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Preeclampsia is a complication of pregnancy that affects 3–5% of pregnancies and is one of the major causes of maternal/neonatal mortality and morbidities worldwide. We aimed to investigate the distribution of Foxp3+ regulatory T-cells and CD68+ Hofbauer cells in the placenta of preeclamptic and healthy pregnant women with a special focus on correlating these findings with placental histology. Decidua and chorionic villi of the placenta obtained from healthy and preeclamptic pregnancies were evaluated in full-thickness sections. Sections were stained with hematoxylin and eosin and Masson’s trichrome and immunostained for Foxp3 and CD68 for histological analyses. The total histomorphological score for placentas was found to be higher in preeclamptic placentas than that in the controls. The CD68 immunoreactivity was higher in the chorionic villi of preeclamptic placentas than that in the controls. The immunoreactivity of Foxp3 was found widely distributed within the decidua in both the groups and did not differ significantly. Interestingly, Foxp3 immunoreactivity in the chorionic villi was found mainly in the villous core and, to a lesser extent, in the syncytiotrophoblasts. We found no significant relation between Foxp3 expressions and morphological changes observed in preeclamptic placentas. Although extensive research is being carried out regarding the pathophysiology of preeclampsia, the findings are still controversial.

This study aimed to compare the serum angiotensin II and its receptor levels (AT1, AT2) in septic patients with catecholamine-responsive or resistant. The effect of hydrocortisone treatment on angiotensin II levels in the catecholamine-resistant septic patients was evaluated.This prospective observational study enrolled 40 patients diagnosed with septic shock based on sepsis-3 criteria. Patients were divided into two groups according to the noradrenalin infusion rate required to keep the mean arterial pressure above 65 mmHg: Control Group and Hydrocortisone Group (control group: below 0.5μg/kg/min, hydrocortisone group: above 0.5μg/kg/min). Serum angiotensin II, AT1, AT2 levels were measured at the time of diagnosis (A), one hour after hydrocortisone treatment (B), and three days later (C).In the catecholamine-resistant group, angiotensin II and AT1 levels were higher than the catecholamine-responder group in all periods. The sensitivity and specificity of AT-1 was observed to be high in all periods. AT2 levels decreased after hydrocortisone treatment in the catecholamine-resistant group and cut-off value was found 11%.It was concluded that angiotensin II and AT1 can be used as a biomarker of refractory septic shock and hydrocortisone may provide their blood pressure correcting effect by reducing AT2 level in these patients. AT2 can be a therapeutic target in the catecholamine-resistant septic shock patients.

Weeks and even months after recovering from the SARS-CoV-2 infection, clinically more severe cases are being reported, which are suggestive of COVID-19- related multisystemic inflammatory syndromes (MIS). Firstly on March 2020, this condition was reported to be COVID-19 related to children (MIS-C). Since June 2020, a syndrome similar to multisystem inflammatory syndrome in adults (MIS-A) came to be noticed in adults as well. We reported here a case of 24-year-old young woman who had gone to a hospital with abdominal pain and later developed a severe cough, followed by development of subconjunctival bleeding, pericardial effusion, pleural effusion, and intra-abdominal fluid that we deemed them to be acute multisystemic clinical symptoms, 47 days after she had undergone a COVID-19 infection of mild clinical severity. It should be kept in mind that a multisystemic inflammatory syndrome along with a delayed immune response during COVID-19 disease can be seen not only in children but also in young adults, and seemingly severe clinical and laboratory findings can improve by controlling the inflammatory process.

The COVID-19 pandemic has brought countries’ health services into sharp focus. It was drawn to our group’s attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.

Objective: Ischemia/reperfusion injury causes parenchymal and endothelial cell damage as a result of inflammation. Vascular endothelial growth factor (VEGF) expressed in every kind of tissue in human body has important roles in migration, proliferation, endothelial cell permeability, angiogenesis and vasculogenesis. IL-1 is a one of the cytokine family members, and plays important roles in hematopoiesis, inflammatory reactions and immune system regulation. Furthermore, auto-inflammatory diseases are treated by IL-1 as therapeutic agent. the aim of this study is to observe changes of VEGF and IL-1 immunreactivity in ischemia/reperfused rat uterus and ovary. Method: Rats were separated into two groups. Control group and ischemia/reperfusion group which rats were subjected to 45 min ischemia/45 min reperfusion. Samples from uterus and ovary were fixed with 10% neutral formaldehyde and stained with H&E. VEGF and IL-1 immunohistochemistry was applied. Results: Histopathological results showed severe degeneration of endometrium in uterus and ovarian follicles in ischemia/reperfusion group. VEGF and IL-1 immunoreactivity increased in uteruses and ovaries of ischemia/reperfusion group when compared to control group Conclusion: in consequence, the present results suggest that VEGF and IL-1 may be potential detection marker for ischemia/reperfusion injured uterus and ovary. Moreover, VEGF and IL-1 might be in relation with each other to regenerate uterus and ovary Amaç: İskemi/reperfüzyon hasarından dolayı oluşan inflamasyon parenkimal ve endotelyal hücre hasarına neden olmaktadır. Vücuttaki her tip hücreden eksprese edilen Vaskuler Endotelyal Büyüme Faktörü (VEGF), anjiyogenez ve vaskülogenezde, endotelyal hücre geçirgenliğinde, çoğalma ve migrasyonda çok önemli bir role sahiptir. Sitokin ailesinin bir üyesi olan IL-1, hematopoiezde, inflamasyon reaksiyonlarında ve immün sistem regulasyonunda önemli bir role sahiptir. Ayrıca, inflamatuvar hastalıklar terapatik ajan olan IL-1 ile tedavi edilmektedir. Bu çalışmanın amacı, İskemi/reperfüzyon yapılmış sıçanların over ve uterusunda VEGF ve IL-1 immunreaktivitesinde ki değişiklikleri araştırmaktır. Yöntem: Sıçanlar iki gruba ayrılmıştır. Kontrol grubu ve 45dk iskemi/45 dk reperfüzyon yapılmış İskemi/reperfüzyon grubudur. Over ve uterus dokuları %10’lık nötral formaldehit ile tespit edilmiş ve H&E ile boyanmıştır. VEGF ve IL-1 immunohistokimyası uygulanmıştır. Bulgular: Histopatolojik sonuçlar, İskemi/reperfüzyon grubunda uterus endometriyumunda ve over foliküllerinde ciddi derecede hasar göstermiştir. Uterus ve over dokusunda VEGF ve IL-1 immunreaktivitesi iskemi/reperfüzyon grubunda kontrol grubuna oranla artmış bulunmuştur. Sonuç: Bu bulgular over ve uterus dokusunda iskemi/reperfüzyon hasarında VEGF ve IL-1 potansiyel bir marker olarak kullanılabilir. Ayrıca, uterus ve over dokusu rejenerasyonunda VEGF ve IL-1 birbirleriyle etkileşim içerisinde olabilir

It is claimed that around 100 million men worldwide have undergone vasectomy for birth control. Vasectomy is an operation to prevent the transfer of sperm by preventing the luminal continuity of the vas deferens. Degenerative changes after vasectomy usually start with loss of spermatogenic cells in the germinal epithelium, while Sertoli cells are affected later. There is no change in Leydig cells. Zinc, which is found at high rates in the male reproductive system, is an element in the structure of many enzymes necessary for cell membrane integrity, growth and sexual maturity.In this study, bilateral vasectomy was performed on 18 young adult male rats and control operation was performed on 18 rats. Afterwards, 6 animals from each group were sacrificed after 6 weeks, 12 weeks and 12 months. Germinal epithelium, tubule structure, basement membrane, interstitium and collagen fiber changes were examined at microscope and transmission electron microscope level. On the other hand, zinc content in testicular tissue was measured by Energy-dispersive X-ray spectroscopy (EDS). Six weeks after vasectomy, localized losses in the germinal epithelium and disorganization of spermatogenic cells were observed. In addition to the loss of spermatogenic cells at the 12th week, separations, thickening and an increase in the collagen fiber in the peritubular area were observed in the interstitium and perinuclear area. Tissue zinc content was also found to be the lowest in the 12 months group.In conclusion, our study showed that the degenerative changes in the rat testis that increased with time after vasectomy were parallel to the decrease in tissue zinc content.

Objective: Francisella tularensis is a gram-negative coccobacillus and is the causative agent of tularemia, which is endemic in our country. The most common clinical form in Turkey is the oropharyngeal form. Sensitive lymphadenopathy is the most important finding, and fever, fatigue, and muscle and joint pain may occur in all clinical forms. Rodents such as rabbits, mice, and squirrels are the main reservoirs for humans, and the transmission is through contact with infected animal secretions and organs, contaminated water, and food. This study aimed to examine the socio-demographic, epidemiological, and clinical features of cases diagnosed with tularemia. Materials and Methods: Among the 583 patients whose serum samples were sent with a preliminary diagnosis of tularemia between 2011 and 2021, tularemia microagglutination test result (MAT) ≥1/160 titer, 18 years and older cases were included in the study. Results: A total of 24 tularemia cases were detected, with a mean age of 43.3±17 years, 10 (41.7%) were male, and 14 (58.3%) were female. The most common symptoms and findings among the cases were lymphadenopathy (LAP) (95.8%), fatigue (66.7%), sore throat, and high fever (58.3%), and the most common epidemiological history was living in a rural area (91.7%) and dealing with animal husbandry (66.7%), and 18 (75%) cases were referred to as oropharyngeal tularemia. More than half of the cases were detected between October and March. Conclusion: Tularemia is one of the endemic diseases in our country, and the epidemiological history should be taken carefully and kept in mind in the differential diagnosis of lymphadenopathy. Since it is the first tularemia study conducted in Malatya, it shows the epidemiological characteristics of the region.

Objective The safety profile of favipiravir in patients with severe renal impairment has not been investigated and available data are insufficient. The study aimed to compare the incidence of favipiravir‐associated adverse events amongst patients with varying renal function statuses. Methods Records of 921 patients who were hospitalised for COVID‐19 and had received at least 5 days of favipiravir treatment were retrospectively evaluated and 228 patients were included in the study. Patients’ age, sex, comorbidities, estimated glomerular filtration rate (eGFR) and haematological and biochemical values were recorded. The incidence of adverse events was compared with the age, sex, comorbidities and eGFR of the patients. Results The mean age of the patients was 59.3 ± 15.6 years, and 38.2% of the patients were women. One hundred and thirty‐one (57.5%) patients had experienced adverse events. These adverse effects consisted of ALT elevation (35.5%), AST elevation (21.5%), anaemia (16.2%), hyperuricaemia (10.5%), hepatocellular injury (9.2%), neutropenia (3.5%) and thrombocytopenia (2.6%). The incidence of adverse events was not significantly different when patients had eGFR >60 mL/min/1.73 m2 or eGFR 30‐60 mL/min/1.73 m2 (P > .05), but significantly increased when the eGFR dropped to

Oral colonization ofThe study began in February 2021. Oral cultures were taken. The microorganisms were identified by a Maldi-tof MS mass spectrometry device. Colistin resistance genes were investigated by polymerase chain reaction. Clonal relationships were determined by pulsed-field gel electrophoresis.Oral colonization of

Objectives: Studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily transmitted from person to person via airborne droplets. It is unclear whether it can be shed into human milk and transmitted to a child via breastfeeding.We investigated the presence of SARS-CoV-2 RNA in human milk samples of 15 mothers with coronavirus disease 19(COVID-19) and in the throat swab samples of their infants. Methods: This is a prospective observational study in which breast milk samples were collected from 15 mothers with COVID-19. The presence of SARS-CoV-2 RNA in the whole human milk samples of the patients was investigated using RT-qPCR. All of the infants underwent a clinical follow-up during their 14-day isolation and their throat swab samples were tested for SARS-CoV-2 RNA. Results: Of 15 mothers with COVID-19, SARS-CoV-2 RNA was detected in milk samples from 4 mothers. The throat swab samples from these mothers’ infants were found to be positive for SARS-CoV-2 RNA. Three of the four mothers were breastfeeding. In addition, during the 14-day isolation, all but three of the mothers breastfed their infants. Of the 12 breastfed infants, while the test for SARS-CoV-2 RNA in throat swab samples was negative in six of the infants, the other six infants, who had mild COVID-19 symptoms, tested positive for SARS-CoV-2 RNA.Clinical outcomes of all mothers and infants were uneventful. Conclusion: To our knowledge, this is the first case series with the largest number of cases with SARS-CoV-2 RNA positivity in human milk samples of mothers with COVID-19. However, we believe that the benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants

OBJECTIVE The aim of this study was to investigate the regenerative effects of alpha lipoic acid on the recovery of sciatic nerve crush injury (SNCI) in rats. DESIGN This was a randomized, experimental, and sham-controlled study. The sciatic nerves of 28 rats in four groups were traumatized for 60 secs: G1, sham operated + saline; G2, SNCI + saline; G3, SNCI + alpha lipoic acid 50 mg/kg/day; and G4, SNCI + alpha lipoic acid 100 mg/kg/day. Sciatic functional index values were measured on day 0, 1, 7, 14, 21, and 28. Sciatic nerve stimulation threshold values were recorded on day 1, 14, and 28. End-point histopathologic evaluation was conducted. RESULTS The mean sciatic functional index value of G2 but not G3/G4 on day 7 was significantly lower than on day 0 (P = 0.035, P = 0.447/P = 0.800). The mean sciatic functional index value of G2 but not G3/G4 increased significantly between day 7 and 14 (P = 0.035, P = 0.447/P = 0.438). The day 14 mean sciatic nerve stimulation threshold values of G3/G4 but not G2 were decreased significantly compared with those on day 1 (P = 0.022/P = 0.022, P = 0.933). The mean sciatic nerve stimulation threshold values of G3/G4 on day 14 were similar to those on day 0 (P = 0.106/P = 0.418). Regeneration in muscle and nerve connective tissues and nerve structures was observed in G3/G4. Inflammation in the muscle and nerve tissues of G4 was suppressed down to similar levels of G1. Myelinated nerve fibers were less degenerated in G3/G4. CONCLUSION Alpha lipoic acid has the potential to accelerate the process of nerve healing in the context of SNCI in rats.

Spermatogenesis is a process that involves cellular and biochemical processes. The purpose of this study is to understand the role of tight junctions in spermatogenesis by evaluating Zonula occludens-1 (ZO-1) protein levels of cells from the testicular sperm extraction (TESE) biopsies in patients with azoospermia. The study included 40 infertile men with azoospermia. They were divided into two groups, as spermatozoa positive (n=20) and spermatozoa negative (n=20). Testis tissues were examined morphologically, immunohistochemically and ultrastructurally by using transmission electron microscopy (TEM). The structure of seminiferous tubules was deteriorated, degenerated and hyalinized in spermatozoa negative group. ZO-1 expression level was normal in blood-testis barrier of spermatozoa positive group in comparing to lateral surfaces of Sertoli cells spermatozoa negative group. The ultrastructural results were also supported with light microscopy findings. These findings suggest that decrease of the ZO-1 protein expression level in Sertoli cells might be one of the factors involved in the impairment of spermatogenesis in spermatozoa negative group. Therefore, we suggest that tight junctions may have crucial roles in spermatogenesis.

BackgroundToday, COVID-19 pandemic has brought countries’ health services into sharp focus. Despite the low incidence of cases(1.2%) and high mortality rate(2.4%) among Turkish population, the low mortality rate(0.3%) despite the high incidence(11.5%) declared in healthcare workers drew our group’s attention. Therefore, we aimed to report the characteristics of infected health-care workers and investigate the relationship between BCG vaccine and tuberculosis history with COVID-19 mortality in infected health-care worker population.MethodThis study was conducted in three hospitals to assess the clinical presentations, disease severity and correlation with BCG vaccine and tuberculous history in COVID-19 positive health-care workers by an online questionnaire platform. The relationship between characteristics and tuberculosis history were investigated according to hospitalization status of the patients.ResultTotal of 465 infected healthcare workers included in the study. The rate of history of direct care and contact to tuberculosis patient, presence of previous tuberculosis treatment and BCG scar, presence of radiological infiltrations was significantly higher in hospitalized healthcare workers. The ratio of direct care and direct contact to the patient with tuberculosis, and presence of family history of tuberculosis were statistically significantly higher in patients with radiological infiltrations.ConclusionAlthough COVID-19 risk and incidence are higher among healthcare workers compared to the normal population due to higher virus load, this study brings evidence for the fact that the lower mortality rate seen in infected healthcare workers might be due to healthcare workers’ frequent exposure to tuberculosis bacillus and the mortality-reducing effects of BCG vaccine, despite the higher hospitalization rate and radiological infiltrations due to over-triggered immune system.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a extremely infectious disease, and the current outbreak has been declared by WHO as a global public health threatening. Researches have showed that transmission of SARS-CoV-2 is mainly from person to person via airborne droplets. It is unclear whether SARS-CoV-2 can be shed into human milk and transmitted to a child via breastfeeding. Here we investigated SARS-CoV-2 RNA in breast-milk samples of three mothers with SARS-CoV-2 and their infant. The human milk sample of one mother for SARS-CoV-2 RNA was positive. By contrast, SARS-CoV-2 RNA was not detected in human milk of two mothers.The throat swab sample was also positive in the infant of the mother whose SARS-CoV-2 RNA was detected in human milk. By contrast, throat swab of others infants was negative. Because the mother with SARS-CoV-2 RNA detected in human milk sample is not breastfeeding, the risk of contagion from the infant to the mother is eliminated. To date, in the literature, the presence of SARS-CoV-2 RNA has only been detected in the breast milk of two mothers with SARS-CoV-2. To the best of our knowledge, our case is third case with SARS-CoV-2 RNA detected in human milk. On the other hand, this is first case with SARS-CoV-2 RNA detected in human milk of mother who does not breastfeed her infant.The existing data indicates that SARS-CoV-2 can be rare transmitted through human milk.

Background In the current situation of the COVID‐19 pandemic, healthcare workers (HCWs) have to comply with hygiene conditions and use gloves more frequently and for a longer period of time than they would previously to avoid infection and prevent transmission. Aims We aimed to characterize the adverse skin reactions occurring after hand hygiene and glove use in HCWs in a tertiary university hospital to determine the possible causative factors and whether the use of these measures is affected. Methods Between 15 April and 1 May 2020, a cross‐sectional survey was conducted, using on‐line questionnaire, answered by HCWs in a tertiary university hospital. Results The increase in general hand skin problems during the pandemic period was statistically significant (p = 0.004). The most common symptom was dryness. During the pandemic period, 67 (24.3%) HCWs thought that the conditions were caused by glove use, 197 (71.4%) thought that they were due to alcohol‐based hand antiseptics. The incidence of other hand‐skin conditions except for vesicles was statistically higher in women than in men (p < 0.001). Conclusions Increased number of hand‐skin conditions during the pandemic should not be ignored, since hand hygiene and glove use are expected to increase.

Aim: Antiretroviral therapy (ART) regimens used in the treatment of HIV are assumed to suppress the virus in plasma indefinitely and restore CD4 lymphocyte count. There is increasing evidence that a reversed CD4/CD8 ratio is associated with immune dysfunction, even in patients who have achieved virological suppression with ART and have elevated CD4 lymphocytes. The CD4/CD8 ratio has emerged as a guiding marker as an indicator of immunoactivation in HIV-infected patients. It was aimed to evaluate the CD4/CD8 ratio of HIV-diagnosed patients at baseline and at follow-up after ART regimen. Materials and Methods: A total of 150 patients were included in the study by retrospectively scanning the CD4/CD8 ratio at the initial and 24th week of follow-up in patients who were diagnosed with HIV and started treatment in the Infectious Diseases and Clinical Microbiology Clinic of the Hospital of the Medical Faculty between 2011-2021. ART treatment regimens were divided into three groups as nucleoside reverse transcriptase inhibitor (NRTI)+protease inhibitor (PI), NRTI+non-nucleoside reverse transcriptase inhibitor (NNRTI) or NRTI+ integrase strand transfer inhibitor (INSTI). Results: A total of 150 patients were included in the study. While the initial CD4/CD8 ratio of the patients was 0.36, it increased to 0.61 at the 24th week of treatment. Among the 144 patients whose baseline values were CD4/CD8

The necessity for reduction of fossil fuel consumption and the increasing energy costs drives the interest in development of alternative renewable energies during past years. OFMSW (Organic Fraction of Municipal Solid Wastes) is a valuable source, while it can be converted to biogas via anaerobic digestion. In this study The anaerobic digestibility and methane generation potential of the organic fraction of municipal solid wastes (OFMSW) sampled during three seasons (autumn, winter and summer) of a year were determined using batch bioreactors with varying initial dry solid matter ratios (DM:5-35 %). Batch experiments were carried out both with and without anaerobic inoculum. On the basis of the laboratory results, biogas production potentials were determined to be in the range of 229 - 484 m3/tonDM for experiment using anaerobic inoculum and 84 – 176 m3 /ton DM for experiments without inoculum. The best organic matter combination belongs to autumn season and the best concentration was observed as 20% DM.

Our country is the epicenter of the OXA-48-like carbapenemase-producing Klebsiella and Escherichia coli; and in the recent years, the concern has been increasing due to both spreading of this resistance to other members of Enterobacteriaceae family and acquiring other carbapenemases by the OXA-48-producing strains. In this study, OXA-48 and NDM-1 co-production was presented in Providencia rettgeri. Two P.rettgeri strains that were resistant to all antimicrobials except colistin and tigecyclin, were isolated from two patients in the burn unit of our hospital, including one from the urine sample of a 68 years female in April 2017, and the other from a burn wound swab of a 35 years old male, in November 2017. Minimal inhibitory concentrations (MICs) of the isolates for imipenem and meropenem were measured as ≥ 32 µg/ml; and for colistin and tigecyclin were 1 ve 0.5 µg/ml, respectively. Multiplex PCR analysis showed that both strains were carrying blaOXA-48 and blaNDM-1 carbapenemases, and blaTEM extended spectrum beta-lactamase genes. By using DNA sequence analysis, the TEM gene was typed as blaTEM-1. The Pulsed Field Gel Electrophoresis (PFGE) analysis indicated that these two strains which were consecutively isolated from two different patients in a single unit within about seven months were genetically indistinguishable. No significant data that could explain the spread of these isolates was obtained from our retrospective analysis of the medical records including the results of environmental surveillance cultures, and patients' history. Nevertheless, hospital infection control committee enforced the infection control measures in that unit, and no further isolation was observed within three months period following the last isolation, neither from environmental nor from clinical samples. With this study, it was emphasized that the co-production of OXA-48 and NDM-1 carbapenemases which was reported from only three Enterobacteriaceae species up to date was ongoing for spreading to other species by using horizontal route, and also showing a potential to be a growing problem in the hospitals, by clonal expansion (vertical route). Effectively using of the molecular epidemiological methods will provide useful data to better understand the transmission dynamics of such rare, but problematic species in hospitals.

Background Understanding the dynamics of aerial spread of Acinetobacter may provide useful information for production of effective control measurements. We investigated genetic relationships between air and clinical isolates of Acinetobacter baumannii in an intensive care unit (ICU) setting. Methods We conducted a prospective surveillance study in a tertiary care hospital for 8 months. A total of 186 air samples were taken from 2 ICUs. Clonal characteristics of air isolates were compared with the prospective clinical strains and the previously isolated strains of ICU patients over a 23-month period. Results Twenty-six (11.4%) air samples yielded A baumannii , of which 24 (92.3%) isolates were carbapenem-resistant. The Acinetobacter concentration was the highest in bedside sampling areas of infected patients (0.39 CFU/m 3 ). Air isolates were clustered in 13 genotypes, and 7 genotypes (including 18 air strains) were clonally related to the clinical strains of 9 ICU patients. One clone continued to be cultured over 27 days in ICU air, and air isolates could be clonally related to 7-week retrospective and approximately 15-week prospective clinical strains. Conclusions The results of this study suggest that infected patients could spread significant amounts of Acinetobacter to ICU air. These strains could survive in air for some weeks and could likely still infect new patients after some months. Special control measurements may be required against the airborne spread of Acinetobacter in ICUs.

Introduction Surgical site infection (SSI) is an important cause of decreased graft survival, prolonged hospital stay, and higher costs following living donor liver transplantation. There are several risk factors for SSI. In this cohort study, we aimed to investigate the incidence of SSI at our center and the associated risk factors. Materials and methods Adult right lobe living donor liver transplantations were included in this prospective cohort. Patients who died postoperatively within 3 days; patients with infected ascites or open abdomen, cadaveric, or pediatric transplants; and patients with biologic or cryopreserved vascular grafts were excluded. Patients' demographic characteristics and perioperative surgical findings were recorded. SSI follow-up was continued for 90 days. CDC-2017 criteria were used to diagnose SSI. In the presence of superficial, deep, and organ/space SSI, only the organ in the poorest condition was included in SSI evaluation. The patients were administered similar to antibiotic prophylaxes and immunosuppressive protocols. Results A total of 101 patients were enrolled in this study, of which 30 (29.7%) were diagnosed with SSI. Organ/space, only deep, and only superficial SSI were noted in 90% (27/30), 6.7% (2/30), and 3.3% (1/30) of the patients, respectively. Twenty-five of 30 patients with SSI had a remote site infection. One or more bacteria observed in cultures were obtained from 28 patients. A donor-recipient age difference of >10 years, cold ischemia lasting for ≥150 minutes, surgical duration of ≥600 minutes, intraoperative hemorrhage of ≥1000 mL, intraoperative blood transfusion, biliary leak or stricture, prolonged mechanical ventilation, prolonged intensive care unit and hospital stay, remote site infection, and the need for reoperation were associated with increased SSI incidence. Preoperative and intraoperative levels of blood glucose, albumin, and hemoglobin were not associated with SSI. A donor-recipient age difference of >10 years, remote site infection, and biliary leak were found to be independent risk factors for SSI. Hospital mortality with and without SSIs was 6.7% vs 4.4%, P = .61. Discussion Organ/space SSIs were the essential part of SSIs following right lobe living donor liver transplantations. Donor-recipient age gap, prolonged cold ischemia time, complicated surgery, and postoperative biliary complications were the main causes of SSIs. Although they did not increase the perioperative mortality, they promote increased rate of reoperations, remote infections, prolonged intensive care unit, and hospital stays.

Aim: Predicting the diagnosis of candidemia remains a challenge for physicians. It is difficult to distinguish candidemia from other potential conditions, especially in patients under intensive care. Although blood culture is the gold standard in diagnosis, there is continued search for other markers that may be used for early prediction.This study intended to assess if procalcitonin (PCT) and C-reactive protein (CRP) may be able to guide the course of Candidemia.Materials and Methods: The study included patients over the age of 18 admitted to the Reanimation Intensive Care Unit and Burn Unit between June 2018 and June 2019 whose blood cultures exhibited growth of Candida species (spp.). Moreover, the patients’ blood cultures were also tested for Gram negative and Grow positive bacterial growth that may accompany Candida species (spp.). For all patients, we recorded the PCT and CRP values three times.Results: This study examined sixty-six patients exhibiting growth of Candida spp. in their blood cultures; 42 (64%) cases had no accompanying bacterial growth in their culture (Group 1). In addition to the growth of Candida spp., the blood cultures showed that 16 patients also had Gram-negative bacteremia (Group 2), and eight patients had Gram-positive bacteremia (Group 3). When a cut-off value of 0.5 ng/mL was considered for all candidemia patients, the first assessments did not show a statistically significant high value (p=0.053). However, when evaluated with bacteremia, the first PCT results were higher in patients with Gram-negative bacteremia. PCT and CRP changes over time were statistically significant based on two-way repeated measures comparisons (p0.05). There was a positive correlation between PCT values and mortality (p0.01).Conclusion: We believe that the decrease in PCT and CRP values are helpful while clinically monitoring patients with candidemia.

Lymphadenopathy (LAP) is a common clinical problem in adult patients and should be thoroughly evaluated in a tertiary hospital to investigate its reasons. In this study, we aimed to present the demographic characteristics, etiology, diagnosis and follow-up results of the patients who applied with LAP symptoms and findings. This study was designed to include adult patients with neck, armpit, or groin swelling accompanied by symptoms, such as fever, night sweats, weight loss, cough and sputum between January 2010 and August 2017, retrospectively. Patients’ data were collected from electronic files. Patients were diagnosed using radiological, histopathological, bacteriological, serological and other microbiological methods. Two hundred-thirty patients were included in this study. The mean age was 43.12±17.06 SD in males and 45.74±16.64 in females. On admission, the most common symptoms were night sweats (31%), fever (23%), weight loss (17%) and cough and/or sputum (13%) in order of frequency. However, 16% of the patients were asymptomatic. In this study, 157 (68.26%) patients were diagnosed. Tuberculosis (n=76; 33%), malignancies (n=28, 12.1%) and tularemia (N=14; 6.1%) were the most common diseases causing LAP that was most commonly located in the bilateral cervical chain. Lymphadenopathy should be evaluated comprehensively concerning diagnosing or ruling out many diseases that must be treated necessarily. Knowledge and awareness of the diseases as a cause of LAP may contribute to the early and correct diagnosis. Therefore, undiagnosed patients should be followed, and the institutions should develop policies for this purpose, such as telemedicine applications.

Aim: To determine etiological microorganisms from urine samples in patients diagnosed with UTI and to detect the antimicrobial susceptibility pattern of Escherichia coli and Klebsiella pneumoniae in a Tertiary Care Hospital.Materials and Methods: A cross-sectional study was conducted using urine culture samples and sensitivity reports collected retrospectively from our laboratory records over a period from Jan 2013 to Dec 2017.Results: A total of 729 urine culture isolates from 660 patients were included. Two-hundred eighty-four (41.8%) of the patients were male and 384 (58.2%) were female. The most common microorganisms were 46.4% E. coli, 18.2% K. pneumoniae and 12.1% Enterococcus spp., respectively. A total of 284 urine culture isolates produced extended spectrum beta-lactamases (ESBL), of which 186 (65.5%) were E. coli and 98 (34.5%) were K. pneumoniae. The most susceptible antimicrobials are meropenem, imipenem, amikacin, and fosfomycin, respectively. We determined that the antimicrobial drugs with the lowest susceptibility rates for both E. coli and K. pneumoniae were amoxicillin-clavulanate (24.5%), trimethoprim-sulfamethoxazole (30.7%) and ceftriaxone (43.2%). Additionally, their susceptibilities have gradually decreased. Ertapenem susceptibility has decreased more in K. pneumoniae isolates than E. coli.Conclusion: Antimicrobial resistance and ESBL-producing for both E. coli and K. pneumoniae have been increasing over the years. Our findings may contribute to choosing the proper antibiotic for the empirical treatment of UTI and preventing treatment failure.

Amac : Bu calismada normospermi ve astenospermi gruplarinda, immunohistokimyasal ve immunofloresan yontemleri kullanilarak fosfolipaz C zeta(PLCζ) proteininin lokalizasyonunun fertilizasyona olan etkileri arastirildi. Hastalar ve yontemler : Bu calismaya yaslari 22-40 arasinda degisen normospermi (sayi 20 milyon\mL ve uzeri, motilite %50 ve uzeri, n=20) veastenospermi (sayi 20 milyon\mL ve uzeri, motilite %30 ve alti, n=20) olmak uzere iki grup semen ornegi dahil edildi. Calismada, normospermive astenospermi gruplari arasinda PLCζ’nin lokalizasyonlari immunohistokimya ve immunofloresan yontemleri kullanilarak incelendi. Ek olarak,normospermi ve astenospermi gruplari gecirimli elektron mikroskobu (TEM) takibi yapilarak incelendiginde gruplar arasinda ultrastrukturel farkliliklaroldugu belirlendi. Bulgular : Normospermi grubu immunohistokimyasal boyama sonuclarinda spermatozoonlarda, bas kisminin membrani boyunca, akrozom vepostakrozomal bolgelerde anlamli PLCζ reaksiyonu gozlendi. Astenospermi grubu spermatozoada PLCζ reaksiyonunun bu bolgelerde azaldigigozlendi. Uygulanan immunofloresan ve TEM yontemlerinde de benzer destekleyici sonuclar elde edildi. Sonuc : Calismamizda PLCζ proteini normospermi ve astenospermi gruplarinda incelendi ve iki grup arasinda belirgin yapisal farklar kaydedildi. Calismasonuclarimiz astenospermi grubu oosit aktivasyon yetersizliginin, azalmis PLCζ varligi ile iliskili oldugunu gostermektedir.

WOS:000506665300001 PubMed: 31810046 Objective: In this study, we aimed to compare patients who have a myocardial protection strategy based on myocardial temperature monitorization with those who had myocardial protection with conventional intermittent cardioplegia. Methods: Twenty-six patients undergoing coronary artery bypass graft surgery were included into the study. Patients were prospectively grouped into two; myocardial protection based on temperature monitoring (group 1, n = 11) and those who had cardioplegia every 20 min (group 2, n = 15) during aortic cross-clamping. In all patients, cold blood cardioplegia was used. Coronary sinus blood sampling was performed immediately before aortic cross-clamping, after 2, 20, and 40 min of aortic clamping and tumor necrosis factor-alpha, malondialdehyde, creatinine kinase-myocardial band isoenzyme (MB), troponin I, lactate, and pH were studied. In addition, myocardial biopsy was taken before and immediately after cross-clamping to evaluate cardiomyocyte apoptosis with caspase-3 tunnel immunostaining. Results: There were no differences in clinical parameters like early mortality, extubation time, inotropic requirements, postoperative drainage, intensive care unit, and hospitalization time between two groups. In addition, blood and blood products were similar in two groups. In group 2, after cross-clamping, troponin I and creatinine kinase-MB values were significantly higher than the other group. In myocardial biopsies, the caspase immunostaining score, before removal of aortic cross-clamp was significantly higher in group 2 than the samples taken before aortic clamping. Conclusion: Our results show that there is no difference between temperature-based myocardial protection strategy with conventional intermittent cardioplegia delivery. We think that the number of patients in our study is less and that the patient population is not a homogeneous structure is the most important limiting factor of our study. Increasing the number of patients, with particularly those who have myocardial dysfunction would help augment the possible different effects of two cardioplegic techniques on myocardial protection. (C) 2019 Elsevier Inc. All rights reserved.

Background: Pathogens surveillance and antimicrobial resistance are essential for the prompt organization of therapeutic and preventive actions in healthcare settings. Objectives: We investigated the causative agents of intensive care unit (ICU)-acquired infections and their antimicrobial resistance in a university hospital over a nine-year period. Methods: An active, prospective surveillance was conducted in the ICUs of a tertiary care hospital between 2007 and 2015. The changing patterns in the frequency of pathogens and their antimicrobial resistance by the time were statistically evaluated with Mann-Whitney U test. Results: A total of 3044 pathogens were isolated from 4272 healthcare-associated infections attacks in 3437 patients. The most frequently detected organisms were Acinetobacter spp. (n = 1060, 34.8%), Pseudomonas aeruginosa (n = 622, 20.4%), Escherichia coli (n = 340, 11.1%), Klebsiella pneumoniae (n = 331, 10.8%), and Candida spp. (n = 285, 9.3%). Carbapenem resistance among Acinetobacter spp., P. aeruginosa, E. coli, and K. pneumoniae was found as 82%, 30.7%, 2%, and 9.3%, respectively. The prevalence of extended-spectrum beta-lactamase (ESBL) among E. coli and K. pneumoniae was 49.7% and 41.3%, orderly, and methicillin resistance in Staphylococcus aureus was 81.8%. Substantial reductions occurred in the rates of E. coli (16.8% to 8.9%), S. aureus (11% to 3.2%), coagulase-negative staphylococci (7.9% to 0), and Stenotrophomonas maltophilia (4.2% to 0.3%) during the study period by the applied infection control measures while the rate of Acinetobacter spp. (9.7% to 51%) significantly increased. Furthermore, the increases in the carbapenem resistance among Acinetobacter spp. (52.5% to 91.4%), Pseudomonas spp. (25.7% to 51.6%), E. coli (0 to 12.7%), and K. pneumoniae (2.6% to 9%) and the decrease in the prevalence of ESBL-producing E. coli (57% to 27.2%) were statistically significant. Conclusions: Despite the decreases in the frequencies of staphylococci and some Gram-negative bacteria, the current infection control measures have been unable to limit the spread of carbapenem-resistant Gram-negative bacteria in our facility. Additional precautions are required to control such pathogens in the intensive care units.

Our country is the epicenter of the OXA-48-like carbapenemase-producing Klebsiella and Escherichia coli; and in the recent years, the concern has been increasing due to both spreading of this resistance to other members of Enterobacteriaceae family and acquiring other carbapenemases by the OXA-48-producing strains. In this study, OXA-48 and NDM-1 co-production was presented in Providencia rettgeri. Two P.rettgeri strains that were resistant to all antimicrobials except colistin and tigecyclin, were isolated from two patients in the burn unit of our hospital, including one from the urine sample of a 68 years female in April 2017, and the other from a burn wound swab of a 35 years old male, in November 2017. Minimal inhibitory concentrations (MICs) of the isolates for imipenem and meropenem were measured as ≥ 32 µg/ml; and for colistin and tigecyclin were 1 ve 0.5 µg/ml, respectively. Multiplex PCR analysis showed that both strains were carrying

Introduction: Brucellosis is a zoonotic disease remaining endemic worldwide and in Turkey. Central nervous system involvement is a rare complication in brucellosis. This study is an overview of 15 neurobrucellosis cases who were followed in our department as inpatients. Patients and Methods: This study is a retrospective analysis of fi fteen cases of neurobrucellosis in the Infectious Diseases and Clinical Microbiology Department of Inonu University Medical Faculty Hospital between the years 2005-2010. Clinical features, laboratory findings, diagnosis, and treatment strategies were recorded retrospectively. Results: Of the fi fteen patients, 6 were females and 9 were males. Mean age of the patientswas 36.2 years (range, 18-68 years). Mean disease duration before diagnosis was 2 months. The most common symptoms were headache and fever, 66 % and 60 %, respectively. Eight patients (53 %) had visual symptoms, 3 patients (20%) had senso-rineural hearing loss, and 2 patients (13%) had ataxia. Two patients had pancytopenia and four patients had abnormal liver function tests. Two patients did not give informed consent for lumbar puncture (LP). The diagnostic LP performed in all thirteen patients revealed high protein levels and pleocytosis in cerebrospinal fl uid (CSF). Seven patients (53.8 %) had low glucose levels in CSF. Twelve patients (80%) had a serum tube agglutination test value 1/160 or higher. Brucella spp. were isolated from the blood culture of six patients and from the CSF culture of three patients. All patients received antibiotic therapy initially with doxycycline, rifampin, ceftriaxone, and trimethoprim-sulfamethoxazole. None of the patients died, but sequelae resulted in two patients. Conclusion: Patients with unexplained fever, headache, and neurological symptoms should be considered for neurobrucellosis in endemic regions.

Objective: The aim of the study was to investigate the role of montelukast (ML), a cysteinyl leukotriene-1 receptor antagonist, on the water avoidance stress (WAS) – induced degeneration of the rat urinary bladder mucosa. Methods: In WAS group, rats were exposed to WAS two hours daily for five days. In WAS+ML group, rats were administered ML (10 mg/kg; i.p.;) following every WAS exposure for 5 days. In control group, rats were injected vehicle solution only. The urinary bladder was evaluated for general morphology at light microscope. Mast cell activation and uroplakin distribution were assassed with immunohistochemistry. Glycosaminoglycan (GAG) distribution and urothelial permeability were observed using ruthenium red (RR) staining techniques in transmission electron microscope and luminal urothelial cells were observed with scanning electron microscope. Tissue malondialdehyde (MDA) and gluthatione (GSH) levels were also analysed. Results: Irregular GAG layer and uroplakin distribution, penetration of RR in the intercellular spaces and dilated tight junctions in urothelial layer, increase in inflammatory cell infiltration, in number of both granulated and activated mast cells, and were observed in the WAS group. The MDA level was increased, and GSH level was decreased significantly in urinary bladder in the WAS group in comparison with the control group. Quite regular GAG layer, uroplakin distribution and tight junctions in most regions, decrease in inflammatory cell infiltration and both of activated and granulated mast cells in the mucosa, were observed in WAS+ML group. Moreover, significant decrease in MDA and increase in GSH levels were observed in this group. Conclusion: Montelukast appears to exert a protective activity in WAS induced urinary bladder injury by inhibiting inflammatory and oxidative activity.

Melchers, Willem/0000-0002-5446-2230; Yalcin, Ata Nevzat/0000-0002-7243-7354; Aktas, Zerrin/0000-0002-5998-0440; Ersoy, Yasemin/0000-0001-5730-6682; Hosoglu, Salih/0000-0002-4034-9202 WOS: 000385857700013 PubMed: 27259712 Epidemic clones of Acinetobacter baumannii, described as European clones I, II, and III, are associated with hospital epidemics throughout the world. We aimed to determine the molecular characteristics and genetic diversity between European clones I, II, and III from Turkey and Azerbaijan. In this study, a total of 112 bloodstream isolates of carbapenem-resistant Acinetobacter spp. were collected from 11 hospitals across Turkey and Azerbaijan. The identification of Acinetobacter spp. using conventional and sensitivity tests was performed by standard criteria. Multiplex polymerase chain reaction (PCR) was used to detect OXA carbapenemase-encoding genes (bla(OXA-23-like), bla(OXA-24-like), bla(OXA-51-like), and bla(OXA-58-like)). Pulsed-field gel electrophoresis (PFGE) typing was used to investigate genetic diversity. The bla(OXA-51-like) gene was present in all 112 isolates, 75 (67 %) carried bla(OXA-23-like), 7 (6.2 %) carried bla(OXA-58-like) genes, and 5 (4.5 %) carried bla(OXA-24-like) genes. With a 90 % similarity cut-off value, 15 clones and eight unique isolates were identified. The largest clone was cluster D, with six subtypes. Isolates from clusters D and I were widely spread in seven different geographical regions throughout Turkey. However, F cluster was found in the northern and eastern regions of Turkey. EU clone I was grouped within J cluster with three isolates found in Antalya, Istanbul, and Erzurum. EU clone II was grouped in the U cluster with 15 isolates and found in Kayseri and Diyarbakir. The bla(OXA-24-like) gene in carbapenemases was identified rarely in Turkey and has been reported for the first time from Azerbaijan. Furthermore, this is the first multicenter study in Turkey and Azerbaijan to identify several major clusters belonging to European clones I and II of A. baumannii. Erciyes University Scientific Research ProjectsErciyes University [BAP kodu 4059] This study was supported by Erciyes University Scientific Research Projects (BAP kodu 4059).

Objectives: The aim of this study was to develop a new diagnostic index (DI) on the basis of clinical and laboratory findings including serum C-reactive protein (CRP) for tuberculous meningitis (TM) and bacterial meningitis (BM). Subjects and Methods: During a 7-year period, 96 adult patients with meningitis (30 with TM and 66 with BM) were studied retrospectively. Multivariate logistic regression analysis was performed to investigate the diagnostic value of clinical and laboratory parameters as independent predictors on discrimination of tuberculous from BM patients. Results: Six features predictive for diagnosis including age, CSF leukocyte count, PML dominance, length of illness, serum CRP level and blood WBC count were used. The DI model developed from these features had very high sensitivity and specificity rates of 100.0 and 95.4%, respectively. The sensitivity and specificity rates were 97.4 and 100%, respectively, in microbiologically proven cases. Conclusion: Our results suggested that this new DI which consists of simple clinical and laboratory parameters had the power to discriminate adult patients with documented tuberculous and BM (excluding Brucella meningitis). It should, however, be tested in prospective studies.

What's known on the subject? and What does the study add? The mastocytosis in detrusor muscle and the leaky epithelium in interstitial cystitis were the most studied features. In this study the leaky epithelium was shown using the ruthenium red staining in electron microscopy and uroplakin distribution in light microscopy besides the mast cell concentration in detrusor muscle using tryptase immunohistochemistry. OBJECTIVE • To study the effects of montelukast (ML), a leukotriene receptor antagonist which has been shown to be effective in inhibiting the action of cysteinyl-containing leukotrienes, on protamine sulphate (PS)-induced changes in rat urinary bladder. MATERIALS AND METHODS • Wistar female rats were catheterized and intravesically infused with PBS (control group) or PS (PS group) dissolved in PBS twice in 24 h. • In the PS-applied and ML-treated group (PS + ML group) after the 10 mg/kg PS instillation, ML was injected i.p. twice daily for 3 days. • The urinary bladder was investigated for general morphology under a light microscope. • Tryptase immunohistochemistry was used to observe mast cell distribution and activation. Uroplakin distribution was also identified with immunohistochemistry. RESULTS • Alterations of glycosaminoglycan (GAG) and urothelial permeability were seen with ruthenium red (RR) staining techniques under a transmission electron microscope, and topographical changes of luminal urothelial structure were seen with a scanning electron microscope. • Biochemically malondialdehyde (MDA) and gluthatione (GSH) concentrations were analysed. In the PS group, there was degenerated urothelium with irregular uroplakin distribution, increased inflammatory cell infiltration, increased number of both granulated and activated mast cells, irregularity of GAG and penetration of RR into the intercellular spaces and dilated tight junctions. • In PS + ML group, there was relatively regular uroplakin distribution, a decrease in inflammatory cell infiltration, a decreased number of both activated and granulated mast cells in the mucosa, regular GAG and no penetration of RR into the intercellular areas, and regular tight junctions in most regions. • The significant decrease in MDA and the increased GSH concentrations in the PS + ML group was in accordance with the histological findings. CONCLUSION • Montelukast appears to have a protective function in the bladder injury model via the anti-inflammatory effects of this leukotriene receptor antagonist.

Background and Aim: Sildenafil, a selective and potent inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase (PDE)5, has a relaxant effect on the smooth muscle cells of the arterioles supplying the human corpus cavernosum acting via nitric oxide (NO)-dependent mechanism. This study aimed to investigate the possible protective effect of sildenafil citrate on the extent of tissue integrity, oxidant-antioxidant status and neutrophil infiltration to the inflamed organ in a rat model of acetic acid-induced colitis. Methods: Colitis was induced by intrarectal administration of 1 mL of 5% acetic acid to Sprague-Dawley rats (200–250 g; n = 7–8/group). Control rats received an equal volume of saline intrarectally. In treatment groups, the rats were treated with either sildenafil citrate (5 mg/kg/day; subcutaneously) or saline for 3 days. After decapitation, distal colon was weighed and scored macroscopically and microscopically. Tissue samples were used for the measurement of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity, and oxidant production. Trunk blood was collected for the assessment of serum tumor necrosis factor (TNF)-α and interleukin (IL)-1β levels. Results: In the colitis group, the colonic tissue was characterized by lesions, increased lipid peroxidation with a concomitant reduction in GSH content, increased MPO activity and oxidant production. Serum TNF-α and IL-1β levels were higher in the colitis group compared to control values. Sildenafil reversed these inflammatory parameters nearly back to control values. Conclusions: Sildenafil citrate administration to rats with acetic acid-induced colitis seems to be beneficial via prevention of lipid peroxidation, oxidant generation, cytokine production and neutrophil accumulation.

Summary Cysteinyl leukotrienes play a part in inflammatory reactions such as asthma and inflammatory bowel diseases. The leukotrienes exert their actions by binding to and activating various receptors. Montelukast, a leukotriene receptor antagonist, which is used in the treatment of asthma has been shown to be effective in inhibiting the action or formation of leukotrienes. Many skin disorders, such as atopic dermatitis and psoriasis, worsen during stress and seem to be related to infiltration and activation of mast cells that are releasing vasoactive and pro-inflammatory mediators. The aim of the present study was to investigate the effects of montelukast on the degranulation of mast cells in the dermis that is induced by water avoidance stress (WAS). Wistar albino rats were divided into four groups of 8 animals each. Control rats were injected with (1) the vehicle solution or (2) the montelukast solution in the absence of WAS. (3) the WAS group of rats was administered vehicle solution following WAS exposure for 2 h daily for 5 days. (4) The WAS+ML group was administered montelukast 10 mg/kg; i.p. following WAS exposure for 2 h daily for 5 days. Dermal mast cell numbers were determined with toluidine blue and tryptase immunohistochemistry and observed using a light microscope. Numbers of both granulated and degranulated mast cells were significantly increased in the WAS group when compared to control rats. Montelukast treatment decreased the number of both mature granulated and degranulated mast cells in rats subjected to WAS. In conclusion, chronic montelukast treatment reduced WAS-induced infiltration and activation of mast cells in the dermis and may provide a useful therapeutic option in stress-induced skin disorders.

This study was carried out to determine the impact of nutrition given to women on their knowledge about osteoporosis over 90 woman trainees at the public education center of Cubuk, the governorship of Ankara. Questionnaire forms were used as pre and post tests. Variance analysis, t test, frequencies and percentages of data were computed. A significant difference was found between the groups in terms of knowledge levels of women concerning nutrition and osteoporosis after the training applied. It was also found in the hand book group that the impact of the training was significant. (C) 2009 Elsevier Ltd. All rights reserved