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Öğe The Effects of Positioning During Colonoscopy on Efficacy and Post-procedure Comfort(AVES, 2025) Ergin, Mustafa; Ergin, Gülencan Yumuşak; Kıvrakoğlu, Fatih; İbiş, MehmetThere are studies with different results on improving effectiveness and patient comfort by increasing lumen distention through positioning during colonoscopy. In our study, we aimed to compare colonoscopy outcomes and post-procedural patient comfort in the left-lateral and right-lateral positions. Materials and Methods: A total of 231 patients who underwent screening colonoscopy were included. Patients were randomized to either the left-lateral or the right-lateral position. Patient age, sex, comorbidities, body mass index (BMI) values, times to reach the cecum, ileum intubation rates, total procedure times, and colonoscopy findings were compared. Pain and discomfort after the procedure were evaluated and compared with the visual analog scale (VAS) scores at 30 minutes, 6 hours, and 24 hours. Results: Colonoscopy was performed in the left-lateral position in 129 patients and in the right-lateral position in 102. The distributions of age, sex, comorbidities, and BMI values were similar in both groups. The time to reach the cecum and the total procedure time were similar in both groups. There were no significant differences in the findings detected by colonoscopy. There was no significant difference in the post-procedural VAS scores. Conclusion: This study failed to show a difference in colonoscopy outcomes and postprocedural discomfort between the left- and right lateral positions.Öğe Pan-immune inflammation value and systemic inflammatory index as a measure of systemic inflammation in patients with psoriasis: A retrospective study(Lippincott Williams and Wilkins, 2025) Başar Kılıç, Şeyma; Erdal, HüseyinPsoriasis is a chronic immune-mediated disease characterized by systemic inflammation. In recent years, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV) were shown to be important indicators of inflammation. The aim of the present study is to investigate NLR, PLR, SII, SIRI, PIV together in patients with psoriasis. This retrospective case-control study encompassed seventy-one individuals diagnosed with psoriasis and seventy healthy controls who underwent evaluation at the Dermatology clinics of Aksaray University Training and Research Hospital from January 2022 to January 2023. Inflammatory process indicators such as NLR, PLR, SII, SIRI, PIV were computed for analysis. A notable discovery from our research was the indication of a direct relationship between SII and Psoriasis Area Severity Index (PASI) scores. A statistically significant difference was found between the 2 groups in terms of neutrophils, lymphocytes, monocytes, and platelets (P < .05). The area under the curve of the SII score for psoriasis was 0.611. The optimal cutoff value of SII to predict psoriasis activation was 442.7, with 55.7% sensitivity and 45.7% specificity (95% confidence interval 0.518-0.704, P = .024). A positive correlation was observed between SII, PIV and PASI (P = .004, r = 0.34; P = .006, r = 0.32 respectively).There was no statistically significant distinction observed in the PLR indices between the groups (P > .05). The present study investigation demonstrates the potential utility of SII, SIRI, and PIV in assessing psoriasis patients. Moreover, the findings suggest that SII and PIV could function as an autonomous prognostic marker for individuals diagnosed with psoriasis.Öğe Effects of Morin on the Wnt, Notch1/Hes1, KI-67/3-Nitrotyrosine and Damage Signaling Pathways in Rats Subjected to Experimental Testicular Ischemia/Reperfusion(Springer International Publishing, 2025) Öztürk, Ayşe Betül; Şimşek, Hasan; Akaras, Nurhan; Kandemir, Fatih MehmetTesticular torsion, which occurs when the testicle rotates around the axis of the spermatic cord, is a serious cause of hospital admission, mostly in newborns and children, but also in adults. Oxidative stress is an important mediator of the development of complications. Morin has anti-inflammatory, anti-autophagic, and anti-apoptotic activities and especially strong antioxidant activity. This study aimed to determine the effects of Morin on testicular torsion injury. Methods: 35 Wistar rats were divided into 5 groups (n = 7): Control, Morin, I/R, I/R + MRN50, and I/R + MRN100. Parameters are effective in oxidative stress, inflammation, endoplasmic reticulum stress, apoptosis, and autophagy damage and Wnt pathway parameters, KI-67, and 3-NT levels were analyzed by biochemical, molecular, and histological methods. Results: I/R injury significantly increased oxidative stress (MDA, p < 0.001) and reduced antioxidant activity (GSH, SOD, CAT, GPx; p < 0.001). MRN administration reversed these effects, with higher doses showing greater improvement (p < 0.01 for CAT, p < 0.001 for others). Inflammation markers (NF-kB, IL-1β, TNF-α, COX-2, iNOS) were elevated in the I/R group, but MRN reduced their expression (p < 0.001). MRN also mitigated ER stress and reactivated the Wnt signaling pathway, particularly at 100 mg/kg (p < 0.001). Additionally, MRN reduced apoptosis (Caspase-3, Bax, p < 0.001) and autophagy (Beclin-1, LC3A, LC3B, p < 0.001), and improved testicular histology and sperm parameters. MRN treatment restored sperm density, motility, and viability (p < 0.05), with higher doses proving more effective. Conclusion: MRN has effects properties in testicular I/R injury by inhibiting many damage pathways and activating protective mechanisms.Öğe Use of the CHA2DS2‑VASc Score to Predict Concurrent Critical Coronary Artery Stenosis in Patients with Severe Carotid Artery Disease(Wolters Kluwer Medknow Publications, 2025) Baran, O.; Yılmaz, Y.; İnci, S.; Çetinkaya, Z.; Keleşoğlu, S.There is a significant correlation between the severity of atherosclerosis in one arterial region and the occurrence of atherosclerotic disease in other regions. Identifying and managing vascular disease in patients with multifocal arterial disease is often complex. The CHA2DS2-VASc score encompasses several cardiovascular risk factors and was initially used to assess the risk of thromboembolism, stroke, and death in patients with atrial fibrillation. In recent years, this score has been proposed to predict the prognosis of various cardiovascular diseases. Aim: The study aimed to investigate the prevalence of concomitant coronary artery disease (CAD) and the correlation between the CHA2DS2-VASc score and CAD in patients who were scheduled for carotid stenting due to carotid artery stenosis (CAS) but had no history of CAD. Methods: A total of 452 patients were included in the study, 213 with symptomatic CAS and 239 with asymptomatic CAS. The patients were separated into two groups: those with and without. Results: One hundred forty-eight (32.7%) of 452 patients had critical CAD. Multivariate logistic regression analysis showed that a high CHA2DS2-VASc score (OR: 4.283, 95% CI: 2.903–6.321, P < 0.001) was an independent predictor of the development of CAD. Receiver operating characteristic curve (ROC) analysis showed 64.9% sensitivity and 82% specificity in detecting CAD of the CHA2DS2-VASc score at >4 cutoff [Area under ROC curve = 0.781 (95% CI: 0.724–0.838), P < 0.001]. Conclusion: When our results were analyzed, a CHA2DS2-VASc score of >4 was highly significant in predicting severe CAD.Öğe Extra virgin olive oil mitigates lung injury in necrotizing enterocolitis: Effects on TGFβ1, Caspase-3, and MDA in a neonatal rat model(Public Library of Science, 2025) Tuşat, Mustafa; Eröz, Recep; Bölükbaş, Ferhan; Özkan, Erkan; Demirtaş, Mehmet Semih; Erdal, Hüseyin; Özocak, Osman OkanNecrotizing enterocolitis (NE), which is common in premature babies, has been associated with lung damage. Our aim is to explore the effect of enterally administered extra virgin olive oil (EO) with rich polyphenol content on clinical parameters, histopathological score, Transforming growt factor beta-1 (TGFβ1), Caspase 3 and Malondialdehyde (MDA) levels in NE-related lung injury of neonatal rats. Methods Three groups (control, NE, NE+EO) were created, with 8 neonatal rats in each group. NE was induced by hypoxia-hyperoxia-hypothermia and formula feeding. EO was given to the treatment group by orogastric probe for 3 days. Intestinal and lung tissue were excised for analysis. Results TGFβ1 expression levels, TGFβ1 and MDA concentration levels were higher in the NE compared to NE + EO and control groups (p < 0.001), and their levels decreased after EO treatment compared to the NE group (p < 0.001). It was determined that EO treatment significantly reduced the histopathological damage and the caspase-3 (CASP3) expression level in the lung (p < 0.001). Conclusion Our findings emphasize that TGFß1 has an crucial function in NE-related lung injury and that EO has therapeutic potential in NE-related lung injury.Öğe Revealing Molecular Diagnosis With Whole Exome Sequencing in Patients With Inherited Retinal Disorders(John Wiley and Sons Inc, 2025) Yavaş, Cüneyd; Doğan, Mustafa; Gezdirici, Alper; Aslan, Elif Sibel; Karapapak, Murat; Barış, Savaş; Eröz, RecepInherited retinal diseases (IRDs) constitute a heterogeneous group of clinically and genetically diverse conditions, standing as a primary cause of visual impairment among individuals aged 15–45, with an estimated incidence of 1:2000. Our study aimed to comprehensively evaluate the genetic variants underlying IRDs in the Turkish population. This study included 50 unrelated Turkish IRD patients and their families. Genomic DNA was extracted from each participant, and candidate variants were identified via next-generation sequencing to determine their pathogenicity. We detected variants in 58% of the patients, of which six novel variants were identified. Among these, 16 cases exhibited variants associated with retinitis pigmentosa and Stargardt disease, while 13 presented variants linked to other retinal diseases. The spectrum of identified variants included 21 homozygous cases and five compound heterozygous variants, both indicative of autosomal recessive inheritance. Three cases revealed heterozygous variants suggestive of autosomal dominant inheritance, and two cases featured hemizygous variants suggestive of X-linked inheritance. Importantly, no matches with copy number variants were detected in our analysis. This study comprehensively portrays clinical and genetic profiles within the Turkish population affected by IRDs. Identifying novel variants and delineating inheritance patterns contribute to a deeper understanding of the genetic diagnosis of IRDs, paving the way for more precise diagnostic and therapeutic interventions. © 2025 The Author(s). Clinical Genetics published by John Wiley & Sons Ltd.Öğe Predictive Value of Ionized Calcium Level for Sinus Rhythm Conversion in Adenosine Treatment for Paroxysmal Supraventricular Tachycardia(Elsevier Inc., 2025) Sert, Ekrem Taha; Kokulu, Kamil; Mutlu, Hüseyin; Gönen, Mustafa Önder; Sert, Zekiye SoykanBackground: Paroxysmal supraventricular tachycardia (SVT) is a recurrent tachydysrhythmia that often leads to emergency department (ED) visits and is commonly treated with intravenous adenosine. Objective: The objective of this paper is to evaluate the relationship between the initial ionized calcium (iCa) level and the achievement of normal sinus rhythm following 6 mg adenosine administration in patients with SVT. Methods: This retrospective, single-center study was conducted in the ED from 2019 to 2023 and included consecutive adult patients diagnosed with SVT who received adenosine treatment. The patients were categorized into two groups based on their response to adenosine treatment. The receiver operating characteristic (ROC) curves were constructed to evaluate the effectiveness of iCa levels in predicting conversion to sinus rhythm. Results: A total of 326 patients were analyzed. The mean iCa level in patients who achieved a sinus rhythm after the initial 6-mg dose was 1.13 ± 0.08 mmol/L, as compared to 1.03 ± 0.11 mmol/L in those who did not respond to this dose, indicating a statistically significant difference (mean difference [95% confidence interval (CI)]: −0.101 [−0.12 to −0.07]). The area under the ROC curve was calculated to be 0.803 (95% CI: 0.752–0.854). An iCa cut-off value of 1.14 mmol/L was determined to be significant for the prediction of achieving sinus rhythm, with a sensitivity of 64.75% (95% CI: 55.6–73.2) and a specificity of 87.75% (95% CI: 83.6–92.7). Conclusion: Our study suggests that the iCa level may be a useful parameter for predicting the response to the 6 mg adenosine dose in patients with SVT.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 EminThe 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, ŞeymaWe 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, MuhammedWe 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, RecepBackground: 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, KenanIntroduction: 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.Öğe 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, ŞehimObjectives: 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, HüseyinAim: 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 FarukBackground: 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 SemihCardiac 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, MuzafferObjectives: 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, SinanDual 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, MeteTo 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.
