76 results on '"İskender G"'
Search Results
2. Pretreatment of Ceftriaxone Formulation Effluents: Drawbacks and Benefits
- Author
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Tezgel, T., Babuna, F. Germirli, Arslan-Alaton, I., Iskender, G., Okay, O., Gökçekus, Hüseyin, editor, Türker, Umut, editor, and LaMoreaux, James W., editor
- Published
- 2011
- Full Text
- View/download PDF
3. Investigations on conical lean turbulent premixed hydrogenated natural gas flames
- Author
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Dilay Güleryüz, Christophe Allouis, and İskender Gökalp
- Subjects
Combustion ,Lean premixed turbulent flames ,Hydrogen ,Optical measurement techniques ,Fuel ,TP315-360 - Abstract
Hydrogen's ability to enhance carbon neutrality in combustion processes puts forward the use of hydrogenated fuels, both in the form of fuel and an energy carrier as a potential decarbonization solution. However, because of the nature of hydrogen, blending it with hydrocarbons causes crucial structural changes in the flame structure, including higher flame propagation velocities and higher flame temperatures, decreased instantaneous flame thickness, and increased risks of flame flashback and an increasing potential of NOx emissions due to higher flame temperatures. These attributes encourage a thorough examination of hydrogenated blends of hydrocarbon fuels. Using lean premixed fuels is another technique to achieve efficient and cleaner combustion. However, due to the problem of flame instability in lean premixed combustion, forecasting the design points in terms of flame attributes is critical for better combustor designs.In this study, conical (Bunsen type) lean premixed turbulent flames of hydrogenated natural gas-air mixtures are experimentally studied. Through chemiluminescence measurements of the OH* and CH* radicals and laser-induced Mie scattering, lean natural gas-air premixed flames are examined with subsequently increasing hydrogen addition rates up to 20% by volume and keeping the premixture velocity constant. The obtained data is utilized for exploring the dynamics of the turbulent flame front. The main turbulent premixed flame parameters we identified relate to the instantaneous and average topology of the flame such as the turbulent flame brush thickness and flame height. We also inferred global combustion parameters like the turbulent flame propagation speed from the experimental findings.
- Published
- 2024
- Full Text
- View/download PDF
4. Learning different language scripts through separation model in a bilingual preschool setting
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Iskender Gelir, Ali Kemal Tekin, and Laila Al-Salmi
- Subjects
Bilingual education ,early bilingualism ,language scripts ,separation model ,Oman ,Yung Kevin, Education University of Hong Kong FEHD: The Education University of Hong Kong Faculty of Education and Human Development, Hong Kong ,Education (General) ,L7-991 - Abstract
AbstractThis study aimed to examine the acquisition of Roman alphabetic script among young children within a bilingual (Arabic and English) educational environment employing a language separation pedagogical approach in Muscat, Oman. Data were collected utilizing participant observations, video recordings to capture the interactions of three children and the instructive practices of the teacher, and teacher interviews, in order to explore the efficacy of this model. The findings of the study indicate that children demonstrate proficiency in script composition in their second language (Roman-English) through engagement in diverse classroom activities, including mathematical and artistic pursuits. Despite prevalent negative perceptions associated with language separation methodologies, our findings suggest its potential effectiveness in facilitating second language acquisition and literacy development. Implications of the study’s outcomes are discussed, along with avenues for future research inquiry.
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- 2024
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5. TRANSFORMATION OF LOCAL GOVERNMENTS IN THE CRISIS OF MODERNITY AND NEW CIVILISATION DEBATES
- Author
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Mehmet Can and İskender Güneş
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International relations ,JZ2-6530 - Abstract
Today, the world is on the brink of a crisis that has plunged it into the darkness of the Middle Ages. The crisis of modernity raises serious questions about the sustainability of existing social, economic and political systems. In this context, the basic principles for the construction of a new civilisation are being determined and a global intellectual struggle is taking place. The crisis of modernity points not only to a material but also to a spiritual impasse. Societies are facing various problems and struggling with difficulties arising from existing paradigms. Therefore, to create a new vision of civilisation is to lay the foundations for a sustainable, just and human-oriented future. In this struggle, it is important to treat diversity not as a threat, but as an asset. Diverse cultures, worldviews and ways of life should be recognised as the cornerstones of a new civilisation. Not only economic growth, but also universal values such as human rights, environmental protection, equality and justice should be central to discussions on a new civilisation. This will enable the adoption of a human-centred approach and sustainable solutions to global and local problems. In conclusion, an intellectual effort is required to deal with the crisis of modernity and to build a new civilisation. This effort should include bringing together different perspectives, seeing diversity as richness and cooperating for a common future. Keywords: Modernity, Crisis, Civilisation, Local Government
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- 2024
- Full Text
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6. Reducing the Toxicity and Recalcitrance of a Textile Xenobiotic Through Ozonation
- Author
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Babuna, F. Germirli, primary, Oructut, N., additional, Arslan-Alaton, I., additional, Iskender, G., additional, and Okay, O., additional
- Published
- 2010
- Full Text
- View/download PDF
7. Pretreatment of Ceftriaxone Formulation Effluents: Drawbacks and Benefits
- Author
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Tezgel, T., primary, Babuna, F. Germirli, additional, Arslan-Alaton, I., additional, Iskender, G., additional, and Okay, O., additional
- Published
- 2010
- Full Text
- View/download PDF
8. patients: a multi-center study, Turkey
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Karacaer, Z, Cakir, B, Erdem, H, Ugurlu, K, Durmus, G, Ince, NK, Ozturk, C, Hasbun, R, Batirel, A, Yilmaz, EM, Bozkurt, I, Sunbul, M, Aynioglu, A, Atilla, A, Erbay, A, Inci, A, Kader, C, Tigen, ET, Karaahmetoglu, G, Coskuner, SA, Dik, E, Tarakci, H, Tosun, S, Korkmaz, F, Kolgelier, S, Karadag, FY, Erol, S, Turker, K, Necan, C, Sahin, AM, Ergen, P, Iskender, G, Korkmaz, P, Eroglu, EG, Durdu, Y, Ulug, M, Deniz, SS, Koc, F, Alpat, SN, Oztoprak, N, Evirgen, O, Sozen, H, Dogan, M, Kaya, S, Altindis, M, Aslan, E, Tekin, R, Sezer, BE, Ozdemir, K, Ersoz, G, Sahin, A, Celik, I, Aydin, E, Bastug, A, Harman, R, Ozkaya, HD, Parlak, E, Yavuz, I, Sacar, S, Comoglu, S, Yenilmez, E, Sirmatel, F, Balkan, II, Alpay, Y, Hatipoglu, M, Denk, A, Senol, G, Bitirgen, M, Geyik, MF, Guner, R, Kadanali, A, Karakas, A, Namiduru, M, Udurgucu, H, Boluktas, RP, Karagoz, E, and Ormeci, N
- Subjects
Chronic hepatitis B infection ,Quality of life ,The Hepatitis B Quality ,of Life Instrument ,Turkey - Abstract
Background: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. Methods: This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. Results: Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. Conclusions: The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.
- Published
- 2016
9. Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey
- Author
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Karacaer ZAUID- ORCID: 0000-0002-2658-4679, Cakir B, Erdem H, Ugurlu K, Durmus G, Ince NK, Ozturk C, Hasbun R, Batirel A, Yilmaz EM, Bozkurt I, Sunbul M, Aynioglu A, Atilla A, Erbay A, Inci A, Kader C, Tigen ET, Karaahmetoglu G, Coskuner SA, Dik E, Tarakci H, Tosun S, Korkmaz F, Kolgelier S, Karadag FY, Erol S, Turker K, Necan C, Sahin AM, Ergen P, Iskender G, Korkmaz P, Eroglu EG, Durdu Y, Ulug M, Deniz SS, Koc F, Alpat SN, Oztoprak N, Evirgen O, Sozen H, Dogan M, Kaya S, and Altindis M
- Subjects
Adult ,Aged ,Antiviral Agents/therapeutic use ,Cross-Sectional Studies ,Female ,Health Status Indicators ,Hepatitis B, Chronic/drug therapy/psychology ,Humans ,Interviews as Topic ,Male ,Middle Aged ,Prospective Studies ,Quality of Life ,Turkey - Abstract
BACKGROUND: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. METHODS: This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. RESULTS: Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. CONCLUSIONS: The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.
- Published
- 2016
10. Quality of life and related factors among chronic hepatitis B-infected patients: A multi-center study, Turkey
- Author
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Karacaer, Z., Cakir, B., Erdem, H., Ugurlu, K., Durmus, G., Ince, N.K., Ozturk, C., Hasbun, R., Batirel, A., Yilmaz, E.M., Bozkurt, I., Sunbul, M., Aynioglu, A., Atilla, A., Erbay, A., Inci, A., Kader, C., Tigen, E.T., Karaahmetoglu, G., Coskuner, S.A., Dik, E., Tarakci, H., Tosun, S., Korkmaz, F., Kolgelier, S., Karadag, F.Y., Erol, S., Turker, K., Necan, Ceyda, Sahin, A.M., Ergen, P., Iskender, G., Korkmaz, P., Eroglu, E.G., Durdu, Y., Ulug, M., Deniz, S.S., Koc, F., Alpat, S.N., Oztoprak, N., Evirgen, O., Sozen, H., Dogan, M., Kaya, S., Altindis, M., Aslan, E., Tekin, R., Sezer, B.E., Ozdemir, K., Ersoz, G., Sahin, A., Celik, I., Aydin, E., Bastug, A., Harman, R., Ozkaya, H.D., Parlak, E., Yavuz, I., Sacar, S., Comoglu, S., Yenilmez, E., Sirmatel, F., Balkan, I.I., Alpay, Y., Hatipoglu, M., Denk, A., Senol, G., Bitirgen, M., Geyik, M.F., Guner, R., Kadanali, A., Karakas, A., Namiduru, M., Udurgucu, H., Boluktas, R.P., Karagoz, E., and Ormeci, N.
- Subjects
Quality of life ,antivirus agent ,Adult ,Male ,demography ,Turkey ,quality of life assessment ,psychology ,Antiviral Agents ,Article ,Turkey (republic) ,Interviews as Topic ,Hepatitis B, Chronic ,antiviral therapy ,middle aged ,cross-sectional study ,Health Status Indicators ,Humans ,chronic hepatitis B ,controlled study ,human ,Prospective Studies ,The Hepatitis B Quality of Life Instrument ,Aged ,Hepatitis B Quality of Life ,interview ,clinical trial ,major clinical study ,Chronic hepatitis B infection ,hepatitis B surface antigen ,female ,multicenter study ,Cross-Sectional Studies ,Short Form 36 ,prospective study ,health status indicator - Abstract
Background: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. Methods: This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. Results: Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. Conclusions: The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients. © 2016 The Author(s).
- Published
- 2016
11. Effect of training about child neglect and abuse to teachers and its effect to awareness
- Author
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İskender Gün, Adeviye Çopur, and Elçin Balcı
- Subjects
Child neglect ,Child abuse ,Schoolteachers ,High schools ,Education ,Turkey ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background This study aimed to evaluate the effects of child neglect and abuse training on the knowledge and awareness of medical vocational schoolteachers in Turkey. Methods This study was conducted based on data taken from a sample of teachers from Kayseri, Turkey, between October 2016 and April 2017. Teachers who agreed to participate in the study received training pertaining to child neglect and abuse. Data were collected through a survey form and the Scale for Identifying the Symptoms and Risks of Child Abuse and Neglect. Data were analyzed using SPSS V.20.0 software. For statistical analyses, Student’s t test, analysis of variance and McNemar tests were conducted, with a value of p
- Published
- 2022
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12. Assessment of Health-Related Quality of Life in Chronic Hepatitis B Infection Patients in Turkey: A Multicenter Study
- Author
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Karacaer, Z., primary, Cakir, B., additional, Erdem, H., additional, Ugurlu, K., additional, Durmus, G., additional, Ince, N.K., additional, Ozturk, C., additional, Batirel, A., additional, Yilmaz, E.M., additional, Bozkurt, I., additional, Sunbul, M., additional, Aynioglu, A., additional, Atilla, A., additional, Erbay, A., additional, Inci, A., additional, Kader, C., additional, Tigen, E.T., additional, Karaahmetoglu, G., additional, Coskuner, S.A., additional, Dik, E., additional, Tarakci, H., additional, Tosun, S., additional, Korkmaz, F., additional, Kölgelier, S., additional, Karadag, F.Y., additional, Erol, S., additional, Turker, K., additional, Necan, C., additional, Sahin, A.M., additional, Ergen, P., additional, Iskender, G., additional, Korkmaz, P., additional, Eroglu, E.G., additional, Durdu, Y., additional, Ulug, M., additional, Deniz, S.S., additional, Koc, F., additional, Alpat, S.N., additional, Cuvalci, N.O., additional, Evirgen, O., additional, Sozen, H., additional, Dogan, M., additional, Kaya, S., additional, Altindis, M., additional, Aslan, E., additional, Tekin, R., additional, Sezer, B.E., additional, Ozdemir, K., additional, Ersoz, G., additional, Sahin, A., additional, Celik, I., additional, Aydin, E., additional, Bastug, A., additional, Harman, R., additional, Ozkaya, H.D., additional, Parlak, E., additional, Yavuz, I., additional, Sacar, S., additional, Comoglu, S., additional, Yenilmez, E., additional, Sirmatel, F., additional, Balkan, I.I., additional, Alpay, Y., additional, Hatipoglu, M., additional, Denk, A., additional, Senol, G., additional, Bitirgen, M., additional, Geyik, M.F., additional, Guner, R., additional, Kadanali, A., additional, Karakas, A., additional, Namiduru, M., additional, Udurgucu, H., additional, and Boluktas, R.P., additional
- Published
- 2016
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13. DETERMINATION OF CYTOTOXIC AND APOPTOTIC EFFECTS OF CAFFEIC ACID PHENETHYL ESTER AND GOSSYPOL IN COMBINATION WITH FLUDARABINE AT A MOLECULAR LEVEL IN ACUTE LYMPHOBLASTIC LEUKEMIA CELLS
- Author
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Baran, Yusuf, Iskender, G., Piskin, O., Ozcan, M., and Izmir Isntitute of Technology
- Abstract
[No abstract available], Turkish Society of Hematology, This study was supported by Turkish Society of Hematology.
- Published
- 2013
14. Enalapril-induced apoptosis of acute promyelocytic leukaemia cells involves STAT5A
- Author
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Purclutepe, O., Iskender, G., Kiper, H. D., Tezcanli, B., Selvi, N., Cigir Biray Avci, Kosova, B., Gokbulut, A. A., Sahin, F., Baran, Y., Saydam, G., TR119193, İskender, Güniz, Adan Gökbulut, Aysun, Baran, Yusuf, Izmir Institute of Technology. Molecular Biology and Genetics, and Ege Üniversitesi
- Subjects
STATs ,ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS ,STAT5A ,ComputingMethodologies_PATTERNRECOGNITION ,Hl60 cells ,Enalapril ,Cytotoxicity ,ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS ,Apoptosis ,InformationSystems_MISCELLANEOUS ,Acute promyelocytic leukaemia - Abstract
PubMed ID: 22753752, Background: In this study, we aimed at evaluating the cytotoxic and apoptotic effects of enalapril on human HL60 acute promyelocytic leukaemia cells and at clarifying the roles of signal transducers and activator of transcription proteins (STATs) on enalapril-induced cell death. Materials and Methods: Cell viability and cytotoxicity tests were conducted by Trypan blue dye exclusion and 2,3-Bis[2-methoxy-4-nitro-5-sulphophenyl]-2H-tetrazolium-5- carboxanilide inner salt (XTT) assays, respectively. Apoptotic analyses were performed by the AnnexinV-enhanced green fluorescent protein (EGFP) staining method and by fluorescence microscopy. Expression levels of STAT3, -5A and -5B genes were analysed by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Results: The results showed that enalapril reduced viability and proliferation, and induced apoptosis in HL60 cells in a dose-and time-dependent manner as compared to untreated controls. The expression levels of STAT5A gene were significantly reduced in enalapril-treated HL60 cells as compared to untreated controls. Conclusion: Taken together, all data showed for the first time that enalapril has significant anticancer potential for the treatment of acute premyelocytic leukaemia.
- Published
- 2012
15. Examining the Turkish Preschool Education Program from an Inclusive Perspective
- Author
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İskender GELİR
- Subjects
Education (General) ,L7-991 - Published
- 2021
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16. Modeling of Agave Salmiana bagasse conversion by hydrothermal carbonization (HTC) for solid fuel combustion using surface response methodology
- Author
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Diakaridia Sangare, Ayoub Missaoui, Stéphane Bostyn, Verónica Belandria, Mario Moscosa-Santillan, and Iskender Gökalp
- Subjects
agave salmiana bagasse ,hydrothermal carbonization ,hydrochar ,solid fuel ,modeling ,response surface methodology ,combustion characteristics ,Production of electric energy or power. Powerplants. Central stations ,TK1001-1841 ,Renewable energy sources ,TJ807-830 - Abstract
Hydrothermal carbonization (HTC) of Agave Salmiana bagasse was investigated to assess the potential of hydrochar as an energy resource. The effect of operating conditions on the mass yield and the energy quality of hydrochar was examined by varying the temperature and the holding time over the ranges of 180–250 ℃ (T) and 0–60 min (t), respectively. These parameters were screened using the response surface methodology through a Doehlert design. Performances of HTC were assessed on the basis of the hydrochar mass yield higher heating value ultimate and proximate analyses. In the studied domain, the modeling results indicated that the hydrochar mass yield varies between 45% and 86% and higher heating valuesfrom18 to 23 MJ.kg-1, which is similar to that of peat. In addition, the volatile matter and fixed carbon fractions of hydrochars ranged from 54 to 80% and between 12 and 36%, respectively. Energy yield modeling indicated that the mass yield is the most influent parameter. The maximal energy yield value was obtained at 180 ℃ with time equal to 0 min. Globally, the evolution of H/C ratio is amplified for temperatures greater than 215 ℃ by increasing the holding time from 30 to 60 min. For O/C ratio the maximal variation is below these conditions. It is concluded that increased hydrothermal carbonization conditions favor dehydration reactions, while decarboxylation reactions are favored in mild HTC conditions. The combustion characteristics such as ignition peak and burnout temperatures were significantly modified for hydrochars. The model results indicated that lowest ignition and peak temperature values are obtained at both low-temperature and low-holding time, and high-temperature and high-holding time zones. An increase in the burnout temperature was correlated with the increase of the fixed carbon content in hydrochars.
- Published
- 2020
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17. ESPING-ANDERSEN VE REFAH REJİMİ TARTIŞMALARI: TEORİK BİR DEĞERLENDİRME
- Author
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İ̇skender GÜMÜŞ
- Subjects
refah devleti ,refah rejimi ,esping-andersen ,alternatif sınıflandırmalar ,Social Sciences ,Management. Industrial management ,HD28-70 ,Finance ,HG1-9999 ,Economics as a science ,HB71-74 - Abstract
Refah rejimi, bir ülkenin uyguladığı sosyal politikalara siyasi, sosyal, ekonomik ve kültürel açıdan ışık tutması nedeniyle önemlidir. Esping-Andersen'in (1990) yaptığı refah rejimi sınıflandırmalarına yönelik çalışma, yaklaşık otuz yıldır sosyal politika araştırmalarının temel tartışma alanlarından birini oluşturmuştur. Esping-Andersen’in çalışması pek çok çalışmaya ilham kaynağı olmuş ve bu doğrultuda yeni araştırmalar yapılmıştır. Bu araştırmaların pek çoğu Esping-Andersen’in sınıflandırmasına hem kapsam hem de yöntem açısından eleştirel yaklaşmaktadır. Ancak, eleştirel yaklaşımların çoğunun Esping-Andersen’in çalışmasını doğruladığı veya katkıda bulunduğu görülmektedir. Bu makalede, refah devletinin gelişim sürecinde ortaya çıkan refah rejimi tartışmaları teorik çerçevede incelenmektedir. Bu doğrultuda, Esping-Andersen’in sınıflandırması ve bu sınıflandırmaya yönelik eleştiriler analiz edilmektedir. Refah rejimi ile ilgili 1990’lardan itibaren yürütülen tartışmaların Esping-Andersen’in çalışması çerçevesinde şekillendiği ve yapılan çalışmaların bunun bir devamı niteliğinde olduğu ortaya konulmaktadır.
- Published
- 2020
- Full Text
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18. THU-174 - Assessment of Health-Related Quality of Life in Chronic Hepatitis B Infection Patients in Turkey: A Multicenter Study
- Author
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Karacaer, Z., Cakir, B., Erdem, H., Ugurlu, K., Durmus, G., Ince, N.K., Ozturk, C., Batirel, A., Yilmaz, E.M., Bozkurt, I., Sunbul, M., Aynioglu, A., Atilla, A., Erbay, A., Inci, A., Kader, C., Tigen, E.T., Karaahmetoglu, G., Coskuner, S.A., Dik, E., Tarakci, H., Tosun, S., Korkmaz, F., Kölgelier, S., Karadag, F.Y., Erol, S., Turker, K., Necan, C., Sahin, A.M., Ergen, P., Iskender, G., Korkmaz, P., Eroglu, E.G., Durdu, Y., Ulug, M., Deniz, S.S., Koc, F., Alpat, S.N., Cuvalci, N.O., Evirgen, O., Sozen, H., Dogan, M., Kaya, S., Altindis, M., Aslan, E., Tekin, R., Sezer, B.E., Ozdemir, K., Ersoz, G., Sahin, A., Celik, I., Aydin, E., Bastug, A., Harman, R., Ozkaya, H.D., Parlak, E., Yavuz, I., Sacar, S., Comoglu, S., Yenilmez, E., Sirmatel, F., Balkan, I.I., Alpay, Y., Hatipoglu, M., Denk, A., Senol, G., Bitirgen, M., Geyik, M.F., Guner, R., Kadanali, A., Karakas, A., Namiduru, M., Udurgucu, H., and Boluktas, R.P.
- Published
- 2016
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19. Atomization and Breakup of Cryogenic Propellants Under High-Pressure Subcritical and Supercritical Conditions
- Author
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Axel Schik, Bruno Vielle, W. Mayer, Douglas G. Talley, Iskender G-ograve, kalp, Rodger D. Woodward, Christian Chauveau, Deutsches Zentrum für Luft- und Raumfahrt [Lampoldshausen] (DLR), Laboratoire de combustion et systèmes reactifs (LCSR), Centre National de la Recherche Scientifique (CNRS)-Université d'Orléans (UO), Air Force Research Laboratory (AFRL), and United States Air Force (USAF)
- Subjects
Materials science ,Physics::Instrumentation and Detectors ,Mixing (process engineering) ,Aerospace Engineering ,02 engineering and technology ,01 natural sciences ,010305 fluids & plasmas ,Physics::Fluid Dynamics ,0203 mechanical engineering ,0103 physical sciences ,Propellant ,020301 aerospace & aeronautics ,business.industry ,Mechanical Engineering ,[SPI.FLUID]Engineering Sciences [physics]/Reactive fluid environment ,Mechanics ,Breakup ,Supercritical fluid ,Chamber pressure ,Fuel Technology ,13. Climate action ,Space and Planetary Science ,Rocket engine ,Liquid oxygen ,business ,Stagnation pressure - Abstract
International audience; Recent results on the atomization and breakup of cryogenic propellants under high-pressure subcritical and supercritical conditions are surveyed. Cryogenic uids were injected into various gases under both cold- ow and hot- re conditions, and the results were visualized using ashlight photography and highspeed cinematography. In some cases, simulation uids were used to study atomization and breakup behavior. In others, hot- re tests with liquid oxygen and gaseous hydrogen demonstrated ow phenomena under realistic cryogenic rocket engine conditions. The visualizations reveal a remarkable difference between subcritical spray formation and evaporation and supercritical injection and mixing. As chamber pressure approaches the critical pressure, injection can no longer be regarded as simple ‘‘spray’’ formation, but rather as a uid/ uid mixing process that can be extremely sensitive to small perturbations in pressure, temperature, local mixture concentrations, and initial injection conditions.
- Published
- 1998
20. Novel Agents Targeting Bioactive Sphingolipids for the Treatment of Cancer
- Author
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Adan-Gokbulut, A., primary, Kartal-Yandim, M., additional, Iskender, G., additional, and Baran, Y., additional
- Published
- 2012
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21. The application of ozonation for the detoxification and biodegradability improvement of a textile auxiliary: Naphtalene sulphonic acid
- Author
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Germirli Babuna, F., primary, Camur, S., additional, Alaton, I. Arslan, additional, Okay, O., additional, and Iskender, G., additional
- Published
- 2009
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22. Effects of Mediterranean Mussel Shell (Mytilus galloprovincialis) on Performance and Egg Quality in Laying Quails
- Author
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Kadir Emre BUĞDAYCI, Hıdır GÜMÜŞ, Mustafa Numan OĞUZ, Fatma KARAKAŞ OĞUZ, and İskender GÜLLE
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Veterinary medicine ,SF600-1100 - Published
- 2019
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23. Effect of chemical treatment on the acute toxicity of two commercial textile dye carriers
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Arslan-Alaton, I., primary, Iskender, G., additional, Ozerkan, B., additional, Babuna, F. Germirli, additional, and Okay, O., additional
- Published
- 2007
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24. Treatability of cefazolin antibiotic formulation effluent with O3 and O3/H2O2 processes
- Author
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Iskender, G., primary, Sezer, A., primary, Arslan-Alaton, I., primary, Germirli Babuna, F., primary, and Okay, O.S., primary
- Published
- 2007
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25. Ozonation of synthetic versus natural textile tannins: recalcitrance and toxicity towards Phaeodactylum tricornutum
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Germirli Babuna, F., primary, Yilmaz, Z., additional, Okay, O.S., additional, Arslan Alaton, I., additional, and Iskender, G., additional
- Published
- 2007
- Full Text
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26. SOSYAL POLİTİKA AÇISINDAN VERGİ ADALETİ: KURAMSAL BİR TARTIŞMA
- Author
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Tarkan Peran and İskender Gümüş
- Subjects
sosyal politika ,vergi adaleti ,vergileme ,social policy ,tax justice ,taxation ,Social Sciences ,Social sciences (General) ,H1-99 - Abstract
Amaç: Bu çalışmada, tarafsız devlet anlayışından sosyal devlet anlayışına geçişle beraber meydana gelen değişmelerin bir sonucu olarak ifade edilen müdahaleci devlet anlayışı bağlamında vergi politikaları sosyal adalet çerçevesinde incelenecektir. Yöntem: Çalışmada, ilgili literatürün eleştirel değerlendirmesi yapılmıştır.Bulgular: Bu doğrultuda, vergi politikaları yoluyla tüm sosyal sınıflar üzerindeki vergi yükünün adil bir şekilde dağıtılabilmesi için çeşitli politikalar önerilmektedir.
- Published
- 2017
27. Treatability of cefazolin antibiotic formulation effluent with O3 and O3/H2O2 processes.
- Author
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Iskender, G., Sezer, A., Arslan-Alaton, I., Babuna, F. Germirli, and Okay, O. S.
- Subjects
- *
ACUTE toxicity testing , *ANTIBIOTICS assay , *MICROBIAL metabolites , *PHARMACEUTICAL biotechnology , *MARINE algae , *OZONIZATION - Abstract
The effect of applying ozonation and perozonation to antibiotic cefazolin-Na formulation effluents were investigated in this study. Twenty minutes of ozonation at a rate of 1,500 mg/L-h was observed to remove COD by 38%, whereas a COD removal efficiency of 40% was achieved via H2O2 enhanced ozonation (same conditions + 31.25 mM H202). Both of the pretreatment alternatives were monitored to elevate the BOD5/COD ratio from 0.01 to 0.08. The initially inert COD was reduced by 38% using ozonation and by 60% employing H2O2 enhanced ozonation. In terms of the lowest achievable effluent COD levels after bio-treatment, ozonation was observed to yield a residual COD of 205 mg L-1, while a residual COD of 135 mgL-1 was involved for perozonation. According to the results of acute toxicity on Phaedactylum tricornutum, ozonated and perozonated samples exhibited more toxicity than the untreated effluent after 4 days. The activated sludge inhibition test demonstrated that both of the pretreatment alternatives efficiently eliminated the inhibition of investigated formulation effluent. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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28. Ozonation of synthetic versus natural textile tannins: recalcitrance and toxicity towards Phaeodactylum tricornutum.
- Author
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Babuna, F. Germirli, Yilmaz, Z., Okay, O. S., Alaton, I. Arslan, and Iskender, G.
- Subjects
TANNINS ,INDUSTRIAL pollution ,TEXTILE industry ,MICROALGAE ,OZONIZATION ,OZONIZATION of water ,INDUSTRIAL waste purification - Abstract
A sound in-plant pollution control strategy can only be defined by paying due attention to bio-recalcitrance and toxicity. In this context the levels of toxicity and inert COD introduced to textile dyebath discharges by two alternative auxiliary chemicals, namely natural tannin (NT) and synthetic tannin (ST), were investigated. The effect of 40 minutes ozonation at 1,000 mg h
-1 at pH 3.5 on the segregated effluent streams containing the above-mentioned tannin formulations was evaluated in terms of changes in toxicity and recalcitrance. The effect of ozonation on the COD distribution of raw and ozonated NT and ST samples according to their molecular weight cut-offs was also assessed. Both untreated tannin formulations exerted high acute toxicity towards marine microalgae Phaeodactylum tricornutum. Moderate decrease in the toxicity levels of both tannins was observed upon ozonation. The raw NT formulation with a COD content more than twice that of its alternative raw ST had an initially inert soluble COD content of only 25 mg/L, while the initially inert COD was 135 mg/L for ST. As the initially inert soluble COD content of NT was considerably lower, this textile auxiliary did not need chemical pretreatment to improve its biodegradability. On the other hand, the initially inert soluble COD content of ST was reduced by 70% by ozone pretreatment. In terms of residual COD contents achievable after passing through a biological treatment system, raw NT and pretreated ST formulations yielded 100 and 95 mg/L COD, respectively. The highest proportion of COD (46% for NT and 38% for ST) was found in the < 1 kDa range. The same fraction increased to 93% for NT after ozonation, while for ST no significant change was observed in the COD distribution of the molecular weight cut-offs after ozonation. [ABSTRACT FROM AUTHOR]- Published
- 2007
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29. GÜNEY AVRUPA VE TÜRKİYE’DE İŞ-YAŞAM DENGESİ: KARŞILAŞTIRMALI BİR ANALİZ
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İskender GÜMÜŞ and Berna TÜRKYILMAZ
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i̇ş yaşam dengesi ,türkiye ve güney avrupa refah ülkeleri ,çocuk bakım hizmetleri ,ebeveyn izni ,esnek çalışma ,work life balance ,turkey and southern european welfare countries ,child care services ,parental leave ,flexible working ,Social Sciences ,Social sciences (General) ,H1-99 - Abstract
Bu çalışmada, Güney Avrupa ülkelerinde ve refah rejimi açısından bu ülkelere benzer olduğu kabul edilen Türkiye’de iş yaşam dengesi politikaları incelenmektedir. Bu doğrultuda, İspanya, İtalya, Yunanistan ve Türkiye’nin çocuk bakım hizmetleri, ebeveyn izni ve esnek çalışma kapsamındaki düzenlemeler hem hukuki boyutuyla ve hem de bu ülkelere ilişkin bazı makro verilerle karşılaştırmalı olarak analiz edilmiştir. Bu ülkelerde iş yaşam dengesinin sağlanması amacıyla oluşturulan politikaların seviyesinin birbirine benzerlik gösterdiği ve iş yaşam dengesi uygulamalarının diğer refah rejimlerine göre daha geri kaldığı tespit edilmiştir. Öte yandan, son yıllarda Avrupa Birliği’ne uyum çabalarının ve düşük doğurganlık ve nüfusun yaşlanması gibi demografik değişimlerin etkisiyle bazı politika uygulamaları hız kazanmasına rağmen bunların yeterli seviyede olmadığı anlaşılmaktadır. Türkiye’nin iş yaşam dengesi politikalarının, Güney Avrupa ülkelerinden bazı alanlarda daha geride olmakla birlikte, bu ülkelerle benzer bir eğilim içerisinde olduğu sonucuna ulaşılmaktadır.
- Published
- 2017
30. Novel Agents Targeting Bioactive Sphingolipids for the Treatment of Cancer
- Author
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Adan-Gokbulut, A., Kartal-Yandim, M., Iskender, G., and Baran, Y.
- Abstract
Sphingolipids are a class of lipids that have important functions in a variety of cellular processes such as, differentiation, proliferation, senescence, apoptosis and chemotherapeutic resistance. The most widely studied bioactive shingolipids include ceramides, dihydroceramide (dhCer), ceramide-1-phosphate (C1P), glucosyl-ceramide (GluCer), sphingosine and sphingosine-1-phosphate (S1P). Although the length of fatty acid chain affects the physiological role, ceramides and sphingosine are known to induce apoptosis whereas C1P, S1P and GluCer induce proliferation of cells, which causes the development of chemoresistance. Previous studies have implicated the significance of bioactive shingolipids in oncogenesis, cancer progression and drug- and radiation-resistance. Therefore, targeting the elements of sphingolipid metabolism appears important for the development of novel therapeutics or to increase the effectiveness of the current treatment strategies. Some approaches involve the development of synthetic ceramide analogs, small molecule inhibitors of enzymes such as sphingosine kinase, acid ceramidase or ceramide synthase that catalyze ceramide catabolism or its conversion to various molecular species and S1P receptor antagonists. These approaches mainly aim to up-regulate the levels of apoptotic shingolipids while the proliferative ones are down-regulated, or to directly deliver cytotoxic sphingolipids like short-chain ceramide analogs to tumor cells. It is suggested that a combination therapy with conventional cytotoxic approaches while preventing the conversion of ceramide to S1P and consequently increasing the ceramide levels would be more beneficial. This review compiles the current knowledge about sphingolipids, and mainly focuses on novel agents modulating sphingolipid pathways that represent recent therapeutic strategies for the treatment of cancer.
- Published
- 2013
31. A new Pseudophoxinus (Teleostei, Cyprinidae) species from Southwestern Anatolia, with remarks on the distribution of the genus in western Anatolia
- Author
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Fahrettin Küçük, İskender Gülle, Salim Güçlü, Yilmaz Çiftçi, and Ömer Erdoğan
- Subjects
Zoology ,QL1-991 - Abstract
Pseudophoxinus burduricus sp. n. is described from drainages of Salda and Burdur lakes, southwestern Turkey. It is distinguished from other Anatolian Pseudophoxinus by a combination of characters: lateral line incomplete, with 21–39 (commonly 26–37) perforated scales and 47–57+1-2 scales in lateral series; 10½–12½ scale rows between lateral line and dorsal fin origin, 3–4(5) scale rows between lateral line and the pelvic fin origin; dorsal fin commonly with 7½ branched rays; anal fin commonly with 6½ branched rays; 7–8(9) gill rakers on the first branchial arch; a faint and diffuse epidermal black stripe from eye to caudal fin base in alive and preserved individuals; mouth slightly subterminal, tip of mouth cleft on about level of lower margin of eye; snout rounded, its length greater than eye diameter. Comparison is given with all Pseudophoxinus species from western Anatolia.
- Published
- 2013
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32. EĞİRDİR GÖLÜ'NDE ELODEA CANADENSIS MICHAUX'İN İLK BİLDİRİMİ VE İSTİLASI ÜZERİNE BİR ARAŞTIRMA
- Author
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Erol KESİCİ, İskender GÜLLE, and İsmail TURNA
- Subjects
Elodea canadensis ,Eğirdir Gölü ,istilacı tür ,trofik düzey ,Science (General) ,Q1-390 - Abstract
Özet: Elodea canadensis Michaux (Hydrocharitacea: Spermatophyta) Türkiye'de ilk olarak 1980'li yıllarda Trakya'dan bildirilmiştir. Eğirdir Gölü'nde, 2005 yılında ilk kez gözlemlenen bu tür dört yıl içerisinde tüm göl alanını kaplayarak baskın konuma gelmiştir. Bu çalışmada, 2005-2008 yılları arasında Eğirdir Gölü'nden alınan E. canadensis'in bazı diagnostik özellikleri ve ilk görüldüğü yıldan günümüze değin göldeki yayılışına ilişkin tespitler ortaya konulmuştur. Anahtar kelimeler: Elodea canadensis, Eğirdir Gölü, istilacı tür, trofik düzey A STUDY ON THE FIRST RECORD OF ELODEA CANADENSIS MICHAUX AND ITS INVASION IN LAKE EĞİRDİR, TURKEY Abstract: Elodea canadensis Michaux (Hydrocharitacea: Spermatophyta) was firstly recorded in Thrace in Turkey by 1980s. Firstly observed in 2005 in Lake Eğirdir, it has become dominant in the following years spreading all the lake area. In this study, some biological features and notes on the distribution of the plant since first observation was recorded, between 2005 and 2008. Key words: Elodea canadensis, invasive species, Lake Eğirdir, trophic level
- Published
- 2010
33. The occurrence and levels of cyanotoxin nodularin from Nodularia spumigena in the alkaline and salty Lake Burdur, Turkey
- Author
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Fatma Sahindokuyucu Kocasari, Iskender Gulle, Sukru Kocasari, Selcuk Pekkaya, and Firdevs Mor
- Subjects
Cyanobacteria bloom ,Burdur Lake ,Nodularia spumigena ,nodularin ,ELISA. ,Geography. Anthropology. Recreation ,Physical geography ,GB3-5030 ,Environmental sciences ,GE1-350 - Abstract
The occurrence of cyanobacteria species Nodularia spumigena and its toxin nodularin were studied in Burdur Lake, a saline alkaline lake with endemic fauna and a Ramsar site of ornithological importance. The water samples were collected from three different locations of Lake Burdur between May and November of 2011. Abundance of Nodularia spumigena and the nodularin levels peaked at the end of July (112,147 cells mL-1 and 4.82 µg L-1), coinciding with the highest levels of chlorophyll a (Chl a) (27.15 µg L-1) and the water temperature (29oC). Although fish or other animal deaths were not detected during the episodes, it is concluded that N. spumigena blooming should be monitored in Burdur Lake for the ecosystem and environmental health.
- Published
- 2015
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34. Risk factors for recurrences in patients with hepatitis C virus after achieving a sustained virological response: A multicentre study from Turkey
- Author
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Arslan F, Ceylan B, Riza Sahin A, Ö, Günal, Kayaaslan B, Uğurlu K, Tanoğlu A, Iskender G, Tosun S, aynur atilla, Sargin F, Batirel A, Karagöz E, Sonsuz A, and Mert A
- Subjects
Steatosis ,HCV ,Relapse ,Hepatitis C - Abstract
In this study, we aimed to determine the late relapse rate in hepatitis C patients with sustained virological response after interferon-based regimens, and evaluated the predictors of late relapse while comparing the real-life data of our country with that of others. A multicenter retrospective study was performed to investigate the data of patients infected with HCV who obtained sustained virological response after classical or pegylated interferon alpha (PegIFN?) and ribavirin (RBV) for 48 weeks. Sustained virological response was based on negative HCV RNA level by PCR at the end of six months after the therapy. The information of patients enrolled in the study was retrieved from the hospital computer operating system and outpatient follow-up archives. We evaluated the age, gender, HCV RNA levels, HCV genotype, six-month and further follow-up of patients with sustained virologic response, presence of cirrhosis, steatosis and relapse. In all, 606 out of 629 chronic hepatitis C patients (mean age was 53±12 years; 57.6 % of them were female) with sustained virological response were evaluated. We excluded 23 patients who relapsed within six months after the end of treatment (EOT). The mean follow-up period of the patients was 71 months (range: 6-136) after therapy. Late relapse rate was 1.8% (n=11) in all patients. Univariate Cox proportional hazard regression models identified that cirrhosis and steatosis were associated with the late relapse [(p=0.027; Hazard Ratio (HR) 2.328; 95% confidence interval (CI): 1.309-80.418), (p=0.021; HR 1.446; 95% CI: 1.243-14.510, respectively]. In multivariable Cox regression analysis, steatosis was the only independent risk factor for late relapse (p=0.03; HR 3.953; 95% CI: 1.146-13.635). Although the late relapse rate was approximately 2% in our study, clinicians should consider that pretreatment steatosis may be an important risk factor for late relapse.
35. Two acute myeloblastic leukemia cases concomitant with hemophagocytic lymphohistiocytosis and review of the literature
- Author
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Akyay, A., Celkan, T., Iskender, G., Tükün, A., Ogan, C., and Lale Olcay
36. Prevailing situation of Turkish urban wastewater treatment plants
- Author
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Arslan-Alaton, I., Gurel, M., Iskender, G., Suleyman Ovez, Tanik, A., and Orhon, D.
37. Premarital screening in Muğla region of Turkey
- Author
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İskender Gencer, Nejat Akar, Sibel Özdemir, and İsmail Hakkı Timur
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2009
38. Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey
- Author
-
Ayse Inci, Fatma Yılmaz Karadağ, Pınar Ergen, Saygin Nayman Alpat, Rezan Harman, Ilhami Celik, Filiz Koc, Hakan Erdem, Mehmet Bitirgen, Ilknur Yavuz, Nefise Oztoprak, Ayse Batirel, Banu Cakir, Mustafa Namiduru, Esmeray Mutlu Yilmaz, Kevser Ozdemir, Emsal Aydin, Yasemin Durdu, Kenan Ugurlu, Nevin Ince, Aynur Atilla, Büşra Ergüt Sezer, Emel Aslan, Serpil Erol, Mustafa Hatipoglu, Hatice Udurgucu, Mustafa Sunbul, Ayşe Erbay, Ercan Yenilmez, Hacer Deniz Ozkaya, Yeşim Alpay, Esma Gulesen Eroglu, Mehmet Faruk Geyik, Emine Parlak, Hüseyin Tarakçı, Rodrigo Hasbun, Gunes Senol, Aynur Aynioglu, Ilkay Bozkurt, Necati Örmeci, Recep Tekin, Seher Ayten Coskuner, Gokhan Karaahmetoglu, Ebru Dik, Zehra Karacaer, Suna Seçil Öztürk Deniz, Gulsen Iskender, Selma Tosun, Fatime Korkmaz, Ilker Inanc Balkan, Ergenekon Karagoz, Fatma Sirmatel, Suzan Sacar, Ömer Evirgen, Mustafa Dogan, Ayten Kadanali, Senol Comoglu, Rahmet Guner, Ahmet Şahin, Affan Denk, Elif Tukenmez Tigen, Ceyda Necan, Aliye Bastug, Ahmet Sahin, Cinar Ozturk, Hamdi Sözen, Çiğdem Kader, Mustafa Altindiş, Şafak Kaya, Selçuk Kaya, Mehmet Ulug, Servet Kolgelier, Gül Durmuş, Kamuran Turker, Ahmet Karakaş, Gülden Ersöz, Pinar Korkmaz, Rukiye Pinar Bölüktaş, Fakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı, Şahin, Ahmet Melih, Karacaer, Zehra, Cakir, Banu, Erdem, Hakan, Ugurlu, Kenan, Durmus, Gul, Ince, Nevin Koc, Ozturk, Cinar, Hasbun, Rodrigo, Batirel, Ayse, Yilmaz, Esmeray Mutlu, Bozkurt, Ilkay, Sunbul, Mustafa, Aynioglu, Aynur, Atilla, Aynur, Erbay, Ayse, Inci, Ayse, Kader, Cigdem, Tigen, Elif Tukenmez, Karaahmetoglu, Gokhan, Coskuner, Seher Ayten, Dik, Ebru, Tarakci, Huseyin, Tosun, Selma, Korkmaz, Fatime, Kolgelier, Servet, Karadag, Fatma Yilmaz, Erol, Serpil, Turker, Kamuran, Necan, Ceyda, Sahin, Ahmet Melih, Ergen, Pinar, Iskender, Gulsen, Korkmaz, Pinar, Eroglu, Esma Gulesen, Durdu, Yasemin, Ulug, Mehmet, Deniz, Suna Secil, Koc, Filiz, Alpat, Saygin Nayman, Oztoprak, Nefise, Evirgen, Omer, Sozen, Hamdi, Dogan, Mustafa, Kaya, Selcuk, Kaya, Safak, Altindis, Mustafa, Aslan, Emel, Tekin, Recep, Sezer, Busra Ergut, Ozdemir, Kevser, Ersoz, Gulden, Sahin, Ahmet, Celik, Ilhami, Aydin, Emsal, Bastug, Aliye, Harman, Rezan, Ozkaya, Hacer Deniz, Parlak, Emine, Yavuz, Ilknur, Sacar, Suzan, Comoglu, Senol, Yenilmez, Ercan, Sirmatel, Fatma, Balkan, Ilker Inanc, Alpay, Yesim, Hatipoglu, Mustafa, Denk, Affan, Senol, Gunes, Bitirgen, Mehmet, Geyik, Mehmet Faruk, Guner, Rahmet, Kadanali, Ayten, Karakas, Ahmet, Namiduru, Mustafa, Udurgucu, Hatice, Boluktas, Rukiye Pinar, Karagoz, Ergenekon, Ormeci, Necati, Karacaer, Z, Cakir, B, Erdem, H, Ugurlu, K, Durmus, G, Ince, NK, Ozturk, C, Hasbun, R, Batirel, A, Yilmaz, EM, Bozkurt, I, Sunbul, M, Aynioglu, A, Atilla, A, Erbay, A, Inci, A, Kader, C, Tigen, ET, Karaahmetoglu, G, Coskuner, SA, Dik, E, Tarakci, H, Tosun, S, Korkmaz, F, Kolgelier, S, Karadag, FY, Erol, S, Turker, K, Necan, C, Sahin, AM, Ergen, P, Iskender, G, Korkmaz, P, Eroglu, EG, Durdu, Y, Ulug, M, Deniz, SS, Koc, F, Alpat, SN, Oztoprak, N, Evirgen, O, Sozen, H, Dogan, M, Kaya, S, Altindis, M, Aslan, E, Tekin, R, Sezer, BE, Ozdemir, K, Ersoz, G, Sahin, A, Celik, I, Aydin, E, Bastug, A, Harman, R, Ozkaya, HD, Parlak, E, Yavuz, I, Sacar, S, Comoglu, S, Yenilmez, E, Sirmatel, F, Balkan, II, Alpay, Y, Hatipoglu, M, Denk, A, Senol, G, Bitirgen, M, Geyik, MF, Guner, R, Kadanali, A, Karakas, A, Namiduru, M, Udurgucu, H, Boluktas, RP, Karagoz, E, Ormeci, N, Sakarya Üniversitesi/Tıp Fakültesi/Temel Tıp Bilimleri Bölümü, Altındiş, Mustafa, Tıp Fakültesi, RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Öztürk, Çınar, MÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Sözen, Hamdi, Zonguldak Bülent Ecevit Üniversitesi, Halk Sağlığı, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Sırmatel, Fatma, and OMÜ
- Subjects
antivirus agent ,Male ,demography ,MARITAL-STATUS ,Turkey ,Cross-sectional study ,IMPACT ,Disease ,DETERMINANTS ,Turkey (republic) ,0302 clinical medicine ,Quality of life ,antiviral therapy ,Health Status Indicators ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,The Hepatitis B Quality of Life Instrument ,food and beverages ,clinical trial ,General Medicine ,Middle Aged ,Hepatitis B ,humanities ,Chronic hepatitis B infection ,Female ,030211 gastroenterology & hepatology ,HEALTH ,prospective study ,Adult ,medicine.medical_specialty ,Chronic Hepatitis B Infection ,quality of life assessment ,psychology ,Antiviral Agents ,Article ,Interviews as Topic ,03 medical and health sciences ,Hepatitis B, Chronic ,Chronic hepatitis ,UTILITIES ,Internal medicine ,medicine ,cross-sectional study ,Humans ,chronic hepatitis B ,controlled study ,human ,Aged ,Related factors ,business.industry ,Research ,fungi ,Public Health, Environmental and Occupational Health ,Hepatitis B Quality of Life ,interview ,medicine.disease ,major clinical study ,COMORBIDITIES ,hepatitis B surface antigen ,multicenter study ,Cross-Sectional Studies ,Health Care Sciences & Services ,Short Form 36 ,Multi center study ,Physical therapy ,Quality of Life ,business ,health status indicator - Abstract
WOS: 000386954300001, PubMed: 27809934, Background: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. Methods: This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. Results: Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. Conclusions: The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.
- Published
- 2016
39. Outbreak caused by multidrug-resistant OXA-48 and NDM-1 producing Klebsiella pneumoniae in the intensive care unit of a cancer hospital.
- Author
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Süzük Yıldız S, Tavukcu E, Şahin S, İskender G, Ünaldı Ö, Demirhan B, Avşar Z, Orman EÖ, Mumcuoğlu İ, and Dal T
- Subjects
- Humans, Male, Middle Aged, Female, Aged, Turkey epidemiology, Cancer Care Facilities, Electrophoresis, Gel, Pulsed-Field, Anti-Bacterial Agents pharmacology, Adult, Microbial Sensitivity Tests, Klebsiella pneumoniae genetics, Klebsiella pneumoniae isolation & purification, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae enzymology, Disease Outbreaks, beta-Lactamases genetics, beta-Lactamases metabolism, Klebsiella Infections epidemiology, Klebsiella Infections microbiology, Intensive Care Units, Drug Resistance, Multiple, Bacterial, Cross Infection microbiology, Cross Infection epidemiology
- Abstract
We report a nosocomial outbreak caused by a multidrug-resistant carbapenemase-producing Klebsiella pneumoniae (MDRCPKp), that was detected in six patients admitted to the medical intensive care unit between 20th of December 2023 and 15th of January 2024 in Ankara, Turkey. The investigation of this outbreak was started on 29th of December 2023. During the outbreak 11 samples were collected from the six patients with MDRCPKp. Pulsed-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness and clonality of MDRCPKp strains. MDRCPKp was isolated in the tracheal aspiration culture, blood, urine, and screening samples. Five patients with MDRCPKp colonization developed healthcare-associated infection. In one patient MDRCPKp was isolated from tracheal aspirate and the screening cultures were considered as colonization not infection. PFGE analysis revealed that all isolates belonged to the same K. pneumoniae clone. MDRCPKp strain of this outbreak exhibited multidrug resistance and co-produced OXA-48 and NDM-1. This outbreak ended after application of strict infection control measures. An outbreak of MDRCPKp can occur in hospitals, especially in the intensive care units; thus, it should be detected early by infection control teams. A strong collaboration between infection control team and microbiology laboratory is essential to cope with MDR bacterial outbreaks in hospitals.
- Published
- 2024
- Full Text
- View/download PDF
40. Six-year evaluation of device-associated nosocomial infections in intensive care units.
- Author
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Mert D, Çalışkan Demirkıran B, İskender G, Avşar Z, Timuroğlu A, Binay S, Aşkın T, and Ertek M
- Subjects
- Humans, Male, Retrospective Studies, Female, Middle Aged, Aged, Adult, Urinary Tract Infections microbiology, Urinary Tract Infections epidemiology, Anti-Bacterial Agents therapeutic use, Tertiary Care Centers statistics & numerical data, Aged, 80 and over, Intensive Care Units, Cross Infection microbiology, Cross Infection epidemiology, Catheter-Related Infections microbiology, Catheter-Related Infections epidemiology, Pneumonia, Ventilator-Associated microbiology, Pneumonia, Ventilator-Associated epidemiology
- Abstract
Introduction: Invasive device-associated nosocomial infections commonly occur in intensive care units (ICUs). These infections include intravascular catheter-related bloodstream infection (CRBSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). This study aimed to evaluate the factors associated with invasive device-associated nosocomial infections based on the underlying diseases of the patients and antibiotic resistance profiles of the pathogens causing the infections detected in the ICU in our hospital over a five-year period., Methodology: Invasive device-associated infections (CRBSI, VAP, and CAUTI) were detected retrospectively by the laboratory- and clinic-based active surveillance system according to the criteria of the US Centers for Disease Control and Prevention (CDC) in patients hospitalized in the ICU of the tertiary hospital between 1 January 2018 and 30 June 2023., Results: A total of 425 invasive device-associated nosocomial infections and 441 culture results were detected (179 CRBSI, 176 VAP, 70 CAUTI). Out of them, 57 (13.4%) patients had hematological malignancy, 145 (34.1%) had solid organ malignancy, and 223 (52.5%) had no histopathologic diagnosis of any malignancy. An increase in extended-spectrum beta lactamase (ESBL) and carbapenem resistance in pathogens was detected during the study period., Conclusions: Antibiotic resistance of the Gram-negative bacteria associated with invasive device-associated infections increased during the study period. Antimicrobial stewardship will reduce rates of nosocomial infections, reduce mortality, and shorten hospital stay. Long-term catheterization and unnecessary antibiotic use should be avoided., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Duygu Mert, Burcu Çalışkan Demirkıran, Gülşen İskender, Zuhal Avşar, Arif Timuroğlu, Songül Binay, Tuğba Aşkın, Mustafa Ertek.)
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- 2024
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41. Thalamic nuclei volume differences in schizophrenia patients and healthy controls using probabilistic mapping: A comparative analysis.
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Dönmezler S, Sönmez D, Yılbaş B, Öztürk Hİ, İskender G, and Kurt İ
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- Humans, Thalamic Nuclei diagnostic imaging, Thalamus diagnostic imaging, Image Processing, Computer-Assisted, Magnetic Resonance Imaging methods, Schizophrenia diagnostic imaging
- Abstract
Aim: We aimed to investigate potential discrepancies in the volume of thalamic nuclei between individuals with schizophrenia and healthy controls., Methods: The imaging data for this study were obtained from the MCICShare data repository within SchizConnect. We employed probabilistic mapping technique developed by Iglesias et al. (2018). The analytical component entailed volumetric segmentation of the thalamus using the FreeSurfer image analysis suite. Our analysis focused on evaluating the differences in the volumes of various thalamic nuclei groups within the thalami, specifically the anterior, intralaminar, medial, posterior, lateral, and ventral groups in both the right and left thalami, between schizophrenia patients and healthy controls. We employed MANCOVA to analyse these dependent variables (volumes of 12 distinct thalamic nuclei groups), with diagnosis (SCZ vs. HCs) as the main explanatory variable, while controlling for covariates such as eTIV and age., Results: The assumptions of MANCOVA, including the homogeneity of covariance matrices, were met. Specific univariate tests for the right thalamus revealed significant differences in the medial (F[1, 200] = 26.360, p < 0.001), and the ventral groups (F[1, 200] = 4.793, p = 0.030). For the left thalamus, the medial (F[1, 200] = 22.527, p < 0.001); posterior (F[1, 200] = 8.227, p = 0.005), lateral (F[1, 200] = 7.004, p = 0.009), and ventral groups (F[1, 200] = 9.309, p = 0.003) showed significant differences., Conclusion: These findings suggest that particular thalamic nuclei groups in both the right and left thalami may be most affected in schizophrenia, with more pronounced differences observed in the left thalamic nuclei., Fundings: The authors received no financial support for the research., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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42. COVID-19 in cancer patients: patient characteristics and outcomes in the post-COVID-19 vaccination period.
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Iskender G, Mert D, Yapar Toros G, Yilmaz F, Bozan E, Tunçbilek S, Çakmak Öksüzoğlu ÖB, Altuntaş F, and Ertek M
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- Humans, Male, Female, Middle Aged, Retrospective Studies, Aged, Risk Factors, SARS-CoV-2, Intensive Care Units statistics & numerical data, Adult, Vaccination statistics & numerical data, Prognosis, COVID-19 epidemiology, COVID-19 mortality, COVID-19 prevention & control, COVID-19 complications, Neoplasms mortality, COVID-19 Vaccines administration & dosage, Hospitalization statistics & numerical data
- Abstract
Background/aim: It wasaimed herein to investigate coronavirus disease (COVID-19) in cancer patients and compare hematological and solid organ cancer patients in terms of the course and outcome of this disease., Materials and Methods: Data from cancer patients with laboratory-confirmed COVID-19 infection were analyzed retrospectively. Risk factors for poor prognosis and the effect of vaccination on the clinical outcomes of the patients were evaluated., Results: A total of 403 cancer patients who were diagnosed with COVID-19 between March 1st, 2021, and November 30th, 2022, were included, of whom 329 (81.6%) had solid and 74 (18.4%) had hematological cancers. Hospitalization and intensive care unit (ICU) admission rates were significantly higher in the hematological cancer patients compared to the solid organ cancer patients (73.0% vs. 35.9%, p< 0.001 and 25.7% vs. 14.0%, p= 0.013, respectively). The COVID-19 - related case fatality rate (CFR) was defined as 15.4%, and it was higher in the hematologicalcancer patientsthan inthe solid organ cancer patients (23.0% vs. 13.7%, p= 0.045) and was higher in patients with metastatic/advanced disease compared to the other cancer stages (p< 0.001). In the solid organ cancergroup, hospitalization, ICU admission, and the COVID-19 CFR were higher in patients with respiratory and genitourinary cancers (p< 0.001). A total of 288 (71.8%) patients had receivedCOVID-19 vaccination; 164 (56.94%) had≤2 doses and 124 (43.06%) had≥3 doses. The hospitalization rate was higher in patients with ≤2 doses of vaccine compared to those with ≥3 doses (48.2% vs. 29.8%,p= 0.002). Patients with COVID-19 - related death had higher levels of leucocyte, neutrophil, D-dimer, troponin, C-reactive protein (CRP), procalcitonin, and ferritin and lower levels of lymphocyte than the survivors. In the logistic regression analysis,the risk of COVID-19 - related mortality was higher in the hematological cancer patients(OR:1.726), those who were male (OR:1.757), and with the Pre-Delta/Delta variants (OR:1.817)., Conclusion: This study revealed that there is an increased risk of COVID-19-related serious events (hospitalization, ICU admission, or death) in patients with hematological cancerscompared with those who have solid organ cancers. It wasalso shown that receiving ≥3 doses of COVID-19 vaccine is more protective against severe illness and the need for hospitalization than ≤2 doses., Competing Interests: Conflict of interest: The authors declare that there are no conflicts of interest, including specific financial interests, relationships, and/or affiliations relevant to the subject matter or materials included herein., (© TÜBİTAK.)
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- 2023
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43. COVID-19 infection among healthcare workers in an oncology hospital.
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İskender G, Mert D, Avşar Z, Kölgelier S, and Ertek M
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- Humans, Female, Male, Adult, Middle Aged, COVID-19 Vaccines, Reinfection, Retrospective Studies, SARS-CoV-2, Hospitals, Health Personnel, COVID-19 epidemiology
- Abstract
Introduction: Healthcare workers are at high risk for acquiring COVID-19 and transmitting it to the patients especially to cancer patients in whom the risk of severe COVID-19 is high. We determined the rate of COVID-19 infection among healthcare workers in an oncology hospital and their epidemiological characteristics., Methodology: Data of infected workers from March 11, 2020, to February 28, 2022 were obtained via Infection Control Committee COVID-19 Surveillance Records and evaluated retrospectively., Results: During this period 58.34% of 2,355 workers were vaccinated with > 3 doses of COVID-19 vaccines. A total of 1,294 COVID-19 attacks developed in 1,181 (50.14%) workers; mean age was 38.08 ± 9.52 years, 744 (63%) were female. Re-infection occurred in 112 (9.5%) workers. Source of infection in 858 attacks (66.31%) was unknown. Hospitalization was needed in 24 (2%) and intensive care unit admission in 1 (0.08%), no death occurred. In the first attacks, 587 (49.70%) were unvaccinated; in re-infections 66 (58.92%) were ≥ 3 doses vaccinated. Hospitalizations were predominantly in the pre-Delta period (16/24: 66.7%, p < 0.05). Re-infections occurred mostly in the Omicron variant period (p < 0.05). Relationship between hospitalization and male gender, age ≥ 50 years, "doctor" profession and presence of chronic diseases were significant (p < 0.05)., Conclusions: During the study period, half of the healthcare workers in our hospital developed COVID-19 infection of whom 9.5% re-infected, predominantly during the Omicron variant period. Our findings highlight the importance of taking preventive measures and administering booster vaccine doses even after initial vaccination/infection., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2023 Gülşen İskender, Duygu Mert, Zühal Avşar, Servet Kölgelier, Mustafa Ertek.)
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- 2023
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44. Exploring the "Insight Paradox" in Treatment-Resistant Schizophrenia: Correlations Between Dimensions of Insight and Depressive Symptoms in Patients Receiving Clozapine.
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Dönmezler S, İskender G, Fıstıkcı N, Altunkaynak Y, Ulusoy S, and Berkol TD
- Abstract
Objective: There remains a lack of clarity as to the possible cross talk of insight into illness and depressive symptoms in treatment-resistant schizophrenia. We therefore set our primary aim to evaluate relationship between insight dimensions and depressive symptoms in patients with treatment-resistant schizophrenia receiving clozapine., Methods: This was a cross-sectional, non-interventional study, conducted in daily clinical practice conditions. Patients in outpatient clinics between March 2020 and May 2020 with treatment-resistant schizophrenia (based on Treatment Response and Resistance in Psychosis), with no comorbid psychiatric disorder, and with no body mass index greater than 40.0 kg/m
2 were included. We collected sociodemographic variables, scores of insight dimensions (treatment compliance, illness recognition, and symptom relabeling with the Schedule for Assessment of Insight), and depressive symptoms with Calgary Depression Score for Schizophrenia. Linear regression models were used to investigate variables associated with depressive symptoms as the outcome of interest., Results: The final analysis sample comprised 55 patients with treatment-resistant schizophrenia, with a mean age of 42.48 (SD = 9.18) years and a predominance of the male sex (n = 42, 76.9%). Model 1 [Calgary Depression Score for Schizophrenia ~ (Schedule for Assessment of Insight + Positive and Negative Syndrome Scale)] displayed that 48% of the variation in the Calgary Depression Score for Schizophrenia can be explained by Schedule for Assessment of Insight-composite and Positive and Negative Syndrome Scale-composite ( P < .001). More effectively, model 2 [Calgary Depression Score for Schizophrenia ~ (Schedule for Assessment of Insight-illness recognition + Positive and Negative Syndrome Scale-general psychopathology)] revealed that 51% of the variation in the Calgary Depression Score for Schizophrenia can be explained by the sub-scales ( P < .001). We further designed a new model in which Global Assessment of Functioning scores were the response variable to explore the link between awareness into illness and functionality (Global Assessment of Functioning ~ Schedule for Assessment of Insight-illness recognition). In this model, awareness of illness did not explain a significant proportion of variance in functionality scores ( R2 = 0.045, F (1,52) = 2.48, P = 0.121)., Conclusion: The treatment compliance part of insight was not one of the significant explanatory variables of depressive symptoms, but it explained the variance in functioning, in contrast to the illness recognition dimension of insight. If our findings were replicated in treatment-resistant schizophrenia, they would suggest that promoting treatment compliance dimension of insight instead of recognition of illness could not increase depressive symptoms., (© 2023 authors.)- Published
- 2023
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45. Evaluation of risk factors, causative pathogens, and treatment in recurrent percutaneous nephrostomy catheter-related urinary tract infections in cancer patients.
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Mert D, Iskender G, Kolgelier S, and Ertek M
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- Humans, Reinfection, Quality of Life, Urinary Catheters adverse effects, Risk Factors, Catheterization adverse effects, Nephrostomy, Percutaneous adverse effects, Urinary Tract Infections microbiology, Kidney Calculi complications, Neoplasms complications, Catheter-Related Infections complications
- Abstract
Introduction: In cancer patients, percutaneous nephrostomy (PN) catheters can be used to relieve obstruction from chemotherapy, radiation therapy, or surgery, thereby improving kidney function and preventing further kidney damage. One of the complications of PN catheters is infections. Recurrent infections may delay chemotherapy, increase antimicrobial resistance with frequent antibiotic use, deteriorate the quality of life of patients, and increase costs. In this study, it was aimed to evaluate risk factors, causative pathogens, and treatment in recurrent PN catheter-related urinary tract infections in cancer patients., Material and Method: Cancer patients with PN catheter-associated urinary tract infection who were followed-up in the Infectious Diseases and Clinical Microbiology Clinic between January 1, 2012 and December 31, 2021 were included in the study., Results: The total catheterization time, and occurrence of preinfection catheter replacement, active chemotherapy, and kidney stones were significantly higher in patients with recurrent infection when compared to the other group (P = .000, P = .000, P = .007, and P = .018, respectively). ESBL-positive Escherichia coli and ESBL-positive Klebsiella pneumoniae were most commonly isolated from the PN catheter urine cultures of patients with recurrent infections., Discussion: Long-term use of the PN catheter increases the risk of urinary tract infection and sepsis. In this study, the total catheterization time, and occurrence of preinfection catheter replacement, active chemotherapy, and kidney stones were found to be risk factors for the development of recurrent PN catheter-related urinary tract infection in cancer patients., Conclusion: It is important to know the risk factors in recurrent PN catheter-related urinary tract infections in cancer patients, take maximum protective measures, and follow-up. Knowing both the causative profile and the resistance rates will increase the chance of success in the treatment when empirical treatment is required. It should also be noted that these patients should be included in the group of patients who need prophylaxis for urinary tract infection., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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46. Latent tuberculosis in adult hematopoietic stem cell transplantation recipients: Clinical experience from a previously endemic population.
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Mert D, Ozer M, Merdin A, İskender G, Uncu Ulu B, Kizil Çakar M, Dal MS, Altuntaş F, and Ertek M
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- Humans, Adult, Retrospective Studies, Tuberculin Test, Latent Tuberculosis diagnosis, Latent Tuberculosis epidemiology, Hematopoietic Stem Cell Transplantation adverse effects, Tuberculosis epidemiology
- Abstract
Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients' records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
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47. Recovery of Symmetrical Peripheral Gangrene of Limbs in a Patient After Performing Hemoadsorption in Septic Shock.
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Uncu Ulu B, Yiğenoğlu TN, Hacıbekiroğlu T, Sağlam DA, Kılınç A, İskender G, Çakar MK, Dal MS, and Altuntaş F
- Subjects
- Adult, Anti-Bacterial Agents pharmacology, Cytokines metabolism, Disease Progression, Disseminated Intravascular Coagulation, Hemadsorption, Humans, Hypotension, Male, Sepsis complications, Sepsis physiopathology, Thrombocytopenia, Treatment Outcome, Vasoconstrictor Agents adverse effects, Gangrene etiology, Gangrene therapy, Hodgkin Disease complications, Hodgkin Disease diagnosis, Shock, Septic therapy
- Abstract
We report a 42-year-old patient who had Hodgkin lymphoma and developed bilateral symmetrical peripheral gangrene (SPG) in the feet and hands, which occurred during septic shock after autologous hematopoietic stem-cell transplantation. SPG is a rare but severe complication of disseminated intravascular coagulation (DIC) and is frequently associated with sepsis. The pathophysiology of SPG includes DIC-mediated intravascular thrombosis and thrombotic occlusion of microcirculation, resulting in low blood flow. Sepsis-induced hypotension has been suspected as one of the other causes of SPG, and it is thought to be aggravated by vasopressor treatments given for hypotension. Our patient first experienced coldness, paleness, and cyanosis in his body's acral parts, and then SPG later developed in both his feet and hands. Septic shock management was performed with cytokine hemoadsorption, broad-spectrum antibiotics, and massive fluid replacement rapidly. The patient fully recovered without the need for amputation. Hemoadsorption is an extracorporeal cytokine-adsorption method for removing excess cytokines. Prompt management of septic shock and early monitoring of peripheral ischemia are essential to avoid SPG., (© 2021 Wiley Periodicals LLC.)
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- 2021
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48. Evaluation of Risk Factors for Mortality in Febrile Neutropenia.
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Ceken S, Gedik H, Iskender G, Demirelli M, Mert D, Yapar Toros G, Yigenoglu TN, Altuntas F, Oksuzoglu B, and Ertek M
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- Adolescent, Adult, Aged, Antifungal Agents therapeutic use, Case-Control Studies, Febrile Neutropenia microbiology, Female, Humans, Invasive Fungal Infections chemically induced, Invasive Fungal Infections drug therapy, Male, Middle Aged, Retrospective Studies, Risk Factors, Young Adult, Antineoplastic Agents adverse effects, Febrile Neutropenia mortality, Hematologic Neoplasms drug therapy
- Abstract
Introduction: We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN)., Methodology: The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated., Results: A total of 135 FEN episodes of 115 patients, who comprised of 72 (63%) patients with 89 FEN episodes due to hematologic malignancies (hemato-group) and 43 (37%) patients with 46 FEN episodes due to solid organ cancers (onco-group), were evaluated in the study. The median age was 47 years (range: 17-75 years) and 66 (57%) patients were male. A total of 12 patients (8.8%) died during 135 episodes of FEN including nine cases from hemato-group and three cases from onco-group. Those factors including a presence of pneumonia, advanced age, persistent fever despite an antimicrobial treatment, and need for mechanical ventilation in intensive care unit (ICU) with were determined as risk factors associated with mortality., Conclusions: Morbidity and mortality are more common in patients with hematological malignancies compared to patients with solid organ cancers due to prolonged neutropenia. In case of persistent fever, an invasive fungal infection (IFI) should be kept in mind in patients with hematologic malignancies and then antifungal treatment should be initiated. Although a persistent fever is also common in patients with solid tumors, the necessity of antifungal therapy is rare due to the short duration of neutropenia., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2020 Sabahat Ceken, Habip Gedik , Gulsen Iskender, Meryem Demirelli, Duygu Mert, Goknur Yapar Toros, Tugce Nur Yigenoglu, Fevzi Altuntas, Berna Oksuzoglu, Mustafa Ertek.)
- Published
- 2020
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49. Hepatitis B Virus Reactivation under Ibrutinib Treatment in a Patient with Chronic Lymphocytic Leukemia
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İskender G, İskender D, and Ertek M
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- Adenine adverse effects, Adenine therapeutic use, Antineoplastic Agents adverse effects, Hepatitis B Core Antigens immunology, Humans, Leukemia, Lymphocytic, Chronic, B-Cell diagnosis, Leukemia, Lymphocytic, Chronic, B-Cell immunology, Male, Middle Aged, Piperidines adverse effects, Protein Kinase Inhibitors adverse effects, Virus Activation drug effects, Virus Activation immunology, Adenine analogs & derivatives, Antineoplastic Agents therapeutic use, Hepatitis B virus immunology, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Piperidines therapeutic use, Protein Kinase Inhibitors therapeutic use
- Published
- 2020
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50. Hepatitis C screening and referral for further investigation and treatment in a tertiary care hospital.
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İskender G, Mert D, Çeken S, Bahçecitapar M, Yenigün A, and Ertek M
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- Adult, Aged, Aged, 80 and over, Antiviral Agents therapeutic use, Awareness, Female, Hepatitis C diagnosis, Hepatitis C drug therapy, Hepatitis C Antibodies blood, Humans, Male, Middle Aged, Practice Patterns, Physicians' statistics & numerical data, Retrospective Studies, Turkey epidemiology, Young Adult, Health Knowledge, Attitudes, Practice, Hepatitis C epidemiology, Hepatitis C prevention & control, Mass Screening, Referral and Consultation statistics & numerical data, Tertiary Care Centers statistics & numerical data
- Abstract
Introduction: Hepatitis C virus infection is a major cause of cirrhosis and liver cancer worldwide. The knowledge of physicians about what should they do in case of any anti-HCV positivity in screening tests is of great importance. In this study the awareness and knowledge of physicians is evaluated by analyzing the rate of the referrals of anti-HCV positive patients to HCV RNA test and their treatment by different clinics., Methodology: The patients tested for anti-HCV in internal medicine, surgery, gastroenterology and infectious disease clinics between 1 January and 31 December 2017 were evaluated retrospectively in a tertiary care hospital., Results: Anti-HCV testing was performed in 32,803 patients. Anti-HCV positivity was detected in 95 (0.28%) patients aged 88 years of age or younger (mean 60.89 ± 16.96 years), 57.89% of them were female. HCV RNA was tested in 50 (%52,63) of anti-HCV positive patients and it was found positive in 18 (36%) patients. In anti-HCV positive patients HCV RNA testing was requested most by infectious disease (100%) and gastroenterology (70.58%) clinics and least by surgery and other clinics (21% and 25% respectively). These differences were found to be statistically significant ( =33.65, p < 001)., Conclusions: Our study highlights the significant deficiencies existed in the referring patients with anti-HCV positivity for further examination and treatment by the attending physicians especially in surgical clinics. Performing HCV screening in the different steps of medical care and using electronic reminder systems directing physicians at appropriate diagnostic and treatment protocols can maximize the likelihood of the detection and treatment of HCV- infected patients., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2020 Gulsen Iskender, Duygu Mert, Sabahat Ceken, Melike Bahcecitapar, Ayla Yenigun, Mustafa Ertek.)
- Published
- 2020
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