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1.
Cent Eur J Public Health ; 27(3): 223-228, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580558

RESUMO

OBJECTIVE: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. METHODS: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. RESULTS: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%. CONCLUSION: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.


Assuntos
Coinfecção , Infecções por HIV , Minorias Sexuais e de Gênero , Sífilis , HIV , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Prevalência , Estudos Retrospectivos , Comportamento Sexual/estatística & dados numéricos , Sífilis/epidemiologia , Turquia
2.
Cent Eur J Public Health ; 27(3): 229-234, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580559

RESUMO

OBJECTIVE: Late presentation of the patients with human immunodeficiency virus (HIV) infection is associated with less favourable treatment responses, more accelerated clinical progression, and a higher mortality risk. Although HIV prevalence is low in Turkey, it is steadily increasing and the information about late presentation among HIV-positives is limited. We aimed to analyze the status of late presentation among HIV-positive patients in Turkey. METHODS: All newly diagnosed HIV/AIDS patients from 2003 to 2016 were enrolled in this study by five dedicated centres in Istanbul, Turkey. Demographic data, CD4+ counts, and HIV RNA were collected from medical records and were transferred to a HIV database system. Late pre- sentation was defined as presentation for care with a CD4 count < 350 cells/mm3 or presentation with an AIDS-defining event, regardless of the CD4 cell count. A medical literature search was done for the analysis of late presentation in Turkey. RESULTS: The cohort included 1,673 patients (1,440 males, median age 35 years). Among them, 847 (50.6%) had an early diagnosis, with a CD count of more than 350 cells/mm3. The remaining 826 were late presenters. Among late presenters, 427 (25.5% of all, 51.7% of late presenters) presented with advanced HIV disease. Late presenters were more elderly and less educated. The gender seemed comparable between groups. Late presentation was more likely among married patients. Early presenters were more likely among homosexuals, those diagnosed in screening studies, and in lower HIV-RNA viral load category. There has been a decreasing trend among late presenters in 2011-2016 when compared to 2003-2011 period. CONCLUSION: Current data suggest that half of HIV-infected patients present late in Turkey. In our cohort, those presented late were more elderly, less educated, married and had heterosexual intercourse. On admission, late presenters had more HIV-related diseases and were more likely in higher HIV-RNA category. In the cohort, men having sex with men were less likely late presenters. Efforts to reduce the proportion of late presentation are essential for almost every country. The countries should identify the risk factors of late presentation and should improve early diagnosis and presentation for HIV care.


Assuntos
Diagnóstico Tardio , Infecções por HIV , Adulto , Idoso , Contagem de Linfócito CD4/métodos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Fatores de Risco , Turquia
3.
Water Sci Technol ; 80(3): 466-477, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31596258

RESUMO

Wetlands are among the most productive ecosystems that provide services ranging from flood control to climate change mitigation. Wetlands are also critical habitats for the survival of numerous plant and animal species. In this study, we used satellite remote sensing techniques for classification and change detection at an internationally important wetland (Ramsar Site) in Turkey. Sultan Marshes is located at the center of semi-arid Develi closed basin. The wetlands have undergone significant changes since the 1980s due to changes in water flow regimes, but changes in recent years have not been sufficiently explored yet. In this study, we focused on the changes from 2005 to 2012. Two multispectral ASTER images with spatial resolution of 15 m, acquired on June 11, 2005 and May 20, 2012, were used in the analyses. After geometric correction, the images were classified into four information classes, namely water, marsh, agriculture, and steppe. The applicability of three classification methods (i.e. maximum likelihood (MLH), multi-layer perceptron type artificial neural networks (ANN) and support vector machines (SVM)) was assessed. The differences in classification accuracies were evaluated by the McNemar's test. The changes in the Sultan Marshes were determined by the post classification comparison method using the most accurate classified images. The results showed that the highest overall accuracy in image classifications was achieved with the SVM method. It was observed that marshes and steppe areas decreased while water and agricultural areas expanded from 2005 to 2012. These changes could be the results of water transfers to the marshes from neighboring watershed.


Assuntos
Monitoramento Ambiental/métodos , Máquina de Vetores de Suporte , Áreas Alagadas , Conservação dos Recursos Naturais , Ecossistema , Eugenol , Redes Neurais (Computação) , Turquia , Óxido de Zinco
4.
Medicine (Baltimore) ; 98(39): e17297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574853

RESUMO

As a modifiable risk factor for cardiovascular disease, presence of hypertension (HT) necessitates the awareness of asymptomatic organ damage (AOD). The aim of this study was to measure plasma micro RNA-21 (miR-21) and the parameters that reflect AOD such as carotid intima-media thickness (CIMT), microalbuminuria (MAU) in hypertensive patients compared with healthy controls. In addition, the aim of this study was to evaluate plasma miR-21 levels in HT patients with AOD.This study was designed as a cross-sectional observational study. The study includes 2 groups: 32 patients with HT and 32 healthy controls. First, we compared these 2 groups. Then, to underline the relationship between plasma miR-21 and HT, hypertensive patients were divided into 2 groups: with AOD and without AOD.Sixteen patients with HT had AOD. MiR-21 levels significantly correlated with clinical systolic and diastolic blood pressure, MAU, C-reactive protein, and CIMT. CIMT, miR-21, and MAU levels were significantly higher in patients with AOD.Our study showed increased miR-21 levels in HT patients with AOD.


Assuntos
Albuminúria , Doenças Cardiovasculares , Hipertensão , MicroRNAs/sangue , Adulto , Albuminúria/diagnóstico , Albuminúria/etiologia , Doenças Assintomáticas/epidemiologia , Pressão Sanguínea/fisiologia , Proteína C-Reativa/análise , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , MicroRNA Circulante/análise , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/genética , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia
5.
Vet Parasitol ; 273: 97-104, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31473450

RESUMO

This study aimed to investigate the presence of the natural transovarial transmission of tick-borne pathogens in unfed larvae obtained from engorged female ticks from domestic animals in Turkey. Larvae (n = 4530, 151 pools) obtained from 75 engorged female ticks and female carcasses were screened for the presence of certain tick-borne pathogens by PCR. The presence of transovarial transmission of Babesia occultans was detected in Hyalomma marginatum and Hy. excavatum, while Ba. ovis in Rhipicephalus bursa. Theileria annulata was detected only in Hy. excavatum and Rh. turanicus female carcasses, but not in their examined progenies. Additionally, Rickettsia aeschlimannii and Rickettsia raoultii were detected in Hy. marginatum and Dermacentor marginatus females, respectively, and all their examined larvae. Besides, Ri. slovaca was detected in a De. marginatus female carcass and its one of two examined larvae pools. The presence of mixed Ba. occultans and Ri. aeschlimannii infection was also determined in an Hy. marginatum female and its larvae. This is the first demonstration of transovarial transmission of Ba. occultans in naturally infected Hy. excavatum. These data suggested that Hy. excavatum may act as vector in the natural cycle of Ba. occultans.


Assuntos
Infecções Bacterianas/veterinária , Infecções Protozoárias em Animais/transmissão , Doenças Transmitidas por Carrapatos/veterinária , Carrapatos/microbiologia , Carrapatos/parasitologia , Animais , Animais Domésticos/microbiologia , Animais Domésticos/parasitologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/transmissão , DNA Bacteriano/genética , DNA de Protozoário/genética , Feminino , Larva/microbiologia , Larva/parasitologia , Ovário/microbiologia , Ovário/parasitologia , Reação em Cadeia da Polimerase , Infecções Protozoárias em Animais/parasitologia , Doenças Transmitidas por Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/parasitologia , Doenças Transmitidas por Carrapatos/transmissão , Turquia
6.
Fortschr Neurol Psychiatr ; 87(9): 504-510, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31519026

RESUMO

BACKGROUND: Neuropsychological dementia diagnosis of migrants are limited regarding the testing of cognitive abilities as well as the recording of everyday activities (Activities of Daily Living, ADL) such as linguistic, educational, lifestyle and cultural-religious factors have not been taken into account in psychometric instruments. AIM OF THE STUDY: We aimed to develop a culturally sensitive ADL scale, which is suitable for both German people and Turkish migrants that takes into consideration gender, cultural-religious and lifestyle aspects. A further aim was to determine the quality criteria for the newly proposed ADL scale. METHODS: After the initial phase, including qualitative interviews (N = 15) with cognitively unimpaired German participants and Turkish migrants, a first version of the ADL instrument was developed. This version was then completed by cognitively unimpaired Germans (n = 197) and Turkish participants (n = 53) and the shortened ADL scale was generated based on an item analysis. It consisted of the three subscales 'cognition', 'Basic Activities of Daily Living (BADL)' and 'Instrumental Activities of Daily Living (IADL)'. For Turkish participants, questions about Islamic prayers were added. Montreal Cognitive Assessment (MoCA) and Geriatric Depression Scale (GDS) were applied to rule out cognitive impairment and depression. The 'Bayer-ADL' was used to measure the validity of the scale. RESULTS: The everyday life of Germans and Turkish migrants differs in aspects of religious practice and in terms of sociocultural activities, which are taken into account in the CC-ADL. The reliability of the new ADL scale in terms of internal consistency (Cronbach's alpha) were regarding 'cognition' α = .43 for Germans and α = .80 for Turkish migrants; 'BADL' α = .55 for Germans and α = -.04 for Turkish migrants; 'IADL' α = .91 for Germans and α = .83 for Turkish migrants and α = .73 for Turkish migrants under the 'prayer items'. The correlation of the ADL total score with the Bayer ADL for Germans was ρ = .347 (p < .00) and for the Turkish sample ρ = .520 (p < .01). CONCLUSION: The development of a final version of the CC-ADL scale requires further data from healthy participants and patients (Mild Cognitive Impairment and dementia).


Assuntos
Atividades Cotidianas , Competência Cultural , Demência/diagnóstico , Demência/psicologia , Emigrantes e Imigrantes/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Feminino , Alemanha , Humanos , Estilo de Vida/etnologia , Masculino , Testes Neuropsicológicos , Religião e Psicologia , Reprodutibilidade dos Testes , Turquia/etnologia
7.
J Glob Health ; 9(2): 020404, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31489187

RESUMO

Background: Displacement after a war or an armed conflict always leads to unexpected health problems, both among migrating people and in places to which new people have migrated. This study aimed to determine the health care needs and trends of Syrian patients. Methods: This retrospective study was conducted in a secondary care hospital in the city of Nevsehir, in central Turkey, between January 2013 and December 2017. All Syrian patients who visited the outpatient clinics and emergency department (ED) were enrolled in the study. Results: Over a span of five years, 41 723 Syrian patients visited the hospital's outpatient clinics and ED. The patients' median age was 23 (inter-quartile range (IQR) = 7-34), and 57.7% of them were female. In 2017, one-third of the Syrian patients visited the ED, a rate that was higher than that found among local patients (30.3% vs 25.0%, P < 0.001, respectively). The rate of pediatric clinic admissions among Syrian patients was about four times greater than the rate of local patients (20.1% vs 5.2%, P < 0.001, respectively), and Syrians' rate of admission to the obstetrics and gynecology clinic was about three times greater than the rate of local patients' admissions (12.3% vs 4.3%, P < 0.001, respectively). Conclusions: This study showed that Syrian patients' visits to the hospital, and especially the ED, are increasing. Further, the needs and expectations of these patients in terms of health care are different from local demands. New approaches should be applied to provide an appropriate use of health care facilities.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos , Síria/etnologia , Turquia , Adulto Jovem
8.
Medicine (Baltimore) ; 98(33): e16773, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415379

RESUMO

Conventional therapy modalities for advanced breast cancer are problematic, whereas checkpoint blockade immunotherapy has been considered as a promising approach. This study aims to determine programmed death-ligand 1 (PD-L1) expression and methylation status of PD-L1 promoter in primary tumor tissue and metastatic foci of patients with stage IV breast cancer.Clinicopathological data and survival rates of 57 breast cancer patients, who were initially staged IV, and operated for intact tumors, were retrospectively analyzed. Immunohistochemical analysis of PD-L1 using 57 primary tumors, 33 paired metastatic lymph nodes, and 14 paired distant metastases was performed. Additionally, the methylation rate of the PD-L1 gene promoter region was determined with real-time polymerase chain reaction (PCR) analysis in 38 samples.Overall PD-L1 expression in primary tumors was 23.1% (12/52). PD-L1 positivity was reduced in lymph nodes by 15.2% (5/33) and in distant metastases by 21.4% (3/14). PD-L1 expression diverged between primary and metastatic foci in a subset of cases (18.2% for lymph node and 33.3% for distant metastasis). In general, the PD-L1 promoter was not methylated, and mean methylation rates were low (min. 0%-max. 21%). We observed no correlation between PD-L1 expression, promoter methylation, and survival.Neither the expression nor the methylation status of PD-L1 in patients, who were presented with stage IV breast cancer and operated for an intact primary tumor, had a statistically significant relation with survival. Discordance in PD-L1 expression between primary tumor and metastasis should be considered during pathological and clinical management of patients who would undergo checkpoint blockade therapy.


Assuntos
Antígeno B7-H1/metabolismo , Neoplasias da Mama/metabolismo , Receptor de Morte Celular Programada 1/metabolismo , Antígeno B7-H1/genética , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Metilação , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Receptor de Morte Celular Programada 1/genética , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Turquia
9.
Am J Orthod Dentofacial Orthop ; 156(2): 248-256.e2, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375235

RESUMO

INTRODUCTION: The treatment options for adults with increased overbite are limited to dentoalveolar changes that camouflage the condition. Because of high relapse tendency, defining the problem area is important when creating a treatment plan. This study aimed to evaluate dentoskeletal morphology in skeletal Class I and II anomalies associated with Angle Class I, Class II Division 1 (Class II/1), and Class II Division 2 (Class II/2) malocclusions with increased overbite compared with normal occlusion. METHODS: Pretreatment cephalograms of 306 patients (131 men, 175 women; overall ages 18-45 years) were evaluated. Four groups were constructed. Three groups had increased overbite (>4.5 mm): group 1 (n = 96) skeletal Class I (ANB = 0.5°-4°), group 2 (n = 85) skeletal Class II (ANB >4.5°) with Class II/1; and group 3 (n = 79) skeletal Class II with Class II/2 malocclusion. Group 4 as a control (n = 46) skeletal Class I normal overbite. Dental and skeletal characteristics of the groups were compared by sex. For statistical evaluations, analysis of variance followed by Tukey post hoc, Mann-Whitney U, and Kruskall-Wallis tests were used. Additionally correlation coefficients between overbite and skeletal/dental parameters were calculated. RESULTS: Between sexes, with regard to skeletal parameters, the men had greater values in millimetric measurements, and the women had higher SN/GoGn values. Maxillary/mandibular molar heights and the mandibular incisor heights were higher in men. In group 1, decreased lower anterior facial height (LAFH), retrusive mandibular incisors, and increased interincisal degree were determined. The maxillary molars were intrusive, whereas the vertical position of the mandibular molars and incisors in both jaws were normal. In group 2, retrognathic mandible, increased LAFH and mandibular plane angle, extrusive maxillary/mandibular incisors, protrusive mandibular incisors, and decreased interincisal degree were found. In group 3, decreased LAFH, increased interincisal degree, and retrusive incisors in both jaws were determined. There were significant negative correlations between SN/GoGN, palatal plane, and overbite in group 2 and between ANS-SN and overbite in group 3, and positive correlation between interinsical angle and overbite in all increased overbite groups. CONCLUSIONS: Dental morphology seems to be the main factor of increased overbite. Differences between groups were related primarily to inclinations and vertical positions of the incisors, rather than molar positions.


Assuntos
Má Oclusão de Angle Classe II/patologia , Má Oclusão de Angle Classe I/patologia , Sobremordida/epidemiologia , Sobremordida/patologia , Adolescente , Adulto , Análise de Variância , Pontos de Referência Anatômicos , Cefalometria , Feminino , Humanos , Incisivo/patologia , Masculino , Má Oclusão de Angle Classe III/patologia , Mandíbula/patologia , Maxila/patologia , Pessoa de Meia-Idade , Dente Molar/patologia , Retrognatismo/patologia , Fatores Sexuais , Turquia , Adulto Jovem
10.
An Acad Bras Cienc ; 91(3): e20180224, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365647

RESUMO

Virus diseases of cool season vegetable crops (mainly cabbage, white and red head cabbage, broccoli, kale, radish, rocket salad, garden cress, and turnip) were surveyed in Bafra Plain, Turkey during winter 2017, and 2018. Leaf samples were collected from different species of the Brassicaceae family showing mosaic, mottling, necrotic spots, malformation, and chlorosis symptoms. These samples were tested for the presence of Cauliflower mosaic virus (CaMV), Cucumber mosaic virus (CMV), Beet western yellows virus (BWYV), Radish mosaic virus (RaMV), Turnip mosaic virus (TuMV), Turnip yellow mosaic virus (TYMV), and Turnip yellows virus (TuYV) by biological and serological methods. A total of 455 samples were collected from cole crop fields and tested for the seven viruses by double-antibody sandwich ELISA using specific polyclonal antibodies. According to the results, out of these, 7 % of the samples were infected by at least one of these viruses. TuMV was the most prevalent virus detected in cole crops. TuMV, CaMV, and CMV were detected in 3 %, 2 %, and 2 % of infected samples, respectively, and the infection rate of these three viruses changed significantly among Brassica species.


Assuntos
Brassicaceae/virologia , Produtos Agrícolas/virologia , Doenças das Plantas/virologia , Brassicaceae/classificação , Estações do Ano , Turquia
11.
An Acad Bras Cienc ; 91(3): e20180404, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365649

RESUMO

In this study, the antimicrobial, antioxidant and antitumor activity of ethanol extracts obtained from Phlomis russeliana (Sims.) Lag. ex Benth. (Lamiaceae) were evaluated. Disc diffusion and microdilution methods were used to test the extracts for antimicrobial activity against seven bacteria strains (Bacillus cereus ATCC 7064, Bacillus subtilis ATCC 6633, Staphylococcus aureus ATCC 6538P, Escherichia coli ATCC 10538, Proteus vulgaris ATCC 6899, Salmonella typhimurium CCM 5445 and Pseudomonas aeruginosa ATCC 27853) and four yeast strains (Kluyveromyces fragilis ATCC 8608, Rhodotorula rubra ATCC 70403, Debaryomyces hansenii DSM 70238 and Candida albicans ATCC 10239). Notably, they were more effective against the yeast strains than the bacterial strains. Of the yeast cultures, D. hanseii was among the most susceptible, having an inhibition zone of 16.2 mm with minimum inhibitory concentrations (MICs) and minimum fungicidal concentrations (MFCs) of 64(128)µg/ml, respectively. For cytotoxic determination, Caco-2 cells were cultured as per ATCC protocol, and were treated with log concentrations (5-80 mg/ml) of P. russeliana. The potency of cell growth inhibition for each extract was expressed as an IC50 value. Moreover, oxidant capacity was evaluated via TOC assay. This product induced antiproliferative activity of 31.33% at 40 mg/ml and 20.96% at 80 mg/ml, without toxic effects on cells, although the oxidant capacity was decreased to 27.06 ± 0.7 nm in the 80 mg/ml-applied group compared to 47.9 ± 1.8 nm in the untreated one. Advanced pharmacological studies are needed to further evaluate P. russeliana for distinctive features.


Assuntos
Antibacterianos/farmacologia , Antioxidantes/farmacologia , Candida albicans/efeitos dos fármacos , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Phlomis/química , Extratos Vegetais/farmacologia , Antibacterianos/isolamento & purificação , Antioxidantes/isolamento & purificação , Células CACO-2 , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Bactérias Gram-Negativas/classificação , Bactérias Gram-Positivas/classificação , Humanos , Turquia
12.
J Vasc Access ; 20(5): 545-552, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31379248

RESUMO

OBJECTIVE: This study aimed to determine the long-term patency duration and rate of thrombosis of autologous arteriovenous fistulas and synthetic grafts treated with endovascular methods in a large patient population. METHODS: A total of 144 arteriovenous accesses (37 radiocephalic, 51 brachiobasilic, 41 brachiocephalic, and 15 femorofemoral) from 143 patients were included in the study. A total of 304 endovascular thrombolytic treatment procedures were performed for 94 (65%) arteriovenous fistula and 50 (35%) arteriovenous graft accesses. RESULTS: The procedural technical success rate was 98.7%. The mean follow-up duration was 32.5 (range, 3-132) months. The primary patency rates for arteriovenous fistulas and arteriovenous grafts were 78% and 78% at 6 months, 66% and 63% at 1 year, and 45% and 0% at 36 months, respectively. The assisted primary patency rates for arteriovenous fistulas and arteriovenous grafts were 82% and 84% at 6 months, 71% and 69% at 1 year, 51% and 29% at 36 months, and 30% and 1% at 60 months, respectively. The secondary patency rates for arteriovenous fistulas and arteriovenous grafts were 94% and 93% at 6 months, 85% and 85% at 1 year, 58% and 59% at 36 months, and 47% and 48% at 60 months, respectively. CONCLUSION: Although the primary patency durations for arteriovenous fistulas were better after endovascular thrombolytic treatment than those for arteriovenous grafts, the long-term outcomes of assisted primary and secondary patency durations after repeated procedures were similar for both types of arteriovenous accesses.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Procedimentos Endovasculares , Oclusão de Enxerto Vascular/cirurgia , Trombectomia/métodos , Trombose/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Endovasculares/efeitos adversos , Feminino , Oclusão de Enxerto Vascular/diagnóstico por imagem , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Trombectomia/efeitos adversos , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Turquia , Grau de Desobstrução Vascular , Adulto Jovem
13.
Mikrobiyol Bul ; 53(3): 274-284, 2019 Jul.
Artigo em Turco | MEDLINE | ID: mdl-31414629

RESUMO

Coxiella burnetii is the causative agent of Q fever, a zoonotic infection. The bacteria is a gram-negative, pleomorphic, coccobacilli and capable to survive and proliferate within the host cell's phagolysosome. There are two morphological cell types of C.burnetii including small and large cell variants. C.burnetii is divided into phase I and phase II serologically variants according to LPS structure in the cell wall. Phase I is the natural phase found in infected animals or humans and is highly infectious. Phase II is not very infectious and could be obtained only in laboratories after serial passages in cell cultures or embryonated egg cultures. Q fever can be asymptomatic (in 50% of the cases), acute or chronic. Major presentations of acute Q fever are flu-like illness, pneumonia, and hepatitis, whereas the chronic form presents mainly as infective endocarditis. The aim of this study was to obtain C.burnetii phase II variant from C.burnetii phase I variant by a phase change study. In this study, C.burnetii was isolated by cell culture method from the heart valve tissue of a Q fever endocarditis case. C.burnetii phase I antigen for the indirect fluorescent antibody test (IFAT) was prepared from the isolated strain. For the isolation and identification of C.burnetii, heart valve tissue of the patient was homogenized and DNA was extracted by tissue extraction kit. C.burnetii DNA in the valve tissue was determined by real-time PCR (Rt-PCR). This C.burnetii DNA positive specimen was inoculated into Vero cells by shell vial centrifugation method. The scraped Vero cells were fixed on the slides after one week of incubation and IFAT was performed using C.burnetii phase I IgG positive sera, bacteria that were grown in and surrounding the Vero cells stained apple green were determined microscopically. Infected cells were disrupted by freeze and thaw method to obtain bacterial suspension. The DNA obtained from the bacterial suspension was again found to be positive for C.burnetii by Rt-PCR. Isolation sample was found to be positive in PCR at an earlier cycle compared to heart tissue sample, thus the bacterial growth was also confirmed with PCR. 16S ribosomal RNA gene of our isolate was amplified by PCR using 27F and 1492 primers and then sequenced. The DNA sequences were compared with reference DNA sequences of GeneBank; and the nucleotide sequence of the 16S ribosomal RNA gene of our isolate was found to be 99% similar to C.burnetii strain ATCC VR-615 an accession number NR104916. Serial cell culture passages of the isolated strain were performed to obtain C.burnetii phase II variant from C.burnetii phase I variant. After each passage, presence of phase change was investigated by IFAT using C.burnetii phase I and phase II IgG positive sera. At the end of 17 cell culture passages, phase change could not be observed. C.burnetii phase I IFAT antigen was prepared from the obtained bacterial suspension. In this study, we presented the isolation and identification of C.burnetii by cell culture, molecular and serological methods from the heart valve of a patient with endocarditis for the first time in our country.


Assuntos
Coxiella burnetii , Endocardite , Valvas Cardíacas , Febre Q , Animais , Antígenos de Bactérias/isolamento & purificação , Antígenos de Bactérias/metabolismo , Cercopithecus aethiops , Coxiella burnetii/genética , Coxiella burnetii/isolamento & purificação , Endocardite/microbiologia , Valvas Cardíacas/microbiologia , Humanos , Febre Q/microbiologia , RNA Ribossômico 16S/genética , Turquia , Células Vero
14.
Mikrobiyol Bul ; 53(3): 308-318, 2019 Jul.
Artigo em Turco | MEDLINE | ID: mdl-31414632

RESUMO

Blastocystis spp. is one of the most common protozoa in Turkey and throughout the world; laboratory diagnosis, genetic diversity and clinical features are among the most controversial topics related to the parasite. The aims of the present study were to investigate the subtype distribution of Blastocystis spp. Isolates from Aydin, Turkey, to evaluate the efficiency of some diagnostic methods and to evaluate the relationship between Blastocystis spp. infection with demographic factors and clinical findings. According to the direct microscopy results, 100 stool samples with and without Blastocystis spp. were selected by simple random sampling method. All were directly subjected to DNA isolation and cultured in Jones medium. DNA isolation was also carried out in Blastocystis spp. positive cultures with a different kit. Genomic DNA samples were analysed by PCR targeting the Blastocystis spp. small subunit ribosomal RNA (SSU rRNA) gene and subtypes (ST) were determined according to the sequence analyses. Moreover, the samples with undetected ST were further studied with sequence tagged site-PCR (STS-PCR). In addition, the patients with and without Blastocystis spp. were compared in terms of demographic characteristics (gender, age, residence) and clinical findings (itching, diarrhoea, abdominal pain, dyspepsia, nausea, vomiting, constipation and weight loss)., Among 100 stool positive samples diagnosed with direct microscopic examination 81 (81%) and 86 (86%) were found as positive with culture and PCR, retrospectively. Additionally, among 100 Blastocystis spp. negative stool samples five (5%) and seven (7%) samples were found positive with the same methods, respectively. The results of the analysis of Blastocystis spp. with SSU rRNA gene sequencing and STS-PCR methods revealed the subtype distribution of 95 Blastocystis spp. isolates as follows: ST3 (n= 50, 52.6%), ST2 (n= 21, 22.1%), ST1 (n= 17, 17.9%), ST7 (n= 4, 4.2%), ST2 + ST3 (n= 2, 2.1%) and ST1 + ST3 (n= 1, 1.1%). In addition, a complete accordance was observed in subtype distribution between direct DNA isolation from stools and 35 randomly selected isolates from the culture. In our study, the comparison of 107 Blastocystis spp. positive (by any of the methods) cases and 93 negative cases showed that there was no correlation in terms of demographic characteristics and clinical findings. Similarly, there was no significant relationship between symptoms and subtypes. In conclusion, it is recommended that in addition to direct microscopic examination, the use of additional methods such as culture and PCR will be useful in routine laboratory diagnosis of Blastocystis spp. The distribution of Blastocystis subtype in Aydin is mainly in accordance with the global findings. Lack of a relationship between Blastocystis spp. Infection and symptoms in our study was supported the idea that Blastocystis spp. infection is mostly asymptomatic in humans and it may be a member of healthy microbiota.


Assuntos
Infecções por Blastocystis , Blastocystis , Código de Barras de DNA Taxonômico , Técnicas e Procedimentos Diagnósticos/normas , Variação Genética , Parasitologia/métodos , Blastocystis/classificação , Blastocystis/genética , Infecções por Blastocystis/diagnóstico , Infecções por Blastocystis/parasitologia , DNA de Protozoário/genética , Fezes/parasitologia , Humanos , Parasitologia/normas , Filogenia , Estudos Retrospectivos , Turquia
15.
Mikrobiyol Bul ; 53(3): 330-335, 2019 Jul.
Artigo em Turco | MEDLINE | ID: mdl-31414634

RESUMO

Most of the nontuberculous mycobacteria (NTM) are opportunistic pathogenic microorganisms and free-living in nature. NTM can cause a wide range of infections. However, pulmonary NTM disease is the most frequent clinical picture. The aim of this study was to identify and evaluate drug susceptibility of slow growing NTM isolated from pulmonary samples of patients prediagnosed as tuberculosis between 2014 and 2018 in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital Microbiology Laboratory by a commercial microtube dilution plaque method. A total of 435 NTM strains obtained from suspected TB patients were included in the study. After the samples were processed by homogenization and decontamination and acid-fast staining, culture in two solid media (Löwenstein-Jensen, Ogawa) and in MGIT-BACTEC960 automated system were performed. Acid-fast bacilli isolated from culture media were identified by using cart test (MPB64, Capilla TB-Neo) and polymerase chain reaction (PCR) based reverse hybridization "line probe assay (LPA)" method (GenoType MycobacteriumCM/AS, Hain Lifescience, GmbH, Germany). After DNA isolation from the culture, PCR was performed by using the primers specific for mycobacterial 23S rRNA spacer region. PCR products were then hybridized with the probes specific for Mycobacterium species on nitrocellulose strips according to the recommendations of the manufacturer and the results were evaluated. In this study, Mycobacterium avium (n= 77, 17.7%), Mycobacterium intracellulare (n= 70, 16.1%), Mycobacterium szulgai (n= 19, 4.4%), Mycobacterium kansasii (n= 10, 2.3%) ve Mycobacterium smiae (n= 9, 2.1%) were isolated as slowly growing mycobacteria from the pulmonary patients. Susceptibility testing was performed in cation-adjusted Mueller-Hinton broth (CAMH), supplemented with "oleic acid, albumin dextrose catalase" according to CLSI/ M24-A2 guideline recommendations. For the antibiotic susceptibility test, ready-to-use plaque drugs for slow-growing mycobacteria (SLOMYCO-Sensititre, TREK Diagnostic Systems Ltd, UK), were used. M.intracellulare, M.avium, M.kansasii and M.smiae isolates were found to be sensitive to clarithromycin %100, %99, %100 and %100, respectively. For M.intracellulare and M.avium isolates, moxifloxacin and linezolid sensitivity values were found to be 91%, 64% and 80%, 74% respectively. M.kansasii isolates were more sensitive than M.simiae isolates to the most of the drugs. M.kansasii isolates, were susceptible to rifabutin, rifampin, moxifloxacin, amikacin, linezolid, trimethoprim-sulfamethoxazole (TMP-SMX), ciprofloxacin and etambutol, with the frequencies of 100%, 90%, 100%, 100%, 80%, 70% and 50%, respectively. The study showed that the species identification and drug susceptibility testing of frequently isolated slow-growing NTM's from pulmonary specimens could guide for the treatment.


Assuntos
Infecções por Micobactéria não Tuberculosa , Micobactérias não Tuberculosas , Alemanha , Hospitais/estatística & dados numéricos , Humanos , Pulmão/microbiologia , Testes de Sensibilidade Microbiana , Infecções por Micobactéria não Tuberculosa/microbiologia , Micobactérias não Tuberculosas/efeitos dos fármacos , Micobactérias não Tuberculosas/crescimento & desenvolvimento , Turquia
16.
Altern Lab Anim ; 47(2): 82-92, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31397165

RESUMO

The legal structure that governs animal use in Turkey is in line with that of the European Union (EU). In 2004, legislation on the use of animals for experimental and other scientific purposes was established in Turkey for the first time. The present study aimed to compare the data on experimental animal use in Turkey (during the period 2008-2017) with similar reports from selected countries (the United States, Australia, Canada and the EU). In Turkey, a total of 2,104,828 animals were used for experimental and other scientific purposes during 2008-2017. Of the animals used, 758,887 were fish (36%), 433,417 rats (21%), 302,512 birds other than quail (14%) and 285,531 mice (13%). According to a breakdown by purpose for use, in Turkey during 2009-2017, out of a total number of 1,955,307 animals used, 56% were for fundamental biological studies, with a high proportion used for research on animal disease. Compared with the other countries, fewer animals were used in Turkey although the national trend seems to indicate that the number is fluctuating. Further studies are required to uncover the reasons behind this reduced animal use in Turkey, as compared to other countries.


Assuntos
Experimentação Animal , Animais de Laboratório , Experimentação Animal/estatística & dados numéricos , Animais , Austrália , Canadá , União Europeia , Turquia , Estados Unidos
17.
Niger J Clin Pract ; 22(8): 1055-1062, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417047

RESUMO

Background: Turkey is the third most populous country of the European region located at the crossroads of Asia, Europe, and the Middle East. In Turkey, approximately 2 million pregnancies occur every year. Half of the pregnancies are involuntary, and five out of every 100 pregnancies end with wanted abortion. There are limitations in access to modern methods in the north of Turkey. This study was aimed to determine the factors associated with better attitudes and participation to family planning (FP) services in primary care settings from Northern Turkey. Materials and Methods: This cross-sectional study, based on primary care settings, was conducted in the Middle Black Sea Region of Turkey with 400 married men. Male attitudes and participation were measured by a questionnaire form. Chi-square testing and logistic regression analyses were applied. Results: We found that male participation was present in 302 participants (75.5%), and 363 participants (90.8%) approved the use of FP. Male participation was significantly different by age, occupation, education, marriage age, spouses' education and occupation, and attitudes towards FP. Based on multivariate analysis, male participation was significantly associated with spouses' level of education, employment status, currently using FP, and the perception of spousal communication. Conclusion: Better participation existed among participants with higher educated spouses, employed spouses, current users of FP, and the better self-perception of communication.


Assuntos
Comportamento Contraceptivo , Anticoncepção/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Cônjuges/psicologia , Adolescente , Adulto , Anticoncepção/psicologia , Estudos Transversais , Serviços de Planejamento Familiar/métodos , Feminino , Humanos , Masculino , Casamento , Pessoa de Meia-Idade , Gravidez , Atenção Primária à Saúde , Fatores Socioeconômicos , Cônjuges/estatística & dados numéricos , Inquéritos e Questionários , Turquia/epidemiologia
18.
Niger J Clin Pract ; 22(8): 1063-1069, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417048

RESUMO

Aim: The objective of this study was to determine the prevalence of burnout syndrome and associated factors among family physicians before and after family medicine system (FMS). Materials and Method: The first part of the study was conducted in 2008 (pre-FMS) and the second part in 2012 (post-FMS). Physician's burnout was investigated by using the Maslach Burnout Inventory (MBI). In total, 139 physicians had been participating pre-FMS and 246 physician's post-FMS. Results: The mean pre-FMS emotional exhaustion score was 15.7 ± 5.8, increasing significantly to 17.14 ± 7.5 post-FMS (P = 0.045). Mean pre-FMS and post-FMS depersonalization and reduced personal accomplishment scores were similar (P > 0.05). Age was negatively correlated with depersonalization in this study (P = 0.012) and positively correlated with personal accomplishment (P = 0.001). The primary care physicians in the post-FMS period were older, female physicians had a greater preference for primary care, and the levels of married doctors were higher. In addition, a higher level of physicians also owned their own home and cars compared to the pre-FMS period. A negative correlation has been reported between physicians' burnout levels and home or car ownership in the present study. Conclusion: Our findings suggest that physicians working under the family medicine system, a new primary care model, are at greater risk of emotional exhaustion, but that no change has occurred in terms of personal accomplishment or depersonalization, despite this new system.


Assuntos
Esgotamento Profissional/psicologia , Estresse Ocupacional/psicologia , Médicos de Família/psicologia , Carga de Trabalho , Adulto , Esgotamento Profissional/epidemiologia , Estudos Transversais , Despersonalização , Emoções , Medicina de Família e Comunidade/organização & administração , Feminino , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/epidemiologia , Prevalência , Atenção Primária à Saúde/organização & administração , Inquéritos e Questionários , Turquia/epidemiologia
19.
Niger J Clin Pract ; 22(8): 1070-1077, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417049

RESUMO

Background: The World Health Organization defines obesity as an abnormal or excessive fat accumulation that can damage health. Aims: This study aims to evaluate the prevalence of obesity and risk factors in high school students in Erzurum City Center. Study Design and Methods: A cross-sectional study was conducted. The number of students participating in the study was 845, including 47.6% females and 52.4% males. Data collection was done by surveys filled in under supervision. Anthropometric measurements were performed by the researchers. Predictions of the Extended International Obesity Task Force were used for body mass index. Parents' body mass indexes were calculated by self-report and classified according to cut-off points for adults in the world health community. A systematic review of the local literature published between 2004 and 2013 was drafted. Results: In girls and boys, the frequency of overweight was 26.9% and 25.7%, respectively, while the frequency of obesity was 12.4% and 9.5%. A logistic regression analysis was performed to reveal significant risk factors for overweight/obesity. Weekly exercise status [odds ratio = 3.0, 95% confidence interval CI (1.2-7.8)] and school transfer % CI = (1.1-7.2) were important independent risk factors for obesity. The local literature showed a 4.3-fold increase in the prevalence of obesity within 10 years. Conclusion: The prevalence of obesity and overweight in adolescents requires the implementation of effective programs to fight this epidemic. Health education targeting peers and their parents, peer education, screening of risk groups, and controlling the sale of unhealthy foods can be some interventions.


Assuntos
Obesidade/epidemiologia , Sobrepeso/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Exercício , Feminino , Humanos , Estilo de Vida , Masculino , Prevalência , Fatores de Risco , Instituições Acadêmicas , Fatores Socioeconômicos , Inquéritos e Questionários , Turquia/epidemiologia
20.
Niger J Clin Pract ; 22(8): 1099-1108, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417053

RESUMO

Background: Upper gastrointestinal system (GIS) bleeding is one of the most common causes of mortality and morbidity. The predictive values of pre-endoscopic Rockall score (PERS), full Rockall score (FRS), Glasgow-Blatchford score (GBS), pre-endoscopic Baylor score (PEBS), and full Baylor score (FBS) to predict bleeding at follow-up, endoscopic therapy, blood transfusion requirement, and death are investigated in our study. Methods: This study was retrospectively conducted in patients admitted to emergency department with upper GIS bleeding. Demographic and clinical characteristics of the patients were recorded. The relationships of the aforementioned scores with in-hospital termination, bleeding at follow-up, endoscopic therapy, blood transfusion requirement, and death were explored. Results: The study included a total of 420 subjects, of which 269 (64%) were men. All scoring systems were able to predict transfusion need and GBS was superior to other scores (P < 0.0001). In terms of endoscopic treatment, it was determined that only PERS, FRS, and FBS were statistically significant in predicting ability and PERS >3, FRS >5 and FBS >10 patients needed endoscopic treatment. All scoring systems were able to predict rebleeding. In comparison of two groups for rebleeding, it was found that PEBS was better able to predict bleeding during follow-up than both FRS and FBS, and PERS was better able to predict bleeding during follow-up than both FRS and FBS. All scoring systems were able to predict mortality. FRS and PERS scores had a greater discriminatory power for predicting death than the rest of the scores (P < 0.001). Conclusion: All scoring systems were effective for predicting need for blood transfusion, rebleeding, and death. GBS had more predictive power for transfusion need, PERS and PEBS for rebleeding, and FRS for mortality. PERS, FRS, and FBS were found to be effective in predicting endoscopic treatment.


Assuntos
Hemorragia Gastrointestinal/diagnóstico , Hospitalização/estatística & dados numéricos , Medição de Risco/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue/estatística & dados numéricos , Serviço Hospitalar de Emergência , Endoscopia do Sistema Digestório , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Hemorragia Gastrointestinal/terapia , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença , Turquia/epidemiologia
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