Serkan Şahin

Objective: This study aimed to evaluate the distribution of uropathogens, their antibiotic susceptibility patterns, and the appropriateness of antibiotic prescriptions in hospitalized patients with urinary tract infections (UTIs) within the framework of rational drug use (RDU). Materials and Methods: This retrospective descriptive study included 1,097 inpatients diagnosed with UTIs at Yozgat City Hospital between January and December 2023. Microbiological culture results and antibiotic susceptibility profiles were analyzed. Additionally, prescriptions of 378 randomly selected patients were evaluated for compliance with antibiogram results. Statistical analyses were performed using SPSS 23.0. Results: A total of 34 microorganisms were identified, with Escherichia coli (36.95%), Klebsiella pneumoniae (16.88%), and Pseudomonas aeruginosa (9.22%) being the most common. High resistance rates were observed for clindamycin (96.3%), cefoxitin (96.2%), and ampicillin (78.7%). Notably, resistance to commonly used broad-spectrum antibiotics such as ciprofloxacin and ceftriaxone was also high (56.8%). Amikacin (83.7%) and meropenem (62.6%) showed higher susceptibility. Among prescriptions, meropenem (22.8%) was the most frequently used antibiotic. Antibiogram compatibility was 65.2% for E. coli and 32.1% for other microorganisms. Conclusion: A substantial proportion of empirical antibiotic treatments were not aligned with susceptibility results. These findings highlight the urgent need for integrating antibiogram data into clinical decision-making and strengthening antimicrobial stewardship programs to promote rational antibiotic use.

Amaç: İç Anadolu'nun kentsel geçiş kuşağında yer alan Yozgat'ta aile hekimliği polikliniğine başvuran bireylerin sağlıklı yaşam dinamikleri, beslenme örüntüleri, ailesel kronik hastalık öyküleri ve temel biyokimyasal parametreler arasındaki ilişkinin belirlenmesi ana hedeftir. Bu ilişkinin biyokimyasal parametreler üzerindeki bağımsız belirleyicilerin ve aile öyküsünün bireylerdeki kronik hastalık riskine katkısının ortaya konulması da çalışma kapsamında amaçlanmıştır.Gereç ve Yöntemler: Bu kesitsel çalışmaya Yozgat Bozok Üniversitesi Tıp Fakültesi Aile Hekimliği polikliniğine başvuran 486 yetişkin birey dahil edilmiştir. Güç analizi G*Power 3.1 ile gerçekleştirilmiş (α=0,05, güç=%80, w=0,30); minimum örneklem 74 olarak hesaplanmış, çalışma 486 katılımcı üzerinden yürütülmüştür. İstatistiksel analizlerde tanımlayıcı istatistikler, Shapiro-Wilk normallik testi, Pearson ki-kare (Cramér V etki büyüklüğü), bağımsız örneklem t-testi ve Mann-Whitney U testi (Cohen d / sıralı iki seri korelasyon), ikili ve çok değişkenli lojistik regresyon [olasılık oranı (OO), %95 güven aralığı (GA)], Spearman korelasyon matrisi (Bonferroni düzeltmesi), ROC eğrisi analizi (AUC, Youden indeksi J, LR+, LR−) ve hiyerarşik çoklu doğrusal regresyon uygulanmıştır. p<0,05 anlamlı kabul edilmiştir.Bulgular: Katılıımcıların diyabet prevalansı %4,9, hiperlipidemi prevelansı %1,9 iken birinci derece akrabalarda bu oranlar sırasıyla %49,6 ve %27,6'ya yükselmektedir. Aile öyküsü pozitifliği diyabet riskini 4,8 kat (OO=4,82; %95 GA: 2,14-10,86; p<0,001), hiperlipidemi riskini 3,6 kat (OO=3,59; p=0,015) artırmaktadır. Cinsiyete göre biyokimyasal parametreler incelendiğinde hemoglobin farklılığı büyük (Cohen d=1,70), HDL ve kreatinin farklılıkları orta etki büyüklüğü (d=0,62; d=0,79) sergilemiştir. Trigliserid-LDL pozitif korelasyonu (rs=0,42) ve TSH-sT4 negatif korelasyonu (rs=−0,38) bulunmuştur. Birleşik ailesel risk skorunun ROC performansı (AUC=0,79; Youden J=0,52; LR+=2,65; LR−=0,25) klinik kullanılabilirliği desteklemektedir. LDL'nin bağımsız belirleyicileri trigliserid (β=0,38) ve egzersiz durumudur (β=−0,14; toplam R²=0,213). Sonuç: Yozgat popülasyonunda yapılmış bu çalışmada bireysel kronik hastalık prevalansı ulusal ortalamaların altında olmakla birlikte ailesel metabolik risk belirgin düzeyde yüksektir. Birinci basamak sağlık hizmetleri, ailesel öyküyü merkeze alan erken tarama protokolleri ve bireyselleştirilmiş yaşam tarzı müdahale programlarıyla güçlendirilmelidir.

Background/Objectives: Vascular diseases remain a leading cause of global mortality, yet the dietary and lifestyle factors that contribute to them are not fully understood in Central Anatolian populations. This study aimed to quantify the dietary and lifestyle predictors of vascular disease status in a case–control cohort from a tertiary care setting in Yozgat province. Methods: A total of 1452 adults were enrolled from Yozgat Bozok University Research Hospital: Cardiovascular Surgery (CVS; cases, n = 720) and Primary Care (PC; controls, n = 732). All participants completed a 43-item questionnaire on diet, lifestyle, and sociodemographic characteristics. Binary logistic regression was used to identify independent predictors of case status, with age, sex, education, and income being included in the model. Results: Chronic comorbidities were present in 33.9% of the control group and 80.3% of the case group. Use of olive oil was most strongly associated with control status (odds ratio [OR] = 0.17; 95% confidence interval [CI]: 0.11–0.27), followed by use of butter (OR = 0.25). Paradoxically, fast food (OR = 0.24) and junk food (OR = 0.31) consumption were more frequent among controls. The use of sunflower oil (OR = 2.30), diabetes (OR = 5.22), and elevated serum ferritin (OR = 1.04 per 10 ng/mL) independently predicted a higher likelihood of being in the case group. The model explained 54.8% of the variance (Nagelkerke R² = 0.548). Conclusions: The apparently higher prevalence of unhealthy dietary behaviours among controls is most plausibly attributed to post-diagnosis dietary modification among cases (an ‘illness effect’), underscoring the window for intervention before disease onset. As this case–control design precludes causal inference, these associations are hypothesis-generating. Promoting olive oil and reducing sunflower oil represent practical, culturally feasible dietary targets for cardiovascular risk counselling in Central Anatolia, pending prospective confirmation.

Arsenic (As) exposure is known to have harmful effects, prompting the search for effective countermeasures. This study investigated the protective effects of cannabidiol (CBD) against arsenic toxicity in liver cell cultures (THLE-2). The IC50 values for As were determined, finding 10 µM in 2D and 15 µM in 3D cell lines. To assess CBD's protective efficacy, 5 µM of CBD was administered alongside arsenic at its IC50 concentration. The levels of oxidative stress markers, including Glutathione (GSH), malondialdehyde (MDA), myeloperoxidase (MPO), and catalase (CAT), as well as inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6), were measured using ELISA kits. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) analysis was conducted to evaluate As uptake in the cells. The results showed that CBD significantly enhanced cell proliferation and reversed the oxidative stress and inflammatory responses induced by arsenic exposure. Furthermore, CBD effectively reduced arsenic uptake into the cells. These findings provide compelling evidence for CBD's protective role against arsenic-induced toxicity, highlighting its potential as a therapeutic agent in mitigating the harmful effects of arsenic

Current chelation treatments used for cadmium poisoning may cause some serious side effects. Thus, safer novel treatments could be promising for clinical use. This study evaluated the effects of cannabidiol on Cd toxicity. Four groups of 10 mice were formed: Groups I and III were cadmium‐free, while groups II and IV received 50 mg/L cadmium in drinking water. Groups III and IV received daily cannabidiol (25 mg/kg) via intragastric gavage. After 30 days, the animals were killed, and blood and tissue samples were collected. Oxidative stress and inflammation markers, including glutathione, catalase, myeloperoxidase, TNF‐α, IL‐1β and IL‐6, were analysed using ELISA. Additionally, histological evaluations of the liver, kidney and testis were performed. Cadmium exposure reduced glutathione and catalase levels in the blood, liver, kidney and testis, while increasing myeloperoxidase. Cannabidiol mitigated these effects on oxidative stress markers. Cannabidiol also reduced the increase in proinflammatory cytokines. Histopathological analysis revealed reduced liver and kidney damage in cannabidiol‐treated groups compared to cadmium‐only groups. In addition, histopathological evaluation showed CBD had no protective effect on the testicular tissue against Cd toxicity. Our results indicate that cannabidiol protects against some toxic effects of cadmium. If confirmed by future studies, cannabidiol may be proposed as a novel treatment for cadmium toxicity.

Aims: Understanding the factors in the etiology of vascular diseases is crucial for prevention. This study assesses the relationship between toxic metal exposure and vascular disease development. Methods: Blood samples from 41 healthy volunteers and 48 cardiovascular disease patients were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). The participants' health data were obtained from hospital records. Results: ICP-MS results showed higher levels of As (5.97 µg/L), Cd (0.44 µg/L), Hg (0.48 µg/L), Pb (37.10 µg/L), Se (75.76 µg/L), Cu (1611.99 µg/L), Mn (14.55 µg/L), Co (0.14 µg/L), Mo (1.93 µg/L), and Ni (0.25 µg/L) in the experimental group. Conversely, Zn (557.0 µg/L), Cr (4.12 µg/L), and Sb (2.35 µg/L) levels were lower. Triglyceride (135.99 mg/dl), folate (8.77 ng/dl), and T3 (1.30 ng/dl) were higher, while HDL (44.13 mg/dl) was lower in the experimental group. Conclusion: These findings suggest a potential relationship between higher exposure to certain toxic metals and the development of vascular diseases. The higher concentrations of toxic metals in the blood of patients with vascular diseases underline the need for further research to confirm these associations and explore potential mechanisms.

Aims: Medicines have been widely used in recent years to support the immune system. Exposure to toxic metals can occur at different stages, such as raw material procurement, production, and packaging of drugs designed to support the immune system. This exposure can lead to serious health problems. In this study, the aim was to determine the levels of toxic metals in drugs used to support the immune system in children. Methods: Ten drug samples, available in pharmacies and intended for strengthening the immune system in children, were collected. Preliminary processes were conducted for the ICP-MS analysis of these collected drugs. Following the initial preparation, levels of Arsenic (As), Copper (Cu), Zinc (Zn), Manganese (Mn), Selenium (Se), Chromium (Cr), Mercury (Hg), Lead (Pb), Cadmium (Cd), Tin (Sn), Cobalt (Co), Aluminum (Al), Molybdenum (Mo), Antimony (Sb), Nickel (Ni) were determined using an ICP-MS device. Results: In our study, we evaluated the levels of toxic metals in drugs used to support the immune system. The average levels of Cr, Zn, As, Se, Cd, and Sn in the samples were found to exceed the limits set by international organizations. However, the average levels of Al, Cu, and Hg were very close to these limit levels. On the other hand, the levels of Mo, Sb, and Pb in the analyzed products were well below the established limits. Conclusion: The levels of toxic metals in immune-supporting drugs can lead to toxicity when the results of the study are evaluated. To inform consumers and safeguard their health, it would be appropriate for manufacturers to include information about the daily intake limits set by international organizations for toxic metals and trace elements. Conducting toxicological tests, especially during these inspections, will greatly contribute to protecting the health of children and fostering the development of healthy generations.

Acetaminophen is widely used among humans as an antipyretic and analgesic. In this study, the protective effect of losartan in hepatotoxicity and nephrotoxicity induced by acetaminophen in mice was investigated owing to its anti-inflammatory and antioxidant effects. An injection of a single dose of 500 mg/kg (i.p.) acetaminophen was administered to induce hepatotoxicity and nephrotoxicity in Groups VI–X. Losartan at doses of 1 mg/kg (Group VII), 3 mg/kg (Group VIII), and 10 mg/kg (Groups III, V, IX, and X) was injected intraperitoneally twice, at 1 and 12 h after the acetaminophen injection. Additionally, a 4 mg/kg dose of GW9662 (peroxisome proliferator-activated receptor gamma (PPAR-γ) antagonist) was injected intraperitoneally 30 min before the losartan injections in Groups V and X. At the end of 24 h, the mice were euthanized, and blood, liver, and kidney tissue samples were collected. Levels of AST, ALT, creatinine, and oxidative stress markers including TBARS, SOD, CAT, GPx, TAS, TOS, GSH, and GSSG, along with pro-inflammatory cytokines IL-1β, IL-6, IL-8, IL-10, IL-17, and TNF-α, were measured using ELISA kits. Additionally, a histological evaluation of the tissue samples was performed. Acetaminophen causes increases in the levels of AST, ALT, creatinine, TBARS, TOS, GSSG, IL-1β, IL-6, IL-8, IL-10, IL-17, and TNF-α in serum, liver, and kidney tissue. Meanwhile, it led to a decrease in the levels of SOD, CAT, GPx, TAS, and GSH. Losartan injection reversed oxidative and inflammatory damage induced by acetaminophen. Histopathological changes in liver and kidney tissue were alleviated by losartan. The substance GW9662 increased the protective effect of losartan. In light of all the data obtained from our study, it can be said that losartan has a protective effect on liver and kidney damage induced by acetaminophen due to its antioxidant and anti-inflammatory effects. In terms of the study, losartan was found to be an alternative substance that could protect people from the harmful effects of acetaminophen.

Amaç Gıda takviyeleri, sağlık desteği sağlaması ve beslenme eksiklerini tamamlaması amacıyla son dönemlerde yaygın olarak kullanılmaya başlanmıştır. Toksik metal maruziyeti ise gıda takviyelerini kullananlarda oldukça ciddi sağlık problemlerine neden olabilmektedir. Bu çalışmada çocuklarda immün sistemi kuvvetlendirmek için kullanılan gıda takviyelerindeki toksik metal düzeyini belirlemek amaçlandı. Gereç ve Yöntem Eczane, market ve internet vb. üzerinden satışa sunulan çocuklarda immün sistemi kuvvetlendirmek için kullanılan 30 adet gıda takviyesi örneği toplandı. Toplanan bu gıda takviyelerinde ICP-MS analizi yapıldı. Örneklerdeki arsenik (As), bakır (Cu), çinko (Zn), mangan (Mn), selenyum (Se), krom (Cr), civa (Hg), kurşun (Pb), kadmiyum (Cd), kalay (Sn), kobalt (Co), alüminyum (Al), molibden (Mo), antimon (Sb), nikel (Ni) düzeyleri tespit edildi. Bulgular Çalışmamızda immün sistemi desteklemek amacıyla piyasada ticari olarak satılan gıda takviyelerindeki toksik metal düzeyleri değerlendirildi. Numunelerdeki Cr, Co, Cu, Zn, As, Se, Mo ve Hg’nin ortalama düzeyleri uluslararası kuruluşlar tarafından belirlenen limitlerin üstünde tespit edildi. Bununla birlikte Cd, Al, Mn, Ni ve Pb’nin ortalama düzeyleri ise bu limit düzeylerine çok yakındı. Buna karşın analiz edilen ürünlerdeki Sn ve Sb düzeyleri limitlerin çok altında bulundu. Analiz edilen tüm metallerin korelasyonları pozitifti. Sonuç Sonuçlarımız değerlendirildiğinde; gıda takviyelerinde bazı toksik metal düzeylerinin toksisite oluşturabilecek düzeyde olduğu tespit edildi. Üretici firmaların tüketicileri bilgilendirmek adına uluslararası denetim kuruluşlarının toksik metaller ve eser elementler için belirlemiş olduğu günlük alım limitleri ve kendi ürünlerindeki toksik metal ve eser element düzeylerini gösteren bir bilgininde etiketlerine eklemelerinin uygun olacağı değerlendirilmektedir. Gıda takviyelerinin hammadde temininde, üretiminde ve pazarlanmasında daha etkin bir yasal düzenleme ve denetimin gerekliliği ortaya çıkmaktadır.