Adalimumab (Humira®) Induced Recurrent Peritonsillar Abscess in A Patient Received Three Different Anti-TNF Therapies:A Case Report

Anti-tumor necrosis factor agents are widely used in treating ankylosing spondylitis, but they increase the risk of infection by suppressing the immune response. Therefore, physicians should be careful about recurrent infections in patients under anti-tumor necrosis factor agents.</p

16S rRNA gene profiling and genome reconstruction reveal community metabolic interactions and prebiotic potential of medicinal herbs used in neurodegenerative disease and as nootropics.

The prebiotic potential of nervine herbal medicines has been scarcely studied. We therefore used anaerobic human fecal cultivation to investigate whether medicinal herbs commonly used as treatment in neurological health and disease in Ayurveda and other traditional systems of medicine modulate gut microbiota. Profiling of fecal cultures supplemented with either Kapikacchu, Gotu Kola, Bacopa/Brahmi, Shankhapushpi, Boswellia/Frankincense, Jatamansi, Bhringaraj, Guduchi, Ashwagandha or Shatavari by 16S rRNA sequencing revealed profound changes in diverse taxa. Principal coordinate analysis highlights that each herb drives the formation of unique microbial communities predicted to display unique metabolic potential. The relative abundance of approximately one-third of the 243 enumerated species was altered by all herbs. Additional species were impacted in an herb-specific manner. In this study, we combine genome reconstruction of sugar utilization and short chain fatty acid (SCFA) pathways encoded in the genomes of 216 profiled taxa with monosaccharide composition analysis of each medicinal herb by quantitative mass spectrometry to enhance the interpretation of resulting microbial communities and discern potential drivers of microbiota restructuring. Collectively, our results indicate that gut microbiota engage in both protein and glycan catabolism, providing amino acid and sugar substrates that are consumed by fermentative species. We identified taxa that are efficient amino acid fermenters and those capable of both amino acid and sugar fermentation. Herb-induced microbial communities are predicted to alter the relative abundance of taxa encoding SCFA (butyrate and propionate) pathways. Co-occurrence network analyses identified a large number of taxa pairs in medicinal herb cultures. Some of these pairs displayed related culture growth relationships in replicate cultures highlighting potential functional interactions among medicinal herb-induced taxa

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Novel Alignment Based Clustering Algorithms for Pan Genome Analysis of Bacteria Species

Understanding the basic rules of bacterial evolution and adaptation is critical in developing new anti-bacterial drugs, the use of bacteria in biotechnology applications as well as in combating undesired consequences of bacterial presence in industrial and environmental settings such as corrosion, product spoilage, and degradation. Accumulation of single nucleotide mutations beneficial (or neutral) for bacterial survival is a well-studied mechanism of bacterial adaptation which also reflects the time of species separation from a common ancestor (molecular clock hypothesis). The gene loss or gain due to horizontal gene transfer is another much more dynamic mechanism of bacterial adaptation. Using these mechanisms, bacteria can acquire new features such as virulence factors, locomotion ability (flagella), and heat or drug resistance. A major functional characteristic of bacterial species is the presence of particular gene sets common to the species (core genome) together with genes that are available to individual or groups of genomes (pan genome). The technical difficulties however, lie in how one can identify the same genes or gene families in evolutionarily distant organisms: 1. Identification of a sequence-similarity threshold 2. Computational complexity of sequence clustering algorithms 3. Creation of a biologically meaningful cluster topology In this work, we have developed methods to improve the quality and performance of gene clustering including heuristics free, novel sequence alignment algorithms able to cluster a large number of sequences significantly faster than traditional methods (a few days compared to months of computation) that permit the identification of appropriate similarity thresholds and formation of biologically meaningful cluster topology. The developed algorithms were used to build a “functional similarity” tree of the species reflecting gene composition similarity. The performed analysis also identified co-appearance and avoidance patterns of genes in bacterial species. We have applied the proposed methods to 22 genomes from Bartonella spp. using 34,060 genes.Computer Science, Department o

Can calcitonin gene-related peptide (CGRP) and pentraxin-3 (PTX-3) be useful in diagnosing acute migraine attack?

Purpose Even if migraine is not fatal, it is a common and challenging disease with adverse effects on individuals' lives. The lack of objective diagnostic tools causes delays in diagnosis and treatment initiation. The primary aim of this study is to reveal the diagnostic value of Calcitonin Gene-Related Peptide (CGRP) and Pentraxin-3 (PTX-3) in acute migraine. To this aim, we compared the serum CGRP and PTX-3 levels of migraine patients with acute attacks to those in healthy individuals. Material and method A total of 135 individuals (85 patients with migraine attacks with or without aura and 50 healthy controls) participated in the study. Serum CGRP and PTX-3 levels were measured with ELISA analysis. A p value less than 0.05 was considered significant. Results Serum CGRP [146.70 (21.52-413.67) vs. 65.90 (3.80-256.60) pg/mL] and PTX-3 levels [12.71 (0.62-33.97) vs. 1.01 (0.06-9.48) ng/mL] were higher in patients with migraine attack than the control group (p < 0.01 and p < 0.01, respectively). ROC analysis showed that the cutoff value for serum CGRP was 121.39 pg/mL (AUC: 0.751, Sen:%61, Spe:%64) whereas the cutoff value for PTX-3 was 4,06 ng/mL (AUC:0.876, Sen:%73, Spe:%76). Serum CGRP levels were positively correlated with pain intensity. Serum CGRP and PTX-3 levels did not differ across gender groups and presence of aura in subgroup analysis. Conclusion Patients with acute migraine attacks have higher serum CGRP and PTX-3 levels than controls. Both biomarkers show high potential for the diagnosis of a migraine attack

Frontal lobe ischemic stroke presenting with peripheral type facial palsy: A crucial diagnostic challenge in emergency practice

Here, we illustrate a 69-year old female admitting with weakness on left side of the face who firstly considered peripheral facial palsy in the forefront. However, detailed neurological examination and cranial MRI findings finally yielded the proper diagnosis of right hemisphere ischemic stroke. Via this remarkable presentation, we point out the clinical challenges in evaluation processes of patients with facial palsy in emergency practice and emphasize the importance of detailed examination for the proper diagnosis as well as initiation of appropriate treatment agents without delay. Keywords: Facial paralysis, Stroke, Emergency department, Facial innervation, Pathophysiolog

Investigation of heavy metal exposure and trace element levels in acute exacerbatıon of COPD

Objectives: The study aims to evaluate the levels of trace and heavy metals among chronic obstructive pulmonary disease (COPD) patients with acute exacerbation and their impact on the severity and mortality of the disease. Methods: 100 healthy volunteers and 114 patients with acute exacerbation participated in this work. According to Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, COPD patients are divided into 4 groups. Analysis of heavy metals (lead, cadmium, arsenic, cobalt, nickel, mercury, aluminum, calcium, and manganese) and trace metals (copper, chromium, and zinc) was performed using a plasma mass spectrometer. Results: Body mass index was lower in COPD exacerbation patients (p < 0.05) in comparison to the control. In comparison with the control group, the levels of heavy metals were greater in COPD cases (p < 0.001). Al, Ca, Co, Ni, Cu, As, Cd, and Hg levels of GOLD group 4 were found to be higher compared to GOLD Group 1 (p < 0.001). Likewise, the Mn level was found higher in GOLD Group 1 (p < 0.05). However, the level of Zn was lower in GOLD group 4 in comparison with GOLD 1 cases (p < 0.001). The factors for the prediction of the disease in the COPD patient group were determined using multivariate regression analysis. Al, Ca, Mn, Co, As, and Hg was determined to be independent risk factors in predicting COPD exacerbations (p < 0.05). Al, Co, Pb, Ni, Hg, and Cd levels were higher in COPD exacerbations that resulted in mortality (p < 0.05). Co, Cd, Hg, and Pb were determined to be independent risk factors for mortality in COPD exacerbation cases (p < 0.05). Conclusions: Our study showed that serum heavy metal levels are linked with the harshness and mortality of acute COPD attacks. These findings may indicate that changes in serum heavy metal levels can be used to determine the severity of a COPD exacerbation