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Öğe Evaluation of the efficacy of heat shock protein inhibitors and antifungal drug combinations against Candida spp.(Springer-Verlag Italia Srl, 2023) Kiraz, Nuri; Kaya, Sümeyye Sen; Öz, Yasemin; Dağ, İlknurCandida species are one of the predominant causes of fungal infections and show drug-resistant infections in immune-compromised individuals. Simultaneous targeting of existing antifungal drugs with heat shock protein 90 (Hsp90) inhibitors may be an approach that increases the efficacy of antifungal drugs. Also, since most of the patients at risk for invasive fungal infections use these anticancer or immunosuppressive drugs, synergistic interaction in combination treatment can reduce the dose of antifungal drugs and create an alternative for the toxicity problem. In this study, in vitro efficacy of commonly used antifungals (amphotericin B, caspofungin, itraconazole, voriconazole, and fluconazole) in combination with four heat shock protein inhibitors geldanamycin, 17-allylamino-17-demethoxygeldanamycin, radicicol, and novobiocin against 30 clinical Candida isolates (C. albicansn = 13, C. krusein = 7, and C. glabratan = 10) were evaluated by time kill and checkerboard methods. The significant synergistic interaction determined especially in the combinations of geldanamycin with antifungal drugs suggests that substances with inhibitory effects on Hsp90 increase the effectiveness of antifungals or reduce the antifungal resistance. Although Hsp90 inhibitors alone did not have any significant antifungal activity, they did not show adverse interactions in combination with antifungals, and at some concentrations, they increased the effectiveness of the antifungals. These in vitro results have been found promising for the development of new therapeutic approaches in the treatment of invasive fungal infections. However, detailed studies are needed.Öğe COVID-19 PANDEMİSİNDE SAĞLIK SİSTEMLERİ: PORTEKİZ ÖRNEĞİ(2022) Tokuç, BurcuKoronavirüs hastalığı 2019 (COVID-19), 2 Mart 2020’den beri Portekiz’i de etkilemeye başlayan dünya çapında bir salgın oluşturmuştur. Ciddi komplikasyonlara ve ölüme neden olan ve son derece bulaşıcı olan hastalık tüm dünyada sağlık sistemlerinin kapasitesini zorlamış, sistemleri kırılma noktasına getirmiş ve halk sağlığında uzun süredir devam eden boşlukları ortaya çıkarmıştır. Halen, tüm dünyada enfeksiyonun yıkıcı etkilerine karşı yeni önlemler için çalışmalar devam etmektedir. Bu yazıda, Portekiz’de COVID-19 salgını, sağlık sistemi içinde salgınla baş etme çalışmaları ve yapılan müdahalelerin incelenmesi amaçlanmıştır.Öğe Novel zinc oxide nanoparticles of Teucrium polium suppress the malignant progression of gastric cancer cells through modulating apoptotic signaling pathways and epithelial to mesenchymal transition(Elsevier, 2023) Bozgeyik, İbrahim; Ege, Miray; Temiz, Ebru; Erdal, Berna; Koyuncu, İsmail; Temiz, Cengiz; Bozgeyik, EsraManagement of gastric cancer is still challenging due to resistance to current chemotherapeutics and recurrent disease. Moreover, green-synthesized zinc oxide nanoparticles (ZnO-NPs) using natural resources are one of the most promising therapeutic agents for anticancer therapy. Here we report the facile green synthesis and char-acterization of ZnO-NPs from Teucrium polium (TP-ZnO-NP) herb extract and the anticancer activities of these nanoparticles on gastric cancer cells. Facile green synthesis of TP-ZnO-NP was achieved using zinc acetate dihydrate. For the characterization of TP-ZnO-NP, UV-vis spectroscopy, FTIR, SEM, XRD and EDX analyses were performed. Antiproliferative and anticancer activities of TP-ZnO-NP were explored using the HGC-27 gastric cancer cell line model. MTT cell viability and colony formation assays were used for the analysis of cell pro-liferation and migration. Wound healing assay was used to analyze the migration capacities of cells. Annexin V/ PI double staining, DNA ladder assay, and Acridine orange/Ethidium bromide staining were performed to analyze the induction of apoptosis. qPCR was used to determine gene expression levels of apoptotic and epithelial to mesenchymal transition marker genes. The aqueous extract of TP served as both a reducing and capping agent for the successful biosynthesis of zinc oxide nanoparticles. Remarkably, synthesized TP-ZnO-NPs were found to have significant antiproliferative and anticancer activities on HGC-27 gastric cancer cells. Collectively, current data suggest that TP-ZnO-NP is a novel and promising anticancer agent for future therapeutic interventions in gastric cancer.Öğe Urothelial bladder cancer immunotherapy strategies(Nova Science Publishers, Inc., 2020) Batar, Bahadır; Güven, M.Bladder cancer is a highly heterogeneous malignant disease and is associated with various molecular characteristics and distinctive clinical outcomes. Bladder cancer is one of the most important health problems due to its incidence, increased risk of recurrence and failure in therapy. For locally advanced and metastatic urothelial bladder cancer patients, the current standard treatment involves platinum-based combination chemotherapy. Nevertheless, up to half of the patients are refractory or ineligible for platinum-based chemotherapy and also toxicity is significant. Recent advances in molecular and genetic studies have revealed new insights into the predictive and prognostic biomarkers and potential therapeutic targets of bladder cancer. Immunotherapy is a novel promising targeted therapy for cancer treatment. Several approaches contributing to tumor recognition and cell death by the immune system have been adopted in oncology, such as immune checkpoint inhibitors, monoclonal antibodies, tumor vaccines, small molecules, and chimeric antigen receptor T-cells (CAR-T cells). The most frequently used form of immunotherapies are immune checkpoint inhibitors. Especially, immunecheckpoint blockade therapy provides rapid and durable antitumor responses in malignancies including bladder cancer. Immune-checkpoint inhibitors are key regulators of the adaptive immune system and promote anti-tumor activity by targeting the pathways which cancer cells exploit to escape from the host immune system. The approved cytotoxic T-lymphocyte-associated protein-4 (CTLA-4), programmed cell death 1 (PD1) and programmed death ligand 1 (PDL1) checkpoint inhibitors have shown improved clinical efficacy in patients with metastatic platinum-refractory urothelial bladder cancer. However, most patients are not responsive to such treatment strategies. Further preclinical and clinical research is ongoing to improve new combinational immunotherapy strategies for patients with bladder cancer. © 2020 by Nova Science Publishers, Inc. All rights reserved.Öğe Aortic ischemia-reperfusion injury and potency of fluoxetine(Mashhad Univ Med Sciences, 2023) Altan, Mehmet; Yaman, Muhittin Onur; Kervancıoğlu, Gülnaz; Kılıç, Aysu; Demirci, Elif Kervancıoğlu; Polat, Sila Hidayet Bozdoğan; Karadeniz, ZelihaObjective(s): Due to cross-clamping of the aorta during aortic aneurysm surgeries, ischemia-reperfusion (IR) develops, and it may cause damage to the aorta itself or even to remote organs by oxidative stress or inflammation. Fluoxetine (FLX) which might be used in the preoperative period for its tranquilizing effect also has antioxidant effects in short-term use. The purpose of our study is to examine whether FLX protects aorta tissue, against the damage caused by IR. Materials and Methods: Three groups of Wistar rats were formed randomly. 1) Control group (sham -operated), 2) IR group (60 min ischemia+120 min perfusion), and 3) FLX+IR group (FLX dose was 20 mg/kg for 3 days IP before IR). At the end of each procedure, aorta samples were collected, and oxidant-antioxidant, anti-inflammatory, and anti-apoptotic status of the aorta were evaluated. Histological examinations of the samples were provided. Results: Levels of LOOH, MDA, ROS, TOS, MPO, TNF alpha, IL-1 beta, IL-6, NF-kB, MMP-9, caspase-9, 8-OHdG, NO, and HA were found to be significantly increased in the IR group compared with control (P<0.05) and SOD, GSH, TAS, and IL-10 levels were significantly lower (P<0.05). FLX significantly decreased LOOH, MDA, ROS, TOS, MPO, TNF alpha, IL-1 beta, IL-6, NF-kB, MMP-9, caspase-9, 8-OHdG, NO, and HA levels in the FLX+IR group compared with IR group (P<0.05) and increased IL-10, SOD, GSH, and TAS (P<0.05). FLX administration prevented the deterioration of aortic tissue damage. Conclusion: Our study is the first study that demonstrates FLX-mediated suppression of IR injury in the infrarenal abdominal aorta by antioxidant, anti-inflammatory, and anti-apoptotic properties.Öğe Protective effects of melatonin receptor agonists on endotoxin- induced uveitis in rats(Mashhad Univ Med Sciences, 2023) Yüksel, Tuğba Nurcan; Yayla, Muhammed; Köşe, Duygu; Halıcı, Zekai; Bozkurt, Erdinç; Toktay, ErdemObjective(s): Melatonin has an important role in regulating a variety of physiological functions of the body. We investigated the protective effects of Agomelatine (AGO) and Ramelteon (RAME) on Endotoxin-Induced Uveitis (EIU) in rats. Materials and Methods: 70 rats were randomly divided into fourteen groups. Healthy group normal saline, (IP), Uveitis group (200 pg/kg lipopolysaccharide (LPS), SC), DEX group (200 pg/kg LPS plus 1 mg/kg dexamethasone, IP), AGO20 group received 200 pg/kg LPS plus 20 mg/kg AGO, AGO40 group received 200 pg/kg LPS plus 40 mg/kg AGO, RAME2 group received 200 pg/kg LPS plus 2 mg/kg RAME, and group RAME4 received 200 pg/kg LPS plus 4 mg/kg RAME. Each group had two subgroups: the 3rd and 24th hour. The eye tissues were collected and investigated biomicroscopically (clinical manifestations and scoring, molecularly(qRT-PCR analyses of Tumor Necrosis Factor-alpha (TNF-alpha), vascular endothelial growth factor(VEGF), and Caspase 3 and Caspase 9 mRNA expression), biochemically (Superoxide dismutase activity, Glutathione, and Malondialdehyde levels) and histopathologically (staining with Harris Hematoxylin and Eosin Y). Results: Melatonin receptor agonist treatment reduced the clinical score count of ocular inflammation in the uveitic rats. TNF-alpha, VEGF, Caspase 9, and Caspase 3 levels markedly decreased in the uveitic rats. Melatonin receptor agonists significantly ameliorated fixed changes in GSH, SOD, and MDA levels. Melatonin receptor agonists also ameliorated histopathological injury in eye tissues associated with uveitis. Conclusion: Melatonin receptor agonists ameliorated the inflammatory response in EIU. These findings suggest that melatonin receptor agonists may represent a potential novel therapeutic drug for uveitis treatment.Öğe Use of Complementary Therapy in Lung Cancer Patients Treated with Chemotherapy and its Effect on Survival: A Cross-sectional Study(Galenos Publishing House, 2023) Çavdar, Eyyüp; Karaboyun, K.; İriağaç, Yakup; Avcı, Okan; Seber, Erdoğan SelçukAim: Complementary therapies are being increasingly preferred in patients receiving anticancer therapy to strengthen the effect of chemotherapy and control cancer-related symptoms. In this study, we investigated the prevalence of complementary therapy (CT), the factors associated with its use, physician-patient information sharing about CT use, and the effect of CT on the survival and treatment process in lung cancer patients receiving chemotherapy. Methods: This study was designed as a cross-sectional study including patients who underwent chemotherapy for lung cancer between November 2020 and March 2022 in the department of medical oncology at Tekirdag Namik Kemal University. A structured questionnaire with twenty questions was used. Fluor-18-fluorodeoxyglucose positron emission tomography/CT, and brain magnetic resonance imaging were used to stage the patients. The stages were grouped as early (stages 1B-3A) and advanced (stages 3B-4A). Results: A total of 242 patients included in the study. One hundred and forty-seven (60.7%) patients reported using at least one type of CT since the first diagnosis. “Families/relatives” (n=128; 63.7%) and “other patients” (n=67; 33.3%) were the primary sources from which patients obtained CT information. The most widely used CT methods were recorded as phytotherapy (79.6%) and apitherapy (59.2%). 125 (85%) of the patients said that they used CT to support their existing anticancer treatments. Of the patients using CT, 94 (63.9%) stated that they did not disclose their use of CT to their physicians. The majority of patients stated that their physicians did not inquire about using CT. In the cox regression analysis performed to determine survival benefit, no survival benefit from the use of CT was determined (hazard ratio=0.86, p=0.495). In the subgroup analysis, the use of CT was associated with survival in early-stage patients, but no survival relationship was found in advanced-stage patients (log-rank p=0.027 and p=0.842, respectively). Conclusion: The use of CT in conjunction with medical treatment is common among patients with lung cancer. The influence of the oncologist in guiding the use of CT in cancer patients is weak. Additionally, the use of CT does not provide benefits in terms of survival. © 2023 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.Öğe Aortic Injury via Ischemia Reperfusion and the Preventive Role of Fluoxetine(Wiley, 2023) Yaman, Muhittin Onur; Altan, Mehmet; Kervancıoğlu, Elif Demirci; Kılıç, Aysu; Kervancıoğlu, Gülnaz; Polat, Sila Hidayet Bozdoğan; Karadeniz, Zeliha[Abstract Not Available]Öğe ATYPICAL CT FINDINGS AND CLINICAL CORRELATION OF COVID-19 PNEUMONIA(2020) Özçağalayan, Ömer; Gücer Şahin, Gülcan; Kurtoğlu Özçağalayan, Tuğba İlkem; Sasanı, Hadi; Şahin, AyhanAim: Our study aimed to evaluate the atypical CT findings and concomitant pathologies of COVID-19 pneumonia and clinical and laboratory findings and compare them with typical CT findings.Materials and Methods: A total of 69 patients were diagnosed with COVID-19, 14 of which were atypical (20.2%), and 55 of which were typical (79%) chest computed tomography (CT) findings. CT images and clinical and laboratory data of patients with atypical findings were retrospectively analyzed. Lesions of the typical and atypical group and CT severity scores were compared.Results: Atypical CT findings were centrilobular nodule, tree in bud, pleural effusion, lobar/segmental consolidation, bronchiectasis, pulmonary embolism, and mosaic attenuation by typical lesions with ground-glass opacity with/without consolidation. CT severity score was significantly higher in the atypical group (p <0.001). CRP, procalcitonin, the neutrophil rate increased, and the lymphocyte count decreased in patients with a high CT severity score. Comorbidity was common in the atypical group (50%).Conclusion: High CT severity score and widespread lung involvement of the patient group with atypical CT findings may be due to disease progression or other concomitant diseases. Atypical lesions accompanying typical lesions may cause false negativity in reporting. As radiologists' experience with COVID-19 pneumonia increases, it may improve that they categorize these images as typical or atypical.Öğe Visceral to subcutaneous fat ratio predicts short-term mortality in patients with Covid 19. A multicenter study(British Institute of Radiology, 2023) Surov, A.; Thormann, M.; Kardaş, H.; Hinnerichs, M.; Omari, J.; Cingöz, E.; Cingöz, M.; Chousein, O.; Sasani, Hadi; Gönen, Korcan AysunObjective: To evaluate the association of body composition parameters with outcomes in Covid-19. Methods: 173 patients hospitalized for Covid-19 infection in 6 European centers were included in this retrospective study. Measurements were performed at L3-level and comprised skeletal muscle index (SMI), muscle density (MD), and adipose tissue measurements [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), visceral-to-subcutaneous-adipose-tissue-area-ratio (VSR)]. The association with mortality, the need for intubation (MV), and the need for admission to ICU within 30 days were evaluated. Results: Higher SAT density was associated with a greater risk of MV (OR = 1.071, 95%CI=(1.034;1.110), p < 0.001). Higher VAT density was associated with admission to ICU (OR = 1.068, 95%CI=(1.029;1.109), p < 0.001). Higher MD was a protective factor for MV and ICU admission (OR = 0.914, 95%CI=(0.870;0.960), p < 0.001; OR = 0.882, 95%CI=(0.832;0.934), p = 0.028). Higher VSR was associated with mortality (OR = 2.147, 95%CI=(1.022;4.512), p = 0.044). Male sex showed the strongest influence on the risk of ICU admission and MV. SMI was not associated with either parameter. Conclusion: In patients hospitalized for Covid-19 infection, higher VSR seems to be a strong prognostic factor of short-term mortality. Weak associations with clinical course were found for MD and adipose tissue measurements. Male sex was the strongest prognostic factor of adverse clinical course. Advances in knowledge: VSR is a prognostic biomarker for 30-day mortality in patients hospitalized for Covid-19 disease. © 2023 The Authors.Öğe The role of NMDA glutamate receptors in lung injury caused by chronic long-term intermittent hypobaric hypoxia(Assoc Bras Divulg Cientifica, 2023) Yaman, Muhittin Onur; Sönmez, O. F.; Ekiz-Yılmaz, T.; Sönmez, D.; Meydanlı, E. E. G.; Güner, İbrahim; Şahin, G.Chronic intermittent hypoxia (CIH), a component of sleep apnea-hypopnea syndrome, is suggested to cause damage to lung tissue, and the role of glutamate is not well studied. We used a chronic long-term intermittent hypobaric hypoxia (CLTIHH) model of rats to find out if such procedure causes lung injury and the potential effect of N-methyl-D-aspartate receptors (NMDARs) by using receptor antagonist MK-801 (dizocilpine). Thirty-two rats were placed into four groups; a control and three CLTIHH groups where rats were placed into a low-pressure chamber set to 430 mmHg for 5 h/day, 5 days/week, for 5 weeks. Only one group received MK-801 (0.3 mg/kg, ip) daily. We evaluated tumor necrosis factor (TNF)-a, interleukin (IL)-6, IL-10, and nuclear factor (NF)-kB for the inflammatory process, superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT), glutathione peroxidase (GPX), total antioxidant status (TAS), and total oxidant status (TOS) for oxidative stress, and caspase-9 levels. Blood plasma, bronchoalveolar fluid (BALF), and lung tissue extracts were evaluated. Both oxidant and inflammatory parameters were significantly increased in all the mediums of the CLTIHH groups except the group that received MK-801. Significant evidence was collected on MK-801 alleviating the effect of CLTIHH. Histological evaluations revealed lung damage and fibrotic changes in the CLTIHH groups. It was first shown that the CLTIHH procedure caused chronic lung injury, and that inflammation and oxidant stress were influential in the formation of lung injury. Secondly, NMDAR antagonist MK-801 effectively inhibited the development of lung injury and fibrosis.Öğe Approach to Breast Cancer Treatment in Elderly Patients(Ortadogu Reklam Tanitim & Yayincilik, 2020) Seber, Selçuk; Çabuk, Devrim; Başaran, GülOld age should be carefully evaluated before the treatment of all kinds of diseases, not only chronologically but also in functional terms. Regardless of the stage of breast cancer, it is known that older patients benefit from standard treatments as much as younger patients to the extent that they are represented in clinical trials, but we also know that toxicity is augmented in this age group. The elderly patient group is a very heterogeneous group within itself, and it is important to separate the healthier, more fit elderly group who will benefit from standard treatments from the group that can only receive standard treatment with some rehabilitation. In addition, it is one of the most important duties of the clinician to identify patients who cannot tolerate both standard and modified treatments before initiation of the cancer treatment. Today, although there are several Comprehensive Geriatric Evaluation tools which are developed for aiding the clinician for making treatment decisions, most of the elderly patients are not properly evaluated in the busy day to day clinical practice. As an alternative,parameters such as patients daily work, social enviorment, prescirbed medicines for other comorbidities, and the potential side effects of the recommended treatment should be carefully reviewed. The validity of the treatment decisions taken at the start of the treatment should be re-evaluated at each visit and if necessary, modifications should be made to maximize benefit with the least toxicity.Öğe Torasemide Improves the Propionic Acid-Induced Autism in Rats: A Histopathological and Imaging Study(Aves, 2023) Doğan, Murat; Albayrak, Yakup; Erbaş, OyutunObjective: Autism spectrum disorder is a neurodevelopmental disease in which impaired social behaviors, impaired sociality, and restricted and repetitive behaviors are seen. Bumetanide is a loop diuretic that inhibits Na+-K+-2Cl(-) cotransporter 1 and it is currently used in clinical phase studies in patients with autism spectrum disorder. In present research, it is purposed to demonstrate the beneficial effects of torasemide which is another Na+-K+-2Cl(-) cotransporter 1 inhibitor on an experimental autism model induced with propionic acid by providing imaging and brain tissue investigations. Methods: Male Wistar rats were used in the present study (n = 30). Propionic acid of 250 mg/kg/day was administrated intraperitoneally in rats to induce autism for 5 days. Three groups were created for present study as follows: group 1, normal control (n = 10); group 2, propionic acid and saline given group (n = 10); group 3, propionic acid + torasemide -administrated group (n = 10). Results: Torasemide group scored higher on behavioral tests compared to saline group. The brain levels of malondialdehyde, tumor necrosis factor-alpha, interleukin-2, interleukin-17, and Nuclear Factor kappa B (NF-kappa B), Glial fibrillary acidic protein (GFAP) were remarkably higher in propionic acid + saline group. In histopathology assessments, torasemide group had higher neuronal count of Cornu Ammonis 1, neuronal count of Cornu Ammonis 2 in hippocampus, and Purkinje cells in cerebellum. GFAP immunostaining index (Cornu Ammonis 1) and cerebellum were lower in torasemide group. Magnetic resonance spectroscopy revealed that mean lactate value was higher in propionic acid + saline group compared to torasemide group. Conclusion: Our experimental results showed that torasemide might enhance gamma-aminobutyric acid activity. Torasemide can be considered another promising Na+-K+-2Cl(-) cotransporter 1 inhibitor in the treatment of autism with a longer half-life and less side effects after further studies.Öğe Impaired vascular function induced by aging: Role of irisin and perivascular adipose tissue(Marmara University, 2023) Özdemir-Kumral, Z.N.; Bülbül, Ahmet Murat; Çilingir-Kaya, O.T.; Kurtel, H.The aim of the study is to explain the possible effects of exercise-induced novel peptide irisin on endothelial function accompanied by perivascular adipose tissue (PVAT) in aortas of both natural aging and D-galactose (D-Gal) aging mimetic rats. Female Sprague-Dawley rats were randomly divided into 6 groups (n=10/per group): sedentary young group (SY), exercised young group (EY), sedentary aging group (SA), exercised aging group (EA), sedentary D-Gal (300 mg/kg/day, i.p., 9 weeks) induced aging group (S+D-Gal), exercised D-Gal induced aging group (E+D-Gal). Cardiac and aortic samples were collected for biochemical and histopathological examinations. The aortas were taken for contractile response studies in the absence or presence of perivascular adipose tissue (PVAT-/+). The levels of irisin in both plasma and PVAT were detected. Regardless of the models the vaso-relaxant effects of irisin were shown alone and age-related vascular dysfunction has also been recorded compared to the SY group these age-related impaired irisin responses were found to be improved by regular exercise. The plasma and PVAT irisin levels were decreased by aging and exercise reversed this decrement which is verified by the immune expression of irisin in aortic and PVAT tissues. Our results show the differences in vascular function and PVAT in aging and the contribution of PVAT to the response of irisin with exercise in two different aging models. © 2023 Marmara University Press.Öğe Effects of Chronic Oral Monosodium Glutamate Consumption on Naloxane-Induced Morphine Withdrawal in Infant Rats(2022) Yananlı, Hasan Raci; Yıldız, Merve; Temel, Hasan; Kılınç, Melih; Özen, Berna; Demirkapu, Mahluga Jafarova; Kutluay, Sena NurAim: The aim of this study was to investigate chronic oral monosodium glutamate (MSG) consumption effects on symptoms of withdrawal, locomotor activity, and anxiety in morphine withdrawal syndrome induced by naloxone in infant rats. Materials and Methods: Twelve 21-day-old male Wistar rats used in the study. Infant rats were given unlimited access to saline (control group) or MSG (MSG group) added to drinking water for 32 days. Withdrawal was induced by naloxone in morphine-dependent rats. Evaluation of withdrawal symptoms and anxiety were performed simultaneously with locomotor activity measurements. Results: Withdrawal sings, such as jumping, wet dog shake, and weight loss; stereotypic, ambulatory, and vertical locomotor activity movements; central, peripheral, and total activities used in the assessment of anxiety in infant rats with naloxone-induced withdrawal syndrome that consumed oral MSG for 32 days were not different from the control group. Conclusion: These findings obtained in our study indicate that chronic consumption of oral MSG in infant rats whose blood-brain barrier has not yet developed does not affect morphine dependence and naloxone-induced withdrawal. Further studies are needed to investigate the mechanism of action of orally administered MSG.Öğe Tıbbi Biyokimya Uzmanlarının 1 Yıllık Covid-19 Pandemi Serüveni(2021) Çelikkol, AliyeAmaç: Devam eden koronavirüs hastalığı-2019 (COVID19) pandemisinde tıbbi biyokimya laboratuvarlarının önemi daha da artmıştır. Bu çalışmadaki amaç 2020 mart ayından 2021 mart ayına kadar 1 yıllık süreçte tıbbi biyokimya uzmanları ve tıbbi biyokimya laboratuvarlarının mevcut durumunu ortaya koymaktır. Materyal ve Metod: Hazırlanan anket internet aracılığı ile katılımcılara gönderilerek cevapları değerlendirilmiştir. Bulgular: Ankete katılan 210 tıbbi biyokimya uzmanından %32,4’ü erkek %67,6’sı kadın ve %62,2’si 40-60 yaş grubunda olup %47,8’si 11-20 çalışma yılındadır. En fazla katılım Marmara bölgesinden olup %78,6 kamu, %21,4 özel laboratuvarlarda çalışmaktaydı. Birlikte çalışan 2-5 uzmanın olduğu %46,4 kişi vardı. Pandemi kliniklerinde görev alan %46,4 uzman olmuş ve %42,3 tek uzman olduğundan devamlı görevde bulunmuştur. Katılımcıların %19,2’si COVID-19 hastalığı geçirmiş, aşılanan %92,3 uzman vardır. Polimeraz zincir reaksiyon (PCR) test çalışmalarına destek veren %20,4 tıbbi biyokimya uzmanı olmuştur. Sonuç: Tıbbi Biyokimya laboratuvarlarının salgınlara en hazırlıklı birimler olduğu ve gereken yönetsel becerileri derhal hazırlıklı bir şekilde uygulamaya koymuş olan tıbbi biyokimya uzmanlarının COVID-19 pandemi dönemindeki aktif rolü gözler önüne serilmiştir. Hekim olarak pandemi servis ve polikliniklerinde çalışarak ekiplere destek vermiş ve gerektiğinde verebileceklerini de ortaya koymuşlardır. Havalandırma, kişisel koruyucu ekipman, malzeme temini, katsayı eşitsizliği gibi sorunlar yaşanmasına rağmen, kliniklerle iş birliği, genel bilgilendirme, rehberlerin hazırlanması, numune transferleri eğitimleri tıbbi biyokimya uzmanları tarafından sağlanmıştır.Öğe Static Postural Control Data Analysis in Patients with Ankylosing Spondylitis(Erciyes Univ Sch Medicine, 2023) Karahan, Menekşe; Parlak, Muhammed; Kayatekin, Ayşe Zeynep Yılmazer; Uluçam, Enis; Taştekin, NurettinObjective: The goal of our study was to determine how ankylosing spondylitis, a chronic inflammatory disease, affected patient's balance.Materials and Methods: Thirty-one healthy volunteers and thirty-five patients with ankylosing spondylitis and no comor-bidities affecting their balance participated in the study. Bipedal balance analysis was performed with the subjects' eyes open and closed in each group. The position of the center of pressure during the measurement was evaluated.Results: The mediolateral deviation of the center of pressure (p=0.035) and the total path length (p=0.042) were signifi-cantly higher in the patient group when measured with eyes open. PL was significantly longer in the patient group when measured with eyes closed (p=0.002).Conclusion: We observed that ankylosing spondylitis negatively affected the balance in patients. Since this disease usually occurs in the young population, it should be taken into consideration that balance impairment can complicate daily life, espe-cially in the professional world. Therefore, it can be useful to consider the balance disorder in the treatment, and the patients should be monitored for an extended period.Öğe Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment(Turkish Neuropsychiatric Society, 2023) Terzi, M.; Helvacı, E.M.; Şen, S.; Boz, C.; Çilingir, V.; Akçalı, A.; Beckmann, Y.; Ünal, AysunIntroduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient. © 2023, Turkish Neuropsychiatric Society. All rights reserved.Öğe Difficulties in emotion and social support in people with epilepsy: relationship with depression levels(Cukurova Univ, Fac Medicine, 2022) Altunan, Bengü; Ünal, AysunPurpose: In this study, we aimed to examine the relationship between depression level, emotion regulation difficulties and social support in individuals with epilepsy. Materials and Methods: Neurological Disorders Depression Inventory-Epilepsy (NDDI-E), Difficulties in Emotion Regulation Scale (DERS), and Two-Way Social Support Scale (2- WSSS) were filled out by the patients followed up with a diagnosis of focal epilepsy. Results: One hundred nine patients were included in the study. Depression was found in 25% of the patients. The median DERS value of the patients with depression was 45 (28-55), and the group without depression was 24 (1833.5). It was determined that the DERS score of the depressed group was significantly higher than the group without depression. There is a negative correlation between social support scale (92 (69.5-102.5)) and emotion regulation difficulties scale (27 (19-41)) in the correlation analysis of the entire study population. According to the regression analysis, difficulties in emotion regulation are the main determinant of depression and explain depression at a rate of 16.8%. Conclusion: Emotion regulation difficulties are one of the main determinants of depression in individuals with epilepsy and inadequate social support is associated with emotion regulation difficulties. In order to reduce the frequency of depression in individuals with epilepsy, rehabilitation programs are needed to strengthen emotion regulation strategies.Öğe Gastrostomy in Hospitalized Patients with Acute Stroke: NoroTek Turkey Point Prevalence Study Subgroup Analysis(Galenos Publ House, 2022) Topçuoğlu, Mehmet Akif; Özdemir, Atilla Ozcan; Aykaç, Özlem; Milanoğlu, Ayşel; Gökçe, Mustafa; Bavli, Songül; Cabalar, Murat; Turgut, NildaObjective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NoroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69 +/- 14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (ss): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (ss): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (ss): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin's scale score 0-2) functional outcome [exp (ss): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (ss): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NoroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method.
