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    Biomonitoring of heavy metal(oid)s in the residents of abandoned mining district in northern cyprus
    (Springer, 2021) Kocadal, Kumsal; Alkaş, Fehmi Burak; Ulutaş, Onur Kenan; Kurt, Mehmet Ali; Battal, Dilek; Şardaş, Semra; Etikan, İlker; Saygı, Sahan
    Abstract Several heavy metal(oid)s are known mutagens and/or carcinogens. Exposure to these elements can lead to the development of malignancies. Gemikonagi, which is in the western part of Cyprus, was the hometown of mining operations. It is believed that the mining site is a significant heavy metal(oid) source for the environment and residents. In this biomonitoring study, a total of 60 blood samples from Gemikonagi region (n = 30) and from a control region located 40 km northeast from the mining site, Tepebasi (n = 30), and 5 soil samples from each region were collected to conduct heavy metal analysis using ICP-MS. To conduct genotoxicity analysis, alkaline comet assay and in vivo micronucleus assays were used. t test for independent samples and Mann-Whitney U tests were applied. Copper and iron were found to be enriched in Gemikonagi, while arsenic was found to be enriched in Tepebasi. Genotoxicity analyses demonstrated a statistically significant increase in parameters of micronuclei frequency (p value = 0.0001) and Comet Assay statistics upon exposure to some elements, such as arsenic (p value = 0.04) and copper (p value = 0.012). The results indicate that a general enrichment in heavy elements is not endemic to Gemikonagi, but a problem that might be generalized to the entirety of Cyprus.
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    Drug-associated cardiovascular risks: a retrospective evaluation of withdrawn drugs
    (Kare Publ, 2019) Kocadal, Kumsal; Saygı, Sahan; Alkaş, Fehmi Burak; Şardaş, Semra
    A considerable number of drugs were withdrawn from the world market in the last decades due to safety reasons. A retrospective review of withdrawals is important in determining the adequacy of regulations regarding the safety and efficacy of drugs. The scope of the present study was to focus on cardiovascular adverse reactions of 61 withdrawn medicinal products, as well as 40 additional drugs withdrawn due to non-cardiovascular toxicity, while being cardiovascular agents themselves. A detailed web-based data search was held to draw a list of withdrawn pharmaceutical products from the pharmaceutical market by regulatory authorities between 1950 and 2017 due to safety reasons. A total of 464 medicinal products were withdrawn from the pharmaceutical markets between 1950 and 2017 due to safety reasons. Hepatotoxicity was the most commonly reported adverse drug reaction (ADR) that led to withdrawal, followed by immune-related reactions, neurotoxicity, and cardiovascular toxicity. The underlying mechanisms leading to cardiovascular toxicity should be investigated in depth to avoid the use of risky drugs for long periods, especially in consideration of the fact that some cardiovascular drugs persisted in the market for many decades. Furthermore, improved reporting of suspected adverse reactions and stricter regulations will lead to quicker detection of ADRs, thus emphasizing the importance of this public health problem and highlighting the need for improved "early warning systems" to manage the risks of high-risk drugs.