Dahili Tıp Bilimleri Bölümü Koleksiyonu

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

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Zirai ilaç zehirlenmesi ile başvuran stent trombozu
(Çanakkale Onsekiz Mart Üniversitesi, 2021) Duygu, Ali; Kırılmaz, Bahadır; Arslan, Mehmet; Küçük, Uğur
İnsanların 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 gösterilmiştir
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]
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 Beyza
Background: 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.
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]
Humic acid attenuates cisplatin-induced nephrotoxicity in rats
(Taylor & Francis Ltd, 2025) Tekeş, Ender; İçkin Gülen, Meltem; Sılan, Coşkun; Güven Bağla, Aysel
Cisplatin-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.
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, Dilan
In 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.
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]
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, Fatma
Introduction 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.
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]
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, Mustafa
Objective: 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.
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, Sevilay
Introduction: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
Machine Learning-Based Survival Prediction Tool for Adrenocortical Carcinoma
(Endocrine Soc, 2025) Saygılı, Emre Sedar; Elhassan, Yasir S.; Prete, Alessandro; Lippert, Juliane; Altieri, Barbara; Ronchi, Cristina L.
Context Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy with difficult to predict clinical outcomes. The S-GRAS score combines clinical and histopathological variables (tumor stage, grade, resection status, age, and symptoms) and showed good prognostic performance for patients with ACC.Objective To improve ACC prognostic classification by applying robust machine learning (ML) models.Method We developed ML models to enhance outcome prediction using the published S-GRAS dataset (n = 942) as the training cohort and an independent dataset (n = 152) for validation. Sixteen ML models were constructed based on individual clinical variables. The best-performing models were used to develop a web-based tool for individualized risk prediction.Results Quadratic Discriminant Analysis, Light Gradient Boosting Machine, and AdaBoost Classifier models exhibited the highest performance, predicting 5-year overall mortality (OM), and 1-year and 3-year disease progression (DP) with F1 scores of 0.79, 0.63, and 0.83 in the training cohort, and 0.72, 0.60, and 0.83 in the validation cohort. Sensitivity and specificity for 5-year OM were at 77% and 77% in the training cohort, and 65% and 81% in the validation cohort, respectively. A web-based tool (https://acc-survival.streamlit.app) was developed for easily applicable and individualized risk prediction of mortality and disease progression.Conclusion S-GRAS parameters can efficiently predict outcome in patients with ACC, even using a robust ML model approach. Our web app instantly estimates the mortality and disease progression for patients with ACC, representing an accessible tool to drive personalized management decisions in clinical practice.
Supernumerary Testis (Polyorchidism)
(Galenos Publ House, 2025) Ertem, Şenay Bengin; Reşorlu, Mustafa; Öz, Koray
[No abstract available]
Tics Induced by Mirtazapine in an Adolescent
(Korean College of Neuropsychopharmacology, 2025) Yapar, Senem; Bolat, Nurullah
Mirtazapine is an antidepressant approved by the FDA whose mechanism of action involves antagonism of alpha-2, H1, 5-HT2A, 5-HT2C, and 5-HT3 receptors. Tics are sudden, rapid, purposeless, recurrent, non-rhythmic motor movements or vocalizations. There have been previous case reports of various medications causing tics. In this article, we report tic symptoms that we thought developed in association with mirtazapine treatment. Copyright© 2025, Korean College of Neuropsychopharmacology.
Lu-177 İşaretli Somatostatin Reseptörleri ve PSMA Dozimetrisi
(Turkish Nuclear Medicine Society, 2025) Toklu, Türkay; Kozanlılar, Burcu; Yeyin, Nami; Hacıosmanoğlu, Tuğba; Demir, Mustafa; Usta, Semra
Bu dozimetri kılavuzu Avrupa Nükleer Tıp Komitesi kılavuzları örnek alınarak hazırlanmış olup, kılavuzun amacı bilim insanlarına ve klinisyenlere, hastaya özgü dozimetri konusunda öneriler ve rehberlik sağlamaktır. Lutesyum-177 (Lu-177) ile işaretlenmiş radyofarmasötikler, özellikle somatostatin reseptörleri için ligandlar ve küçük molekül prostat spesifik membran antijeni (PSMA) hedefli ligandlar kullanılarak, metastatik nöroendokrin tümörlerin ve prostat adenokarsinomunun tedavisinde kullanılmaktadır. Bu kılavuz, bu tedaviler için rapor edilen dozimetri verilerinin bir genel bakışını sağlamakta ve normal dokularda radyasyona bağlı yan etkiler ve tümörler için doz etkisi ilişkileri hakkındaki mevcut bilgileri özetlemektedir. Dozimetri yöntemleri ve verileri, böbrekler, kemik iliği, tükürük bezleri, gözyaşı bezleri, hipofiz bezleri ve tümörler için özetlenmiştir. Bu önerilerin amacı, Lu-177 ile işaretlenmiş bileşiklerle yapılan terapide hastaya özgü dozimetri uygulamasını teşvik etmektir. Önerilen yöntemler, somatostatin reseptörleri için ligandlar veya küçük molekül Lu-177 PSMA hedefli ligandlarla terapi sunan merkezlerin kapsamı içinde olmalıdır.
Y-90 Microsphere Radioembolization Dosimetry
(Galenos Publishing House, 2025) Kovan, Bilal; Medyenoğlu, Muhammed; Demir, Mustafa; Özdemir, Semra
The need for dosimetric calculations has arisen to enhance the therapeutic efficacy of Yttrium-90 (Y-90) microsphere therapy, determine tumor absorbed dose threshold values, and accurately identify lung tolerance dose thresholds and liver toxicity thresholds. In microsphere therapies, there are three different dosimetry approaches: standard dosimetry, multicompartment dosimetry, and voxel-based dosimetry. Dosimetric procedures are generally performed using Technetium-99m macroaggregated albumin. However, dosimetry based on scintigraphic images obtained from positron emission tomography/computed tomography (CT) or single photon emission computerized tomography/CT after Y-90 administration is also feasible. Copyright© 2025 Yazar.
Kardiyak Transtiretin Tip Amiloidoz Değerlendirilmesinde Sintigrafik Görüntüleme Kılavuzu
(Galenos Publishing House, 2024) Özdemir, Elif; Coşkun, Nazım; Altun, Gülay Durmuş; Demir, Hakan; Özdemir, Semra; Çağlıyan, Feyza; Özkan, Elgin
Amiloidoz amiloid fibrillerinin doku ve organlarda ekstrasellüler birikiminden kaynaklanan multisistemik bir hastalık olup; kardiyak tutulum izlenebilir. Kardiyak amiloidoz kalp yetmezliğinin nadir ve tanısı atlanabilen sebeplerinden biridir ve tanısı sıklıkla endomiyokardiyal biyopsi ile konulmaktadır. Farklı amiloid tiplerinde kardiyak tutulum izlenmekte olup, Teknesyum-99m (Tc-99m) ile işaretli bifosfonat bileşikleri ile sintigrafik görüntüleme amiloidozun kardiyak tutulumunun tespitine ve farklı amiloidoz tiplerinin ayrımına katkı sağlar. Bu kılavuzun amacı Nükleer Tıp hekimlerine transtiretin amiloidozun kardiyak tutulumunun değerlendirilmesi amacı ile Tc-99m kemik sintigrafisi ajanları ile yapılan sintigrafik görüntülemede; endikasyonların belirlenmesi, görüntüleme, raporlama ve bulguların yorumlanması konusunda yardımcı olmaktır
Kişisel Dozimetreler
(Galenos Publishing House, 2025) Yüksel, Alptuğ Özer; Kovan, Bilal; Özdemir, Semra
Radyasyon güvenliği, radyasyon çalışanlarının bireysel sağlık koruması ve iş güvenliği ve yasal zorunluluklar açısından birincil önceliğe sahiptir. Kişisel dozimetreler, radyasyonla çalışan bireylerin iyonlaştırıcı radyasyona maruz kalma seviyelerini ölçmek, izlemek ve kayıt altına almak amacıyla kullanılan hayati öneme sahip ekipmanlardır. Yasal zorunluluk veya bireysel radyasyon korunumu açısından kişisel dozimetrelerin teknolojik gelişmelerle birlikte artan doğruluk, taşınabilirlik ve kullanıcı dostu özelliklerine sahip olması gerekmektedir.
Predictors for Publication of Specialty Theses in the Field of Infectious Diseases and Clinical Microbiology
(DOC Design and Informatics Co. Ltd., 2025) İrkören, Pelin; Agüloğlu-Bali, Elif; Usta, Oğuz; Şenol, Arzu; Manavlı, Barış; Tanır, Büşra; Gürbüz, Esra; Alıravcı, Işıl Deniz
Objective: Specialty theses in the field of infectious diseases and clinical microbiology (IDCM) play an important role in shaping medical knowledge, yet their publication in scientific journals remains a critical concern. We reviewed the theses of the IDCM specialty program, analyzed the publication rates in scientific journals, and made some recommendations for the future. Materials and Methods: We analyzed the registered IDCM theses in the electronic database of the Council of Higher Education (YÖK, Ankara) between 1984 and 2021. Specialty theses from other medical fields, PhD and master theses, were excluded from the study. Results: Out of 1265 theses, 1061 were included after exclusion criteria were applied. The study revealed that 647 (61%) of residents were female. Of 1061 authors, 117 (11%) received financial support during the preparation of the thesis. The most common thesis topics were viral hepatitis, healthcare-associated infections, antibiotic susceptibility, zoonotic diseases, febrile neutropenia, and sepsis. The predominant type of study design was observational (88%). Notably, 27 (3%) were randomized controlled trials. The overall rate of publication in a peer-reviewed journal was 25%. Nonetheless, 117 (11%) theses were published in the journals indexed in the Science Citation Index (SCI) or the Science Citation Index-Expanded (SCI-E). The median time from the presentation of theses to publication was four years. Conclusion: The publication rate of specialty theses in scientific journals in the field of IDCM was found to be low. Publication of the thesis as a scientific manuscript should be a part of the residency program and the completion process of the thesis. All the residents or young specialists should be encouraged to submit their theses for publication. © 2025, DOC Design and Informatics Co. Ltd.. All rights reserved.
Syphilis coinfection in individuals living with HIV: tertiary university hospital data
(Pamukkale University, 2025) Alıravcı, Işıl Deniz; Yenice Aktaş, Sevinç; Kaya, Selçuk
Purpose: This study aimed to examine the coinfection of syphilis in HIV-positive individuals and the epidemiological and clinical characteristics of these patients. Material and methods: Our study was conducted in Çanakkale Onsekiz Mart University, between 13.02.2018 and 13.02.2024, in 26 patients with clinically and laboratory-confirmed syphilis co-infection among 142 HIV/AIDS patients who were followed up and confirmed in the infectious diseases and clinical microbiology outpatient clinic. Results: A total of 142 HIV positive and 26 (18.3%) syphilis coinfected patients between the ages of 17-77 were included in the study. The mean ages of the infected and syphilis coinfected patients were 39.1 and 41.07, respectively. Six (23%) of the coinfected patients were married, the remaining 14 (53.8%) were single or divorced, five had multiple partners; 20 (77%) were heterosexual, four (15%) were men who have sex with men (MSM), and two (8%) were bisexual. Simultaneous HIV/syphilis positivity was detected in 14 (54%) of the coinfected patients at the time of diagnosis, while 7 (27%) were detected during the HIV treatment follow-up period, and 5 (19%) were detected before HIV diagnosis. Of the patients with coinfection, five (19.2%) had primary syphilis, 10 (38.5%) had latent syphilis, and 11 (42.3%) had secondary syphilis at the time of diagnosis. Twenty-two (85%) of the patients had been diagnosed and treated for syphilis only once, while the remaining (15%) had received two or more treatments. Conclusions: The prevalence of syphilis coinfection and reinfection in patients was 18.3% and 15%, respectively. In cases of coinfection, male gender, alcohol and drug consumption, being MSM, irregular lifestyles, and sexual habits were found to be effective. It is important to conduct screening for syphilis and other sexually transmitted diseases (STDs) in HIV-infected patients. Providing psychiatric support to these patients in organizing their life plans is also very important for preventing HIV transmission and syphilis coinfection. © 2025, Pamukkale University. All rights reserved.

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