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Beyond access: rethinking assistive technology for ındividuals with visual ımpairments in Türkiye
(Taylor & Francis, 2025) İşlek, Önder
Purpose: This qualitative study explores systemic barriers to assistive technology (AT) access among individuals with visual impairments (VI) in Türkiye. It aims to identify commonly used AT tools, acquisition methods, training pathways, unmet technological needs, access barriers, and participant recommendations for inclusive policymaking. Materials and methods: Eighty-three individuals with VI across Türkiye responded to open-ended survey questions. Participants varied in age, education, and employment. A qualitative descriptive approach guided the thematic analysis, organized around six focal areas: AT usage, acquisition, learning methods, inaccessible technologies, barriers, and policy suggestions. Results: Participants reported widespread use of mainstream digital tools (e.g., smartphones, computers), primarily acquired independently and often without public financial support. Training was informal, relying on self-teaching or peer assistance. Desired technologies-such as Braille displays and accessible navigation aids-were often inaccessible due to cost, availability, or lack of localization. Key barriers included high prices, insufficient training resources, weak enforcement of disability rights, and persistent social stigma. Respondents recommended increased public funding, integration of AT training in education, improved legal enforcement, and expanded public awareness. Conclusion: Despite demonstrating adaptability, individuals with VI in Türkiye face significant structural barriers to equitable AT access. Informal learning limited public support, and a lack of locally adapted tools contribute to digital exclusion. A rights-based approach-emphasizing inclusive funding, institutionalized training, localized AT development, and policy accountability-is essential to creating an inclusive technological and social environment.
Vitamin D deficiency and uterine leiomyoma in unexplained infertility
(Basic Medical Sciences, 2025) Onaran, Yüksel; Göktaş, Esra; Altın Öztürk, Beyza; Kahyaoğlu, Serkan
Uterine leiomyomas are the most common benign tumors of the female genital tract, and alongside hormonal and genetic factors, emerging evidence implicates vitamin D deficiency in their pathogenesis. We investigated the association between serum 25-hydroxyvitamin D [25(OH)D] and the presence of uterine leiomyomas in women with unexplained infertility. In this retrospective case-control study, 148 women aged 18-45 years presenting to the Infertility Clinic of Ankara Bilkent City Hospital between July 2019 and February 2024 were included: 74 had imaging-confirmed leiomyomas (non-submucosal; FIGO types 4-6) and 74 infertile controls had no leiomyomas. Serum 25(OH)D was measured and demographic/clinical data were analyzed with appropriate parametric and non-parametric tests; correlations used Spearman's rho, and an ANCOVA adjusted for body mass index (BMI) and season assessed group differences. Groups were comparable in age and BMI (e.g., age 35.08 ± 5.79 vs 33.30 ± 5.57 years; p = 0.062). Mean serum 25(OH)D was significantly lower in women with leiomyomas than in controls (41.4 ± 23.7 vs 62.0 ± 34.2 nmol/L; p < 0.001), and this difference remained significant after adjustment for BMI and season (ANCOVA F = 10.7, p = 0.001). Vitamin D levels did not differ by leiomyoma number (single vs multiple: 44.1 ± 21.6 vs 38.5 ± 25.83 nmol/L; p = 0.32) or location (intramural vs subserosal: 40.7 ± 24.9 vs 43.1 ± 21.1 nmol/L; p = 0.69), and were not correlated with leiomyoma size (Spearman r = -0.04; p = 0.70). Among women with unexplained infertility, uterine leiomyomas are thus associated with significantly lower serum 25(OH)D levels, independent of BMI and season, whereas vitamin D status is unrelated to leiomyoma number, size, or location. These findings support a potential role of vitamin D deficiency in leiomyoma pathogenesis and underscore the need for larger, multicenter prospective studies to clarify causality and clinical implications.
Captivity-associated variations in fecal testosterone and progesterone metabolite concentrations in mountain gazelle (Gazella gazella)
(Frontiers, 2025) Karaer, Mina Cansu; Kankılıç, Tolga; Tavşanoğlu, Çağatay; Vake, Tilen; Dovc, Alenka; Snoj, Tomaz
Background: Mountain gazelle (Gazella gazella) is a medium-sized antelope native to arid regions that is currently listed as an endangered species. There are only two known populations of mountain gazelles worldwide, one of which is in Hatay (Türkiye). In this study, we investigated the differences in the fecal concentrations of testosterone and progesterone metabolites in free-ranging and captive mountain gazelle. Methods: Fecal samples were collected from the ground in the Hatay Mountain Gazelle Wildlife Development Area, located in Hatay Province (Türkiye) during each season of the year. In total, 246 samples, 170 from free-ranging population and 76 from captive population, were collected and used to determine testosterone and progesterone metabolite concentrations. The metabolites were extracted from dried fecal samples using methanol, and their concentrations were quantified using ELISA. The detection methods were partially validated. The analytical validation includes the determination of coefficients of variation, sensitivity of the measurements, recovery rate, linearity and cross-reactivity. In biological evaluation, the predicted reproductive status of the animals was compared with the concentrations of the progesterone and testosterone metabolites in feces. Results and conclusion: Our analysis revealed that fecal samples obtained from free-ranging individuals consistently contained higher levels of testosterone metabolites than those obtained from the captive individuals. No consistent pattern was detected for fecal progesterone metabolites. Our results suggest that a constant supply of water stimulates intestinal transit. Therefore, due to faster intestinal transit the population with continuous water availability throughout the year (captive population) has lower concentrations of fecal hormone metabolites. These findings are relevant not only for the mountain gazelle as a species of endangered status but also provide important information regarding the mechanisms underlying the dynamics of steroid hormone excretion in ruminants.
Protective effects of quercetin against vincristine-ınduced nephrotoxicity via modulation of oxidative stress, ınflammation, and apoptosis in rats
(John Wiley and Sons Inc, 2025) Kandemir, Özge; Küçükler, Sefa; Özdemir, Selçuk; Dalkılıç, Elif; Sağ, Sevda; Çağlayan, Cüneyt; Kandemir, Fatih Mehmet
Vincristine is a widely used chemotherapeutic agent in pediatric leukemias and solid tumors, but the use of this chemotherapeutic agent is associated with many organ damages, especially nephrotoxicity. Quercetin, a natural flavonoid, is known for its antioxidant and anti-inflammatory potential. Vincristine was intraperitoneally administered at a dose of 0.1 mg/kg body weight, and quercetin was orally administered at doses of 25 and 50 mg/kg body weight. Both treatments were applied to the rats on days 1–6 and 9–14. Renal function was assessed via serum urea and creatinine levels. Oxidative stress and lipid peroxidation were evaluated by measuring GSH, SOD, CAT, GPx, and MDA. The mRNA levels of apoptotic markers such as p53, Bax, Bcl-2, Jnk and Beclin-1 and inflammatory markers such as TNF-α, IL-1β, COX-2, and PGE-2 were analyzed by RT-qPCR. The HO-1, Nrf2, PGC-1α and SIRT1, NFκB and STAT3 protein levels were determined by ELISA. In addition, the protein levels of PI3K and AKT in survival pathways were analyzed using the Western blot method. The results showed that vincristine significantly impaired renal function by increasing oxidative stress, inflammation, and apoptosis. Quercetin protected renal function by enhancing antioxidant defense, reducing inflammatory signals and reversing apoptosis. The findings reveal that quercetin exhibits protective effects against vincristine-induced nephrotoxicity through antioxidant, anti-inflammatory and antiapoptotic mechanisms.
Dietary Nigella sativa oil confers protection against diazinon toxicity in nile tilapia (Oreochromis niloticus): a detoxification-based approach
(Springer, 2025) Öz, Mustafa; Üstüner, Enes; Jumayava, Merjan; Dikel, Suat
This study evaluated how dietary black seed oil (Nigella sativa L.) against the diazinon waterborne toxicity on Nile tilapia (Oreochromis niloticus), focusing on growth performance, hematological and biochemical parameters as well as oxidative stress markers and histological changes. A 40-day feeding trial was carried out using four experimental groups: Group 1 (control group), Group 2 (N. sativa-supplemented group), Group 3 (diazinon-exposed group), and Group 4 (diazinon-exposed with N. sativa supplementation group). The LC₅₀ value of diazinon for Nile tilapia was determined to be 4.642 mg/L, and fish were exposed to a sublethal concentration of LC₅₀/20 during the trial. Results demonstrated that diazinon exposure significantly impaired growth, hematological parameters, and liver function while increasing oxidative stress and tissue damage. Conversely, dietary supplementation with N. sativa oil significantly mitigated these adverse effects by enhancing specific growth rate, restoring RBC, Hb, and Hct values, improving liver enzyme profiles, and increasing antioxidant enzyme activity (SOD, CAT, GPx). Histological examinations confirmed that N. sativa oil reduced diazinon-induced damage in gill and liver tissues. The results show that N. sativa oil can be used as a functional feed ingredient to enhance fish resistance to chemical stressors that are commonly found in intensive aquaculture.
New frontiers in radiologic interpretation: evaluating the effectiveness of large language models in pneumothorax diagnosis
(PLOS One, 2025) Bulut, Bensu; Akkan Öz, Medine; Genç, Murat; Gür, Ayşenur; Yortanlı, Mehmet; Yortanlı, Betül Çiğdem; Sarıyıldız, Oğuz; Yazıcı, Ramiz; Mutlu, Hüseyin; Kotanoğlu, Mustafa Sırrı; Çınar, Eray; Uykan, Zekeriya
Background: This study evaluates the diagnostic performance of three multimodal large language models (LLMs)-ChatGPT-4o, Gemini 2.0, and Claude 3.5-in identifying pneumothorax from chest radiographs. Methods: In this retrospective analysis, 172 pneumothorax cases (148 patients aged >12 years, 24 patients aged ≤12 years) with both chest radiographs and confirmatory thoracic CT were included from a tertiary emergency department. Patients were categorized by age and pneumothorax size (small/large). Each radiograph was presented to all three LLMs accompanied by basic symptoms (dyspnea or chest pain), with each model analyzing each image three times. Diagnostic accuracy was evaluated using overall accuracy (all three responses correct), strict accuracy (≥2 responses correct), and ideal accuracy (≥1 response correct), alongside response consistency assessment using Fleiss' Kappa. Results: In patients older than 12 years, ChatGPT-4o demonstrated the highest overall accuracy (69.6%), followed by Claude 3.5 (64.9%) and Gemini 2.0 (57.4%). Performance was significantly poorer in pediatric patients across all models (20.8%, 12.5%, and 20.8%, respectively). For large pneumothorax in adults, ChatGPT-4o showed significantly higher accuracy compared to small pneumothorax (81.6% vs. 42.2%; p < 0.001). Regarding consistency, Gemini 2.0 demonstrated excellent reliability for large pneumothorax (Kappa = 1.00), while Claude 3.5 showed moderate consistency across both pneumothorax sizes. Conclusion: This study, the first to evaluate these three current multimodal LLMs in pneumothorax identification across different age groups, demonstrates promising results for potential clinical applications, particularly for adult patients with large pneumothorax. However, performance limitations in pediatric cases and with small pneumothoraces highlight the need for further validation before clinical implementation.
Association between subclinical mastitis pathogens and passive transfer of immunity in calves
(Frontiers, 2025) Sanioğlu Gölen, Gökçenur
Introduction: Colostrum plays a critical role in providing passive immunity in newborn calves, and its immunological effectiveness is closely linked to the health status of the producing cow. Subclinical mastitis, an inflammation of the mammary gland without visible clinical signs, frequently caused by pathogens such as Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae, and Corynebacterium bovis, can impair colostrum quality. Haptoglobin (Hp) and serum amyloid A (SAA) are acute phase proteins that increase during infection and inflammation and may serve as biomarkers for detecting subclinical mastitis and assessing its impact on calf health. Methods: Colostrum and serum samples were collected from 20 healthy cows and 20 cows diagnosed with subclinical mastitis, along with their newborn calves. Bacteriological cultures were performed to identify mastitis pathogens. Hp, SAA, and total immunoglobulin (Ig) concentrations were measured using ELISA kits. Correlations between colostrum and calf serum biomarker levels were analyzed. Calves were monitored for diarrhea in the first week of life, and fecal samples from diarrheic calves were tested for common enteric pathogens. Results: All cows in the subclinical mastitis group were positive for at least one mastitis-causing pathogen, most frequently S. aureus (35%), followed by E. coli (30%), S. agalactiae (20%), and C. bovis (15%). Cows with subclinical mastitis had significantly higher Hp and SAA levels and lower Ig concentrations in colostrum compared with healthy cows (p < 0.05). Calves from the subclinical mastitis group also exhibited higher serum Hp and SAA concentrations and lower serum Ig levels (p < 0.05). Positive correlations were found between colostrum and calf serum Hp and SAA concentrations, while colostrum Ig showed negative correlations with both biomarkers. Four calves from the subclinical mastitis group developed diarrhea, all with low serum Ig concentrations, and fecal analysis revealed rotavirus, coronavirus, or E. coli K99. Discussion: Subclinical mastitis, particularly infections caused by S. aureus and E. coli, is associated with increased inflammatory markers and reduced immunoglobulin content in colostrum, leading to impaired passive immune transfer in calves. Elevated Hp and SAA in calves may indicate both passive transfer from colostrum and early activation of the neonatal immune system. These findings highlight the importance of pathogen-driven alterations in colostrum composition and support the potential of Hp and SAA as biomarkers for monitoring subclinical mastitis and predicting calf health outcomes.
Eosinophilic infiltration in gallbladder pathologies: A clinical dilemma
(2025) Martlı, Hüseyin F.; Aydın, Arzu H.; Şahingöz, Eda; Er, Sadettin; Akgül, Özgür; Turhan, Nesrin; Tez, Mesut
Objectives: To determine the clinicopathological features and prevalence of Eosinophilic cholecystitis (EC) with a single-center experience. Eosinophilic cholecystitis is an exceedingly uncommon pathologic issue caused by examining cholecystectomy specimens. Methods: A retrospective analysis was performed on 8,342 cholecystectomy specimens. Of these, 33 pathology results confirmed EC and were re-examined by pathologists. This study obtained demographic data, medical histories, comorbidities, clinical laboratory results, radiological findings, and pathological information from an electronic record system. Results: The average age of the patients was 47 years, with a range of 24 to 82 years. Acute cholecystitis was reported in 5 (15.6%), chronic cholecystitis in 25 (75.8%), and cholelithiasis in 3 (9.1%) gallbladder specimens. Five of the 33 patients had liver hydatid cysts. There was no statistically significant difference in parameters such as blood eosinophil count, eosinophil ratio, eosinophil count in the gallbladder wall, and gallbladder wall thickness between patients with and without liver hydatid cysts who had eosinophilic cholecystitis. Conclusion: Eosinophilic infiltration is a component of inflammatory processes, including acute and chronic inflammation. Importantly, hydatid cysts can be observed in the liver, which relates to EC. In our study, no distinct clinical, laboratory, or radiological findings of EC were identified, and the diagnosis of EC was made pathologically.
Investigation of protective effects of rutin\cyclodextrin inclusion complex against testicular damage caused by diisononyl phthalate in rats
(Mashhad University Medical Sciences, 2025) Bozalı, Ramazan; Akarsu, Serkan Ali; Gür, Cihan; Küçükler, Sefa; Akaras, Nurhan; Leritürk, Mustafa; Sunar, Serhat; Kandemir, Fatih Mehmet
The aim of this study was to investigate the protective effects of Rutin\cyclodextrin (RUT\CD) complex in rats exposed to diisononyl phthalate (DINP). Materials and Methods: In the study, 35 male Sprague Dawley rats were used. The rats were randomly divided into five groups: Control, DINP, RUT\CD, DINP+RUT\CD100, and DINP+RUT\CD200. The control group received Tween 80 by oral gavage, while the DINP groups received DINP at a dose of 200 mg/kg/bw. RUT+CD groups received the RUT\CD complex by oral gavage. After 14 days of administration, rats were sacrificed, and testicular tissues were used for histopathological and biochemical analyses, and epididymal tissues were used for semen analysis. Results: DINP administration caused an increase in MDA level and a decrease in SOD, CAT, GPx1 enzyme activities, and GSH level in rats. RUT\CD administration decreased oxidative stress and increased antioxidant activity. In addition, DINP administration caused a decrease in Nrf-2 and HO-1 levels. DINP caused a significant increase in eIF2 alpha, ATF4, NF-kappa B, TNF-alpha, IL-1 beta, IL-6, Inos, and Cox2 levels in the testicular tissue of rats. RUT\CD administration decreased these levels in a dose-dependent manner. Apoptosis markers p53, Apaf-1, Bax, Bcl-2, and Caspase-3 mRNA transcript levels and Bax and Bcl-2 protein levels were significantly increased in the DINP-administered group. In the DINP+ RUT/CD group, these levels decreased in a dose-dependent manner. Moreover, DINP administration caused an increase in sperm DNA damage. Conclusion: DINP administration induced testicular toxicity by increasing oxidative stress, apoptosis, and inflammation, and changes in testicular histology. Moreover, RUT\CD administration attenuated DINP-induced toxic effects.
Urinary total superoxide dismutase activity is low in rheumatoid patients, and its low levels are associated with higher DAS28 scores
(Elsevier, 2025) Kor, Mehmet; Yalçın, Merve; Okyar, Göktuğ; Kor, Tahire Betül; Doğan, İsmail; Atalar, Ebru; Konak, Hatice Ecem; Dağlı, Pınar Akyüz; Tam, Dudu Çelik; Işık, Sema; Polat, Bünyamin; Neşelioğlu, Salim; Erel, Özçal; Erten, Şükran
Rheumatoid factor and anti-citrullinated peptide antibodies are generally used to diagnose rheumatoid arthritis (RA). However, these antibodies are negative in 15-20 % of RA cases. This study aimed to investigate new biomarkers that can be used in diagnosing RA and evaluating disease activity. Methods: This study included 99 RA patients and 94 healthy volunteers. Modified Disease Activity Score28 (DAS28) erythrocyte sedimentation rate (ESR) was used for disease activity score. Thiol/disulfide molecules were measured using an automatic spectrophotometric method, and ischemia-modified albumin was measured using an albumin-cobalt binding test. A spectrophotometer calculated urinary and serum total superoxide dismutase (SOD) activities at 420 nm wavelength. Results: In the RA group, serum IMA level was higher (unstandardized beta [B]: 5.552, Odds Ratio [OR]: 250.1, CI 95 %: 1.29-48219.1, p: .040), and urinary total SOD activities were significantly lower (B: 2.640 OR: .071, CI 95 %: .027-.192, p < 0.0001) than in the control group. A cut-off value of 5.06 for urinary total SOD was found to have a sensitivity of 97.9 % and a specificity of 97 % in distinguishing RA patients from healthy controls (AUC [95 %Cl] = .986 [.967-1.000], p < 0.001). Urinary total SOD activity was significantly lower in the RA subgroup with high disease activity compared to the groups with moderate disease activity (B: .954, OR: 2.596, CI 95 %: 1.104-6.103, p: .029) and low disease activity (B: 1.251, OR: 3.494, CI 95 %: 1.143-10.678, p: .028). Conclusion: This study showed that urinary total SOD activity has high sensitivity and specificity in distinguishing RA patients from healthy controls and that RA patients with higher DAS28 ESR activity scores have lower urinary total SOD activity.
Evaluation of the systemic immune-inflammation index in relation to histological stages of celiac disease
(BMC, 2025) Kıvrakoğlu, Fatih; Ergin, Mustafa
Celiac disease (CD) is an immune-mediated enteropathy characterized by histopathological changes, such as villous atrophy and chronic inflammation, often assessed using the Marsh classification. The systemic immune-inflammation index (SII), a novel inflammatory biomarker, has been increasingly investigated in chronic inflammatory diseases, including CD.ObjectiveThis study aims to evaluate the relationship between SII and histopathological progression in CD, as classified by the Marsh scores, and to assess other hematological and inflammatory parameters.MethodsA retrospective analysis was conducted on 115 biopsy-confirmed CD patients from 2 hospitals between February 2022 and November 2023. Demographic, clinical, and laboratory data were analyzed, and SII values were calculated. Statistical comparisons were performed across Marsh stages.ResultsSII levels did not significantly differ among Marsh groups (p = 0.408). However, the Marsh Grade 3a group exhibited higher median SII values compared to others. Hemoglobin (Hb) levels showed significant differences across Marsh stages (p = 0.012), with a notable decrease in Marsh Grade 3c. Other parameters, such as ESR and CRP, showed no significant variation across groups.ConclusionWhile SII shows potential as an inflammatory marker, its limited association with histological stages suggests a need for larger, prospective studies to validate its utility in clinical practice.
Protective effect of N-acetylcysteine in doxorubicininduced primary ovarian failure in female rats
(Galenos Publishing House, 2025) Aslan, İlke Özer; Öz, Mehmet; Erdal, Hüseyin; Karaboğa, İhsan; Doğan, Mehmet
N-acetylcysteine (NAC), an aminothiol compound, eliminates free radicals and enhances glutathione (GSH) synthesis, thereby strengthening intracellular antioxidant defenses. Although its protective effects against ovarian injury have been reported, its efficacy in doxorubicin (DOX)-induced ovarian failure has not been demonstrated. This study aimed to investigate whether NAC exerts a protective role against DOX-induced ovarian toxicity in female rats. Materials and methods: Twenty-one adult female rats were randomly assigned to three groups: Control, DOX (10 mg/kg, i.p., single dose), and DOX+NAC (150 mg/kg, i.p., for 5 days; DOX administered on day 3, one hour after NAC). Serum and tissue oxidative stress parameters, histopathological changes, proliferating cell nuclear antigen (PCNA) immunoreactivity, and TUNEL assay were evaluated. Results: DOX significantly reduced serum anti-M & uuml;llerian hormone (AMH) (6.75 -> 5.31 ng/mL; p<0.001) and GSH (422.64 -> 280.98 mg/L; p<0.001), while increasing tumor necrosis factor alpha (TNF-alpha) (175.87 -> 260.77 ng/L; p<0.001) and total oxidant status (TOS) (7.18 -> 11.84 U/mL; p=0.002). NAC treatment reversed these alterations, namely: AMH (6.51 ng/mL; p=0.004), GSH (363.86 mg/L; p=0.018), TNF-alpha (184.55 ng/L; p<0.001), TOS (7.88 U/mL; p=0.003). In ovarian tissue, DOX reduced GSH (123.63 -> 80.64 mg/L; p=0.001) and total antioxidant status (14.88 -> 10.57 U/mL; p<0.001), while elevating TOS (7.14 -> 12.64 U/mL; p<0.001) and caspase-3 (2.06 -> 3.14 ng/mL; p<0.001). NAC significantly improved all these parameters (p <= 0.005). Histologically, DOX caused edema, hemorrhage, infiltration, and a reduction in the percentage of healthy follicles, whereas NAC markedly ameliorated these alterations. Furthermore, NAC enhanced PCNA expression and reduced TUNEL-positive granulosa cells, supporting its anti-apoptotic effect. Conclusion: NAC preserved ovarian reserve and follicular integrity by suppressing oxidative stress, inflammation, and apoptosis induced by DOX. These findings highlight NAC as a promising protective agent against chemotherapy-induced ovarian toxicity.
Factors predicting incidentally found appendiceal tumors following appendectomy: propensity score matching analysis
(Sage Public Inc, 2025) Er, Sadettin; Göktaş, Abidin; Özden, Sabri; Akın, Merve; Akın, Mercan; Martlı, Hüseyin Fahri; Aydın, Arzu Hazal; Birben, Birkan; Acehan, Fatih
Purpose The factors that predict coincidental appendiceal neoplasms in patients who underwent appendectomy due to appendicitis were investigated.Methods 5829 patients diagnosed with appendicitis and underwent appendectomy in the department of surgery were examined. Among these patients, patients with appendiceal neoplasia and benign pathology were selected by propensity score matching analysis in a ratio of 1:4. As a result of analysis, 74 and 274 patients were grouped as appendiceal neoplasia and benign pathology, respectively.Results The mean age of the 348 appendiceal neoplasia and benign pathology groups included in the study was 45.6 and 46.4, respectively. Appendiceal diameter, contrast enhancement in the appendix wall, and neutrophil count were independent parameters for appendiceal neoplasia pathology. The AUC value of the combination of appendix diameter, lack of enhancement in the appendix wall, and neutrophil count in distinguishing appendiceal neoplasia pathology was 0.787.Conclusion Appendix diameter, lack of wall enhancement, and neutrophil count are the three predictive indicators useful in helping clinicians suspect appendiceal neoplasms.
Dynamic alteration of halp score as a predictor in patients with receiving immunotherapy for advanced non-small cell lung cancer
(MDPI, 2025) Koçanoğlu, Abdülkadir; Karakaya, Serdar; Zeynelgil, Esra; Düzköprü, Yakup; Doğan, Özlem
This study aimed to investigate the prognostic value of the hemoglobin-albumin-lymphocyte-platelet (HALP) score-a marker reflecting both inflammatory and nutritional status-in patients with metastatic non-small cell lung cancer (NSCLC) undergoing immunotherapy. We also sought to determine whether dynamic changes in the HALP score during treatment could predict therapeutic success and help distinguish between pseudoprogression and hyperprogression. Materials and Methods: A retrospective analysis was conducted on 160 patients diagnosed with metastatic NSCLC and treated with immunotherapy at the Ankara Atat & uuml;rk Sanatorium Training and Research Hospital. Chemotherapy regimens, metastatic sites, baseline and third-month hemograms and biochemistry parameters, and survival data were recorded. Survival outcomes were analyzed using the Kaplan-Meier method with the log-rank test and the Cox proportional hazards regression model using IBM SPSS Statistics. Results: The median overall survival (OS) for the entire cohort was 15 months (95% CI: 11.88-18.12). HALP1 score (p = 0.048), HALP2 score (p = 0.026), and hyperprogression (p < 0.001) were statistically significant predictors of OS. Regarding progression-free survival (PFS), the HALP2 score (p = 0.031), line of immunotherapy (p = 0.046), and hyperprogression (p < 0.001) were found to be significant. When comparing patients with increasing versus decreasing HALP scores, those with increasing HALP scores demonstrated significantly better outcomes for both OS (p = 0.034) and PFS (p = 0.007). Conclusions: In patients with metastatic NSCLC undergoing immunotherapy, the HALP score and its dynamic alterations during treatment appear to be non-invasive, easily calculable biomarkers that may predict both OS and PFS.
Pseudo-Meigs syndrome owing to a retained fibroid following total laparoscopic hysterectomy for multiple leiomyomas: A case report and review of the literature
(Wiley, 2025) Atılgan, Adeviye Elçi; Dilmaç, Ayşegül Evren; Akcaoğlu, Tuğba
Total laparoscopic hysterectomy (TLH) is the most common gynecologic procedure for fibroids. However, massive serous ascites has not yet been reported. For this reason, the management of ascites is challenging because it is an unexpected situation. We present the case of a 42-year-old woman complaining of menorrhagia who was diagnosed with multiple leiomyomas on ultrasound examination. No abnormal findings were observed in the endometrium or ovaries. TLH and bilateral salpingectomy were performed. Specimens were extracted via vaginal morcellation using a scalpel. No intraoperative complications were observed. The final pathologic examination of the uterus, which contained 25 fibroids and tubes, was benign. However, serous ascites began to enter the drain on the first day. The volume of the ascites was approximately 9000 mL over 3 days. There were no abnormalities in vital signs, liver test results, or serum albumin, electrolyte, or hemoglobin levels. Radiologic images excluded bowel and urinary tract injuries. However, an intra-abdominal mass measuring 26 x 33 x 44 mm was detected on magnetic resonance imaging. Diagnostic laparoscopy revealed a myoma between the bowel loops, which was removed by placing it in an endobag. Thereafter, the ascites spontaneously resolved. Ascitic fluid is generally observed in gynecologic cancers. The basic treatment principles include close monitoring of vital signs, appropriate replacement of fluid deficits, drainage, and mobilization. Furthermore, treatment based on the etiopathology is crucial. In cases of multiple myomas, when extracting the uterus vaginally, a pedunculated myoma may break off or be missed in the abdomen. Leiomyomas have oncotic properties and can induce fluid flow from the intravascular to the peritoneal space. Rapid resolution of ascites after myoma removal indicates pseudo-Meigs syndrome.
Correction to: the effect of biopsychosocial-spiritual factors on medication adherence in chronic diseases in Türkiye (Journal of Religion and Health, (2025), 10.1007/s10943-025-02317-3)
(Kluwer Academic/Human Sciences Press Inc., 2025) Bilgin, Aylin; Döner, Ayser; Erdoğan Yüce, Gülyeter; Muz, Gamze
Correction to: Journal of Religion and Healthhttps://doi.org/10.1007/s10943-025-02317-3. In this article, the title was incorrectly given as ‘The Effect of Biopsychosocial-Spiritual Factors on Medication Adherence in Chronic Diseases in Turkey Using Structural Equation Modeling’ but should have been ‘The Effect of Biopsychosocial-Spiritual Factors on Medication Adherence in Chronic Diseases in Türkiye’.
Does Zn-Mediated regulation of the Kynurenine Pathway provide the link between periodontal disease and diabetes
(Springer, 2025) Afşar, Ebru; Doğan, Kadirhan; Arslan, Erdem; Eranil, Işıl; Oral, Neşe; Kuzzu, Kadir Bahadır; Ceylan, Tayfun; Öz, Mehmet
It has long been known that there is a relationship between periodontal diseases and diabetes. The present study aimed to assess the effect of pancreatic zinc (Zn) levels on Kynurenin pathways (KP) and glucose homeostasis and the impact of Thymoquinone (TQ) in the periodontal disease animal model. Ten microliters of Porphyromonas gingivalis-lipopolysaccharide (P. gingivalis-Lps) (1 mg/ml) was injected at 48-h intervals into the palatal gingiva of rats, and TQ was given by oral gavage (10 mg/kg per day) for 2 weeks. Glucose homeostasis was assessed using the Homeostatic Model Assessment (HOMA-IR), and β-cell function (HOMA-β Levels). Kynurenine (KYN), Tryptophan (TRP), kynurenic acid (KYNA), quinolinic acid (QA), KYN 3-monooxygenase (KMO), kynureninase, interferon-γ (IFN-γ), insulin, ZIP10, and caspase-3 levels measured by the enzyme-linked immunosorbent assay (ELISA). Zinc levels in the pancreas tissue and plasma samples were measured using a colorimetric method. Morphological changes in the pancreas were identified by hematoxylin and eosin staining, and X-ray radiography determined bone resorption in the maxillary bone. In the LPS group, pancreas ZIP10 and Zn levels increased, the KP pathway was altered to favor KYNA, and impaired glucose homeostasis was observed. TQ administration decreased pancreatic Zn levels, changed KP to favor QA, and improved morphological changes in the pancreas. During the progression of periodontal diseases, KP may be altered by Zn levels through ZIP10 in the pancreas, thereby impairing pancreatic function. Regulation of Zn levels may be key to shared pathways between periodontal diseases and diabetes.
First report on the isolation of salmonella enterica subsp. enterica serovar hofit in wild boars (sus scrofa) in Türkiye
(Mary Ann Liebert Inc., 2025) İlhan, Ziya; Hasdoğan, Harun; Gökmen, Mukadderat
The aim of this study was to isolate potential bacterial pathogens, such as Salmonella spp., from wild boars (Sus scrofa) inhabiting the Southern Marmara Region of Turkiye and to evaluate the in vitro antibiotic susceptibility of the isolates. Samples, including feces and internal organs (lymph nodes, liver, lungs, kidneys, and spleen), were collected from a total of 34 legally hunted wild boars. Salmonella enterica subsp. enterica serovar Hofit was isolated from 6 (17.6%) animals. Ciprofloxacin, streptomycin, ampicillin, tetracycline, chloramphenicol, enrofloxacin, gentamicin, ceftiofur, cefoxitin, nalidixic acid, amoxicillin/clavulanic acid, and trimethoprim/ sulfamethoxazole discs were used to determine the in vitro antimicrobial susceptibility of S. Hofit isolates. All S. Hofit isolates had 100% sensitivity to 11 of the antibiotics tested, and three isolates were resistant only to streptomycin. As a result, this study is the first to report the isolation of S. Hofit from wild boars worldwide. The high isolation rate (17.6%) suggests a potential adaptation of this serovar to swine hosts. The apparent prevalence of S. Hofit in wild boars raises concerns not only for wildlife but also for potential public health implications.
Prognostic value of the hemoglobin, albumin, lymphocyte, platelet score in metastatic mesothelioma: a retrospective study
(S. Karger AG, 2025) Doğan, Özlem; Düzköprü, Yakup; Eren, Tülay
Malignant mesothelioma is a rare but aggressive cancer with limited treatment options and poor prognosis. Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score, reflecting inflammation and nutritional status, is a potential prognostic marker in various cancers. Our study aimed to investigate the prognostic value of the HALP score in mesothelioma. Methods: This retrospective study included 68 metastatic mesothelioma patients diagnosed between 2015 and 2023. Clinical and laboratory data were collected, and HALP scores were calculated at the time of metastasis. Patients were divided into HALP-low and HALP-high groups based on the median HALP score. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, and prognostic factors were assessed using univariate and multivariate analyses. Results: The median HALP score was 24.85. The median OS for the entire cohort was 11.59 months. Patients with low HALP scores had significantly worse OS (7.81 months) compared to those with high HALP scores (16.36 months) (p = 0.01). Similarly, median PFS was significantly shorter in the HALP-low group (7.29 months) compared to the HALP-high group (12.12 months) (p = 0.02). In multivariate analysis, low HALP score (p = 0.02) and de novo metastatic disease (p = 0.01) remained independent prognostic factors for OS. Conclusion: This study demonstrates that the HALP score is an independent prognostic biomarker in metastatic mesothelioma. Low HALP scores are associated with worse OS and PFS. Given its simplicity and cost-effectiveness, the HALP score may be a valuable tool for risk stratification and treatment decision-making in clinical practice.
PET-CT indications and contributions to diagnosis in the rheumatology clinic: a retrospective analysis
(Springer Science and Business Media Deutschland GmbH, 2025) Kahraman Denizhan, Tuğba; Kaplan, Hüseyin; Kızıltepe, Melih; Kökoğlu, Emel Oğuz; Cengiz, Celil Barlas; Abdulrezzak, Ümmühan; Şenel, Abdurrahman Soner
Positron emission tomography-computed tomography (PET-CT) is a valuable imaging modality in both oncology and autoimmune or inflammatory diseases. This study evaluates the indications for PET-CT in rheumatology patients, compares PET-CT findings with other imaging modalities, and assesses its contribution to definitive diagnosis. Methods: Between January 2022 and December 2023, 63 patients (38 women, 25 men) who underwent PET-CT at Erciyes University Rheumatology Clinic were retrospectively analyzed. Clinical, laboratory, and imaging findings—including prior CT, magnetic resonance imaging (MRI), and angiographic evaluations—were reviewed. PET-CT findings were classified based on metabolic uptake patterns indicating malignancy, vasculitis, inflammatory involvement, lymphadenopathy, and IgG4-related diseases. PET-CT results were statistically compared with final diagnoses. Results: The most common indications for PET-CT were suspected vasculitis (42.9%), fever/inflammation of unknown origin (30.2%), and suspected malignancy (27.0%). PET-CT detected inflammation in 65.1% of cases, lymphadenopathy in 52.4%, nodules in 41.3%, malignancy in 31.7%, and vasculitis in 20.6%. Vasculitis findings were significantly higher in patients with pre-existing rheumatic disease (p = 0.012), while malignancy-related findings were more frequent in those without (p = 0.025). Anti-SSA and anti-Scl70 positivity were significantly associated with malignancy (p = 0.003 and p = 0.030, respectively). PET-CT effectively detected malignancy (p < 0.001) but showed limited diagnostic accuracy for vasculitis (47.6%). Conclusion: PET-CT complements conventional imaging in evaluating vasculitis, inflammation, and malignancy in rheumatic diseases. However, it is insufficient for diagnosing vasculitis alone, necessitating a comprehensive clinical and laboratory approach. While PET-CT is highly effective in malignancy detection, autoantibody presence should be carefully considered in suspected cases.

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