Transmitted antiretroviral drug resistance mutations in newlydiagnosed HIV-1 positive patients in Turkey

Introduction: The objective of this study was to determine the transmitted drug resistance mutations (TDRMs) in newly diagnosed HIV-1 positive patients in Turkey. Materials and Methods: The study was carried out between 2009 and 2014 and antiretroviral naïve 774 HIV-1 infected patients from 19 Infectious Diseases and Clinical Microbiology Departments in Turkey were included; gender: 664 (86%) male, median age: 37 (range; 1–77), median CD4+T-cell: 360 (range; 1–1320) count/mm3, median HIV-RNA load: 2.10+E6 (range; 4.2+E2–7.41+E8) IU/mL. HIV-1 drug resistance mutations were detected by population based sequencing of the reverse transcriptase (codon 41–238) and protease (codon 1–99) domains of pol gene of HIV-1, and analyzed according to the criteria by the World Health Organization 2009 list of surveillance drug resistance mutations [1]. Results: The patients had TDRMs to NRTIs (K65R, M184V), NNRTIs (K101E, K103N/S, G190A/E/S, Y181I/C, Y188H/L) and PIs (M46L, I54V, L76V, V82L/T, N83D, I84V, L90M). The prevalence of overall TDRMs was 6.7% (52/774). Resistance mutations were found to be 0.7% (6/774), 4.1% (32/774) and 2.1% (17/774) to NRTIs, NNRTIs and PIs drug groups, respectively. Three patients had NRTIs+NNRTs resistance mutations (M184V+K103N) as multi-class drug resistance. However, thymidine analogue resistance mutations (TAMs) determined two distinct genotypic profiles in the HIV-1 reverse transcriptase: TAM1: M41L, L210W and T215Y, and TAM2: D67N, K70R, K219E/Q, and T215F. The prevalence of TAM1 and TAM2 were 7.7% (60/774) and 4.3% (34/774), respectively. Conclusions: The TDRMs prevalence of antiretroviral naïve HIV-1 infected patients may be suggested current situation of Turkey. These long-term and large-scale results show that the resistance testing must be an integral part of the management of HIV infection in Turkey

In Vitro Phenotypic, Genomic and Proteomic Characterization of a Cytokine-Resistant Murine β-TC3 Cell Line

Type 1 diabetes mellitus (T1DM) is caused by the selective destruction of insulin-producing β-cells. This process is mediated by cells of the immune system through release of nitric oxide, free radicals and pro-inflammatory cytokines, which induce a complex network of intracellular signalling cascades, eventually affecting the expression of genes involved in β-cell survival

JunB Inhibits ER Stress and Apoptosis in Pancreatic Beta Cells

Cytokines contribute to pancreatic β-cell apoptosis in type 1 diabetes (T1D) by modulation of β-cell gene expression networks. The transcription factor Activator Protein-1 (AP-1) is a key regulator of inflammation and apoptosis. We presently evaluated the function of the AP-1 subunit JunB in cytokine-mediated β-cell dysfunction and death. The cytokines IL-1β+IFN-γ induced an early and transitory upregulation of JunB by NF-κB activation. Knockdown of JunB by RNA interference increased cytokine-mediated expression of inducible nitric oxide synthase (iNOS) and endoplasmic reticulum (ER) stress markers, leading to increased apoptosis in an insulin-producing cell line (INS-1E) and in purified rat primary β-cells. JunB knockdown β-cells and junB−/− fibroblasts were also more sensitive to the chemical ER stressor cyclopiazonic acid (CPA). Conversely, adenoviral-mediated overexpression of JunB diminished iNOS and ER markers expression and protected β-cells from cytokine-induced cell death. These findings demonstrate a novel and unexpected role for JunB as a regulator of defense mechanisms against cytokine- and ER stress-mediated apoptosis

Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is the most common acute hyperglycaemic emergency in people with diabetes mellitus. A diagnosis of DKA is confirmed when all of the three criteria are present — ‘D’, either elevated blood glucose levels or a family history of diabetes mellitus; ‘K’, the presence of high urinary or blood ketoacids; and ‘A’, a high anion gap metabolic acidosis. Early diagnosis and management are paramount to improve patient outcomes. The mainstays of treatment include restoration of circulating volume, insulin therapy, electrolyte replacement and treatment of any underlying precipitating event. Without optimal treatment, DKA remains a condition with appreciable, although largely preventable, morbidity and mortality. In this Primer, we discuss the epidemiology, pathogenesis, risk factors and diagnosis of DKA and provide practical recommendations for the management of DKA in adults and children

EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE

This study compared the effects of transcutaneous electrical nerve stimulation (TENS), saline solution (SS), povidone-iodine (PI), and lavender oil (Lavandula angustifolia) through expression of growth factors in a rat model of wound healing. Six experimental groups were established, each containing 8 rats: a healthy group with no incision wounds, an incision-control group, an incision and TENS group, an incision and SS group, an incision and PI group, and an incision and lavender oil group. Experiments continued for 5 days, after which the skin in the excision area was removed. Tissue concentrations of epidermal growth factor (EGF) and platelet-derived growth factor (PDGF)-A were measured using enzyme-linked immunosorbent assay (ELISA). Tissue expressions of EGF, PDGF-A, and fibroblast growth factor (FGF)-2 were determined using immunohistochemistry. Wound closure progressed more rapidly in the TENS and lavender oil groups than in the control and other study groups. In particular, PDGF-A expressions in the dermis and EGF expression in the epidermis were significantly intense in the TENS group (p < 0.05). In addition, ELISA levels of growth factors such as PDGF-A and EGF were significantly higher in TENS group compared to the control group (p < 0.05). These immunohistochemical and ELISA results suggest that TENS may improve wound healing through increasing growth factors in the dermis and epidermis more than other topical applications

GASTROENTEROLOGY NURSING

The aim of this study is to translate into the Turkish language, and test the reliability and validity, of the Turkish version of the Constipation Risk Assessment Scale (CRAS). This study consisted of 245 adult in-patients who were hospitalized in the medical and surgical clinics of Celal Bayar University Hospital in January through May 2007. The patients were categorized into two groups (constipated and not constipated) according to Rome II criteria. All participants were assessed with the CRAS. The CRAS was retested on 32 patients selected randomly from among the initial constipated group (n = 152). The statistical analysis consisted of reliability and validity analyses. Test-retest comparison and internal consistency were used to assess the reliability of the instrument. Divergence and known groups approaches were used to test for construct validity. Correlation analysis using the Pearson's coefficient was conducted to assess the test-retest. For testing of the criteria and known groups, Student's t test and Mann-Whitney U test were used. Cronbach's alpha value for the constipated respondents was r = 61.9. According to the effect size comparisons, the most effective variable on the CRAS score was perception of constipation risk requirement. The overall score and subsection score correlations were also found acceptable (r = 0.47-0.57)

thyroid cartilage, cricoid cartilage, sex and stature: an autopsy study

Background/Aim. Cartilage structures, such as the thyroid cartilage and cricoid cartilage, which are readily accessible and easy to remove from the surrounding soft tissues, can be useful in the identification of a dismembered corpse. The present study investigates the relationship between anthropologic measurements of the thyroid and cricoid cartilages and sex and stature measurements.Methods. Included in the study were the thyroid and cricoid cartilages of 65 males and 26 females aged 18 years and above that underwent a medicolegal autopsy. The stature, anterior thyroid height, length of the thyroid lamina, thyroid angle, height of the cricoid arch and height of the cricoid lamina were measured in all cases,Results. With the exception of thyroid angle, all measurements in the thyroid cartilage and cricoid cartilage were greater in males than in females (p<0.001), The thyroid angle was greater in females (93.88 degrees +/- 10,39) than in males (76.08 degrees +/- 10.34) (p< 0.001). A discriminant function analysis showed that the measured parameters of the thyroid cartilage yielded an accuracy of 97.8%, those measured in the cricoid cartilage yielded an accuracy of 95.6%, and the model comprising all parameters measured in the thyroid and cricoid cartilages yielded an accuracy of 100% in sex estimation. For all cases, there was a moderate positive correlation between stature and all parameters except thyroid angle,Conclusion. The results of the present study show that anthropometric measurements of the thyroid and cricoid cartilage can be useful in sex estimation,C1 [Dereli, Ayse Kurtulus; Acar, Kemalettin; Kutlu, Erdi] Pamukkale Univ, Fac Med, Dept Forens Med, TR-20020 Denizli, Turkey.[Sahin, Beyza] Pamukkale Univ, Fac Med, Dept Biostat, Denizli, Turkey