Enteric viruses are commonly found obligate parasites in the gastrointestinal (GI) tract. These viruses usually follow a fecal-oral route of transmission and are characterized by their extraordinary stability as well as resistance in high-stress environments. Most of them cause similar symptoms including vomiting, diarrhea, and abdominal pain. In order to come in contract with mucosal surfaces, these viruses need to pass the three main lines of defense: mucus layer, innate immune defenses, and adaptive immune defenses. The following atypical gastrointestinal infections are discussed: SARS-CoV2, hantavirus, herpes simplex virus I, cytomegalovirus, and calicivirus. Dysbiosis represents any modification to the makeup of resident commensal communities from those found in healthy individuals and can cause a patient to become more susceptible to bacterial and viral infections. The interaction between bacteria, viruses, and host physiology is still not completely understood. However, with growing research on viral infections, dysbiosis, and new methods of detection, we are getting closer to understanding the nature of these viruses, their typical and atypical characteristics, long-term effects, and mechanisms of action in different organ systems.

Amaranthaceae Juss. family encompasses many edible plants with prominent biological activity. This investigation tested the bioactive properties of ethanolic and methanolic extract of three well-known species: spinach (Spinacia oleracea L.), chard (Beta vulgaris L. subsp. vulgaris), and orache (Atriplex hortensis L.) through the determination of total phenolic and flavonoid content, antioxidant activity, and antibacterial properties. The particular goal was to evaluate the antibiofilm potential of extracts and to demarcate concentration-depending changes in the biofilm-forming category of included bacterial strains. The mass of the chard and orache methanolic extracts gained by maceration are lower in comparison to the mass of ethanolic extracts obtained by the Soxhlet method. In the case of spinach, the results are the opposite. All extracts have an antiradical activity that can be attributed to the established amounts of phenols and flavonoids. Total phenolics in dry leaves ranged from 0.09 to 0.44 mg GAE/g dw, and total flavonoids from 0.42 to 1.9 mg RTE/g dw. All investigated extracts performed inhibitory potential in terms of bacterial growth, while there was no bactericidal effect observed. Values of the minimum inhibitory concentration ranged from 125 µg/ml to 500 µg/ml. Overall results suggested orache extracts as the strongest inhibitory agents. Antibiofilm assays showed that examined extracts of spinach, chard, and orache caused changes in the biofilm-forming capacity of investigated bacterial pathogens. Fluctuations in observed biofilm-forming categories after application of extracts were concentration-dependent.

In recent years, it has been shown that gastrointestinal microflora has a substantial impact on the development of a large number of chronic diseases. The imbalance in the number or type of microbes in the gastrointestinal tract can lead to diseases and conditions, including autism spectrum disorder, celiac disease, Crohn’s disease, diabetes, and small bowel cancers. This can occur as a result of genetics, alcohol, tobacco, chemotherapeutics, cytostatics, as well as antibiotic overuse. Due to this, essential taxa can be lost, and the host’s metabolism can be severely affected. A less known condition called small intestine bacterial overgrowth (SIBO) can be seen in patients who suffer from hypochlorhydria and small intestine cancers. It is characterized as a state in which the bacterial population in the small intestine exceeds 105–106 organisms/mL. The latest examination methods such as double-balloon enteroscopy and wireless capsule endoscopy have the potential to increase the accuracy and precision of diagnosis and provide better patient care. This review paper aims to summarize the effect of the gastrointestinal environment on chronic disease severity and the development of cancers.

INTRODUCTION Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. METHODOLOGY In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children. RESULTS Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all). CONCLUSIONS Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.

Sweet cherry (Prunus avium L.) stems in the form of infusions and decoctions are traditionally consumed for diuretic and anti-inflammatory purposes. This study aimed to evaluate antimicrobial and antibiofilm activity of ethanolic and methanolic extract made from sweet cherry stems. Extracts are obtained by the Soxhlet extraction and maceration procedures. For the determination of the minimum inhibitory concentration, the broth microdilution method is employed, and the assessment of the microbiocidal activity of the extracts is conducted. The antibiofilm activity was tested through the tissue culture plate method, which also allowed the determination of the biofilm-forming categories of investigated strains. The final step involved the calculation of the biofilm inhibition percentage. Examined extracts with the balanced activity inhibited the growth of all microorganisms, with Gram-negative bacteria being more sensitive in comparison to Gram-positive. The values of the minimum inhibitory concentration were 125 µg/ml, and 250 µg/ml, respectfully. Candida albicans was the most susceptible and the minimum inhibitory concentration of both extracts was 62.50 µg/ml. The microbiocidal activity of the extracts was not recorded. Extracts exhibited different impacts on the biofilm-forming capacity of the investigated microbes, and both inhibition and stimulation effects are noted. The percentage of the biofilm inhibition was from 14.27% to 84.78%, with the highest inhibition recorded for the multidrug-resistant Escherichia coli, treated with the ethanolic extract. Sweet cherry stems are a valuable source of natural bioactive compounds, but their usage in the treatment of microbial infections should be correctly and carefully implemented.

The infection with SARS-CoV-2 virus in cats and dogs raised issue of human-to-animal transmission of SARS-CoV-2 in domestic pets in close contacts with their owners. Our study was designed to research this in the framework of Bosnia and Herzegovina. Using ELISA, AFIAS fluorescent immunoassay, RT-qPCR and WGS on Nanopore MinION platform with ARTIC Network Amplicon sequencing protocol for SARS-CoV-2, we showed that three out of thirteen dogs and one out of five cats from the households with confirmed human cases of COVID-19 in Bosnia-Herzegovina were infected with SARS-CoV-2. The high viral RNA load was detected in samples collected from a 4-year-old male Havanese (Ct = 12.52), a 6-year-old German Shepherd (Ct = 21.36) and a 9-year-old female American Staffordshire terrier (Ct = 25.74). The antibody response in dogs and one cat was observed. The viral genetic sequences from dogs were identical to the sequences detected in the owners suggesting the human-to-animal transmission of the virus. These findings, especially the low initial Ct values detected, from the public health perspective additionally stress the need for precautionary measures to protect both humans and animals.

Celiac Disease (CD) represents an immune-mediated disorder that involves the body’s inability to digest gluten prop-erly. After contact with gluten, patients of all ages might experience symptoms such as bloating, diarrhea, gas, growth issues

To the Editor—In a study of neutralizing antibodies for human coronavirus (HCoV) NL63 by Henss et al [1], the severity of coronavirus disease 2019 (COVID-19) appeared to be correlated with low HCoV-NL63 neutralizing activity, and patients with severe COVID-19 had no high-level NL63-neutralizing antibodies. However, some severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)– naive individuals analyzed in that study had high NL63-neutralizing antibodies, so the authors considered it worthwhile to explore the hypothesis that preexisting immunity to NL63 or other common cold coronaviruses might reduce the risk of severe disease. To examine this hypothesis, we tested for the presence of HCoV-NL63 antibodies, using the human antiHCoV-NL63 immunoglobulin G enzyme-linked immunosorbent assay kit produced by Creative Diagnostics. We tested 4 groups: individuals who were negative for SARS-CoV-2 (control group), those who tested negative even though they took care of family members with COVID-19 (high-risk contacts), patients with mild COVID-19, and patients with severe COVID-19. In the control group (negative for SARS-CoV-2), 3 of 42 individuals tested were positive for HCoV-NL63 antibodies. This is consistent with the presumed positivity in the general population. In highrisk contacts (individuals who took care of family members with COVID-19 but did not test positive for SARS-CoV-2), 6 of 8 tested positive for HCoV-NL63 antibodies. In the patients with mild COVID19 (score 1–3; no oxygen needed), 11 of 13 tested positive, while none of the 20 patients with severe COVID-19 (score 4–6; treated with supplemental oxygen) had serum positive for HCoV-NL63 antibodies. The scoring system is slightly modified from the recommendation made by the Clinical Characterisation and Management Working Group of the WHO Research and Development Blueprint Programme. These results strengthen the hypothesis that positive results for HCoV-NL63 antibodies indicate immunity from previous infection with HCoV-NL63, which may both protect individuals from infection with SARS-CoV-2 and protect infected individuals from progression to severe disease. Because the number of individuals in our study was small, we suggest that this finding should be confirmed in larger studies. One possible follow-up study would involve large numbers of individuals at high risk of infection. Notes

Amaç: İnterlökin-6’nın (IL-6) periodontal hastalık patogenezi ve periodontal doku yıkımındaki rolü geniş çapta ele alınmıştır. Çalışmanın amacı, evre IV periodontitis hastalarının tükürüklerindeki IL-6 seviyelerini değerlendirmektir. Gereç ve Yöntemler: Araştırmaya evre IV periodontitis teşhisi konulan 28 hasta ile 22 hastadan oluşan kontrol grubu dahil edildi. Hastaların tümü sistemik olarak sağlıklıydı. Tükürük örnekleri toplandı ve sondalama derinliği (SD), klinik ataşman seviyesi (KAS), papil kanama indeksi (PKİ), sondalamada kanama yüzdesi (SK %), plak indeksi (Pİ) ve diştaşı indeksini (Dİ) içeren klinik periodontal ölçümler kaydedildi. Her bir hastanın uyarılmamış tükürükleri, tükürük toplayıcı ile toplandı ve örneklerdeki IL-6 seviyesi enzim bağlı immünosorbent testi ile analiz edildi. Bulgular: Evre IV periodontitis hastalarının ortalama IL-6 değeri 22,18±5,96 pg/mL idi. Kontrol grubunun ortalama IL-6 değeri ise 2,23±2,17 pg/mL idi. Periodontitis Objective: The role of interleukin-6 (IL-6) in the pathogenesis of periodontal disease and tissue destruction at the periodontal site has been widely reported. This study aimed to evaluate the salivary IL-6 levels in patients with stage IV periodontitis. Materials and Methods: The study included 28 patients who were diagnosed with periodontitis stage IV and the control group of 22 periodontally healthy patients. All the patients were systemically healthy. Saliva samples were collected, and clinical periodontal measurements, including probing depth (PD), clinical attachment level (CAL), papilla bleeding index (PBI), the percentage of sites with bleeding on probing (BOP) %, plaque index (PI) and calculus index (CI), were recorded. The unstimulated saliva of each patient was collected by a saliva collector, and all samples were analysed using the enzyme-linked immunosorbent assay method for the detection of IL-6. Results: The mean value of salivary IL-6 in patients with periodontitis stage IV was 22.18±5.96 pg/mL. In the control group, the average measured value of IL-6 was 2.23±2.17 pg/mL. The periodontitis group had a significantly higher salivary IL-6 levels than the control group. A strong positive correlation was observed between the salivary IL-6 and clinical periodontal parameters (PD, CAL, PBI, BOP %, PI and CI) in patients with periodontitis stage IV (p<0.0001). Conclusion: We demonstrated a statistically significant relationship between periodontal parameters and salivary IL-6 in patients with periodontitis stage IV. New studies are needed to accurately establish salivary IL-6 potential as a biomarker for periodontal disease monitoring, including all stages and grades of periodontitis.