Introduction: Antibiotic resistance is the main factor that affects the effi cacy of current therapeutic regimens against Helicobacter pylori. This study aimed to determine the rates of resistance to effi cacy clarithromycin, amoxicillin, tetracycline, levofl oxacin and metronidazole among H. pylori strains isolated from Turkish patients with dyspepsia. Methods: H. pylori was cultured from corpus and antrum biopsies that were collected from patients with dyspeptic symptoms, and the antimicrobial susceptibility of H. pylori was determined using the E-test (clarithromycin, amoxicillin, tetracycline, metronidazole and levofl oxacin) according to the EUCAST breakpoints. Point mutations in the 23S rRNA gene of clarithromycin-resistant strains were investigated using realtime PCR. Results: A total of 98 H. pylori strains were isolated, all of which were susceptible to amoxicillin and tetracycline. Of these strains, 36.7% (36/98) were resistant to clarithromycin, 35.5% (34/98) were resistant to metronidazole, and 29.5% (29/98) were resistant to levofl oxacin. Multiple resistance was detected in 19.3% of the isolates. The A2143G and A2144G point mutations in the 23S rRNA-encoding gene were found in all 36 (100%) of the clarithromycin-resistant strains. Additionally, the levofl oxacin MIC values increased to 32 mg/L in our H. pylori strains. Finally, among the clarithromycin-resistant strains, 27.2% were resistant to levofl oxacin, and 45.4% were resistant to metronidazole. Conclusions: We conclude that treatment failure after clarithromycin-or levofl oxacinbased triple therapy is not surprising and that metronidazole is not a reliable agent for the eradication of H. pylori infection in Turkey.

Introduction Dental caries is an infectious disease with predominantly of cariogenic bacteria such as Streptococcus mutans (S mutans). Xylitol is considered as one of the effective agents that can limit this dental infection. In this randomised, placebo‐controlled trial, we aimed to evaluate the potential reflection of short‐term xylitol consumption on pro‐inflammatory cytokines (TNF‐α, IL‐6 and IL‐8) and S mutans counts by ELISA and qPCR (Quantitative real‐time PCR), respectively. Methods In this study, 154 participants were assigned to two groups, control and xylitol. Dental examination, saliva and swab samples were done at baseline and at 3‐week for clinical and microbiological assessment. Results In xylitol group at the end of 3‐week, gingival and plaque index scores were significantly decreased with respect to baseline values (P < .001 and P < .05, respectively). The salivary concentration of TNF‐α, IL‐6 and IL‐8 were statistically declined at 3‐week, more so than those at baseline in xylitol group (P < .001). S mutans expression was reduced about fivefold at 3‐week use of xylitol and it was a statistically significant difference compared to baseline (P < .001). Conclusion Intriguingly, even short‐term consumption of xylitol might play a favourable role in maintaining the oral health status, possibly as a result of decreasing the release of pro‐inflammatory cytokines and the counts of S mutans. Nonetheless, this investigation warrants further endorsement.

ÖzAralık 2019'un son günlerinde Çin'in Hubei eyaleti Wuhan kentinde etiyolojisi bilinmeyen pnömoni vakaları görülmeye başlanmıştır. Kısa süre sonra Dünya Sağlık Örgütü (DSÖ) bu vakalardaki etkenin Coronavirus ailesinin yeni bir üyesi olduğunu duyurmuş ve genetik analizler sonucu bu etkenin 2002 yılında salgın yapan SARS (Şiddetli Akut Solunum Sendromu) ile yüksek oranda benzerlik gösterdiği belirlenmiştir. DSÖ tarafından virüsün güncel isimlendirmesi SARS-CoV-2, oluşturduğu hastalık ise COVID-19 olarak kabul edilmiştir. Küresel önlem ve karantina çabalarına rağmen virüsün insidansı artmaya devam etmektedir. Laboratuvar yöntemleri ile 145.000'in üzerinde kişiyi infekte ettiği ve 5.400'den fazla ölümle ilişkilendirilmesinin belirlenmesi ve 130'dan fazla ülkede görülmesi nedenleri ile SARS-CoV-2, DSÖ tarafından 11 Mart 2020 tarihinde pandemik olarak değerlendirilmiştir. Bu derlemede SARS-CoV-2/COVID-19 ile ilgili güncel durum özetlenmiştir.

Geographical variation in the frequency of various gastroduodenal pathologies was shown to be related to the geographical diversity of H. pylori CagA Glu-Pro-Ile-Tyr-Ala (EPIYA) patterns. We examined the EPIYA patterns of H. pylori and the association of EPIYA patterns with gastric cancer (GC) for the first time, to the best of our knowledge, in Turkey. The patient group (PG) contained 60 patients [38 GC and 22 duodenal ulcer (DU) patients]. The control group (CG) was 110 individuals [94 gastritis patients and 16 persons with a normal gastrointestinal system (NGIS)]. Specific primers were used for the detection of cagA including empty-site-positive and EPIYA-A, -B, -C, -D PCR. Bands of EPIYA-A, -B, -C were confirmed by DNA sequencing. One hundred and forty-two (83.5 %) strains [60 in the PG (38 GC, 22 DU), 82 in the CG (72 gastritis, 10 NGIS)] were positive for the cagA gene. EPIYA-C with multiple repeats was detected in 34 (23.9 %) strains, and 22 (64.7 %) were from GC patients. EPIYA-C with one repeat was detected in 89 (62.7 %) strains, and 54 (60.7 %) were from gastritis patients. EPIYT was detected in 10 strains, and EPIYA-D was not detected. The number of EPIYA-C with multiple repeats was significantly higher for the PG than for the CG (P,0.0001). In GC patients, the number of EPIYA-C with multiple repeats was significantly higher than one repeat (P,0.0001). In conclusion, our study showed that multiple EPIYA-C repeats increases the GC risk by 30.6-fold and the DU risk by 8.9-fold versus the CG. This indicates that Western-type H. pylori strains in Turkey have similar EPIYA motifs to those of neighbouring countries and Western populations. INTRODUCTIONHelicobacter pylori is the principal cause of gastritis and gastric or duodenal ulcer (DU) diseases and is involved in the development of gastric cancer (GC) and mucosaassociated lymphoid tissue lymphoma (Atherton, 2006).H. pylori is a class 1 carcinogen identified by the International Agency for Research on Cancer for chronic and persistent infections. It is resistant to antibacterial agents in spite of innate and adaptive immunity (International Agency for Research on Cancer, 1994). Depending on virulence factors such as cytotoxin-associated gene A (CagA), blood group antigen-binding adhesion (BabA2) and vacuolating cytotoxin gene A (VacA), different genotypes cause different pathological and clinical outcomes and geographical regional differences (Atherton et al., 1995;Basso et al., 2008). Recently, the Glu-Pro-Ile-Tyr-Ala (EPIYA)Abbreviations: cagPAI, cag pathogenicity island; CG, control group; CI, confidence interval; DU, duodenal ulcer; EPIYA, Glu-Pro-Ile-Tyr-Ala; CagA, cytotoxin-associated gene A; GC, gastric cancer; NGIS, normal gastrointestinal system; PG, patient group; OR, odds ratio. pattern of CagA was suggested to be involved in the pathogenesis of GC, as this pattern manifests important variations depending on the region (Argent et al., 2004(Argent et al., , 2005.The CagA protein is injected into host epithelial cells with its peptidoglycan b...

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