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International versus domestic?: the question of the applicability of intellectual property law to the CISG
(Taylor and Francis, 2021) Kiraz, Şerife Esra
As a result of the increase in trade over intellectual property (IP)-related goods, the risk of encountering intellectual property rights (IPRs) infringement occurs. When a third party’s IPRs are infringed, the buyer of such goods can be prevented from using or reselling the goods in question according to IP law. Article 42 of the United Nations Convention on Contracts for the International Sale of Goods (CISG) covers these situations and obliges the seller to ‘deliver goods which are free from any right or claim of a third party based on industrial property or other intellectual property’. However, there is no definition of ‘industrial property or other intellectual property’ either within the wording of Article 42 or the scope of the CISG. This chapter questions whether the international IP agreements and IP rules of domestic law where the claim is raised should be applied in Art 42 CISG cases to examine the existence of third-party IPRs over the goods purchased by the buyer. Although the CISG should be interpreted regarding its international character, I argue that any IPRs or claims should be examined according to the law under which the right or claim has been raised.
Effectiveness of repetitive transcranial magnetic stimulation in patients with failed back surgery syndrome: a double-blind randomized placebo-controlled study
(American Society of Interventional Pain Physicians, 2021) Bursalı, Canan; Ünlü Özkan, Feyza; Yılmaz Kaysın, Meryem; Dörtcan, Nimet; Aktaş, İlknur; Geler Kulcu, Duygu
Background: Failed back surgery syndrome (FBSS) is the term of persistent back /and or leg pain after lumbar surgery. Repetitive transcranial magnetic stimulation (r-TMS) is a technique that allows noninvasive and relatively painless stimulation of cerebral cortex. It can reduce the experience of chronic pain by producing the small electrical currents in the cortex via magnetic field. Objectives: The aim of this study is to determine the effectiveness of r-TMS treatment on patients with FBSS. Study Design: A double-blind, randomized, placebo-controlled trial. Setting: The Physical Medicine and Rehabilitation Clinic of Istanbul Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey. Methods: In this double-blinded, randomized, placebo-controlled trial, 20 patients (aged 34-65 years) clinically diagnosed as FBSS who had a history of surgery for lumbar disc herniation with persistent back and leg pain were reviewed. Only patients with no root compression and or spinal stenosis in postoperative magnetic resonance imaging of lumbar spine were included. Patients were randomly assigned to r-TMS (n:10) and sham (n:10) groups. Patients in the r-TMS group received 5 Hz of r-TMS as a 20-minute (1,000 pulses) daily session, 5 days per week, for a total of 10 sessions. r-TMS was applied with MagVenture device (MagPro X100, Denmark, 2009) and figure 8 coil (MMC 140 parabolic, MagVenture). Control group received sham r-TMS with the same protocol. Each patient was evaluated at baseline, days 5 and 10 of treatment, and 1 and 3 months after treatment. Visual Analog Scale (VAS), DN4 (Douleur Neuropathique en 4 Questions), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI) were used for evaluation. Results: There were no statistically significant differences between the groups for age, gender, number of surgeries, pain duration, working status, and drug usage. Significant improvements were achieved in DN4, ODI, BDI, and PSQI scores in the r-TMS group in comparison to the sham group. Both groups displayed improvements in VAS scores, whereas improvement in the sham group was limited to the first month. Achieved improvements in the r-TMS group in terms of VAS, DN4, ODI, BDI, and PSQI scores were sustained at the third month. Limitations: The limited number of patients and the short follow-up periods are the main limitations of our study. Further placebo-controlled studies with longer follow-up periods and greater number of cases would be beneficial for examining r-TMS application as a new treatment option in patients with FBSS. Conclusions: r-TMS might be an effective alternative treatment in patients with FBSS, further studies with larger groups are needed.
Managing precocious puberty: A necessity for psychiatric evaluation
(Elsevier B.V., 2021) Temeltürk, Rahime Duygu; İlçioğlu Ekici, Gokçen; Beberoğlu, Merih; Şıklar, Zeynep
Precocious puberty (PP) is one of the most common endocrine disorders in school-age girls. It has been reported that there is an increased tendency for psychiatric disorders for early maturing girls. The aim of this study was to determine the prevalence of psychiatric problems and to investigate depression and anxiety levels, and self-concept characteristics in girls with PP. Methods: Girls with PP (n = 41) and controls (n = 45) aged 7−11 years participated in this study. Psychiatric evaluations were conducted with semi-structured interviews. Behavioral and emotional problems were assessed using Child Behavior Check List and Teacher Report Form. Children's Depression Inventory, State-Trait Anxiety Inventory for Children and Piers-Harris Children's Self Concept Scale were administered, respectively. Results: Girls with PP had significantly more psychiatric diagnosis than controls (68.3 % vs 20 %, p < 0.001). PP group had significantly higher anxious-depressed, somatic complaints, social problems, aggresive behaviors and interestingly autistic traits. Increased symptom levels of depression and anxiety, and lower self-concept scores were also obtained from PP subjects. Conclusions: PP is an independent predictor of psychiatric disorders. It is also associated with poorer psychiatric status, lower self esteem characteristics, and autistic traits. A multidisciplinary approach combining endocrinologic and psychiatric evaluations seem to be beneficial for the management of girls with PP. © 2021 Elsevier B.V.
Vitamin D intoxication due to misuse: 5-year experience
(Elsevier Masson s.r.l., 2021) Çağlar, A.; Tuğçe Çağlar, H.
Introduction: Vitamin D intoxication (VDI) is a well-known cause of hypercalcemia in children and leads to serious kidney, heart, and neurological problems. In the treatment of VDI, the goal is to correct hypercalcemia. Our aim was to evaluate the clinical features of patients with VDI, identify the causes of VDI in our region, and help guide precautions and treatment of VDI. Materials and methods: The medical records of patients with VDI presenting between January 2015 and December 2019 were retrospectively analyzed. Results: In total, 38 patients aged 0.3–4 years including 20 males (52.6%) were included in the study. Vomiting (65.8%), loss of appetite (47.4%), and constipation (31.6%) were the most common symptoms. The cause of intoxication was prescribed D3 vials in 23 patients, non-prescribed D3 vials in nine patients, and incorrectly produced fish oil supplement in six patients. Admission serum calcium and 25 (OH) D levels were 3.75 ± 0.5 mmol/L and 396 ± 110 ng/mL, respectively. A statistically significant correlation was found between the serum calcium levels at the time of diagnosis and the dose of vitamin D received, serum 25 (OH) D, phosphorus, and parathyroid (PTH) levels. Nephrocalcinosis was present in 15 (39.5%) patients. The mean time to achieve normocalcemia was 6.18 ± 2 days. The mean time to achieve normocalcemia in patients treated with pamidronate was 5.94 ± 0.7 days. Conclusion: Stoss therapy should not be administered for children of families with problems of adherence to treatment. It should be noted that VDI may develop as a result of improperly produced nutritional supplements. General practitioners and pediatricians must be aware of VDI risks and explain them to parents. Pamidronate is effective for treating VDI in children.
The importance of heart rate variability in predicting cardiac autonomic dysfunction in patients with amyotrophic lateral sclerosis
(John Wiley and Sons Inc, 2021) İşcan, Dilek; Karaaslan, Muhammet Buğra; Deveci, Onur Sinan; Akıllı Eker, Rabia; Koç, Filiz
Aim: Amyotrophic lateral sclerosis (ALS) is a progressive disease characterized by degeneration in the upper and lower motor neurons of the corticospinal tract, brain stem, and spinal cord. Recent studies have revealed that the disease does not present solely with motor neuron involvement. Accordingly, the aim of this study is to investigate the presence of cardiac autonomic impairment in patients diagnosed with ALS. Material and Method: A total of 61 patients, who were diagnosed with ALS according to the Revised El Escorial Criteria (R-EEC), were included in this prospective study, in addition to the 29 healthy individuals, who were included in the study as controls. In order to assess the cardiac autonomic involvement, the presence of orthostatic hypotension was investigated, and transthoracic echocardiography and 24-hour electrocardiogram (ECG) using a Holter monitor were performed. Results: Orthostatic hypotension was detected in 14 (22.2%) patients. Holter electrocardiogram results of the patient group revealed statistically significantly lower heart rate variability (HRV) indicators in the time domain (SDNN, SDANN, SDNN index, rMSSD, and pNN50) and in the frequency domain (high frequency [HF], low frequency [LF], and very low frequency [VLF]) than those of the control group (P <.05). Conclusion: Contrary to the popular opinion, cardiac autonomic dysfunction in patients with ALS can occur at any stage of the disease. Therefore, it is recommended that the patients are evaluated via periodic examinations during the follow-up period for cardiac autonomic involvement.
The comparison of the efficacy of diffusion weighted imaging (DWI) sequences with 3 different t2-weighted sequences in the detection of focal liver lesions
(Universa Press, 2019) Dilek, O.; Gülek, B.; Yılmaz, C.; Kaya, Ömer; Söker, G.; Akın, M.A.
In this study we aimed to compare and evaluate the efficacies of the low and high b value diffusion weighted imaging (DWI) sequences with three different T2-weighted (T2W) sequences. Materials and Methods: 255 liver lesions of 147 patients who had undergone MR examinations of the upper abdomen were evaluated. A maximum number of 4 lesions was taken for consideration in patients with multiple lesions. Low and high b valued DWI and 3 different T2W sequences (SSFSE, FIESTA, and PROPELLER FSE) were utilized. The evaluations were done by 3 different radiologists, by utilizing the double blind principle. Results: The lesion detection performances of the b 0 DWI, b 600 DWI, FIESTA T2W, SSFSE T2W, and PROPELLER FSE T2W sequences, were 95.7 %, 66.3 %, 94.4 %, 92.8 %, and 93.8 %, in sequence order. The high b value DWI sequence was able to detect malignant lesions with a higher accuracy rate than the T2W sequences. There was a moderate to high rate of agreement among the interpreters, and the lesion-detection rates of the interpreters were in line with their levels of expertise. Conclusion: Even though the higher lesion detection rates of the DWI sequences were not found to be statistically significant, it was concluded that making the evaluations with the addition of DWI to the imaging protocol would certainly decrease the lesion-missing rate, and it would be wise to utilize the DWI technique in routine liver MR imaging.
Effect of riluzole on spinal cord regeneration with hemisection method before injury
(Elsevier Inc., 2018) Çağlar, Yusuf Şükrü; Demirel, Altan; Doğan, İhsan; Hüseynov, Ramis; Eroğlu, Ümit; Özgüral, Onur; Cansız, Cevriye; Bahadır, Burak; Kılınç, Mustafa Cemil; Al-Beyati, Eyyüb S.M.
The pathophysiology of spinal cord injury (SCI) with the information obtained to date has not been elucidated fully. A safe drug or treatment protocol that results in cell regeneration for SCI remains unknown. Neuroprotective and neuroregenerative effects of riluzole, administered after a SCI, have been shown in experimental studies. This study aimed to investigate the effect of riluzole on neural regeneration in a rat SCI model. Methods: Thirty-two rats were divided into 8 groups, with 4 rats in each group. Hemisection method was performed after T7–T9 laminectomy. Rats were intraperitoneally aministered with riluzole (6 mg/kg). Locomotor recovery of the rats was assessed at 1 day, and 1, 2, 3, and 4 weeks after the 21-point Basso, Beattie, and Bresnahan test. Subsequently, the spinal cords of the rats were scored according to a semiquantitative grading system using a light microscope, and the numbers of myelinated axons, neurons, and glial cells were calculated. Results: Basso, Beattie, and Bresnahan test changes were statistically significant when groups 4–6 and 8 were compared with the other groups (P < 0.05, P < 0.00625). The results of the numbers of neurons, glial cells, and myelinated axons were statistically significant. Especially group 8, in which riluzole was administered 5 days before injury, more positive clinical and histopathologic results were obtained. Conclusions: Riluzole treatment is more effective when provided before injury. Riluzole may contribute to functional recovery when used in the preoperative period in patients who are at a high risk for permanent neurologic deficit.
Is it time to evaluate multiple familial cavernous malformations with ultra-high resolution flat-detector CT angiography
(American Association of Neurological Surgeons, 2018) Koçak, Burak; Kızılkılıç, Osman; Koçer, Naci; Islak, Civan
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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.
Role of stromal area and tumor:stroma ratio in predicting response to neoadjuvant chemoradiotherapy in rectal cancer patients
(Springer Wien, 2025) Şahingöz, Eda; Aydın, Arzu Hazal; Turhan, Nesrin; Tez, Mesut
Neoadjuvant chemoradiotherapy (nCRT) improves outcomes in locally advanced rectal cancer (LARC). However, the response varies, thus necessitating predictive markers. Methods We analyzed 44 LARC patients treated with nCRT followed by surgical resection. Pretreatment biopsies were evaluated for the tumor:stroma ratio (TSR) and stromal area using digital image analysis by two pathologists. Pathological response was graded with the College of American Pathologists Tumor Regression Grade (CAP-TRG). Results Good/partial responders (TRG 0-2) comprised 68.2% of the cohort. Median stromal area was lower in good/partial responders (2.5 mio. px(2) vs. 3.3 mio. px(2); P = 0.006). Median TSR was higher in good/partial responders (0.85 vs. 0.38) but not significantly (P = 0.137). Receiver operating curve (ROC) analysis identified a stromal area cut-off of 2.9 mio. px(2) (area under the curve [AUC] 0.745, sensitivity 80.77%, specificity 64.29%; P = 0.009) for a poor response. Multivariate regression confirmed stromal area (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.12-4.09; P = 0.021) and perineural invasion (OR 3.45, 95% CI 1.33-8.94; P = 0.010) as independent predictors. Conclusion Higher stromal area predicts a poorer nCRT response in LARC, while TSR trends toward significance. Stromal area may guide personalized treatment, pending larger cohort validation and practical implementation in clinical settings.
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.
Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder
(Springer Nature, 2025) Uygun, Sabide Duygu; Toprak Kosku, Zeynep; Temeltürk, Rahime Duygu; Cıkılı Uytun, Merve; Yürümez, Esra; Öztop, Didem Behice; Menteşe Babayiğit, Tuğba; Efendi, Gökçe Yağmur; Kılıç, Birim Günay
Attention Deficit Hyperactivity Disorder (ADHD) comorbidity patterns vary by sex and age, necessitating understanding for effective diagnosis and intervention. The aim was to assess the prevalence, timing, and distribution of comorbid psychiatric disorders in a Turkish sample, focusing on potential sex differences. Methods A retrospective study included 322 children with ADHD (aged 6 to 18 years). Data, including Conners' Parent/Teacher Rating Scales (CP/TRS), were collected from university-based clinical records. Results Females with ADHD had a higher rate of psychiatric comorbidity compared to males (83.5% vs. 62.7%, p < .001). Neurodevelopmental disorders were more prevalent in females (p < .001). All CTRS indexes (ADHD, restless/impulsive, emotional lability, and total), as well as oppositional and hyperactive/impulsive subscale scores, showed mild negative correlations with the timing of the first comorbidity other than neurodevelopmental disorders. Logistic regression identified age and specific learning disorders (SLD) as predictors of comorbidity onset (p = .004 and p = .001, respectively). Atomoxetine was preferred more often as a first-line treatment in females, while psychostimulants were used at higher doses in males (p = .035 and p = .050, respectively). Conclusions More attention is needed for females with ADHD. Oppositionality, impulsivity, emotional lability, ADHD severity, age, and SLD appear to be important for the onset of internalizing and externalizing comorbidities.
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.
Aggressive breast cancer in young women: Single-center experience
(Adıyaman Üniversitesi, 2025) Doğan, Özlem; Düzköprü, Yakup; Çavdar, Eyyüp; Eren, Tülay
Breast cancer is the most common malignancy among women, with poorer survival outcomes in younger patients. Adolescents and young adults (AYAs), typically defined as women under 40–45 years, often present with aggressive tumor subtypes and advanced-stage disease. This study analyzes the epidemiological and demographic characteristics of breast cancer patients under 45 at our center to provide insights into this high-risk group. Materials and Methods: This retrospective study analyzed 90 breast cancer patients aged 45 years or younger, diagnosed at our clinic between January 2015 and December 2023. Results: A total of 90 female breast cancer patients, with a median age of 39 years (25–45), were analyzed in our study. At diagnosis, 27.8% were in early stages (stage 1–2), 57.8% had locally advanced disease (stage 3), and 14.4% were de novo metastatic. Axillary lymph node positivity was observed in 72.2%, and invasive ductal carcinoma was the most common histological subtype (61.1%).Tumor grades 2 and 3 were identified in 24.4% and 56.7% of patients, respectively. Hormonal receptor positivity was detected in 86.7% of patients, HER2 positivity in 41.1%, and BRCA mutation in 20%. Metastases were most commonly found in the bone (20%) and lung (12.2%). Conclusion: Our study underscores the aggressive nature of breast cancer in young patients, marked by advanced stages and high-risk features at diagnosis. These findings highlight the need for enhanced early detection and personalized treatment approaches to improve outcomes for young breast cancer patients.
Tebriz Başkonsolosu İhsan Hüsnü Bey’in raporu ışığında İran’daki ermeni komitelerinin faaliyetleri: diplomatik ve stratejik yaklaşımlar
(Terazi Yayıncılık, 2025) İme, Gamze
Ermeniler, özellikle Osmanlı Devleti’nin altı vilayetini kapsayan bir bölgede bağımsız bir Ermenistan devleti kurma hayaliyle hareket etmiş, bu amaca yönelik olarak çeşitli siyasi ve örgütsel komiteler oluşturmuşlardır. Bu çabanın ilk adımı, Van’da Armenakan adı altında bir komite kurulmasıyla atılmış; daha sonra Tiflis’te sırasıyla Genç Ermenistan Komitesi, Taşnaksutyun ve Cenevre’de Hınçak komiteleri hem yerel hem uluslararası arenada Ermenilerin sözde talepleri için harekete geçmişlerdir. Özellikle stratejik planlarını uygulamaya koymak amacıyla İran topraklarını bir üs olarak kullanan bu komiteler, İran’ın sunduğu özgürlükçü siyasi ortamdan birçok yönden faydalanmışlardır. Bunun temelinde, İran hükümetinin sağladığı serbestlik sayesinde yalnızca farklı siyasi ve toplumsal grupların güç kazanması değil, aynı zamanda silah üretimi, taşıma ve sevkiyat gibi stratejik gerekliliklerin kolaylaştırılması yatmıştır. Bu durum, Ermeni komiteleri için İran’ı vazgeçilmez bir merkez haline getirmiştir. Osmanlı Devleti ile sınır komşusu olan İran’ı böyle bir üs olarak benimseyen Ermeni komiteleri, burada şubeler açarak faaliyet alanlarını genişletmişlerdir. Osmanlı Devleti, bu komitelerin İran Hükümeti tarafından gerek dolaylı gerek doğrudan siyasi ve askeri destek gördüğünü tespit etmiş ve bu durumu diplomatik kanallarla İran yönetimine ileterek ciddi uyarılarda bulunmuştur. Ancak İran yönetimi, özellikle Osmanlı sınırına yakın bölgelerde gerçekleşen saldırılara karşı yeterli önlem almamış ve Ermeni komitelerinin bu bölgelerdeki faaliyetlerine göz yummayı sürdürmüştür. Bunun yanı sıra, Ermeni komiteleri dini liderler ve ibadet yerlerini içeren bir propaganda stratejisi benimseyerek kendi eylemlerine dini bir kimlik kazandırma çabasına girişmiştir. Her ne kadar sosyalist temeller üzerine inşa edilmiş olsalar da, dini öğelere vurgu yaparak daha geniş bir kitle desteği elde etmeyi amaçlamışlardır. Bu strateji, halkın dini ve milli duygularını kendi lehlerine çevirmeye dönük dikkat çekici bir manevra olarak öne çıkmıştır. Tebriz Başşehbenderi İhsan Hüsnü Bey, Ermeni komitelerinin İran’daki örgütlenme ve saldırı faaliyetlerini detaylı bir şekilde raporlayarak bu faaliyetlerde din adamlarının oynadığı rolü, eğitim-öğretim çalışmalarını ve İran Hükümeti’nden sağlanan desteklerin boyutunu içerecek biçimde kapsamlı bilgiler sunmuştur. Bu raporlar ışığında, Osmanlı Hariciye Nezareti tarafından Ermeni komitelerinin saldırılarına İran’ın sağladığı lojistik destekler titizlikle incelenmiştir. Araştırmalar sürecinde Osmanlı arşiv belgeleri temel alınmış, konuyla ilgili telif eserler ve birbirinden farklı kritik analizlerden yararlanılmıştır. Çalışma, tarama modeli ve doküman analizi gibi sistematik yöntemler doğrultusunda ele alınmış ve oldukça detaylı bir değerlendirme sürecine tabi tutulmuştur. Bu süreçte ortaya çıkarılan bulgular, dönemin Osmanlı-İran ilişkileri bağlamında Ermeni sorununun çok boyutlu yapısını gözler önüne sermiştir.
Reference intervals of hematological parameters in a large sample of the Turkish population in the Çukurova district of Türkiye
(Ali Cangül, 2022) Koç, Gizem Gül; Kokangül, Ali; İşcan, Dilek; Menziletoğlu Yıldız, Şule; Karaboğa, Gülser; Güvenç, Birol
A complete blood count (CBC) analysis is an essential laboratory test for the diagnosis, treatment, and follow-up of numerous health problems. The aim of this study was to evaluate the reference intervals for CBC parameters of hemoglobin (Hb), hematocrit (Hct), white blood cell (WBC), platelet (Plt), and mean platelet volume (MPV) for the adult population in the Çukurova district of southern Türkiye. Materials and Methods: Data of 117,759 donors (112,557 males) 18–65 years of age who presented at the Çukurova University Blood Center between January 2015 and June 2020 for blood donation were included in the analyses. All of those who met the World Health Organization blood donor criteria were included in the study. Hematological reference intervals, stratified by age and gender, were compared. Results: The mean age of the donors was 37±9.8 years. The median parameter value was Hb: 15.4 g/dL, Hct: 46, WBC: 7.1x103/μL, Plt: 238x103/μL, and MPV: 8.3 fL. Comparison of the parameters between sexes revealed that Hb (p<0.001) and Hct (p<0.001) levels were significantly higher in males, while WBC and Plt counts were significantly higher in females (p<0.001 for each). The MPV values were similar. Conclusion: The reference ranges for CBC parameters as evaluated by sex and age group were clinically reasonable and in accordance with the literature data. However, given the single-center design of this study, additional studies with greater detail are needed to more fully assess the reference intervals of the general population in the region.
Effects of hypokalemia on clinical outcomes in hospitalized patients with covid-19 pneumonia
(Çukurova Üniversitesi Tıp Fakültesi, 2021) Kaya, Bülent; Paydaş, Saime; Kuzu, Tolga; Balal, Mustafa; Püren Yücel, Sevinç; Taşova, Yeşim; Demiroğlu, Ömer
We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia. Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized covid-19 pneumonia patients and laboratory test results on the first hospital day. Duration of hospitalization, requiring intensive care including mechanical ventilation and survival, were determined. Results: Our study included 185 patients and of them 111 male (60% male) patients with mean age of 64 ± 14.5 (23- 90). Patients were grouped as hypokalemic (16.8%) and normokalemic patients (83.2%). The number of diabetic patients was higher in the normokalemic group. Serum total protein and albumin levels were lower in hypokalemic group, while alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, blood pH and bicarbonate level were higher. In multiple logistic regression analyses, alkalosis increased risk of hypokalemia 5.73 times. Duration of hospitalization, requirement of intensive care and hospital mortality were similar in hypokalemia and normokalemia patients. Conclusion: In patients with Covid-19 pneumonia, hypokalemia has been found to be quite common as high as 16.8% at the first presentation. Hypokalemia was related to metabolic alkalosis but unrelated to the duration of hospitalization, requirement of intensive care including mechanical ventilation and hospital mortality.
Assessing clinicians' views: the development of the Bakirkoy clinician stance questionnaire
(Kare Yayıncılık, 2021) Ulusoy, Sevinç; Yavuz, K.Fatih; Burhan, Hüseyin Şehit; Nalbant, Ahmet; Terzioğlu, Merve; İlkay, Şengül; Esen, Fatma Betül
Although there is a wide range of theoretical perspectives and clinical practices, there is no assessment tool that reveals these variations among clinicians. In this study, we presented the development process of a new measure for clinicians that assess their psychological flexibility levels, attitudes towards psychotherapy and inclination to the mechanistic approach. Method: Participants included 167 psychiatrists and psychiatry residents from all over Turkey. They completed 29 items intended to form the basis for the Bakirkoy Clinician’s Attitude Questionnaire (BCSQ). Item-total correlation and Cronbach’s alpha correlation analyses were performed to determine internal consistency. The Acceptance and Action Questionnaire-II (AAQ-II) and the Mental Illness: Clinicians’ Attitude Scale V.4 (MICA v4) were used to assess the convergent and concurrent validity of BCSQ. Results: Principal component analyses with varimax rotation were conducted to ensure construct validity and to explore subdimensions. Finally, a three-dimensional version (Clinical inflexibility, Treatment preference, Mechanistic approach) of the scale with 20 items was created. The BCSQ demonstrated good internal consistency (Cronbach’s alpha coefficient was 0.82) and transient stability. Convergent validity analyses showed that BCSQ subscales have significant relationships with higher psychological inflexibility and stigmatization levels. Conclusion: BCSQ proves to be a valuable tool for assessing changes in the level of psychological flexibility of clinicians in clinical practice, their attitudes towards psychotherapy/psychopharmacology and their view of psychopathology.
Hastaneye yatan çocukların annelerinin akılcı ilaç kullanımına ilişkin tutumlarının belirlenmesi
(Türkiye Klinikleri Yayınevi, 2021) Çalışır, Özlem; Çalışkan, Zehra; Gördeles Beşer, Nalan
Bu araştırma, hastaneye yatan çocukların annelerinin, akılcı ilaç kullanımına ilişkin tutumlarının belirlenmesi amacıyla kesitsel-tanımlayıcı olarak yapılmıştır. Gereç ve Yöntemler: Araştırmanın örneklemini, bir eğitim araştırma hastanesinin pediatri kliniğinde 0-6 yaş çocuğu yatan anneler (n=351) oluşturmuştur. Etik kurul, kurum ve ebeveyn onamı alınarak yapılan çalışmada veriler; “Anket Formu” ve “Akılcı İlaç Kullanımına Yönelik Ebeveyn Tutum Ölçeği (AİKYETÖ)” ile toplanmış, değerlendirilmesi bilgisayar ortamında tanımlayıcı istatistikler, independent-t ve ANOVA (Post-hoc:Tukey) testleri ile yapılmıştır. Bulgular: Çocukların yaş ortalaması 18,63±18,40 ay olup, %57,0’ının erkek ve klinikte %62,5’inin üst solunum yolu enfeksiyonları nedeniyle takip edildiği belirlenmiştir. Annelerin AİKYETÖ toplam puanlarına (161,46±17,53) göre akılcı ilaç kullanımına yönelik tutumlarının olumlu olduğu, çocuğun yaşı, cinsiyeti, tanısı, ebeveynlerin kronik hastalığı, sürekli-düzenli ilaç kullanma durumunun annelerin AİKYETÖ puanı üzerinde etkili olmadığı belirlenmiştir (p>0,05). Eğitim düzeyi düşük, çocuk sayısı 4 ve üzerinde olan, ileri yaş (38 ve üzeri) annelerin AİKYETÖ ölçek toplam puanının daha düşük olduğu bulunmuştur (p<0,05). Ayrıca annelerin, çocuğunu hekime götürmeden reçetesiz ilaç verme, reçete edilen antibiyotiği hekimin önerdiği süre kadar kullanmama, süspansiyon ilaçları içinden çıkan ölçek kaşığı ile vermeme, ilaçları besinlerle karıştırıp verme gibi davranışlarının da olduğu saptanmıştır. Sonuç: Annelerin AİKYETÖ’den aldıkları puanlara göre akılcı ilaç kullanımına ilişkin tutumlarının olumlu olmasına karşın, akılcı olmayan ilaç kullanımına yönelik davranışlarının da olduğu belirlenmiştir. Bu nedenle, annelerin akılcı ilaç kullanımına yönelik farkındalıklarının artırılması ve doğru davranışların kazandırılması için düzenli aralıklarla eğitim ve danışmanlık hizmetlerinin verilmesi önerilmektedir.

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