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Öğe Planned iliohypogastric neurectomy for prevention of chronic pain after inguinal hernia repair(Springer-Verlag Italia s.r.l., 2025) Gemici, Kazım; Özeren, ErsinPurpose: The present study aimed to investigate the effect of planned ilohypogastric neurectomy (IHPN) in preventing chronic postoperative inguinal pain (CPIP) after anterior herniorrhaphy (AH). Materials and methods: This prospective, randomized study was conducted between 2016 and 2023. Emergency and incarcerated hernia cases, bilateral inguinal hernias, cases with complications such as postoperative hematoma infection, cases in which the neuroanatomy of the inguinal region was unintentionally damaged, femoral hernias, and paraplegic patients with loss of sensation who underwent anterior inguinal herniorrhaphy with prolene mesh were excluded, and the remaining 1375 patients were included in this study. The patients were randomized into preoperative control and study groups. After further excluding 247 patients (18%) in whom the IHN could not be identified during the operation, 82% of the 1375 patients (n = 1128) were included in this study. In the control group, the RCA segment of the IHN that would remain under the mesh was preserved (control group = G1 = 534). The second group in which this segment of the RCA was excised comprised the study group (G2 = 594). Two groups were prospectively followed and pain scores (PS) were recorded regularly with a 4-point scale. The average follow-up period was 15 months (range 11–19 months) in G1 and 14 months (range 10–18 months) in G2. Results: The number of patients with CPIP was 68 in G1 and 19 in G2, this difference was found to be statistically significant (p: < 0.001). There were 19 patients in G1 and 41 patients in G2 with loss of sensation in the operation area, and a significant difference was detected in this respect (p = 0.012). Conclusion: The rate of developing CPIP was significantly lower in patients who underwent IHPN during anterior herniorrhaphy than in those who did not undergo IHPN. The subjective nature of the pain sensation complicates measuring and scoring this sensation and methodologically limits the study.Öğe Response to commentary on: ChatGPT-4o's performance on pediatric vesicoureteral reflux(Elsevier Ltd, 2025) Akyol Önder, Esra Nagehan; Ensari, Esra; Ertan, PelinThe current study evaluated the reliability and readability of ChatGPT-4o’s responses regarding pediatric vesicoureteral reflux [1]. The sources of information have been rapidly evolving, with AI and chatbots, such as ChatGPT, emerging as significant contributors. The scope of artificial intelligence (AI) usage has been expanding in the medical field. However, further research and validation by researchers and healthcare professionals are required before AI can be widely used as a reliable public source of information.Öğe 18β-glycyrrhetinic acid Mitigates bisphenol A-induced liver and renal damage: Inhibition of TNF-α/NF-κB/p38-MAPK, JAK1/STAT1 pathways, oxidative stress and apoptosis(Elsevier Ltd, 2025) Darendelioğlu, Ekrem; Cağlayan, Cüneyt; Küçükler, Sefa; Bayav, İbrahim; Kandemir, Fatih Mehmet; Ayna, Adnan; Sağ, SevdaBisphenol A (BPA) has been commonly used in various consumer products, including water bottles, food containers, and canned food linings. However, there are concerns about its potential toxicity to human health, particularly its impact on the liver and kidneys. The objective of this research was to investigate the potential ameliorative effects of 18β-glycyrrhetinic acid (GA) against BPA-induced hepatotoxicity and nephrotoxicity in rats. The animals were supplemented with BPA (250 mg/kg b.w.) alone or with GA (50 and 100 mg/kg b.w.) for 14 days. GA treatment alleviated the BPA-induced hepato-renal tissue injuries through reducing the serum ALT, AST and ALP levels, and urea and creatinine levels. GA co-treatment also increased activities of SOD, CAT and GPx enzymes and levels of GSH, and suppressed MDA levels in BPA induced tissues. BPA also induced inflammation by increasing the levels of TNF-α, NF-κB, JAK1, STAT1, P38 MAPK and JNK in liver and kidney tissues and GA treatment ameliorated these effects. BPA triggered apoptosis by increasing caspase-3, Bax, and cytochrome c at protein levels and also by decreasing the antiapoptotic Bcl-2 level. However, treatment with GA (50 and 100 mg/kg) decreased apoptosis. Overall, our results have revealed the potential ameliorative mechanisms of GA, as a possible agent for BPA-induced hepatotoxicity and nephrotoxicity.Öğe Potential impact of obstetric history on postmenopausal fragility fracture risk: A reassessment of the Fracture Risk Assessment Tool(Turkish Joint Diseases Foundation, 2024) Sezgin, Aydan; Saçıntı, Huriye Güvenç; Osmanlı, Elşad; Mangır, Kübra; Saçıntı, Koray Görkem; Sezgin, Erdem ArasObjectives: This study aimed to evaluate the impact of integrating obstetric parameters into the Fracture Risk Assessment Tool (FRAX) on the precision of risk assessment. Patients and methods: In this retrospective study, patients who experienced postmenopausal fragility fractures of the distal radius, proximal femur, or lumbar vertebrae between January 1, 2021, and December 31, 2023, were included. Obstetric histories, along with standard FRAX parameters, were obtained by phone interviews. Based on the FRAX major osteoporotic fracture risk score calculated without bone mineral density, patients were classified into high-, intermediate-, and low-risk group categories. Differences in age at menarche, age at menopause, lactation duration, gravidity, and parity were analyzed across risk categories. Results: A total of 328 patients (mean age: 64.5±5.8 years; range, 55 to 75 years) were included. The mean FRAX score was 16±8.8 (range, 3 to 58), and 85, 191, and 52 patients were classified as high-, intermediate-, and low-risk, respectively. A positive correlation was observed between FRAX scores and both later age at menarche and earlier menopause (p<0.001 and p=0.008, respectively). The mean age at menopause was significantly different between the high- and low-risk groups (46.4 vs. 49.3 years, p=0.016). The intermediate-risk group was also evaluated, showing no significant differences in obstetric parameters compared to the low-risk group (p>0.05). Conclusion: Although late menarche is not explicitly included in FRAX, its association with higher fracture risk was evident. The established influence of early menopause on FRAX scores supports its role in fracture risk estimation. However, the inclusion of additional obstetric parameters did not enhance the predictive accuracy of FRAX in this cohort.Öğe ChatGPT-4o?s performance on pediatric Vesicoureteral reflux(Elsevier Ltd, 2024) Akyol Önder, Esra Nagehan; Ensari, Esra; Ertan, PelinVesicoureteral reflux (VUR) is a common congenital or acquired urinary disorder in children. Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence-driven platform offering medical information. This research aims to assess the reliability and readability of ChatGPT-4o?s answers regarding pediatric VUR for general, non-medical audience. Materials and methods: Twenty of the most frequently asked English-language questions about VUR in children were used to evaluate ChatGPT-4o?s responses. Two independent reviewers rated the reliability and quality using the Global Quality Scale (GQS) and a modified version of the DISCERN tool. The readability of ChatGPT responses was assessed through the Flesch Reading Ease (FRE) Score, Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Results: Median mDISCERN and GQS scores were 4 (4–5) and 5 (3–5), respectively. Most of the responses of ChatGPT have moderate (55 %) and good (45 %) reliability according to the mDISCERN score and high quality (95 %) according to GQS. The mean ± standard deviation scores for FRE, FKGL, SMOG, GFI, and CLI of the text were 26 ± 12, 15 ± 2.5, 16.3 ± 2, 18.8 ± 2.9, and 15.3 ± 2.2, respectively, indicating a high level of reading difficulty. Discussion: While ChatGPT-4o offers accurate and high-quality information about pediatric VUR, its readability poses challenges, as the content is difficult to understand for a general audience. Conclusion: ChatGPT provides high-quality, accessible information about VUR. However, improving readability should be a priority to make this information more user-friendly for a broader audience.Öğe Prognostic value of systemic immune-inflammatory index in pulmonary embolism(Galenos Yayınevi, 2024) Mermer, Mehmet; Kaçer, İlker; Çağlar, AhmetThis study aimed to investigate the extent to which the systemic immune-inflammatory index (SII) is associated with patients with acute pulmonary embolism (PE), compare the SII with other commonly used biomarkers and scoring systems, and evaluate its suitability for routine use in PE risk classification. Materials and Methods: Patients with acute PE admitted in 2021 were retrospectively reviewed. A cut-off value for the SII was obtained to examine the predictive value of the SII for 30-day mortality as the primary outcome. The secondary outcome of the study was to compare the SII with other predictors of 30-day mortality in patients with acute PE. Results: A total of 139 patients with a mean age of 68.33±14.58 years were included in the study. The cut-off value for 30-day mortality was an SII of ?0.904 (sensitivity: 88.5%; specificity: 58.4%; area under the curve: 0.803; p<0.001). Lactate, age, right ventricular dysfunction (RVD), and SII ?0.904 were independent risk factors for 30-day mortality in PE (p<0.05). The SII has a strong correlation with lactate and the presence of RVD (p<0.001). Conclusion: The SII was found to be strongly associated with RVD, age, and lactate in patients with acute PE. Prospective studies may prove that the SII can fill the gap of inexpensive, rapid, and accessible prognostic biomarkers in rural emergency departments where echocardiography is not accessible.Öğe Evaluation of the effect of age-related macular degeneration type and stage on the risk of parkinson’s disease(Eskişehir Osmangazi Üniversitesi, 2024) Yaşar, Erdoğan; Gürlevik, Uğur; Bilgeç, Mustafa Değer; Güneş, MuzafferThe aim of the study was to investigate the distance between Parkinson's Disease (PD) and Age-Related Macular Degeneration (AMD) type and stage.. Our prospective study, the dry-type AMD group consisted of 296 patients with early and 284 patients with late-stage. The neovascular AMD group included 285 early and 277 late-stage patients. The control group consisted of 300 patients. AMD patients were grouped as dry and neovascular type and early and late stage. The patients were questioned about the use of drugs for PD, and the use was recorded as having the disease. If any of the complaints seen in the PD were present, the patient was referred to a neurologist. PD was detected in 1% of the control group and 4.6% in the neovascular type AMD group, and this difference was significant (p:0.04). This difference was present in both the early (%4.5) and late-stage (%4.6 ) (p:0.04, p:0.04). PD was determined 3.78 times greater among neovascular AMD patients(p:0.03), and significant association was present in both early (3.72 times) and late-stage (3.82 times) (p:0.03, p:0.03). In the dry-type AMD group 2.7% PD was detected and there was no statistical difference (p>0.05). This difference was not significant in the early stage (%2.3) or late-stage (%2.8) and also there was no association with dry-type AMD (p>0.05). Also, unilateral and bilateral involvement in AMD was not associated with PD (p>0.05). Our study revealed the association between both early and late neovascular AMD and PD. However, any significant relationship was not detected in terms of both unilateral and bilateral involvement.Öğe Prevalence, distribution, and prognostic significance of morphological variants of neuroendocrine tumors of the gastrointestinal tract - a multicenter study(Versalius University Medical Publisher, 2024) Akay, Ebru; Ordu, Melike; Çoban, Ganime; Darakcı, Seher; Topaloğlu, Nahit; Taştekin, Filiz Meral; Ekinci, Büşra; Şahin, Nurhan; Gucin, Zuhal; Karaman, HaticeThe incidence and prevalence of neuroendocrine neoplasms (NENs) in many organs are increasing. Although such NENs have similar grades, they may exhibit quite different behaviors. In this multicenter study, we aimed to investigate the prevalence and distribution of different morphological NEN variants in the non-pancreatic gastrointestinal (GI) tract and determine whether they can guide prognosis prediction. Two hundred and fifty-six patients diagnosed with NENs originating from the GI tract from 7 different centers were included in the study. In 89 (36.6%) cases, different morphological variants were detected. When the variants were grouped according to their aggressiveness as described in the literature, a statistically significant relationship between aggressiveness and the variables organ and age was found ( p < 0.05). The oncocytic variant was found to metastasize more than the other aggressive types (42.9%). The paraganglioma-like variant was found to have a smaller size, lower proliferation index, and a more benign clinical course. This study demonstrated that well-differentiated GI neuroendocrine tumors (GI-NETs) have considerable morphological diversity. Generally, case reports of rare morphological variants of GI-NETs are available in the literature. We believe that our study contributes to a better understanding of the prevalence, localization, and significance of morphological variations in GI-NETs.Öğe Does heart failure have an effect on the progress of diabetic retinopathy(Bayrakol Medical Publisher, 2024) Yaşar, Erdoğan; Aktaş, Halil; Gül, Murat; Gürlevik, UğurTo evaluate the effect of concomitant heart failure on diabetic retinopathy (DR) in patients with Diabetes Mellitus (DM). Material and Methods: In this cross-sectional study, 40 eyes of 20 patients with DM alone (control group) and 70 eyes of 35 patients with heart failure and DM were included. Anterior segment and dilated fundus examination were performed in all patients. DR was classified as mild, moderate, severe non -proliferative DR and proliferative DR. According to the ejection fraction (EF), the stage of heart failure was classified as decreased (HFrEF) if LVEF <40%, moderate (HFmrEF) if LVEF was 40-49%, and preserved (HFpEF) if LVEF >= 50%. After this staging of HF patients; 13 were classified as HFpEF, 12 as HFmrEF and 10 as HFrEF Results: In our cross-sectional study, the mean age of the patients in the HF+DM+ group consisting of 35 patients was 54.4 +/- 12.6 and the mean age of the control group consisting of 20 patients was 51.7 +/- 6.8. PDR and DR in the HFrEF group were found to be significantly higher than the control (p=0.02, p=0.04 respectively. In addition, as a result of examining the relationship between the factors affecting the severity of DR, the duration of DM (p=0.01, OR=1.62), HbA1c (p=0.03, OR=2.95) and HF severity (p=0.02, OR=1.86). Discussion: Our study shows that the risk of PDR is increased in the HFrEF stage in patients with HF accompanying DM, in addition to blood glucose regulation, HF treatment may contribute positively to DR.Öğe Open Reduction and Plate Fixation, External Fixator, and Conservative Treatment for Intra-articular Distal Radius Fractures(Cureus, 2024) Akdemir, Mehmet; Kılıç, Ali İhsan; Kurt, Cengizhan; Çapkın, SercanDistal radius fractures are common fractures. Treatment of intra-articular fractures is controversial, with treatment modalities including closed reduction and casting, open reduction and plating, and closed reduction and fixation with an external fixator. In this study, we compared the clinical and radiological outcomes of our patients treated with three different methods for intra-articular distal radius fractures. We hypothesize that open reduction and plate application are superior. Methodology Adult patients with intra-articular (AO type B and C) fractures of the distal radius and treated with closed reduction-casting, volar locking plate, and external fixator were identified. Radiologically, joint stepping at the end of treatment, radial inclination, radial height, volar tilt, and distal ulna fracture were examined. For clinical scoring, Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores were computed. Obtained data were compared statistically between groups. Results A total of 164 patients were included in the study. Overall, the treatment modality was conservative in 61, volar with plating in 78, and external fixation in 25. The mean age of the patients was 53.7 years (range = 20-82 years). Overall, 39.6% of the patients were male and 60.4% were female. The mean follow-up period of the patients was 16.7 months (range = 12-28 months). No statistically significant difference was found between Q-DASH scores in the statistical evaluation (p > 0.05). There was a statistically significant difference between the groups in the radiological evaluation. When conservative treatment and the volar plate group were compared, the volar plate was superior in all radiological parameters (p < 0.05). Compared with conservative treatment and external fixation, only volar tilt and radial inclination angle were different. External fixation was better (p < 0.05). Radial length, volar compared to plate and external fixation tilt, and ulnar variance were better in the plate group (p < 0.05). Regarding joint stepping and radial, there was no difference in inclination between the two groups (p > 0.05). Reflex sympathetic dystrophy was seen in a total of 10 (6.1%) patients. Pin-site infection was seen in three (12%) patients in the external fixator group. Implant removal was performed in seven (9.0%) patients who developed plaque due to irritation and tenosynovitis. Early arthrosis was seen in three (4.3%) patients. Conclusions The treatment of distal radius intra-articular fractures should be evaluated and decided individually for each patient. No single method is directly superior to other methods. However, in some cases, the best results radiologically in the treatment of comminuted intra-articular fractures have been obtained in patients with volar plates.Öğe Admissions of Refugee and Turkish Children to Emergency Departments(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Kılıçaslan, Cengizhan; Özdemir Kaçer, Emine; Ateş, CanDue to increasing population of refugees, rapid alterations have been experienced in the racial and ethnic composition of our country. Such alterations have increased health services to those from different races/ethnic origins, especially in emergency departments (ED). In this study, we aimed to compare health services administered to refugees and Turkish citizens and give recommendations regarding health policies. Data were obtained from the hospital database, and one-year admissions to the pediatric ED were retrospectively analyzed. Such criteria as race, sex, and age of refugees and Turkish citizens were investigated through waiting time before the examination, length of stay in ED, findings of computed tomography (CT), magnetic resonance imaging (MRI) and ultrasonography (USG), and way of quitting ED. Refugees were observed to take boys more to ED, apply to ED more during the daytime, be admitted more often with green zone and polyclinic diagnoses, and undergo imaging techniques at a lower rate (p<0.001). However, refugees were also seen to stay in ED for a shorter time and have lower waiting times (p<0.001). Refugees were detected to benefit ED as visits to outpatient clinics, take younger children and boys more, stay in ED shorter, and undergo imaging techniques less due to such challenges as health insurance and language barriers and inability to access to medical call centers. Although statistically significant differences are considered to be mostly due to the use of ED, more studies are needed to elucidate ethnic/racial differences and implicit biases.Öğe Protective effects of naringin against oxaliplatin-induced testicular damage in rats: Involvement of oxidative stress, inflammation, endoplasmic reticulum stress, apoptosis, and histopathology(Mashhad University of Medical Sciences, 2024) Akaras, Nurhan; Gür, Cihan; Çağlayan, Cüneyt; Kandemir, Fatih MehmetOxaliplatin (OXL) is a platinum-based chemotherapeutic agent widely used in the treatment of colorectal cancer. Unfortunately, this important drug also causes unwanted side effects such as neuropathy, ototoxicity, and testicular toxicity. This study aimed to investigate the possible protective effects of naringin (NRG) against OXL-induced testicular toxicity in rats. Materials and Methods: In the present study, rats were injected with OXL (4 mg/kg, b.w./day, IP) in 5% dextrose solution 30 min after oral administration of NRG (50 and 100 mg/kg, b.w./day) on the 1st, 2nd, 5th, and 6th days. Then, the rats were sacrificed on the 7th day and the testicular tissues were removed. Results: The results showed that NRG decreased (P<0.001) lipid peroxidation, increased (P<0.001) the activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), and the levels of glutathione (GSH), and also maintained the testis histological architecture and integrity. NRG decreased the levels of apoptosis-related markers such as caspase-3, Bax, and Apaf-1 and increased Bcl2 in the OXL-induced testicular toxicity (P<0.001). In addition, NRG reversed the changes in mRNA transcript levels of oxidative stress, inflammation, and endoplasmic reticulum stress parameters such as Nrf2, HO-1, NQO1, RAGE, NLRP3, MAPK-14, STAT3, NF-?B, IL-1?, TNF-?, PERK, IRE1, ATF6, and GRP78 in OXL-induced testicular toxicity (P<0.001). Conclusion: Our results demonstrated that NRG can protect against OXL-induced testicular toxicity by enhancing the anti-oxidant defense system and suppressing apoptosis, inflammation, and endoplasmic reticulum stress.Öğe Zingerone attenuates sciatic nerve damage caused by sodium arsenite by inhibiting NF-?B, caspase-3, and ATF-6/CHOP pathways and activating the Akt2/FOXO1 pathway(Mashhad University of Medical Sciences, 2024) Yılmaz, Selçuk; Gür, Cihan; Kücükler, Sefa; Akaras, Nurhan; Kandemir, Fatih MehmetIn the present study, the potential protective effects of zingerone (ZNG) against sciatic nerve damage caused by sodium arsenite (SA), a common environmental pollutant, were evaluated by various biochemical, molecular, and histological methods. Materials and Methods: In the study, SA and ZNG were given to 35 male Sprague Dawley rats for 14 days. At the end of the period, the sciatic nerve tissues were taken and the markers involved in oxidative stress, endoplasmic reticulum stress, inflammation, and apoptosis were analyzed. Results: The data obtained showed that SA decreased glutathione (GSH) levels and increased malondialdehyde (MDA) levels in the sciatic nerve tissue. However, it was determined that these markers approached the control group levels due to the anti-oxidant properties of ZNG. While SA triggered endoplasmic reticulum stress and apoptosis pathways, ZNG suppressed them. Moreover, SA up-regulated inflammatory markers such as nuclear factor kappa-B (NF-?B), tumor necrosis factor-alpha (TNF-?), interleukin-1-beta (IL-1?), and neuronal nitric oxide synthases (nNOS) in the sciatic nerves and caused neuro-inflammation and inhibited cell survival by suppressing serine/threonineprotein kinase 2 (Akt2) and forkhead box protein O1 (FOXO1) genes. It has also been shown histopathologically that SA causes degeneration in the sciatic nerves. In contrast, ZNG suppressed neuro-inflammation, activated Akt2/FOXO1 signaling, and repaired histological irregularities. Conclusion: In general, SA caused oxidative stress, inflammation, ER stress, and apoptosis in the sciatic nerves of rats, causing damage to the tissues, however,Öğe Evaluation of Orthopaedics and Traumatology Patients Referred From a Tertiary Hospital(Cureus, 2023) Yolaçan, Hakan; Güler, SerkanBackgroundThis study aims to determine the rate of interhospital transfer, transfer diagnoses, where they were referred, and the reasons for the transfer of patients who presented to the emergency department and requested orthopaedic and traumatology consultations and to evaluate measures that may be effective in reducing the number of referrals for a more effective health service provision as a result of this information.Material and methodsIn this descriptive study, 59 patients were transferred to the emergency department of our hospital between January 1, 2019, and January 1, 2022, for whom orthopaedic and traumatology consultations were requested and for whom the orthopaedic physician requested transfer (training and research hospitals, university hospitals and private hospitals), and they were retrospectively evaluated.ResultsThe ages of the study participants ranged from 1 to 91 years, with a mean age of 39.8 +/- 20.9 years. Therefore, the majority of referred patients were male and Turkish citizens aged 18-65 years; there were no forensic cases; they were evaluated in the yellow area as a result of triage; and most of the transfers were from training and research hospitals and university hospitals, which are tertiary health institutions. On categorising patients based on their transfer diagnoses, it was found that patients with subtotal amputation of the finger were the most common among the referred patients. ConclusionTo reduce the number of referrals, it is recommended to increase the standards in assistant training, especially in pelvis, acetabulum, and hand surgeries. It is also recommended to optimise material supply and skilled labour distribution.Öğe Hesperidin counteracts chlorpyrifos-induced neurotoxicity by regulating oxidative stress, inflammation, and apoptosis in rats(Springer, 2024) Küçükler, Sefa; Çağlayan, Cüneyt; Özdemir, Selçuk; Çomaklı, Selim; Kandemir, Fatih MehmetChlorpyrifos (CPF), considered one of the most potent organophosphates, causes a variety of human disorders including neurotoxicity. The current study was designed to evaluate the efficacy of hesperidin (HSP) in ameliorating CPF-induced neurotoxicity in rats. In the study, rats were treated with HSP (orally, 50 and 100 mg/kg) 30 min after giving CPF (orally, 6.75 mg/kg) for 28 consecutive days. Molecular, biochemical, and histological methods were used to investigate cholinergic enzymes, oxidative stress, inflammation, and apoptosis in the brain tissue. CPF intoxication resulted in inhibition of acetylcholinesterase (AChE) and butrylcholinesterase (BChE) enzymes, reduced antioxidant status [superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione (GSH)], and elevation of malondialdehyde (MDA) levels and carbonic anhydrase (CA) activities. CPF increased histopathological changes and immunohistochemical expressions of 8-OHdG in brain tissue. CPF also increased levels of glial fibrillary acidic protein (GFAP) and nuclear factor kappa B (NF-?B) while decreased levels of nuclear factor erythroid 2-related factor 2 (Nrf-2), heme oxygenase-1 (HO-1) and peroxisome proliferator–activated receptor gamma coactivator-1 alpha (PGC-1?). Furthermore, CPF increased mRNA transcript levels of caspase-3, Bax, PARP-1, and VEGF, which are associated with apoptosis and endothelial damage in rat brain tissues. HSP treatment was found to protect brain tissue by reducing CPF-induced neurotoxicity. Overall, this study supports that HSP can be used to reduce CPF-induced neurotoxicity.Öğe Value of increased CRP/albumin ratio in predicting embolic events in patients with infective endocarditis(Newlands Press Ltd, 2023) Keleşoğlu, Şaban; İnci, Sinan; Gül, Murat; Düzgün, İsmail; Tuncay, Aydın; Aktaş, Halil; Elcik, Deniz; Kalay, NihatThe CRP/albumin ratio (CAR), a new inflammatory marker, is associated with adverse outcomes in various cardiovascular diseases. We evaluated the effectiveness of CAR in predicting embolic events in patients diagnosed with infective endocarditis (IE). Methods: A total of 145 patients with IE were included in the study and categorized into two groups according to the presence of embolic events. We retrospectively analyzed the patients' clinical, laboratory and echocardiographic data. Results: CRP (94.2 vs 63.3; p < 0.001) and CAR (25.8 vs 15.1; p < 0.001) values were significantly higher in patients who experienced embolic events. Multivariate analysis showed that a high CAR value (odds ratio: 1.030; 95% CI: 1.000-1.060; p = 0.041) was an independent predictor of embolic events in patients with IE. Conclusion: The CAR is a cheap and easily accessible marker that can predict the development of embolic events in patients diagnosed with IE.Öğe Management Patterns of Male Urethral Stricture Disease among Urologists: What Do the Guidelines Say? What Do Urologists Do?(Iniestares, S.A., 2024) Değer, Mutlu; Cebeci, Oğuz Özden; Ateş, Tunahan; Geyik, Serdar; Girgin, Reha; Bozkurt, OzanThe aim of the present study is to evaluate and analyze the daily clinical practice for male urethral stricture disease (MUSD) among urologists. Methods: Considering the latest guidelines on urethral stricture disease, a survey was developed regarding the various treatment options and preferences in different sites of male urethral stricture disease. The survey was sent to urologists via e-mail and phone application. Results: A total of 266 urologists completed the survey and were included in the final analysis. In regard to workplace, 62 (23.3%), 58 (21.8%), 71 (26.7%), and 75 (28.2%) respondents worked in university hospitals, training and research hospitals, state hospitals, and private practice hospitals, respectively. In regard to the diagnostic method used in male urethral strictures, 88.7% of the participants would choose uroflowmetry + postvoiding residual (UF + PVR), and 64.6% would choose retrograde urethrography (RUG). Direct vision internal urethrotomy (DVIU) was the most frequently chosen method in penile urethral strictures (PUS), being chosen by 72.9%. Direct vision anterior internal urethrotomy was the most common method for both ?2 cm and >2 cm strictures, 63.1%, and 30.8%, respectively. The most preferred graft for augmentation urethroplasty was buccal mucosa (75.8%). Endoscopic incision/resection (transurethral resection (TUR)) is the most frequently applied treatment method for posterior urethral/vesicourethral anastomotic strictures (86.4%). Conclusions: The present study clearly shows that most urologists still prefer DVIU and urethral dilatation to urethroplasty in MUSD, which contradicts current guidelines. Urologists should be encouraged to perform urethroplasty and/or refer patients to experienced centres for recurrent MUÖğe Urinary Tract Infections in Children: Clinical and Antibiotic Susceptibility Data from a Tertiary Care Hospital(Zonguldak Bülent Ecevit Üniversitesi, 2023) Akyol Önder, Esra Nagehan; Türkel, Selçuk; Kılıçaslan, CengizhanUrinary tract infections (UTIs) are among the most common bacterial infections in children. Empirical antibiotic treatment is recommended until the antibiogram reports of urine culture are available. It is essential to initiate local UTI agents and their antimicrobial susceptibility patterns in specific geographical regions to choose the best empirical antibiotics. The current study aimed to determine causative microorganisms and antibiotic resistance patterns in children diagnosed with UTI. Material and Methods: The study was carried out retrospectively with 216 children diagnosed with UTIs for the first time. The patients were categorized into two groups according to age (?1 year and >1 year). Demographic data, presenting symptoms, imaging findings, and urine and culture analysis results were collected and compared between these two groups. Results: Cefazolin and nitrofurantoin use may be preferred in the empirical treatment of UTIs caused by Escherichia coli and Enterococcus spp. Additionally, amoxicillin/clavulanate was recommended in the empirical therapy of UTIs caused by Enterococcus spp., Klebsiella spp., and Proteus spp. The trimethoprim-sulfamethoxazole and nitrofurantoin resistance of E. coli was found to be statistically significantly higher in the ?1 year group (p=0.03 and p=0.01, respectively), while the nitrofurantoin resistance of Klebsiella was statistically significantly higher in the >1 year group (p=0.01). The gentamicin resistance of Klebsiella spp. was statistically significantly higher in the ?1 year group (p=0.03). Conclusion: It is important to detect regional antibiotic resistance patterns to manage UTIs and minimize related complications. Antibiotic susceptibility studies are necessary to reduce improper antibiotic use and resistance rates of antibiotics.Öğe Protective Effect of Morin Hydrate in Ischemia/Reperfusion Injury of Rat Skeletal Muscle(Veteriner Hekimler Derneği, 2023) Semis, Halil Sezgin; İleritürk, Mustafa; Gür, Cihan; Kaynar, Özgür; Kandemir, Fatih MehmetReaktif oksijen türlerinin neden olduğu hücre hasarı iskemi/reperfüzyon (I/R) hasarında temel etiyolojik faktör olarak kabul edilmektedir. Bu nedenle sunulan çalışmada morin’in iskelet kası I/R hasarındaki etkilerinin incelenmesi amaçlandı. I/R modeli oluşturmak için Srague-Dawley ratların arka bacaklarına turnike aplikasyonu yapıldı ve hayvanlar rastgele dört gruba ayrıldı. Sham grubu ile karşılaştırıldığında malondialdehit (MDA) düzeylerinin I/R hasarında arttığı, morin uygulaması ile doza bağlı olarak azaldığı tespit edildi. Süperoksit dismutaz (SOD), glutatyon peroksidaz (GPx) ve katalaz (KAT) aktivitelerinin ve glutatyon (GSH) düzeylerinin I/R hasarında artmasına karşın morin uygulaması sonucu bu parametrelerin değerleri kontrol grubuna yaklaştı. Nrf-2 ve HO-1 gen ekspersyonları I/R hasarı durumunda baskılanmasına karşın morin uygulaması bu genlerin upregüle edilmesini sağladı. MPO ekspresyon düzeyleri I/R grubunda artarken morin uygulanan gruplarda azaldı. NF-?B, TNF-?, IL-1?, iNOS, COX-2, STAT3 ve MAPK 14 gen ekspresyonları I/R hasarı durumunda artarken özellikle I/R+Morin 100 grubunda anlamlı şekilde azaldığı tespit edildi (P<0.001). Morin’in caspase-3 ve Bax proteinlerinin ekspresyonlarını azaltırken Bcl-2 proteinin ekspresyonunu upregüle ettiği bulundu. I/R grubunda artan ICAM1 düzeyi ve beclin-1 aktivitesinin özellikle I/R+Morin 100 grubunda azaldığı tespit edildi. Sonuçlarımız, morin’in iskelet kası I/R hasarına karşı antioksidan savunma sistemini güçlendirerek ve apoptozu, otofajiyi ve inlamasyonu baskılayarak koruyabileceğini göstermektedir.Öğe Investigation of the Effects of Rutin on Valproic Acid Induced Testicular Damage in Rats(Afyon Kocatepe Üniversitesi, 2023) Akarsu, Serkan Ali; Kankılıç, Nazım Abdülkadir; Erdoğan, EnderValproic acid (VALP) is a drug used for many psychiatric diseases such as epilepsy. However, the use of VALP has potential side effects on various tissues, including the testicles. Rutin (RUT) is a flavonoid with protective effects against oxidative stress-induced diseases and lipid peroxidation. In this study, the protective effects of RUT against testicular damage caused by VALP were investigated. For this purpose, 35 male Spraque-Dawley rats weighing 220-250 g were used in the study. The rats were randomly divided into 5 groups as Control (physiological saline), RUT (100 mg/kg/bw), VALP, (500mg/kg/bw), VALP+RUT 50 (500 mg/kg/bw VALP+50 mg/kg/bw RUT), and VALP +RUT 100 (500 mg/kg/bw VALP+100 mg/kg/bw RUT).
