Histochemical and Histological Investigations on Duvernoy's Gland in Natrix tessellata (Squamata: Colubridae)

Duvernoy's gland, an oral gland located in temporal region, is only found in Colubrid snakes. This is the first report describing morphological and histological structure of Duvernoy's gland in Natrix tessellata (Laurenti, 1768). It is surrounded by a connective tissue layer which penetrates into the gland by forming many septa, dividing the glandular body into lobules and including the acini and the inner ducts. Duvernoy's gland is formed by seromucous acini composed of seromucous cells, and mucous acini composed of mucous cells and they are recognized by their histochemical characteristics. The gland is mainly organized in seromucous acini, mucous cells are restricted to the gland center region and to the inner secretion duct lining epithelium

Natrix tessellata’nın (Squamata: Colubridae) Duvernoy bezinde histolojik ve histokimyasal incelemeler

Temporal bölgede konumlanan ve oral bir bez olan Duvernoy bezi sadece colubrid yılanlarda bulunur. Bu çalışma Natrix tessellata (Laurenti, 1768)’da Duvernoy beziyle ilgili ilk morfolojik ve histolojik çalışmadır. Bez bağ dokusu tarafından kuşatılır. Bağ dokusu bezin iç kısımlarına uzanarak asinuslar ve iç salgı kanallarını da kuşatarak lobulleri oluşturur. Duvernoy bezi seromukoz hücrelerden oluşan seromukoz asinuslar ve mukoz hücrelerden oluşan mukoz asinuslardan oluşur. Asinuslar histokimyasal özelliklerine göre karakterize edilirler. Bez temel olarak seromukoz asinuslardan oluşurken, mukoz hücreler bezin merkezi ve iç salgı kanalı etrafı ile sınırlı kalır.Duvernoy’s gland, an oral gland located in temporal region, is only found in Colubrid snakes. This is the first report describing morphological and histological structure of Duvernoy’s gland in Natrix tessellata (Laurenti, 1768). It is surrounded by a connective tissue layer which penetrates into the gland by forming many septa, dividing the glandular body into lobules and including the acini and the inner ducts. Duvernoy’s gland is formed by seromucous acini composed of seromucous cells, and mucous acini composed of mucous cells and they are recognized by their histochemical characteristics. The gland is mainly organized in seromucous acini, mucous cells are restricted to the gland center region and to the inner secretion duct lining epithelium

Cross-Resistance to Other Antimicrobials Among Clindamycin Resistant Bacteroides fragilis and Bacteroides thetaiotaomicron Strains

Combination therapy with clindamycin and gentamycin for mixed aerobic-anaerobic infections has been considered as the “gold standard” for years. However, clindamycin resistance among Bacteroides species has increased worldwide. The aim of this study was to determine the incidence of clindamycin resistance against Bacteroides species and to determine the clindamycin resistant isolates whether less susceptible to other antimicrobials. Clindamycin activity in vitro was determined against Bacteroides fragilis (n= 130) and Bacteroides thetaiotaomicron (n= 80) isolated from clinical materials and stool specimens, MIC values to clindamycin and certain antimicrobials were determined using National Committee for Clinical Laboratory Standards (NCCLS)-recommended agar dilution methodology. Data were analyzed by grouping the isolates into two groups: (1) Those clindamycin-susceptible (MIC ≤ 2 µg/mL) and (2) those clindamycin-resistant (intermediate + resistant; MIC ≥ 4 µg/mL). Of a total 210 isolates tested, 126 (60%) were susceptible to clindamycin while 84 (40%) were nonsusceptible. Comparison of the two groups showed that, for clindamycin-resistant isolates susceptibility to antimicrobials decreased by: piperacillin (48%; p< 0.0001), cefoxitin (63%; p= 0.0007), tetracycline (94%; p< 0.0001), chloramphenicol (12%; p= 0.0005). No appreciable differences were noted for imipenem, amoxicillin-clavulanate and metronidazole. Although ampicillin resistance rates (MIC ≥ 2 µg/mL) showed no statistically significant difference in two groups (96% and 100%), the high dose ampicillin resistant (≥ 64 µg/mL) strains among clindamycin resistant group were higher than the other (57-15% respectively; p< 0. 0001). The data indicate that clindamycin resistance is associated with a decrease in susceptibility to tetracycline, chloramphenicol as well as some beta-lactams among Bacteroides species. The mechanisms of this association will need further studies

Netherton syndrome: Temporary response to dupilumab

Netherton syndrome (NS) is an orphan disease characterized by congenital ichthyosis, hair abnormalities, and atopy, with limited treatment options. We achieved temporary improvement only during the initial 6 weeks of treatment with dupilumab, which differs from the sustained improvement observed in 2 other recently published cases. Although the clinical presentation of atopy and increased pre-allergic cytokines in NS patients suggest that dupilumab may be beneficial, larger studies are required

Evaluation of possible COVID-19 reinfection in children: A multicenter clinical study

Background: Although it was originally unknown whether there would be cases of reinfection of coronavirus disease 2019 (COVID-19) as seen with other coronaviruses, cases of reinfection were reported from various regions recently. However, there is little information about reinfection in children. Methods: In this study, we aimed to investigate the incidence and clinical findings of reinfection in pediatric patients who had recovered from COVID-19. We retrospectively evaluated all patients under 18 years of age with COVID-19 infection from a total of eight healthcare facilities in Turkey, between March 2020 and July 2021. Possible reinfection was defined as a record of confirmed COVID-19 infection based on positive reverse transcription-polymerase chain reaction (RT-PCR) test results at least 3 months apart. Results: A possible reinfection was detected in 11 out of 8840 children, which yielded an incidence of 0.12%. The median duration between two episodes of COVID-19 was 196 (92–483) days. When initial and second episodes were compared, the rates of symptomatic and asymptomatic disease were similar for both, as was the severity of the disease (p = 1.000). Also, there was no significant difference in duration of symptoms (p = 0.498) or in hospitalization rates (p = 1.000). Only one patient died 15 days after PCR positivity, which resulted in a 9.1% mortality rate for cases of reinfection in pediatric patients. Conclusion: We observed that children with COVID-19 were less likely to be exposed to reinfection when compared with adults. Although the clinical spectrum of reinfection was mostly similar to the first episode, we reported death of a healthy child during the reinfection

qnrA prevalence in extended-spectrum β-lactamase-positive enterobacteriaceae isolates from Turkey

Quinolone resistance mostly originates from chromosomal mutations. In recent years, however, plasmid-mediated quinolone resistance has been reported in several parts of the world. Plasmid-borne qnrA, qnrB, or qnrS genes are responsible for this kind of resistance. Little is known about the diversity, type, and species range of the qnr genes in Turkey. We screened qnrA, qnrB, and qnrS genes in quinolone-resistant blood culture isolates collected from six different medical centers in Turkey which produced extended-spectrum β-lactamases (ESBLs). Atotal of 78 ESBL-positive isolates were enrolled in this study. Of these, 37 (47.4%) were nalidixic-acid resistant or intermediate. qnrA was found on large plasmids isolated from five (6.4%) of the NalI/R isolates. In three of these, the same plasmid also carried blacCTX-M. Four of the qnrA-positive isolates were Klebsiella pneumoniae from Dokuz Eylul University Hospital, Izmir, and the fifth isolate was Escherichia coli from Istanbul University Hospital. Two of the isolates from Izmir were found by enterobacterial repetitive intergenic consensus sequpnce-PCR to be clonally related, This is the first report on the qnrA prevalence among ESBL-positive blood culture isolates collected from different regions in Turkey. According to our results, plasmid-mediated resistance is a potential problem for the spread of quinolone resistance, and this mechanism could be emerging strongly among the ESBL-positive Enterobacteriaceae in Turkey

The Role of Adenovirus in Hepatitis of Unknown Etiology Among Children in Turkey, July 2022 to January 2023

Background: In the first half of 2022, the increase in cases of severe acute hepatitis in children with no epidemiological link and unknown cause has aroused concern worldwide. In this study, we aimed to determine the frequency of adenovirus in children with hepatitis of unknown origin in Turkey. Methods: In this study, which was conducted with the participation of 16 centers from Turkey, between July 2022 and January 2023, 36 pediatric patients under the age of 18 who met the definition of acute hepatitis were included. Results: Twenty (55,6%) of patients were female and 16 (44,4%) were male, with a mean age of 41.55 ± 39.22 (3-192) months. The most common symptoms were fever (66.7%), weakness (66.7%), loss of appetite (66.7%), fatigue (61.1%), vomiting (61.1%), and diarrhea (47.2%). Six (16 %) children had acute hepatic failure. Eight of the 15 children (46%) had respiratory viral infections (rhinovirus/enterovirus, n = 4; rhinovirus + parainfluenza, n = 1; parainfluenza, n = 1, SARS-CoV-2 n = 2). Adenovirus was detected in 16 (44%) patients. Adenovirus and coinfections were detected in 7 patients. History of diarrhea and fatigue in the last month was significantly higher in the adenovirus group (P = 0.023 and 0.018). One child who had both adenovirus and rhinovirus infection required liver transplantation; all others recovered with supportive care. Conclusion: There were no deaths in our series; however, the number of cases, etiology, and severity of the clinical course may have differed between countries owing to differences in case definitions, laboratory facilities, or regional genetic differences