Complementary medicine methods have a long history, but modern medicine has just recently focused on their possible modes of action. Medicinal leech therapy (MLT) or hirudotherapy, an old technique, has been studied by many researchers for possible effects on various diseases such as inflammatory diseases, osteoarthritis, and after different surgeries. Hirudo medicinalis has widest therapeutic usage among the leeches, but worldwide, many different species were tested and studied. Leeches secrete more than 20 identified bioactive substances such as antistasin, eglins, guamerin, hirudin, saratin, bdellins, complement, and carboxypeptidase inhibitors. They have analgesic, anti-inflammatory, platelet inhibitory, anticoagulant, and thrombin regulatory functions, as well as extracellular matrix degradative and antimicrobial effects, but with further studies, the spectrum of effects may widen. The technique is cheap, effective, easy to apply, and its modes of action have been elucidated for certain diseases. In conclusion, for treatment of some diseases, MLT is not an alternative, but is a complementary and/or integrative choice. MLT is a part of multidisciplinary treatments, and secretes various bioactive substances. These substances vary among species and different species should be evaluated for both treatment capability and their particular secreted molecules. There is huge potential for novel substances and these could be future therapeutics.
Background/aim: This prospective study aimed to determine the presence of the most common carbapenemase genes, blaOXA-48, blaKPC, blaIMP, blaVIM and blaNDM on carbapenem resistant clinical K.pneumoniae and E.coli isolates. Materials and methods: Isolates were selected according to EUCAST guideline; gradient test and disc diffusion with both meropenem and ertapenem discs. Resistance rates of these isolates to other antimicrobial agents were also examined by disc diffusion method. Carbapenem resistance gene were investigated by using Real-Time PCR. Results: A total of 3845 E. coli and 1689 K.pneumoniae isolates from clinical samples between January 2015 and April 2017 were evaluated. The 419 isolates were found as carbapenem resistant but only the first resistant isolate (n=155; 126 K.pneumoniae and 29 E.coli) of each patient were included. Carbapenem resistant isolates were most frequently isolated from intensive care units (48.8%). Colistin was the most effective antibiotic (91.0%). The 121 (78.1%) of the tested isolates were positive for OXA-48 (103 K.pneumoniae and 18 E.coli) and 9 K. pneumoniae carrying blaNDM were also positive for blaOXA-48. VIM, IMP and KPC type carbapenemases were not detected in any isolates. Conclusion: Carbapenem-resistant pathogens have been shown to be able to develop resistance mechanisms with more than one carbapenemase encoding gene.
Objective: The present study aimed to evaluate the performances of the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test for detecting second-line antituberculosis drug resistance in Multidrugresistant TB (MDR-TB) cases. Materials and Methods:Forty-six MDR-TB strains were studied. Second-line antituberculosis drug resistances were detected using the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test. The Middlebrook 7H10 agar proportion method was used as the reference test.Results: The sensitivity and specificity values for the BACTEC MGIT 960 SL DST kit were both 100% for amikacin, kanamycin, capreomycin (4 µg/mL), and ofloxacin; 100% and 95.3%, respectively, for capreomycin (10 µg/mL); and 85.7% and 100%, respectively, for moxifloxacin (0.5 µg/mL). The sensitivity and specificity values for the GenoType MTBDRsl test to detect fluoroquinolone and aminoglycoside/cyclic peptide resistance were 88.9% and 100%, respectively, for ofloxacin and 85.7% and 94.9%, respectively, for moxifloxacin (0.5 µg/ mL). The accuracy of the GenoType MTBDRsl assay for kanamycin, capreomycin, ofloxacin, and moxifloxacin was lower than that of the BACTEC MGIT 960 SL DST. Conclusion:The BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl were successful in detecting second-line antituberculosis drug resistance. Preliminary results of the GenoType MTBDRsl are very valuable for early treatment decisions, but we still recommend additional BACTEC MGIT 960 SL DST kit usage in the routine evaluation of drug-resistant tuberculosis.Keywords: Mycobacterium tuberculosis, agar proportion method, MDR-TB, second-line drug susceptibility ÖZ Amaç: Bu çalışmanın amacı, çok ilaca dirençli tüberküloz (ÇİD-TB) vakalarında, BACTEC MGIT 960 SL DST kitinin ve GenoType MTBDRsl testinin, ikincil antitüberküloz ilaçlara karşı duyarlılığı saptamasındaki performansının değerlendirilmesidir.Gereç ve Yöntem: 46 tane ÇİD-TB suşu çalışıldı. BACTEC MGIT 960 SL DST kiti ve GenoType MTBDRsl testi ile ikincil antitüberküloz ilaçlara karşı direnç durumu tespit edilmiştir. Middlebrook 7H10 agar proporsiyon metodu referans yöntem olarak kullanılmıştır.Bulgular: BACTEC MGIT 960 SL DST kitinin duyarlılık ve özgüllüğü; amikasin, kanamisin, kapreomisin (4 µg/ mL) ve ofloksasin için her ikisi de %100; kapreomisin (10 µg/mL) için sırasıyla %100 ve %95,3; moksifloksasin (0,5 µg/mL) için sırasıyla %85,7 ve 100% olarak bulunmuştur. GenoType MTBDRsl testinin florokinolon ve aminoglikozid/siklik peptit direnci tespitinde duyarlılık ve özgüllüğü; ofloksasin için sırasıyla %88,9 ve %100; moksifloksasin (0,5 µg/mL) için sırasıyla %85,7 ve %94,9 olarak bulunmuştur. GenoType MTBDRsl yönteminin kanamisin, kapreomisin, ofloksasin ve moksifloksasin için doğruluğu, BACTEC MGIT 960 SL DST kitine göre daha düşük saptanmıştır.Sonuç: BACTEC MGIT 960 SL DST kiti ve GenoType MTBDRsl testi ikincil antitüberküloz ilaçlara karşı direncin saptanmasında başarılı bulunmuştur. GenoType MTBDRsl testi ile elde edilen ön bilgiler, erken dönemde tedavi kararlarının alınmasında değerlidir,...
Royal jelly is a secretion of honeybees that is actually for feeding of bee larvae. It contains many bioactive substances such as jelleins, royalisin, major royal jelly proteins and 10-hydroxy-2-decenoic acid. Recently, many studies were published investigating activities of royal jelly. In overall, royal jelly found to have antioxidant, neurotrophic, antidiabetic, hypocholesterolemic, regulatory on blood pressure, antimicrobial, immunomodulatory, anti-tumor and tissue-protective effects. These activities are strongly related to each other and cannot be evaluated separately. Researchers claim that royal jelly can be an excellent therapeutic agent (or an additional agent), especially in treatments of cancer and metabolic syndrome. However, there are huge gaps due to limited number of in vivo studies and there are standardization issues both for usage and investigations. Furthermore, wide variability of contents in royal jelly due to geographic locations, climate, etc also causes a problem in choice of exact royal jelly. Currently it seems to be safe and effective nutritious agent for healthy people, but it is hard to gain an overall perspective in usage as a therapeutic, since there is a necessity of wider studies with more different types of royal jelly. Sığ et al. / Royal jelly 334 ORTADOGU TIP DERG 2019; 11(3): 333-341 ÖZ Arı sütü aslen arı larvalarının beslenmesi için bal arıları tarafından üretilen bir sekresyondur. Jelleinler, royalizin, ana arı sütü proteinleri ve 10-hidroksi-2-desenoik asit gibi çok sayıda biyoaktif madde içermektedir. Son yıllarda arı sütü konusunda çok sayıda makale yayımlanmıştır. Genel olarak, arı sütü, antioksidan, nörotropik, antidiyabetik, hipokolesterolemik, kan basıncı düzenleyici, antimikrobiyal, immünomodülatör, anti-tümör ve doku koruyucu etkileri göstermektedir. Bu etkiler aslen bir bütündür ve mekanizmaları ayrı ayrı değerlendirmek mümkün değildir. Araştırmacılar, özellikle kanser ve metabolik sendrom tedavisinde iyi bir tedavi ajanı (veya tedaviye ek bir ajan) olabileceğini iddia etmektedir. Öte yandan, in vivo çalışmaların sayısı son derece sınırlıdır ve hem araştırma hem kullanım alanlarında standardizasyon sorunu vardır. Ayrıca, coğrafi konum, iklim gibi koşullara bağlı olarak arı sütü içeriğinin ciddi farklılıklar göstermesi, arı sütünün seçiminde sorunlar yaratmaktadır. Şu an için, sağlıklı insanlarda güvenli ve etkin bir besleyici gıda olarak gözükmekte, fakat terapötik kullanımı konusunda genel bir görüş elde etmek mümkün gözükmemektedir. Farklı türlerde arı sütleri üzerinde daha geniş çaplı araştırmalar yapılmalıdır.Anahtar kelimeler: arı sütü, apiterapi, arı ürünleri, biyofarmasötik ajanlar, geleneksel ve tamamlayıcı tıp
The emerging of multi-drug resistant strains of Mycobacterium tuberculosis complex and the resurgence of tuberculosis have forced new methods for diagnosis and antimicrobial susceptibility to be developed. In this study, we evaluated a recently marketed diagnostic technique, GeneXpert MTB/RIF test, in terms of identifying Mycobacterium tuberculosis complex and detecting rifampicin resistance from clinical samples. Material and Methods: In our study, GeneXpert MTB/RIF assay was compared with conventional and automated culture methods. 389 various clinical samples (171 pulmonary and 218 ekstrapulmonary samples) were cultured with BACTEC MGIT 960 culture system and Löwenstein-Jensen medium and were tested with GeneXpert MTB / RIF test. Results: 23 samples were positive for Mycobacterium tuberculosis complex by GeneXpert MTB/RIF test, but 22 samples were positive for Löwenstein-Jensen medium and BACTEC MGIT 960 culture system. 2 of 23 samples were detected rifampicin resistant at the first study, but restudying of these samples resulted as rifampicin resistant for only one sample. According to culture findings of all pulmonary samples, the sensitivity and specificity for GeneXpert MTB / RIF test were both 100% (16/16). The sensitivity and specificity for extrapulmonary samples were 83.3% and 99.5%, respectively. Conclusion: GeneXpert MTB / RIF test is an effectual automated molecular diagnostic technique with its successful and reliable performance in early diagnosis of tuberculosis and detecting multi-drug resistant strains.
Introduction: In this study, we aimed investigate the relationship of SARS-CoV-2 viral load cycle threshold (Ct) values with pneumonia. Methodology: A total of 158 patients in whom SARS-CoV-2 was confirmed in upper respiratory tract (URT) samples with molecular method and who had computed tomography (CT) of the chest, between April 2020 and June 2020 were included in this retrospective cross-sectional study. Results: Mean age of 158 PCR positive patients was 45.22 ± 17.89 and 60.8% of them were male. Pneumonia was detected in 40.5% of the patients on their chest CT. A weak but significant correlation was found between SARS-CoV-2 Ct value detected with PCR in analysis of oropharyngeal/ nasopharyngeal (OP/NP) samples and chest CT score (Pearson’s r: 0.197, p = 0.01). No correlation was found between the first detected viral load Ct value and age, gender and mortality. There was no significant correlation between chest CT score and mortality. While the areas remaining under ROC curve for Ct value in analysis of OP/NP samples in prediction of chest CT score ≥ 1, ≥ 5 and ≥ 10 were 0.564, 0.640 and 0.703 respectively. Conclusions: We found that the amount of SARS-CoV-2 viral load (inverse relationship with Ct) detected in OP/NP samples of patients with COVID-19 pneumonia did not reflect the increasing severity of pulmonary lesions on chest CT. Although primary target of SARS-CoV-2 is all epithelial cells of the respiratory tract we believe studies comparing viral loads in lower respiratory tract samples are needed to determine the severity of pulmonary disease.
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