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Öğe Zirai ilaç zehirlenmesi ile başvuran stent trombozu(Çanakkale Onsekiz Mart Üniversitesi, 2021) Duygu, Ali; Kırılmaz, Bahadır; Arslan, Mehmet; Küçük, Uğurİnsanların kimyasal maddelere maruz kalması büyüyen bir endişe kaynağıdır. Glifosat bazlı herbisit (GBH) kullanımı da akut zehirlenme sonucu çeşitli hastalıklara neden olur. GBH bazlı ilaçlar sinüs bradikardisi, QT uzaması, torsade de pointes, AV blok gibi elektrokardiyografi değişikliklerine ve nadiren koroner arter trombozu neden olabilir. 2 yıl önce ilaç kaplı stent uygulanmış olan 68 yaşında erkek hasta göğüs ağrısı şikayeti ile acil servise başvurdu. Hastadan alınan anamnezde GBH içeren zirai ilaç kullanarak 2 gündür tarlada maskesiz ilaçlama yaptığı, göğüs ağrısının başladığı ve acil servise başvurduğu anlaşıldı. Akut GBH entoksikasyonu hipotansiyon, solunum sıkıntısı, gastrointestinal semptomlar, bilinç kaybı, oligüri ve nadiren ölüme neden olabilir. GBH'ye kronik maruziyetin koroner arter hastalığına neden olduğu gösterilmiştirÖğe Identifying early left atrial dysfunction in individuals with obstructive sleep apnea: The role of the morphology-voltage-P wave duration electrocardiography score(Lithographia, 2024) Küçük, Uğur; Mutlu, Pınar; Mirici, Arzu; Özpınar, Uğur; Özpınar, Selin BeyzaBackground: Obstructive sleep apnea (OSA) can lead to left atrial (LA) dysfunction, which increases the risk of severe heart problems such as atrial fibrillation and heart failure. Early detection of LA dysfunction is essential to prevent these complications. We investigated whether the new morphology-voltage-P wave duration electrocardiography (MVP ECG) level could effectively identify early-stage LA functional abnormality in OSA individuals, as current diagnostic techniques have limitations. Methods: We studied a sample of 120 OSA patients using speckle-tracking echocardiography to assess LA function. After the echocardiography exam, we divided these individuals into two groups: those with regular LA and those with impaired LA functions. Our main measure of LA function was peak atrial longitudinal strain (PALS). Results: We found significant differences in PALS values between groups (p <0.001) despite having an equivalent LA size, suggesting occult LA dysfunction in OSA patients. The MVP ECG score proved effective in identifying LA dysfunction caused by changes in atrial structure (sensitivity: 89 %, specificity: 63 %, AUC: 0.862). Conclusions: The MVP ECG score is a promising non-invasive method to detect early atrial changes in OSA patients. Using this score in regular medical care could help physicians intervene earlier, potentially reducing the risk of heart problems in these high-risk individuals.Öğe Variable phenotype and genotype of pediatric patients with HNF1B nephropathy [2](Springer, 2024) Gülhan, Bora; Ekici, Ozan; Dursun, İsmail; Göknar, Nilüfer; Yüksel, Selçuk; Alaygut, Demet; Özçakar, Zeynep Birsin[No abstract available]Öğe Moxifloxacin-Impregnated Contact Lenses for Treatment of Keratitis in Rabbit Eyes(Wiley, 2025) Erdoğan, Hakika; Güngör, Buket; Sağbaş Suner, Selin; Sılan, Coşkun; Saraydın, Serpil U.; Saraydın, Dursun; Ayyala, Ramesh S.; Şahiner, NurettinMoxifloxacin (MOX) was loaded into commercial contact lenses (CLs) via supercritical carbon dioxide (ScCO2) to attain MOX-impregnated CL for keratitis treatment. This study aimed to investigate Pseudomonas keratitis treatment with MOX-impregnated CL compared to the traditional eyedrop administration. MOX impregnation was accomplished employing optimum parameters of 2.5 h drug exposure time, 25 MPa pressure, and 313 K for ScCO2 conditions using ethanol co-solvent rendering sustainable delivery, up to 7 days at effective dosage formulation. The MOX-impregnated CL was found to be safe with no significant toxicity on fibroblast cells after 5 days of contact time. Bacterial viability in vivo keratitis treatment in rabbit eyes was significantly decreased to 10(2) from 10(9) CFU/cornea for MOX-impregnated CL treatment, almost similar to exhaustive conventional 0.5% MOX eye drop treatments. The MOX-impregnated CL treatment revealed no conjunctival hyperemia, edema, or secretion for all eyes in the relevant group, and transparent cornea with no keratitis focus was obtained for two of the eyes (n = 6). The normal histological structure was seen with MOX-impregnated CL treatment on healthy eyes. Moreover, polymorphonuclear cell infiltration observed in keratitis eyes without any treatment was significantly decreased to a few polymorphonuclear cells in the groups treated with MOX eyedrops and MOX-impregnated CL.Öğe Publisher Correction: The clinical characteristics of patients with congenital nephrotic syndrome secondary to NPHS1 mutation: Is nephrectomy still a therapeutic option for selected cases?(Springer, 2025) Uğurlu, Yüksel; Gülhan, Bora; Dursun, İsmail; Nalcacıoğlu, Hülya; Kaya Aksoy, Gülşah; Canpolat, Nur; Bayazit, Aysun; Yüksel, Selçuk[No abstract available]Öğe The clinical characteristics of patients with congenital nephrotic syndrome secondary to NPHS1 mutation: Is nephrectomy still a therapeutic option for selected cases?(Springer, 2025) Uğurlu, Yüksel; Gülhan, Bora; Dursun, İsmail; Nalcacıoğlu, Hülya; Kaya Aksoy, Gülşah; Canpolat, Nur; Bayazıt, Aysun; Yüksel, SelçukBackgroundManaging congenital nephrotic syndrome (CNS) remains a clinical challenge. While albumin infusions and nephrectomy have been long-standing treatments, a conservative approach is increasingly favored. This study aimed to compare clinical outcomes between nephrectomy (Nx) and non-Nx in patients with bi-allelic NPHS1 mutations.MethodsThis retrospective cohort study included 29 pediatric CNS patients (15 female, 14 male) with confirmed NPHS1 mutations. Clinical parameters including albumin infusion requirements, infections, hospitalizations, growth, and survival rates were analyzed in the Nx and non-Nx groups.ResultsThe median age at the time CNS was diagnosed was 29 days (IQR: 11-62 days). In all, 24 patients (82.8%) had homozygous NPHS1 mutations and 5 (17.2%) had compound heterozygous NPHS1 mutations. None of the patients had Fin-major mutation (i.e., p. Leu41 Aspfs*50). Unilateral/bilateral nephrectomy was performed in 16 patients. At 12 months post-nephrectomy the number of albumin infusions required, infections, and hospitalizations decreased significantly in the Nx group, as compared to the pre-nephrectomy period (p = 0.001, p = 0.027, and p = 0.004, respectively). Among the 13 (44.8%) patients in the non-Nx group, at 12 months after CNS was diagnosed the number of serum albumin infusions required significantly decreased (p = 0.007); however, the number of infections and hospitalization did not differ significantly (p = 0.589 and p = 0.5, respectively). Receiver operating characteristic (ROC) analysis showed that requiring albumin infusions >= 14 days/month predicted the decision to perform nephrectomy with 68% accuracy (73% sensitivity and 62% specificity).ConclusionsNephrectomy reduces albumin infusions, infections, and hospitalizations, suggesting it may be a beneficial treatment for selected CNS patients with NPHS1 mutations.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary informationÖğe Erysipelas-like erythema on elbow in a child with familial Mediterranean fever: an unexpected localization(Springer London Ltd, 2025) Yüksel, Selçuk; Yüksel, Gülten[No abstract available]Öğe Acute and subacute cardiovascular effects of synthetic cannabinoid JWH-018 in rat(Springer, 2025) Özhan, Onuralp; Ermiş, Necip; Celbis, Osman; Şamdancı, Emine; Petekkaya, Semih; Oruç, Mücahit; Soylu, ÖzcanPurposeThis study investigates the cardiovascular effects of the synthetic cannabinoid naphthalene-1-yl-(1-pentylindole-3-yl)methanone (JWH-018) in rats. The research aims to evaluate the pharmacologic, cardiologic, biochemical, and histopathological effects of acute and subacute administration at low and high doses. The primary research question is how JWH-018 impacts heart function, blood pressure, ECG patterns, and cardiac tissue integrity.MethodsWistar albino rats were divided into five groups: control, acute low-dose (ALD, 0.5 mg/kg), acute high-dose (AHD, 5 mg/kg), subacute low-dose (SALD, 0.5 mg/kg for 14 days), and subacute high-dose (SAHD, 5 mg/kg for 14 days). Cardiovascular effects were assessed using echocardiography, hemodynamic and ECG analysis, histopathology, biochemical markers, and LC-MS/MS quantification of JWH-018 and its metabolites in heart tissue.ResultsAcute high-dose JWH-018 caused bradycardia and hypotension, while subacute high-dose increased heart rate but continued to lower blood pressure. JWH-018 induced cardiac arrhythmias, conduction blocks, and ischemic ECG changes, with prolonged QT intervals in subacute high-dose rats. Histopathological findings revealed myocardial infarction-like features, including contraction bands and ischemic damage, particularly in subacute groups. Elevated pro-BNP and triglycerides indicated cardiac stress and metabolic effects. JWH-018 and its metabolites were detected in heart tissue, primarily in high-dose groups.ConclusionsJWH-018 has significant cardiovascular risks, causing heart rate dysregulation, hypotension, arrhythmias, and ischemic damage. These effects depend on dose and duration. The study highlights the potential dangers of synthetic cannabinoids, emphasizing that they should not be considered safe alternatives to natural cannabis.Öğe Can a familial history of migraine and motion sickness be used in the diagnosis of childhood migraine?(Elsevier, 2025) Çokyaman, Turgay; Erdem, Ülgen ÖzcanObjective: Childhood migraine is a recurrent neurobiological complex disease and caused by multiple genetic and environmental factors. In this study, the clinical relevance of ICHD-3 diagnostic criteria, familial history of migraine and motion sickness was investigated. Methods: This study was conducted on children aged 10-18 years, who were randomly selected from 22 middle and 26 high schools. The survey, prepared in Turkish, asked about headache characteristics (ICHD-3 diagnostic criteria: 7 items), familial history of migraine, and presence of motion sickness (2 items). Results: According to data from the survey, 4 main factors emerged in the exploratory factor analysis. Photophobia, pain attack duration >= 1 h, headache attacks more than 4 times, familial history of migraine in factor-1, vomiting and nausea in factor-2, pulsatile pain and forehead and bitemporal localization in factor-3, avoidance routine physical activities and motion sickness in factor-4 are collected. Conclusion: Migraine, in which strong genetic pieces of evidence have been uncovered is a multifactorial brain disease. Moreover, the intense connections between the trigeminal system and vestibular nuclei demonstrated in the current literature reveal that the relationship between motion sickness and migraine cannot be ignored. Therefore, a positive familial history and motion sickness in childhood migraine are important additional diagnostic clues in addition to ICHD-3.Öğe Comparison of piperacillin-tazobactam and vancomycin (TZP-VAN) with piperacillin-tazobactam and teicoplanin (TZP-TEI) for the risk of acute kidney injury (CONCOMITANT): A prospective observational, multinational, multi-centre cohort study(Elsevier, 2025) Aslan, Abdullah Tarik; Kara, Emre; Köksal, Gamze; Bilir, Yeliz; Saraçoğlu, Kemal Tolga; Eser, Fatma; Güner, Rahmet; Alkan, SevilObjective: Both vancomycin (VAN) and teicoplanin (TEI) augment the risk of acute kidney injury (AKI) when combined with piperacillin-tazobactam (TZP). We aimed to compare the risk of AKI among patients receiving TZP-VAN vs. TZP-TEI. Methods: This was a prospective, multinational, multicentre cohort study conducted in 12 centres from Turkiye, Italy, and Spain between 1 June 2022, and 31 December 2023. The primary outcome was the occurrence of AKI between the first day of antibiotic treatment and the third day after completing therapy, according to the Kidney Disease Improving Global Outcomes criteria. Multivariable logistic regression and propensity-score match analyses were employed to adjust for confounding variables. Stratified Kaplan- Meier analysis was used to assess the time-to-AKI between the comparison groups. Results: Of 187 patients (TZP-TEI, n = 102; TZP-VAN, n = 85), the AKI occurred in 21 patients (24.7%) who received TZP-VAN and in 15 patients (14.7%) with TZP-TEI (unadjusted odds ratio [OR], 1.90; 95% CI: 0.91-3.97; P = 0.087). After adjusting for confounding variables with multivariable analysis, TZP-VAN was not associated with increased odds of AKI compared with TZP-TEI; with an adjusted OR of 2.24 (95% CI: 0.78-6.42; P = 0.133). In propensity-score matched analysis ( n = 49 pairs), the AKI risk was similar between the two groups (OR, 2.10; 95% CI: 0.67-6.50; P = 0.199). The stratified Kaplan-Meier analysis indicated no difference between the treatment groups in terms of time-to-AKI (log-rank test, P = 0.107). Conclusions: The risk of AKI in TZP-VAN was similar to that in TZP-TEI. These results should be confirmed in randomized controlled trials.Öğe Bibliometric analysis of neurocysticercosis case reports and evaluation of presented cases(Academic Press Ltd- Elsevier Science Ltd, 2025) Gürbüz, Esra; Aydemir, Selahattin; Barlik, Fethi; Saygın, Murat; Yıldız, Rahmi; Alkan, Sevil; Ekici, AbdurrahmanNeurocysticercosis (NCC) has been classified as a neglected tropical disease by the World Health Organization (WHO), with the condition being regarded as the most significant parasitic disease affecting the nervous system. Hence, the aim of this study was to conduct a review of previously published case reports on this topic in order to ascertain whether there is an increasing trend of NCC worldwide and evaluate the cases that have been presented. After a comprehensive search of the Web of Science Core Collection using the keywords neurocysticercosis and case reports, studies were selected by applying inclusion criteria. Important data attributes that were extracted in plain text format included the document titles, publication years, journal names, author(s) name(s), keywords, institutions, and countries. In addition, to evaluate the cases, the age and gender of the patients, complaints on admission, localization of the cyst, and treatment procedure used were recorded in an Excel file. The bibliometric analysis was conducted using Biblioshiny. Additionally, GraphPad and Excel were employed for the creation of graphical representations. The dataset analyzed included 297 documents, 162 from various sources, with an average age of 12.2 years and 6.3 citations per document. The number of case reports tended to increase over the years. India and the USA were the leading contributors to NCC case reports, with 78 (26.3 %) and 64 (21.5 %), respectively. This was followed by Brazil, France, and Spain with 31 (10.4 %), 14 (4.7 %) and 13 (4.4 %) case reports, respectively. Moreover 55.5 % of the patients in the cases presented in the articles were male and 12.9 % were in the 21-25 age group. In regard to the cysts, 81.2 % were located in the brain and 15.1 % were in the spine. The most common complaints were headache and seizures in brain localized NCC cases and back pain and numbness or weakness in extremities in spine localized NCC cases. Albendazole was used in 174 (54.5 %) cases, praziquantel in 22 (6.9 %) cases, and ivermectin in five (1.6 %) cases. In conclusion, NCC continues to be an increasingly serious public health problem in India as well as developed countries such as the USA and European countries. NCC can be seen in all age groups, males are more susceptible than females, cysts are more localized in the ventricular system, and albendazole and/or paraziquentel are used in treatment. In addition, more comprehensive studies on the use of ivermectin in the treatment of NCC should be conducted, as success was achieved in cases where ivermectin was used in treatment.Öğe Corrigendum to “The role of oligoclonal band count and IgG index in treatment response and disease activity in multiple sclerosis” [Multiple Sclerosis and Related Disorders 83 (2024) 105391](Elsevier Sci Ltd, 2025) Taşkıran, Esra; Terzi, Murat; Helvacı, Elif Merve; Eser, Meltem Zeycan; Avcı, Bahattin; Faruk, Turan Ömer; Yetkin, Mehmet Fatih; Çam, Mustafa[No abstract available]Öğe Malaria in Turkey: A comprehensive analysis of diagnosis, treatment, and the impact of COVID-19, ten years after malaria elimination (2012-2023)(Elsevier Sci Ltd, 2025) Şahin, Özgün Ekin; Kalay, Zeynepgül; Sarı, Nagehan Didem; Batırel, Ayşe; Ersöz, Gülden; Ertem, Guenay Tuncer; Turunc, Tuba; Alkan, SevilBackground: The characteristics, diagnosis, and treatment stages of malaria in Turkey in the last ten years are not known except few case reports. We aimed to describe the details of the diagnosis and treatment practices of malaria cases in various hospitals across Turkey between 2012 and 2023 after the declaration of the elimination of malaria. Methods: We collected the patient data from 30 centers by using Qualtrics Survey Software. The patients were categorized according to the WHO Malaria Severe Disease Symptoms guidelines. Results: We detected 299 malaria cases. Of these patients, 23.7 % experienced misdiagnosis, with 77.5 % of misdiagnosed cases receiving antibiotics. Among the patients, 9 (3 %) had no travel history. Additionally, 28 (9.4 %) patients required admission to the intensive care unit (ICU) during hospitalization. There is a significant association between misdiagnosis and subsequent ICU admissions. Additionally, the duration between malaria diagnosis and the initiation of treatment significantly affected ICU admissions. Furthermore, the number of cases with severe malaria (according to WHO criteria) and ICU admissions increased after the COVID-19 period. In multivariate analysis, initial misdiagnosis was found to be associated with ICU admission (OR: 2.8, p < 0.05), while each day's treatment delays post-diagnosis increased ICU admissions (OR: 1.26, p < 0.05). Conclusion: Misdiagnosis is common which delays the treatment and is correlated with higher admissions to ICUs. Post-COVID-19, there was a notable increase in both ICU admissions and cases of severe malaria, suggesting an escalation in disease severity that warrants further investigation. The resurgence of rare malaria cases with no travel history to abroad highlights the necessity of continued vigilance for new malaria cases. Efforts to promptly treat upon diagnosis and improve diagnostic accuracy in Turkey, where malaria is uncommon, are crucial. Enhancing diagnostic methods and treatment strategies remains essential, especially in significant events like COVID-19.Öğe Humic acid attenuates cisplatin-induced nephrotoxicity in rats(Taylor & Francis Ltd, 2025) Tekeş, Ender; İçkin Gülen, Meltem; Sılan, Coşkun; Güven Bağla, AyselCisplatin-induced nephrotoxicity, a major limitation of this chemotherapeutic agent, involves oxidative stress, inflammation, and apoptosis. This study investigated the potential renoprotective effects of humic acid in a rat model of cisplatin-induced nephrotoxicity. Forty-two male Wistar rats were assigned to six groups: control, humic acid, cisplatin, cisplatin + humic acid 10 mg/kg, cisplatin + humic acid 20 mg/kg, and cisplatin + humic acid 40 mg/kg. On day 7, the rats were sacrificed, and cardiac blood and kidneys were collected for biochemical and histopathological examinations. Humic acid administration significantly attenuated the cisplatin-induced increases in renal TNF-alpha and NF-kappa B levels, indicating a reduction in inflammation. Humic acid also ameliorated histopathological damage, including Bowman's capsule dilatation, tubular cell degeneration, and hemorrhage. However, humic acid did not significantly alter oxidative stress parameters or caspase-3 levels. Humic acid demonstrates a protective effect against cisplatin-induced nephrotoxicity in rats, primarily by mitigating the inflammatory response. While HA's beneficial effects on oxidative stress and apoptosis were limited in this study, its ability to reduce inflammation highlights its potential as a therapeutic strategy to mitigate cisplatin-induced kidney injury.Öğe Histological and flow cytometric evaluation of astaxanthin's effects against cyclophosphamide induced heart injury in rats(Taylor & Francis Ltd, 2025) Zengin, Tuğba; Tekelioğlu, Yavuz; Keskin, Oğuzhan; Reis Köse, Göksen Derya; Ari, Neziha Senem; Arıcı, Tuğba; Çetinavcı, DilanIn this study, the protective effect of astaxanthin (AST) against cyclophosphamide (CP) induced adult rat heart damage was investigated. Eighteen rats were divided into 3 groups as Group 1: control, Group 2: cyclophosphamide and Group 3: cyclophosphamide + astaxanthin. The CP group, received a 200 mg/kg single dose intraperitoneal (i.p.) injection of CP on the seventh day of the experiment, while the control group received no treatment. For CP+AST group 25 mg/kg/day AST administered by oral gavage on days 1-7 and on the 7th day 200 mg/kg/day CP was administered by i.p injection. On the 8th day, the rats were sacrificed by exsanguination and the hearts were dissected. Histopathological examinations were performed by Hematoxylin&Eosin (H&E), Masson Trichrome and Periodic Acid-Schiff (PAS) staining methods; Annexin-V and Anti-NOX2/gp91phox analyzes were performed by flow cytometry. In histological evaluation of the CP Group; disruptions in cardiac histology and increased PAS(+) staining were observed. These findings were reduced in the CP+AST group compared to the CP group. According to flow cytometry measurements, there was an increase in Annexin-V and Anti-NOX2/gp91phox bound cells in the CP group. With the AST pretreatment, in the CP+AST group Annexin-V and Anti-NOX2/gp91phox bound cell level showed decrease. Based on our study's data, CP may alter cardiac histology and have a negative impact on apoptosis and oxidative damage processes. Astaxanthin may ameliorate these effects of CP on the heart. To enhance the assessment of this protective effect, we propose conducting future research utilizing varied dosages, application durations and advanced analytical techniques.Öğe The crucial importance of preventive and cardiac rehabilitation programmes in patients with atrial fibrillation: AF-CARE units(Oxford Univ Press, 2025) Akşit, Ercan; Küçük, Uğur; Taylan, Gökay[No abstract available]Öğe Exploring and Expanding Secondary Findings Through Exome Sequencing in the Turkish Population(Wiley, 2025) Akcan, Mehmet Berkay; Köse, Canan Ceylan; Çelik, Kübra Müge; Tekin, Koray; Kaya, Derya; Sılan, FatmaIntroduction Exome-sequencing (ES) methods enable accurate diagnosis in challenging cases and uncover secondary findings (SFs) potentially linked to life-threatening or preventable diseases. The American College of Medical Genetics and Genomics (ACMG) publishes a list detailing which SFs should be reported and regularly updates it. We aimed to compare results across different SF versions in patients and explore additional SFs to identify potential new recommendations for SF reporting. Methods We conducted a retrospective analysis of 724 patients to identify ACMG SFs using the QIAGEN Clinical Insight (QCI) Interpret database. Furthermore, we investigated pathogenic/likely pathogenic variants in cancer and cardiovascular disease genes not listed in ACMG SFs, as well as genes associated with common diseases prevalent in our country. Methods ACMG SF v3.2 variants were identified in 56 patients (7.7%), with no observed differences between ACMG v3.1 and v3.2. Additionally, our analysis revealed that 208 patients harbored non-ACMG SF variants. Conclusion In this study, we focused on known SFs and identified additional variants that could be considered as new recommendations. While expanding the list of SFs can pose challenges during analyses and genetic counseling, a thoughtfully curated SF list has the potential to enhance patient care and improve clinical outcomes.Öğe INVESTIGATION OF THE EFFICACY OF SELF- MANAGEMENT SUPPORTED TELEREHABILITATION IN CHILDREN AND ADOLESCENTS WITH JUVENILE IDIOPATHIC ARTHRITIS: A RANDOMIZED CONTROLLED STUDY(Elsevier, 2024) Balkışlı, B. C.; Başakçı Çalık, B.; Gür Kabul, E.; Kılbaş, G.; Yüksel, Selçuk[No abstract available]Öğe Acute Measurement of Developmental Dysplasia of the Hip: Comparing Two Approaches for Measuring the Alpha Angle Using the Graf Technique(Sage Publications Inc, 2025) Dindar, Fırat; Aylanç, Nilüfer; Aylanç, Hakan; Ertem, Şenay Bengin; Sıddıkoğlu, Duygu; Reşorlu, MustafaObjective: The Graf method, in ultrasonography screening of developmental hip dysplasia, is based on angle measurements. Using different reference points may cause varied results. The aim of this study was to investigate to what extent the alpha angle obtained, varied at different reference points.Materials and Methods: There were 178 hips evaluated by two trained observers. Both measured the alpha angle with different reference points and these were labeled as methods A and B, for all the hips evaluated. The statistical analysis was performed with SPSS Version 21.Results: The average of observer 1, based on measurements with method A, were 65.63 (SD +/- 5.95) and based on method B were 73.39 (SD +/- 6.29). The average of the measurements of observer 2, utilizing method A were 64.39 (SD +/- 4.85) and based on method B were 69.92 (SD +/- 6.08). It was observed that method B showed higher mean and variability compared to method A. The agreement between observers was moderate in method A and poor in method B. The intraobserver correlation coefficient (ICC) was 0.69 for method A and 0.47 for method B. The ICC was considered good (e.g., 95%) for both observers in terms of using methods A and B.Conclusion: The use of ultrasonography still maintains its place in the diagnosis of developmental hip dysplasia. The Graf method is based on precise measurements, and the most decisive parameter is the alpha angle. Reference points in method A would be more useful in patient management and may increase the diagnostic accuracy.Öğe Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study(Karger, 2025) Alpsoy, Erkan; Fettahlıoğlu Karaman, Bilge; Demirseren, Duriye Deniz; Çınar, S. Levent; Kaçar, Nida; Turel Ermertcan, Aylın; Bülbül Başkan, Emel; Kılıç, SevilayIntroduction:The natural history, the progression of a diseaseprocess in an individual over time, has not yet been fully elu-cidated in hidradenitis suppurativa (HS). In this large multicenterstudy, we aimed to investigate the natural history of HS and itsgender differences.Methods:This cross-sectional study in-cluded 827 patients. The chronological order of the clinicalmanifestations for each patientwas recorded retrospectively.Sociodemographic characteristics, triggering factors, clinical,treatment, and prognostic features were also evaluated.Results:The mean age of disease onset was significantly younger inwomen than in men (22.42 +/- 9.28 vs. 27.06 +/- 20.56,p<0.001)and those with a family history (p<0.0001). The mean diseaseduration was 91.17 +/- 83.64 months. The most commonsymptom was purulent discharge (81%). The mean duration ofabscess was shorter in women than in men (3.11 +/- 2.65 vs.3.75 +/- 3.75,p= 0.01). The axilla was the most common onsetarea followed by the inguinal and gluteal regions. The diseaseran a more severe course in men. Abscess/inflammatory nodulewas defined in the last 6 months in 88.6% of the patients;however, thefirst 5 years of the disease were the most activedisease period in 67.5% of the patients. Multivariate analysisrevealed being male, older age, family history, involvement ofthe axillary, inguinal, and perianal regions independently as-sociated with HS severity. While antibiotic use was the mostimportant factor in improving thedisease symptoms, stress wasthe most common aggravating factor. Biological therapy in men,laser epilation and pregnancy in women were significant alle-viating factors, whereas weight gain was a more commonaggravating factor for women.Conclusion:HS shows a re-lentlessly progressive course with inflammatory attacks, but thefirst years of the disease are the most active period. This studyconfirms that environmental and hormonal factors may play animportant role in the disease course, probably with other en-dogenous or exogenous factors.(c) 2024 S. Karger AG, Basel
