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To evaluate the serotype distribution and antibiotic resistance in pneumococcal infections in adults and to provide a perspective regarding serotype coverage of both current and future pneumococcal vaccines. This passive surveillance study was conducted with the Streptococcus pneumoniae strains isolated from the specimens of patients with pneumonia (materials isolated from bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015 and 2018. Serogrouping and serotyping were performed by latex particle agglutination and by conventional Quellung reaction using commercial type-specific antisera, respectively. The strains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilities by E-test. In the whole study group (410 samples from adults aged ≥18 years), the most frequent serotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15, PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillin non-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patients aged <65 and ≥65 years, respectively. About 21.1% and 4.3% of the patients with and without IPD had cefotaxime resistance. Non-susceptibility to erythromycin and moxifloxacin was 38.2% and 1.2%, respectively. The results revealed that novel PCV vaccines may provide improved coverage as compared with the currently available vaccine, PCV13. The significant antibiotic resistance rates imply the need to extend the serotype coverage of the vaccines. Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution and incidence changes of IPD cases in the population and to inform policy makers to make necessary improvements in the national immunization programmes. This multicentre study demonstrated the most recent serotype distribution and antibiotic resistance in adult population in Turkey. Shifting from PCV13 to novel conjugated vaccines will significantly increase the coverage. Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution changes and the incidence of cases with invasive pneumococcal disease in the population. [ABSTRACT FROM AUTHOR]

The Maçka subvolcanic intrusions (MSIs) in the eastern part of the Sakarya zone, northeastern Turkey, play a critical role in understanding the petrogenetic and geodynamic processes that took place during the growth of Late Cretaceous arc crust of this region. U–Pb zircon (79.97 ± 0.97 Ma) and two40Ar–39Ar amphibole ages (average 81.37 ± 0.5 Ma) indicate that the MSIs were emplaced in Late Cretaceous (Campanian) time into the coeval volcanic rocks. A slightly younger zircon fission track (FT) age (73 ± 9 Ma) points to a rapid exhumation and cooling after crystallization. The intrusions are observed in areas less than 1 km2in the field and contain abundant mafic microgranular enclaves (MMEs). The host rocks (HRs) are entirely composed of tonalite (SiO2 = 63–65 wt.%, Mg# = 43–52), and the MMEs are gabbro-diorite in composition (SiO2 = 53–57 wt.%, Mg# = 45–48). Both the HRs and the MMEs are I-type, high-K calc-alkaline in composition and display a metaluminous character. They are characterized by geochemical features typical for magmas of subduction-related environments. Chondrite-normalized REE patterns are moderately fractionated [(La/Yb)N = 6–11] and display slightly negative Eu anomalies (Eu/Eu* = 0.7–0.9), with weak concave-upward REE patterns, suggesting that amphibole fractionation played a role during their evolution. The MMEs have slightly differentISr(0.7081–0.7085) and εNd(−5.0 to −5.4) values compared with those of their HRs (ISr = 0.7084–0.7087 and εNd = −5.7 to −6.9), indicating that variable amounts of crustal and mantle components were involved in the generation of parental magma to these rocks. All of these data, combined with those of previous regional studies, suggest that the MSIs are hybrid in origin, produced by the mixing of enriched lithospheric mantle- and lower crust-derived melts in an extensional arc setting that was caused by slab rollback. [ABSTRACT FROM AUTHOR]

Early Eocene adakitic volcanic and granitoid rocks are widespread in the Eastern Pontides of NE Turkey, providing significant constraints for the early Cenozoic tectonomagmatic evolution of the region. These adakitic rock units exhibit relatively high Sr/Y and La/Yb ratios, but low Y and Yb values, similar to modern adakites generated by partial fusion of a subducted oceanic slab. They also have high K2O and low MgO contents, and show moderately enriched ISrand low ϵNd(t) isotopic signatures. Our trace element modelling suggests that these adakitic magmas were generated from partial melting at low pressures of a garnet-bearing amphibolitic source in the continental lower crust. This lower crustal melting resulted from slab break off-induced asthenospheric upwelling and related magmatic underplating beneath the Eastern Pontides. We interpret this melting event and the adakitic magmatic activity as a syn- to post-collisional process involving early Cenozoic collision of the Pontide and Anatolide–Tauride continental blocks. The geochemical and tectonic constraints presented here indicate that early Eocene adakitic magmatism in the Eastern Pontides did not result from partial fusion of a subducted oceanic slab, but instead represent continental-type adakite formation. [ABSTRACT FROM AUTHOR]

Describes a case of helicobacter heilmannii-associated gastritis in a male patient. Case history; Clinical findings; Diagnosis; Treatment.