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Background Fasciola hepatica is an important pathogen that causes liver fluke disease in definitive hosts such as livestock animals and humans. Various excretory/secretory products have been used in serological diagnosis and vaccination studies targeting fasciolosis. There are no commercial vaccines against fasciolosis yet. Bioinformatic analysis based on computational methods have lower cost and provide faster output compared to conventional vaccine antigen discovery techniques. The aim of this study was to predict B- and T-cell specific epitopes of four excretory/secretory antigens (Kunitz-type serine protease inhibitor, cathepsin L1, helminth defense molecule, and glutathione S-transferase) of Fasciola hepatica and to construct a multiepitope vaccine candidate against fasciolosis. Methods and Results Initially, nonallergic and the highest antigenic B- and T- cell epitopes were selected and then, physico-chemical parameters, secondary and tertiary structures of designed multiepitope vaccine candidate were predicted. Tertiary structure was refined and validated using online bioinformatic tools. Linear and discontinuous B-cell epitopes and disulfide bonds were determined. Finally, molecular docking analysis for MHC-I and MHC-II receptors was performed. Conclusion This multi-epitope vaccine candidate antigen, with high immunological properties, can be considered as a promising vaccine candidate for animal experiments and wet lab studies.

Introduction: Toxoplasma gondii is a protozoan parasite that has a widespread distribution among mammalians and birds. One of the reasons for the high prevalence may be due to ingesting oocyst disseminated by stray cats' feces. In Turkey, most of the citizens are closely associated with stray cats and they love to pet and feed them on the streets. In this study, we aimed to determine the prevalence of T. gondii DNA in feces of stray cats living in Izmir, Turkey in order to identify the transmission potential to humans and other animals. Methodology: Feces and blood samples of 465 stray cats were investigated for the presence of T. gondii oocysts by microscopy and for the presence of T. gondii DNA by two real time PCR methods. Furthermore, serum samples were analyzed for anti-T. gondii IgG antibodies using an ELISA. Results: Oocysts were detected in 0.43% of the stray cats by microscopy. T. gondii DNA was detected in 14.37% of the stray cats' feces samples. The seroprevalence rate was 37.84%. In the feces and/or blood PCR positive group, 35.89% of them were seropositive. Among the 176 seropositive cats, T. gondii DNA was detected in feces of 27 cats (15.34%). Conclusions: This study first time showed the inter relation of T. gondii DNA in feces and blood samples and seropositivity. In sum, over 14% of the stray cats living outdoor may have an important role in transmission of toxoplasmosis to humans in Izmir as well as to other animals. © 2021 Journal of Infection in Developing Countries. All rights reserved., 2016-TIP-042, This study was supported by the grant given by the Scientific Research Projects Branch Directorate of Ege University, Turkey (Grant No: 2016-TIP-042) to M.D.

The authors report a patient with masticator space abscess due to an ascending infection following a wisdom tooth extraction. They administered antibiotics and did an incision and drainage; however, osteomyelitis of the mandible and compartment syndrome of the temporal muscle complicated the course. The authors suggest a physiopathology and discuss the management of this study.

Toxoplasma gondii has a very wide host range and infects all warm-blooded animals including humans. The disease causes great economic losses both in animals and humans. Vaccination is the most effective approach to fight against toxoplasmosis however an effective vaccine has not been developed yet. In the present study, GRA8 protein of T. gondii that showed high immunogenicity in our previous microarray screening study was used to develop a DNA vaccine using pcDNA 3.3 vector for the first time. In order to increase the potency of the DNA vaccine, 10 times lower amount of GRA8 DNA vaccine was combined with molecular adjuvant CpG and formulated into a commercial liposome (pcDNA3.3-GRA8+CpG+Escort). Mice were vaccinated intramuscularly two times at three-week intervals and challenged orally with the T. gondii PRU strain tissue cysts. The humoral immune response was determined by Western Blot and ELISA. The cellular immune response was analyzed by flow cytometry, cytokine ELISA and MTT assay. Among the vaccine groups, pcDNA3.3-GRA8 and pcDNA3.3-GRA8+CpG+Escort induced strong IgG response compared to controls (P < 0.001). The IgG1 and IgG2a responses showed a balanced Th1-Th2 polarization. The ratio of CD4(+) and CD8(+) T lymphocytes secreting IFN-gamma increased, and significantly higher extracellular IFN-gamma secretion was achieved compared to the controls (P < 0.01). The amount of tissue cysts in the group of mice vaccinated with pcDNA3.3-GRA8 decreased significantly compared to control groups (P < 0.0001). In the group vaccinated with pcDNA3.3-GRA8+CpG+Escort, the amount of tissue cysts also decreased significantly compared to PBS (P = 0.0086) and Empty plasmid+CpG+Escort (P = 0.0007) groups. This study showed for the first time that pcDNA 3.3. vector encoding GRA8 with or without CpG and Liposome can induce strong cellular and humoral immune responses and confer strong protection against mouse model of chronic toxoplasmosis., Scientific and Technological Research Council of Turkey [119S367], This study was supported by the Grant given by The Scientific and Technological Research Council of Turkey (119S367) to M.D. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

This study aimed to investigate the Feline immunodeficiency virus (FIV) / Feline leukemia virus (FeLV) infection prevalence among looking healthy stray cats in Western Turkey by serologic and molecular-based tests. A total of 1008 blood samples from the stray cats were used in this study. All samples were tested for FIV antibodies / proviral DNA and FeLV antibodies / antigens / proviral DNA. The genetic characterization and phylogenetic analysis of FeLV and FIV were carried out in this study. These cats also tested for Leishmaniasis and Toxoplasmosis previously. FIV Ab and proviral DNA detected in 25.2 % and 25.5 % of samples, respectively. FeLV Ab, Ag, proviral DNA positivity was in 45.2 %, in 3.3 %, in 69.7 %, respectively. The molecular detection and phylo-genetic analysis of the current FeLV pol gene and FIV gag gene performed. The molecular characterization for the pol gene of FeLV (enFeLV and exFeLV) among Turkey's cat population was reported for the first time. The exFeLV pol sequences closer to the FeLV-A genotype, and the enFeLV pol sequences overlapped with other enFeLV. The current FIV gag sequences were clustered within the subtypes A, B, and C. The findings revealed FeLV subtype A and FIV subtype-A, subtype-B, subtype-C circulate among Turkish stray cats. Single and multiple co-infection positivity was found higher compared to previous reports.

BackgroundToxoplasma gondii is an obligate intracellular parasite that can infect almost all warm-blooded animals, avian species and humans. Toxoplasmosis is asymptomatic in healthy individuals, whereas it may lead to death in immune suppressed or deficient patients. A vaccine against T. gondii is required to prevent consequences of the infection. the aim of this study is to generate a multivalent recombinant protein vaccine against T. gondii.Methods49 previously discovered antigenic proteins of T gondii were evaluated by their expression level in E. coli and by comprehensive bioinformatics analyses to determine antigenic epitopes. Based on these analyses, six vaccine candidate proteins were selected to generate a hexavalent recombinant protein vaccine adjuvanted with Montanide ISA 50V. Humoral and cellular immune responses were determined by flow cytometry and ELISA. Vaccinated mice were challenged with T. gondii Ankara strain tachyzoites.ResultsIn mice vaccinated with hexavalent vaccine, strong total IgG (P, Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [110S200], This study was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) grant 110S200 to AYG. the funding bodies played no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Pneumocystis jirovecii is an opportunistic respiratory pathogen causing Pneumocystis pneumonia (PcP) in immunocompromised patients. The aim of this study was to investigate the genetic diversity of P. jirovecii isolates (n: 84) obtained from PcP patients using multilocus sequencing method based on mt26S, SOD, and CYB loci. Among the 84 clinical samples that were positive for P. jirovecii DNA, 31 (36.90%) of them were genotyped using at least one locus. Of the 31 clinical samples, 26 of them were successfully genotyped using all loci whereas three samples were genotyped using either mt26S/CYB loci or mt26S/SOD loci. Additionally, there were two more clinical samples that were genotyped using CYB or SOD locus. Using mt26S locus, genotypes 2, 3, 7, and 8 were detected. Frequencies of genotype 7 and 8 were higher and both of them were found in 11 (n: 29; 37.93%) clinical samples. Using SOD locus, SOD 1, 2, and 4 genotypes were detected. SOD 1 was the predominant genotype (20/28; 71.42%). During the analyses of CYB locus, CYB 1, 2, 5, 6, and 7 as well as a new CYB genotype were detected. CYB 1 (16/29; 55.17%) and 2 (10/29; 34.48%) were the predominant genotypes. Overall, according to the multilocus sequencing results E, F, M, N, P, and V multilocus genotypes were detected among the PcP patients. In addition, SOD 1 was the predominant genotype and CYB had a more polymorphic locus. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature., 2013TIP050, TGA-2019-20253, This study was supported by Ege University Scientific Research Projects Coordination Unit (Project Numbers: TGA-2019-20253 and 2013TIP050).

Purpose The effect of botulinum toxin type A (BTX-A) on fracture healing of the long bones is controversial, and no controlled clinical or experimental study has investigated the effect of BTX-A on mandibular fractures. The purpose of this study was to investigate whether BTX-A injection into the masseter muscles affects bone healing by reducing the displacing forces in an unfavorable mandibular fracture model. Materials and Methods Forty-eight male New Zealand white rabbits were used. Ten units of BTX-A was injected into each masseter muscle in the animals in the BTX-A group, whereas saline solution was injected in the animals in the control group. A unilateral osteotomy and fixation with a microplate were performed. Bone healing was evaluated by radiodensitometric, biomechanical, histologic, and histomorphometric methods after 21 days. Results The mean bone mineral density in the fracture area was significantly higher in the BTX-A group (P = .038). The mean failure load and bending modulus values were significantly higher in the BTX-A group than in the control group (P = .032 and P = .005, respectively). The mean histologic bone healing scores, bone volume–total volume values, and trabecular diameter values were significantly higher in the BTX-A group than in the control group (P = .001, P = .001, and P = .026, respectively). Conclusions BTX-A application into the masseter muscles improves bone healing of a unilateral mandibular fracture in rabbits.

Introduction: Toxoplasma gondii is an opportunistic protozoan and can be grown using several human cell lines. Breast cancer is the second leading cause of cancer death in women. Her2/Neu-expressing mammary cancer cell lines called TUBO can be grown in vitro. in recent years, protozoan parasites have become popular means of use in cancer therapy research. in this study, we analyzed whether T. gondii tachyzoites can destroy TUBO cells using a novel continuous feed medium approach. Methodology: Two sets of flasks (each containing four groups) containing TUBO cells were inoculated with T. gondii Ankara strain tachyzoites. First set containing 5x10(6) TUBO cells were inoculated with TUBO-tachyzoite ratios of 1:2, 1:1, 2:1, and 4:1 and second set containing 1x10(6) TUBO cells were inoculated with TUBO-tachyzoite ratios of 10:1, 100:1, 1000:1, and 2000:1. Thereafter, culture supernatants were harvested at various days until TUBO cells were destroyed and tachyzoites were counted. Results: in the first and second sets of flasks, TUBO cells were destroyed between days 8 to 12 and 12 to 25, respectively. in addition, the amount of tachyzoites increased 743 and 595 to 112500 times in the first and second set of flasks, respectively. Conclusions: These results show that T. gondii tachyzoites successfully destroy Her2/Neu-expressing mammary cancer cells using a continuous feed medium approach. Although this idea may be too premature for the moment, the approach defined herein may support future researchers investigating the relationship between cancer and parasites which can make important progress toward saving cancer patient lives., Scientific Research Projects Branch Directorate of Ege University, TurkeyEge University [2016TIP082], The authors would like to acknowledge Prof. Federica Cavallo and Irene Fiore Merighi (University of Torino, Torino, Italy) for providing TUBO cells and technical assistance for the maintenance of TUBO cells in our lab. This study was partly supported by the grant given by the Scientific Research Projects Branch Directorate of Ege University, Turkey (Grant No: 2016TIP082) to L.Y.

Displacement of a foreign body in maxillary sinuses is a common complication in dentistry. However, metallic foreign bodies except dental implants are rarely found in the maxillary sinus. Displaced foreign bodies can cause serious complications and disturb the mucociliary function and this causes potential complications, mainly acute or chronic maxillary sinusitis. This article reported metallic objects penetrating maxillary sinuses of two patients including a membrane fixation screw and a dental burr, as well as their removal with Caldwell-Luc technique. Foreign bodies should be detected and removed on time in order to prevent complications. Otherwise, in advanced stages, the affected area should be reached with Caldwell-Luc operation or endoscopic approaches. Keywords: Maxillary Sinus, metallic foreign body, Caldwell-Luc MAKSILLER SINUSE KACAN METALIK YABANCI CISIMLERIN CIKARTILMASI: IKI VAKA RAPORU OZ Dis hekimligi uygulamalari esnasinda maksiller sinuse yabanci cisim kacmasi sik karsilasabilen bir komplikas- yondur. Diger yonden dental implantlar disinda kalan metalik yabanci cisimlerin maksiller sinuse kacmasi oldukca nadirdir. Yabanci cisimler sinus icerisinde mu- kosiliyer aktiviteyi etkileyerek akut ya da kronik sinuzit gibi ciddi komplikasyonlara sebep olabilirler. Bu maka- lede iki farkli hastanin maksiller sinusune kacan memb - ran fiksasyon vidasi ve dental frez olmak uzere iki me- talik yabanci cisim ve maksiller sinusten Caldwell-Luc islemi ile cikartilmalari rapor edilmistir. Sinus icerisine kacmis yabanci cisimler mumkun olan en kisa zaman- da tespit edilip mumkunse sinuse kactigi acikliktan bol- geden uzaklastirilmalidirlar. Aksi halde ilerleyen do- nemlerde Caldwell-Luc ya da endoskopik yaklasimlara ihtiyac duyulabilir. Anahtar Kelimeler: Maksiller sinus, metalik yabanci cisim, Caldwell-Luc

karakavuk, muhammet/0000-0002-2468-5564; Can, Huseyin/0000-0001-9633-9786, WOS: 000511157700003, PubMed: 31823777, Background: Toxoplasma gondii is an opportunistic protozoan parasite that can infect all warm-blooded animals including humans and cause serious clinical manifestations. Toxoplasmosis can be diagnosed using histological, serological, and molecular methods. in this study, we aimed to detect T. gondii RE gene in various human samples by in house and commercial real time polymerase chain reactions. Methods: A total of 38 suspected cases of toxoplasmosis [peripheral blood (n:12), amnion fluid (n:11), tissue (n:9), cerebrospinal fluid (n:5), and intraocular fluid (n:1)] were included to the study. An in house and a commercial RT-PCR were applied to investigate the T. gondii RE gene in these samples. Results: the compatibility rate of the two tests was 94.7% (37/38). When the commercial RT-PCR kit was taken as reference, the sensitivity and specificity of in house RT-PCR test was 87.5 and 100%. When the in house RT-PCR test was taken as reference, the commercial RT-PCR kit has 100% sensitivity and 96.8% specificity. Incompatibility was detected in only in a buffy coat sample with high protein content. Conclusions: Both the commercial and in house RT-PCR tests can be used to investigate T. gondii RE gene in various clinical specimens with their high sensitivity and specificity. in house RT-PCR assay can be favorable due to cost savings compared to using the commercial test., Scientific Research Projects Branch Directorate of Ege University, TurkeyEge University [2013-TIP-050], This study was partly supported by the grant given by the Scientific Research Projects Branch Directorate of Ege University, Turkey (Grant No: 2013-TIP-050) to Y.G. the funding body does not have any role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Acanthamoeba is a free-living amoeba which can be isolated from environment and among others well known as an opportunist protozoan parasite causing infections in humans and animals. Eyes are extremely important for the wild birds and losing sight ability due to Acanthamoeba can be dangerous. The studies on Acanthamoeba infection in wild birds is very few in world and Turkey therefore we aimed to screen deceased wild birds found in Izmir and Manisa provinces located in western Turkey using PCR and non-nutrition agar (NNA) plate method. Cornea samples were obtained from 18 deceased wild birds. During the external examination, signs of keratitis were observed in two Eurasian sparrowhawks (Accipiter nisus). All of the corneal samples were analyzed by two PCR methods and NNA plate. According to results, the Acanthamoeba positivity in corneal samples was 16.6% and 5.5% by PCR and plate method, respectively. According to sequencing data, two of isolates belonged to genotype T5 and one was genotype T4. In conclusion, Acanthamoeba infection was detected in wild bird cornea samples with/without keratitis for the first time in the world. The result of this study also show that Acanthamoeba can be a cause of keratitis in wild birds of Turkey and thus these predator birds can be a target of other wild animals due to loss of sight ability. In terms of public health, these results show the importance of wild birds as a source of Acanthamoeba infection in nature. Ege Üniversitesi - 2014-TIP-073

PubMed ID: 30280697, Toxoplasma gondii is an obligatory intracellular protozoon parasite that causes toxoplasmosis in humans and all warm-blooded animals. In this study, we aimed to investigate the presence of T. gondii DNA in a Eurasian badger (Meles meles) that was found dead in the wildlife area of Izmir. According to the results of real time polymerase chain reaction, T. gondii REP gene was found to be positive in the Eurasian badger brain homogenate. In conclusion, Eurasian badger, a known carnivore, can be a potential source of toxoplasmosis in the natural settings of İzmir, Turkey.

PubMedID: 30911855 The aim of this study was to investigate the effects of metabolic syndrome (MetS) on bone mineral density (BMD) and microstructure of jawbones, and circulating bone metabolic markers. MetS was induced in male Wistar rats by a 16-week high-sucrose drinking water diet. Mandibles were analyzed for BMD and microstructure by standard radiographs and X-ray diffraction. BMD of three different regions of mandible in MetS group was significantly lower compared to control group. The diffraction intensity of mandibular bone in MetS group was significantly decreased (8.2%) compared to control group; however, crystallite radiuses of mandibular bone samples in both groups were not significantly different. In MetS group, serum bone-specific tartrate-resistant acid phosphatase-5b (TRACP-5b) activity was significantly increased (47%), whereas bone-specific alkaline phosphatase (BALP) activity was significantly decreased (44%) compared to control group. The serum magnesium level in MetS rats (1.82 ± 0.27 mg dL-1) was lower than that of controls (2.11 ± 0.16 mg dL-1). Rats with MetS had significantly higher serum calcium level (9.70 ± 0.41 mg dL-1) than the controls (9.21 ± 0.50 mg dL-1). Overall data suggested that MetS is associated with a significant decrease in BMD and slight deterioration in microcrystallite structure of the jawbones. The changes in TRACP-5b and BALP activities and serum Ca2+ and Mg2+ concentrations also support these findings at a biochemical level. © 2019, The Society of The Nippon Dental University.

Toxoplasma gondii can infect nearly all warm-blooded animals, including humans. In the laboratory diagnosis of toxoplasmosis, serological tests have importance in detecting antibody response. Traditionally T. gondii tachyzoites grown in vivo are being used as an antigen source in serological assays. Currently, tachyzoites produced in vitro are being tested as an antigen source in order to decrease animal use. Microcarrier technology allowed us to grow anchorage-dependent host cells on microcarrier suspension in short time and approximately 10 times more than traditional flask technique. The ability of T. gondii tachyzoites to grow in host cells adhered to microcarriers has not been analyzed yet. In this study, we aimed to develop a novel in vitro culture method to produce T. gondii tachyzoites abundantly using HeLa cells adhered to Cytodex 1 microcarriers. Initially, the growth of HeLa cells adhered to Cytodex 1 was analyzed using RPMI 1640, DMEM, and EMEM. Next, HeLa cells with a concentration of 1 × 10(5) cells/ml and 2 × 10(5 )cells/ml were adhered to Cytodex 1 and grown in spinner flasks. Then, T. gondii tachyzoites were inoculated with 1:1 and 2:1 cell:tachyzoite ratios to HeLa cells adhered to microcarriers in spinner flaks. During continuous production in spinner flasks, tachyzoites were harvested at the 2nd, 4th, and 7th day of culture and the quality of antigens produced from these tachyzoites were tested in ELISA and Western Blotting using sera of patients with toxoplasmosis. The optimization studies showed that finest HeLa inoculation value was 2 × 10(5 )cells/ml using RPMI 1640, and the cell:tachyzoite ratio to obtain the highest tachyzoite yield (17.1 × 10(7)) was 1:1 at the 4th day of inoculation. According to the results of ELISA comparing HeLa cell and mouse derived antigens, the highest correlation with mouse antigen was achieved at the 4th day of HeLa cell culture with 1:1 HeLa:tachyzoite ratio (P

Toxoplasma gondii is a protozoan parasite that can infect warm-blooded animals including humans. Vaccination studies mostly use tachyzoite specific proteins however in natural route of infection, toxoplasmosis initiates with tissue cysts (bradyzoites) or oocysts (sporozoites) and thereafter stage conversion takes place where the tachyzoites take action and cause acute infection continues with tachyzoites. Despite this knowledge, challenging models used in the vaccination studies prefer administration of tissue cyst forming strains intraperitoneally or subcutaneously instead of oral administration which is the natural route of infection. In the present study, a multivalent adjuvanted recombinant protein vaccine that contains bradyzoite specific BAG1 and tachyzoite specific GRA1 protein and controls were administered to female Swiss Webster outbred mice. Humoral and cellular immune responses were analyzed by Rec-ELISA, Western blot, and flow cytometry. Mice were infected orally with T. gondii PRU strain tissue cysts using feeding needle to mimic the natural route of infection. 40 days after challenging microscopy and Real Time PCR were performed to determine the protection level. Analysis of sera obtained from vaccinated mice showed strong anti-BAG1 and anti-GRA1 IgG responses. The IgG2a response was significantly higher (P < 0.0001) and the ratio of CD8 + T lymphocytes secreting IFN-? almost doubled compared to PBS control which are indicative of protection against toxoplasmosis. The amount of tissue cysts in vaccinated group was reduced 10.5% compared to control group. To generate a protective vaccine against toxoplasmosis, multistage vaccines and usage of challenging models mimicking natural route of infection are critical cornerstones. In this study, we generated a BAG1 and GRA1 multistage vaccine that induced strong immune response in which the protection was not at anticipated level. In addition, the murine model was orally challenged with tissue cysts to mimic natural route of infection. © 2015 Published by Elsevier Ltd., 110S200, This study was supported by the Grant given by The Scientific and Technological Research Council of Turkey (110S200) to Y.G. T. gondii PRU strain was kindly obtained from Prof. Marie-Laure Dardé. The authors would like to acknowledge AtaFen Inc., Veterinary Vaccine Production Plant and their team for their generous help through the project and Prof. Wolfgang Bohne for providing BAG1 DNA backbone. The topic of the study was presented in 23rd ECCMID (European Congress of Clinical Microbiology and Infectious Diseases) in Berlin, Germany, 2013. The authors state that they have no conflict of interest.

WOS: 000462753600009, Introduction: In the classic treatment of Trichomonas vaginalis infection, although metronidazole has been used since the 1960s, there has been an increase in MTZ-resistant T. vaginalis strains and failure in the treatment of trichomoniasis causes serious concerns. Therefore, the present study aimed to investigate the in vitro antitrichomonal activities of extracts (ethanol and total alkaloid) and pure compounds (chrysosplenetin, dictamnine, gamma-Fagarine, skimmianine) of H. myrtifolium against T. vaginalis. Methodology: H. myrtifolium was collected from the town of Honaz in Denizli, located in the Aegean region of Turkey, and preparation of extracts and isolation and structure elucidation of pure compounds were performed. Later, different concentrations of extracts and pure compounds were incubated with T. vaginalis trophozoites isolated from Turkey, which are known to be sensitive to metronidazole. Results: It was found that ethanol extract caused a more effective lysis on T. vaginalis trophozoites compared with total alkaloid extract (P < 0.05). No compounds except for furoquinoline alkaloid skimmianine prepared above 37.5 mu g/mL were found to have any inhibitory effect on T. vaginalis trophozoites. Conclusion: The ethanol extract of H. myrtifolium and skimmianine can be considered as potential candidates for antitrichomonal drug development.

WOS: 000430290200079, PubMed ID: 29668747, Toxoplasma gondii is a protozoon parasite that causes congenital toxoplasmosis, as well as other serious clinical presentations, in immune compromised humans. Analyses of the prevalence and genotyping of strains from the definitive host and intermediate hosts will help to understanding the circulation of the different strains and elucidating the role of the genotype (s) in human toxoplasmosis. Turkey has a specific geographic location bridging Africa, Europe, and Asia. We hypothesized that T. gondii strains may have been transferred to Turkey from these continents via migratory birds or vice versa. The present study aimed to assess the prevalence of toxoplasmosis in wild birds of prey of Izmir and Manisa provinces as well as genetically characterize T. gondii strains from these wild birds to show the relation between bird strains and neighboring stray cats as well as human strains previously isolated in Turkey. Tissues obtained from 48 wild birds were investigated for the presence of T. gondii DNA and then bioassayed in mouse. Isolated strains were genotyped using 15 microsatellite markers. The prevalence of T. gondii DNA was found to be 89.6% (n: 43/48) in wild birds. Out of 43 positive samples, a total of 14 strains were genotyped by 15 microsatellite markers. Among them, eight were type II, three were type III and three were mixture of genotypes (two type II/II and one was II/III). These are the first data that showed the presence of T. gondii and types II and III genotypes in wild birds of Turkey. Moreover, Africa 1 was not detected. In addition, cluster analysis showed that T. gondiistrains within type II and III lineage have close relation with strains previously isolated from stray cats in Izmir. Further studies are required to isolate more strains from human cases, other intermediate hosts, and water sources to reveal this relation., Scientific Research Projects Branch Directorate of Ege University, TurkeyEge University [2014-TIP-073], This study was supported by the grant given by the Scientific Research Projects Branch Directorate of Ege University, Turkey (Grant No: 2014-TIP-073) to A.Y.G. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

WOS: 000452407200006, Complex clinical symptoms such as ulcerative skin lesions, destructive mucosal inflammation, and disseminated visceral infection can reveal in leishmaniasis. The conventional drugs are toxic and expensive. In addition, patients receive a long treatment with these drugs which have adverse effects and unfortunately there are some limitations during the treatment. The aim of this study is to investigate the in vitro anti-leishmanial activities of four different extracts of Sarcopoterium spinosum against Leishmania tropica. Initially, different concentrations of ethanol, methanol, n-hexane, and water extracts of S. spinosum were incubated with L. tropica promastigotes. After 72 hours of incubation, the growth of L. tropica promastigotes was significantly inhibited and the percentage of inhibition ranged between 42.8 and 100 %. Among these extracts, the most efficient growth inhibition (100 %) was obtained with methanol extract (at a dose of 50 mu g/ml). In conclusion, S. spinosum may be a potential source for the development of novel therapeutic agents to treat L. tropica infection.

WOS:000455820300004, PubMed ID: 30683024, Introduction: Sleep quality is known to be associated with the distressing symptoms of cancer. The purpose of this study was toanalyze the impact of cancer symptoms on insomnia and the prevalence of sleep-related problems reported by the patients with lung cancer in Turkey. Materials and Methods: Assesment of Palliative Care in Lung Cancer in Turkey (ASPECT) study, a prospective multicenter study conducted in Turkey with the participation of 26 centers and included all patients with lung cancer, was re-evaluated in terms of sleep problems, insomnia and possible association with the cancer symptoms. Demographic characteristics of patients and information about disease were recorded for each patient by physicians via face-to-face interviews, and using hospital records. Patients who have difficulty initiating or maintaining sleep (DIMS) is associated with daytime sleepiness/fatigue were diagnosed as having insomnia. Daytime sleepiness, fatigue and lung cancer symptoms were recorded and graded using the Edmonton Symptom Assessment Scale. Results: Among 1245 cases, 48.4% reported DIMS, 60.8% reported daytime sleepiness and 82.1% reported fatigue. The prevalence of insomnia was 44.7%. Female gender, patients with stage 3-4 disease, patients with metastases, with comorbidities, and with weight loss 5 kg had higher rates of insomnia. Also, patients with insomnia had significantly higher rates of pain, nausea, dyspnea, and anxiety. Multivariate logistic regression analysis showed that patients with moderate to severe pain and dyspnea and severe anxiety had 2-3 times higher rates of insomnia. Conclusion: In conclusion, our results showed a clear association between sleep disturbances and cancer symptoms. Because of that, adequate symptom control is essential to maintain sleep quality in patients with lung cancer., Giriş: Uyku kalitesinin, kanser semptomlarının şiddetiyle ilişkili olduğu bilinmektedir. Bu çalışmada, Türkiye’de akciğer kanseri hastalarında uyku ile ilişkili sorunların prevalansı ve kanser semptomlarının insomnia üzerine etkisinin araştırılması amaçlandı. Materyal ve Metod: Türkiye’de 26 merkezin katılımıyla gerçekleştirilen, akciğer kanserli olguların dahil edildiği çok merkezli bir çalışma olan ASPECT çalışması verileri, bu hastalarda görülen uyku sorunları, insomni ve bunların kanser semptomları ile ilişkisi yönüyle yeniden değerlendirildi. Hastaların demografik özellikleri ve hastalıkları hakkında bilgi, hasta ile yüz yüze görüşülerek ve hastane kayıtları aracılığıyla derlendi. Uykuyu başlatma ve sürdürme zorluğu (DIMS) ile gündüz artmış uyku hali veya yorgunluk tanımlayan olgular insomni olarak değerlendirildi. Gündüz uyku hali, yorgunluk ve akciğer kanseri semptomları Edmonton Semptom Değerlendirme Skalası kullanılarak kaydedildi. Bulgular: Katılan 1245 olgunun, %48.4’ünde DIMS, %60.8’inde gündüz uyku hali ve %82.1’inde yorgunluk mevcuttu. Insomni prevalansı %44.7 olarak bulundu. Kadın cinsiyet, evre 3-4 hastalık, metastatik hastalık, komorbid hastalıklar ve kilo kaybı 5 kg olan olgularda insomnia oranı anlamlı olarak daha yüksekti. Diğer yandan insomnisi olan hastalarda ağrı, bulantı, dispne ve anksiyete semptomları anlamlı düzeyde yüksek bulundu. Multivariate lojistik regresyon analizi, orta ileri şiddetli ağrısı ve dispnesi olan, ayrıca ciddi anksiyetesi olan hastalarda insomni sıklığının 2-3 kat fazla olduğunu ortaya koydu. Sonuç: Çalışmamız, kanser semptomları ile uyku kalitesi arasında yakın bir ilişki olduğunu ortaya koymuştur. Bu nedenle, akciğer kanserli hastalarda kaliteli bir uyku için, kanser semptomların yeterince kontrol edilmesi gereklidir.

Background Breast cancer is the most common cause of deaths of cancer in women. Nowadays, following completion of imaging methods, mainly fine needle aspiration biopsy (FNAB) and core biopsy methods have been used for establishing cytopathological diagnosis although discussions regarding superiority continue. Materials and methods Those with a complaint of "mass in breast" along with those diagnosed to have a mass as a result of routine physical examination among all patients applying to our clinic between 01.01.2009 and 31.12.2011 were retrospectively assessed. Totals of 146 and 64 patients with complete radiological observation who had undergone FNAB and core biopsies, respectively, were evaluated. Postoperative pathological results of patients of both groups receiving surgery were also taken into consideration. All results were compared in terms of false positivity/negativity, sensitivity/specifity, surgery types and distribution of postoperative results with regard to diagnoses along with those of malignant/benign masses with regard to quadrants determined. Results Diagnostic malignancy power of mammographic BIRADS classification was 87.3%. However, the value was 75% in the core biopsy group. Sensitivity and specifity following comparison of FNAB and postoperative pathology results of those receiving surgery were 85.4% and 92.9% while they were 93.5% and 100% in the core biopsy group. Diagnostic malignancy power, calculated by determining AUC in ROC analysis, of FNAB was 89.1% while that of core biopsy was 96.7%. Conclusions It was shown that core biopsy is superior to FNAB in terms of sensitivity, specificity and accurate histopathological classification. However; quick, cheap and basic diagnosis by means of FNAB should not be ignored. Sensitivity of FNAB is rather high in experienced hands and furthermore it would be expected to be lower than with core biopsy.

Objectives: Iron deficiency (ID) is the most common nutritional problem in the world and is the most common cause of childhood anemia. In this study, our aim was to find out about the state of usage of iron preparation, which is distributed free of charge by the Ministry of Health, for the infants between 4-12 months in our country, as well as detecting the awareness degree of families those who are informed about iron-deficiency anemia (IDA), prophylaxis of the drug and to determine the drug’s effectiveness. Methods: It was a cross-sectional survey. The laboratory values from the files of the children aged 1-2 those who visited our hospital’s department of pediatrics, between January 2010 to August 2013, were collected. The survey included families who have children diagnosed with IDA. Questions included about families’ sociodemographic characteristics, the state of the usage of the iron drug, how much information received in terms of the side effects- consumption period and dosage. Results: A total of 139 children were enrolled in our study. While 77.7% of the families who participated stated that (n = 108) iron medicine was prescribed other 43.2% of families stated (n = 60) was prescribed and they were informed about iron pills and IDA. 25.9% of families had received information about drug’s side effects, 74.8% of them had information about period of consumption and 77.7% said they were given information about the drug dose. The average duration of use of iron medicine was 6.98±4.52 (min: 1, max: 24) months. It has been noted that; parent’s education level, mother’s occupation, child’s gender, how the child was born and receiving information about how to use the medicine had no effects on usage of the drug in children. Nevertheless, it has been noticed that, when the families were given proper information the drug use increased and the patients compliance with medications also increased. Conclusion: We believe that, due to frequent diagnosis of anemia in children, prophylaxis iron supplementation should be continued for up to the age of two years.

Summary Twenty nine years after the introduction of Pregnancy Risk Categories, U.S. Food and Drug Administration (FDA) concluded that categories were not successful at conveying the possible risks of drug use in pregnancy. FDA announced its second generation approach to labeling drugs for use in pregnancy and lactation with the publication of Proposed Rule for Pregnancy and Lactation Labeling for Human Prescription Drug and Biological Products on May 29, 2008. The proposed rule is designed as a narrative text containing elements such as fetal risk summary, clinical considerations and data. This manuscript aims to increase information and awareness of family practitioners on this subject.

PubMedID: 29655818 The aim of this study was to identify the risk factors associated with sinus membrane perforation and the effect of sinus membrane perforation and other risk factors on graft success and postoperative sinusitis. Sinus membrane perforation, graft failure, and postoperative sinusitis were tested for an association with age, sex, operator experience, side of the operation, residual bone height, presence of septa, presence of a mucous retention cyst, and smoking (?2 test). Logistic regression analysis was used to model the odds ratio (OR) with corresponding risk factors. One hundred and twenty patients were included in this study. A total of 22 (18.3%) perforations occurred. A residual bone height of 3–6 mm (OR 6.808, P = 0.002) and presence of septa (OR 4.023, P = 0.025) were identified as significant risk factors. Twenty-eight (23.3%) sinus grafts were classified as failed. Membrane perforation (OR 16.819, P < 0.005) and residual bone height of 3–6 mm (OR 5.363, P = 0.01) were identified as significant risk factors for graft failure. None of the risk factors investigated in this study was significantly associated with postoperative sinusitis. These results suggest that the presence of septa and a residual bone height of 3–6 mm are associated with an increased risk of sinus membrane perforation, and that sinus membrane perforation has a negative effect on graft success. © 2018 International Association of Oral and Maxillofacial Surgeons

WOS: 000391457100008, PubMed ID: 27780164, Objective: To investigate the symptoms of lung cancer in Turkey and to evaluate approaches to alleviate these symptoms. Subjects and Methods: This study included 1,245 lung cancer patients from 26 centers in Turkey. Demographic characteristics as well as information regarding the disease and treatments were obtained from medical records and patient interviews. Symptoms were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and were graded on a scale between 0 and 10 points. Data were compared using the. 2, Student t, and Mann-Whitney U tests. Potential predictors of symptoms were analyzed using logistic regression analysis. Results: The most common symptom was tiredness (n = 1,002; 82.1%), followed by dyspnea (n = 845; 69.3%), appetite loss (n = 801; 65.7%), pain (n = 798; 65.4%), drowsiness (n = 742; 60.8%), anxiety (n = 704; 57.7%), depression (n = 623; 51.1%), and nausea (n = 557; 45.5%). Of the 1,245 patients, 590 (48.4%) had difficulty in initiating or maintaining sleep. The symptoms were more severe in stages III and IV. Logistic regression analysis indicated a clear association between demographic characteristics and symptom distress, as well as between symptom distress (except nausea) and well-being. Overall, 804 (65.4%) patients used analgesics, 630 (51.5%) received treatment for dyspnea, 242 (19.8%) used enteral/parenteral nutrition, 132 (10.8%) used appetite stimulants, and 129 (10.6%) used anxiolytics/antidepressants. Of the 799 patients who received analgesics, 173 (21.7%) reported that their symptoms were under control, and also those on other various treatment modalities (dyspnea: 78/627 [12.4%], appetite stimulant: 25/132 [18.9%], and anxiolytics/antidepressants: 25/129 [19.4%]) reported that their symptoms were controlled. Conclusion: In this study, the symptoms progressed and became more severe in the advanced stages of lung cancer, and palliative treatment was insufficient in most of the patients in Turkey. (C) 2016 S. Karger AG, Basel

Sıtma, tropikal ve subtropikal bölgelerde yaygın olarak görülen ve hayatı tehdit eden bir hastalıktır. Sıtmanın endemik olarak görüldüğü bölgelere seyahat öyküsü olan ve tipik klinik belirtileri olan hastalarda ön tanı olarak sıtma düşünülmektedir. Sıtmanın laboratuvar tanısının temelini boyalı preparatların mikroskobik incelemesi oluşturmaktadır. Fakat mikroskobik inceleme ile tanı ve Plasmodium tür ayrımının yapılmasında zorluklar yaşanabilmektedir. Birinci olguda; ateş, üşüme-titreme şikayetleri olan ve Nijerya seyahati öyküsü bulunan 26 yaşındaki erkek olguda, ince yayma kan preparatında %1 oranında saptanan enfekte eritrositlerde klasik Plasmodium vivax eritrositer formlarından farklı görünüm saptanmıştır. Parazitin çekirdekleri belirgin olmayıp, kromatin veya boya tanesi şeklinde düzensiz olarak sitoplazmada yer almış, bazı eritrositlerde dağınık ve granüler, sitoplazmada noktalar şeklinde Schüffner granüllerine benzer nükleus parçaları, bazı Plasmodium eritrositer formlarının sitoplazmalarının düzensiz olduğu ve nükleuslarının olmadığı gözlenmiştir. Enfekte olan eritrositlerin hiçbirinde Schüffner granüllerine rastlanmamıştır. Hastanın periferik kan örneğinde Plasmodium türlerine ait antijenleri saptayabilen hızlı tanı testi (OptiMAL, DiaMed, İsviçre) ile olgumuzda P.vivax saptanmıştır. Multipleks gerçek zamanlı polimeraz zincir reaksiyonu ile P.vivax 18S rRNA geni gösterilmiştir. Hastanın serum örneğinde Pan Malaria Antibody CELISA (CeLLabs, Pty Ltd, Brookvale, Avustralya) kiti kullanılarak Plasmodium türlerine karşı antikor aranmış ve hasta örneğinin optik dansite (OD) değeri pozitif kontrolün OD değerinin beş katı olarak ölçülmüştür. İkinci olgu ise 31 yaşında Nijerya'da çalıştığı öğrenilen erkek hasta olup, düşmeyen ateş, şiddetli baş ağrısı, kulaklarda ve gözlerde ağrı şikayetleriyle başvurmuş ve ince yayma kan preparatında %12 oranında saptanan enfekte eritrositlerde klasik P.falciparum eritrositer formlarından farklı görünüm saptanmıştır. Bazı Plasmodium trofozoitlerinin, P.vivax gibi eritrositin 1/3'ü büyüklüğünde ve granüler olmayan sitoplazmaya sahip oldukları, bazı eritrositer formların yuvarlak olduğu ve nükleus ve sitoplazmasının zor ayrıldığı, bazılarının ise hilal şeklinde görülüp nükleusların sitoplazmanın ortasına yakın yer aldığı, bazı eritrositer formların P.vivax'ın olgun trofozoitlerine benzer şekilde tek nükleus ve dağınık bir sitoplazma ile karakteristik bir görünümde olduğu saptanmıştır. Plasmodium genç trofozoitlerinin büyüklük olarak P.vivax'a benzemesine rağmen özellikle nükleuslarının eritrosit çeperine yapışmış formları çok miktarda gözlenmiştir. P.falciparum gametosit formlarına rastlanılmamıştır. Yapılan dört yaymanın sadece birinde P.falciparum benzeri genç trofozoite rastlanılmıştır. Hızlı tanı testi ile P.falciparum saptanmış ve multipleks gerçek zamanlı polimeraz zincir reaksiyonu ile P.falciparum 18S rRNA geni tespit edilmiştir. ELISA testinde Plasmodium türlerine karşı antikor saptanmamıştır. Bu olgu sunumunda dış kaynaklı iki sıtma olgusunun laboratuvar tanısı ve Plasmodium tür ayrımında antijen saptayan hızlı test, serolojik ve moleküler yöntemlerin mikroskobik tanıya desteğinin önemi ortaya konulmuştur., Malaria is a widespread and life-threatening disease in tropical and subtropical regions. In patients with typical clinical symptoms, malaria is considered as a preliminary diagnosis if there is a travel history to malaria-endemic areas. The basis of the laboratory diagnosis of malaria is the microscopic examination of Giemsa stained smears. On the other hand, the diagnosis and differentiation of Plasmodium species with microscopic examination may have some difficulties. In the first case, adifferent appearance from the classical Plasmodium vivax erythrocytic forms in infected erythrocytes were detected in 1% of all erythrocytes in thin smear blood preparations of a 26-year-old male with complaints of fever and chills and a story of travel to Nigeria. It was observed that parasitic nuclei were not prominent, and were located in the cytoplasm irregularly as chromatin or dye particles, nucleus fragments similar to Schüffner's granules in the form of scattered and granular spots were present in some erythrocytes, the cytoplasm of some Plasmodium erythrocytic forms were irregular and nuclei were not seen. There were no Schüffner's granules in any of the infected erythrocytes. P.vivax was detected by the rapid diagnostic test (OptiMAL, DiaMed GmbH, Switzerland), which searches for the antigens of Plasmodium species, in the peripheral blood sample of the patients. The P.vivax 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibodies against Plasmodium species were searched by using the Pan Malaria Antibody CELISA (CeLLabs Pty Ltd, Brookvale, Australia) kit in the patient's serum sample and the optical density (OD) value of the patient sample was measured five times the OD value of the positive control. In the second case, adifferent appearance from the classical P.falciparum erythrocytic forms in infected erythrocytes were detected in 12% of all erythrocytes in thin smear blood preparations of a 31-year-old male who has been suffering from persistent fever, severe headache, pain in the eyes and was known to be working in Nigeria. It was observed that some Plasmodium trophozoites have 1/3 of the size of erythrocytes such as P.vivax and have non-granular cytoplasm, some erythrocytic forms were round and the nucleus and cytoplasm were hardly distinguished, some of them were seen as crescent and close to the nucleus of the cytoplasm and some erythrocytic forms had characteristically a single nucleus and a scattered cytoplasm, similar to mature trophozoites of P.vivax. Although the Plasmodium young trophozoites were similar to P.vivax in means of magnitude, the forms in which the nuclei adhered to the erythrocyte wall were common. There were no P.falciparum gametocyte forms. P.falciparum like young trophozoite was observedonly in one of the four smears. P.falciparum was detected by the commercial rapid diagnostic test and P.falciparum 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibody formation against Plasmodium species was not detected in the ELISA test. In these case reports, the importance of the support of rapid diagnostic tests, serological and molecular methods to microscopic diagnosis and species determination of two imported malaria cases were demonstrated.

Impairments in social functioning commonly seen in schizophrenia are thought to be mediated by deficits in the domains of social cognition. Some previous research has explored how social cognitive skills and psychotic symptoms are associated with social functioning, however these associations are still under debate. The main aim of this study was to investigate the relationship between different domains of social cognition and psychotic symptomatology, and also to look at the relationships with individual subdomains of social functioning within a clinically stable schizophrenia population. 45 outpatients were recruited and symptoms were assessed with the PANSS, and measures of emotion processing, affective and cognitive theory of mind (ToM), mental state reasoning attributional biases, and social functioning were taken. A correlational analysis was performed with the data. Following this, a regression analysis was used to reveal which domains of social cognition best predicted psychotic symptoms. In this stable group of patients, our results support the suggestion of a likely distinction between affective and cognitive components of ToM. The study also demonstrated that ToM and mental state reasoning were the best predictors of psychotic symptoms. Here we reveal that cognitive ToM had the most widespread relationship with social functioning, across multiple subdomains, while only some specific subdomains of social functioning correlated with other domains of social cognition and symptomatology. Further to this, positive symptoms were associated with much fewer subdomains of social functioning than negative and general symptoms. These findings imply that different aspects of social functioning may be served by different domains of social cognition and symptomatology. (C) 2014 Elsevier Inc. All rights reserved.

Background: Cervical cancer is one of the ten most frequent cancers in Turkey. We here examined knowledge about cervical cancer in relation to Papanicolaou (Pap) testing among female primary health care workers in Hatay, a city is located in the south of Turkey. Materials and Methods: The study was completed on 261 women healthcare workers who were or had been sexually active and who accepted to participate to the study. The participants gave verbal informed consent and thereafter questionnaires prepared by the investigators were administered by personal interview. Results: Only 30.3% (n=79) of the participants regularly had a gynecologic examination. While 87.4% (n=228) of the participants reported that they had already heard about the Pap smear test, only 45.2% (n=118) had undergone this test. It was determined that had undergone an average of 1.66±0.89 times (1-4) within the last five years. Some 56.0% (n=117) of the participants were well informed about the Pap smear test (p

Background Detection of Pneumocystis jiroveci colonization in lungs or oral samples due to high sensitivity of PCR methods results in undue treatment of patients without any symptoms of Pneumocystis pneumonia. The aim of the present study is to demonstrate Pneumocystis carinii in rats, immune suppressed by oral and subcutaneous administration of dexamethasone. Material/Methods Blood, oral, nasal and eye swabs were collected prior to immune suppression and 2, 6, 12 weeks after administration of dexamethasone. Also, samples were collected from lung, heart, liver, kidney, diaphragm, brain, spleen, tongue, muscle, eye, intestine, and feces. Cysts and trophozoites were investigated in stained slides and MSG gene was detected by PCR. Results The results showed that weight loss is significantly higher in rats administered oral dexamethasone (P

OBJECTIVE Mastalgia is the most common symptom in women, who has gone under breast imaging. 70% of women face with mastalgia at least once in their lifetime. In our study, we aimed to investigate the examinations and the results of the females referred to our outpatient clinics with mastalgia and to determine the frequency of malignancy. MATERIALS AND METHODS Files of all women patients referred to General Surgery Outpatient Clinics between 01.06.2014-31.05.2015 has been investigated retrospectively. Cases only with breast pain complaint (n=789) out of 2798 women has been included in the study. Women with lump in breast, nipple discharge, redness, breast retraction and pregnant and lactating women were excluded. Breast examination findings, ultrasonography (USG), mammography results, whether biopsies are done or not and diagnoses have been investigated retrospectively. RESULTS Mean age was 42.97±12.36 (16-74) years. 59.7% (n=471) of the women had bilateral mastalgia and 91.1% (n=719) of the breast examinations were found to be normal. USG was required from 664 (84.2%) women and mammography was required from 448 (56.8%) women. Considering diagnoses; fibrocystic changes in 32.3% (n=201), ductal ectasia in 8.8% (n=55), fibroadenomas in 6.1% (n=38), reactive lymphoid hyperplasia in 1.1% (n=7) was observed. Only 1 (0.2%) woman was diagnosed with invasive ductal carcinoma. CONCLUSION According to researches, 0.5% of the women with mastalgia were diagnosed with breast cancer. In our study this rate was found as 0.2%. Women with only mastalgia without any abnormality in physical examination should be informed about dealing with pain.

WOS: 000378184000010, PubMed ID: 27175499, Cystic echinococcosis (CE) and alveolar echinococcosis (AE) caused by Echinococcus granulosus and Echinococcus multilocularis, respectively, are important helminthic diseases worldwide as well as in our country. Epidemiological studies conducted in Turkey showed that the prevalence of CE is 291-585/100.000. It has also been showed that the seroprevalence of AE is 3.5%. For the diagnosis of CE and AE, radiological (ultrasonography, computed tomography, magnetic resonance) and serological methods, in addition to clinical findings, are being used. The definitive diagnosis relies on pathological examination When the hydatid cysts are sterile or does not contain protoscolex, problems may occur during pathological discrimination of E.granulosus and E.multilocularis species. In this study, we aimed to develop a novel multiplex real-time polymerase chain reaction (M-RTPCR) targeting mitochondrial 12S rRNA gene of E.granulosus and E.multilocularis using Echi S (5'-TTTATGAATATTGTGACCCTGAGAT-3') and Echi A (5'-GGTCTTAACTCAACTCATGGAG-3') primers and three different probes;. Anchor Ech (5'-GTTTGCCACCTCGATGTTGACTTAG-fluoroscein-3'), Granulosus (5'-LC640-CTAAGGTTTTGGTGTAGTAATTGATATTTT-phosphate-3') and Multilocularis (5'-LC705-CTGTGATCTIGGTGTAGTAGTTGAGATT-phosphate-3') that will enable the diagnosis of CE and AE in same assay. During M-RTR-PCR, plasmids containing E.granulosus (GenBank: AF297617.1) and E.multilocularis (GenBank: NC_000928.2) mitochondrial 12S rRNA regions were used as positive controls. Cysts samples of patients which were pathologically confirmed to be CE (n: 10) and AE (n: 15) and healthy human DNA samples (n: 25) as negative control as well as DNA samples of 12 different parasites (Taenia saginata, Hymenolepis nana, Trichuris trichiura, Fasciola hepatica, Enterobius vermicularis, Toxoplasma gondii, Pneumocystis jirovecii, Trichomonas vaginalis, Cryptosporidium hominis, Strongyloides stercoralis, Plasmodium falciparum, Plasmodium vivax) were used to develop M-RT-PCR. E.granulosus and E.multilocularis control plasmids were constructed to detect analytic sensitivity of the test using TOPO cloning. Positive control plasmids were diluted to determine analytical sensitivity and specificity by distilled water at 10(6)-10(5)-10(4)-10(3)-10(2)-10(1)-1 plasmid copy of dilution in each reaction. According to the results, analytical sensitivity of the assay for E.granulosus and E.multilocularis was 1 copy plasmid/mu l reaction. The non-existence of cross reactivity with 12 different parasites' DNA samples showed the analytical specificity of the assay. Displaying Echinococcus DNA in cyst samples among 25 patients and species discrimination as well as non-existence of cross reactivity with human DNA samples showed that the clinical sensitivity and specificity of the assay were 100%. As a result, the M-RT-PCR developed in the present study provided a sensitive, specific, rapid, and reliable method in the diagnosis of echinococcosis and the discrimination of E.granulosus and E.multilocularis from cyst samples.

WOS: 000404381800027, PubMed ID: 28618740, Background/aim: Strongyloides stercoralis causes life-threatening hyperinfection or disseminated strongyloidiasis in immunocompromised patients such as HIV-positive, organ transplantation, and cancer patients. This study investigated the presence of strongyloidiasis in immunocompromised patients for the first time in Turkey. Materials and methods: Serum and stool samples were collected from 108 patients (25.9% of them were chronic renal failure and 74.1% were renal transplantation patients) who were admitted to Ege University Medical School in Izmir, located in western Turkey. Serum samples were analyzed by ELISA (DRG, Germany) and the presence of 18S rRNA gene of S. stercoralis was detected in stool samples by real-time PCR. Results: The analysis of serum samples showed that only one patient was anti-S. stercoralis IgG antibody and real-time PCR positive (0.92%). The patient was treated twice with albendazole (400 mg/day for 3 days) at 2-week intervals. Follow up real-time PCR was negative and the patient became seronegative 6 months after the initial diagnosis. Conclusion: This screening showed that the prevalence of strongyloidiasis in this small group of patients who were at risk of strongyloidiasis was 0.92%. Overall, the results showed that more systematic studies are required in Turkey to show the prevalence of strongyloidiasis., Ege University, TurkeyEge University [2013TIP022], This study received financial support through a grant given by Ege University, Turkey (Grant number: 2013TIP022) to Meltem Isikgoz Tasbakan.

PubMed ID: 27905280, OBJECTIVE: Malaria is an important tropical disease that is detected in 198 million people and causes 367-755 thousand deaths annually. Recently, the real-time Polymerase Chain Reaction (PCR) technique has enabled quick determination of Plasmodium spp. and species identification in the same assay with a low contamination risk. In the present study, we aimed to use real-time PCR targeting the 18S rRNA gene to diagnose Plasmodium spp. and perform species identification.METHODS: DNA samples of 15 patients with malaria (14 caused by P. vivax, 1 caused by P. falciparum) confirmed by microscopy as well as positive control plasmids were used. As the negative control, DNA samples of 15 individuals without malaria were used.RESULTS: According to the results of real-time PCR, samples of 15 patients with malaria were found to be positive for Plasmodium spp. Melting curve analysis showed that 14 of them were P. vivax and the remaining was P. falciparum. In addition, mixed infection with P. falciparum and P. vivax was successfully detected by real-time PCR when DNA of P. falciparum- and P. vivax-positive samples was experimentally mixed.CONCLUSION: The present study showed that real-time PCR can be useful in the diagnosis and species identification of Plasmodium spp. as well as the detection of mixed infections in addition to microscopy in Turkey.

Background/aim: The aim of this study was to determine the patient profile, treatment, and outcomes of a coronary care unit (CCU) by retrospective screening of 12-year patient records. Materials and methods: The data of 13,463 patients admitted to the CCU of a tertiary referral hospital between 1 January 1997 and 30 June 2008 were collected. The patients were assessed with respect to demographics, admission diagnosis, treatment, and outcomes. Results: The mean age of patients was 61 ± 13 years (66.7%, male). While the diagnosis of acute coronary syndrome (ACS) accounted for 65%, the rate of ST elevation myocardial infarction (STEMI) was 43.4%. Thrombolytic therapy was administered to 48.7% of the patients with STEMI. Systolic heart failure was the most frequent disease (11.9%) among the non-ACS diagnoses. The mortality rate of the CCU was 12.7% on average; it increased gradually after 2005 when the CCU became a general intensive care unit. Conclusion: This study is one of the largest comprehensive analyses of patient profile and outcomes of a CCU. Despite advances in the diagnosis and treatment of cardiac emergencies, the mortality rate of the CCU was high. Serving as a general intensive care unit, the absence of a coronary angiography laboratory and lower use of thrombolytic therapy for STEMI might be responsible factors.

Background: We here examined the awareness of female health employees (doctors, nurses, midwives) working in primary health care service about cervical cancer and its risk factors. Additionally attitude and behavior for gynecologic examination and pap smear screening wwere researched. Materials and Methods: This cross-sectional, descriptive study con cerned female health employees working at primary health care services in two southern cities of Turkey, over a four month period in 2013. Participants were recently or previously sexually active research was explained and verbal informed consent was obtained face to face. The questionnaire consisted of two parts; socio-demographic characteristics and level of knowledge about cervical cancer and its risk factors. Results: The average age of the participants (midwives 43.7%, n=143; nurses 40.4%, n=132; doctors 6.4%, n=21; emergency medical technicians and others, 9.5%, n=31; total, n=327) was 30.9±6.41 years. 64.2% (n=210) were working in Diyarbakir and 35.8% (n=117) in Batman. A large proportion reported low knowledge and inadequate screening practice Conclusions: Health employees should be better informed about the importance of screening for cancers, given their preventive roles for the general population.

Background: Although adjuvant chemotherapy is a standard treatment in stage III colon cancer, its benefit is not as clear for stage II patients. In this retrospective analysis, we aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease. Materials and Methods: One hundred and seventeen patients who were diagnosed with stage II colon cancer between January 2006 and December 2011 were included in the study. Patients were stratified into two groups as being low-risk and high-risk according to risk factors for stage II disease. Adjuvant 5-fluorouracil-based chemotherapy were administered to the patients with risk factors. Results: Ninety-four patients were treated with adjuvant chemotherapy due to high risk factors and 23 were monitored without treatment. Median follow-up time was 43 months. In terms of disease free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Univariate analysis demonstrated that bowel obstruction was the major risk factor for shortened disease-free survival, while bowel perforation and perineural invasion were both negative prognostic factors for overall survival. Conclusions: The recommendation of adjuvant chemotherapy for stage II colon cancer is not clear. In our study, it was found that adjuvant chemotherapy did not contribute to survival in high-risk stage II patients. Due to the fact that prognosis of stage II patients is good, many more patients will be needed for statistically significant differences in survival. Adjuvant chemotherapy containing 5 fluorouracil is being used to high-risk stage II patients although it is not a standard treatment approach.

Background: We aimed to investigate anxiety, depression and sexual satisfaction levels and the effects of depression and anxiety upon the sexual satisfaction of Turkish breast cancer patients and their partners. Materials and Methods: Data were collected from one hundred breast cancer patients and their partners, using three forms: one covering information about socio-demographic characteristics of the patients, the Hospital Anxiety and Depression Scale (HADs) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Results: The frequencies, avoidance and touch subscores were statistically significantly high in the patients. Among those with high anxiety scores, the frequency, communication, satisfaction, touch, and anorgasmic subscale scores of GRISS were found to be significantly high. Among the partners whose anxiety scores were high, only the premature ejaculation subscale was statistically significant. It was determined that for partners with higher depression scores, the communication, satisfaction, avoidance, premature ejaculation and erectile dysfunction subscores of GRISS were statistically higher compared to partners with lower depression scores. Conclusions: Patients' quality of life may be increased by taking precautions to reduce their and their partners' psychosocial and psychosexual concerns.

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Plasmodium vivax is the most common cause of malaria worldwide as well as southeastern Turkey. After the implementation of a successful national elimination program that the local malaria cases were not reported in 2011, malaria returned to county of Savur located in southeastern Turkey in summer of 2012. The present study aimed to determine the prevalent P. vivax genotypes isolated from southeastern Turkey. Genetic polymorphism in P. vivax CSP gene was analyzed by PCR-RFLP to assess the ratio of VK210 and VK247 types. Blood samples were obtained from 15 patients who lived in southeastern between 2005-2006. According to the results, VK210 type was detected in 10 samples (66.6%), VK247 type was observed in three samples (20%). Remaining two samples showed mixed infection (13.3%). The results of the present study first time showed the ratio of P. vivax genotypes in southeastern Turkey before the elimination in 2011. The results of the present study will be enable researchers to compare the new isolates with the previously detected ones and design new treatment and/elimination strategies.

We aimed to investigate anxiety, depression and sexual satisfaction levels of testicular cancer survivors (TCSs) and compare the scores with healthy men's. The Hospital Anxiety and Depression Scale (HADS), Gol- ombok-Rust Inventory of Sexual Satisfaction (GRISS) and European Organization for Research on Treatment of Cancer Questionnaires Quality of Life-C30 were used. Forty-one TCSs and thirty-eight healthy men were partic- ipated in this study. The total HADs scores of TCSs (12.21 ± 8.19) were less than the healthy group (14.44 ± 6.53; p ( 0.05). The high depression scores rate was 29.2 and 55.2, and high anxiety scores rate was 24.4 and 28.9 for TCSs and healthy group, respectively. When we evaluated GRISS subscores and anxiety levels, we found significantly increase only in avoidance subscores in the TCSs (p = 0.04). When we evaluated GRISS subscores and depression levels, GRISS subscores of the TCSs who had high depression scores were also high. However, sta- tistical significance was found in satisfaction (p = 0.009), touch (p = 0.04), avoidance (p = 0.01) and erectile dysfunction (p = 0.04) subscores in the TCSs. In the TCSs whose anxiety scores were high, emotional functioning (p = 0.009) and global QoL (p = 0.01) subscores of GRISS was found significantly low. In the TCSs whose depression scores were high, physical (p = 0.01), cognitive (p = 0.04), emotional (p = 0.03), social functioning (p = 0.02) and global QoL (p \ 0.001) subscores of GRISS were found significantly low. Anxiety, depression and sexual satisfaction levels of TCSs were found to be similar with the control population.

WOS: 000343671700080, PubMed ID: 25268351, Toxoplasma gondii causes congenital toxoplasmosis in newborns resulting with fetal anomalies. Determining the initiation time of infection is very important for pregnant women and current serological assays have drawbacks in distinguishing the recently acute toxoplasmosis. Diagnosis of recently acute infection may be improved by using stage specific antigens in serological assays. In the present study, the diagnostic value of sporozoite specific SporoSAG, bradyzoite specific BAG1 proteins and GRA1 protein expressed by all forms of the parasite have been evaluated ELISA using sera systematically collected from mice administered orally with tissue cyst and oocysts. The anti-SporoSAG IgM antibodies in sera obtained from mice infected with oocysts peaked significantly at days 1, 10, and 15 (P, Scientific and Technological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S359]; Scientific Research Projects Branch Directorate of Ege UniversityEge University [2007TIP015], This study was supported partly by the grants given by The Scientific and Technological Research Council of Turkey (107S359) and the Scientific Research Projects Branch Directorate of Ege University (2007TIP015) to Yuksel Guruz. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

WOS: 000340879300061, PubMed ID: 25127360, Currently, some Toxoplasma gondii genotypes are being associated with serious clinical presentations. A recent report showing the Africa 1 genotype in two local congenital toxoplasmosis cases acquired in Turkey formed the basis of this study because atypical Africa 1 genotype is most frequently detected in animals and patients from sub-Saharan Africa. Since stray cats are considered as the linkage between wild life and urban life in T. gondii transmission, the present study aimed to isolate and characterize T. gondii strains circulating in stray cats of Izmir (Western Turkey). A secondary objective was to determine toxoplasmosis seroprevalence in this cat population. Tissues obtained from 100 deceased stray cats were bioassayed and isolated strains were genotyped using 15 microsatellite markers. In addition, toxoplasmosis seroprevalence was analyzed in 1121 cat sera collected from several large veterinary clinics in Izmir. Among the 22 isolates, 19 were Type II (86.3%), two were Type III (9%) and one was Africa 1 genotype (4.5%). The overall seropositivity rates in cats were 42-48% and 33.4-34.4% according to IFA and ELISA, respectively. Seroprevalence in deceased cats was significantly higher than in healthy cats (P = 0.0033). Finding both the major clonal Type II lineage together with the Type III lineage also found in Middle East, and an atypical genotype, Africa 1 appears consistent with the specific geographic location of Turkey between three continents and raises the possibility of transportation of these strains between continents through trade routes or long distance migratory birds. In addition, the first large study of toxoplasma seroprevalence in a stray cat population was also reported. The relatively high seropositivity rates and the variety of T. gondii genotypes confirm the local stray cat population as a risk factor for human toxoplasmosis in Izmir., Scientific Research Projects Branch Directorate of Ege University, TurkeyEge University [2010-TIP-091, 2011-TIP-034], This study was supported by the grants given by the Scientific Research Projects Branch Directorate of Ege University, Turkey (Grant No: 2010-TIP-091 and 2011-TIP-034) to Y.G. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Introduction: Greater than half of cancer patients suffer from the pain, which is the one of the major problems that disrupt the quality of life at, any time during the disease. Pain should be decreased as soon as possible and the maintenance treatment should be planned in these groups of patients. The World Health Organization (WHO) suggests the use of a three-step analgesic ladder approach including non-opioid, weak opioid and strong opioids according to the severity of the pain. However, the pain palliation can’t be accomplished in more than 80% of patients because of the wrong thoughts of health professionals, patients and patients’ relatives about narcotic analgesics. Methods: In this study 72 lung cancer patients, hospitalized between 29 July 2013 to 31 December 2015 at Izmir Katip Celebi University Ataturk Education and Research Hospital Palliative Care and Support Service were assessed retrospectively about pain palliation. Results: Patients mean ages 61.2 ± 8.2 and 77.8% (56) were male, and 22.2% (16) were female. Patients applied with different complaints such as Inability to feed, pain, general condition disorders, shortness of breath and nausea and 27.8% (20) of patients had only admitted with pain. The median duration of hospital stay was 7 (2-45) days, which is the 18.1% of patients were not given any analgesics. 49.2% (29) of patients have second line treatment, 50.8% (30) had received third line treatment. Hospitalization indication and discharge status of the patients was statistically significant association between analgesic use (p = 0.002; p = 0.03). Conclusion: Cancer pain is the most common symptom affecting the quality of life negatively. Pain management should be well known by clinicians. Success in the treatment of pain patients linked to multidisciplinary approach include the whole psychological and social environment will be possible with the treatment applied by step approach.

International audience; INTRODUCTION: Toxoplasma gondii is a protozoon parasite that has a worldwide dissemination. It can cause serious clinical problems such as congenital toxoplasmosis, retinochoroiditis, and encephalitis. Currently, T. gondii genotypes are being associated with these clinical presentations which may help clinicians design their treatment strategy. CASE REPORTS: Two T. gondii strains named Ankara and Ege-1 were isolated from newborns with congenital toxoplasmosis in Central and Western Anatolia, respectively. Ankara and Ege-1 strains were isolated from the cerebrospinal fluid of newborns. According to microsatellite analysis, Ankara and Ege-1 strains were sorted as Africa 1 genotype. CONCLUSION: T. gondii strains isolated in Turkey were first time genotyped in this study. Africa 1 genotype has previously been isolated in immunosuppressed patients originating from sub-Saharan Africa. The reason of detecting a strain mainly detected in Africa can be associated with Turkey's specific geographical location. Turkey is like a bridge between Asia, Europe and Africa. Historically, Anatolia was on the Silk Road and other trading routes that ended in Europe. Thus, detecting Africa 1 strain in Anatolia can be anticipated. Consequently, strains detected mainly in Europe and Asia may also be detected in Anatolia and vice versa. Therefore, further studies are required to isolate more strains from Turkey.

Toxoplasma gondii the causative agent of toxoplasmosis is an obligate intracellular parasite with a wide host range including all warm-blooded animals and birds. T.gondii infection causes congenital toxoplasmosis in newborns and this may lead to fetal anomalies, retinochoroiditis leading to blindness, lethal toxoplasmic encephalitis in immune compromised patients, and organ failure in transplantation patients. The pathogenesis of toxoplasmosis change due to differences in the specific immune response elicited by diverse T.gondii strains. The protective immunity against toxoplasmosis is conferred by cellular immune responses. In the present study, two different strains isolated from Turkey named T.gondii Ankara and Ege were used to evaluate the types of humoral and cellular immune responses elicited by adjuvanted tachyzoite protein vaccines in an animal model. In the study, 6-8 weeks old female BALB/c mice were used and six study groups (each contains three mice) were composed for vaccination. The first and second groups were vaccinated with T.gondii Ankara and Ege (TAnkPE and TEgePE, respectively) tacyhzoite lysates, the third and fourth groups were vaccinated by tacyhzoite lysates adjuvanted with Freund's adjuvant (TAnkPE-Freund; TEgePE-Freund, respectively). The fifth and sixth groups were vaccinated with PBS and Freund's adjuvant as controls. Immunization of the animals was performed two times at three weeks intervals. The serum samples were collected before vaccination and after each vaccination to determine the IgG response by Western blotting, and IgG1 and IgG2a responses by ELISA. To determine the cellular immune response, CD8/CD4 cell ratio, intracellular IFN-gamma and IL-4 levels were determined in stimulated spleen cells grown in cell culture systems by flow cytometry. Toxoplasma IgG antibodies were only detected in TAnkPE-Freund group. IgG1 and IgG2a responses did not increase in any vaccination groups and there was not any polarization towards IgG1 or IgG2a. There was no significant increase in CD8/CD4 ratio of stimulated spleen cells. IFN-gamma level was increased in only TAnkPE-Freund vaccination group, however IL-4 levels were increased in TAnkPE-Freund, TEgePE-Freund and TEgePE groups. Our data showed that TAnkPE-Freund vaccine led to increase in IgG and IFN-gamma responses in BALB/c mice, however, tachyzoite lysate vaccines developed in this study did not induce sufficient protective immune response against toxoplasmosis. Thus, use of specific immunogenic proteins must be taken into consideration in the future vaccine development studies against toxoplasmosis.

Introduction: Diabetic foot wounds are one of the most important causes of long duration hospitalizations regarding diabetic patients. Lower extremity amputation risk is 15 to 40 times higher in diabetics compared to normal population. Methods for preventing diabetic foot wounds are providing good blood glucose regulation, appropriate shoe wearing, foot care, toe-nail care, regular foot examinations and patient education. We aimed to investigate the effects of education level of the patients and the caregivers on the diabetic foot wound. Methods: 67 patients having diabetic foot wound applying to General Surgery, Internal Medicine and Diabetes outpatient clinics of Izmir Tepecik Education and Research Hospital in 2009 and 57 caregiver caring for these patients were analyzed prospectively with a face to face questionnaire for a correlation between education levels of patients and caregivers and Wagner staging of patients’ diabetic foot wounds and foot examination findings. Results: It was found that education levels of patients and caregivers did not affect Wagner staging of the wounds (p=0.167), but patients with regular follow-up and previously educated for diabetic foot wounds had a lower stage of wound (p=0.021). Conclusion: Education level of patients and caregivers was not found to be effective on the stage of the wound, but regular clinical follow-up and patient education had an decreasing effect on the stage of wound. Whatever the patients’ education levels are, educations on diabetic foot care and providing regular follow up of patients at risk for diabetic foot will decrease the rates of extremity amputations. Keywords : Care Givers, Diabetic Foot, Education/Nursing, Wagner Grade OZET Giris: Alt ekstremite amputasyonu yapilan hastalarin yaklasik %40-60’ini diyabetik hastalar olusturmaktadir. Diyabetik ayak yaralari, diyabetik hastalarin hastanede uzun sure yatislarinin en onemli nedenlerindendir. Diyabet hastasi olanlarda, normal populasyona nazaran alt ekstremite amputasyon riski 15-40 kat daha fazladir.Yara olusmadan yapilacak profilaksi ve olusmus olan diyabetik ayak yaralarinin tedavisi, amputasyonlari ve morbiditeyi %50 azaltmakta ve maliyeti dusurmektedir. Diyabetik ayak yaralarini onlemeye yonelik yontemler; kan sekeri regulasyonu saglanmasi, uygun ayakkabilar giyilmesi, ayak bakimi, ayak tirnagi bakimi, duzenli ayak muayenesi ve hasta egitimidir. Diyabetik ayak yarasi uzerinde, diyabetik ayak hastasi ve bakicisinin ogrenim duzeylerinin etkisini arastirmayi amacladik. Yontem: 2009 yilinda Izmir Tepecik Egitim ve Arastirma Hastanesi Genel Cerrahi, Dahiliye ve diyabet polikliniklerine basvuran, diyabetik ayak yarasi olan toplam 67 hastanin ve bu hastalara evde bakim yapan 57 bakicinin ogrenim duzeyi ile, Wagner siniflamasina gore hastalardaki diyabetik ayak yara evresinin iliskisi ve ayak muayenesi prospektif olarak yuz yuze anket metodu ile arastirildi. Bulgular: Hastalarin ve bakicilarinin ogrenim durumlarinin, Wagner siniflamasina gore diyabetik ayak yarasi Wagner evrelerini etkilemedigi (p=0.167) fakat diyabet izlemlerini duzenli yaptiran ve daha once diyabetik ayak yarasi hakkinda bilgilendirilen hastalarin yara evrelerinin daha dusuk oldugu saptandi (p=0.021). Sonuc: Hastanin ve bakicisinin ogrenim seviyesinin, yara evresi uzerine etkisi olmadigi fakat duzenli klinik takip ve hastanin egitiminin yara evresini iyi yonde etkiledigi ortaya cikmistir. Diyabetik ayak icin risk altindaki hasta grubuna, ogrenim duzeyi ne olursa olsun diyabetik ayak hastaligi hakkinda bir egitim programi uygulamak ve duzenli izlemlerinin yapilmasini saglamak ekstremite amputasyonlarinin oranlarini azaltacaktir. Anahtar kelimeler: Bakici, Diyabetik Ayak, Egitim/Bakicilik, Wagner Evrelemesi

Giriş: Palyatif bakım hastalarında en sık görülen ve belki de en önemli semptom, “ölümün kendisinden daha korkunç” olarak tanımlanan şiddetli ağrıdır. Çalışmamızda ağrı şikayeti olan kanser hastalarında palyatif ağrı tedavisinin etkinliğinin belirlenmesi amaçlandı.Yöntem: İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Kanser Hastalarında Palyatif Bakım ve Destek Servisinde 29 Temmuz 2013 – 1 Şubat 2016 tarihleri arasında yatan tüm hastaların dosyaları retrospektif olarak tarandı. 704 hastadan yatışı ve taburculuğu esnasında Vizüel Analog Skala (VAS)’ya göre ağrı skoru kaydedilmiş olan hastalar (n=112) çalışmaya dahil edildi. Çalışmaya dahil edilen hastaların yaş, cinsiyet, tanıları, yatış ve taburculuk esnasındaki VAS skorları, kullanılan analjezik ilaçlar ve hastanın yatarak tedavi gördüğü gün sayısı geriye dönük olarak incelendi.Bulgular: Hastaların 64’ü (%57,1) erkek olup, tüm olguların yaş ortalamaları 59,8 ± 14,5 yıl idi. Kolorektal kanser %15,2 ile en çok görülen tanı olup, bunu %14,3 ile meme, %13.4 ile akciğer ve %11,6 ile mide kanserinin izlediği saptandı. Hastaların ortalama 13,0 ± 11,5 gün yatarak tedavi gördükleri tespit edilmiştir. Olguların servise yatış sırasında kaydedilen VAS ağrı skorlarının ortalama değeri 5,2 ± 2,6 olup, taburculuk sırasındaki bu değer ortalamasının 2,2 ± 1,8’a gerilediği saptandı. Hastaların ağrı tedavisinde; 82’sinde tramadol, 36’sında fentanil, 28’inde asetaminofen ve 18’inde morfin kullanıldığı tespit edildi.Sonuç: Çalışmamızda etkin analjezik tedaviyle hastaların ağrı skorlarında önemli derecede azalmalar tespit edilmiştir. Ağrı tedavisinin önündeki engeller; ağrı tedavisi konusunda bilgi eksikliği olan doktorlar, narkotik bağımlılığıyla ilgili çekinceler, semptomlarını gizleyen hastalar ve semptom kontrolüne yeterince önem verilmemesi olarak sıralanabilir. Palyatif bakım birimlerinde semptom yönetimine gereken önemin verilmesi ve yaşam kalitesinin en yüksek düzeyde tutulması temel hedefler olmalıdır., Introduction: The most common and most important symptom in the palliative care patients is severe pain as defined "more terriblethan death". In our study, we aimed to determine the effectiveness of palliative pain treatment in cancer patients with pain.Methods: Files of all patients hospitalized in Palliative Care and Support Services for Cancer Patients at Izmir Katip Celebi UniversityAtatürk Research and Training Hospital between 29.07.2013 – 01.02.2016 has been investigated retrospectively. Patients (n=112) withrecorded pain scores according to the Visual Analogue Scale (VAS) from 704 patients has been included in the study. Age, gender,diagnosis, VAS scores during hospitalization and discharge of patients included in the study, used analgesic drugs and number of daysin treatment have been investigated retrospectively.Results: 57.1% (n=64) of the patients were male and the mean age was 59.8 ± 14.5 years. Considering diagnoses; colorectal cancer in15.2%, breast cancer in 14.3%, lung cancer in 13.4% and stomach cancer in 11.6% was observed. The patients were inpatient treatmentthe mean 13.0 ± 11.5 days. The mean VAS pain scores of the patients recorded during hospitalization was 5.2 ± 2.6 and the mean ofthese values at discharge was 2.2 ± 1.8. In the pain treatment of the patients; using tramadole in 82, fentanyl in 36, acetaminophen in28 and morphine in 18 was observed.Conclusion: A significant reduction in pain scores of the patients in our study were identified with an effective analgesic treatment.Obstacles to the treatment of pain; the doctors who are lack of information about pain treatment, fears about drug addiction, the patientswho hide their symptoms and ignoring to symptom control as can be listed. Symptom management is important in palliative care unitsand quality of life should be kept at a high level.