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    Epidemiological investigation of bovine tuberculosis infection dynamics in Turkey
    (Tubitak Scientific & Technological Research Council Turkey, 2022) Cakir, Sahin; Yildirim, Murat; Diker, Kadir Serdar; Keskin, Fevziye Ipek; Yuksel, Selcen; Deveci, Burak; Akcay, Erhan
    A national epidemiological research project was carried out to define the dynamics affecting the epidemiology of bovine tuberculosis (bTB) infection in Turkey and to identify the risk factors. Official veterinarian (OV) and breeder original questionnaires were produced separately as part of this study to collect thorough data regarding the disease from the field. The number of questionnaires that needed to be filled out was decided by 95% confidence interval (CI) and 5% margin of error. The findings of 371 OV and 317 breeder questionnaires completed online across the country were analyzed. In addition, 28 outbreaks determined by random method were visited. To observe regional differences and field conditions, the opinions of OVs who monitored the disease and breeders were compiled. It was observed that the data obtained from both questionnaires was largely compatible. The main factors in the epidemiology of bTB infection were found to be effective fight, development of state policy, providing adequate financing, animal purchase, ear tagging and records, animal traders, animal markets, animal movements, conditional slaughtering, slaughterhouses, postmortem inspection, premise conditions, socio-economic impact, evaluation of raw milk, disease-free premises, compensation payments, and quarantine processes.
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    Öğe
    Safety and efficacy of mesenchymal stromal cell therapy for multi-drug-resistant acute and late-acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation
    (Springer, 2023) Keklik, Muzaffer; Deveci, Burak; Celik, Serhat; Deniz, Kemal; Gonen, Zeynep Burcin; Zararsiz, Gokmen; Saba, Rabin
    Graft versus host disease (GvHD) remains a significant risk for mortality and morbidity following allogeneic hematopoietic stem cell transplantation (HSCT). A growing literature supports successful applications of mesenchymal stromal cells (MSCs) for the treatment of steroid-refractory acute GvHD (aGvHD). However, there is limited knowledge about the effects of MSC treatment on late-acute GvHD (late aGvHD). In this article, we present our multicenter study on the safety and efficacy of MSC therapy for patients with steroid-refractory late aGvHD in comparison to those with aGvHD. The outcome measures include non-relapse mortality (NRM) and survival probability over a 2-year follow-up. The study includes a total of 76 patients with grades III-IV aGvHD (n = 46) or late aGvHD (n = 30), who had been treated with at least two lines of steroid-containing immunosuppressive therapy. Patients received weekly adipose or umbilical cord-derived MSC infusions at a dose of median 1.55 (ranging from 0.84 to 2.56) x 10(6)/kg in the aGvHD group, and 1.64 (ranging from 0.85 to 2.58) x 10(6)/kg in the late aGvHD group. This was an add-on treatment to ongoing conventional pharmaceutical management. In the aGvHD group, 23 patients received one or two infusions, 20 patients had 3-4, and three had >= 5. Likewise, in the late aGvHD group, 20 patients received one or two infusions, nine patients had 3-4, and one had >= 5. MSC was safe without acute or late adverse effects in 76 patients receiving over 190 infusions. In aGvHD group, 10.9% of the patients had a complete response (CR), 23.9% had a partial response (PR), and 65.2% had no response (NR). On the other hand, in the late aGvHD group, 23.3% of the patients had CR, 36.7% had PR, and the remaining 40% had NR. These findings were statistically significant (p = 0.031). Also, at the 2-year follow-up, the cumulative incidence of NRM was significantly lower in patients with late aGvHD than in patients with aGvHD at 40% (95% CI, 25-62%) versus 71% (95% CI, 59-86%), respectively (p = 0.032). In addition, the probability of survival at 2 years was significantly higher in patients with late aGvHD than in the aGvHD group at 59% (95% CI, 37-74%) versus 28% (95% CI, 13-40%), respectively (p = 0.002). To our knowledge, our study is the first to compare the safety and efficacy of MSC infusion(s) for the treatment of steroid-resistant late aGVHD and aGVHD. There were no infusion-related adverse effects in either group. The response rate to MSC therapy was significantly higher in the late aGvHD group than in the aGvHD group. In addition, at the 2-year follow-up, the survival and NRM rates were more favorable in patients with late aGVHD than in those with aGVHD. Thus, the results are encouraging and warrant further studies to optimize MSC-based treatment for late aGVHD.