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  • Öğe
    An ex vivo experimental study comparing the effects of the holmium: yttrium–aluminum-garnet and thulium fiber lasers on testicular tissue
    (Springer Science and Business Media Deutschland GmbH, 2025) Karaaslan, Mustafa; Yılmaz, Mehmet; Ordu, Melike; Şirin, Mehmet Emin
    The effects of lasers on testicular tissue have not yet been investigated in detail. In this experimental ex vivo study, we aimed to demonstrate and compare the effects of the holmium:yttrium–aluminum-garnet (Ho:YAG) and thulium fiber laser (TFL) lasers on testicular tissue. An ex vivo experiment was performed using calf testes. A 100W Ho:YAG laser and a 60W TFL devices with a setting spectrum at 10–60W, a frequency of 20–40 Hz, energy levels at 0.5–1–1.5 J, and medium pulse duration were tested. Histopathological parameters such as Incision depth (ID), vaporization area (VA), coagulation area (CA), and total laser area (TLA = VA + CA) were evaluated. In testicular tissue without a tunica layer, a statistically significant difference was found in the mean VA and TLA values between the Ho:YAG and TFL, in favor of Ho:YAG (p = 0.003, p = 0.003, respectively). In testicular tissue with a tunica layer, there was a statistically significant difference in mean VA, CA, TLA, ID values between Ho:YAG and TFL, in favor of Ho:YAG (all p < 0.001). At 1.5 J–20 Hz and 1.5 J–40 Hz, we observed that the features indicating tissue dissection, such as VA and ID, were lower in the TFL than those in Ho:YAG, while CA values were higher. VA, CA, TLA, ID values were significantly increased in tissue with tunica compared to non-tunicated tissue in both the Ho:YAG and TFL applications. At 30W and 60W, the penetrative effect of the TFL on tissue was less than that of the Ho:YAG, but its coagulation property was superior. (Table presented.)
  • Öğe
    Determination of both the expression and serum levels of epidermal growth factor and transforming growth factor β1 genes in COVID-19
    (Nature Research, 2025) Yıldız Gülhan, Pınar; Eröz, Recep; Öztürk, Cihadiye Elif; Yekenkurul, Dilek; Altınsoy, Hasan Baki; Güleç Balbay, Ege; Erçelik, Merve; Davran, Fatih; Yıldız, Şeyma
    We aimed to evaluate the effects of both the expression and serum levels of Epidermal growth factor (EGF) and Transforming growth factor-β1 (TGF-β1) genes in patients with different degrees of cellular damage as mild, moderate, severe, and critical illness that can lead to fibrosis caused by SARS-CoV-2. Totally 45 individuals (male: 21(46.67%); female: 24(53.33%)) with COVID-19 infection were included in this study. Four groups were constituted as mild (n = 16)], moderate (n = 10), severe (n = 10), and critical (n = 9) according to the severity of the disease. Blood samples were drawn from the patients, and all of the hemograms, EGF and TGFβ1 gene expression, and serum levels were evaluated. The mean age of individuals was 57.311 ± 18.383 (min: 28, max: 94). Significant differences were found among the groups for PLT (χ2 = 9.955; p = 0.019), CRP (χ2 = 7.693; p = 0.053), Ferritin (χ2 = 22.196; p < 0.001), D-dimer (χ2 = 21.982; p = 0.000), LDH (χ2 = 21.807; p < 0.001) and all these parameters (exclude PLT in severe groups) was increased depending on the severity of the disease. Additionally, significant differences were detected for EGF (χ2 = 29.528; p < 0.001), TGFB1 (χ2 = 28.981; p < 0.001) expression (that increased depending on the disease severity), and EGF (χ2 = 7.84; p = 0.049), TGFB1 (χ2 = 17.451; p = 0.001) serum concentration levels (that decreased depending on the disease severity). This study found statistically significant differences for both EGF 2−ΔΔCt. TGFβ1 2−ΔΔCt and EGF, TGFβ1 serum concentration values among all patient groups. As disease severity increased, EGF 2−ΔΔCt. TGFβ1 2−ΔΔCt levels increased, while EGF and TGFβ1 serum concentration levels decreased. Perhaps this study will be useful in managing COVID-19 infection severity and pulmonary fibrosis cases secondary to COVID-19.
  • Öğe
    ChatGPT's ECG interpretations: Sensitivity or specificity? Which matters more in the emergency department
    (W.B. Saunders, 2025) Sert, Ekrem Taha; Akay, Muhammed
    We read with great interest the article by Zaboli et al. [1], titled “Exploring ChatGPT's potential in ECG interpretation and outcome prediction in the emergency department.” This study provides valuable insights into a critical issue in emergency medicine, where both high patient volumes and the potential consequences of misdiagnoses demand precise and efficient decision-making. By exploring the potential role of ChatGPT, the study contributes significantly to the ongoing dialogue on leveraging artificial intelligence (AI) to enhance diagnostic accuracy and streamline workflows in emergency settings.
  • Öğe
    Novel biallelic nonsense mutation in IGHMBP2 gene linked to neuropathy (CMT2S): A comprehensive clinical, genetic and bioinformatic analysis of a Turkish patient with literature review
    (Elsevier B.V., 2024) Yavaş, Cüneyd; Doğan, Mustafa; Özgör, Bilge; Akbulut, Ekrem; Eröz, Recep
    Background: Spinal muscular atrophy with respiratory distress type 1 (SMARD1) and Charcot-Marie-Tooth type 2S (CMT2S) typically present before age 10. Genetic factors account for up to 50 % of neuropathies, which often display varied symptoms. Mutations in the IGHMBP2 gene are associated with both CMT2S and SMARD1, resulting in a rare clinical condition marked by axonal neuropathy, spinal muscular atrophy, respiratory distress, and muscle weakness. Method: Detailed family histories and medical data were collected. Segregation analysis was performed using Sanger sequencing and whole exome sequencing. Additionally, a review of molecularly confirmed patients was conducted. Protein tertiary structures expressed in the IGHMBP2 gene were tested for topological and conformational changes using modeling programs and in-silico tools. Results: We identified a novel homozygous nonsense mutation (c.2568_2569del p.Gly857Alafs*27) in a family with a member showing neuropathy. This report details the clinical and genetic findings of the affected individuals, including a Turkish patient with neuropathy, and compares them with literature cases. Conclusion: Understanding the clinical impact of the (c.2568_2569del p.Gly857Alafs*27) mutation will enhance our knowledge of IGHMBP2 gene defects role in neuropathy. This study aims to highlight this severe recessive disease caused by pathogenic IGHMBP2 gene mutations and to examine the mutation spectrum and phenotype differences.
  • Öğe
    Investigation of interleukin-4 (IL-4) and leukotriene C4 synthase (LTC4S) genes in patients with asthma by next-generation sequencing analysis
    (Termedia Publishing House Ltd., 2024) Engin, Muhammet Mesut Nezir; Kılıçaslan, Önder; Eröz, Recep; Özdemir, Öner; Temizkan, Ramazan Cahit; Kocabay, Kenan
    Introduction: Asthma is the most common childhood chronic respiratory disease. There are many studies on asthma genetics today, but asthma genetics is still not clearly understood. As far as we know, there is no study in the literature evaluating the IL-4 or leukotriene C4 synthase (LTC4S) gene with the next generation sequencing method. Aim: In this study, we aimed to reveal the changes in IL-4 and LTC4S genes by next-generation sequencing analysis in patients followed up with the diagnosis of asthma. Material and methods: This is a prospective study conducted on 50 patients who were diagnosed with asthma and followed up by a specialist physician according to GINA criteria at an outpatient clinic of Pediatrics in a University Hospital. DNA isolation was performed, and IL-4 and LTC4S genes were scanned from the isolated DNA samples using the next generation sequencing method. In addition, demographic, clinical and laboratory data of the patients were recorded. Results: A total of 50 patients, 32 (64%) male and 18 (36%) female, were included in the study. Variation was detected in 31 (62%) of 50 patients included in our study. The variants c.-33C>T in intron 1, c.361-9C>A in intron 3, c.360+18 C>A in intron 3 and c.23G >A in exon 4 of the IL-4 gene were detected in the asthmatic case group. The variants c.59-10 C>A in intron 1, c.-33 C>T in intron 1, c.230-12 T>C in intron 3, c.361-9 C>A in intron 3 and c.312-16 T>C in intron 5 were identified in the LTC4S gene. Conclusions: In our study, we found 9 different genetic changes that may contribute to the pathogenesis of the disease in the presence of available data in patients with asthma. The genetic changes detected in IL-4 and LTC4S genes in our study will contribute to studies on the diagnosis, prognosis and treatment of asthma.
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    Investigation of TLR4 Polymorphism in Children with Vesicoureteral Reflux and Renal Scarring
    (Sciendo, 2024) Sav, Nm; Eröz, Recep; Kalay, Duran N.; Kılıçaslan, O.; Eriş Karaca S.
    Vesicoureteral reflux (VUR) is an important factor in the etiology of recurrent urinary tract infections (UTIs). Permanent kidney damage may develop in children with high-grade VUR in the long term. This damage may progress with the development of scar tissue in some patients. The TLR4 gene is an important resistance mechanism, especially against UTIs. TLR4 gene polymorphism is associated with recurrent UTIs and kidney scar development in the long term. This study aimed to examine the relationship between scar development and TLR4 gene polymorphism in children with VUR. This cross-sectional study included 49 patients with recurrent UTIs and primary vesicoureteral reflux. Patients were divided into two groups (26 patients with the scar, and 23 patients without scar) according to the presence of scar tissue. TLR4 gene polymorphisms of the patients were evaluated by Next Generation Sequencing. The TLR4 gene polymorphism was significantly higher in the compound heterozygous group with scarring than in the group without scarring (p=0.03). Gene polymorphisms, c.958T>C, c.942A>G, c.776A>G, c.1076C>T, c.896AT, c.1078C>T were presented more commonly in the group with scarring. Moreover, gene polymorphisms c.942A>G and c.776A>G were defined for the first time in this study among patients with scar tissue. The higher incidence of some TLR4 gene polymorphisms in patients with scarring suggested that these variations might cause permanent kidney damage. In addition to genetic predisposition, environmental factors such as untreated UTIs might also contribute to scar formation.
  • Öğe
    Efficacy of pulsed electromagnetic field therapy in the treatment of knee osteoarthritis: A double-blind, randomized-controlled trial
    (Baycinar Tibbi Yayincilik (baycinar), 2025) Hashemi, Seyed Ehsan; Gök, Haydar; Güneş, Seçilay; Ateş, Can; Kutlay, Şehim
    Objectives: This study aims to evaluate the efficacy of combined pulsed electromagnetic field (PEMF) treatment and physical therapy on pain, stiffness, and functional limitation in patients with knee osteoarthritis (OA). Patients and methods: In this double-blind, randomized-controlled study, a total of 70 female patients with primary knee OA (mean age: 59.74 +/- 9.82 years; range, 40 to 80 years) were randomly allocated into PEMF and sham groups between March 2014 and July 2015. Both groups received 15 sessions of physical therapy over three weeks. Additionally, the PEMF group received PEMF treatment for 30 min/day, while the control group received sham PEMF. The patients were assessed by the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the Physician Global Assessment (PGA) scale before and three and seven weeks after treatment. Results: Regardless of the group, all patients' pain levels were significantly improved in both scales at three and seven weeks after treatment (p<0.001). The PEMF group had significantly less pain than the sham group based on the VAS score (p=0.003). The PEMF group had significantly lower functional limitation and stiffness at seven weeks (p=0.008). Recovery ratios based on the PGA score were significantly higher in the PEMF group both at three and seven weeks (p<0.05). Conclusion: Patients with knee OA who receive PEMF therapy in addition to physical therapy have more pain reduction and physical improvement. Based on these findings, PEMF is a safe and well-tolerated treatment of choice in this patient population.
  • Öğe
    Comparison of urine culture and complete urinalysis results in female patients with suspected urinary tract infection
    (Bayrakol MP, 2024) Kalaycı, Hacer Özlem; Gürpınar, Ahmet Burak; Erdal, Hüseyin
    Aim: This study aims to assess the effectiveness of fully automated urine tests by using urine culture results from female patients with suspected urinary tract infections as the reference standard and to determine their practicality for clinicians. Material and Methods: Chemical and microscopic analysis of urine was performed using a fully automatic urine analyzer (Roche Cobas 6500 u601-u701, Roche Diagnostics GmbH, Mannheim, Germany) in patients with a preliminary diagnosis of symptomatic urinary tract infection who were admitted to xxx University Training and Research Hospital gynecology outpatient clinic between January 2023 and January 2024. Midstream urine samples sent in sterile containers were inoculated on 5% sheep blood agar and EMB agar with a 0.001 caliber core and incubated at 37°C for 18-24 hours under aerop conditions. According to complete urinalysis, leukocyte count ≥5 and bacterial count ≥1 were considered positive, leukocyte esterase positivity and nitrite positivity were considered positive. Results: Escherichia coli (E.coli), Streptococcus agalactiae, Klebsiella pneumoniae, Staphylococcus sapropyticus and Candida spp. were most frequently isolated from a total of 295 urine cultures. The most effective antibiotics against the isolated E.coli strains were nitrofurantoin, fosfomycin, imipenem, meropenem and amikacin. When culture results were taken as gold standard, the diagnostic sensitivity, specificity and accuracy rates of leukocyte esterase and nitrite positivity were 78.3%, 44%, 52.1%, 24.1%, 99.9%, 82.1% for leukocyte esterase and nitrite, respectively. Discussion: We think that nitrite positivity may be a guide for unnecessary urine culture requests, but urinalysis parameters should not be used instead of culture due to their low accuracy rates.
  • Öğe
    Risk Factors for Refractory Anaphylaxis in the Emergency Department
    (Hindawi Publication, 2024) Yazıcı, Ramiz; Mutlu, Huseyin; Sert, Ekrem Taha; Kokulu, Kamil; Turan, Ömer Faruk
    Background: Anaphylaxis is a serious allergic reaction that has a rapid onset and can result in death. Identifying the factors that trigger anaphylaxis and increase its severity is important for preventing refractory anaphylaxis (RA). In this study, we aimed to determine the factors associated with an increased risk of developing RA. Preventive measures to reduce the frequency and intensity of anaphylactic events are essential to provide the best care for allergic patients. Aggravating factors can trigger or increase the severity of anaphylaxis and therefore need to be recognized and avoided.Methods: We retrospectively analyzed the data of 1378 patients over the age of 18 who were diagnosed with anaphylaxis in our clinic between January 1, 2020, and December 31, 2024. We divided the patients into two groups: anaphylaxis and RA. We evaluated the patients' clinical characteristics in the ED, demographic information, and elicitors that caused anaphylaxis.Results: Of the 1384 anaphylaxis patients included in the study, 46 (3.3%) were diagnosed as RA. We determined that having a history of anaphylaxis is the most important determinant of the increased risk of RA. Having a history of anaphylaxis (OR: 2.87, 95% CI: 1.71-5.72), beta-blockers/ACEI use (OR: 2.47, 95% CI: 1.71-5.42), IV contrast agent (OR: 2.33, 95% CI: 1.64-5.39), and low blood pressure or related symptoms (OR: 2.34, 95% CI: 1.67-5.43) were more frequently associated with severe reactions.Conclusion: We found that having low blood pressure or related symptoms, a known history of anaphylaxis, beta-blockers/ACEI, and IV contrast agent are risk factors for RA. To prevent mortality and morbidity in patients with this risk factor, early interventions such as rapidly repeating epinephrine doses and rapid fluid resuscitation should not be avoided.
  • Öğe
    Incidental Cardiac Lipoma in a Pediatric Patient
    (Wolters Kluwe Medknow Publications, 2024) Memiş, Sebahattin; Demirtaş, Mehmet Semih
    Cardiac lipomas are primary benign tumors of the heart, consisting mainly of fat cells and the capsule surrounding them. They are rare, usually detected incidentally, and are mostly asymptomatic or may cause symptoms depending on their location. In this case, we planned to present a 13-year-old male patient who was diagnosed with cardiac lipoma, had echocardiography follow-up at regular intervals, and was treated symptomatically. Although cardiac magnetic resonance imaging and histopathological diagnosis are required to confirm the diagnosis of cardiac lipoma, resection may not be necessary due to the location of the mass and the fact that it does not cause any life-threatening symptoms, as in our patient.
  • Öğe
    Factors in the development of refractory status epilepticus in status epilepticus patients
    (Academic Press Inc Elsevier Science, 2025) Şahin, Oruç; Güneş, Muzaffer
    Objectives: Status epilepticus (SE) is a severe neurological condition associated with a poor prognosis. Refractory status epilepticus (RSE) is a treatment-resistant form of SE with an even worse prognosis. The exact mechanisms underlying the development of RSE are not fully understood. The aim of this study was to investigate the factors contributing to the development of RSE in SE patients and to identify predictors of RSE occurrence. Methods: This retrospective study was conducted on patients diagnosed with SE and RSE between 2014 and 2024. Demographic information, comorbid conditions, and blood sample data of the patients were recorded for statistical analysis. The statistical analyses used included the Mann-Whitney U test, Chi-square test, Fisher's exact test, ROC curve analysis, and logistic regression. Results: A total of 82 SE patients were included in the study. Of these, 44 were non-RSE patients (control group), and 38 were RSE patients. Significant differences were observed between the groups in terms of median age (p = 0.001), blood glucose level (p = 0.023), pan-immune inflammation value (PIV) (p = 0.002), Monocyte/ Lymphocyte Ratio (MLR) (p = 0.009), Neutrophil/Albumin Ratio (NAR) (p = 0.003), Systemic Immune Inflammation Index (SII) (p = 0.013), Eosinophil/Lymphocyte Ratio (ELR) (p = 0.016), Eosinophil/Neutrophil Ratio (ENR) (p = 0.006), and Eosinophil/Monocyte Ratio (EMR) (p = 0.002). The multivariate logistic regression model identified the presence of arterial hypertension as the only factor significantly associated with the development of RSE (p < 0.001). In the ROC curve analysis, PIV (AUC = 0.696) and NAR (AUC = 0.689) were found to be predictive factors for RSE. Conclusions: The findings obtained in the current study suggest that systemic inflammation and arterial hypertension may be associated with the progression of SE to RSE. Further research is needed to confirm these findings and integrate them into routine clinical practice.
  • Öğe
    Fixed-Dose Antiplatelet Dual Combination in Patients with Coronary Artery Disease in Turkish Population: DAPT-TR
    (Sociedade Brasileira de Cardiologia, 2024) Öz, Ahmet; Toprak, Kenan; Aydın, Ertan; Saraç, İbrahim; Doğduş, Mustafa; Opan, Selçuk; Yenerçağ, Mustafa; İnci, Sinan
    Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued. Objectives: The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study. Methods: A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%. Results: Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes.
  • Öğe
    The role of inflammatory markers and βhCG levels in predicting the success of single-dose methotrexate treatment in tubal ectopic pregnancy
    (John Wiley and Sons Ltd, 2024) Soykan Sert, Zekiye; Bertizlioğlu, Mete
    To evaluate the predictive ability of serum beta human chorionic gonadotropin (βhCG) levels and inflammatory markers derived from hemogram parameters in the success of methotrexate (MTX) treatment for tubal ectopic pregnancy. Methods: This retrospective study involved the examination of patients diagnosed with tubal ectopic pregnancy and treated with a single dose of MTX at our clinic between 2018 and 2023. The monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated from blood samples taken at the time of presentation. βhCG levels were recorded on days 1, 4, and 7 of treatment. The patients were categorized into successful and unsuccessful treatment groups based on their response to MTX. Results: No statistically significant differences were found between the two groups regarding MLR, NLR, PLR, or SII values (P = 0.284, P = 0.097, P = 0.455, and P = 0.061, respectively). In the receiver operating characteristic analysis of serum βhCG from day 1 to day 4, the area under the curve value was calculated as 0.832. The cutoff value for the serum βhCG change from days 1 to 4 was −0.093 (−9.3%), with a sensitivity of 85.53% and specificity of 74.14%, and a positive predictive value (PPV) of 87.5%. Conclusion: There were no significant differences in inflammatory markers (MLR, NLR, PLR, and SII) between the successful and unsuccessful MTX treatment groups. The change in serum βhCG levels between days 1 and 4 can be used as an early predictor of MTX treatment success in tubal ectopic pregnancy.
  • Öğe
    Gestational Oxidative Stress and OGTT: Are Pregnant Women’s Fears Justified?
    (Dove Medical Press Ltd, 2024) Genç, Şerife Özlem; Erdal, Hüseyin
    Pregnancy induces significant metabolic, immunological, and endocrinological changes to support fetal growth. The 75-gram oral glucose tolerance test (OGTT) is standard for gestational diabetes screening, but concerns exist about its potential to induce oxidative stress, affecting both maternal and fetal health. The aim of the study is examining changes in oxidative stress markers and thiol/disulfide homeostasis in pregnant women to evaluate these concerns. Patients and Methods: Thirty pregnant women undergoing gestational diabetes screening between the 24th and 28th weeks participated. Blood samples were collected at 0, 60, and 120 minutes as part of the OGTT protocol. Oxidative stress markers were analyzed only in samples from 0 and 120 minutes, while the 60-minute sample was used solely for glucose measurement. Results: Results showed a significant increase in TOS (p = 0.008) and OSI (p = 0.035) post-OGTT, indicating an acute oxidative stress response. Thiol and disulfide levels showed non-significant changes, suggesting that antioxidant mechanisms were largely unaffected. Conclusion: Further research is necessary to explore the long-term implications of these findings and develop strategies to mitigate oxidative stress during pregnancy. This study provides insights into the acute oxidative stress response caused by OGTT in pregnant women. Although the OGTT induces oxidative stress, it does not significantly disrupt the body’s antioxidant capacity in the short term. These results highlight the need for more research to understand the effects of heightened oxidative stress on maternal and fetal health.
  • Öğe
    A rare case of limb anomalies: Rothmund-Thomson syndrome
    (University of Nis, Faculty of Medicine, 2024) Memiş, Sebahattin; Demirtaş, Mehmet Semih
    Introduction. Rothmund-Thomson syndrome (RTS) or congenital poikiloderma is a rare autosomal recessive genodermatosis with involvement of many systems. The risk of mesenchymal malignancy is high in this disease which is accompanied by skin findings such as skin atrophy, hypohyperpigmentation, short stature, growth retardation, hypogonadism, nail and tooth dysplasia, limb abnormalities, and gastrointestinal system symptoms such as chronic diarrhoea and vomiting. Case report. A syndromic patient with thumb aplasia in bilateral fingers, hypopigmented and hyperpigmented macular lesions on the skin, and hypogonadism was referred to the Pediatric Genetics Department and diagnosed with RTS. Conclusion. In this rare disease, early diagnosis, awareness of possible malignancies, and a multidisciplinary treatment approach plan are required.
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    Increased PCSK9 associated with cIMT in AS: A useful marker for subclinical atherosclerosis in patients with ankylosing spondylitis
    (Turkish League Against Rheumatism (TLAR), 2024) Karakoyun, Ahmet; Akkubak, Yasemin; Göktepe, Mevlüt Hakan; Yılmaz, Pınar Diydem; Kadıyoran, Cengiz; Oğul, Mustafa; Kucuk, Adem
    This study aims to investigate the relationship between proprotein convertase subtilisin/ kexin type 9 (PCSK9) levels and subclinical atherosclerosis (SA) in patients with ankylosing spondylitis (AS). Patients and methods: Between January 2022 and March 2022, a total of 56 patients (33 males, 23 females; mean age: 37.8±9.3 years; range, 20 to 60 years) who were under regular follow-up in our clinic and fulfilled the criteria of the Modified New York Diagnostic Criteria for AS and American College of Rheumatology (ACR) for AS were included. Age-and sex-matched 56 healthy volunteers (25 males, 31 females; mean age: 38.4±8.2 years; range, 20 to 60 years) were also recruited as the control group. Demographic, clinical, and laboratory data were recorded. The PCSK9 level and carotid intima-media thickness (cIMT) were evaluated using appropriate methods. Results: The mean serum PCSK9 levels in AS patients (609.3±149.9 vs. 136.3±120.8 ng/mL, p<0.001) and the mean cIMT values (0.51±0.19 vs. 0.43±0.08 mm, p=0.003) were higher than healthy controls. In the multivariate stepwise regression analysis, there was an independent relationship between SA and PCSK9 (?=0.324, p=0.001). Additionally, there was an independent relationship between carotid plaque and PCSK9 (?=0.265, p=0.006). Based on the receiver operating characteristic curve analysis, the optimal PCSK9 cut-off value for plaque was 472.0 ng/mL, sensitivity 90.9%, specificity 65.0% (area under the curve [AUC]=0.759; 95% CI: 0.660-0.857, p=0.005). The optimal PCSK9 cut-off value for SA was 459.5 ng/mL, sensitivity 63.2%, specificity 63.0% (AUC=0.625; 95% CI: 0.512-0.739, p=0.031). Conclusion: Our study showed that serum PCSK9 levels in patients with AS were higher than that in healthy individuals and were associated with SA and arterial plaque formation.
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    Rotavirus vaccination status in rotavirus infection presenting to pediatric emergency department
    (Aksaray Üniversitesi, 2025) Memiş,Sebahattin; Demirtaş, Mehmet Semih; Mutlu, Hüseyin; Erdal, İzzet; Kılıçaslan, Cengizhan; Kokulu, Kamil; Sert, Ekrem Taha; Yazıcı, Ramiz
    Objectives
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    Yedi yaş altı çocuklarda yanık yaralanmalarının değerlendirilmesi
    (Mersin Üniversitesi Sağlık Bilimleri Enstitüsü, 2024) Tuşat, Mustafa; Demirtaş, Mehmet Semih
    Ebeveyn/bakıcı güvenlik ihmalinden kaynaklanan çocukluk çağı yanıkları, çocukluk çağı morbidite ve mortalitesinde rol oynayan önemli bir halk sağlığı sorunudur. Bu çalışmada, güvenlik ihmali sonucu oluşan yanık yaralanması nedeniyle acil servise başvuran çocukların tanımlayıcı özelliklerini araştırmayı amaçladık. Yöntem: Çalışmamız 01.01.2020 ile 31.12.2023 tarihleri arasında Aksaray Eğitim ve Araştırma Hastanesi Çocuk Acil Servisine başvuran yedi yaş altı toplam 122 yanık hastası ile yürütüldü. Sosyodemografik özellikler ve yanıkla ilgili bilgiler anket uygulamasıyla ve hasta dosyalarının geriye dönük taranmasıyla elde edildi. Bulgular: Yanıkların %84.4'ü (n=103) ev içinde, %15.6'sı (n=19) ev dışında meydana gelmiş idi. Evdeki yanıkların %45.1'i (n=55) oturma odasında/salonda ve %29.5'i (n=36) mutfakta meydana gelmiş idi. Su, çorba gibi sıcak sıvı dökülmesine bağlı yanıklar %49.2 (n=60); soba veya ütü temasına bağlı yanıklar %12.3 (n=15); çay ve kahve içimi sırasında dökülme sonucu yanıklar %20.5 (n=25) sıklıkta saptandı. Çocukların %72.1’inde (n=88) yanığın 12.00-21.50 saatleri arasında gerçekleştiği görüldü. Üç yaş altı çocuklarda en sık görülen yanık nedeni üzerlerine sıcak sıvı dökülmesi sonucu oluşan haşlanma yanıkları iken, beş yaş üstü çocuklarda en sık ateşle oynama ve elektrik çarpması sonucu oluşan yanıklar tespit edildi (p=0.005). Sonuç: Ebeveynler üç yaş altı çocuklarda haşlanma yanıkları konusunda daha dikkatli olmalıdır. Anneler, evde daha aktif ve yoğun çalıştıkları saatlerde gözetim ihmali durumuna dikkat etmelidir. Yanıkların görülme sıklığını azaltmak için ebeveyn eğitimi ve farkındalığı sağlanmalıdır.
  • Öğe
    Assessment of the educational value of undescended testicle operation videos on YouTube
    (İnönü Üniversitesi Tıp Fakültesi, 2024) Tuşat, Mustafa; Çalapoğlu, Ahmet Salih; Demirtaş, Mehmet Semih
    Today, Youtube, which is also used as a source of health information, is one of the most visited social platforms. The aim of this study was to evaluate the content and reliability of videos on undescended testicular operations for surgeons and parents. Materials and Methods: On 25/9/2023, the keywords "undescended testicle operation," "orchiopexy," and "children" were searched on the YouTube search engine. The selected videos were divided into two groups: useful and misleading. In addition to the descriptive characteristics of the videos, the reliability, quality and content of the videos were analysed using the global quality score (GQS), modified DISCERN (mDISCERN), and video power index (VPI) score. Results: Of the 62 videos evaluated in our study, 69.4% (n=43) were of high quality, 14.5% (n=9) were of medium quality and 16.1% (n=4) were of low quality. GQS and mDISCERN scores were higher in the useful group (p=0.002, p=0.001, respectively). While 91.1% (n=51) of the videos in the useful group were addressed to healthcare professionals (p=0.024), 78.6% (n=44) of these videos were uploaded by physicians. A positive correlation was observed between GQS and mDISCERN scores (p<0.001). Conclusion: Videos uploaded by academicians, surgeons and addressed to health professionals were found to be reliable and of high quality. Undescended testicular operations videos uploaded to social platforms should be prepared by a committee with health professionals and checked for compliance with scientific standards.
  • Öğe
    Revolutionizing vision restoration: Unleashing the power of Bowman’s layer transplantation
    (Ali Cangül, 2024) Akbulut Yağcı, Betül; Karataş, Ezgi; Utine, Canan Aslı
    Bowman layer inlay and outlay transplantation is a cutting-edge surgical technique that has revolutionized the field of corneal transplantation. This novel technique entails the transfer of the Bowman layer, a slender layer of the cornea, with the purpose of rectifying diverse corneal abnormalities and enhancing visual results. The Bowman layer inlay and outward transplantation approach differs from typical corneal transplantation methods by specifically targeting and replacing the affected layer of the cornea, rather than replacing the whole cornea. This method has many benefits, including accelerated healing periods, less chance of rejection, and enhanced visual acuity. Bowman layer inlay and outlay transplanting is recommended for several corneal diseases and illnesses. Common indications for this operation include keratoconus, corneal dystrophies, corneal scarring, corneal ectasia, and corneal abnormalities. This article will examine the complexities of Bowman layer inlay and outward transplanting, its uses, and the possible advantages it provides to individuals with corneal diseases. Bowman layer inlay and outlay transplanting appropriateness for each unique instance is evaluated by a comprehensive review of the patient’s particular condition and demands.