Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

SOME MOLECULAR TECHNIQUES APPLIED in DETERMINATION of ENVIRONMENTAL MICROBIAL DIVERSITY

The most important questions to be answered in the studies regarding the diversity of microorganisms in natural ecosystems are the functions of bacterial communities and how the compositions of these communities are affected by environmental changes. In order to answer these questions, there needs to be conducted advanced studies concerning the community structure. The total bacteria community studies require a huge amount of genetic data and high range of genetic diversity. Molecular techniques are quite valuable in researching the structure and diversity of bacterial communities. To combine various complementary molecular techniques is a nice strategy to keep track of microbial community changes in natural ecosystems. Combining some commonly-used techniques, i.e. polymerase chain reaction (PCR), denaturing gradient gel electrophoresis (DGGE), molecular cloning and fluorescence in situ hybridization (FISH), this review evaluates the advantages of using these techniques together in determining microbial diversity in environmental samples

Major impacts of caving activities on cave microbial diversity: case study of Morca Cave, Turkey

Some of microorganisms identified in cave ecosystems have been reported to play a permanent and strategic role for maintaining life of these environments. Human entrance into caves can induce some changes of cave physicochemical parameters which ultimately impacts the living organisms. In these facts, for the first time, Morca Cave was explored in a purpose to evaluate the impacts that can be caused by the human activities on microbial diversity in a limited period of time. Morca is a karts cave located in the Taseli Plateau in the Middle Taurus mountains in Turkey. The first entrance into this cave was in 2018, and expeditors reached to - 500 m. During the second expedition in 2019, a camp was established at the - 1040-m depth during 4 days. In order to evaluate the human impacts in a new explored cave, this camping depth is chosen to be our studied area because it was its first entrance. Before the installation and at the end of the camp, sediments and surface samples were taken from different points of the camp area and around. Sequencing of 16 s rRNA of each sample to isolate DNA by using the next-generation sequencing (NGS) method was performed. The profile of the microbial diversity before the camping revealed that the class Thermoplasmata was dominated the archaea group and Gammaproteobacteria and Alphaproteobacteria were the most dominant bacterial classes. After the camp, most studied sites were noted with a decrease of microbial diversity especially the previous cited classes strains. Bacteria belonging to Bacilli class have increased after the camp. Increase of bacteria that are belonging to Bacteroidia has also observed in the most active areas. This present study highlight how cave microbial diversity can respond to the human activities within a short period inside a closed cave. Furthermore, it may constitute a solid basis and support on the improvement of techniques for cave management and expedition planning for the conservation of cave nature

Profiling of Bacteria Capable of Precipitating CaCO3 on the Speleothem Surfaces in Dupnisa Cave, Kirklareli, Turkey

This study aimed to identify the bacteria which take part in the CaCO3 precipitation on the speleothem surfaces of Dupnisa Cave. In addition, this study highlighted the CaCO3 precipitation ability of the bacteria with negative urease activity. 150 isolates with microbial induced calcium carbonate precipitation features were selected and identified. They were belonging to Proteobacteria (53.3%), Firmicutes (32.7%) and, Actinobacteria (4.7%) phyla. The dominant bacterial species on all surface samples were Bacillus mycoides (9.3%), Bacillus zhangzhouensis (5.3%), and Serratia quinivorans (4%). Our results showed that most of the bacteria which can precipitate calcium carbonate on the B4 medium at the first 3 days, have urease negative activity. Within this study, it has been emphasized that other mechanisms enabling the precipitation of CaCO3 besides the urease mechanism should also be investigated. EDS analyses confirmed that the crystals were predominantly composed of calcium, carbon, and oxygen. In addition, the EDS highlighted that the two strains of Bacillus mycoides, isolated from two different surfaces, produced crystals of different morphology. Our study results to the identification of the bacteria which contribute to the Dupnisa Cave walls formation. Besides, our results showed that the Dupnisa Cave is housing bacteria with biotechnological and engineering applications potentials

The Effect of Desulfovibrio sp Biofilms on Corrosion Behavior of Copper in Sulfide-Containing Solutions

This study aims to detect the effect of Desulfovibrio sp. on copper in terms of biofilm formation and corrosion in 722 h. In that way, appropriate strategies to inhibit microbiological corrosion in copper systems with Desulfovibrio sp. can be evaluated. For this purpose, experiments were performed in 1 L glass model system containing 28 copper coupons and pure culture of the sulfate-reducing bacteria (SRB) strain Desulfovibrio sp. in Postgate's medium C. Also, a control system with copper coupons but without Desulfovibrio sp. containing sterile Postgate's medium was studied concurrently with the test system. The test coupons were collected from systems at certain time intervals, namely 24, 168, 360, and 720 h. The samples were then subjected to several characterization analyses such as measurement of Desulfovibrio sp. numbers, corrosion resistance, EPS extraction, carbohydrate analysis, SEM, and EDS. During the experiments, the maximum Desulfovibrio sp. count in biofilm samples was found at 360 h. Carbohydrate and copper concentrations in biofilm were increased over time. EDS analysis revealed Cu, S, C, O, and Cl peaks on the surface of the samples. For the control coupons, only Cu peaks were observed. The results obtained from this study showed that copper was corroded by Desulfovibrio sp. in the model system under laboratory conditions

Investigation of the bacterial load and antibiotic susceptibility of dental units

The aim of this study was to evaluate the bacterial contamination level and to determine the antibiotic susceptibility of the isolated bacteria from dental unit waterlines (DUWLs) in Istanbul. Bacterial quality of DUWLs is very important, as patients and dental staff are regularly exposed to water and aerosols generated by the unit. If opportunistic pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa, and Legionella pneumophila are present in DUWLs, patient and dental staff can be infected. One hundred water samples were collected from high-speed drills and input waters from 50 dental units. Aerobic heterotrophic bacteria counts and the presence of Legionella, Pseudomonas, oral streptococci, and Staphylococcus were investigated in dental unit waters and aerosol samples. In addition, the antibiotic susceptibility of the isolated and identified bacteria from DUWLs was examined. This research found that 37 out of 50 dental unit water samples exceeded the American Dental Association's limit of 200 colony-forming units (CFU)/mL(-1). Legionella, oral streptococci, and S. aureus were not detected in any water or aerosol samples, but P. aeruginosa was isolated in three DUWLs. Also, Pseudomonas and Staphylococcus were found in water and aerosol samples. Cefoperazone, ofloxacin, gentamicin, ciprofloxacin, and piperacillin were the most effective antibiotics against the isolated bacteria from DUWLs

OPPORTUNISTIC BACTERIAL PATHOGENS OF AEROSOL AND WATER SAMPLES FROM DENTAL EQUIPMENTS

Water and aerosol derived from high-powered aerosolizing instruments in dental units represents a potential source of bacterial infection especially by Legionella and Pseudomonas. In this study, water and aerosol samples were taken from 41 dental units in Istanbul. In the samples taken, the count of aerobic heterotrophic bacteria and the presence of Legionella and Pseudomonas were researched by using culture methods. The aerosol samples were collected by active sampling. Physical and chemical parameters of the samples were also measured. The number of aerobic heterotrophic bacteria in 26 dental units out of 41 (63. 41%) exceeded the acceptable limit. Gram negative rods were the predominant bacteria. Legionella spp. and Pseudomonas spp. were detected in one and eight water samples (19.5%), respectively. Pseudomonas was not detected in aerosols. The presence of Legionella in the aerosol taken from high-speed drills has been searched and detected for the first time in Turkey. These findings indicate that investigation on bacterial contamination and related risk factors in dentistry should be expanded and effective precautions should be applied in order to reduce bacterial loads

Effect of Mixed-Species Biofilm on Copper Surfaces in Cooling Water System

This study aimed to investigate the formation and effect of a biofilm on copper heat exchangers in full-scale system conditions. A modified Pedersen device with copper coupons was installed in parallel to a heat exchanger system to investigate several physico-chemical parameters, such as bacterial enumeration, carbohydrate content of exopolymeric substances, weight loss of test/control coupons, Cu concentrations, and corrosion products over ten months. Findings of this study showed that planktonic bacterial cells attach to each other and form a mixed-species biofilm on the copper coupon surface even though copper is toxic to a variety of microorganisms. These results also revealed that the mixed-species biofilm has a corrosive effect on copper surfaces used in cooling water systems despite the presence of biocide and the corrosion inhibitor. Additionally, it was demonstrated that a shock-dosed biocide application increased the corrosion rate on copper surface in a real system. Preventing risk of microbiologically influenced corrosion entails appropriate material selection and proper/regular chemical treatment of cooling systems. The current study provides useful insights through the evaluation of corrosion of materials with microbiological techniques

Joint awareness after unicompartmental and total knee arthroplasty: Which feels more natural?

Background/Purpose: The purpose of this study was to compare the joint awareness and knee function after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) for the management of isolated medial compartment osteoarthritis. Methods: Patients who underwent UKA or TKA at our institution for isolated medial compartment osteoarthritis from 2015 to 2020 with a minimum follow-up of I year were screened. 116 eligible patients were invited and 94 volunteer patients participated. All patients were evaluated with The Forgotten Joint Score-12 and Lysholm Knee Scale. Results: Average follow-up period was 29.13 +/- 15.48 months for UKA and 31.66 +/- 2.91 months for TKA groups (p=0.292). FJS-12 of the UKA group was significantly higher than that of the TKA group (79.74 +/- 15.06 and 63.25 +/- 19.86, respectively; p=0.024). The Lysholm Knee Scale score was also significantly higher in the UKA group compared with the TKA group (92.94 +/- 8.74 and 78.34 +/- 14.99, respectively; p = 0.002). Conclusion: Our findings suggest that patients who underwent UKA were less aware of their artificial joints and had better knee function compared to patients who underwent TKA for medial osteoarthritis of the knee

Biocides Effect on the Microbiologically Influenced Corrosion of Pure Copper by Desulfovibrio sp.

The aims of this study were to determine the corrosion behavior of pure copper in the presence of Desulfovibrio sp. and also to investigate the effects of glutaraldehyde (GD) and isothiazolinone (ISO) on the corrosion behavior of pure copper in the presence of this sulfate-reducing bacteria (SRB) strain by using electrochemical techniques. Electrochemical measurements of pure copper were carried out at specified time intervals (0, 8, 24, 48, and 96 hr) over a period of exposure. Corrosion rates of pure copper from anodic and cathodic Tafel slopes and corrosion potential (E-corr) were determined. Biofilm and corrosion products on the copper surfaces were observed by Field Emission Scanning Electron Microscopy (FESEM) and Energy Dispersive X-Ray Spectrometry (EDS) analyses. The effects of solution types (PC (Postgate's C medium) and SRB (Desulfovibrio sp.)) and exposure times of copper and biocides (ISO or GD) on the corrosion rates of pure copper were evaluated by statistical analyses. As a result of the FESEM analysis, biofilm formation was observed on the surfaces of pure copper exposed to the Desulfovibrio sp. cultures both with and without the biocides. The results show that the pure copper was corroded by Desulfovibrio sp. However, the addition of GD or ISO to the Desulfovibrio sp. culture resulted in a decrease in the corrosion rate of the pure copper. It was also observed that both of the biocides showed a similar effect on pure copper's corrosion rate caused by Desulfovibrio sp