Search

Background: Drug-resistant tuberculosis (DR-TB) poses a significant threat to global TB control and remains a major public health issue. This study aims to evaluate treatment outcomes and identify risk factors for unfavorable outcomes in patients with multi-DR-TB (MDR-TB) treated at a major reference hospital in Istanbul. Methods: We conducted a retrospective analysis of 413 patients with rifampicin-resistant and MDR-TB who received treatment between January 1, 2013, and December 31, 2023, at the University of Health Sciences Süreyyapaşa Chest Diseases Training and Research Hospital. Patients were treated following the World Health Organization and national guidelines, with regimens tailored to individual drug resistance profiles and side effect management. Demographic data, comorbidities, microbiological follow-up, drug resistance patterns, treatment regimens, and radiological findings were analyzed. Results: Treatment success was achieved in 350 patients (84.74%). Thirty-two patients (7.74%) were lost to follow-up, and 32 patients (7.74%) died. Logistic regression analysis identified several factors associated with unfavorable treatment outcomes: comorbidities (odds ratio [OR]: 7.555, P = 0.001), quinolone resistance (OR: 3.695, P = 0.030), and bronchiectasis (OR: 4.126, P = 0.013). Additional significant factors included male gender (P = 0.007), foreign-born status (P = 0.013), age over 35 years (P = 0.002), previous treatment history (P = 0.058), and drug side effects (P = 0.012). Conclusion: The long-term regimen for MDR-TB was found to be highly successful, with an 84.74% treatment success rate. Effective treatment regimens, close patient follow-up, early recognition of side effects, and comprehensive management are crucial for achieving successful outcomes. Identifying and addressing risk factors such as comorbidities, drug resistance, and specific patient demographics can further improve treatment success rates. This study underscores the importance of tailored treatment strategies and robust patient management in combating MDR-TB.

Background: Tuberculosis (TB) is one of the leading infectious causes of mortality globally. The purpose of this research is to examine the clinical and radiological characteristics of patients with TB and diabetes. Methods: The research comprised 276 TB patients, 52 of whom were diabetic and 224 of whom were not. During the evaluation of the patients' clinical histories, age, gender, diagnostic indicator, and whether or not they had undergone prior treatment were questioned, as were the requirement of inpatient treatment and the existence of drug resistance. Radiographically, they were questioned in terms of bilateral–unilateral extent, percentage of parenchymal involvement, cavitation, tree-in-bud appearance, the presence of ground glass, consolidation, miliary involvement, sequela fibrotic changes, parenchymal calcification, mediastinal lymphadenopathy, pleural effusion, and pleural calcification. In addition, segmenting was used to assess involvement in the affected lobes. Results: When we look at the results of 276 patients, 182 males and 94 females, the mean age is 46.01 ± 17.83. Diabetes and TB coexistence are more prevalent in male individuals (P = 0.029). Smear positivity and the need for inpatient treatment were found to be higher in the clinical features of diabetic patients (P = 0.05 and P = 0.01, respectively). Radiologically, diabetes individuals are more likely to have larger mediastinal lymph nodes (P = 0.032). Conclusion: In the coexistence of both TB and diabetes, there are variations in radiological findings, complexity in treatment response, and patient management.

Background: In recent years, with the development of laboratory methods, the frequency of nontuberculosis mycobacteria (NTM) infections has increased. The primary aim of this study was to evaluate the clinical significance of therapeutic drug monitoring (TDM) growths in respiratory samples, and the secondary aim was to evaluate the treatment regimens and treatment outcomes of treatment for TDM disease. Methods: This study was a retrospective cohort study. Persons with NTM growth in respiratory samples admitted to the reference hospital between 2009 and 2020 were included in this study. Samples detected as NTM by the immunochromatographic rapid diagnostic test, those requested by the clinicians, species were determined by the hsp65PCRREA method. The subjects were classified into 3 groups: patients with NTM infection who received treatment (135, 12.7%), those followed up without treatment (690, 65.1%), and a last group of patients with Mycobacterium tuberculosis (TB) complex strains were isolated and received TB treatment (236, 22.2%). Initiating NTM treatment was decided in accordance with the American Thoracic Society recommendations. Results: The mean ± standard deviation age of patients was 53.8 ± 16.5 years, and 749 (70.6%) were male. In total, 278 (26.2%) out of 1061 cases had identified, and the most frequent species were MAC (81; Mycobacterium avium: 39, Mycobacterium intracellulare: 39, and MAC: 3), Mycobacterium abscessus (67), Mycobacterium kansasii (48), Mycobacterium fortuitum (23), Mycobacterium chelonae (12), Mycobacterium gordonae (11), and Mycobacterium szulgai (11). In the NTM treatment group, 116 (85.9%) of 135 patients had multiple culture positivity. Previous TB treatment history had 51 (37.8%) of 135 patients, respiratory comorbidities were evident in 37 (27.4%) of 135 patients. Thorax computed tomography imaging in 84 patients revealed nodule 38 (45.2%), consolidation 46 (54.8%), cavity 52 (61.9%), and bronchiectasis 27 (32.1%). Treatment results in the NTM treatment group were as follows: ongoing treatment 14 (10.4%), cure 64 (47.4%), default 33 (24.4%), exitus 19 (14.1%), recurrence 3 (2.2%), and refractory disease 2 (1.5%). Conclusion: This is a large case series evaluating the clinical significance of NTM growths and NTM treatment in Turkey. The clinical significance of NTM growth in respiratory samples is low. Treatment success rates of NTM patients who are treated are low. Treatment defaults and mortality rates are high. New drugs and new regimens are needed.

Abstract Objective In this study, it was aimed to investigate the prevalence of type 1 hypersensitivity reaction under tuberculosis treatment and the management of hypersensitivity. Methods The study is a case series. All of the patients who were hospitalized between 01.02.2015–01.05.2021 were examined. All patients who developed a drug-induced type 1 immediate hypersensitivity reaction were included. Antituberculosis drugs were given with the protocol made by Buhari et al. However, unlike what is stated in the protocol, pyrazinamide was given last during the administration of the drugs. Results 2677 patients received inpatient tuberculosis treatment; type 1 immediate hypersensitivity reactions were seen in 94 (3.5%) patients. Due to missing data in the file, 81 patients were included in the study. 44 (54.3%) of the cases were women; mean age (mean ± SD) 50.7 ± 17.69 years; 76 (93.8%) of them are citizens of the Republic of Turkey; 58 (71.6%) of them were diagnosed bacteriologically; 65 (80.2%) of them were pulmonary tuberculosis. The most common skin finding was urticaria in 49 (60.5%). The drug responsible for the most common reaction was pyrazinamide. In 49 (60.5%) cases, drugs were given by desensitization and it was successful. The duration of treatment was 7.91 ± 2.5 months (6–18 months). When evaluated in terms of treatment results, 68 (84%) patients successfully completed the treatment. Conclusion Our study is the largest series of patients who developed type 1 immediate hypersensitivity reaction while receiving antituberculosis treatment. A practical, easy desensitization scheme has been shared.

Background and Aim: Increasing the extensity of latent tuberculosis infection (LTBI) treatment which is one of the important parameters of tuberculosis (TB) control and completing the treatment in success are important. The purpose of this study is to evaluate LTBI treatment indications and treatment outcomes of patients who received LTBI treatment in İstanbul between 2016 and 2018. Methods: The treatment outcomes of people who started LTBI treatment registered in TB dispensaries in Istanbul between 2016 and 2018 were analyzed retrospectively according to the variables of the age groups, gender, dispensary subgroups, and prevention treatment indications. Data collected from the health institutions were evaluated. Results: 26.920 patients received LTBI treatment in all Istanbul TB dispensaries between 2016 and 2018. The evaluation of LTBI treatment indications; contact 15.696, Tuberculin skin test (TST) positivity 2224, immunosuppression 8746, TST conversion 58, sequelae lesion 15, and other indications are identified as 181. The groups which diagnosed with TB disease, mortality, transfer, other, and still in treatment are excluded from the analysis of LTBI treatment outcomes. A total of 25.253 patients were analyzed. 65 percent of the patients had completed LTBI treatment. Variables effective for treatment outcomes are analyzed with logistic regression. Treatment discontinuation was statistically significantly lower in 2017 (odds ratio [OR]: 0.906 confidence interval [CI] [95%] [0.849–0.968]) and 2018 (OR: 0.635 CI [95%] [0.594–0.679]) compared to 2016. Treatment lost to follow-up was statistically significantly lower in those receiving LTBI treatment with the indication of tuberculin skin test positivity (OR: 0.541 CI [95%] [0.487–0.600]) and the indication of immunosuppression (OR: 0.284 CI [95%] [0.142–0.569]) compared to those who received LTBI treatment due to contact. When the treatment results are evaluated according to the TB incidence of the region where the dispensaries are located, treatment lost to follow-up was higher in 101–200 per 100,000 incidence group (OR: 1.201 CI [95%] [1.123–1.285]) and incidence of 201–370 per 100,000 (OR: 1.461 CI [95%] [1.358–1.572]). Treatment lost to follow-up was higher in dispensaries on the European side (OR: 1.293 CI [95%] [1.203–1389]) and the 0–35 age group (OR: 1.248 CI [95%] [1.168–1.333]). Conclusion: In conclusion, the treatment completion rate should be improved for an effective LTBI treatment which is one of the important parameters of targeted TB elimination. Particularly people under the age of 35 years and regions with high-TB incidence should receive special care and close follow-up.

Background: The World Health Organization Global Tuberculosis Report 2021 defines tuberculosis as the second infectious disease that causes sickness and death after COVID 19 and ranks it as the 13th among the global causes of death. However, the prevalence of the patients developing a hypersensitivity reaction against antituberculosis treatment is yet unknown. This study aimed to investigate the prevalence of drug allergy against antituberculosis treatment and the management of such a problem. Methods: This is a case–-control study. All patients hospitalized in the tuberculosis inpatient service between February 01, 2015 and May 01, 2021 due to hypersensitivity reaction or who developed hypersensitivity during hospitalization were included in the case group. Patients who received inpatient treatment between the same dates and did not develop any drug allergy were included in the control group. The demographic characteristics of the patients, the tuberculosis diagnostic indicator, the type of hypersensitivity reaction that developed, the duration of the manifestation of the reaction and its treatment were evaluated for the purpose of the study. Results: A total of 2677 patients were hospitalized in the tuberculosis inpatient service between the specified dates. Two hundred and ten patients were consulted for drug hypersensitivity reactions in the Allergy Clinic. The prevalence of drug allergy in inpatients was calculated as 7.8%. One hundred and forty-eight patients examined by the authors were included in the study. Seventy-nine of the 148 patients (53.4%) who developed a hypersensitivity reaction were male, the mean age of these patients was 47.20 ± 18.95 years, 89.2% (n = 132) were citizens of the Republic of Turkey, 7.4% (n = 11) of the patients had received tuberculosis treatment before, 16.9% (25) had developed antituberculosis drug resistance and the bacteriological diagnosis was present in 79.7% (118) of the patients. Chi-square test results applied in the allergy group revealed that the risk of developing a hypersensitivity reaction is statistically significantly higher in female patients (P < 0.001), Turkish citizen patients (P = 0.004), in new cases (P = 0.017), in the group not diagnosed bacteriologically (histopathologically, clinically, and radiologically) (P = 0.006). The results of the logistic regression analysis performed also revealed that the risk of developing a hypersensitivity reaction is statistically significantly higher in female patients (P = 0.006), Turkish citizen patients (P = 0.023), in new cases (P = 0.017) and in the group not diagnosed bacteriologically (histopathologically, clinically, and radiologically) (P = 0.006). The success of the treatment was higher in the group that developed a hypersensitivity reaction compared to the control group. About 63.5% (94) of the patients examined developed Type I hypersensitivity reactions, whereas 36.7% (53) of the patients examined developed Type IV hypersensitivity reactions. Type I and Type IV reactions were observed simultaneously in a single patient. Considering the prevalence of developing a hypersensitivity reaction, pyrazinamide was determined as the drug inducing the hypersensitivity reaction in 25 (48.1%) patients. This figure was 15 patients (28.2%) for rifampicin, nine patients (17.3%) for isoniazid, and five patients (9.6%) for ethambutol. As a result, even patients who developed Type I or Type IV reactions were able to complete their antituberculous drug regimens with successful desensitization. Conclusion: The risk of developing an allergic reaction in patients who are administered on antituberculosis treatment is common, particularly in the first 2 months of treatment. However, we believe that the compliance of the patients to the antituberculosis treatment has been improved at the end of appropriate management of hypersensitivity reactions and the treatment results in success.

In this paper, the effects on secondary metabolite accumulation of brassinosteroid (BR) (24-epibrassinolide (24-eBL) on immobilized cells that were obtained from Vitis vinifera cv. Cinsault was investigated. 24-eBL was treated to immobilized cells covered calcium alginate beads at concentrations of 0, 0.25, 0.50, 0.75 and 1.0 mg L-1 for one month. As a result of this study, it was found that 24-eBL applications modified secondary metabolite accumulation and had positive effects on secondary metabolite production when the suitable concentration was used. While the highest total phenolic, catechin, p-coumaric acid and chlorogenic acid contents were found in immobilized cells treated 0.75 mg L-1 24-eBL, the highest epicatechin, quercetin, trans-resveratrol contents were obtained in immobilized cells treated 0.50 mg L-1 24-eBL and the highest gallic acid content was determined in immobilized cells treated 0.25 mg L-1 24-eBL. Moreover, the highest 24-eBL concentration (1 mg L-1) decreased the content of secondary metabolite compared to the control (0 mg L-1 24-eBL) except total phenolic and catechin content. To conclude, 0.50 and 0.75 mg L-1 24-eBL concentrations were the most suitable concentrations for immobilized cell culture to provide the highest secondary metabolite accumulation.

Current planning literature considers rail transit usage a function of neighborhood design (ND) parameters (such as density, diversity, and connectivity) around station areas at a microlevel. However, during the early development stages of a rail transit system in a city, integration with the other modes may be equally influential on the rail transit usage, which must be determined. For this purpose, ridership data of 14 rail transit stations were evaluated based on both (i) ND parameters and (ii) multi-modal integration (MMI) parameters, along two existing urban rail corridors in Ankara, Turkey. A principal component analysis, as a part of quantitative analysis, suggested MMI as one of the three main components. Statistical regression model results also showed a clear relation between the ridership and MMI, which was clearer along the metro corridor, which serves suburban regions. Key words: rail transit ridership, urban rail transit planning, regression models, ranking analysis. Les documents de planification actuels tiennent compte de l'utilisation du transport ferroviaire en fonction des parametres de conception des quartiers (CQ) (comme la densite, la diversite et la connectivite) autour des secteurs des gares a un niveau microeconomique. Toutefois, au cours des premieres etapes du developpement d'un reseau de transport en commun dans une ville, l'integration avec les autres modes de transport, qui peut egalement influer sur l'utilisation du transport en commun ferroviaire, doit etre determinee. A cette fin, les donnees sur l'achalandage de 14 gares de transport ferroviaire ont ete evaluees en fonction (i) des parametres de CQet (ii) des parametres d'integration multimodale (IMM), le long de deux corridors ferroviaires urbains existants a Ankara, en Turquie. Dans le cadre de l'analyse quantitative, une analyse des composantes principales, a suggere l'IMM comme l'une des trois composantes principales. Les resultats du modele de regression statistique ont egalement montre une relation claire entre l'achalandage et l'IMM, qui etait plus clair le long du couloir de metro, qui dessert les regions suburbaines. [Traduit par la Redaction] Mots-cles : achalandage du transport ferroviaire, planification du transport ferroviaire urbain, modeles de regression, analyse de classement., 1. Introduction Amongst public transport modes, urban rail systems are particularly favored by planners, since rail systems are believed to be more effective in attracting car users to public transport. [...]

Minerals are essential for plant metabolism, serving as crucial components of enzymes, structural elements, and signaling molecules. Stress-induced changes in mineral uptake and distribution can disrupt these physiological functions, compromising plant health and resilience. Understanding how drought and salt stress affect the mineral composition of vine saplings is essential for identifying potential nutrient deficiencies or imbalances that may arise in stressed environments. The aim of this study was to determine the effect of combined and separately applied drought and salt stress on the mineral contents of vine saplings. For this purpose, a trial was carried out with potted own-rooted "Alphonse Lavallée" (AL), three rootstocks (1103 P, 41 B, and 5 BB) and also AL grafted onto these rootstocks. 0, 50, and 100 mM of NaCl for salt stress and 25%, 50%, and 100% water levels of evapotranspiration (ETP) for water stress in combined and separately were applied to vines during two years. At the end of the experiment, the highest foliar damage was found in 41 B rootstock treated with 100 mM NaCl + 25% ETP and Alphonse Lavallée grafted onto 5 BB treated with 50 mM NaCl + 25% ETP in the first and second year, respectively. Saplings were significantly affected by salt and water stress in terms of mineral contents, which varied depending on whether they were grafted or not. Particularly in grafted AL, the amount of Cl was low, but the Nacontent was high compared to own-rooted Alphonse Lavallée and rootstocks. [ABSTRACT FROM AUTHOR]

This study was conducted of Ilıcapınar highland pasture in Taşkent district of Konya in 2017-2018. The aim of this study was to determine the plant covered area, botanical composition, grazing capacity, aboveground biomass, belowground biomass and pasture condition in a pasture. Vegetation measurements were conducted in spring and autumn periods. Quadrat and line intercept methods were used in order to determine the characteristics of pasture vegetation in the research area. The plant-covered area was determined as nearly 33.5%. The botanical composition of the study area consists of 56.2% Poaceae, 12.0% Fabaceae and 31.8% other families. The aboveground and belowground biomass productions were calculated as 474.8 kg/da and 820.5 kg/da respectively. As a result, the grazing capacity of the pasture area was determined as 36.9 animal units. The pasture condition was found to be moderate. According to these results, conservation of natural vegetation and complying with grazing capacity is very important for sustainable pasture management.

This research was carried out in order to determine the plant composition in the Kuruca highland pasture which is located in Kaş district of Antalya Province during the 2017 vegetation period. The characteristics of plants which occur vegetation in pasture area was investigated such as; species name, life span, phytogeographical regions, endemism, quality degree. Plant samples were collected and dried in consideration of the vegetation period in order to determine the plant of species. Identified studies of plant samples were carried out at Herbarium of Faculty of Forestry (Isparta University of Applied Sciences). The vegetation structure of the study area was investigated and 88 taxa belonging to 26 families were detected. The most taxa were determined in Fabaceae (12 taxa), Brassicaceae (10 taxa) and Asteraceae (8 taxa) respectively. The botanical composition of the pasture area consists of 47.4% Poaceae, 21.0 % Fabaceae, and 31.6% other families. Among the 88 plant taxa, 43% of annual plants; 3% of biennial plants; and 54% of them were perennial plants. Moreover, the taxa in the pasture area, 30 species of them were recorded as the element of the East Mediterranean Region; 7 taxa were recorded as the element of the Mediterranean Region; 7 of it, as the element of Irano-Turanian Region; 2 Euro-Siberian Region; 7 belonging to an unknown region and 35 of it multi regional. In addition, 18 of the species are endemic in the research area. This condition shows that the pasture area has got a rich flora.

Multifunctional biomedical materials capable of integrating optical functions are highly desirable for many applications, such as advanced intra-ocular lens (IOL) implants. Therefore, poly(ethylene glycol)-diacrylate (PEG-DA) hydrogels are used with different photoinitiators (PI). In addition to standard UV PI Irgacure, Erythrosin B and Eosin Y are used as PI with high sensitivity in the optical range of the spectrum. The minimum PI concentrations for producing new hydrogels with PEG-DA and different PIs were determined. Hydrogel films were obtained, which were applicable for light-based patterning and, hence, the functionalization of surface and volume. Cytotoxicity tests confirm cytocompatibility of hydrogels and compositions. Exploiting the correlation of structure and function allows biomedical materials with multifunctionality.

This research was conducted in Karaören Village Rangeland, during the vegetation period of 2016. The Karaören Village is located within Eskişehir/Seyitgazi district boundaries and its average altitude about 1050 meters and slope is about 8%. During the research, while characteristics of the vegetation in the area that plant covered area, botanical composition, aboveground/belowground biomass and rangeland condition have been determined. Transect and quadrat methods were used in order to determine the rangeland flora of the case study area. In the research area 89 taxa belonging to 49 families were detected. The families with the highest taxa were identified as Poaceae with 10 taxa, Fabaceae with 8 taxa and Asteraceae with 7 taxa. The average plant covered area value of the rangeland was determined as 51.2%. The botanical composition of rangelands’ taxa is approximately 44% Poaceae, 23% Fabaceae and 33% of other families. The aboveground biomass and belowground biomass yields were calculated as 351.6 kg/da and 560.7 kg/da respectively. The case study area of rangeland condition was established as good.

In this study, which was carried out in Çatoluk forest rangeland located within the borders of the Aksu district of Isparta province during the vegetation period of 2013, the characteristics of the vegetation and the general features of the soil of the rangeland area in the forest were examined. In addition to examining plant species, plant-covered area, botanical composition, aboveground biomass, belowground biomass, grazing capacity and rangeland condition in the study area, some general characteristics of the soil have also been determined. The texture class of the study area was determined to be clay loam. The average bulk density was determined to be 1.196 g/cm3, pH value to be 7.35 as slightly alkaline, lime content to be 5.09 % as medium lime, organic matter content to be 5.33% as moderate level, salinity value to be 0.41 dS/m as nonsaline. The vegetation of the study area was examined and 127 taxa belonging to 33 families were identified in the rangeland area. The mean value of the plant-covered area in the rangeland was determined to be 42.6%. Also, the botanical composition of the rangeland area consists of 52.44 % Poaceae, 18.04 % Fabaceae, and 29.52 % other species. The average aboveground biomass of the rangeland area was determined to be 331.20 kg/da and the average belowground biomass was determined to be 398.80 kg/da. The grazing capacity and the rangeland condition were found to be 184 animal units and medium, respectively. Based on the results of the research, it has been determined that there is an intensive grazing pressure on the forest rangeland and the vegetation in the rangeland area has been destroyed.

The objective of this study is to determine the some vegetation properties in Kocapınar Rangeland of Kozağacı Highlands of Davraz Mountain (Isparta) during 2011-2012. The measurements were carried out for a period of two years during the months of June and September of the grazed and ungrazed rangeland areas. “Line intercept (transect)” method was used for the determination of plant-covered area whereas “quadrate method” was used to determine dry forage yield. A total of 30 families and 140 plant species were identified in the rangeland areas. The families that have the most taxa in the site are Asteraceae with 25 taxa, Lamiaceae with 14 taxa, Brassicaceae and Fabaceae with 12 taxa. With respect to the botanic composition of the vegetation of the research area, total ratio of Poaceae family, Fabaceae family, and the plant species belonging to the other families were found as 60.9 % and 58.7 %, 14.4 % and 18.0 %, 24.7 % and 23.3 % in the grazed and ungrazed areas, respectively. The ratio of plant covered area was found as on average 24.3 % in the grazed area and 30.5 % in the ungrazed area. Besides, the range quality degree, which was on average 3.478 in the grazed areas, was found as 3.787 in the ungrazed ones. Above-ground biomass proved to be on average 208.24 kg/da in the grazed area and 256.49 kg/da in the ungrazed area, while the under-ground biomass was determined to be 347.88 kg/da and 454.41 kg/da, respectively. The grazing capacity for an area of 1 ha was found as on average 0.39 animal units in the grazed areas and 0.48 animal units in the ungrazed ones.

This research was conducted in Zengi Rangeland, in the vegetation period of 2012. The Zengi Rangeland is located within Isparta/Sütçüler district boundaries and its average altitude about 1280 meters and slope is about 5%. During the research, while characteristics of the vegetation in the area that covered by plants, botanical composition, aboveground/underground biomass and rangeland condition have been handled have been examined. Transect and quadrat methods were used in order to determine the rangeland flora of the case study area. A general soil characteristic of the research area has been examined and texture class has been found as a clayey texture. It has been figured out that soil is in good level with the following features; slightly alkaline with the amount of pH 7.83, more chalky with the rate of 17.5%, with 3.76% of organic matter. In the research area 122 taxa belonging to 30 families have been detected. The families that have much taxa are as follows in order; Fabaceae, Asteraceae and Lamiaceae. The plant cover area was identified as 21.75% of total area. Additionally, the botanical composition of rangeland consists of 63.51% of Poaceae, 16.39% Fabaceae and other family 20.10%. The aboveground and underground biomass yields were calculated as 475.45 kg/da and 700.40 kg/da, respectively. The rangeland condition was established as poor.