労働界の再編と八六年体制の意味 : 労組・自民・政府三者関係 一九七五～八七年（特集 新保守主義の台頭）

社会党・総評ブロックの社会的適応への「失敗」と民間大企業労組の自民党との政策協調の「成功」という二重の帰結の中で、政府を入れた三者の新しい関係・構図の成立と国際的・国内的問題への対応を分析する

Farelerde interferon ve steroid uygulamasının karaciğer, dalak ve kemik iliğindeki regülatuvar t-hücrelerine etkisi

Objectives: Regulatory T-cells (T-regs) maintain immune tolerance by affecting other cells of the immune system. They play an important role in autoimmune diseases and the prevention of graft rejection. Steroids suppress the immune system, especially inhibiting cytokine secretion of T-lymphocytes, initiation of the cell- mediated immune response, and stimulation of T-regs. Interferons (IFN) also have immunomodulatory, antiviral, and anti-proliferative effects. They activate macrophages and cytotoxic T-cells and stimulate the differentiation of T-regs. The aim of this study was to evaluate the effects of IFN and steroids on T-regs in the liver, spleen, and bone marrow in a mouse model, and to determine if they exert their immunosuppresive/immunomodulatory effects through T-regs. Materials and Methods: A total of 24 mice were randomly separated into 3 groups and administered an intraperitoneal injection for five days. The control group received 0.1 mL saline every day, the IFN group received IFN-alpha-2b 20,000 IU on the first, third, and fifth days, and only 0.1 mL saline on the other days, and the steroids group received 5 mg/kg dexamethasone in 0.1 mL saline every day. Two days after the end of therapy, each mouse was anesthetized, the portal vein was explored via laparotomy, and 5 mL bovine serum albumin (BSA) was administered through the portal vein. The inferior vena cava was cut to allow BSA perfusion of the liver, and then the mice were sacrificed. The liver, spleen, and bone marrow were removed for analysis. T-regs were identified and counted using flow cytometry. Results: The flow cytometry count results showed no significant difference between the IFN, steroid, and control groups. Conclusion: IFN and steroid use do not seem to affect the quantity of T-regs.Amaç: Regülatuvar T-hücreleri (T-reg) immün sistemde görevli birçok hücre çeşidine etki ederek immünolojik toleransı sağlayan hücrelerdir. Otoimmün hastalıklar, greft rejeksiyonunun önlenmesi ve enfeksiyon hastalıklarında önemli role sahiptirler. Steroidler, immün sistemi baskılarlar; özellikle T-lenfositlerin sitokin salgılamasını ve hücresel immünolojik yanıtın başlamasını önlerler ve T-reg’leri de stimüle ederler. Diğer yandan interferonlar (İFN) immünomodülatör, antiviral ve anti-proliferatif etkiye sahiptirler. Makrofajları ve sitotoksik T-hücrelerini aktive ederler ve T-reg’lerin diferansiyasyonunu uyarırlar. Biz bu çalışmamızda İFN ve steroidin karaciğer, dalak ve kemik iliğindeki T-reg’lere etkisini, bilinen immünosüpresif/immün düzenleyici etkilerini T-reg’ler üzerinden yapıp yapmadıklarını değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bunun için 24 fareye 5 gün boyunca intraperitoneal enjeksiyon yapıldı. Kontrol grubuna 0,1 cc serum fizyolojik her gün uygulandı. İFN grubuna İFN-alfa-2b 20.000 IU 0,1 cc olacak şekilde serum fizyolojik ile sulandırılarak gün aşırı 3 kez diğer günler 0,1 mL serum fizyolojik uygulandı. Steroid grubuna deksametazon 5 mg/kg 0,1 mL olacak şekilde serum fizyolojik ile sulandırılarak her gün uygulandı. Enjeksiyonlar bittikten sonra 2 gün beklendi. Farelere genel anestezi uygulandı, laparotomi yapılıp portal ven açığa çıkarıldı, portal venden 5 mL bovine serum albümin (BSA) verildi, inferior vena kava kesilerek karaciğerin BSA ile perfüzyonu sağlandı, fareler feda edilmiş oldu. Karaciğer, dalak ve kemik ilikleri elde edildikten sonra T-reg’lerin ayrımı yapıldı ve akım sitometrisi ile sayıldı. Bulgular: Akım sitometrisi ile sayımda İFN, steroid ve kontrol grubunda T-reg sayılarında istatiksel olarak anlamlı bir farlılık bulunamadı. Sonuç: Sağlıklı farelerde İFN ve steroid kullanımının karaciğer, dalak ve kemik iliğindeki T-reg’lerin miktarına etki etmediği düşünüldü

İnfektif endokarditin epidemiyolojik, klinik ve prognostik sonuçları: 90 atağın retrospektif kohortu

To evaluate the epidemiological, clinical, microbiological, and echocardiographic features, as well as the prognosis and long- term outcome of patients with infective endocarditis. Methods: The clinical records and follow-up data of 90 endocarditis episodes in 86 patients diagnosed with definite and possible infec- tive endocarditis according to the modified Duke criteria in a tertiary university hospital, between 1998 and 2016, were reviewed. Results: Fifty-six patients were male (65.1%), and the mean age was 49.9 ± 14.3. Native valve endocarditis constituted 62.2% of the cases, while the remaining patients had prosthetic valve endocarditis. The aortic (34.4%) and mitral (24.4%) valves were infected more frequently. Streptococci (27.7%) and staphylococci (24.4%) were the most frequently isolated microorganisms. Embolic complications (35.5%) were the leading cause of morbidity, followed by valve insufficiency (28.8%) and heart failure (21.1%). Valve replacement surgery was performed in 28 patients (31%). The in-hospital mortality rate was 15.1% (n = 13). Chronic renal failure (P = .042) and degenerative valves (P = .036) were significantly associated with mortality. Among 43 of the 73 cases available for telephonic survey, 36 (83.7%) patients were alive and without disease, with a median follow-up of 52.9 (4-163) months. Twenty-five (69.4%) of these patients were younger than 55 years, and 24 (66.6%) had native valve endocarditis. Conclusion: Underlying cardiac conditions and chronic renal failure increase mortality in infective endocarditis, regardless of the patho- gen. Long-term survival seems promising in cases with native valve endocarditis and in younger patients with low rates of comorbidities.İnfektif endokardit tanısıyla izlenen hastaların epidemiyolojik, klinik, mikrobiyolojik, ekokardiyografik özellikleri, prognozu ve uzun dönem sonuçlarını değerlendirmek. Yöntemler: 1998 ve 2016 yılları arasında bir üniversite hastanesinde modifiye Duke kriterlerine göre kesin ve olası infektif endokardit tanısı konan 86 hastanın 90 endokardit atağının klinik kayıtları ve takip verileri retrospektif olarak incelendi. Bulgular: Çalışmamızda hastaların 56’sı (%65,1) erkek ve ortalama yaş 49,9 ± 14,3 idi. Doğal kapak endokarditi olguların %62,2’sini oluştururken, diğerlerinde protez kapak mevcuttu. En sık aort (%34,4) ve mitral (% 24,4) kapak tutulumu saptandı. Etken olarak strep- tokoklar (%27,7) ve stafilokoklar (%24,4) en sık izole edilen mikroorganizmalardı. Tüm komplikasyonlar içinde embolik komplikasyonlar (%35,5) ilk sırada yer almış, bunu kapak yetmezlikleri (%28,8) ve kalp yetmezliği (%21,1) izlemiştir. Hastaların 28’ine (%31) kapak replasman operasyonu yapılmış ve tüm hastalar içinde 13 hasta (%15,1) hastane takibinde kaybedilmiştir. Mortalite kronik böbrek yetmezliği (P = ,042) ve dejeneratif kapak hastalarında (P = ,036) istatistiksel olarak daha anlamlı bulundu. Taburculuk sonrası prognoz ve uzun dönem sonuçlar değerlendirildiğinde sağ kalan 73 hastanın 43’üne ulaşılabilmiş ve bu hastalardan 36’sının (%83,7) ortalama 52,9 ay (4-163) hayatta ve genel durumlarının iyi olduğu, 25 hastanın (%69,4) <55 yaş, 24’ünün (%66,6) doğal kapak endokarditi tanısıyla izlenmiş olduğu görülmüştür. Sonuç: İnfektif endokardit hastalarında altta yatan kalp hastalıkları ve kronik böbrek yetmezliği patojenden bağımsız olarak mortalit- eyi arttırmaktadır. Doğal kapak endokarditi ve komorbiditeleri daha az olan genç yaş hastalarda ise uzun dönem sağkalım umut verici görünmektedir

Heterologous booster COVID-19 vaccination elicited potent immune responses in HCWs

The objective of our study was to evaluate the antibody responses of health care workers (HCWs) who were vaccinated with booster dose BNT162b2 6 months after 2 doses of the CoronoVac vaccine. The study included 318 HCWs vaccinated with inactive CoronaVac SARS-CoV-2 vaccine in 2 doses. Anti-spike/RBD IgG levels were measured immediately before and 1 month after the booster dose. In the sixth month after CoronaVac vaccination, the median of antibody levels of 1212.02 AU/ML, while it was 9283 AU/mL after BNT162b2 vaccination. IgG antibody titers of over 1050 AU/mL (which is equivalent to 1:80 dilution in the plaque reduction neutralization test) were detected in HCWs 15.09% and 97.8%, respectively. Our results showed that antibody titers increased 8-fold after the booster dose. We believe that the administration of the mRNA vaccine as a booster dose can provide more effective protection against COVID-19 infection, especially in individuals with risk factors.IU-Cerrahpaşa Scientific Research Projects Uni

Waning immunity to inactive SARS-CoV-2 vaccine in healthcare workers: Booster required

Aims Despite high vaccination rates, increasing case numbers continue to be reported with the identification of new variants of concern, and the issue of durability of the vaccine-induced immune response remains hot topic. Real-life data regarding time-dependent immunogenicity of inactivated COVID-19 vaccines are scarce. We aimed to investigate the changes in the antibody at the different times after the second dose of the CoronaVac vaccine. Methods The study included 175 HCWs vaccinated with inactive CoronaVac (Sinovac Life Sciences, China) SARS-CoV-2 vaccine in two doses. Anti-spike/RBD IgG levels were measured first, third, and sixth months after the second dose. Chemiluminescent microparticle immunoassay (IgG II Quant test, Abbott, USA), which is 100% compatible with plaque reduction neutralization test, was used. Results Mean age of the participants was 38 +/- 11.23 years (range between 22 and 66) of whom 119 (63.9%) were female, and 56 (32%) were male. Dramatic reductions were demonstrated in median antibody levels particularly in the infection-naive group, comprising 138 HCWs compared to those with prior history of COVID-19 infection (n = 37) (p < 0.001). There was no difference between the two groups in terms of age, gender, blood groups, BMI, and comorbid diseases. Conclusions While antibody positivity remained above 90% in the 6th month after two doses of inactivated vaccine in HCWs, the median titers of neutralizing antibodies decreased rapidly. The decrease was more rapid and significant in those with no history of prior COVID-19 infection. In this critical phase of the pandemic, where we are facing the dominance of the Omicron variant after Delta, booster doses have become vital.IU-Cerrahpasa Scientific Research Projects Uni

Different epidemiology of bloodstream infections in COVID-19 compared to non-COVID-19 critically ill patients: A descriptive analysis of the Eurobact II study

Background: The study aimed to describe the epidemiology and outcomes of hospital-acquired bloodstream infections (HABSIs) between COVID-19 and non-COVID-19 critically ill patients. Methods: We used data from the Eurobact II study, a prospective observational multicontinental cohort study on HABSI treated in ICU. For the current analysis, we selected centers that included both COVID-19 and non-COVID-19 critically ill patients. We performed descriptive statistics between COVID-19 and non-COVID-19 in terms of patients’ characteristics, source of infection and microorganism distribution. We studied the association between COVID-19 status and mortality using multivariable fragility Cox models. Results: A total of 53 centers from 19 countries over the 5 continents were eligible. Overall, 829 patients (median age 65 years [IQR 55; 74]; male, n = 538 [64.9%]) were treated for a HABSI. Included patients comprised 252 (30.4%) COVID-19 and 577 (69.6%) non-COVID-19 patients. The time interval between hospital admission and HABSI was similar between both groups. Respiratory sources (40.1 vs. 26.0%, p < 0.0001) and primary HABSI (25.4% vs. 17.2%, p = 0.006) were more frequent in COVID-19 patients. COVID-19 patients had more often enterococcal (20.5% vs. 9%) and Acinetobacter spp. (18.8% vs. 13.6%) HABSIs. Bacteremic COVID-19 patients had an increased mortality hazard ratio (HR) versus non-COVID-19 patients (HR 1.91, 95% CI 1.49–2.45). Conclusions: We showed that the epidemiology of HABSI differed between COVID-19 and non-COVID-19 patients. Enterococcal HABSI predominated in COVID-19 patients. COVID-19 patients with HABSI had elevated risk of mortality. Trial registration ClinicalTrials.org number NCT03937245. Registered 3 May 2019