Immune-escape mutations and stop-codons in HBsAg develop in a large proportion of patients with chronic HBV infection exposed to anti-HBV drugs in Europe

Background: HBsAg immune-escape mutations can favor HBV-transmission also in vaccinated individuals, promote immunosuppression-driven HBV-reactivation, and increase fitness of drug-resistant strains. Stop-codons can enhance HBV oncogenic-properties. Furthermore, as a consequence of the overlapping structure of HBV genome, some immune-escape mutations or stop-codons in HBsAg can derive from drug-resistance mutations in RT. This study is aimed at gaining insight in prevalence and characteristics of immune-associated escape mutations, and stop-codons in HBsAg in chronically HBV-infected patients experiencing nucleos(t)ide analogues (NA) in Europe. Methods: This study analyzed 828 chronically HBV-infected European patients exposed to ≥ 1 NA, with detectable HBV-DNA and with an available HBsAg-sequence. The immune-associated escape mutations and the NA-induced immune-escape mutations sI195M, sI196S, and sE164D (resulting from drug-resistance mutation rtM204 V, rtM204I, and rtV173L) were retrieved from literature and examined. Mutations were defined as an aminoacid substitution with respect to a genotype A or D reference sequence. Results: At least one immune-associated escape mutation was detected in 22.1% of patients with rising temporal-trend. By multivariable-analysis, genotype-D correlated with higher selection of ≥ 1 immune-associated escape mutation (OR[95%CI]:2.20[1.32-3.67], P = 0.002). In genotype-D, the presence of ≥ 1 immune-associated escape mutations was significantly higher in drug-exposed patients with drug-resistant strains than with wild-type virus (29.5% vs 20.3% P = 0.012). Result confirmed by ana

Hemşirelik Öğrencilerinin Güdülenme Kaynakları ve Sorunları: Meslek Seçimi, Okul Kültürü ve İlişkili Diğer Faktörler

AMAç: Çalışmanın amacı, hemşirelik öğrencilerinin güdülenme kaynakları ve sorunları ile meslek seçimi ve okul kültürü arasındaki ilişkiyi değerlendirmektir. YöNTEM: Kesitsel tipte bir çalışmadır. Çalışma Türkiye'nin Batı Karadeniz bölgesinde bulunan iki üniversitede yürütülmüştür. Çalışma evrenini, 2013-2014 eğitim öğretim dönemindeki toplam 914 hemşirelik öğrencisi oluşturmuştur. Çalışma 662 öğrenci ile yürütülmüştür. Veriler Öğrenci Bilgi Formu, Güdülenme Kaynakları ve Sorunları Ölçeği, Hemşirelikte Meslek Seçimi Ölçeği ve Okul Kültürü Ölçeği kullanılarak toplanmıştır.BulgulAR: Mesleği tercih nedeninin, mesleğe yönelik şimdiki algının, mesleğin geleceğine yönelik algının, okula bağlılığın, öğretim elamanı ile ilişkilerin, okuldaki yapı ve işleyişin, cinsiyetin ve aile tipinin öğrencilerin güdülenmelerini etkilediği belirlenmiştir (p<0.05). SONuç: Hemşirelik eğitimi veren kurumlar yapı ve işleyişlerini değerlendirmeli, eğitimde kalite çalışmaları ve öğrencilerin güdülenmeleri açısından değişim ve gelişim gereksinimlerini saptamalı, öğretim elemanları, öğrenciler ve diğer çalışanlar için olumlu okul ortamı oluşturmalıdır.OBjECTıVE: The aim of this study was to analyze the relationship between motivational resources and problems of nursing students and their vocational choice and school culture. METhODS: This was a cross-sectional study. The study was conducted at two universities in Western Black Sea region of Turkey. The population of the study consisted of a total of 914 nursing students educating during 2013-2014 academic years. The study was conducted with 662 students. Data were collected by using Student Information Form, Occupational Learning Motivation Scale, and Problems Scale, Vocational Choice in Nursing and School Culture Scale.RESulTS: It was determined that students' motivation for choosing the vocation was effected by the current perception about the vocation, perception about the future of the vocation, commitment to school, relationships with the teaching staff, structure and organization in the school, gender and family type (p<0.05).CONCluSıON: Institutions providing nursing education should assess their structure and organization, detect their needs for change and improvement in terms of quality research in education and students' motivation and should create a positive school environment for teaching staff, students and other employees

Effects of breast cancer fatalism on breast cancer awareness among nursing students in Turkey

PubMed ID: 25921179Background: Breast cancer is the most common cancer among women and leading cause of death worldwide, including in Turkey. High perceptions of cancer fatalism are associated with lower rates of participation in screening for breast cancer. This study was conducted to evaluate the effect of breast cancer fatalism and other factors on breast cancer awareness among nursing students in Turkey. Materials and Methods: This cross-sectional descriptive study was conducted at three universities in the Western Black Sea region. The sample was composed of 838 nursing students. Data were collected by Personal Information Form, Powe Fatalism Inventory (PFI) and Champion's Health Belief Model Scale (CHBMS). Results: Breast cancer fatalism perception of the students was at a low level. It was determined that students' seriousness perception was moderate, health motivation, BSE benefits and BSE self-efficacy perceptions were high, and BSE barriers and sensitivity perceptions were low. In addition, it was determined that students awareness of breast cancer was affected by breast cancer fatalism, class level, family history of breast cancer, knowledge on BSE, source of information on BSE, frequency of BSE performing, having breast examination by a healthcare professional within the last year and their health beliefs. Conclusions: In promoting breast cancer early diagnosis behaviour, it is recommended to evaluate fatalism perceptions and health beliefs of the students and to arrange training programs for this purpose

Recurrent Legionnaires’ Disease in an HIV Positive Renal Transplant Patient

Legionnaires’ disease is a community-acquired or nosocomial pneumonia caused by Legionella species, and the immunocompromised patient is at particular risk. In this study we report a case of Legionnaires’ disease repeating three times in an HIV positive renal transplant patient. The laboratory diagnosis was obtained by detection of Legionella pneumophila using direct fluorescent antibody (DFA) staining. An environmental investigation failed to reveal L. pneumophila in any water specimens taken from the patients private accomodation. We conclude that Legionnaires’ disease should be always considered in the diagnosis among immunocompromised patients who have pneumonia without an etiologic diagnosis or in cases of treatment failure. We also remark that patients who have AIDS should be considered at risk for recurrent Legionella infections