Sanko University

This study demonstratesthe feasibility of industrial-scale, column-freesynthesis of tert-butoxycarbonyl (Boc)-protectedindigo derivatives and highlights their application potential in thetextile industry for the dyeing of previously undyeable synthetictextiles with indigo. The direct synthesis of N-mono-tert-butoxycarbonyl (Boc) indigo, an important intermediatefor indigo substitution studies, was achieved under very mild conditionsand in a moderate yield. For the first time, the molecular structuresof all synthesized compounds were comprehensively characterized throughdetailed NMR and HRMS analyses as well as the single-crystal X-raydiffraction method. The influence of the Boc groups on the photophysicaland thermal properties, oxidation–reduction behavior, and dyeingperformance was thoroughly investigated and defined. Importantly,the oxidation mechanism of dihydro-di-Boc indigo (i.e., reduced di-Bocindigo) was elucidated by combined experimental and theoretical approaches.Furthermore, this study shows that indigo-dyed textile waste can serveas valuable starting materials for the synthesis of Boc-protectedindigo derivatives. This innovative methodology offers significantpromise not only for textile-to-textile recycling technologies butalso as a sustainable strategy to address global waste managementand environmental pollution challenges.

Amaç: Bu araştırmada geleceğin sağlık profesyonellerinin HPV enfeksiyonu ve aşısına ilişkin bilgisini, Sağlık İnanç Modeli temelli inancını ve aşılanma kararını belirlemek amaçlanmıştır. Yöntem: Tanımlayıcı ve kesitsel türdeki çalışmanın örneklemini Sağlık Bilimleri Fakültesi’nde okuyan 201 öğrenci oluşturmuştur. Veriler “Tanıtıcı Bilgi Formu”, “Human Papilloma Virüs (HPV) ve Aşılamasına İlişkin Sağlık İnanç Modeli Ölçeği (SİMÖ-HPVA)” ve “HPV Bilgi Ölçeği (HPV-BÖ)” ile toplanmıştır. Verilerin değerlendirilmesinde tanımlayıcı istatistikler, bağımsız örneklem t-testi, tek yönlü varyans analizi, Mann Whitney U testi ve Kruskal-Wallis testi kullanılmıştır. Bulgular: Çalışmaya katılan öğrencilerin yaş ortalaması 21.51±1.84’tür. Öğrencilerin %83.6’sının kadın olduğu, %79.1’inin hayatının en uzun bölümünü Güneydoğu Anadolu Bölgesi’nde geçirmiş olduğu, %47.8’inin hemşirelik bölümünde okuduğu tespit edilmiştir. Öğrencilerin %64.2’sinin HPV aşısını duyduğu, %24.9’unun HPV ve HPV aşısı hakkında eğitim aldığı, %90.5’ine HPV aşısı önerilmediği, %56,2’sinin HPV aşısı yaptırma konusunda kararsız olduğu belirlenmiştir. HPV-BÖ puan ortalaması 11.43±7.51 olup, SİMÖ-HPVA alt boyut puan ortalamaları 5.19±1.28 ile 11.31±2.47 arasındadır. Öğrencilerin okudukları bölüm, cinsel yolla bulaşan hastalık hakkında bilgisi olma, HPV ve HPV aşısı hakkında eğitim alma ve bugüne kadar HPV, HPV testi ve aşısını duyma durumuna göre HPV-BÖ puan ortalaması ve SİMÖ-HPVA alt boyut puan ortalamaları arasında istatistiksel olarak anlamlı bir farklılık saptanmıştır (p

Background and Objectives: To evaluate the impact of gonadotropin-releasing hormone agonist (GnRHa) triggering compared to human chorionic gonadotropin (hCG) triggering on frozen–thawed and fresh embryo transfer outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF). Materials and Methods: This retrospective cohort study analyzed 267 IVF cycles of 261 PCOS patients treated with GnRH antagonist protocols. Patients were divided into three groups: GnRHa-triggered frozen–thawed embryo transfer (ET) (n = 126), hCG-triggered frozen–thawed ET (n = 68), and hCG-triggered fresh ET (n = 73). Baseline characteristics, stimulation parameters, and cycle outcomes were compared between groups. A binary logistic regression analysis was established to identify independent predictors of clinical pregnancy. Results: The GnRHa-triggered group had significantly higher numbers of retrieved oocytes, mature (MII) oocytes, and fertilized oocytes compared to both hCG-triggered groups (p < 0.001). The number of obtained embryos and frozen embryos (good-quality embryos) was highest in the GnRHa group (p < 0.001). However, clinical pregnancy rates were comparable between the groups with a similar number and grade of transferred embryos (32.53%, 38.23%, and 32.87%, respectively). Multivariate regression analysis revealed that the grade of the transferred embryo was a significant predictor of clinical pregnancy (p = 0.034). Conclusions: This study provides insights into different triggering strategies for final oocyte maturation in PCOS patients. GnRH-agonist-triggered frozen–thawed cycles showed comparable clinical pregnancy outcomes to those of hCG-triggered cycles, with a potentially lower OHSS risk. The findings suggest that individualized triggering approaches based on patient characteristics and OHSS risk may be beneficial for PCOS patients undergoing IVF.

This case report presents an early 60s male patient who developed generalised tremor and dyskinesia within 24 hours of initiating levofloxacin treatment for community-acquired pneumonia and was diagnosed with granulomatous polyangiitis. The patient was receiving immunosuppressive therapy with rituximab and corticosteroids. Neurological examination revealed choreiform movements and gait disturbance, but laboratory parameters, including brain imaging and kidney and liver function tests, were normal. Alternative causes, such as infections, metabolic imbalances and neurodegenerative conditions were ruled out. After levofloxacin was discontinued, the patient's symptoms improved rapidly, and complete recovery was observed within 1 week. A literature review revealed that the number of similar cases is limited. This case demonstrates that levofloxacin-induced movement disorders, although rare, may occur, particularly in elderly patients or those with underlying comorbidities. Proposed mechanisms include GABA-A receptor inhibition and NMDA receptor activation, which contribute to neuronal hyperexcitability. This case highlights the importance of recognising fluoroquinolone-induced neurotoxicity as a potential side effect, particularly in susceptible populations.

Patients with ankylosing spondylitis (AS) may require biological therapy, particularly tumour necrosis factor (TNF) inhibitors, which are effective but increase the risk of tuberculosis (TB). Secukinumab, an interleukin-17A inhibitor, has not been linked to TB reactivation; however, its safety in the setting of active TB remains unclear. We report two patients with AS who developed active TB during long-term anti-TNF treatment. Both experienced disease flares while receiving anti-TB therapy and needed alternative biologic treatment. Secukinumab was started 2 months after initiating standard four-drug TB therapy and achieved rapid and sustained control of AS activity without compromising TB management. Both patients completed 9 months of anti-TB treatment without adverse events or TB reactivation during 1 year follow-up. These observations suggest that secukinumab may be a safe and effective therapeutic option for patients with AS with concomitant active TB when anti-TNF agents are contraindicated, though confirmation in larger studies is warranted.

Background:Carbapenem-resistant Klebsiella pneumoniae (CRKp) is an urgent global health threat due to its rapid spread and limited treatment options. Ceftazidime–avibactam exhibits broad efficacy against gram-negative bacteria, including CRKp; however, emerging resistance to this agent is increasingly reported. Understanding the prevalence of ceftazidime–avibactam resistance and the underlying carbapenemase genes is critical for optimizing antimicrobial stewardship and guiding clinical management. This study aimed to determine the prevalence of ceftazidime avibactam resistance among CRKp isolates collected from various clinical specimens, and to analyze their associated carbapenemase genes and antibiotic resistance profiles.Methods:This cross-sectional study analyzed 312 K pneumoniae isolates obtained from various clinical specimens of hospitalized patients at a tertiary care hospital in Turkey. Antibiotic susceptibility testing was performed using the disk diffusion method for ceftazidime–avibactam and broth microdilution for both colistin and ceftazidime–avibactam. Molecular detection of carbapenemase genes was carried out using polymerase chain reaction.Results:Ceftazidime–avibactam resistance was identified in 21.5% (67/312) of CRKp isolates. Among these isolates, 37.3% harbored both OXA-48 and NDM genes, 13.4% carried NDM alone, 10.4% carried OXA-48 alone, and 38.8% lacked these genes. The majority of resistant isolates originated from urine (31.3%), followed by tracheal aspirate (29.9%), and blood (22.4%) specimens. The prevalence of colistin susceptibility among ceftazidime–avibactam-resistant CRKp isolates was 56.7%.Conclusions:The coexistence of NDM and OXA-48 genes is a major contributor to ceftazidime–avibactam resistance in CRKp isolates, particularly in urinary and respiratory tract infections. These findings underscore the need for ongoing surveillance and tailored antibiotic stewardship programs to control the spread of resistance in hospital settings.

Sjögren's disease (SD) is a systemic autoimmune disease characterised by lymphocytic infiltration of exocrine glands, leading to xerophthalmia and xerostomia, but it may also cause extraglandular involvement, including musculoskeletal, neurological, renal and pulmonary manifestations. Although interstitial lung disease and small airway obstruction are well-documented pulmonary manifestations, pleural effusion is rare. In this report, we present a male patient in his 40s who presented with left-sided pleuritic chest pain and pleural effusion with no previous history of systemic disease, infection or malignancy. Initial laboratory and imaging findings suggested exudative pleural effusion, but further investigations excluded infectious causes, tuberculosis and malignancy. Following a detailed history and physical examination, autoimmune tests (ANA, ENA) were requested based on clinical suspicion. Anti-SSA (Ro) was positive, and the Schirmer test was positive, leading to a diagnosis of pSS. While pulmonary involvement is common in primary SD, pleural effusion is a rare manifestation.