Blood transfusion knowledge levels of nurses in İzmir Atatürk training and research Hospital, turkey

Despite their use in life-saving treatment, blood and blood products can cause life-threatening complications. To administer blood transfusion safely, national guidelines and protocols should be consulted in healthcare organizations. In Türkiye, there are guides and regulations published by the Ministry of Health. With the definition of hemovigilance in the regulations; training in clinical use of blood and transfusion practice fields is now mandatory. This study presents data from a survey designed to assess transfusion knowledge levels of clinical departments for the purpose of planning our training programs. A two-part survey was conducted on 110 nurses from various departments. Questions included sociodemographic attributes, department they worked in, employment duration, knowledge level on transfusion practices. Statistical analysis was performed. Of the nurses that participated; 52.7% were above 40 years old, 15.5% were 31-40 years old and 31.8% were below 30 years old. For education; 84.5% of the nurses were graduates or postgraduates. For work experience; 64.5% were working in internal medicine departments, 58.2% had been working as a nurse for 10 or more years while 85.5% worked in the same department for less than 5 years. It was determined that the nurses should know more about transfusion. Beginner nurses in the intense care unit were found to have lower levels of transfusion practice knowledge, from this it was deduced additional training should be scheduled for beginner nurses with low transfusion knowledge. In addition to theoretical instructions, one-on-one training on operation controls and "observation and guidance" style practical training should be implemented. Theoretical and practical topics with inadequate knowledge should be instructed in finer detail to increase the knowledge level in these subjects.

Influences of genotype and location interactions on oil, fatty acids and agronomical properties of groundnuts

An enhanced adaptation to specific environmental conditions could provide higher seed quality and quantity from groundnuts. In this investigation, nine groundnut genotypes and two controls were evaluated for morphological and oil traits in two different Mediterranean locations. The traits of shelling percentage and pod yield indicated significant differences among the genotypes. The highest pod yield was observed for ACG 154 from the subsp. hypogaea var. hypogaea and ACG 107 from the subsp. fastigiata var. vulgaris in the locations of Adana and Antalya, respectively. The genotype ACG 154 also had about 60 g of 100-seed weight, which is desirable for commercial production as a Runner commercial type. Significant differences were recorded for oil yield, palmitic, oleic and linoleic acids in both locations among the genotypes studied. The groundnut genotypes were further evaluated with allele-specific PCR markers for possible SNP mutations in the ahFAD2A and ahFAD2B genes for high-oleic mutants. ACG 14, ACG 154 and ACG 156 had the mutant ahFAD2A allele, while no ahFAD2B allele mutation was found. The statistical model GGE bi-plot was used to identify the ideal and representative location for each genotype according to pod yield performance. The genotypes ACG 107 and ACG 116 presented the highest oil yield and were relatively stable across locations. Therefore, they should be evaluated as candidates for cultivar releases in the two studied climatic areas. In addition, the selected desirable genotypes in this study can be used as parents in hybridization programs to develop populations for future releases.

[Macrolide-lincosamide-streptogramin B (MLSB) resistance phenotypes in clinical Staphylococcus isolates and investigation of telithromycin activity]

Staphylococci are one of the most common pathogens isolated from nosocomial and community acquired infections. Antibiotics such as clindamycin and erythromycin have been useful options for treating skin and soft-tissue infections caused by staphylococci. However, expression of macrolide-lincosamide-streptogramin B resistance (MLSB) can limit the effectiveness of these drugs. The aims of this study were to investigate the prevalence and phenotypes of MLSB resistance in staphylococcus strains isolated from clinical samples and to determine the telithromycin activity against these isolates. A total of 218 strains [92 Staphylococcus aureus and 126 coagulase-negative staphylococci (CNS)] isolated from different clinical samples (wound, abscess, blood, sterile body fluids, catheter, upper respiratory tract samples) between February 2011 to December 2012 were included in the study. The isolates were identified by using conventional methods and automated bacterial identification system (BD Phoenix 100™ System, Becton Dickinson, USA). Methicillin resistance of the isolates was determined with the use of cefoxitin (30 µg) disk and telithromycin (15 µg) activity was detected by Kirby-Bauer disk diffusion method. MLSB resistance phenotypes were investigated by the D-test method using erythromycin (15 µg) and clindamycin (2 µg) disks. Of 92 S.aureus isolates, 23 were methicillin-resistant (MRSA) and 69 were methicillin-susceptible (MSSA), whereas 78 of 126 CNS isolates were methicillin-resistant (MRCNS) and 48 were methicillin-susceptible (MSCNS). Hundred and seventy-two (79%) isolates were found as erythromycin-resistant, and the rates of erythromycin resistance in MRSA, MSSA, MRCNS and MSCNS strains were 83%, 71%, 95% and 63%, respectively. Inducible type of MLSB resistance (iMLSB type) was observed in 26%, 6%, 51% and 33%; chromosomal resistance (cMLSB type) in 32%, 27%, 27% and 17% and efflux pump connected resistance (MSB type) in 42%, 67%, 22% and 50% of the MRSA, MSSA, MRCNS and MSCNS, respectively. Forty-four (20%) strains were found susceptible to both clindamycin and erythromycin (S type resistance). Resistance due to enzymatic inactivation (L type) was observed only in two of the CNS strains (0.9%), one was methicillin-resistant and the other was susceptible. Total telithromycin resistance was detected as 26.6% (n= 58), while the resistance rates in MRSA, MSSA, MRCNS and MSKNS isolates were 35%, 35%, 28% and 8%, respectively. Telithromycin resistance rate was 34% (58/172) in erythromycin-resistant isolates. However, all erythromycin-susceptible isolates (n= 46) were also susceptible to telithromycin. Telithromycin-resistant isolates frequently exhibited cMLSB phenotype (39/44; 67.2%), followed by MSB (16/72; 27.6%) and iMLSB (3/56; 5.2%). In conclusion, clindamycin is still an effective antibiotic for the treatment of staphylococcal infections in our hospital, however, 34% resistance rate against telithromycin may limit the use of this agent which is an alternative for the treatment of infections caused by clindamycin and erythromycin-resistant strains.

Evaluation of the reproductive toxicity of naproxen sodium and meloxicam in male rats

Nonsteroidal anti-inflammatory drugs that are cyclooxygenase (COX) enzyme inhibitors have generally been used in short-term pain management and also to treat inflammation chronically. It is known that COX enzyme and prostaglandins play important roles in the regulation of reproductive functions in females. However, there are relatively few studies for the male reproductive system, and the results of these studies are contradictory. In this study, sperm count and motility, COX-1, COX-2, prostaglandin E1 (PGE1), prostaglandin E2 (PGE2), and prostaglandin F2α (PGF2α) levels in testis tissue, plasma follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels, and histopathological examination of testis tissue were evaluated after naproxen sodium and meloxicam administration in male rats. Also, testis superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), and glutathione (GSH) levels were measured to investigate the oxidation status. According to our results, sperm count and motility were significantly decreased in treatment groups. Plasma hormone levels did not show any statistical differences between the groups. COX-1, PGE2, and PGF2α levels were significantly decreased, while the decreases in COX-2 and PGE1 levels did not show any significance statistically. Testis SOD, catalase, GPx, and GSH levels were decreased significantly. According to the results of histopathological examination, damage in seminiferous tubules, where spermatogenesis developed, was observed. In conclusion, naproxen sodium and meloxicam decreased the sperm count and motility and also induced the damage of seminiferous tubules as a direct effect without affecting plasma hormone levels in our study. The mechanism of the reproductive toxicity induced by these agents may be based on the inhibition of prostaglandin synthesis and the induction of oxidative stress can be emphasized as a secondary factor.

Parameters of infection in replacement and voluntary donors in the western part of Turkey

BACKGROUND

According to our center's experiences familial/replacement donors (FRDs) frequently donate blood for the first time in their lives. Therefore, results of infection parameters are expected to be different voluntary donors (VDs), at similar rates to the population. The present study aimed to investigate if there were any difference in VDs and FRDs in terms of infection parameters.

OBJECTIVE

The blood donation records over 6 years (2004-2010) were reviewed, retrospectively. HBsAg, anti-HCV, anti-HIV screening tests were performed by ELISA and syphilis screening was performed by the RPR method.

MATERIAL AND METHODS

Out of 71.217, 16.727 donors donated whole blood as FRD. Among the whole blood donated by FRD, the positives for HBsAg, anti-HCV and RPR were 1.23%, 0.37%, and 0.07%, respectively. Confirmed anti-HIV screening test was not observed in this group. Positivities for HBsAg, anti-HCV, anti-HIV and RPR in VD were 1.36%, 0.42%, 0.004%, and 0.04%, respectively.

RESULTS

When FRD and VD were analyzed statistically, HBsAg rates were significantly higher among FRD in the years 2004, 2007 and 2008, whereas they were significantly high among VD in year 2005. HBsAg rates stated in the years 2006-2009 were insignificant. Significantly high results were observed in HCV rates in the year 2005 among VD, whereas insignificant levels were observed in other years. HIV rates were insignificant among VD in the years 2004 and 2005, confirmed positivity was established in only one patient. Values in all years in RPR rates were statistically insignificant. Grouping donors as replacement and voluntary has no importance in infection parameters.

CONCLUSION

Grouping donors as replacement and voluntary has no importance in infection parameters. Appropriate donor inquiries and screening of infection parameters by reliable proven tests preserve their significances.

First Report of a 16SrIX Group (Pigeon Pea Witches'-Broom) Phytoplasma Associated with Sesame Phyllody in Turkey

Sesame (Sesamum indicum L.) is an important oilseed crops widely grown in the southern regions of Turkey. Sesame seeds are primarily used in production of tahini as well as a garnish on sweets and bakery products in the country. Sesame plants with phyllody disease symptoms have increasingly been observed in the fields of Antalya province since 2007. The disease incidence in these fields was found to range from 37 to 62% (2). Infected plants display a variety of the disease symptoms such as virescence, asymptomatic shoot proliferation, infertile flower formation, reduced leaf size, and thin and weak capsule development. Total genomic DNA was extracted from samples collected from symptomatic (10 plants) and asymptomatic healthy-looking plants (10 plants) using a CTAB method and amplified with universal primers P1/P7 and R16F2n/R16R2 in direct and nested PCR, respectively (1,3). Amplifications of the DNA from the symptomatic plants yielded a product of 1.8 kb in direct and 1.2 kb in nested PCR assays. No amplification was observed in symptomless plants of the same age and collected from the same fields. Amplicons were purified, cloned in a pTZ57R/T Vector, and sequenced using a Beckman Coulter 8000 CEQ Genetic Analysis System. Four aligned 16S rDNA sequences (1,845 bp) were found to be all identical and belonging to one species. One sequence was deposited in GenBank under the accession number KC139791. A BLAST similarity search revealed that the sequence shared 99% homology with the sequences of the members of 16SrIX group phytoplasmas, 'Brassica rapa' phyllody phytoplasma (HM559246.1) and Iranian Almond witches'-broom phytoplasma (DQ195209.1) available in GenBank. In addition, iPhyClassifier software (4) was employed to create a virtual RFLP profile. The analysis showed that the RFLP profile of the sesame phytoplasma 16S rDNA sequence is identical (a similarity coefficient of 1.00) to the profile of the 16Sr group IX phytoplasma reference sequence (Y16389). A phylogenetic tree was also constructed using the neighbor joining plot option of the Clustal X program. The sequence clustered together with 16SrIX group phytoplasmas. To our knowledge, this is the first report of a natural infection of sesame by a new phytoplasma species from the 16SrIX group in Turkey. References: (1) D. E. Gundersen and I.-M. Lee. Phytopathol. Mediterr. 35:144, 1996. (2) C. Ikten et al. Phytopathogenic Mollicutes 1:101, 2011. (3) C. D. Smart et al. Appl. Environ. Microbiol. 62:2988, 1996. (4) Y. Zhao et al. Int. J. Syst. Evol. Microbiol. 59:2582, 2009.

Seroprevalence of transfusion transmissible infections among blood donors in western part of Turkey: a six-year study

BACKGROUND

The most frequently encountered complication of blood transfusion is transfusion transmissible infections. Screening of transfusion transmissible infections are for safe blood transfusions, the results provide a crude idea about seropositivity rates of regions.

OBJECTIVE

The present study aimed to investigate distributions of transfusion transmissible infection seroprevalences in years and according to gender through medical records, and to define the regional data, retrospectively.

METHODS

80.454 Blood donors, applied to our center between dates August 2004 and December 2010, were investigated by HBsAg, anti-HVC, anti-HIV ELISA (Abbott, AXSYM) and RPR methods.

RESULTS

Out of 80.454 donors, 7.321 (9.1%) were females, 73.133 (90.0%) were males. Age range of donors was 18-64 years (mean 41 years). While 61.950 (77%) of donors were voluntary, 18.504 (23%) were familial/replacement donors. 1.405 units of blood out of 80.454 were disposed, because one of infection parameters was positive. 45 units (3.2%) of disposed blood were from females, the rest belonged to male donors (1.360 units; 96.8%). HBsAg was positive in 1.054 donors (1.31%), whereas positivities of anti-HCV, anti-HIV and RPR were 312 (0.38%), 2 (0.002%) and 39 (0.04%), respectively.

CONCLUSIONS

Seropositivity was determined in accordance with national data, but was at lower limits. Seropositivity rates in years differed, but neither regularly increases nor decrease was observed. When all positivities were investigated according to genders, positivity in HBsAg and VDRL tests were significantly high in male donors.

[Comparison of Cefoxitin Disk Diffusion Test, Automated System and Chromogenic Medium for Detection of Methicillin Resistance in Staphylococcus aureus Isolates]

The mecA gene is responsible for the development of methicillin resistance in staphylococci however accurate detection of methicillin resistance is not feasible evermore because of heterogenous expression of mecA gene. Although mecA gene determination by polymerase chain reaction (PCR) is considered as the gold standard method, molecular tests are not easily applied in all routine laboratories. Thus, for the rapid and accurate diagnosis of MRSA strains, easy and practical phenotypic tests are still required. This study was aimed to compare the performance of mecA gene analysis by gel bases multiplex PCR with dual primer (Seeplex, Seegene Inc, Korea), cefoxitin disc diffusion method (30 µg, Oxoid, UK), automated system (Phoenix 100, Becton Dickinson, USA) and chromogenic medium CHROMagar MRSA (CHROMagar Microbiology, Salubris, Turkey) for the detection of methicillin resistance in staphylococci. It was found that 60 of the 98 Staphylococcus aureus strains carried the mecA gene. Methicillin resistance was observed by cefoxitin disc diffusion test in 59 isolates, by automated system in 61 isolates, and by CHROMagar MRSA in 65 isolates. When mecA gene analysis was considered as the reference method, the sensitivity, specificity, positive and negative predictive values of the tests that were used for the detection of methicillin resistance were found as 98.3%, 100%, 100% and 97.4% for cefoxitin disc diffusion (CDD) method; 100%, 97.4%, 98.4% and 100% for automated system; 96.7%, 81.6%, 89.2% and 93.9% for chromogenic medium CHROMagar MRSA, respectively. The highest sensitivity and negative predictive values were obtained by the automated system, and the highest specificity and positive predictive values were obtained by the CDD test. Although the sensitivity of chromogenic medium was found to be similar with the CDD test at the end of 48 hours, the specificity of chromogenic medium was lower than the other tests at the end of each incubation period. Likewise, positive and negative predictive values of the chromogenic medium were determined low compared to other tests. In laboratories that cannot perform molecular analysis, the determination of methicillin resistance should be done by the CDD test which is known to be a better inducer of the mecA gene expression of staphylococci. Determination of minimum inhibitory concentration (MIC) with automated systems can be the second choice especially in laboratories with intensive work loads. As a result chromogenic media can be particularly used for screening in laboratories that have a heavy workload and insufficient personnel number. However, due to its low specificity and the possibility of false positive results, it was recommended that positive strains should be confirmed by other methods such as disc diffusion or microdilution.

Dual phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography with forced diuresis in diagnostic imaging evaluation of bladder cancer

INTRODUCTION

(18)F-FDG PET has been regarded as a limited value in urooncology due to urinary excretion of the tracer. The purpose of this retrospective study was to investigate the clinical value of dual-phase FDG PET/CT with forced diuresis protocol (iv furosemide-voiding and oral hydration) in invasive or high grade bladder cancer.

METHODS

Fifty-one patients were included in this study. All patients underwent standard staging procedures and dual-phase FDG PET/CT before planned therapy. PET/CT findings before and after furosemide were compared with each other for pelvic region. Dual phase PET/CT findings were also compared with the results of prior imaging studies and all findings were correlated with final diagnosis (histopathology or clinical follow-up for at least 12 months).

RESULTS

Intravesical FDG activity significantly decreased in 90% of the patients with forced diuresis protocol. Eighty eight percent of the bladder findings and 20% of the local lymph node metastases, and other pelvic findings (local invasion and second primary malignancy of prostate) were detected only by the additional pelvic PET/CT images. As a result, dual phase PET/CT changed the staging and/or the therapy strategy in 16 patients (31%).

CONCLUSION

Dual phase FDG PET/CT contributes staging and decision of therapy strategy by detecting local disease and pelvic metastases with high accuracy when combined with forced diuresis protocol. Thus, we recommend dual phase imaging method with forced diuresis protocol in FDG PET/CT for bladder cancer and all other urogenital system malignities.

Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for the detection of skeletal muscle and skin metastases in uterine leiomyosarcoma: a case report

We report the clinical value of FDG PET/CT imaging in a 57-year-old woman who was diagnosed with uterine leimyosarcoma 6 years ago. In a staging procedure, whole body FDG PET/CT discloses the presence of both local recurrence and remote metastases at widespread musculocutaneous sites, liver and femur. With its advantage of scanning the whole body in a single procedure, we propose the use of PET/CT imaging for the evaluation of patients with uterine leimyosarcomas, a tumor with a propensity for widespread hematogenous spread to unusual sites.

[A case of leech infestation mimicking upper respiratory tract infection]

Urban life and industrialization leads to a decrease in the incidence of many parasitic diseases. Especially, using the supervised water supplies in urban areas decreases the chance of such infestations and limits it in rural areas. However, the people who live in urban areas and have diseases such as kidney stones think that mountain waters may be beneficial for their illness. These types of water supplies are generally unsafe, uncontrolled and septic. That is why usage of them can cause some elusive parasitic infestations in people who live in urban areas. It is meaningful to submit the case described below to illustrate the possibility of parasitic infestations in patients who have upper respiratory tract infection symptoms who are admitted to the physician.