Browsing by Author "Akcali, S"

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    A novel concept: occult HBV infection in the western region of Turkey
    Akduman, E; Sanlidag, T; Akcali, S; Ellidokuz, E; Celebi Kobak, A
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    In vitro activity of ciprofloxacin, ofloxacin and levofloxacin against Mycobacterium tuberculosis
    Akcali, S; Surucuoglu, S; Cicek, C; Ozbakkaloglu, B
    BACKGROUND:The increasing incidence of drug-resistant Mycobacterium tuberculosis necessitates therapeutic alternatives. The fluoroquinolones fulfill most of the criteria for an ideal class of antimycobacterial drugs. The aim of the present study was to determine to in vitro activities of ciprofloxacin, ofloxacin, and levofloxacin against M. tuberculosis strains. METHODS: Susceptibility to four antituberculous drugs used in first-line treatment of tuberculosis was tested in 100 strains isolated from clinical samples. Nineteen strains (19%) were resistant to at least one of the four antituberculous drugs and 13 were multidrug resistant. The in vitro antimycobacterial activity of ciprofloxacin, ofloxacin, and levofloxacin was then determined against 100 M. tuberculosis strains using standard agar proportion dilution method. RESULTS: Ciprofloxacin, ofloxacin, and levofloxacin were active against all tested strains of M. tuberculosis in vitro. CONCLUSIONS: Ciprofloxacin, ofloxacin, and levofloxacin have relatively potent in vitro activity against M. tuberculosis. Further in vivo studies are needed to determine the role of these compounds in the treatment of tuberculosis, but use should be limited to special circumstances rather than first-line treatment.
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    Are Human Adenovirus-5 and 36 Associated With Obesity in Children?
    Cakmakliogullari, EK; Sanlidag, T; Ersoy, B; Akcali, S; Var, A; Cicek, C
    Objectives: The aims of this study were to determine the association between adenovirus-5- and adenovirus-36-specific antibodies and obesity in children and to investigate their relationship with serum lipid and leptin levels. Methods: A cross-sectional study was performed on a total of 120 children who were divided into subgroups according to body mass index percentile as obese (>= 95th percentile) or nonobese (<95th percentile). The presence of adenovirus-36 and adenovirus-5-neutralizing antibodies was investigated by using the serum neutralization assay. Serum leptin levels were determined by microenzyme immonoassay; high-density lipoprotein, low-density lipoprotein, triglyceride, and cholesterol levels were measured by chemiluminescence method. Results: The presence of adenovirus-5-specific antibodies was 28.3% and 6.6% in the obese children and in non-obese children, respectively (P = 0.02). The frequency of adenovirus-36-specific antibodies was significantly greater (P = 0.018) in the obese children (26.6%) than in the nonYobese children (10.0%). Serum leptin level of the obese group were significantly higher than that of the non-obese group (P = 0.000). Conclusions: Our data support the association between obesity and the presence of specific antibodies to adenovirus-36 and adenovirus-5 in children. Our research has the feature of being the first national study to indicate the relationship between adenovirus-36 and human obesity as well as the first international study to indicate the relationship between adenovirus-5 and human obesity.
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    Evaluation of Serological Tests for Diagnosis of Brucellosis
    Pabuccuoglu, O; Ecemis, T; El, S; Coskun, A; Akcali, S; Sanlidag, T
    The aim of the present study was to compare serological tests (Rose Bengal [RB]; standard agglutination test [SAT]; enzyme immunoassay [ETA] for detection of IgM, IgA, and IgG; and 2-mercaptoethanol [2-ME] test) that are routinely used in patients prediagnosed with different clinical types of brucellosis (acute, subacute, or chronic), and to evaluate the results of the IgG avidity test. Ninety-two patients having titers >= 1/160 as measured by SAT were included in the study. The IgG avidity test was performed in 78 patients who had positive EIA-IgG results. RB test results were positive in 88 (95.7%) patients. A statistically significant correlation was found between a positive EIA-IgM result and the diagnosis of acute brucellosis. When compared to the results of the SAT, the 2-ME test showed a lower titer in 55 (59.8%) patients, and the agreement between the 2-ME test and EIA-IgG was calculated as 84.8%. No statistical difference was found between the 40% avidity index used in the IgG avidity test and avidity maturation time (6 months). From our study, we concluded that (i) the RB and SAT tests are appropriate and reliable tests for the serological diagnosis of brucellosis; (ii) IgM can be used as a marker of acute brucellosis; (iii) the 2-ME test, similar to EIA, can be used to determine IgM levels; and (iv) the IgG avidity test should be standardized.
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    Evaluation of the pol/S Gene Overlapping Mutations in Chronic Hepatitis B Patients in Northern Cyprus
    Arikan, A; Sayan, M; Sanlidag, T; Suer, K; Akcali, S; Guvenir, M
    Mutations associated with the pol and the S gene can emerge as a consequence of the high replication capacity and proofreading deficiencies of hepatitis B virus during replication. The current study was constructed to evaluate primary, partial, compensatory and the escape mutations in chronic hepatitis B patients in Northern Cyprus. The samples of HBsAg positive treatment naive 100 patients were involved in this study. HBV pol gene region was sequenced, amplified and HBV pol/S gene mutations were determined. The samples of thirty-two patients were excluded because of their low viral load (HBV < 1000 lu/ml). Among the sequenced 68 samples, there was a partial mutation (1.5%) and 36.7% displayed a resistance profile to lamivudine, adevofir, and telbivudine. Immune response escape, vaccine escape, HBIg and diagnosis escape mutations were determined in 24%, 10%, 6%, and 4% samples of the patients, respectively. Additionally, there were six different combined mutations. These data underscored that there is no concern for primary mutations in Northern Cyprus, however, we have identified a compensatory mutation (rtV173M) that may have primary mutation characteristics by combining with other mutation patterns. Additionally, HBsAg escape mutants demonstrated that detection of the S gene together with the pol gene mutations might be beneficial and important to monitor the surveillance of S variants.
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    Comparison of immunogenicity for Sinovac-CoronaVac vaccine vs. natural infection during cancer treatment
    Çakir, E; Saydan, D; Gülbagci, B; Özen, M; Ugurlu, I; Demirci, A; Bilir, F; Hacibekiroglu, I; Yildiz, N; Akcali, S; Altindis, M; Varim, C; Yaylaci, S; Bilir, C
    - OBJECTIVE: Efficacy of the COVID-19 vaccines in cancer patients, especially during their active treatment, are lacking. Most of the studies in the literature compared the immuni-ty in cancer patients with a cross-sectional cohort or retrospectively. Our study investigated Sino-vac-CoronaVac COVID-19 vaccine immunogenici-ty and compared it with natural COVID-19 disease in cancer patients during their cancer therapy.PATIENTS AND METHODS: A total of 111 pa-tients with cancer and who are on active treat-ment were included in the study. This is a sin-gle-center study and was designed prospec-tively. Two group of patients were included in the study, natural disease and vaccinated group.RESULTS: A total of 111 patients were in-cluded in the study, 34 of whom had natural COVID-19 disease. Antibody levels following the first dose vaccine were 0.4 (0-1.9) U/ml while af-ter the second dose of vaccine were 2.6 (1.0-7.25) U/ml. Immunogenicity levels were 82.4% in the natural disease group and 75.8% in the vaccinated group after the second shot of the vaccine. Immunogenicity rate was significantly higher in non-chemotherapy (receiving immu-notehrapy/targeted therapy or biologic agent) group compared to chemotherapy drug (92.9% vs. 63.3%, p=0.004). There was a difference be-tween the antibody levels following the first and second vaccination [median (IQR): 0.3 (0-1.0) and 3.3 (2.0-6.7), p=0.001, respectively].CONCLUSIONS: The present study revealed that the Sinovac-CoronaVac vaccine showed an acceptable immunogenicity following two shots in cancer patients who were receiving ac-tive systemic therapy. On the other hand, nat-ural disease immunogenicity was higher than vaccinated group.
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    Factors affecting the serologic response to SARS-CoV-2 vaccination in patients with solid tumors: A prospective study
    Erdogan, AP; Ekinci, F; Akcali, S; Goksel, G
    Objective: To evaluate the factors affecting seropositivity and antibody levels after SARS-CoV-2 vaccines in patients with cancer because they were excluded from clinical studies of SARS-CoV-2 vaccines. Methods: This prospective, observational, single-center study included 290 patients with solid tumors followed up in our medical oncology clinic between March 2021 and August 2021. SARS-CoV-2 antibody status was determined before the first dose of vaccine. Fifty-one patients with positive prevaccine baseline antibody tests were excluded from the study, regardless of whether they had previously confirmed SARS-CoV-2 PCR positivity. To determine the quantitative IgG antibody response of the vaccines, blood samples were collected at least 28 days after each dose of vaccine. Quantitative IgG levels against virus spike protein receptor binding domain (RBD) were measured using chemiluminescent enzyme immunoassay (CLIA). Demographic and clinical features affecting seropositivity were analyzed. Results: One hundred and fifty-one (69.3%) patients were vaccinated with two doses of CoronaVac followed by one dose of BNT162b2 (Biontech) (group 1). Sixty-seven (30.7%) patients were vaccinated with three doses of BNT162b2 (group 2). The proportion of patients who developed seropositivity was significantly higher in group 2 (78.6% vs. 54.9%, p < 0.012). Antibody response increased significantly after the second dose of vaccine in both groups. Female sex, being younger than 65 years, and chemotherapy status were significantly related to higher anti-SARS-CoV-2 S antibody levels (p = 0.033, p = 0.036, and p = 0.047, respectively). Antibody levels were significantly higher in patients who had previously received chemotherapy than in patients receiving active chemotherapy (p = 0.042). Conclusions: Our study is the first to evaluate basal SARS-CoV-2 IgG levels before the first dose of vaccine and after three doses in patients with solid tumors. The rate of development of seropositivity with two doses of mRNA vaccine was found to be higher than with two doses of inactivated SARS-CoV-2 vaccine. More attention should be paid to preventive measures in addition to vaccination in patients aged over 65 years and men with cancer diagnoses.
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    The effect of COVID-19 vaccinations on menstrual cycle and serum anti-Mullerian hormone levels in reproductive age women
    Hasdemir, PS; Akar, SS; Goker, A; Kosova, F; Ucar, D; Ates, FSO; Akcali, S
    The aim of this prospective cohort study was to investigate the effect of coronavirus disease 2019 (COVID-19) vaccinations on menstrual cycle and ovarian reserve in reproductive aged-women. Health care providers (n = 258) vaccinated with inactivated (CoronaVac) and mRNA based (Pfizer-BioNTech (R)) COVID-19 vaccines were included. All subjects completed a gynaecological and menstrual history questionnaire and Anti-Mullerian Hormone (AMH) levels were measured in serum samples collected before first vaccination and at 1(st), 3(rd), 6(th) and 9(th) months. The prevalence of new-onset menstrual dysregulation following vaccination was 20.6% and it was statistically significant compared to baseline (p = 0.001). Menstrual pattern turned back to normal in 59.6% of vaccinated women. Serum AMH levels gradually decreased until 6(th) month of follow-up compared to baseline (p < 0.001). A significant increase in serum AMH level was observed at 9(th) month of follow-up compared to 6(th) month follow-up levels (p < 0.001). The decrease in serum AMH level was statistically significant regardless of serum anti SARS-CoV-2 antibody levels, subgroups of age, occupation, menstrual dysregulation following vaccination and presence of gynaecological diseases. In conclusion, vaccination against SARS-CoV-2 causes a transient decrease on serum AMH levels and moderate irregularities in menstrual pattern increasing with age and is mostly reversible.
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    Human Papilloma Virus Frequency and Genotype Distribution in a Turkish Population
    Akcali, S; Goker, A; Ecemis, T; Kandiloglu, AR; Sanlidag, T
    Objectives: To determine human papillomavirus (HPV) frequency, genotypes and the relation between cervical smear results, risk factors and types in women living in Manisa, Turkey. Materials and Methods: A total of 410 women were included in the study. Cervical specimens were obtained for linear array HPV genotyping and pathological testing. Conventional Pap test and Bethesda system were used for evaluation of cytology specimens. Results: A total of 410 women with a mean age of 34.9 years were tested. A positive result of any HPV was found in 35 patients (8.5%). Among them, 26 different serotypes of HPV were identified and the most frequent type was HPV 16 (28.5%) followed by type 45 and 53 (11.4%). Patients were infected by 65.7% high risk, 11.4% probable high risk and 22.9% low risk HPV types. Multiple HPV positive results were found in 13 patients (37.1%). Patients with single partner, history of abnormal smear or condyloma had positive HPV results and this was statistically significant (p<0.05). Correlation analysis showed a statistically weak relation between positive HPV and abnormal smear results (r=0.120). Conclusions: Determining HPV types of genital HPV infections is important for epidemiological studies. We have found the rate of positive HPV as 8.5% which implies the need for extended screening programs in order to diagnose oncogenic HPV at an early stage.
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    Seroprevalance of Measles, Rubella, Mumps, Varicella, Diphtheria, Tetanus and Hepatitis B in Healthcare Workers
    Ciliz, N; Gazi, H; Ecemis, T; Senol, S; Akcali, S; Kurutepe, S
    Objective: We aimed to determine the antibody levels of healthcare workers of Celal Bayar University Hospital against vaccinepreventable diseases such as measles, rubella, mumps, diphtheria, tetanus, varicella and hepatitis B, and encourage compliance to recommended vaccinations for non-immune staff. Methods: The antibody levels were tested by enzyme-linked immunosorbent assay (ELISA). Demographic characteristics were collected by a questionnaire, and the history of the diseases, immunization and the sharps-related injuries were queried. Results: 44% percent of 309 healthcare personnel were exposed to occupational injury at least once, and 78.3% of the injuries were needle-stick injuries. Injuries were found to be more common among doctors and nurses, and pediatric and surgical departments, respectively. Frequency of anti-HBs positivity among healthcare workers was 84.1%, while 71.5% of healthcare workers were immunized with HBV vaccine before starting to work, and the immunization status directly correlated with the level of education. In general, high seropositivity was noted for measles (99.7%), rubella (97.0%), mumps (99.7%) and varicella (99.7%), while diphtheria (60.8%) and tetanus (93.5%) antibody levels significantly decreased with age. Histories of the disease and vaccination were not reliable while verifying the immunity status. Conclusions: It is necessary to increase adherence to universal protective measures in healthcare workers and to take corrective and protective measures for sharps-related injuries. It is also essential to increase hepatitis B vaccination rates and to confirm the immune status of medical staff working in high risk departments and diphtheria and tetanus vaccinations should be repeated once every ten years.
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    Celiac disease and polycystic ovary syndrome
    Kuscu, NK; Akcali, S; Kucukmetin, NT
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    Serum hepatitis B DNA: stability in relation to multiple freeze-thaw procedures
    Sanlidag, T; Akcali, S; Ozbakkaloglu, B
    Quantitation of hepatitis B virus (HBV) DNA is often performed in specimens that have been frozen and thawed more than once. It is important to establish whether viral load measurements are affected by repeated freeze-thaw cycles. The effect of multiple freeze-thaw cycles on HBV DNA quantitation was carried out by testing serum specimens subjected to I (baseline) to 10 cycles with the appropriate Digene Hybrid Capture System. Five HBV DNA-positive samples were selected at random from sera with concentrations ranging from 7 pg/ml to 3529 pg/ml and they were frozen and thawed up to 10 cycles and then tested for changes in HBV DNA levels. Negative control and positive standards were tested in triplicate; and all specimens were tested in duplicate. The stability of HBV DNA in serum was evaluated by scattergrarn analysis by determining the number of samples showing a greater than or equal to20% change in HBV DNA levels after freeze-thaw cycles. With the exception of one sample (7 pg/ml) 10 cycles of freezing and thawing did not change significantly the HBV DNA quantity in any of the samples tested. The results showed that the quantity of HBV DNA in four of five serum specimens subjected up to 10 freeze-thaw cycles was stable. (C) 2004 Elsevier B.V. All rights reserved.
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    Serum Vitamin D Levels in Relation to Development of Multisystem Inflammatory Syndrome in Pediatric COVID-19
    Zengin, N; Bal, A; Goren, TA; Sen Bayturan, S; Alkan, F; Akcali, S
    Objective The aim of the study is to evaluate vitamin D (vit D) levels in children with and without development of multisystem inflammatory syndrome in children (MIS-C) after coronavirus disease 2019 (COVID-19) and also between those with severe and moderate MIS-C. Methods This comprises retrospective data of 68 patients including 34 patients with MIS-C and admitted into the pediatric intensive care unit (MIS-C group) and 34 patients without MIS-C (non-MIS-C group) were analyzed for their presenting characteristics, serum vit D levels, ventilatory needs, and prognostic scores. Results Vit D levels were significantly lower in patients with versus without MIS-C [9 (2-18) vs. 19 (10-43) ng/mL, p <0.001], and also in patients with severe versus moderate MIS-C [7.5 (2-17) vs. 9 (5-18) ng/mL, p = 0.024]. Vit D deficiency (levels <12 ng/mL) was more common in the MIS-C versus non-MIS-C group (79.4 vs. 11.8%, p <0.001) and in severe versus moderate MIS-C (92.9 vs. 70.0%, p <0.001). The severe versus moderate MIS-C was associated with significantly higher levels of procalcitonin [7.6 (0.9-82) vs. 1.7 (0.2-42) ng/mL, p = 0.030] and troponin [211 (4.8-4,545) vs. 14.2 (2.4-3,065) ng/L, p = 0.008] and higher likelihood of reduced ejection fraction (75.0 vs. 15.4%, p = 0.004). Conclusion Our findings indicate the higher prevalence of vit D deficiency in pediatric COVID-19 patients with versus without MIS-C, as well as in those with severe versus moderate MIS-C. Higher troponin and procalcitonin levels and dyspnea at presentation seem also to be risk factors for severe MIS-C, more pronounced cardiac dysfunction, and poorer prognosis.
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    Oropharyngeal carriage and penicillin resistance of Neisseria meningitidis in primary school children in Manisa, Turkey
    Gazi, H; Surucuoglu, S; Ozbakkaloglu, B; Akcali, S; Ozkutuk, N; Degerli, K; Kurutepe, S
    Introduction: To determine the oropharyngeal carriage rates and serogroups of Neisseria meningitidis in primary schoolchildren in Manisa, Turkey as well as the prevalence and penicillin resistance of N. meningitidis. Materials and Methods: Throat swabs obtained from 1128 children were cultured and recovered organisms were tested by disk diffusion method and the E-test for antimicrobial susceptibilities. Results: The carriage rate of N. meningitidis in our region was 6.2% (71 strains) and the serogroups identified were serogroups A (28.1%), B (22.5%), C (35.2%), D (2.8%) and W-135 (11.2%). Penicillin resistance was found in 16 strains (22.5%), while beta-lactamase activity was found in none. Conclusions: The carriage rate of N. meningitidis and serogroups are similar to the rates reported in other countries. Continued surveillance of meningococci for antimicrobial resistance will allow early detection of changes in susceptibility patterns that might affect recommendations for chemoprophylaxis as well as for treatment.
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    DETECTION OF HPV E6/E7 MRNA USING NUCLISENS EASYQ HPV™ IN ABNORMAL CYTOLOGY SPECIMENS
    Guvenal, T; Birge, O; Ulkumen, BA; Akcali, S; Sanlidag, T; Koltan, SO; Koyuncu, FM; Kandiloglu, AR
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    Determination of NS3 inhibitors drug resistance mutations in chronic Hepatitis C patients infected with genotype 1
    Sanlidag, T; Sanlidag, T; Sayan, M; Sayan, M; Akcali, S; Kasap, E; Buran, T; Arikan, A; Arikan, A
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    Investigation of adipogenic effects of human adenovirus serotypes 36 and 5 in a Colo-320 cell line
    Sanlidag, T; Akcali, S; Vatansever, S; Cicek, C; Sayan, M; Cakmakliogullari, EK; Sen, PT
    Aim: We aimed to investigate the adipogenic effects of adenovirus (Ad) serotypes 5, 36 and 8 in a Colo-320 cell line using histochemical, immunohistochemical and electron microscopic methods. Materials & methods: Ad serotypes were inoculated in a Colo-320 cell line and were cultured for 14 days. They were then collected and fixed with 4% paraformaldehyde to analyze their adipogenic effects using histochemistry, immunohistochemistry and electron microscopic methods. Intracellular lipid droplets were detected in the Colo-320 cells inoculated with Ad36 and Ad5 by electron microscopic analyses. Results: After Oil Red O staining, the pink-orange staining was positive intracellularly in Colo-320 cells infected with Ad36 and Ad5. In addition, the leptin immunoreactivity was also positive in these cells. Conclusion: Our results suggested that intracellular lipid accumulation occured after infection with Ad36 and Ad5. The positive staining of Oil Red O and leptin also supported the electron microscopic results; therefore, we conclude that this accumulation occurred due to adipogenic effects of Ad36 and Ad5.
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    Prevalence of Chlamydia trachomatis/Neisseria gonorrhoeae and Human Papilloma Virus among Women-at Risk in the Aegian Region of Turkey, and their knowledge about IIIV/AIDS
    Gazi, H; Surucuoglu, S; Yolasigmaz, G; Sen, M; Akcali, S; Dinc, G; Teker, A; Sanlidag, T; Koroglu, G
    Background. The aim of this study was to determine the prevalence of selected sexually transmitted diseases (STDs) and the level of knowledge and attitudes regarding HIV/AIDS among Turkish brothel based sex-workers (SWs). Subjects and Methods: A pre-designed questionnaire was administered to 199 SWs to obtain their sexual behaviours and their level of knowledge of HIV/AIDS. The specimens collected for C trachomatis/N gonorrhoeae and human papillomavirus (HPV) were tested using Gen-Probe PACE 2 and HPV-screening assays, respectively. Result. Aproximatelly sixty-seven per cent of the SWs knew that condoms afforded protection against HIV/AIDS and 62% reported continued use of condoms. Although most of the SWs had heard about HIV/AIDS, thorough knowledge of transmission and prevention was lacking. The overall estimated rates for C trachomatis/N gonorrhoeae and HPV were 18.6% and 9.7%, respectively. CONCLUSION: There is a need for further studies to generate more data on the prevalence of STDs and the knowledge of STDs in this population.