Bakteriyel Vajinal Mikrobiyotanın Metagenomik Yaklaşımla Tanımlanması

Amaç: Bu çalışmanın amacı, alem düzeyinden tür düzeyine kadar farklı taksonomik seviyelerde yüksek verimli yeni nesil dizileme ve metagenomik yaklaşım kullanarak 38 Türk kadınının vajinal bakteriyel mikrobiyotasını belirlemektir. Gereç ve Yöntem: Yeditepe Üniversitesi Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde Haziran 2021’de DNA/RNA koruma toplama tüplerine vajinal sürüntü örnekleri (n=38) alındı ve ZymoBIOMICS DNA miniprep kiti ile DNA ekstraksiyonu yapıldı. Hastaların yaşı, medeni durumu, ön tanı ve anamnez durumu ile ilgili bilgiler toplandı. Vajinal mikrobiyotayı belirlemek için 16S rRNA amplikon DNA dizilimi kullanılarak metagenomik bir yaklaşım uygulandı. Bulgular: Vajinal örneklerde baskın filum Firmicutes’i Proteobacteria, Actinobacteria, Tenericutes, Fusobacteria ve Synergistetes izledi. Lactobacillus en fazla bulunan “cins düzeyinde bakteri” olup onu Prevotella, Enterobacter, Gardnerella ve Dialister izledi. Vajinal sürüntü örneklerinde tür düzeyinde Lactobacillus iners baskın bulundu, bunu Gardnerella vaginalis, Enterobacter tabaci, Prevotella timonensis, Prevotella bivia ve Lactobacillus jensenii izledi. Kanonik uyum analizi (CCA), filum düzeyinde Proteobacteria ve Fusobacteria’nın en yüksek yüzdelerle evli/bekar değişkeni ile ilişkili olduğunu, ancak Actinobacteria ve Tenericutes’in yaş değişkeni ile ilişkili olduğunu gösterdi. Campylobacter, Atopobium, Enterobacter ve Lactococcus en yüksek yüzdelerle evli/bekar değişkeni ile ilişkili bulunurken, Anaerococcus, Streptococcus, Sutterella ve Veillonella en yüksek yüzdelerle yaşla ilişkili bulundu. Ayrıca, CCA, Campylobacter ureolyticus, Lb. jensenii ve Atopobium vajinae türlerinin evli/bekar değişkeni ile en yüksek yüzdelerle ilişkilendirirken, Lactobacillus johnsonii ve G. vaginalis en yüksek yüzdelerle yaş değişkeninde ilişkili bulundu. Sonuç: Vajinal hastalıklar hala önemli bir halk sağlığı sorunudur. Son yıllarda teknolojik gelişmeler sayesinde daha derinlemesine çalışılan vajinal mikrobiyotanın sanıldığından daha karmaşık olduğu keşfedilmiştir. Bu bulguları doğrulamak ve geliştirmek için daha fazla hasta araştırmasına ihtiyaç vardır

1940-1964 yılları arasında radyonun Türkiye'de gelişimi

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2012.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by İbrahim Mert Öztürk.Öztürk, İbrahim Mert. HIST 200-04ÖZTÜRK HIST 200-04/5 2011-1

Digoxin is Not Related to Mortality in Patients with Heart Failure: Results from the SELFIE-TR Registry

Aims: Digoxin has been used in the treatment for heart failure for centuries, but the role of this drug in the modern era is controversial. A particular concern is the recent observational findings suggesting an increase in all-cause mortality with digoxin, although such observations suffer from biased results since these studies usually do not provide adequate compensation for the severity of disease. Using a nationwide registry database, we aimed to investigate whether digoxin is associated with 1-year all-cause mortality in patients with heart failure irrespective of phenotype. Methods: A total of 1014 out of 1054 patients in the registry, of whom 110 patients were on digoxin, were included in the study. Multivariable adjustments were done and propensity scores were calculated for various prognostic indicators, including signs and symptoms of heart failure and functional capacity. Crude mortality, mortality adjusted for covariates, mortality in the propensity score-matched cohort, and Bayesian factors (BFs) were analyzed. Results: Crude 1-year mortality rate did not differ between patients on and off digoxin (17.3% vs 20.1%, log-rank p = 0.46), and digoxin was not related to mortality following multivariable adjustment (hazard ratio 0.87, 95% confidence interval 0.539–1.402, p = 0.57). Similarly, all-cause mortality was similar in 220 propensity-score adjusted patients (17.3% vs 20.0%, log-rank p = 0.55). On Bayesian analyses, there was moderate to strong evidence suggesting a lack of difference between in unmatched cohort (BF10 0.091) and weak-to-moderate evidence in the matched cohort (BF10 0.296). Conclusions: In this nationwide cohort, we did not find any evidence for an increased 1-year mortality in heart failure patients on digoxin

Unruptured non-coronary sinus of Valsalva aneurysm presenting with nausea secondary to functional tricuspid stenosis

Keskin, Muhammed/0000-0002-4938-0097; Altay, Servet/0000-0001-7112-3970; Guvenc, Tolga Sinan/0000-0002-6738-266XWOS: 000418481400018PubMed: 29226903

A novel prognostic indicator for in-hospital and 4-year outcomes in patients with pulmonary embolism: TIMI risk index

Guvenc, Tolga Sinan/0000-0002-6738-266X; Keskin, Muhammed/0000-0002-4938-0097WOS: 000415210400031PubMed: 28575813Background: Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) was recently evaluated in patients with acute myocardial infarction and found as an important prognostic index. In the current study, we evaluated the prognostic value of TRI in patients with moderate-high and high risk pulmonary embolism (PE) who were treated with thrombolytic agents. Methods: We retrospectively evaluated the in-hospital and long-term(4-year) prognostic impact of TRI in a total number of 456 patients with moderate-high and high risk PE. Patients were stratified by quartiles (Q) of admission TRI. Results: In-hospital analysis revealed significantly higher rates of in-hospital death for patients with TRI in Q4. After adjustment for confounding baseline variables, TRI in Q4 was associated with 2.8-fold hazard of in-hospital death. Upon multivariate analysis, admission TRI in Q4 vs. Q1-3 was associated with 3.1 fold hazard of 4-year mortality rate. Conclusion: TRI in Q4, as compared to Q1-3, was significantly predictive of short term and long-term outcomes in PE patients who treated with thrombolytic agents. Our data suggest TRI to be an independent, feasible, and cost effective tool for rapid risk stratification in moderate-high and high risk PE patients who treated with thrombolytic agents. (C) 2017 Elsevier Inc. All rights reserved

Suboptimal use of non-vitamin K antagonist oral anticoagulants: Results from the RAMSES study

WOS: 000384041400052PubMed ID: 27583892This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study).RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines. The independent predictors of UT and OT were determined by multivariate logistic regression.Of the 2086 eligible patients, 1247 (59.8%) received adequate treatment. However, off-label use was detected in 839 (40.2%) patients; 634 (30.4%) patients received UT and 205 (9.8%) received OT. Independent predictors of UT included >65 years of age, creatinine clearance 50mL/min, urban living, existing dabigatran treatment, and HAS-BLED score of <3, whereas that of OT were creatinine clearance <50mL/min, ongoing rivaroxaban treatment, and HAS-BLED score of 3.The suboptimal use of NOACs is common because of physicians' poor compliance to the guideline recommendations in patients with nonvalvular atrial fibrillation (NVAF). Older patients who were on dabigatran treatment with good renal functions and low risk of bleeding were at risk of UT, whereas patients who were on rivaroxaban treatment with renal impairment and high risk of bleeding were at risk of OT. Therefore, a greater emphasis should be given to prescribe the recommended dose for the specified patients