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    Aşılı Splenektomili Hastalarda Pnömokok Aşısı ile İndüklenmiş Total IgG, IgG2 ve IgA Düzeylerini Etkileyen Faktörler
    (2022) Gazi, Umut; Derici, Mehmet Kürşat; Karasartova, Djursun; Güreser, Ayşe Semra; Şahiner, İbrahim Tayfun; Dolapçı, Mete; Özkan, Ayşegül Taylan
    Splenektomi yaşam boyu devam eden, pnömokok ve diğer kapsüllü bakteri enfeksiyonları riski ile\ryakından ilişkilidir. Bu çalışmada, Streptococcus pneumoniae’ye karşı aşılama sonrası oluşan antikor dü-\rzeylerinin yaşa, cinsiyete, splenektomiden sonra yıllara göre değişiminin ve splenektominin IgG aviditesi\rüzerindeki olası etkisinin incelenmesi amaçlanmıştır. Ek olarak, katılımcıların splenektomi sonrası aşılama\rve bulaşıcı hastalıklarla ilgili eğitim ve farkındalık düzeyleri de araştırılmıştır. Üç aşamada yürütülen bu\rçalışmanın ilk aşamasına 32 splenektomili birey dahil edilmiştir. Hastaların splenektomi sonrası olası riskler\rhakkındaki farkındalık düzeyleri basit bir anketle araştırılmıştır. Rutin laboratuvar test sonuçları incelene-\rrek klinik muayeneleri yapılmıştır. İkinci aşamada 29 splenektomili bireyin total Ig değerleri belirlenmiş-\rtir. Üçüncü aşamada 14 splenektomili ve beş sağlıklı gönüllü, Aşılama Uygulamaları Danışma Komitesi\r(ACIP) kılavuzlarına göre aşılanmıştır. Pnömokoklara özgü antikor düzeyleri ve IgG aviditesi “enzyme\rlinked immunsorbant assay (ELISA)” ile ölçülmüştür. Splenektomililerin %68.8’inin aşılanma durumu ve\r%78.2’sinin de asplenik koşullarda artmış enfeksiyon hastalıkları riski konusunda farkındalığı olmadığı\rsaptanmıştır. Hastane Bilgi Yönetim Sistemine göre bir hasta dışındaki 31 (%96.87) hastanın tamamının\rPPV23 ile aşılanmış olduğu belirlenmiştir. Beklendiği gibi, aşılanmış hastalar yüksek düzeylerde aşıya özgülantikor üretimi sergilemiş, IgG, IgG2 ve IgA antikor konsantrasyonları sırasıyla, 321 ± 76.68 mg/l, 73.07\r± 8.273 mg/l ve 117.8 ± 14.94 mg/l olarak belirlenmiş ancak aşılanmamış hastaların antikor düzeyi çok\rdüşük (IgG, IgG2 ve IgA antikor konsantrasyonları sırasıyla, 11.5 mg/l, 1.3 mg/l ve 1.2 mg/l) bulunmuş-\rtur Antikor titreleri ile cinsiyet, yaş grupları veya ateş öyküsü varlığı arasında bir korelasyon olmamasına\rkarşın total IgG, IgG2 ve IgA titrelerindeki düşüş splenektomiden bu yana geçen süre ile güçlü bir ilişki\rgöstermiştir. Antikor titreleri, 10 yıldan daha uzun süre önce aşılanmış splenektomili hastalarda önemli\rölçüde daha düşük olarak bulunmuştur. Trombosit sayılarının düşüklüğü dışında rutin laboratuvar sonuç-\rları normal düzeyde tespit edilmiştir. Öte yandan, hem splenektomi uygulanan hem de sağlıklı kontrol\rdeneklerinde, aşılama programından sonra benzer IgG avidite indeksi değerleri (kontrol ve hastalarda,\rsırasıyla, %61.8 ve %64.4 inhibisyon) saptanmıştır. PPV23 ile splenektomi sonrası aşılamanın, beş yıldan\rfazla sürebilen yüksek düzeylerde pnömokoka özgül antikor üretimini indüklediği gösterilmiştir. Hasta-\rların splenektomi sonrası enfeksiyon riskleri konusundaki farkındalıkları zayıf olduğundan, pnömokok ve\rdiğer splenektomi sonrası ağır enfeksiyonlarla (OPSI) ilgi bilgi düzeylerini artırmak için daha fazla çaba\rgösterilmesinin gerektiği belirlenmiştir. Özellikle, 10 yıldan uzun süre önce splenektomi operasyonu ge-\rçiren hastalarda aşıya özgül antikor üretimi anlamlı derecede düşük olarak belirlendiğinden bu hastalar\rasplenik olmaları konusunda daha dikkatli olmalıdır. Bu çalışma splenektominin pnömokok aşılamasının\rneden olduğu IgG aviditesini değiştirmediğini gösteren ilk çalışmadır.
  • Küçük Resim
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    The Effect of Heavy Metals on Miscarriage
    (2019) Yıldırım, Engin; Derici, Mehmet Kürşat
    Objective: In a world where industrial pollution is increasing day by day, heavy metals are one of the important factors threatening human health. The rates of pregnancy loss and subfertility are continuously increasing. This study aims to explain the effects of lead (Pb), cadmium(Cd), and mercury (Hg) levels on the etiology of abortions. Material and Methods: The study wasdesigned as a case-control study with two groups: healthy volunteers (n20) and miscarriage (n29)group. The pregnant women with similar demographic characteristics were divided into two groupsand peripheral venous blood samples of the study subjects were collected. Atomic absorption spectrophotometer was used to examine the blood samples and the levels of heavy metal. Results: Whilethe Pb level was found to be higher in the miscarriage group (p0.038), there was no statistical difference between Cd and Hg levels (p0.005) in the two groups. On comparing the laboratory values of pregnant women in the control and miscarriage groups, blood progesterone values wereobserved to be lower in the miscarriage group (p0.001). Conclusion: This study indicates that heavymetals, even below the toxic dose limits, can cause miscarriage. Higher blood Pb levels were foundin the miscarriage group while Hg and Cd levels were not different between the two groups. Thisresearch points out that the high levels of lead may have an effect on pregnancy loss.
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    Effect of the tunneled-cuffed central venous catheters on oxidative stress indices and inflammation in chronic hemodialysis patients
    (2021) Korucu, Berfu; Yeter, Hacı Hasan; Bali, Elif Burcu; Derici, Mehmet Kürşat
    Objectives: The use of central venous catheters as hemodialysis (HD) vascular access is associated with worse\rmorbidity and mortality in HD patients. This occasion is often attributed to comorbidities of the patients with\rcentral venous catheters. Studies reveal that a biofilm layer occurs on most of the tunneled-cuffed central\rvenous catheters (TC-CVCs). This study aimed to determine the oxidative stress (OS) and systemic\rinflammation (SI) status in patients with TC-CVCs as HD vascular access without clinical signs and symptoms\rof infection.\rMethods: The study is composed of eighty-five patients with a minimum HD vintage of one year. Patients\rwith a history of infection or a cardiovascular event within six months, malignancy, systemic inflammatory\rdiseases, or malnutrition were excluded. OS indices and SI markers were studied and compared in patients\rwith arteriovenous fistula (AVF) and TC-CVCs.\rResults: Mean native thiol/total thiol (NT/TT) ratio was significantly higher and mean disulphide/total thiol\r(DT/TT) ratio was significantly lower in AVF group comparing TC-CVC group (0.46 ± 0.17 and 0.36 ± 0.17,\rp = 0.03 for NT/TT; 0.27 ± 0.08 and 0.31 ± 0.08, p = 0.04 for DS/TT; respectively). Mean OS index was\rsignificantly lower in the AVF group comparing TC-CVC group (0.15 ± 0.14 and 0.24 ± 0.23, p = 0.04;\rrespectively]. Median hs-CRP levels and median IL-6 levels were significantly lower in AVF group comparing\rTC-CVC group (5.8 [min: 3.0-max: 82.5] mg/L and 9.7 [min: 3.0-max: 45.4] mg/L, p = 0.004 for hs-CRP; 6.2\r[min: 2.0-max:159.0] pg/mL and 12.2 [min: 2.6-max: 41.3) pg/mL, p = 0.01 for IL-6; respectively).\rConclusions: TC-CVCs inversely affect OS and systemic inflammatory status in HD patients, presumably\rdue to foreign body reactions and biofilm layers.
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    GLOBAL RESEARCH TRENDS ON VAGINISMUS AND FEMALE SEXUAL DYSFUNCTION IN 1980-2019: A SCIENTOMETRIC ANALYSIS
    (2020) Yıldırım, Engin; Derici, Mehmet Kürşat; Türkler, Can
    Objective: Physiological and psychological conditions can causefemale sexual dysfunction (FSD). It is called vaginismus whensexual dysfunction occurs with vaginal cramps and spasms. Theaim of our research is to present the research topics and trendsabout FSD and vaginismus to the reader in a global contextMaterial and Methods: We used the terms ‘female sexualdysfunction’ and ‘vaginismus’ as keywords and we determinedthe articles indexed in the Web of Science database. We includedall the articles in the database between 1980 and 2019.Documents of 2020 were excluded from this study. Gunnmap freeopen web-based application was used to visualize global researchproductivity. Vos-viewer 2019 program was used to determinethe scientific relevance of the data.Results: We reached 2212 documents in total, 95.6 % of thesearticles were written in English, and 64.4% of the documentswere original articles. Articles about vaginismus and FSDincreased in the 1995s, the most productive year was 2019. Themost productive country in genital cosmetics and aesthetics wasthe United States (USA), the most productive university was TheUniversity of British Columbia. The most productive writer wasGoldstein I.Conclusion: Studies on vaginismus and FSD have increased overthe past decade, and and non-invasive psychiatric interventionsappear to be popular. Our analysis is an identity provider forarticles covering vaginismus and FSD.
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    Is there a relationship between serum kisspeptin levels and endometrial polyps in women with premenopausal status
    (2019) Yıldırım, Engin; Derici, Mehmet Kürşat; Simsek, Omer Yavuz; Demir, Emre
    Aim: Endometrial polyps are frequently associated with abnormal uterine bleeding. The kispeptin family is one of the peptidesthat play a role in reproductive functions and whose expression varies in various uterine pathologies. The aim of the study was todetermine the relationship between serum Kisspeptin levels and endometrial polyps in women with premenopausal status.Material and Methods: The blood was collected prior to endometrial sampling from women admitted to the hospital due to abnormaluterine bleeding. According to the pathology results, patients were identified as polyp group (n38) (endometrial polyps) and controlgroup (n50) (normal endometrial findings). Kisspeptin-54 levels were determined by ELISA method from serum obtained fromvenous blood.Results: There were no difference was found between the patients’ age, body mass index, gravida, para, abortus and the numberof living children were compared (p0.05). There was no statistically significant difference between the groups in terms of folliclestimulating hormone, luteinizing hormone and thyroid stimulating hormone values (p0.05). Plasma kisspeptin (1.840.93 ng/dLand 1.320.47 ng/dL, p 0.008) and estradiol (90.3413.02 pg/mL and 81.7512.36 pg/mL, p0.002) levels were significantly higherin the polyp group than in the control group. After the Receiver Operating Characteristic (ROC) analysis the area under the curve(AUC) was 1.26 (p 0.08), (95% CI, 0.550-0.782). The sensitivity value was 0.684 (0.512-0.819), the specificity was 0.620 (0.471-0.750).Conclusion: The serum Kisspeptin-54 and estradiol levels were found higher in patients with endometrial polyps.
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    Regulatory Aspects of Vaccines
    (2020) Şenel, Sevda; Derici, Mehmet Kürşat; Devrim, Burcu
    In order to get a marketing authorisation, a vaccine product mustfullfill the national/international requriements for efficiency,safety and quality. Due to its complex structure, the manufacture,control and regulation of a vaccine requires special expertise andprocedures when compared to that of a small molecule drug. Inthis paper, the registration procedures of vaccines in differentcountries including Turkey, European Union, USA and thecountries covered by the World Health Organization (WHO)will be reviewed and the regulatory requirements and relatedguidelines are summarised.
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    The Role of Nitric Oxide Related Therapeutics in the Treatment of Cardiovascular Pathologies
    (2018) Derici, Mehmet Kürşat; Yılmaz, Emine Demirel
    The heart is a bio pump responsible for the provision of oxygen and nutrients to all body cells. It plays a vital role in the survival of the organism. The essential function of the heart is performed through the close interaction of the cardiac myocytes with the endocardial and capillary endothelial cells. The endothelium releases nitric oxide (NO) and modulates several physiological and pathological processes. The cardiac myocyte is also capable of NO production. Although the effect of NO on cardiac responses has been examined, data regarding the effect of NO on the heart remain controversial. The discrepancies in studies can be explained by several factors, such as different animal species, preparation, redox status, and NO concentration. However, an increasing interest in the role of NO has generated significant progress in the investigation of NO-based therapies. In this review, first, the general properties of NO are described as well as the physiological functions and pathological role in the heart. Then, an evaluation is made of several important NO-related treatment options, such as NO donors, NO synthase inhibitors, phosphodiesterase inhibitors, and soluble guanylate cyclase stimulators/activators. A summary is also given of NO-based drug candidates planned for use in clinical trials in the near future.