Orhan Bedir

The Effect of Hyperbaric Oxygen Treatment on the Renal Functions in Septic Rats: Relation to Oxidative Damage

PurposeTo investigate the effects of hyperbaric oxygen (HBO) treatment on renal functions and damage in septic rats.MethodsThe animals were divided into four groups, each containing ten animals: control, hyperbaric oxygen, sepsis, and sepsis/hyperbaric oxygen. One milliliter of saline containing live Escherichia coli cells (2.1 × 109) was injected intraperitoneally to induce sepsis. The groups treated with HBO were given five sessions of 2 atmospheres absolute of 100% oxygen at intervals of 6 h. Blood, urine, and tissue samples were then collected, and the functional renal parameters, malondialdehyde (MDA) levels, and superoxide dismutase (SOD) and catalase activities were examined.ResultsThe reduced glomerular filtration rate and urine flow returned to normal levels after HBO treatment; however, the increase in fractionated sodium excretion continued. The increased MDA levels in the renal cortex and medulla also decreased to the level of the control group. In the sepsis group, both the SOD and catalase activities decreased in the renal cortex, while a reduction was observed only in the catalase activity in the medulla. The reduced enzyme activities significantly increased in the sepsis/hyperbaric oxygen group.ConclusionHBO treatment has a beneficial effect on renal dysfunction in sepsis. The probable reason for this effect is the reduction in oxidative damage because of the increase in antioxidative capacity.

Effect of a self-etching adhesive containing an antibacterial monomer on clinical periodontal parameters and subgingival microbiologic composition in orthodontic patients

INTRODUCTION The aims of this study were to evaluate the effect of a self-etching adhesive system containing an antibacterial monomer on periodontal health and subgingival microbiologic composition in orthodontic patients and to compare it with a conventional adhesive system. METHODS A split-mouth design was chosen, and 15 patients were included in the study. Brackets in contralateral quadrants were bonded with either a conventional adhesive system (control) or a self-etching adhesive system that contained an antibacterial monomer. Clinical periodontal parameters including plaque index, gingival index, probing depths, and bleeding on probing were determined. Subgingival plaque samples were collected before bracket placement (T0) and at the 6-month follow-up (T1). The real-time TaqMan polymerase chain reaction assay was used to determine the subgingival counts of Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Campylobacter rectus. For clinical periodontal parameters, analysis of covariance (ANCOVA) and, for bacterial counts, Wilcoxon tests were used for statistical comparisons at the P <0.05 level. RESULTS Clinical periodontal parameters were not changed, and they were not different between the groups from T0 to T1. T forsythensis and F nucleatum increased during the treatment period in both groups (P <0.05). The majority of the bacteria were T nucleatum at T0 and T1 in both groups. Changes in bacterial load from T0 to T1 were not different between groups except for T forsythensis and F nucleatum (P <0.05). CONCLUSIONS The use of an antibacterial monomer did not have an additional positive effect on clinical periodontal parameters. When used in bonding orthodontic brackets, the antibacterial monomer failed to reduce periodontopathogenic bacteria when compared with the conventional adhesive system during a 6-month treatment period.

Ozone therapy prevents renal inflammation and fibrosis in a rat model of acute pyelonephritis

Abstract Introduction. Not only bacterial characteristics but also oxidative/nitrosative stress could play a significant role in renal parenchymal inflammatory processes in acute pyelonephritis (APN). This study was conducted to evaluate the effect of ozone therapy (OT), as an immunomodulator and antioxidant, on the renal function, morphology and biochemical parameters of oxidative stress in an experimental model of APN in rats. Materials and methods. Forty rats were divided equally into five groups as control, APN, APN + Antibiotic, APN + OT, and APN + Antibiotic + OT. APN was induced by 0.1 ml of freshly prepared Escherichia coli (ATCC 25922) solution containing 1010 colony-forming unit/ml into the kidney. A control group was administered 0.1 ml of 0.9 % NaCl solution. Treatment was begun 72 h after bacterial inoculation. Control and APN groups were given 0.9% NaCl solution, APN + Antibiotic and APN + OT were given either antibiotic (ciprofloxacine 150 mg/kg intramuscular/twice daily) or OT. APN + Antibiotic + OT group was given both antibiotic and OT for five consecutive days. At the end of the seventh day, animals were killed via decapitation and trunk blood was collected. Both kidneys were harvested and one half of each kidney were immediately stored for antioxidant enzyme activity, tissue lipid peroxidation and protein carbonyl content. The remainder was fixed for histopathologic examination. Results. E. coli-induced APN increased the renal glomerular and tubular dysfunction, oxidative stress parameters and antioxidant enzyme activities. Either antibiotherapy or OT markedly ameliorated renal dysfunction, the antioxidant status of the kidneys and histopathological injuries subjected to E. coli-induced APN. Interestingly, the combination of antibiotherapy and OT was much more effective than either of the treatment modalities alone. Conclusion. The combination of antibiotherapy and OT markedly ameliorated renal dysfunction and improved antioxidant status and histopathologic modalities in rats subjected to E. coli-induced APN than either antibiotherapy or OT treatment alone. Therefore, OT may be considered as an adjuvant therapy to classical antibiotherapy to prevent renal inflammation and fibrosis in APN.

Neisseria meningitidis Serogroup X Sequence Type 767 in Turkey

Neisseria meningitidis is a common inhabitant of the nasopharyngeal tracts of healthy humans and is a significant cause of invasive infections such as meningitis in young children and adolescents worldwide (14). N. meningitidis has been classified into 13 serogroups on the basis of antigenic variation of the capsule, but only serogroups A, B, C, Y, and W-135 have commonly caused invasive infections (8). In Turkey, W-135 has been the most frequently reported serogroup since an international outbreak was reported following the annual Hajj seasons in Saudi Arabia in 2000 and 2001 (10). During the years 2003 to 2008, 17 serogroup W-135 strains (from eight meningitis cases) were isolated from Turkish recruits vaccinated with A+C polysaccharide meningococcal vaccine (10-12). We describe here the first meningococcal meningitis case caused by a serogroup X N. meningitidis strain in Turkey. The patient was a 22-year-old male soldier, working in a military unit, who was admitted to the emergency department with complaints of a 1-week history of fever (39°C), cough, and vomiting on 10 January 2010. There was little petechiate rash on his chest and a lower leg. The laboratory evaluation at that time revealed a leukocyte count of 3,700/mm3, a hemoglobin level of 13.4 g/dl, and an erythrocyte sedimentation rate of 5 mm/h. The patient was then admitted to the infectious disease service with a diagnosis of meningococcal meningitis based on the clinical symptoms and results of confirmatory laboratory tests, including blood culture and cerebrospinal fluid analysis. He was given ceftriaxone (4 g/day) for 10 days and then discharged from the hospital in good condition. Oropharyngeal swab specimens were obtained from the patients close military personnel contacts, and one person was found to be positive for an N. meningitidis serogroup X strain. He was given a single dose of 500 mg ciprofloxacin immediately. Clinical and oropharyngeal swab specimens were inoculated immediately onto BBL-modified Thayer-Martin medium plates (MTM II; Becton Dickinson Microbiology Systems) and Thayer-Martin medium with VCAT selective supplement (SR10B; Oxoid, Hampshire, England). After incubation, suspect colonies were identified by Gram staining and oxidase reactivity testing and the identification was confirmed by the API NH system (bioMerieux) (4). An antibiotic susceptibility test was performed by the Etest method (AB BIODISK, Solna, Sweden) for ciprofloxacin, ceftriaxone, cefotaxime, penicillin, rifampin, and chloramphenicol (3). The strains were susceptible to the antibiotics tested, except penicillin, with a MIC of 0.75 μg/ml. Serogrouping of the meningococcal isolates was performed by a slide agglutination technique as recommended by Difco Laboratories (Detroit, MI). porA variant region sequencing was performed using the standard primers and identified by querying the respective databases hosted at http://neisseria.org. Multilocus sequence typing (MLST) was performed using the standard primers listed at the Neisseria MLST website (http://pubmlst.org/neisseria/). The isolates had the strain designation X: P1.5-1,10-1: sequence type 767 (ST-767) (cc167). ST-767 meningococci have been found previously among N. meningitidis serogroup A and Y strains in Europe and Africa between 1999 and 2008 (http://pubmlst.org/neisseria/). PFGE typing of NheI-digested DNA was performed by a modification of a previously described method (12). The clinical and carrier isolates had the same genotypic pattern. N. meningitidis serogroup X strains were first described in the 1960s and have been isolated from a few cases of invasive meningococcal diseases in North America, Europe, Australia, and China (2, 6, 7). Outbreaks of N. meningitidis serogroup X strains have been reported in Niger (1), western Kenya (13), and northern Ghana (5). N. meningitidis serogroup X strains were reported to be very efficient in colonization among military recruits in the United Kingdom (9). Before May 2009, eight invasive meningococcal disease cases caused by serogroup W-135 were reported in Turkish soldiers who had been vaccinated with A+C polysaccharide meningococcal vaccine; four of these were fatal. Since that time, a quadrivalent meningococcal polysaccharide vaccine (against A/C/Y/W-135) has been successfully introduced into the Turkish recruit expanded immunization program. We describe here the first meningococcal meningitis case caused by a serogroup X strain in our recruits since the introduction of the quadrivalent vaccine. It was reported that repeated mass vaccination in many African countries might have contributed to colonization by and meningococcal diseases due to serogroup X strains and might result in a changed profile of meningococcal disease (5). We suggest that comprehensive conjugate vaccines including X polysaccharides should be developed. In addition, these data highlight the need for further epidemiological surveillance to carefully monitor the pattern of incidence of meningococcal diseases caused by serogroup X strains and to inform future public health strategies.

Stability of hepatitis C virus RNA in blood samples by TaqMan real-time PCR.

The storage conditions of blood samples for reliable results are very important in hepatitis C virus (HCV) RNA amplification tests used in routine HCV analyses. According to many studies, storage conditions could affect the RNA stability for HCV RNA detection. We have studied HCV RNA stability in blood samples stored at 4°C. Nineteen blood samples containing different HCV RNA levels were stored at 4°C and they were then analyzed by TaqMAN real‐time PCR method. HCV RNA levels remained almost stable (100%) at least for five weeks at this storage condition. However, among them, the stability period was up to 11 weeks in two of the samples. As with these findings, there was a slightly significant correlation between the positivity time and the beginning HCV RNA levels (r=0.474, P=0.040). We conclude that, blood samples can be stored at 4°C for five weeks without any significant difference in detected HCV RNA level by using TaqMan real‐time PCR. J. Clin. Lab. Anal. 24:134–138, 2010.

Effect of 2 elastomeric ligatures on microbial flora and periodontal status in orthodontic patients

INTRODUCTION The aim of this study was to compare the effects of a nonconventional elastomeric ligature (Slide; Leone, Florence, Italy) with those of a conventional elastomeric ligature (Ormco, Orange, Calif) on microbial flora and periodontal status in orthodontic patients. METHODS A total of 13 orthodontic patients scheduled for fixed orthodontic treatment were selected for this study. The use of Slide and conventional elastomeric ligatures in fixed orthodontic appliances was tested. Microbial and periodontal records were obtained before bonding and 1 and 5 weeks after bonding. For the statistical analysis and calculations, SPSS software (version 15.0; SPSS, Chicago, Ill) was used. In the statistical decisions, P <0.05 values were accepted as significantly different. RESULTS No significant differences between Slide and conventional elastomeric ligatures were evident at 1 week or 5 weeks after bonding, with regard to gingival index, plaque index, gingival bleeding index, or pocket depth scores (P >0.05). Similarly, aerobic and anaerobic bacteria counts did not differ significantly on the surface or on the elastics (P >0.05). CONCLUSIONS Although the Slide ligatures cover the total surface of the bracket, they do not cause significantly more plaque accumulation or periodontal problems than do the conventional elastomeric ligatures.

Prevalence of HIV and syphilis among Turkish blood donors.

To the Editor: Screening of blood is now mandatory for many diseases and is undertaken routinely in blood banks. Many studies have been done on human immunodeficiency vir rus (HIV) and syphilis, separately, but knowledge about the interrelar tionship between these transfusion transmitted diseases is limited.1,2 This study was undertaken to assess the correlation between positivity for HIV infection and syphilis among blood donors of Eskisehir. Donors who applied to our blood center in a 10ryear period (1998r2007) were retrospectively evaluated. No pror fessional or honorary donation was included. Serum samples were screened for antirHIV by ELISA (microparr ticle enzyme immunoassay, Axym, Abbott Corp., IL, USA) and for syphilis by the Veneral Disease Research Laboratory (VDRL) test (nontreponemal test, immunotrep Omega Diagnostic, Scotland, UK). Samples were not screened for VDRL. Of the total of 19 630 individuals, 6850 (34%) were fer males and 12 780 (66%) were males. VDRL positivity was found in 33 donors (0.168%) and antirHIV was positive in 3 cases (0.015%) (Table 1). When the VDRL test was posir tive, a confirmatory treponemal test was done. AntirHIV positivity was also confirmed by the western blot test. For the statistical analyses, chir square and the Fisher exact test were used. The prevalence of VDRL reacr tivity varied from 0.03% to 0.3% in blood donors in different regions of Turkey.3 VDRL reactivty increased from 0.1% in first period to 0.3% in the second period (P=.001). This seems to be an alarming signal in the local blood banks for the probr able increase in syphilis and further diagnostic tests should be applied in these cases. According to the rer sults reported from other regions of Turkey, antirHIV positivity rates ranged between 0% and 0.66%.4 AntirHIV positivity was not found in the first period , but in the second period it was 0.03% (P=.105). Two donors with positive HIV serology (66.6%) were also positive for VDRL (P≤.001). The problem of safe blood has become an issue worldwide; there is no available method to reduce the infection risk from transfusion to zero. Thus, it appears to be essential to carefully select appropriate donors and to avoid unnecessary transfur sion. In conclusion, blood donors in our region show lower seropositivity rates, although there seems to be a regular increase in the rates of antir HIV and syphilis. Thus, taking into consideration the rising prevalence of these infections, a routine screenr ing of all the donated blood products for antirHIV and syphilis should be done, which will assist blood transr fusion services in improving transfur sion safety. Omer Coskun,a Cem Gul,a Hakan Erdem,a Orhan Bedir,b Can Polat Eyiguna

Urinary tract infections caused by Shigella species.

tp://dx.doi.org/10.1016/j.tmaid.20 77-8939/a 2015 Elsevier Ltd. All rig Dear sir, it is well known that Shigella spp. primarily cause gastrointestinal infections. Extra-intestinal manifestations are uncommon and mainly include neurological manifestations and arthritis [1]. Urinary tract infections (UTIs) due to Shigella spp. are rare, and Shigella sonnei UTIs are particularly unusual [2]. S. sonnei can be responsible for UTI during pregnancy even when no predisposing factors or an apparent source of infection can be identified [3]. In a study from USA, laboratory confirmed 208,368 Shigella isolates were examined and of these 71.7% were S. sonnei, 18.4% S. flexneri, 1.6% S. boydii, and 0.7% S. dysenteriae. Nearly all of these strains (99%) were recovered from stool and only 0.63% from urine [4]. This study also stressed that urine is the second most common source of positive isolates after feces. The contribution of fecal contamination should be noted for this rate. Unlike other studies, S. boydii was the most common isolated pathogen

Evaluation of microorganisms isolated from blood cultures and their susceptibility to antibiotics in two year period.

Bloodstream infections (BSIs) are a major cause of healthcare-associated morbidity and mortality. Analyses of the frequency of microorganisms isolated from blood cultures and antibiotic susceptibility can provide clinicians with relevant information for the empirical treatment of patients. The purpose of the study was to investigate to frequency of microorganisms isolated from blood cultures and their sensitivity to antimicrobial agents between January 2009 and December 2010 at the Training Hospital of Gulhane Military Medical Faculty. Blood cultures were processed by automatized BACTEC/9050 (Becton Dickinson, Maryland, USA). The observed growth of microorganisms in culture media was identified by conventional methods and PhoenixTM 100 automatized systems (BD Phoenix System, Beckton Dickinson, USA).Antimicrobial susceptibility tests were performed by Kirby-Bauer disc diffusion method and automatized systems (BD Phoenix System, Beckton Dickinson, USA) in accordance with the recommendations of Clinical and Laboratory Standarts Institute (CLSI). In the study period among the 6823 blood culture samples, 957 (14%) yielded positive results. Results of 600 (8.7%) blood culture samples evaluated as contamination. Of the 957 isolated microorganisms, 61.0% were Gram negative, 31.1% were Gram positive and 7.8% were yeast. E.coli was the most frequently isolated species (15.9%), followed by Klebsiella spp (15.4%) and Coagulase Negative Staphylococcus (CNS) (13.2%). Twenty eight percent% of S. aureus and 89% of CNS isolates were resistant to methicillin. Only one isolate (1.73%) was resistant to glycopeptides among Enterococcus spp. ESBL (Extended-spectrum beta lactamase) was detected in 36.8% of E.coli and 51.3% of Klebsiella spp. isolates.