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    Distribution of the Prevalence of Human Leukocyte Antigen (HLA)-B*57:01 Positivity in HIV-1 Infected Individuals and Its Effects on Treatment: Türkiye Map-Buhasder Working Group
    (Ankara Microbiology Soc, 2024) Buyuktuna, Seyit Ali; Oksuz, Caner; Tahmaz, Alper; Sarigul Yildirim, Figen; Turken, Melda; Gunal, Ozgur; Topal, Seyma
    Human immunodeficiency virus (HIV)/acquired immundeficiency syndrome (AIDS) is a critical global public health problem that significantly affects both life expectancy and the overall quality of life of in dividuals in all age groups. The landscape of HIV infection has changed significantly in recent years due to the introduction of effective combination antiretroviral therapies (ART). A key component of first -line ART regimens for HIV treatment is abacavir, a nucleoside HIV reverse transcriptase inhibitor. Although ab acavir is effective in suppressing viral replication and managing disease, its clinical utility is overshadowed by the potential for life -threatening hypersensitivity reactions in HLA-B*57:01-positive patients. In our country, local data obtained from various centers regarding the prevalence of HLA-B*57:01 in HIV -1 -infected patients are available. In this study, it was aimed to determine the prevalence of the HLA-B*57:01 genotype in HIV -infected patients who were followed up and treated in many regions of our country. This retrospective study consists of the data of the patients aged 18 years and over diagnosed with HIV -1 infection between 01.01.2019 and 31.07.2022. Age, gender, place of birth, mode of transmission of the disease, death status, CD4+ T cell count and HIV RNA levels at the first clinical presentation, HLA-B*57:01 positivity, and the method used, clinical stage of the disease, virological response time with the treatment they received were recorded from the patient files. Data were collected from 16 centers and each center used different methods to detect HLA-B*57:01. These methods were sequence -specific oligonucleotide probe hybridization (SSOP), DNA sequence -based typing (SBT), single -specific primer-polymerase chain reaction (SSP-PCR), allele -specific PCR (AS-PCR) and quantitative PCR (Q-PCR). A total of 608 HIV -infected individuals, 523 males (86%) and 85 females (14%), were included in the study. The mean age of the patients was 36.9 +/- 11.9 (18-73) years. The prevalence of HLA-B*57:01 allele was found to be 3.6% (22 patients). The number of CD4+ T lymphocytes in HLA-B*57:01 allele -positive patients was > 500/ mm(3) in 10 patients (45.5%), while the number of CD4+ T lymphocytes in HLA-B*57:01 negative pa- tients was > 500/mm(3) in 216 patients (36.9%) (p> 0.05). Viral load at the time of diagnosis was found to be lower in patients with positive HLA-B*57:01 allele but it was not statistically significant (p> 0.05). Although different treatment algorithms were used in the centers following the patients, it was observed that the duration of virological response was shorter in HLA-B*57:01 positive patients (p= 0.006). Although the presence of the HLA-B*57:01 allele has a negative impact due to its association with hypersensitivity, it is likely to continue to attract interest due to its association with slower progression of HIV infection and reduced risk of developing AIDS. In addition, although the answer to the question of whether it is cost-effective to screen patients for HLA-B*57:01 before starting an abacavir-containing ART regimen for the treatment of HIV infection is being sought, it seems that HIV treatment guidelines will continue to recommend screening to identify patients at risk in this regard.
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    Regulatory nexus in inflammation, tissue repair and immune modulation in Crimean-Congo hemorrhagic fever: PTX3, FGF2 and TNFAIP6
    (Walter De Gruyter Gmbh, 2025) Hasbek, Mursit; Cakir Kiymaz, Yasemin; Oksuz, Caner; Ertuerk Zararsiz, Goezde; Ipekten, Funda; Buyuktuna, Seyit Ali
    Objectives This study emphasizes the importance of determining the serum levels of pentraxin-3 (PTX3), fibroblast growth factor-2 (FGF2), and tumor necrosis factor-stimulated gene-6 (TNFAIP6) in patients with Crimean-Congo hemorrhagic fever (CCHF).Methods This prospective study involved 30 confirmed CCHF patients and 30 healthy controls. Serum concentrations of PTX3, FGF2, and TNFAIP6 were quantified utilizing a quantitative sandwich ELISA method.Results CCHF patients exhibited markedly elevated PTX3 levels, reflecting an acute inflammatory response. As a long pentraxin, PTX3 functions as a pattern recognition receptor that activates the complement system to aid in pathogen clearance. Additionally, FGF2 levels were significantly increased, indicating a potential role in repairing endothelial damage. Known for promoting angiogenesis and immune regulation, FGF2 may counteract endothelial dysfunction induced by CCHF. Conversely, TNFAIP6 levels were lower in patients, possibly due to shifts in cytokine activity that suppress its anti-inflammatory and extracellular matrix-regulating effects, potentially leading to greater tissue injury.Conclusions The dysregulation of PTX3, FGF2, and TNFAIP6 in CCHF patients signifies a disrupted equilibrium in inflammatory and vascular response mechanisms. This triad of biomarkers could serve as a valuable tool for assessing the severity of CCHF and may present therapeutic targets for modulating inflammation and mitigating endothelial damage. Achieving a balance among PTX3, FGF2, and TNFAIP6 could be instrumental in alleviating disease complications, thereby suggesting a potential therapeutic strategy for managing CCHF effectively.
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    Secondary infections after cytotoxic chemotherapy in patient with hematological malignancies
    (J Infection Developing Countries, 2017) Buyuktuna, Seyit Ali; Saba, Rabin; Gozel, Mustafa Gokhan; Turhan, Ozge; Inan, Dilara; Asik, Zahide; Kose, Adem
    Introduction: This study was initiated to investigate the risk factors of secondary infections in febrile neutropenic patients following chemotherapy, and to evaluate the clinical, microbiological, and mortality outcomes of these infections. Methodology: An evaluation was done on all patients with hematological malignancy who developed a febrile neutropenic episode (FNE) after cytotoxic chemotherapy in the Department of Hematology, Akdeniz University Faculty of Medicine, between January 2007 and December 2008. Results: A total of 294 primary FNEs that responded to the initial empirical or targeted treatment were included in the study, and secondary infections developed after 72 (24.5%) of 294 primary FNEs. Risk factors for secondary infections were determined as acute leukemia as the underlying disease, salvage chemotherapy for refractory/relapse diseases, prolonged neutropenia (10 days and over), Multinational Association of Supportive Care in Cancer (MASSC) score < 21, and fungal infection during the primary episode. The mortality rate of patients who developed secondary infections was significantly higher compared to patients without secondary infections (27.8% and 5.4%, respectively; p = 0.001). Conclusions: The development of secondary infections in patients with hematological malignancy was not very rare. Greater concern should be shown for these infections to increase patient survival rates.