Reyhan Caliskan

Background: HIV has been a major global health issue since the 1980s. The proportions of diagnosed and undiagnosed infections are important indicators of HIV control. This study investigated the prevalence and characteristics of HIV based on blood samples from patients presenting for diagnosis and treatment at a tertiary healthcare hospital in the Central Black Sea Region over a four-year retrospective period. Methods: We retrospectively evaluated 271,367 samples submitted for anti-HIV serology testing for pre-operative screening or clinical suspicion between 2020 and 2023. HIV-1/2 antibodies and p24 antigen were screened using chemiluminescence microparticle immunoassay (CMIA), and reactive samples were confirmed by real-time RT-PCR. HIV RNA results and immunological parameters were also analyzed. Results: Among 271,367 samples, 694 were HIV-positive, yielding a prevalence of 0.25%. Of 2207 individuals tested for HIV RNA, 699 (31.7%) were positive. HIV RNA positivity was higher in men than women (35.5% vs. 18.6%). Absolute CD4+ T-cell counts were similar between genders, while the CD4/CD8 ratio was significantly higher in women. Both CD4+ T-cell counts and CD4/CD8 ratios increased significantly after three months of treatment. Conclusions: This study demonstrates a low but increasing HIV seroprevalence in the region, with a clear predominance among males and young adults. The findings also reflect effective viral suppression among treated patients and significant immunological recovery after therapy, providing important regional data to guide HIV monitoring and public health interventions.

Background: The COVID-19 pandemic underscored the critical importance of hygiene, particularly among high-risk populations such as haemodialysis patients. Maintaining strict hygiene and infection-control measures is therefore vital for this group. However, excessive hygiene routines may also affect patients’ daily lives and overall well-being. In this study aims to determine the personal protective attitudes of hemodialysis patients during the COVID-19 pandemic and the impact of increased hygiene behaviors on quality of life. Methods: A cross-sectional study was conducted between December 2021 and January 2022 in three dialysis centres across Türkiye with 383 adult haemodialysis patients. Data were collected face-to-face interviews using the COVID-19 Hygiene Scale and the COVID-19 Impact on Quality of Life Scale. Statistical analyses included Chi-square, Kruskal–Wallis, Mann–Whitney U, and Pearson correlation tests, with p < 0.05 considered significant. Results: Female patients scored significantly higher than males in “changed hygiene behaviours”, “home hygiene”, and “hygiene after returning home”. Participants younger than 65 years showed greater adherence to hygiene practices after returning home. Higher income levels were associated with better compliance with “social distancing and mask use” and “shopping hygiene”. There was a negative correlation between the quality of life scale and hygiene behaviors. Conclusions: Haemodialysis patients demonstrated strong adherence to hygiene measures during the COVID-19 pandemic; however, excessive hygiene behaviours were negatively associated with quality of life. These findings highlight the importance of adopting balanced, patient-centred infection-control strategies that support both behavioural adherence and overall well-being. Clinical trial number: Not applicable.

Introduction. Aspergillosis represents a significant global health threat, with increasing concerns about azole resistance. Hypothesis/Gap Statement. There is limited evidence on the prevalence and distribution of azole resistance among clinical Aspergillus isolates. Aim. This study investigated the prevalence of azole resistance in clinical Aspergillus isolates and evaluated different susceptibility testing methods. Methodology. A total of 125 Aspergillus spp. isolates were collected from clinical samples (abscess, corneal abscess, biopsy, tissue and respiratory samples). Species identification was performed using conventional morphological methods and Matrix assisted laser desorption Ionization time of flight massspectrometry (MALDI-TOF) MS. Azole susceptibility testing was conducted using the gradient test (E-test), the agar plate screening method and broth microdilution for voriconazole (VOR), itraconazole (ITR) and posaconazole (POS). Molecular analysis was performed to detect cyp51A gene mutations associated with resistance. Results. Among 125 isolates, species distribution was 44% Aspergillus fumigatus , 33.6% Aspergillus flavus , 5% Aspergillus terreus , 3% Aspergillus niger and 14% Aspergillus spp. Using gradient testing, A. fumigatus showed 1.8% resistance to VOR, 5.45% to ITR and 1.8% to POS, with one isolate resistant to all azoles. A. terreus showed 16.7% resistance to VOR, A. niger 25% resistance to ITR and Aspergillus spp. showed various resistance patterns. The agar plate method detected resistance with 100% susceptibility/specificity for non-fumigatus species but 33.3% susceptibility for A. fumigatus ITR resistance. CypA-L98H mutations were detected in six isolates and CypA-M220 mutations in seven isolates. Conclusion. This study confirms the presence of azole resistance in clinical Aspergillus isolates with species-specific variations. The agar plate screening method shows promise for non-fumigatus species but requires optimization for A. fumigatus .

Background: Recent evidence suggests that the human stomach hosts a diverse microbiota beyond Helicobacter pylori , and that shifts in microbial composition may influence gastric health. In particular, oral-origin bacteria may dominate the gastric niche in the absence of H. pylori , yet their specific roles in different gastroduodenal disorders remain unclear. This study aimed to profile and compare the gastric microbiota composition in Turkish patients with non-ulcer dyspepsia (NUD) and peptic ulcer disease (PUD), in order to better understand microbial profiles potentially associated with gastroduodenal disease. Methods: Ninety-eight patients underwent endoscopic evaluation and were divided into two groups according to the presence or absence of ulcers. Group 1 ( n = 52) included individuals with NUD, while Group 2 ( n = 46) comprised patients with PUD. Gastric biopsy samples from both groups were analyzed for the relative abundance of H. pylori using quantitative real-time PCR (qPCR), and next-generation sequencing was employed for a comprehensive analysis of the gastric microbiota. Results: In total, H. pylori DNA was detected in 71.4% (70/98) of the samples, with a significantly higher prevalence in PUD patients (82.6%) compared to NUD patients (61.5%) ( p = 0.02). Distinct microbial profiles were observed based on H. pylori status. In NUD patients, Alloprevotella showed significantly higher relative abundance in H. pylori -negative samples ( p < 0.05). Among PUD patients, the absence of H. pylori was associated with increased levels of Porphyromonas and Neisseria compared to NUD patients without H. pylori ( p < 0.05). These genera, typically associated with the oral cavity, appeared to expand opportunistically when H. pylori was absent. Conclusions: The absence of H. pylori in gastric disorders was linked to a notable shift in microbiota composition, with increased representation of oral-origin bacteria such as Alloprevotella , Porphyromonas , and Neisseria . These findings, observed in a Turkish patient cohort, may reflect a potentially compensatory or opportunistic microbial shift in H. pylori -negative gastroduodenal disease. As exploratory findings, this study represents the first analysis from Türkiye comparing gastric microbiota profiles in NUD and PUD patients and provides novel regional insight into gastric microbial ecology.

Background/Objectives: Schizophrenia (SCH), bipolar disorder (BPD), and major depressive disorder (MDD) are increasingly viewed as neuroimmune disorders shaped by viral exposure and inflammation. Disorder-specific immunovirological profiles, however, remain poorly defined. Methods: In this cross-sectional study, we assessed Epstein–Barr Virus (EBV) and Herpes Simplex Virus type 1 (HSV-1) seropositivity and measured serum CRP, IL-6, and IL-1β in 708 participants: 110 with SCH, 121 with BPD, 135 with MDD, and 342 healthy controls (HC). Statistical analyses included Shapiro–Wilk tests for normality; Kruskal–Wallis with Bonferroni-adjusted Dunn post hoc comparisons; and logistic regression adjusted for age, sex, and marital status. Results: EBV seropositivity was higher in SCH (90.9%) than in HC (78.9%) (OR = 3.46, 95% CI: 1.68–7.12; p = 0.001) but not in BPD or MDD. HSV-1 seropositivity was elevated in BPD (83.5%) versus HC (67.0%) (OR = 2.29, 95% CI: 1.34–3.92; p = 0.003), with no differences in SCH or MDD. Inflammatory biomarkers were significantly increased in SCH and MDD compared to HC (p < 0.001), while BPD showed no differences. Conclusions: The findings delineate distinct immunovirological patterns across major psychiatric disorders. Schizophrenia was characterized by EBV seropositivity accompanied by systemic inflammatory activation, bipolar disorder by HSV-1 seropositivity in the absence of inflammatory changes, and major depressive disorder by inflammatory dysregulation independent of viral exposure. These disorder-specific profiles highlight heterogeneity in neuroimmune pathways and underscore the potential relevance of biomarker-based stratification for generating hypotheses regarding targeted antiviral or anti-inflammatory interventions in psychiatric populations.

Azole-resistant mycotic infections pose an escalating global health threat, with an estimated 6.5 million invasive fungal infections (IFIs) annually leading to 3.8 million deaths, 68% directly caused by IFIs. While azole antifungals are the cornerstone of treatment, emerging resistance, mainly due to gene mutations and efflux pump overexpression, is a major concern. This study, spanning 2015–2023, investigated azole resistance in clinical Aspergillus isolates in Turkey, a region lacking comprehensive surveillance. Of 200 causative isolates, A. fumigatus accounted for 45% and respiratory samples 57%. Overall azole resistance was 7%, rising to 11% for A. fumigatus. Findings highlight the persistent challenge of azole resistance, emphasizing the critical need for continued local and global surveillance to inform treatment guidelines and public health interventions. Despite limitations, including a single-center focus, this research provides crucial epidemiological insights into the evolving landscape of antifungal resistance in Turkey.

Background: Theophylline, which is biologically important and found in tea, coffee, and cocoa beans, can be synthesized chemically or by direct extraction and concentration from natural sources. Theophylline derivatives have garnered attention in recent years for their potential therapeutic effects on Mycobacterium tuberculosis, antihistaminic, anti-inflammatory, and anticancer. Also, trifluoromethyl (CF₃) group has also been widely used in drug and agrochemical design. Methods: In this study, a series of new theophylline derivatives containing substituted trifluoromethyl and trifluoromethoxy groups were synthesized. The structures of these new compounds were confirmed by NMR, FT-IR, and elemental analyses. Additionally, the anticancer activities of the molecules were analyzed against VEGFR-2, CYP P450, and estrogen receptor by molecular docking method. Furthermore, in vitro biological effects of the compounds were comprehensively evaluated in cancer (A549 and HeLa) and normal (BEAS-2B) cells. Cell viability was assessed by MTT assay, and selectivity index (SI) values were calculated to determine tumor-specific toxicity. Results: N(7)-substituted theophyllines were prepared by the reaction of 1,3-dimethyl-3,7-dihydro-1H-purine-2,6-dione (theophylline) and trifluoromethyl substituted benzyl halide compounds. The synthesized N(7)-substituted theophyllines were obtained as white powder in high yield. The structure of synthesized compounds was confirmed by various spectroscopic techniques such as ¹H, ¹³C, ¹⁹F NMR, and FT-IR spectroscopy, and elemental analysis. The highest interaction was recorded as −5.69 kcal/mol for 3-CF₃ substituted against VEGFR-2 structure while the best binding affinity was determined for 4-OCF₃ substituted with −6.69 kcal/mol against Human Cytochrome P450 with in silico analysis. The in vitro anticancer activities of the molecules were also evaluated against A549 and HeLa cells, and displayed considerably higher cytotoxicity with 2-CF₃, 3-CF_3, and 4-CF₃ substituted molecules in Hela and A549 cell line. To elucidate the molecular mechanism, apoptosis-related gene expression changes were analyzed by RT-qPCR in A549 and HeLa cells treated with compound 2-CF₃. Significant upregulation of pro-apoptotic markers and downregulation of anti-apoptotic genes were observed. Consistently, ELISA-based quantification confirmed increased protein levels of Caspase-3, BAX, and Cytochrome C, and decreased BCL-2, validating the apoptotic mechanism at the protein level. Also, the antibacterial and antibiofilm activity details of the molecules were evaluated against DNA Gyrase, and SarA crystal structures by molecular docking method. The highest interaction was recorded as −5.56 kcal/mol for 2-CF₃ substituted with H-bonds with Asn46, Val71, Asp73, and Thr165 against DNA Gyrase crystal structure while 3-CF₃ substituted has the best binding affinity against SarA. The in vitro antimicrobial effects of the molecules were also evaluated. Conclusions: The synthesized molecules may provide insight into the development of potential therapeutic agents to the increasing antimicrobial resistance and biofilm-forming capacity of microorganisms. Additionally, compound 2-CF₃ substituted exhibited promising and selective anticancer activity through apoptosis induction, supported by gene and protein level evidence.

Background and Objectives: Helicobacter pylori infection is associated with chronic gastritis, ulcers, and gastric cancer. The H. pylori Type 4 secretion system (T4SS) translocates the CagA protein into host cells and plays an essential role in initiating gastric carcinogenesis. The CagL protein is a component of the T4SS. CagL amino acid polymorphisms are correlated with clinical outcomes. We aimed to study the association between CagL amino acid polymorphisms and peptic ulcer disease (PUD) and non-ulcer dyspepsia (NUD). Materials and Methods: A total of 99 patients (PUD, 46; NUD, 53) were enrolled and screened for H. pylori by qPCR from antrum biopsy samples. The amino acid polymorphisms of CagL were analyzed using DNA sequencing, followed by the MAFFT sequence alignment program to match the amino acid sequences. Results: Antrum biopsy samples from 70 out of 99 (70.7%) patients were found to be H. pylori DNA-positive. A positive band for cagL was detected in 42 out of 70 samples (PUD, 23; NUD, 19), and following this, these 42 samples were sequenced. In total, 27 different polymorphisms were determined. We determined three CagL amino acid polymorphism combinations, which were determined to be associated with PUD and NUD. Pattern 1 (K35/N122/V134/T175/R194/E210) was only detected in PUD patient samples and was related to a 1.35-fold risk (p = 0.02). Patterns 2 (V41/I134) and 3 (V41/K122/A171/I174) were found only in NUD patient samples and were linked to a 1.26-fold increased risk (p = 0.03). Conclusions: We observed three new patterns associated with PUD and NUD. Pattern 1 is related to PUD, and the other two patterns (Patterns 2 and 3) are related to NUD. The patterns that we identified include the remote polymorphisms of the CagL protein, which is a new approach. These patterns may help to understand the course of H. pylori infection.