INTRODUCTION: The coronavirus disease 2019 (COVID-19) has caused the world to face a pandemic that has negative effects in many areas from education to health, transportation to economy. In this process throughout the world, various measures have been tried to be taken and different policies have been implemented to lessen the impact on human health and to end this disease. The aim of this study is to evaluate the effects of COVID-19 through selected health status indicators for Türkiye and to make future predictions through different scenarios.
METHODS: Within the scope of the study, Türkiye’s public and private health expenditures per capita, crude death rate, crude birth rate and life expectancy at birth were evaluated. These indicators cover the years 2009-2021. Two scenarios were produced. Scenario 1 poses the question: “What changes would be observed in selected health indicators by 2030 if there were no pandemic?”. For this purpose, future forecasts were made until 2030 using 2009-2021 data. In the second scenario, an assessment is made: “How will the selected health indicators develop by 2030 after the pandemic has occurred?”. In this context, forecasts were made until 2030 using 2009-2021 data. The study used the ONGBM (1,1) model for estimation and found that the MAPE (mean absolute percentage error) values were less than 10%.

RESULTS: According to Scenario 2, it is expected that there will be a higher increase in public health expenditures and a lower increase in private health expenditures until 2030 compared to Scenario 1. While a decrease in the crude death rate was expected until 2030 in Scenario 1, an expectation for an increase in Scenario 2 emerged. The expectation of a decrease in the crude birth rate is graeater in Scenario 2. In terms of life expectancy at birth, it is expected to increase in Scenario 1 and decrease according to Scenario 2. When the forecast results of Scenarios 1 and 2 from 2022 to 2030 were compared, it was determined that there were statistically significant differences between the two scenarios. Therefore, it was concluded that COVID-19 had a breaking effect on health indicators.
DISCUSSION AND CONCLUSION: The findings revealed that decision makers and managers should reconsider future decisions because of COVID-19 and develop alternative solutions by creating different scenarios while planning.

INTRODUCTION: The study aimed to evaluate the data obtained by comparing the bacteriological examination of dairy cattle with subclinical mastitis and the change in somatic cell count, which is used as a quality indicator.
METHODS: For this purpose, milk samples were taken from a total of 280 randomly selected Holstein breed dairy cattle and from 1120 mammary lobes, which did not show clinical signs of mastitis. The general microbial status of the milk samples was assessed using the California Mastitis Test (CMT) and somatic cell count (SCC), and bacterial species were identified through identification analysis.
RESULTS: According to the CMT results, 58 (20.7%) of the dairy cattle were found positive for subclinical mastitis. Of the 232 breast lobes included in the study, they were scored as 82 of them (35,3%) CMT (-), 47 of them (20,3%) CMT (+), 78 of them (33,6%) CMT (++) and 25 of them (10,8%) CMT (+++). The bacterial growth rate in CMT-positive mammary lobes was determined to be 64,66%, and E. coli (26,10%), S. aureus (21,29%), and S. agalactiae (20,08%) were isolated from samples, respectively. When the SHS values in the samples were examined, it was determined that the values varied between 50,000 and 960,000 cells/mL and the average value was 333,862 cells/mL.
DISCUSSION AND CONCLUSION: The results indicate that subclinical mastitis is prevalent in dairy farms, and that Staphylococcus spp. and E. coli are more frequently isolated from the milk obtained from these animals. In the context of food safety, it is considered that the implementation of measures related to udder health and milking hygiene in the milk supply chain will contribute to the production of high-quality milk and dairy products.

INTRODUCTION: The genus Acinetobacter is a heterogeneous group of organisms belonging to the Gram-negative coccobacillus group, widely found in nature. These bacteria are isolated from human and animal sources. Antimicrobial agents play a vital role in the treatment of infectious diseases in both humans and animals. Acinetobacter genus antibiotic resistant bacteria are of increasing concern for human and animal health. The aim of this study was to identify bacteria belonging to the genus Acinetobacter from reproductive organs of different animals and their antimicrobial susceptibility.
METHODS: Our study material consisted of 247 uterine swabs from horses (mare), 56 heifers (cattle), and 32 vaginal swabs from cows in different regions. In bacteriological examination, the samples were incubated in Fluid Thioglycollate Medium (BBL; 221196) at 37 °C for 24 hours. After incubation, isolation studies were carried out on EMB agar (Eosin Methylen-Blue Lactose-Saccharose, BBL; 221355) and Blood Agar (BBL; 297876). Identification of pure cultures obtained as a result of bacterial isolation studies was performed using BBL crystal (Becton-Dickinson, Sparks, USA) Gram positive and Gram negative ID system kits and computer program. The susceptibility of the identified Acinetobacter spp. isolates to different antibiotics was investigated by disc diffusion method.
RESULTS: Acinetobacter lwoffii was isolated from 247 uterine swabs from horses and 56 vaginal swabs from heifers (respectively, n = 4 and n=3), while Acinetobacter johnsonii was determined from 32 vaginal swabs from cows (n = 3). Acinetobacter lwoffii was isolated from all samples. Acinetobacter lwoffii which was isolated most frequently in horses. Among the antibiotics tested by disc diffusion method, amikacin, doxycycline and ampisilin/sulbaktama were found to be 100% effective against. In addition to these two antimicrobial agents, 100% susceptibility was detected against netilmicin and gentamicin in heifers where the same agent was isolated. In the antimicrobial susceptibility test applied to Acinetobacter lwoffii isolated in cows, 100% susceptibility was found to ofloxacin in addition to the antimicrobials showing 100% susceptibility in heifers.
DISCUSSION AND CONCLUSION: Acinetobacter spp. may also represent a serious public health problem due to recent evidence of transmission between human and animal. Therefore, we believe that expanding the knowledge about antibiotic-resistant Acinetobacter in the livestock environment will be a resource for future studies.

INTRODUCTION: Ever since Covid-19 outbreak in Wuhan, China, medical scientists actively strive to contribute in the diagnosis and management of the disease. For this purpose, many markers have been studied so far for the follow-up and prognosis of the disease, apart from these routine tests, the number of targeted and untargeted metabolomic studies have been growing gradually. Organic acids are the intermediate products in various metabolic pathways. Abnormal urinary organic acids can be present in amino acid and carbohydrate metabolism disorders, mitochondrial fatty acid beta oxidation disorders, and some mitochondrial oxidative phosphorylation defects. The aim of this study is to evaluate the organic acids detected in the urine due to the metabolic processes that may be affected by hypoxia in Covid-19 patients who develop clinically mild, moderate and severe pneumonia, to determine their relationship with the disease severity and to compare the results with the control group.
METHODS: A total of 120 patients with the clinical spectrum of SARS-CoV-2 infection as mild, moderate and severe according to the WHO Covid-19 disease severity classification were included in the present study. First morning urine samples taken inpatient setting were aliquoted and frozen immediately until the analysis day. Urine organic acid levels were measured using Gas chromatography-mass spectrometry.
RESULTS: Among 104 organic acids, pyruvic acid, lactic acid, 2-hydroxybutyric acid levels were significantly higher in the severe disease group (p=0.006, p<0.001, p<0.001, respectively), citric acid and homovanilic acid (HVA) levels were significantly lower in all disease groups (p<0.001), α-ketoglutaric acid, vanillylmandelic acid and succinic acid levels were significantly lower in the severe and moderate disease group (p<0.001), β-hydroxybutyric acid was significantly higher in the severe and moderate disease group p(<0.001), oxalic acid was significantly higher in the moderate disease group compared to the control group (p=0.041). The binary logistic regression model included, α-ketoglutaric acid, succinic acid, and HVA. It was statistically significant with χ2 = 98.680; p < 0.001.
DISCUSSION AND CONCLUSION: α-ketoglutaric acid, succinic acid and HVA were independent predictors of the disease severity, measurement of these spesific metabolites might facilitate the developments of novel therapies and may improve responses to currently available therapies with the ease of prognosis prediction of Covid-19.

INTRODUCTION: Some changes in genes, protein, and function in chondrocytes can cause them to develop into a fibroblastic morphology. Our study aims to transform chondrocytes in monolayer cultures into a mesenchymal stem cell-like immunophenotype by inducing chondrocyte de-differentiation with recombinant basic-fibroblast growth factor (FGF-b) supplementation.
METHODS: In our study, chondrocytes were obtained from Erciyes University Genome and Stem Cell Center as ready-made cell lines. Chondrocytes grown on a standard medium were used as the control group. An experimental group was formed by adding recombinant basic FGF at a concentration of 5 ng/ml to the normal growth medium. MSC-specific surface markers expressions such as CD271, CD166, CD29, CD44, CD73, CD90, and CD105 were compared between groups by flow cytometry. “Muse Annexin-V assay kit” and “Muse Count and viability kit” were used according to the production procedure to compare apoptosis and viability data between groups. Colony-forming potentials in chondrocytes were determined by Colony-forming units-fibroblast assay. Statistical analyzes were performed using the statistics software GraphPad Prism (version 8.02). Data with P<0.05 were considered statistically significant.
RESULTS: The addition of recombinant basic-FGF to chondrocyte cultures reduced the percentage of total apoptosis in chondrocytes and increased viability. Our flow cytometry findings showed a significant increase in the expression of MSC-specific surface markers CD105, CD90, CD166, and CD271 in recombinant basic-FGF-treated chondrocytes. On the other hand, a decrease was observed in CD29 and CD73 expressions. There was no statistically significant difference among the groups in terms of CD44 expression.
DISCUSSION AND CONCLUSION: In conclusion, the addition of recombinant basic-FGF to chondrocyte cultures decreased the percentage of total apoptosis in chondrocytes and increased viability. Our flow cytometry findings showed a significant increase in the expression of MSC-specific surface markers CD105, CD90, CD166, and CD271 in recombinant basic-FGF-treated chondrocytes. The increase in these MSC key markers suggests that recombinant basic FGF may induce chondrocyte differentiation at the level of MSC phenotype. In this study, we hypothesized that recombinant basic FGF might be an effective growth factor in the differentiation of chondrocytes into MSC immunophenotype. De-differentiation of chondrocytes to the MSC immunophenotype by recombinant basic-FGF may render these cells more effective and potential for chondrocyte implantation for regenerative medicine in cartilage damage such as osteoarthritis (OA) or other joint disorders.

INTRODUCTION: In Turkey HIV/AIDS diagnosed patients’ number is gradually increasing currently and there are only two Toxoplasma seroprevalence studies published from one center in the literature. The aim of this study was to reveal the seropositivity rate in our center and to contribute to control measures with the data obtained.
METHODS: All patients, who were diagnosed with HIV infection from 1985 to today and followed from 1995 to 2024 at the Marmara University Pendik Training and Research Hospital, Infectious Diseases and Clinical Microbiology HIV outpatient clinics and (starting from the Marmara University Faculty of Medicine University Hospital period) whose Anti-Toxoplasma IgG test results could be obtained, were included in the study. The patients’ age, gender, sexual orientation, CD4 T lymphocyte counts, and Anti-Toxoplasma IgG results were recorded. Cerebral toxoplasmosis diagnosed patients were found from records.
RESULTS: A total of 916 HIV/AIDS diagnosed patients with Anti-Toxoplasma IgG test results were included in the study. 88.1% of the patients (n=807) were male. The average age of all patients was 36.9 years (±11.4 years; min-max: 18-81 years). The median CD4 T lymphocyte count was 369.0, and the mean was 408.9 (±275.34; min-max: 0.0-1659.0). 41.3% of all patients (n=378) were men who have sex with men (MSM). The mean age in the MSM group was 32.5 years (±9.9 years; min-max: 18-81 years). 9.4% of all patients (n=86) and 78.9% of women (n=86) were in childbearing age (18-49 years). The seropositivity rate for Toxoplasma gondii was found to be 36.5%. A statistically significant difference was detected in the seropositivity rates, with 46% among women and 28% in the MSM group.
DISCUSSION AND CONCLUSION: In this study, a seropositivity rate of 36.5% was found in HIV-infected patients at our center, which is close to seroprevalance rate in general population (30%) and it has been observed that there has been a decrease in this rate over the last 20 years. The seropositivity is significantly lower in the MSM group, which has a lower mean age. In the follow-up of HIV/AIDS diagnosed and anti-Toxoplasma IgG negative individuals, reminding transmission ways, risk factors, and preventive measures at the time of initial diagnosis and during each visit will contribute to reducing the Toxoplasma burden in our country.

INTRODUCTION: Copper plays an important role in the catalyzing of enzymes involved in the function of many enzymes in the cell, especially in mitochondria, where energy is produced in the cell, and is involved in mechanisms such as iron homeostasis, scavenging of free radicals, collagen, and elastin bond formation. The expression of internal potassium channels (Kir) is known in various tissues, especially in brain tissue. In this context, the aim of this study was to evaluate the morphological effect of Copper Sulphate (CuSO4) in male and female rat brain tissue and the expression of Kir2.1 and Kir4.1 in the prefrontal cortex and hippocampus regions of the brain.
METHODS: In this study, female and male Sprague dawley rats were divided into control group (n=10) and CuSO4 group (n=10) and administered saline to the control group and CuSO4 (100 mg/kg) to the CuSO4group by oral gavage daily for 14 days. The animals were then euthanised and the brain tissues were examined histologically for morphological and tissue integrity and the expression of Kir channel proteins Kir2.1 and Kir4.1 was evaluated by immunohistochemical method.
RESULTS: Histomorphological characteristics of CuSO4 group brain tissues were observed to change and tissue integrity was disrupted. In both the control group and CuSO4 group, Kir2.1 expression in the prefrontal cortex region was more intense than in the hippocampus region in both sexes. Especially in female rats, intense Kir2.1 expression was observed in neurons in the prefrontal cortex region (p=0.001). In CuSO4 group, the main effect of region was found to be significant for Kir2.1 expression (p=0.014). Kir4.1 expression was observed to be intense in the hippocampus region of the control group, while there was a statistically significant difference between the regions in the control group (p<0.001).
DISCUSSION AND CONCLUSION: We found that brain tissue exposed to excessive CuSO4 could not fully preserve its morphology. In addition, we determined that Kir2.1 was intensely expressed especially in the prefrontal cortex region of the brain, but the expression of Kir4.1 was decreased in both prefrontal cortex and hippocampus regions of male rat brain tissues by CuSO4 treatment. The relationship between the damage caused by intensive CuSO4 application in brain tissue and the activation/inhibition of Kir channels needs to be investigated in more detail.

INTRODUCTION: The number of individuals living with HIV increases in Turkey. Aim of this study is to reveal and compare the percentage of Syphilis seropositivity in our centre with other studies done in Turkey and all over the world. It is aimed to give contribution to the control measures to prevent the transmission of these two diseases with the data obtained.
METHODS: Individuals diagnosed with HIV infection at the Marmara University Pendik Training and Research Hospital, Infectious Diseases and Clinical Microbiology since 1985 and followed up from 1995 to 2024 (starting from the Marmara University Faculty of Medicine University Hospital period) and whom Treponema pallidum Hemagglutination (TPHA) test results were available were included. The patients’ age, gender, sexual orientation, CD4 T lymphocyte counts and TPHA results were recorded.
RESULTS: A total of 1042 individuals living with HIV with TPHA test results were included in the study. 87.9% (n=916) were male, the median age was 35.0 years (mean: 37.0±11.7 years; min-max: 18-81). Regarding their sexual orientation, 35.7% (n=372) were homosexual/bisexual, 37.8% (n=389) were heterosexual, and 27.0% (n=281) were unknown. TPHA was positive in 24.9% (n=259) of 1042 individuals living with HIV. Of the TPHA positive individuals, 95.0% were male (n = 246) and 5.0% were female (n = 13). The sexual orientation of 45.5% (n=112) of TPHA-positive men was homosexual/bisexual, while 29.7% (n=73)was heterosexual and 24.8% (n=61) was not known. Seropositivity was observed to be higher in men who have sex with men (MSM), at 30.1%. There was no difference in terms of TPHA positivity in MSM individuals living with HIV according to age groups (p = 0.329). TPHA positivity was found to be higher in those who had hepatitis B virus infection, at 35.7%, compared to those who had not. Pregnancy was present in 7,9 % (n=10) of female individuals living with HIV. TPHA was detected positive in 20.0% (n=2) of pregnant women. TPHA was detected positive in 11,5 % (n=12) of females in the childbearing period.
DISCUSSION AND CONCLUSION: The highest seropositivity level of 24.9% was reached in our study when compared with others. The level of syphilis seropositivity in MSM individuals living with HIV was found to be high at 30.1%, similar to other studies done in Istanbul. It can be thought that the development of control measures such as syphilis screening, treatment, use of barrier measures, partner information and treatment for MSM individuals may play a key role in controlling the spread of both diseases.

INTRODUCTION: Carbapenem-resistant Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii serve as key reservoirs and transmitters of resistance, contributing to a rise in the antimicrobial-resistant globally. These bacteria have also been classified as urgent priority pathogens in terms of the need for new antibiotics. The purpose of this study was to determine the susceptibility of carbapenem resistant K. pneumoniae, P. aeruginosa, and A. baumannii isolates to imipenem-relebactam and ceftazidime-avibactam as described new drugs.
METHODS: This study included a total of 183 isolates, comprising 82 K. pneumoniae, 45 P. aeruginosa, and 56 A. baumannii isolates, which were isolated from various clinical samples. The identification and antibiotic susceptibility testing of the isolates were performed using the Vitek 2 automated system (bioMérieux, France) according to the EUCAST criteria. Each isolate that exhibited resistance to one or more antibiotics from the carbapenem group underwent phenotypic confirmation for carbapenem resistance using the Carbapenem inactivation method (CIM) and the Blue-carba test (BCT). The susceptibility of all isolates to imipenem-relebactam (35 µg, Liofilchem, Italy), and ceftazidime-avibactam (10/4 µg, Bioanalyse, Turkey) was evaluated using the disk diffusion method according to EUCAST standards.
RESULTS: The resistance to ceftazidime and ceftazidime-avibactam were found to be, respectively, 100%, 3.7% for K. pneumoniae, 24.4%, 8.9% for P. aeruginosa, and 100%, 98.2% for A. baumannii. The resistance rates of isolates to imipenem and imipenem-relebactam were found to be 80.5%, 85.4% for K. pneumoniae, 68.9%, 13.3% for P. aeruginosa, 100%, 98.2% for A. baumannii respectively. The positivity rates for CIM and BCT were determined as 79.3% and 80.5% for K. pneumoniae, 9% and 50% for P. aeruginosa, and 80.4% and 62.5% for A. baumannii isolates, respectively.
DISCUSSION AND CONCLUSION: Ceftazidime-avibactam has been determined to be effective against carbapenem-resistant K. pneumoniae and P. aeruginosa. Imipenem-relebactam has been found to be effective in P. aeruginosa isolates, while being observed to be less effective against K. pneumoniae. It was concluded that ceftazidime-avibactam can be used as an alternative option in the treatment of carbapenem-resistant K. pneumoniae and P. aeruginosa infections and imipenem-relebactam can be used as an alternative option in the treatment of carbapenem-resistant P. aeruginosa infections.

INTRODUCTION: Chronic diseases refer to long-lasting health problems that are generally difficult to treat. The most common chronic diseases include diabetes, heart disease, hypertension, chronic respiratory diseases, and cancer. These diseases are typically associated with lifestyle factors such as genetic predisposition, poor nutrition, insufficient physical activity, excessive smoking, and alcohol consumption. In addition to physical discomfort, chronic diseases also have psychological and social impacts on individuals. The treatment process usually requires long-term management and patient adherence. Therefore, regular medical check-ups, healthy lifestyle habits, and proper medication dosage are crucial. The prevalence of chronic diseases is increasing in OECD (Organisation for Economic Co-Operation and Development- Ekonomik İşbirliği ve Kalkınma Örgütü) countries, and the impact of drug use and lifestyle factors on the global burden of disease and mortality is becoming increasingly important. Type 2 diabetes is an important example in this context. This study aims to examine the impact of medication use and lifestyle factors in the management of type 2 diabetes mellitus on the global burden of disease and mortality.
METHODS: The study population includes all OECD countries. Medications used in type 2 diabetes mellitus, alcohol consumption, tobacco consumption, obesity, physical inactivity were used as independent variables; type 2 diabetes-related mortality, type 2 diabetes DALYs (Disability-adjusted life years) were used as dependent variables.
RESULTS: Regression analysis showed that lifestyle factors (lnAlc, lnTob, lnObes, lnPInact) and medication use (lnDrug) effected both lnDALY and lnDMort (p<0.05).

DISCUSSION AND CONCLUSION: The effective use of medication and lifestyle changes in the management of type 2 diabetes is an important step in controlling the disease. Therefore, in addition to the use of medication, healthy lifestyle habits should be promoted to prevent and control chronic diseases. These measures can contribute both to improving the health of individuals and to the sustainability of health systems.

In this article, it is aimed to discuss the importance and application of nutritional therapy in a case diagnosed with polycystic ovary syndrome. The patient applied to the University's Nutrition and Dietetics Clinic. She was diagnosed with polycystic ovary syndrome by her gynecologist. Medical nutrition therapy was applied for his existing disease. Polycystic ovary syndrome (PCOS) is one of the most common endocrine metabolic disorders in women of reproductive age and is a heterogeneous disease that is difficult to define. Weight control in PCOS patients is of great importance in relieving the symptoms of the disease and reducing the risk of comorbid diseases. In all cases, it should be preferred to regularly monitor the body weight of the patients under the supervision of a dietician, check the compliance with the diet, and ensure the control of the patient by making biochemical findings together with the doctor's checks.
Key words: Polycystic Ovary Syndrome, Diet therapy, Weight management

Most important components of public health are the clean water, sanitation and immunization against preventable diseases through vaccination. Established vaccination programs are one of the most important and cost effective intervention prevention that elimination of infectious diseases, reducing the morbidity and mortality of diseases, and the development of a healthy society. The aim of this programs, which took its final form published in 2008 in our country, that is 'The main purpose of immunization services is to prevent the emergence of preventable diseases in the society, especially in infants and children, and therefore to prevent deaths and disabilities caused by these diseases, and the main goal is not to leave unvaccinated children'. Rejection or delay in accepting vaccines despite accessible vaccination services is defined as vaccine refusal. Vaccine hesitations and refusals, which are known to increase gradually over time that are an important threat at the global level according to the World Health Organization and are among the most important public health problems. Reasons related to communication and media tools, individual and group effects, vaccine and vaccination effects are the most important topics that affect vaccine acceptance. In this regard, it is very important to determine the causes and to make plans for the cause. Today, one of the primary goals of public health and health providers is seen as increasing health literacy and improving health communication. Although the legal regulations to be made will lead to positive increases, the main goal should be to increase the health literacy of the people and to develop their self-responsibility through correct communication methods. Thus, in this review, it was aimed to review the results about vaccine refusal, causes of vaccine refusal and effects of this condition.

The bacterium of the genus Legionella were first detected during the American Legion convention held in Philadelphia in 1976, following a largeoutbreak of severe pneumonia (among residents of the Bellevue-Stratford Hotel) isolated by Dr. Joseph McDade. Legionella is an environmental Gram-negative bacterium that can cause spontaneously healing febrile illnesses (Pontiacfever) and fatal pneumonia (Legionnaires’ disease) in humans. Legionella pneumophila is an important cause of community- and hospital-acquired pneumonia. It is phagocytosed within alveolar macrophages or epithelial cells by inhalation of aerosols contaminated with Legionella. Legionnaires’ disease is caused by the bacilli engulfed in alveolar macrophages forming a vacuole containing Legionella by preventing phagolysosomal fusion, thanks to the Type 4 Secretion System encoded by the Dot/Icm genes, and its proliferation within this vacuole by escaping the host immune mechanisms. The most interesting aspect of the Legionella bacterium’s genome is the motifs, most of which are of eukaryotic origin, that it acquired through gene transfer during its parasitism in amoebae. Thanks to the semotifs obtained by horizontal gene transfer, Legionella bacteria have an incredible number of virulence factors that will increase their resistance to environmental factors and host immunity, that is, “an army with a huge arsenal”. Moreover, these eukaryotic motifs also apply to bacteria; Provides the capacity to develop exceptional adaptation strategies. Their survival in biofilms and amoebae protects them from intensive disinfection practices and increases their resistance to environmental factors. The two-phase life cycle of Legionella includes the infectious phase and the non-infective replicative phase; It also reveals physiological, morphogenetic and metabolic change abilities. Amoebae and macrophages suggests that environmental amoebae act as an “educator” the similarity of the infection cycle between. It is aimed to review current information on the abilities of Legionella to infect amoebae and macrophages, virulence/survival strategies, infection mechanisms, host immunity and Legionella immunopathogenesis.