHB) patients (mean age: 42 +/- 13.6 years; 31 were male) and 30 chronic hepatitis C (CHC) patients (mean age: 47 +/- 12.4 years; 8 were male) were included to this study which was carried on between September 2007-March 2008. Mutational analysis and antiviral drug resistance studies were performed by sequence analysis (ABI PRISM 310 Genetic Analyzer; Applied Biosystems, USA), with the use of the region between 80-260 codons in HBV DNA polymerase gene, and the genotype determining sequences in 5' non-coding region in HCV genome. As a result, all of the 44 CHB patients (100%) were found to be infected with HBV genotype D, while genotype 1 (26/30; 86.6%) was found to be the predominant HCV genotype in CHC patients. The frequency of HCV genotypes were as follows; 63.3% (n = 19) genotype 1b, 20% (n = 6) 1a, 13.3% (n = 4) 4a and 3.3% (n = 1) 1c. Various mutations were detected in 34.1% (15/44) of CHB patients and these were identified as M2041 (n = 6), Q215S (n = 2), L801 + M2041 (n = 1), L80V + M2041 (n = 1), Q215S + M2041 (n = 1) and M2041 + L180M (n = 1) mutations responsible for LAM resistance; V214A (n = 1) and A181T + N236T (n = 1) mutations responsible for adefovir (ADV) resistance, and V84M + V173L (n = 1) mutation responsible for ADV + LAM resistance. In 12% (3/25) of the treatment-naive CHB patients LAM resistance was detected. However, total antiviral resistance rate was found 63.2% (12/19) for CHB patients (LAM resistance in 9, ADV resistance in 2, and LAM + ADV resistance in 1 patient) who were currently under LAM treatment. Accordingly, total LAM resistance in our CHB cases was 27.3% (6.8% primary and 20.5% secondary resistance), ADV resistance was 4.5% and multidrug (LAM + ADV) resistance was 2.3%. It was concluded that, our data would be helpful in the diagnosis and management of patients with chronic liver diseases due to viral hepatitis in our region.

Short period of preconditioning protects by decreasing the TNF-alpha and IL-6 values before laparoscopic surgery (a rat experiment).

BACKGROUND: Laparoscopy produces ischemia reperfusion injury mediated by inflammatory cytokines. Preconditioning is a protective maneuver in laparoscopic surgery; however, there is an argument in the literature about the length and number of the preconditioning sequence(s), thus the present study evaluates the effects of short (5 min) and long (10 min) periods of preconditioning on laparoscopy-induced inflammatory response. MATERIAL/METHODS: Thirty-two rats were enrolled into 4 groups: control, laparoscopy, 5 min preconditioning and 10 min preconditioning groups, each containing 8 rats. Laparoscopy was performed by application of 60 min of pneumoperitoneum with 15 mmHg. The preconditioning maneuvers were performed before laparoscopy in respective groups. Following the cessation of experiment blood samples were obtained to determine the TNF-alpha and IL-6 levels. RESULTS: Laparoscopy produced significantly increased levels of plasma TNF-alpha and IL-6 values as compared to the sham group. Five min preconditioning caused significant decrease in plasma TNF-alpha and IL-6 values compared to laparoscopy group. Although 10 min preconditioning caused partially decreased levels of TNF-alpha and IL-6 values, they were still higher than that of the 5 min preconditioning group. CONCLUSIONS: Preconditioning maneuvers longer than 5 min lose protective activity and begin to produce ischemia reperfusion injury. We found that 5 min of inflation followed by 5 min of deflation seems to protect against subsequent post-laparoscopic inflammatory response. Thus it is advisable not to use any preconditioning maneuvers longer than 5 min in order to avoid increasing the operation and anesthesia times.

Frequency of norovirus in stool samples from hospitalized children due to acute gastroenteritis in Anatolia, Turkey, 2006-2007.

Noroviruses are among the most common causes of sporadic enteritis in childhood. In this pilot study, the frequency of norovirus infection in children in mid-western Turkey was investigated from November 2006 to June 2007. Noroviruses were detected in 17% of samples (15/88) by a combination of 2 different RT-PCR assays, both targeting an overlapping region of the RNA-dependent RNA polymerase gene. By sequence analysis, most strains were characterized as GIIb/Hilversum. One strain was characterized as GII.4/2006a, a variant that appeared worldwide in 2006, while another strain was characterized as a rare genotype, GII.6. This study demonstrates the importance of norovirus in paediatric diarrhoea and suggests the heterogeneity of circulating strains in Turkey.

Human papillomavirus typing and soluble interleukin-2 receptor levels in female sex workers with a negative cervical smear result.

OBJECTIVE: To investigate the association between high-risk human papillomavirus (HPV) types and soluble interleukin-2 receptor (sIL-2R) levels in female sex workers with a negative cervical smear result, and to determine the effectiveness of using sIL-2R levels to screen for high-risk strains of HPV. METHOD: A negative cervical smear result and a blood sample were obtained from 68 women: 43 female sex workers and 25 women acting as controls. HPV DNA genotyping was performed and sIL-2R levels were assessed. RESULTS: Female sex workers had significantly higher sIL-2R levels than women in the control group (318.37+/-239.7 vs 114.4+/-56.5 U/mL, respectively P<0.001). In addition, female sex workers with high-risk strains of HPV had significantly higher sIL-2R levels than those who did not have high-risk strains of HPV (736.7+/-251.5 vs 250.5+/-156.1 U/mL, respectively; P=0.001). CONCLUSION: High sIL-2R levels may be useful in screening for high-risk strains of HPV in female sex workers who have a negative cervical smear result.