Rotavirus and adenovirus frequency among patients with acute gastroenteritis and their relationship to clinical parameters: a retrospective study in Turkey

<p>Abstract</p> <p>Background</p> <p>Diarrhea is the third leading cause of death related to infectious diseases all over the world. The diseases related to viral gastroenteritis are gradually increasing, particularly in the developed countries. The purpose of our study was to determine the frequency and to investigate the clinical manifestations of acute rotavirus and adenovirus gatroenteritis and to assess the diagnostic value of the related clinical findings.</p> <p>Methods</p> <p>In 2007-2008 patients with diarrhea and/or vomiting attended to Yeditepe University Hospital and related clinics, Istanbul, were studied. The rotavirus and/or adenovirus antigen in stool of these patients were investigated. Data regarding clinical findings were collected from the electronic records, retrospectively. Age, gender, symptoms, fever, antibiotic use, vomiting, number of vomiting and diarrhaeae, dehydration, abdominal pain, the other pathological physical examination findings were analyzed by the physicians in the study group. To investigate the rotavirus and adenovirus antigen CerTest Rota-Adeno Blister Test (CerTest, Biotec, Spain), a qualitative immunochromotographic assay was used. Statistical analysis wasperformed with SPSS v. 11,5 statistical software. X²test was used for bivariate and logistic regression analysis was used for multivariate analysis.</p> <p>Results</p> <p>Rotavirus positivity was 18,7% (n = 126). Concomitantly, in 596 cases adenovirus antigen test were also performed. Adenovirus positivity was 8,9% (n = 53) and rota-adenovirus co-infection was 4,4% (n = 26). Most of rotavirus positive cases were seen in December, January, February and March (p < 0.001). In clinical parameters, there was a significant difference between rotavirus positive cases and negative cases regarding to vomiting, dehydration and vomiting and diarrhea coexistence (respectively p = 0.010, p < 0.00, p = 0.007).</p> <p>Conclusion</p> <p>Rotavirus can be seen in all age groups, but more frequently in childhood. Although there is no clinical gold standard to distinguish the rotavirus cases from the other gastroenteritis agents, the findings of dehydration and vomiting-diarrhea coexistence, considering months of referral may lead clinician to perform rapid antigen tests and affect approach to the treatment. Prospective studies with representative samples are needed to determine the rotavirus and adenovirus incidence and to develop safe and reliable protective policies in our country.</p

Co-circulation of West Nile virus and distinct insect-specific flaviviruses in Turkey

Background: Active vector surveillance provides an efficient tool for monitoring the presence or spread of emerging or re-emerging vector-borne viruses. This study was undertaken to investigate the circulation of flaviviruses. Mosquitoes were collected from 58 locations in 10 provinces across the Aegean, Thrace and Mediterranean Anatolian regions of Turkey in 2014 and 2015. Following morphological identification, mosquitoes were pooled and screened by nested and real-time PCR assays. Detected viruses were further characterised by sequencing. Positive pools were inoculated onto cell lines for virus isolation. Next generation sequencing was employed for genomic characterisation of the isolates. Results: A total of 12,711 mosquito specimens representing 15 species were screened in 594 pools. Eleven pools (2%) were reactive in the virus screening assays. Sequencing revealed West Nile virus (WNV) in one Culex pipiens (s.l.) pool from Thrace. WNV sequence corresponded to lineage one clade 1a but clustered distinctly from the Turkish prototype isolate. In 10 pools, insect-specific flaviviruses were characterised as Culex theileri flavivirus in 5 pools of Culex theileri and one pool of Cx. pipiens (s.l.), Ochlerotatus caspius flavivirus in two pools of Aedes (Ochlerotatus) caspius, Flavivirus AV-2011 in one pool of Culiseta annulata, and an undetermined flavivirus in one pool of Uranotaenia unguiculata from the Aegean and Thrace regions. DNA forms or integration of the detected insect-specific flaviviruses were not observed. A virus strain, tentatively named as “Ochlerotatus caspius flavivirus Turkey”, was isolated from an Ae. caspius pool in C6/36 cells. The viral genome comprised 10,370 nucleotides with a putative polyprotein of 3,385 amino acids that follows the canonical flavivirus polyprotein organisation. Sequence comparisons and phylogenetic analyses revealed the close relationship of this strain with Ochlerotatus caspius flavivirus from Portugal and Hanko virus from Finland. Several conserved structural and amino acid motifs were identified. Conclusions: We identified WNV and several distinct insect-specific flaviviruses during an extensive biosurveillance study of mosquitoes in various regions of Turkey in 2014 and 2015. Ongoing circulation of WNV is revealed, with an unprecedented genetic diversity. A probable replicating form of an insect flavivirus identified only in DNA form was detected

Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: a global survey, current guidelines, and expert recommendations.

PURPOSE: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. MATERIALS AND METHODS: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. RESULTS: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). CONCLUSIONS: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

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Relationship between FokI polymorphism in the vitamin D receptor gene and fibromyalgia syndrome

Aim: The aim of this study was to evaluate the vitamin D receptor (VDR) gene FokI polymorphism frequencies distribution in subjects with fibromyalgia syndrome (FMS) compared to healthy controls. Method: Using a case-control design, 100 female patients, who were diagnosed with FMS according to the American College of Rheumatology criteria and 100 healthy female subjects were enrolled in this study. FokI polymorphisms of the VDR gene were analyzed by restriction fragment length polymorphisms (RFLP) in both groups. Results: No significant differences in the frequencies distribution of both genotype and alleles of the FokI polymorphism in the VDR gene were observed between the two groups. Conclusion: The relationship between VDR gene FokI polymorphism and FMS, particularly in Turkish women, could not be determined in this study. However, further studies with larger patient numbers may be needed to prove a relation between VDR gene polymorphism and FMS. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Lt

Effectiveness of the kinesiotaping in the patellofemoral pain syndrome

Objectives: This study aims to evaluate the effect of kinesiotaping implementation on pain and functional status in patellofemoral pain syndrome (PFPS). Patients and methods: Between January 2014 and July 2014, this prospective, single-center, randomized-controlled study included a total of 75 knees from 43 patients (20 males, 23 females; mean age 33.8±7.9 years; range, 20 to 50 years). All patients were divided into three treatment groups: Group 1 (25 knees) were treated with kinesiotaping and exercise, Group 2 (25 knees) were treated with sham taping + and exercise, and Group 3 (25 knees) were treated with exercise alone. The Visual Analog Scale (VAS) was used to assess the pain severity. The Kujala Patellofemoral Scale (KPS) was used to determine the effect of the knee pain on the patients’ daily living activities. All three groups were given the same exercise program during six weeks. Kinesiotaping was applied twice a week, 12 times in total during the treatment period of six weeks. The VAS and KPS assessments for all patients were made at baseline, then at the end of the treatment (week 6) and at week 12 the end of the 12th week. Results: There were no statistically significant differences between the three groups in terms of age, sex, height, weight, and Body Mass Index (p&gt;0.05, for all). A statistically significant improvement was observed in all groups in terms of the mean VAS and KPS scores before the treatment, at week 6, and at week 12 (p&lt;0.001, for all). There was no statistically significant change in the mean changes of the VAS and KPS among the groups at week 6 and 12. Conclusion: Our study results suggest that the addition of the kinesiotaping application to the exercise treatment for PFPS seems to be ineffective on pain control and improved daily life activities. © 2017 by Turkish Society of Physical Medicine and Rehabilitation