Dahili Tıp Bilimleri Bölümü Koleksiyonu

Bu koleksiyon için kalıcı URI

https://hdl.handle.net/20.500.12428/2270

Listeleniyor 1 - 20 / 620

Safety and efficacy of cladribine in patients discontinuing fingolimod due to elevated liver enzymes: FinClad study
(Wiley, 2025) Sönmez, M.; Yetkin, M.; Mehdiyev, D. Arslan; Köseoğlu, M.; Mungan, S.; Kale, N.; Terzi, M.; Çam, Mustafa
[No abstract available]
The Impact of Lipomastia on Self-Esteem and Social Anxiety in Adolescents with Obesity
(Canadian Acad Child & Adolescent Psychiatry, 2025) Kara, Özlem; Kaymaz, Nazan; Şirin, Hande; Uzun, Mehmet Erdem
Background: Obesity can negatively impact adolescents' self-esteem, and lipomastia can further complicate the situation. Objective: The current study endeavors to examine the influence of lipomastia on the levels of social anxiety and self-esteem in individuals with obesity. Methods: Seventy adolescent male outpatients with obesity completed a form of demographics, the SAS-A (Social Anxiety Scale for Adolescents), and the Rosenberg Self-Esteem Scale (RSES-10 item). Participants were stratified according to the presence of lipomastia, and correlation analyses were conducted to investigate the association between social anxiety and self-esteem in relation to lipomastia. Results: No significant difference was found between the lipomastia and non-lipomastia groups regarding self-esteem. While the lipomastia group had slightly higher overall social anxiety scores, significant differences were noted only in fear of negative evaluation. There was no relationship between the SAS-A total score and anthropometric measurements in both groups. However, a negative relationship was observed between self-esteem and anthropometric measurements in the lipomastia group, whereas such a relationship was not observed in the control group. Conclusion: Adolescents with lipomastia showed higher social anxiety, particularly fear of negative evaluation, despite similar demographic and anthropometric characteristics to their peers. Higher BMI correlated with lower self-esteem, highlighting the complex interplay between body image, self-esteem, and social anxiety. These findings underscore the need for targeted interventions to support adolescents with obesity and lipomastia.
Electrophysiological evaluation of peripheral nerve injuries after the february 6 earthquake in Turkey
(Wiley, 2025) Yıldırım, A.; Akbaş, E.; İnan, R.; Eyigürbüz, T.; Güçlü Altun, İlknur; Hoşver, B.; Adatepe, T.
[No abstract available]
Increased pulmonary artery-to-aorta diameter ratio in patients with dyspnea is associated with impaired right ventricular systolic function
(Wiley, 2025) Özpınar, U.; Kaya, Hakkı; Akşit, Ercan
[No abstract available]
A Novel Homozygous Frameshift Variant of SACS Gene in the Turkish Siblings With Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS)
(Wiley, 2025) Çokyaman, Turgay; Saltık, Zeynep Alara; Turan, Nihan Ecmel
Pathogenic variants of sacsin (SACS) gene cause autosomal recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS). It is a hereditary neurological disorder manifested with gait ataxia, intentional tremor, lower limb pyramidal signs and pes cavus. It was originally described in the late 1970s and has a high prevalence in northeastern Quebec, Canada. Here, we present for the first time a new SACS frameshift variant in two Turkish siblings. We detected a new homozygous frameshift variant of the SACS gene in the Turkish siblings diagnosed with ARSACS for the first time.
Clinical Profiles and In-Hospital Outcomes of Pre-Existing Versus Newly Diagnosed Atrial Fibrillation in Coronary Care Units: Insights From the MORCOR-TURK National Registry
(Wiley, 2025) Aydın, Ertan; Öğütveren, Muhammed Mürsel; Mert, Gurbet Özge; Yeni, Mehtap; Gülastı, Sevil; Küçük, Uğur; Candemir, Başar
Objective To compare demographic, clinical, and laboratory profiles and short-term outcomes between pre-existing (chronic) atrial fibrillation (AF) and newly diagnosed AF among patients admitted to coronary care units (CCUs) in Turkey, and to identify factors associated with in-hospital mortality within AF subtypes. Methods This multicenter, prospective national registry analysis included 540 consecutive AF patients from 50 CCU centers across seven geographic regions in Turkey (MORCOR-TURK National Registry; September 1–30, 2022). Patients were categorized as pre-existing AF (documented AF prior to or at admission) or newly diagnosed AF (first detected during hospitalization). Demographics, comorbidities, admission diagnoses, laboratory biomarkers (including NT-proBNP and hs-troponin I), management, and outcomes were recorded. Multivariable logistic regression identified independent predictors of in-hospital mortality. Results Pre-existing AF (n = 324) had higher prevalences of diabetes mellitus (42.3% vs. 31.5%; p = 0.012) and acute coronary syndromes (58.6% vs. 34.7%; p < 0.001). Newly diagnosed AF (n = 216) more frequently presented with heart failure (45.8% vs. 28.4%; p < 0.001) and dyspnea (67.1% vs. 48.5%; p < 0.001). Newly diagnosed AF exhibited higher inflammatory burden (CRP median 28.4 vs. 12.6 mg/L; p < 0.001) and lower hemoglobin (11.8 ± 2.1 vs. 12.9 ± 1.8 g/dL; p < 0.001). NT-proBNP was elevated in both groups and higher in newly diagnosed AF (median 4850 vs. 3240 pg/mL; p = 0.003). In-hospital mortality was greater with newly diagnosed AF (12.0% vs. 6.8%; p = 0.042). Independent mortality predictors included age, chronic kidney disease, cardiogenic shock, and log-transformed NT-proBNP, hs-troponin I, and CRP. Conclusion In Turkish CCUs, pre-existing and newly diagnosed AF constitute distinct clinical phenotypes with differing presentations, biomarker profiles, and short-term risk. Newly diagnosed AF is associated with greater inflammatory and hemodynamic stress and higher in-hospital mortality. Biomarker-enriched risk stratification may refine prognostication and guide targeted management within AF subtypes.
The Effect of Brief Group Psychoeducation on Cognitive Distortions, Automatic Thoughts and Functioning in Major Depressive Disorder: A Randomized Controlled Trial
(Wiley, 2025) Sağbaş, Serap; Korkmaz, Şükrü Alperen; Öyekçin, Demet Güleç
Major depressive disorder (MDD) causes significant impairment and reduced functioning, yet it remains undertreated. This study examined the effectiveness of a structured, brief group psychoeducation programme for individuals diagnosed with MDD. The randomized controlled trial involved 52 adults diagnosed with MDD according to DSM-5 criteria. Participants were divided into two groups: an experimental group (n = 29) that received psychoeducation during a 12-week follow-up and a control group (n = 23) that received only standard pharmacotherapy. The intervention included two interactive psychoeducation sessions, each lasting 90–120 min, conducted in a group setting. Levels of depression, anxiety, cognitive distortions, automatic thoughts and functioning were assessed using the Hamilton Depression and Anxiety Rating Scales (HAM-D/HAM-A), the Cognitive Distortion Scale (CDS), the Automatic Thoughts Scale (ATQ) and the Functioning Assessment Short Test (FAST), respectively. The findings indicated that depression and anxiety scores significantly decreased in both groups after 12 weeks, with no difference between them in this regard. However, the group receiving psychoeducation experienced greater improvements in cognitive distortions and automatic thoughts compared to the control group, especially in areas such as helplessness, negative self-concept and giving up/helplessness. Although functioning levels improved in both groups, there was no significant difference between them. Structured brief group psychoeducation resulted in significant improvements, particularly in reducing cognitive distortions and automatic thoughts in patients with MDD. Psychoeducation is a practical approach that emphasizes cognitive processes along with pharmacotherapy. Including a broader range of psychotherapeutic modalities in treatment plans may further enhance functional outcomes.
Longitudinal trajectories of major depressive disorder provide further clinical perspectives for precision psychiatry
(Wiley, 2025) Atagün, Murat İlhan
Major depressive disorder (MDD) is a common and debilitating disorder. MDD was considered to be a relatively benign disorder compared to other major psychiatric disorders. However, longitudinal research revealed heterogeneous and frequently chronic course. Episodic or chronic progress reframes MDD as a disorder with a variable and enduring course. The recognition of MDD's heterogeneity has prompted a methodological evolution in psychiatric research, moving away from group-level averages toward more sophisticated, person-centered analytical techniques. In addition to inherent heterogeneity, biological, psychosocial, and environmental factors are also influential on the clinical manifestations of MDD. The course of major depressive disorder is not only heterogeneous among individuals but also varies systematically across different populations. Multiple models have consistently identified several distinct trajectory classes across diverse populations and study designs, providing a more nuanced map of how MDD unfolds over a lifetime. The concept of MDD subtyping within precision psychiatry directly addresses its inherent heterogeneity. If different subtypes of MDD possess distinct neurobiological underpinnings, then identifying these specific subtypes through biomarkers may lead to highly targeted and significantly more effective treatments. Longitudinal perspectives are indispensable for an accurate understanding of prognosis, the development of preventive strategies, and the implementation of effective long-term management plans that can alter the illness's trajectory. It was aimed to review the MDD trajectories, treatments, and symptom clusters from population and life span-based perspectives in this paper.
Response to: Nephrectomy for congenital nephrotic syndrome: unanswered questions
(Springer, 2025) Uğurlu, Yüksel; Gülhan, Bora; Dursun, İsmail; Nalçacıoğlu, Hülya; Kaya Aksoy, Gülşah; Canpolat, Nur; Bayazıt, Aysun; Yüksel, Selçuk
[No abstract available]
Cutaneous manifestations of autoinflammatory bone diseases: a retrospective multicenter study
(Springer London Ltd, 2025) Öner, Nimet; Kasap Cüceoğlu, Müşerref; Kılıç Konte, Elif; Kayhan, Eda; Çakan, Mustafa; Demir, Selcan; Baba, Özge; Yüksel, Selçuk
Objectives The aim of this study was to describe the cutaneous manifestations of patients with autoinflammatory bone diseases and to evaluate the relationship between cutaneous manifestations, bone involvement, and systemic inflammation in Turkish children. Methods This retrospective multicenter study was conducted in nine pediatric rheumatology centers between the years 2013 and 2023 in patients with a diagnosis of autoinflammatory bone disease with cutaneous manifestations. Demographic data, laboratory findings, cutaneous manifestations, bone involvement, and treatments were recorded. Results Two hundred and sixty-nine autoinflammatory bone disease patients were evaluated. Fifty-one patients with cutaneous manifestations (46 CRMO and five Majeed syndrome) were included in this study. The mean diagnostic delay was 16.1 ± 11.7 months in those with cutaneous manifestations and 25.3 ± 9.9 months in those with bone involvement (p = 0.02). The most common skin lesions were acne (n = 26), pustules (n = 23), and papules (n = 10). Patients with acne had more frequent male sex and higher ESR and CRP levels (p = 0.01, p = 0.03, and p = 0.04, respectively). Patients with pustules had a younger age at symptom onset and age at diagnosis and higher ESR and CRP levels (p = 0.04, p = 0.04, p = 0.04, p = 0.02, p = 0.03, respectively). In patients with CRMO, the mean time to remission was 2.1 ± 0.7 years for cutaneous manifestation and 2.9 ± 1.4 years for bone involvement (p = 0.04). Conclusion Skin lesions may appear before bone lesions in autoinflammatory bone diseases, serving as an important early warning sign for diagnosis. Lesions such as acne and pustules are more common in these conditions and may contribute to the severity of inflammation in autoinflammatory bone diseases.
Syndrome of undifferentiated recurrent fever (SURF): a multicenter real-world experience from Turkiye
(Springer London Ltd, 2025) Güngörer, Vildan; Ünal, Dilara; Çakan, Mustafa; Ayduran, Semra; Gül, Ümit; Zora, Hatice Kübra; Öner, Nimet
Introduction/objectives Syndrome of undifferentiated recurrent fever (SURF) is an autoinflammatory disorder that is recognised in an increasing number of patients. In this study, we aimed to assess the data of SURF patients from the main reference centres in our country. Methods Data for this retrospective multicentre observational cohort study were obtained from the records of SURF patients aged 0–18 years who were followed up in 10 pediatric rheumatology clinics in Türkiye between 2010 and June 2023. Patients with recurrent fever that could not be explained by periodic fever, aphthous stomatitis, pharyngitis and adenopathy (PFAPA) and hereditary recurrent fevers and had no other cause were included in the study. Results Of the 134 patients included in the study, 74 (55.2%) were male. The median age at diagnosis was 67 months. The most common symptom was abdominal pain in 98 (73.1%), arthralgia in 82 (61.2%), malaise in 77 (57.5%). The age at symptom onset was ≤ 5 years in 109 patients (81.3%). Pharyngitis was more common symptom in children aged ≤ 5 years (p = 0.008), headache, arthralgia, chest pain were more common findings in children > 5 years (p = 0.008, p = 0.032, p = 0.045). There were 113 patients receiving colchicine alone or in combination therapy and 74.3% of them achieved complete or partial remission. The presence of abdominal pain (p = 0.021, OR = 0.254) increased the remission rate with colchicine. Conclusion SURF patients present with a wide range of clinical manifestations. Distinguishing between SURF and PFAPA is not concrete. Further omics studies will enlighten whether there is a true group of SURF.
Bibliometric analysis of publications on suicide emphasizing the academic contributions of MENA countries
(Springer Heidelberg, 2025) Şevik, Ali Emre; İçbay, Mehmet Ali
Aim This study examines the research on suicide in the Middle East and North Africa (MENA) region, analyzing 1000 publications from MENA countries. It reveals trends, citation patterns, collaboration networks, and thematic areas, providing insights into the region’s scholarly contributions to the global public health challenge of suicide. Subject and methods This study analyzes suicide-related publications in the Web of Science electronic database from MENA countries, focusing on academic contributions and trends. It uses bibliometric techniques to identify key contributors, influential research topics, and the impact of MENA countries on global suicide research. The analysis includes publication trends, citation patterns, collaboration networks, and thematic areas. The study uses Boolean operators to determine relationships between terms and customize search queries. Results The dataset from 1971 to 2023 shows steady growth in scholarly output, with a peak of 107 articles in 2023. Highly cited articles, such as the study by Nock et al. (Br J Psychiatry 192(2):98–105, 2008) on cross-national prevalence and risk factors for suicidal ideation, highlight the impact of certain studies. The journal Crisis: The Journal of Crisis Intervention and Suicide Prevention leads in articles published. Israel is a significant research hub, contributing substantially to suicide-related literature. Collaboration networks are evident, with international partnerships and ties between Israel and the USA. The study also analyzes funding agencies, revealing prevalent themes like “behavior,” “risk factors,” and “depression.” Conclusion This study underscores the need for global collaboration and interdisciplinary approaches in addressing suicide research in the MENA region, highlighting the critical public health issue.
Managing penicillin resistant pneumococcal meningitis: an international id-iri study
(Springer, 2025) Erdem, Hakan; Doğan, Elif; Ankaralı, Handan; Dragovac, Gorana; Seyman, Derya; Tarakcı, Arzu; Dalmanoğlu, Enes; Alkan, Sevil
Penicillin-resistant pneumococcal meningitis (PRPM) is a challenging and fatal infection. We conducted a multicentre international retrospective study to evaluate the clinical features, outcomes, predictors of outcomes antimicrobial efficacy and drug susceptibility in patients with PRPM. The study, conducted through the Infectious Diseases-International Research Initiative across 33 centers in 11 countries, analyzed PRPM patients treated between 2019 and 2024 using univariate and multivariate analyses. A total of 138 patients were included. Of these, 83 (60.1%) were fully cured, 27 (19.6%) died, and 28 (20.3%) survived with sequelae. Mortality was associated with ICU admission (OR 14.886; p = 0.021), mechanical ventilation (OR 7.205; p = 0.049), and vasopressor use (OR 8.983; p = 0.025). Higher CSF leukocyte count (OR 0.854; p = 0.060) and blood leukocyte count (OR 0.283; p = 0.021) were linked to lower mortality risk. Patients who developed sequelae were more likely to require mechanical ventilation (OR 9.354; p = 0.001), experience recurrent meningitis (OR 5.562; p = 0.081), and have lower platelet counts (OR 0.001; p = 0.050), compared to those who fully recovered. Sequelae patients had higher GCS scores (OR 1.365; p = 0.014), more corticosteroid use (OR 5.301; p = 0.061), and less vasopressor use (OR 0.205; p = 0.019) compared to those who died. The antibiotic susceptibility profiles of the isolates in our PRSP cohort were: Ceftriaxone (75/134, 55.9%), meropenem (26/44, 59%), moxifloxacin (47/48, 97.9%). PRPM is a fatal disease in which mortality and sequelae occurring in two-fifths of cases. Severe illness markers such as ICU admission, mechanical ventilation, and vasopressor use, along with recurrent meningitis are linked to worse outcomes. Thrombocytopenia, low leukocyte counts, and lower GCS scores are indicators of poor prognosis, while corticosteroid therapy appears protective in PRPM. Therapeutic optimization is challenged by rising resistance and pharmacokinetic limitations, though moxifloxacin shows the highest susceptibility; further research is warranted.
Clinical characteristics, mid-term outcomes and management of asymptomatic primary hyperparathyroidism: A multicentre retrospective cohort study
(Springer, 2025) Engin, İsmail; Tuna, Mazhar Müslüm; Köroğlu, Ekin Yiğit; Çakır, Bekir; Fırat, Sevde Nur; Yağcı, Hüseyin; Tura Bahadır, Çiğdem; Saygılı, Emre Sedar
Purpose The primary objective of this study was to retrospectively evaluate the demographic, biochemical, and clinical characteristics of patients with asymptomatic primary hyperparathyroidism (aPHPT), analyze their long-term outcomes, and discuss the effectiveness of current therapeutic strategies in light of the existing literature. We anticipate that our study will provide clinicians with guidance regarding surgical decision-making beyond the standard criteria for aPHPT. Methods This was a nationwide, multicenter, observational, retrospective cohort study. All tertiary care endocrinology departments across the country were invited to participate. Center inclusion criteria required the enrollment of a sufficient number of aPHPT patients, confirmed by careful diagnostic evaluation in accordance with established guidelines, regular follow-up for at least one year, and systematic monitoring for complications. Results Data from 27 centers representing various regions of Turkey were included in the study. A total of 829 patient records were reviewed, and after excluding 25 patients who did not meet eligibility criteria, 804 patients were included in the final analysis. The mean age was 55.59 ± 11.54 years, with a female predominance (85%, n = 683). The baseline prevalence of comorbidities was as follows: hypertension in 43% (n = 346), diabetes mellitus in 27.1% (n = 216), and cardiovascular disease in 10.8% (n = 87) of patients. Bone mineral density (BMD) measurements were available for 701 patients, among whom osteoporosis was present at 23.4% and osteopenia at 50.5%. Glomerular filtration rate (GFR) significantly declined by the third year compared to baseline (p = 0.003). The prevalence of cardiovascular disease significantly increased at year three compared to baseline and the first year (p = 0.002). A significant association was found between the presence of osteoporosis and lower baseline serum magnesium levels (p < 0.001), particularly among patients with magnesium levels below 1.6 mg/dL compared to those with levels within the normal range (1.6–2.5 mg/dL). Additionally, patients with osteoporosis demonstrated significantly lower serum phosphate levels compared to other groups (p < 0.001). Conclusion The management of asymptomatic PHPT continues to present numerous unanswered questions. Hypertension, cardiovascular disease, and diabetes mellitus were found to be more prevalent among aPHPT patients compared to the general population. The observed increase in cardiovascular events over time suggests that cardiovascular disease could become a more prominent factor in future surgical decision-making. Furthermore, the significant decline in GFR over follow-up may necessitate revisiting the surgical threshold of GFR < 60 mL/min in future guidelines. Routine assessment of serum magnesium and phosphate levels should be considered, particularly in patients at high risk for osteoporosis. Future research may further redefine surgical indications in the management of aPHPT.
Cabergoline monotherapy in polycystic ovary syndrome patients with elevated prolactin: a viable option?
(Springer, 2025) Sığınır, Aslı; Bostan, Hayri; Saygılı, Emre Sedar; Tufan, Ceren; Karakılıç, Ersen
Purpose Cabergoline is widely used to treat hyperprolactinemia, but its effects on polycystic ovary syndrome (PCOS) remain unclear. Since hyperprolactinemia is present in nearly 30% of PCOS cases, this study aims to assess the impact of cabergoline on androgen levels and clinical outcomes in PCOS with elevated prolactin cases, discussing these findings with the results in prolactinoma cases. Methods A total of 66 women aged 18–40 were included in this retrospective cohort study, with 36 in the PCOS with elevated prolactin group (median 24.0 (22.0–27.5) years) and 30 in the prolactinoma group (median 28.0 (23.7–33.0) years). Only patients who had been started on cabergoline treatment and had available follow-up data were included. Hormonal profiles and clinical findings, including hirsutism, and menstrual cycle regularity, were assessed before and after cabergoline treatment. Results After cabergoline treatment, significant reductions in prolactin and total testosterone levels were observed in both groups. In the PCOS group, total testosterone decreased from 0.65–0.49 ng/mL (p < 0.001) and dehydroepiandrosterone-sulphate levels from 407.5–301.0 µg/dL (p < 0.001). In the prolactinoma group, total testosterone decreased from 0.39–0.29 ng/mL (p < 0.001). Menstrual irregularities improved markedly in both groups, with prevalence decreasing from 83.3–5.6% in PCOS group and from 80.0–10.0% in the prolactinoma group (p < 0.001). Furthermore, in PCOS group, the prevalence of hirsutism was decreased from 86.1–61.1% (p = 0.007). Conclusion Cabergoline is effective in lowering prolactin and androgen levels while improving menstrual regularity in both PCOS and prolactinoma patients, highlighting its potential as a valuable therapeutic option for patients with PCOS with elevated prolactin.
Understanding stigma in multiple sclerosis: workplace discrimination, social challenges and psychological impacts
(Springer Heidelberg, 2025) Bülbül, Nazlı Gamze; Tunç, Abdulkadir; Bunul, Sena Destan; Demir, Serkan; Seferoğlu, Meral; Sıvacı, Ali Özhan; Aksoy, Selma
Background Stigmatization in MS patients is an important problem that affects social interaction, work life and daily life. In this study, we investigated the prevalence, severity and especially the effects of stigmatization on work life in MS patients. Methods A cross-sectional study of 420 people living with MS (PwMS) assessed stigma using the NeuroQoL Stigma Short Form and a direct stigma survey. Demographic, clinical, workplace, and social data were collected through an online survey. Statistical analyses were performed. Results Stigma was prevalent, with 77% reporting stigma in direct surveys and 67.6% scoring > 8 on the NeuroQoL Stigma Short Form. Stigma was more severe in patients with progressive MS and higher EDSS scores. The most disturbing symptoms were fatigue (73.3%), imbalance (46.7%) and attention deficit 50.5%). The most prominent complaint affecting work life was fatigue (41.2%). Only 7.3% of the patients had sought psychological support for this issue. 57.4% of patients had disclosed their illness to their employer and 68.1% to their coworkers. Conclusions Stigma in MS is pervasive, linked to clinical severity, workplace challenges, and social withdrawal. Interventions targeting stigma’s psychological and social dimensions, along with workplace education and support are essential.
COPET study findings regarding the clinical relevance of biomass exposure as an etiotype in COPD
(Elsevier Science Inc, 2025) Ertan Yazar, Esra; Demirci, Nilgün; Arpınar Yiğitbaş, Burcu; Çalıkoğlu, Mukadder; Gülbaş, Gazi; Turan, Muzaffer Onur; Şahin, Hülya; Mirici, Nihal Arzu
Purpose The finding that COPD can also develop in non-smokers has led to further investigations of etiologic causes other than smoking. This study evaluated the relationship between tobacco smoking and/or biomass-burning smoke exposure (BBS) and the demographic, clinical, and prognostic characteristics of individuals with COPD. Methods A total of 1129 stable COPD patients from the COPET study were retrospectively analyzed. The patients were divided into three groups: the COPD-B group ( n = 52), which included patients who were solely BBS; the COPD-C group ( n = 634), which included patients who exclusively tobacco smoking; and the COPD-BC group ( n = 443), which included patients with both BBS and tobacco smoking. Results The average age of the patients was 65.8 ± 9.1 years, and 87.4 % of them were men. In the COPD-B group, the following factors were significantly greater compared to the COPD-C and COPD-BC groups: age ( p = 0.001), BMI ( p = 0.001), percentage of female patients ( p < 0.001), FEV 1 /FVC ratio ( p = 0.014), eosinophil count ( p < 0.001), ADO score ( p < 0.001), and the proportion of patients with frequent exacerbations ( p = 0.013). Thorax CT scans showed that the COPD-BC group had a greater incidence of bronchiectasis and emphysema than the COPD-B and COPD-C groups ( p < 0.001). Conclusions This study highlights significant clinical and radiological differences among COPD patients based on tobacco smoking and BBS, which may substantially impact COPD outcomes, including exacerbations and prognosis.
Predicting stimulated C-peptide in type 1 diabetes using machine learning: a web-based tool from the T1D exchange registry
(Elsevier Ireland Ltd, 2025) Saygılı, Emre Sedar; Batman, Adnan; Karakılıç, Ersen
Aims The mixed-meal tolerance test (MMTT), though considered the gold standard for evaluating residual beta-cell function in type 1 diabetes mellitus (T1D), is impractical for routine use. We aimed to develop and validate a machine learning (ML) model to predict MMTT-stimulated C-peptide categories using routine clinical data. Methods Data from 319 individuals in the T1D Exchange Registry with complete MMTT and clinical information were analyzed. The cohort was randomly split into training (70%) and test (30%) sets. Five clinical variables—age at diagnosis, diabetes duration, HbA1c, non-fasting glucose, and non-fasting C-peptide—were selected via recursive feature elimination. Four ML algorithms (random forest [RF], XGBoost, LightGBM, and ordinal logistic regression) were trained with 10-fold cross-validation. Results The RF model showed the highest performance: AUC 0.94 (95% CI: 0.92–0.96), sensitivity 0.84 (95% CI: 0.80–0.89), and specificity 0.92 (95% CI: 0.90–0.94) in cross-validation. In the test set, AUC was 0.97, sensitivity 88%, and specificity 94%. Notably, 17.7% of individuals with undetectable non-fasting C-peptide had measurable levels after MMTT. Conclusions This ML model provides a practical, non-invasive tool for estimating beta-cell function in T1D and is available online at https://cpeptide.streamlit.app.
Key predictors of mortality in Crimean-Congo haemorrhagic fever: a retrospective multicentre cohort study
(Elsevier Sci Ltd, 2025) Güllü, Deniz; Yığcı, Defne; Baykam, Nurcan; Kocagül Çelikbaş, Aysel; Yapar, Derya; Akdoğan, Özlem; Özden, Kemalettin; Alıravcı, Işıl Deniz
Objective This study aimed to identify key predictors of mortality in patients with Crimean-Congo haemorrhagic fever (CCHF). Our specific goals included characterizing the demographic and clinical features of hospitalized CCHF patients in Türkiye, determining the factors associated with mortality among these patients, and evaluating the impact of early ribavirin administration. Methods A retrospective study was conducted on 1103 CCHF patients across 18 hospitals in Türkiye from 1 January 2019 to 20 November 2024. All data were obtained via an online data collection system by the designated physician at each centre. Patients with laboratory-confirmed CCHF infection who were hospitalized were included in the study. Univariate analyses and time-dependent Cox regression were conducted. Results Of the 1103 patients, 65.7% (725/1102) were men; 87.2% (962/1103) resided in rural areas; and the mean age was 53 years. Ticks were identified as the transmission route in 68.4% (755/1103) of the cases. Comorbidities included diabetes mellitus, chronic heart disease, and hypertension; 4.6% (51/1103) of the patients developed healthcare-related infections. Intensive care unit admission was required in 8.0% (88/1103) of the patients, and the overall mortality rate was 5.1% (56/1103). In univariate analyses, age ≥50 years (odds ratio [OR], 3.1; 95% CI, 1.58–6.08; p < 0.001) and diabetes mellitus (OR, 4.49; 95% CI, 2.20–9.18; p < 0.001) were associated with increased mortality. Both variables remained statistically significant predictors in the multivariate analysis. Although early ribavirin administration, ≤96 hours from symptom onset, did not reach statistical significance in univariate analysis (OR, 0.52; 95% CI, 0.26–1.05; p = 0.065), it was significantly associated with reduced mortality in time-dependent Cox regression (adjusted hazard ratios, 0.21; 95% CI, 0.07–0.69; p = 0.010). Discussion Key factors such as age and comorbidities can predict mortality in CCHF patients. Timely identification of these predictors, along with early administration of ribavirin, may contribute to improved survival and better clinical outcomes.
Association between polypharmacy and mortality in the community dwelling elderly: A retrospective cohort study
(Mosby-Elsevier, 2025) Kılınçarslan, Mehmet Göktuğ; Çıbık, Birol; Şahin, Erkan Melih
In this study, we examined the association between the use of multiple medications (polypharmacy) and mortality in 116 community-dwelling elderly people. This retrospective cohort study included 116 participants randomly selected from a population of 1161 community-dwelling elderly individuals. Of the 116 participants, 60 (51.72 %) were female, with a mean age of 74.09±6.53 years at the start of the study in 2015. After a median follow-up of 2932 days, 37 participants (31.90 %) were identified as deceased. The results showed that higher mortality was associated with increased medication adherence and a higher total number of medications. Notably, the use of topical medications did not contribute to the observed mortality. When assessing polypharmacy, it is recommended to exclude topical medications from the count, as they were found to have no effect on mortality. These findings highlight the need for thoughtful medication management to improve health outcomes in older populations.

Güncel Gönderiler