Chronic hepatitis B (CHB) is a global health problem that can result in serious complications associated with collagen degradation. Prolidase is a specific imidodipeptidase that plays an important role in the breakdown of collagen. The aim of this study was to investigate prolidase activity and oxidant–antioxidant status in children with CHB. This prospective case control study includes 38 patients with CHB, 31 patients with inactive hepatitis B (IHB), and 29 healthy matched control subjects. Serum prolidase enzyme activity (SPEA), total antioxidant capacity (TAC), total oxidative activity (TOA), and malondialdehyde (MDA) level were measured and oxidative stress index (OSI) was calculated for each group. Patients with CHB had significantly higher SPEA levels (207.82 ± 186.80 IU/L) than did the controls (58.6 ± 38.1 IU/L) and IHB patients (67.1 ± 39.9) (p < 0.001). CHB patients also had significantly higher TOA (45.0 ± 19.9 vs. 29.4 ± 11.7 (μmolH2O2 Eq./L), p = 0.005), OSI (33.1 ± 21.4 vs. 17.5 ± 10.2, p = 0.002) and MDA (13.4 ± 4.0 vs. 7.8 ± 2.6 μm/L, p < 0.001) values compared with the controls. TOA (32.0 ± 10.0) and OSI (15.4 ± 11.0) values of IHB patients were significantly lower than those of CHB patients (p < 0.05). SPEA had significant correlations with HBV- DNA and ALT values (r =0.514 and r =0.454, p < 0.001). Our results suggest that prolidase activity can be considered as a reliable marker for CHB and increased oxidative stress appears to be related to chronicity of the disease.

Objective: The objective of this study was to evaluate the demographic, clinical, laboratory, and microbiological features of ventriculoperitoneal shunt (VPS) infections through a 13-year retrospective study. VPS bacterial agents and their antibiotic susceptibility were also investigated through the occurrence of single VPS (SVPS) and recurrent VPS (RVPS) infections. Methods: This study included 110 patients with SVPS infections and 55 patients with RVPS infections. Results: In patients who developed multiple infections, Gram-negative organisms were found to be the most predominant (60%, 54/90). The resistance rates were 85.2% for third-generation cephalosporins (3GCs), 83.3% for piperacillin–tazobactam, and 10.4% for carbapenem. Of the patients in the SVPS infection group, 49% were treated with combinations with carbapenem; of the patients in the RVPS infection group, 84.4% were treated in the same way. Central nervous system (CNS) tuberculosis as the etiology of hydrocephalus; short duration of antibiotics used for treatment; high cerebrospinal fluid (CSF) protein and blood C-reactive protein (CRP) levels; and prolonged use of prophylactic antibiotics were found to be related to an increased rate of recurrent infection occurrence. A two-stage shunt change approach decreased the risk of recurrent infections. Conclusions: Based on the findings of our study, it is essential to closely monitor patients with independent risk factors for RVPS infection development, due to the high rates of resistant Gram-negative bacterial growth and the initiation of empirical antimicrobial treatment with glycopeptide plus carbapenem. Certain treatment options, such as 3GCs plus glycopeptide, should be revised based on clinical progress and microbiological culture results.

Objective: Coronavirus disease 2019 (COVID-19) is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress and preterm delivery are the two major complications induced by SARS-CoV-2 infection during pregnancy. In the presence of dyspnea, the use of systemic corticosteroids was recommended in pregnant and non-pregnant groups. Our primary aim was to investigate the effect of early-onset steroid treatment on mortality and adverse effects in pregnant women with COVID-19. Our secondary aim was to investigate the effect of steroid treatment on the length of hospital stay and intensive care unit (ICU) stay, and duration of treatment. The study also investigated infection, preterm birth, and ideal body weight (lbw) in newborns. Methods: In this retrospective study, 253 patients were divided into three groups according to steroid administration. In Group 1 patients (n:112), treatment was started at the time of hospitalization. In Group 2 patients (n:90), treatment was started at least 24 h after hospitalization. Group 3 consisted of patients (n:51) who did not receive steroid treatment. Methylprednisolone (32 mg/day) was given to pregnant patients with a gestational age below 24 weeks or above 34 weeks, and dexametazone (6 mg/day) was given in four doses followed by 32 mg/day methylprednisolone for the others (whose baby was at a gestational age of 24 weeks and above but less than 34 weeks). Result: The hospital stay, ICU stay, and steroid administration time were significantly lower in the Group 1 when compared to the others (p < 0.05). The steroid treatment requirement was 4.4 days in Group 1 and 5.7 days in Group 2 (p < 0.05). While no death was observed in Group 1, one patient died in Group 2 and three patients died in Group 3. There was no difference between the groups in terms of complications, including preterm labor. Conclusions: No death was also observed with early-onset treatment. Early-onset treatment may be beneficial for fewer hospitalizations, fewer ICU stays, and less mechanical ventilation requirement in pregnant women with COVID-19. In addition, with early treatment, the total number of steroid administration days was reduced, which is important in terms of reducing the risk of side effects.