INTRODUCTION: Prosthetic infections are commonly caused by coagulase-negative staphylococci (CoNS) and Staphylococcus aureus (S. aureus). Despite recommendations for preoperative S. aureus screening, data on screening for staphylococcal carriage, including CoNS, remains limited. Our study aimed to explore the relationship between nasal carriage of S. aureus and other staphylococci and prosthesis infections.
METHODS: This prospective cohort study, conducted from January to September 2019, included 151 patients undergoing prosthetic surgery. Nasal cultures for staphylococcal carriage were collected 24 hours before surgery. Patients were monitored and blood tests were conducted at 1, 2, and 3 months postoperatively to assess prosthesis infection development. Infection rates were compared between patients with and without nasal carriage.
RESULTS: In the postoperative three-month period, 5 patients (3.3%) developed prosthetic infections. Preoperative nasal swabs revealed methicillin-resistant coagulase-negative staphylococci (MR-CoNS) in four patients and methicillin-sensitive coagulase-negative staphylococci (MS-CoNS) in one patient. None of the patients had preoperative Staphylococcus aureus. The increased risk of prosthetic infection was significantly associated with nasal CoNS carriage (p=0.025). The infected group exhibited elevated leukocyte, neutrophil, and lymphocyte counts, as well as increased C-reactive protein (CRP) levels at 24 hours post-surgery.
DISCUSSION AND CONCLUSION: This study found no evidence of an association between S. aureus carriage and prosthesis infections, but an association was found for CoNS carriage. However, it is not possible to establish a clear relationship between carrying CoNS and infection. The results of our study suggest that nasal carriage screening before prosthetic surgery may be unnecessary. Further studies are needed to clarify the relationship between nasal carriage and prosthetic infection. Monitoring leukocyte and CRP levels in the early postoperative period may indicate prosthesis infection.

INTRODUCTION: Aim of this study was to investigate the antifungal properties of different acrylic resins coated with Cocos nucifera oil. The escalating threat to human health posed by serious Candida spp. infections and the growing challenge of antimicrobial resistance underscores the pressing need for novel antifungal compounds. In response to this, our study explored the antifungal properties arising from the application of Cocos nucifera oil coating on different acrylic resins. Since there are no previous studies in the literature investigating the relationship between Candida albicans, Cocos nucifera oil, and commonly used 3D-printed acrylic resins, this topic deserves further investigation.

METHODS: In our study, six discs were fabricated using the heat-cured method, and the other six discs were fabricated using the 3D-printing method. The surfaces of the experimental acrylic discs were coated with Cocos nucifera oil, but the surfaces of the acrylic discs in the control group were not coated with Cocos nucifera oil. The antifungal activities of acrylic resins coated with Cocos nucifera oil against C. albicans ATCC 90028 strains were determined using the plate counting method.

RESULTS: Contrary to expectations, Cocos nucifera oil did not exhibit any antifungal effects; it was determined that C. albicans promoted growth increase on acrylic discs coated with Cocos nucifera oil than on the control acrylic discs. Thus Cocos nucifera oil was found to promote C. albicans growth.
DISCUSSION AND CONCLUSION: This study demonstrated that both heat-cured and 3D-printed acrylic resins coated with Cocos nucifera oil did not have any antifungal effects against C. albicans, the contrary, the acrylic resins coated with Cocos nucifera oil promoted C. albicans growth.

INTRODUCTION: This study investigates the role of various compounds in the prevention or repair of tissue damage associated with insulin resistance at the molecular level. It aims to evaluate the effects of thymoquinone (TK), the principal active compound of Nigella sativa known for its numerous beneficial effects, on DNA damage and some molecular pathways in experimental insulin resistance.


METHODS: The insulin resistance model was induced using glucocotiocoids. A total of 40 Wistar-Albino rats were utilized, comprising 7 in the control (C) group, 7 in the insulin resistance (IR) group, 7 receiving TK, 7 protection with TK (TKIR), and undergoing treatment with TK (IRTK) and 5 for tretament control with insulin resistance plus metformin (IM) groups. Expression levels of metabolic genes (antioxidant: Gpx, Sod; necrotic: Rip1, Rip3; autophagic: Atg3, Atg5; apoptotic: Caspase 3, Caspase 8, Caspase 9; DNA repair: KU70, KU80, TP53) in liver tissue were determined using Real-time qPCR. Differences between groups were assessed by comparing fold changes in expression against the control group. Statistical analysis was performed using SPSS.
RESULTS: The expression levels of DNA repair and damage genes KU70 and KU80 increased in the groups receiving TK. The TP53 gene exhibited a significant increase in the IR group but decreased in the TK treatment group. Apoptotic Caspase 8 gene expression was elevated in the IR group and reduced in the TK groups, while no significant differences were observed for Caspase 3 and Caspase 9 expression. No significant differences were noted in antioxidant gene expression (Gpx1, Sod1) among the groups. Autophagic Atg5, and necrotic Rip1 and Rip3 gene expressions increased in the IR group but decreased in the TK groups.
DISCUSSION AND CONCLUSION: The results suggest that TK may reduce insulin resistance, improve glucose tolerance, and support pancreatic β-cell functions through mechanism including enhancing DNA repair via KU70 and KU80, upregulating antiapoptotic genes, and inhibiting autophagic and necrotic pathways. These results could provide valuable insights into the biochemical basis for the hepatoprotective effects of TK in the treatment and prevention of insulin resistance-related complications.

INTRODUCTION: Cold Atmospheric Plasma (CAP),known for its antibacterial properties and potential therapeutic benefits, is emerging as a promising alternativeto traditional chemical disinfectants. This study aims to investigate the dual role of CAP in skin disinfection and its potential effects on melanoma. Specifically, the study examines how CAP affects gene expression and the potential implications of these effects on both skin health and cancer progression.
METHODS: In this study, gene expression analysis was performed on human skin epithelial keratinocytes (HaCaT) post-treatment with Cold Atmospheric Plasma (CAP) and melanoma cell lines. Raw gene expression data were obtained from Array Express (E-GEOD-46343) and Gene Expression Omnibus (GSE22301) databases. The data were normalized using the Robust Multichip Average (RMA) method. For the melanoma cell lines, normal human melanocytes were used as the control group to ensure a comparative analysis of gene expression changes between cancerous and non-cancerous cells. Differentially expressed genes (DEGs) were identified using R packages Limma, affy, and edgeR. Common genes were identified with Venny 2.1.0, and hierarchical clustering analysis was performed using Gene Cluster v3.0. Pathway analysis was conducted using DAVID and KEGG, DAVID provides functional annotation clustering, while KEGG offers pathway mapping to identify significant biological processes. In addition, network analysis was performed using GeneMANIA and Cytoscape software.
RESULTS: This study revealed significant differential gene expressions highlighting CAP’s impact on both antimicrobial activity and cancer-related gene regulation. Key genes involved in oxidative stress responses, including ARID1A, NIPBL, BPTF, and OTUB1, showed notable changes. Downregulation of ARID1A, NIPBL, and BPTF is linked to impaired DNA repair and increased genomic instability, critical in melanoma progression. In contrast, upregulation of OTUB1 promotes cell survival and resistance to apoptosis. These findings suggest CAP’s dual role in enhancing antimicrobial defenses and influencing cancer-related pathways, particularly through the modulation of oxidative stress responses.
DISCUSSION AND CONCLUSION: Our findings provide a foundation for understanding the molecular effectsof CAP and its potential in developing novel therapeutic strategies for melanoma.These studies clarify CAP’s beneficial impacts on skin health and potential carcinogenic risks, providing robust scientific data for future applications.

INTRODUCTION: Tetanus is a vaccine-preventable disease; however, approximately one million new cases of tetanus are reported worldwide each year. As a result of successful vaccination policies in developed countries, tetanus cases are observed in individuals who are not vaccinated or who have not completed the vaccination schedule. The aim of this study is to determine the quantitative tetanus antibody levels in patients admitted to our hospital and to analyse the correlation between age, sex and antibody levels.
METHODS: The study included the serum of 408 adult patients over 18 years of age who were admitted to the outpatient clinics and services of our hospital between 01/01/2022 and 06/08/2024. Tetanus IgG antibody levels were quantitatively determined using the VIRCLIA ELISA device (Vircell, Spain) using the Tetanus VIRCLIA® IgG ELISA kit (Vircell, Spain) in the serum of patients arriving at our medical microbiology laboratory. The data analyzed with the SPSS (Statistical Package for Social Sciences) 20.0 package program. The conformity of the numerical data to the normal distribution was examined by visual (histogram) and analytical methods (Kolmogorov-Smirnov test). Mann Whitney U test was performed for pairwise comparisons in groups with significant differences between them. The statistical significance level for all tests was accepted as p<0,05.

RESULTS: The mean ± standard deviation values of the ages of the adults included in the study were determined as 40.07±15.10. 233 (57.1%) of patients were female. In our study, non-protective tetanus antibody levels of <0.1 IU/mL were detected in 25 adults (6.1%) and protective tetanus antibody levels of ≥0.1 IU/mL were detected in 383 adults (93.9%). The median tetanus antibody level was 1.12 IU/mL in men and 0.99 IU/mL in women. However, there was no statistically significant difference between the sexes (p>0,447). A negative correlation was found between age and antibody level above 40 years of age (r=-0,334; p=0,001).

DISCUSSION AND CONCLUSION: In our study, lower tetanus antibody levels were found in older ages, and antibody monitoring should be performed at older ages and a tetanus booster dose should be administered if necessary.

INTRODUCTION: This study aims to describe characteristics of poisonings in patients who were treated with extracorporeal methods between January 01, 2011 and December 31, 2017 in Dokuz Eylul University Drug and Poison Information Center (DEUDPIC).
METHODS: This cross-sectional and descriptive study included patients who received extracorporeal treatment for poisoning. The data were obtained from the hospital automation system, extracorporeal treatment unit forms, and DEUDPIC forms. The severity was classified using the Poisoning Severity Score, and Glasgow Coma Scores (GCS) were recorded. Statistical analyses involved Kolmogorov-Smirnov tests for normality, Student’s t-test for parametric comparisons, and Mann-Whitney U test for non-parametric data. Risk factors for mortality in specific common drug toxicities are determined using logistic regression analysis. Analyses were conducted using SPSS-24.

RESULTS: A total of 75 cases participated in the study. The mean age was 51.5±19.7 years, with 60% of cases being male. Methanol (37.3%), lithium (18.7%), carbamazepine (10.7%), and digoxin (6.7%) caused the most poisonings, respectively. Extracorporeal treatment was used for “increasing the elimination of the substance exposed” in 74.7% of the cases for “renal support” in 25.3%, and the method was hemodialysis in all. Specific antidote treatment was applied to 29.3% of all cases and 67.9% of methanol poisonings. The most common complication of hemodialysis was hypotension (28%). A majority of the patients (73.3%) necessitated intensive care unit support. Three patients recovered with sequelae (4%), and 21 (28%) died. Among patients who suffered from methanol poisoning, pH<7.00, serum creatinine (SCr)>1.2 mg/dL, and lower GCS were associated with mortality in univariate analysis. In the multivariate regression analysis, the sole independent predictor of mortality was found to be the GCS (OR 0.62, 95% CI 0.39-0.99, p=0.05).
DISCUSSION AND CONCLUSION: Despite adequate hemodialysis, mortality rate is high in the setting of common drug poisonings. A low GCS is the only independent predictor of mortality in the setting of methanol poisoning.

INTRODUCTION: Reimbursement methods are important for the provision and continuity of health services. Reimbursement methods significantly affect elements such as quality and efficiency in the provision of health services. In addition, the size and diversity of the services provided by health institutions are also affected by reimbursement systems.Although there are many different reimbursement mechanisms for health service providers, case-based payment-DRG (Diagnosis Related Groups) is among the reimbursement methods used in terms of efficient use of resources and reimbursement according to costs. In this respect, reimbursement methods are explained in general terms in the study and the case-based-DRG method is discussed in detail.
METHODS: In the study, case mix indexes (CMI) were calculated with the DRG data of 27 hospitals located in Ankara. The hospitals studied were evaluated according to their role groups and the severity levels and cost requirements of the cases were compared. In addition, the actual allocations sent according to the global budget in the studied hospitals were compared with the budget allocations formed according to the DRG-CMI and the differences between them were emphasized. The findings obtained as a result of the study indicate that reimbursement based on case-by-case basis is important for the financial sustainability of healthcare providers.
RESULTS: BMI values ​​of Group A hospitals were higher than Group B and C hospitals and A role group hospitals among the hospitals located in Ankara were affected negatively as role group by failure to perform planning according to DRG-CMI in 2023. C role group hospitals are the hospitals most positively affected. If planning were performed according to DRG-CMI the allowance distribution table of the hospitals would be formed very differently. Since the allowance planning performed according to DRG-CMI takes into consideration the complexity and costs of the cases, it shall lead to a more correct allowance distribution for A group hospitals compared to B and C group hospitals.
DISCUSSION AND CONCLUSION: The Ministry of Health hospitals in the province of Ankara were analyzed by being divided according to the DRG data and role groups and CMI calculations were performed in this study. As expected, CMI values of A role group hospitals were found higher compared to the B and C group hospitals. In the case that reimbursement is made according to DRG-CMI, it is observed that A role group hospitals dealt with more severe and complex cases compared to the other role groups and needed higher allowance in terms of source requirement.

INTRODUCTION: Blood donation is a life-saving activity. However, it is indispensable to protect the health of blood donors during and after the donation process. This study aimed to evaluate investigate the effect of blood donation on thiol/disulfide homeostasis by the new automated colorimetric method that measures native thiol (NT), total thiol (TT), disulfide and ischemia-modified albumin levels.

METHODS: A total of 30 voluntary blood donors who were eligible to donate blood were enrolled in this study. Peripheral venous blood samples were collected just before and after 30 minutes blood donation. Demographic data (age, sex, weight, height), and the number of blood donations within one year period of donors, were recorded. Individuals were classified into four age groups: Group 1, 18-30; Group 2, 31-40; Group 3, 40 and over. A repeat donor was defined as a donor who has donated blood at least once in the past. Body-Mass Index (BMI) measurement was calculated by use of the formula weight (kg)/height (m2). Donors were classified according to their BMI values as <25 and ≥25. Test parameters of the dynamic thiol/disulfide homeostasis (TDH) were measured by the automated spectrophotometric method.

RESULTS: Nineteen of the individuals were first-time donor and the others were repeat donors. There were no significant differences in TDH parameters after blood donation. The IMA levels of repeat blood donors were statistically significantly higher after blood donation while other parameters of THD were not (p=0.04). Statistically significant decreases were found in the levels of native and total thiol in the 18-30 age group donors (p=0.03).
DISCUSSION AND CONCLUSION: Test results of this study showed that blood donation does not cause oxidative stress. Further studies designed with the participation of more blood donors needed to be conducted to present more clearly the association between blood donation and oxidative stress. Considering that blood donation has no adverse effects on human health is considerably valuable in terms of encouraging people to donate blood.

INTRODUCTION: This study aimed to evaluate the incidence, risk factors, causative microorganisms, and antibiotic resistance patterns of healthcare-associated infections (HAIs) over a six-year period in a tertiary physical medicine and rehabilitation hospital.
METHODS: In this retrospective study, the medical records of 9,139 patients hospitalized between January 1, 2017, and December 31, 2022, in a 210-bed tertiary physical medicine and rehabilitation hospital were reviewed. HAIs were defined according to the National Healthcare-Associated Infections Surveillance Diagnostic Guideline of the Directorate General of Public Health, Ministry of Health of the Republic of Türkiye.
RESULTS: During the study period, 179 patients developed HAIs. The incidence of HAIs was 1.95, and the incidence density was 0.56. The majority of patients were male (82.7%), with a median age of 40 years. The most common diagnoses were spinal cord injury (62%) and stroke/traumatic brain injury (15.2%). Of the HAIs, 92.2% were urinary tract infections (UTIs) and 7.8% were skin and soft tissue infections. The most frequently isolated microorganism was Escherichia coli (E. coli) (52.5%). Multidrug-resistant organisms accounted for 27.9% of isolates. Over the six-year period, a decreasing trend in HAI incidence density was observed; the incidence density of catheter-associated UTIs decreased by 67%, while the standardized infection ratio (SIR) declined from 1.6 in 2017 to 0.6 in 2022. This reduction was associated with infection control measures such as regular staff training, improved compliance with hand hygiene, implementation of national infection prevention bundles, antimicrobial stewardship, daily catheter assessments, and timely removal of unnecessary catheters.
DISCUSSION AND CONCLUSION: HAIs are common in physical medicine and rehabilitation centers, and this is particularly pronounced among patients with neurological disorders. The most frequent type of infection is UTI, with urinary catheter use being the main modifiable risk factor. E. coli was the most frequently isolated pathogen, and multidrug resistance remains a major concern. The decline in infection rates underscores the importance of infection control measures that are implemented effectively and continuously in rehabilitation hospitals.

INTRODUCTION: Many anticancer agents exhibit limited therapeutic efficacy due to high systemic toxicity or rapid elimination by the reticuloendothelial system. Therefore, nanocarrier systems that enable drug targeting directly to tumor tissue have become a significant research area in recent years. The aim of this study was to prepare and characterize methoxy polyethylene glycol-block-polycaprolactone (mPEG-b-PCL)-based doxorubicin (DOX)-loaded micelles (DOXld-M) and micelles formed by covalent conjugation of DOX (DOXconj-M), and to compare the biological effects of these systems on MDA-MB-231 breast cancer cells.
METHODS: DOX was either loaded directly onto mPEG-b-PCL micelles (DOXld-M) or covalently conjugated to hydrazide-functionalized mPEG-b-PCL (DOXconj-M), resulting in micelle formation. The physicochemical properties and drug release profiles of the micelles were determined. At the cellular level, their effects on cytotoxicity, cell internalization, cell migration, and colony formation were evaluated in MDA-MB-231 cells. Apoptotic responses were investigated using flow cytometry, qRT-PCR, mitochondrial transmembrane potential measurements, and reactive oxygen species (ROS) assays. Furthermore, the anti-angiogenic effects of both micelle formulations were investigated in a co-culture system with HUVEC cells.
RESULTS: Both micelle types exhibited faster drug release under acidic conditions compared to neutral conditions, offering a therapeutic advantage given the acidic nature of the tumor microenvironment. DOX conjugation provided more controlled and slower drug release compared to loading. Drug-free micelles did not exhibit any cytotoxicity. The natural fluorescence of DOX confirmed that the micelles were effectively internalized by the cells. All DOX-containing micelles significantly suppressed proliferation and migration in MDA-MB-231 cells. In particular, DOXld-M was characterized by an increase in the proportion of apoptotic cells, a significant increase in Bax and p53 gene expression, a significant decrease in Bcl-2 and Bcl-xL expression, and an increase in ROS production. Both micelle formulations decreased mitochondrial membrane potential and triggered apoptosis induction.
DISCUSSION AND CONCLUSION: The results indicate that DOXld-M was more effective than DOXconj-M in inducing apoptosis and inhibiting proliferation of MDA-MB-231 cells. These findings suggest that mPEG-b-PCL-based DOX-loaded micelles may be promising nanocarrier systems for cancer therapy.

INTRODUCTION: Cancer is one of the most significant health problems in both developed and developing countries today. Most of the currently available anticancer drugs can cause severe side effects and toxicities, which negatively affect patients’ quality of life. Therefore, the development of safer and more selective anticancer agents remains one of the primary goals of contemporary oncology research. In recent years, the cytotoxic and antiproliferative effects of various pharmacological agents on different cancer cell lines have been extensively studied. This study aimed to investigate the potential anticancer effects of the Climbazole (CBZ) derivative, Climbazole-alcohol, on different human-derived cancer cell lines (HT-29, MKN28, A549, MDA-MB-231) and a normal control cell line (HEK293) under in vitro conditions.
METHODS: CBZ was reduced to Climbazole-alcohol according to previously reported procedures, and the structure was confirmed by ¹H-NMR spectroscopy. Human cancer cell lines (HT-29, MKN28, A549, MDA-MB-231) and the normal HEK293 cell line were cultured under standard conditions at 37°C in a humidified atmosphere containing 5% CO2. Cells were treated with various concentrations of Climbazole-alcohol for 72 hours. Cytotoxicity was assessed using the MTT assay, and IC50 values were determined using GraphPad Prism software.
RESULTS: Climbazole-alcohol induced a mild decrease in cell viability in all tested cell lines but did not exhibit a significant cytotoxic effect. The calculated IC50 values were 179.2 µM for HT-29, 168.1 µM for MKN28, 164.1 µM for A549, 158.6 µM for MDA-MB-231, and 169.8 µM for HEK293. No statistically significant difference was observed between cancer and normal cell lines (p>0.05).
DISCUSSION AND CONCLUSION: Climbazole-alcohol did not display selective anticancer activity within the tested concentration range. The findings indicate that this compound lacks cancer-specific cytotoxicity, suggesting limited potential as an anticancer agent. Future studies should focus on structural modifications or combination therapies to enhance its anticancer properties.

Streptococcus constellatus (S. constellatus) is a Gram-positive, non-spore-forming, immobile, and catalase-negative coccus. Its growth is enhanced in the presence of CO2, while growth is reduced under aerobic conditions, with some strains requiring anaerobic conditions for optimal growth. A member of the Streptococcus anginosus group (SAG), S. constellatus is naturally found in the flora of the oral cavity, gastrointestinal system, and urogenital system. Although typically considered a commensal organism, it can become an opportunistic pathogen in immunocompromised individuals, leading to severe invasive infections. Among these infections, empyema is rare, with only a limited number of case reports in the literature. This study presents the first reported case from the Nakhchivan region. This study presents a rare case of empyema caused by S. constellatus in a healthy individual. The patient presented with classical symptoms of bacterial empyema, including fever, chest pain, and shortness of breath. During the diagnostic process, microbiological investigations confirmed that the cause of the infection was S. constellatus. “Microbiological culture analysis revealed that the isolated bacterium exhibited beta-hemolytic properties; following antibiotic susceptibility testing, an effective targeted treatment protocol was established. With appropriate antibiotic selection, the infection was quickly controlled, and the patient experienced rapid clinical improvement.” This case emphasizes the need to consider S. constellatus as a rare cause of empyema and highlights the importance of early diagnosis in such cases. Early diagnosis plays a critical role not only in controlling the infection but also in optimizing the response to treatment. In conclusion, this case report underscores the importance of recognizing S. constellatus as an agent of empyema, contributing a rare infection to the literature. Furthermore, it addresses the challenges encountered in the diagnosis and treatment of such infections and provides significant contributions to clinical practice. This case reiterates the necessity of considering atypical pathogens in the management of serious infections like empyema.

One Health is a holistic and integrative approach aimed at optimizing the health of humans, animals, and ecosystems in a sustainable harmony. This approach recognizes the close interconnections between human, animal, plant, and environmental health. This paper seeks to highlight the significance of the One Health approach for public health and to discuss successful case studies worldwide. To conduct this study, a thorough review of literature and resources on PubMed and Google Scholar databases was undertaken. Institutional websites of major health and environmental organizations such as WHO, CDC, FAO, UNEP, WOAH, PAHO, the European Commission, FDA, the Turkish Medical Association, the Association of Veterinary Physicians, the Association of Public Health Specialists, the Ministry of Health, and the Ministry of Agriculture and Forestry were examined. Relevant action plans and prominent global texts on the subject were reviewed. In critical areas impacting public health—such as emerging infectious diseases, re-emerging infections, vector-borne diseases, antimicrobial resistance, food safety and security, environmental health, and climate change—the One Health approach facilitates a comprehensive assessment of information, allowing for early risk identification, preventive measures, and enhanced control strategies. Due to the close interrelationship between human, animal, and environmental health, as well as the complex nature of health issues, achieving lasting solutions to common health problems requires a transdisciplinary, holistic approach rather than isolated solutions from individual disciplines. Sustainable solutions for shared health problems require moving beyond isolated, discipline-specific solutions to establish an integrative approach that involves multiple disciplines. For the successful implementation of this approach, it is essential to establish local and national frameworks, led by public authorities, to integrate systems and ensure community engagement. These integrated structures should prioritize the main issues that can be addressed under the One Health framework. An intervention plan, developed with insights from academics across relevant disciplines, should address these priority issues. Following implementation in pilot regions, gaps should be identified and adjustments made to expand the plan nationally. This paper explores the development of the One Health concept, its parallels and complementary aspects with public health, and highlights exemplary practices worldwide.