Temel Tıp Bilimleri Bölümü Koleksiyonu

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https://hdl.handle.net/20.500.12428/2277

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Outcomes of retrograde intrarenal surgery in patients on anticoagulant or antiplatelet therapy: a multicenter matched case-control study by the RIRSearch Study Group
(Springer, 2025) Şimşekoğlu, Muhammed Fatih; Ozman, Oktay; Şahin, Mehmet Fatih; Çakır, Hakan; Teke, Kerem; Çınar, Önder; Akgül, Murat; Sancak, Eyüp Burak; Sıddıkoğlu, Duygu
Purpose This study aimed to assess the outcomes of various perioperative management strategies employed during retrograde intrarenal surgery (RIRS) in patients receiving anticoagulant (AC) or antiplatelet (AP) therapy. Methods In this multicenter retrospective matched case–control study, we included patients with nephrolithiasis who received AC or AP therapy and underwent RIRS. The control group consisted of patients not receiving AC/AP therapy. Group 1 included patients who discontinued AC/AP treatment prior to RIRS, whereas Group 2 comprised patients who also discontinued AC/AP therapy but received bridging anticoagulation. The primary endpoints were surgical success and RIRS-related complications. These outcomes were assessed using non-contrast abdominopelvic computed tomography (CT) scans obtained during the first postoperative month. Results In the final analysis, Group 1 and Group 2 each comprised 50 patients, while the control group consisted of 56 patients. The mean age was 59.36 ± 8.86 years in Group 1, 59.96 ± 9.70 years in Group 2, and 56.59 ± 11.56 years in the control group (p = 0.452). Surgical success was significantly lower in Group 2 (p = 0.026), and the need for auxiliary procedures was significantly higher in this group (p = 0.009). Although perioperative complications tended to be higher in Group 2 (p = 0.053), no statistically significant differences were observed in postoperative or overall complication rates. Conclusions Patients undergoing RIRS with bridging anticoagulation demonstrated lower surgical success rates and a higher need for auxiliary procedures. These findings underscore the importance of close monitoring and individualized perioperative management in this high-risk patient population.
Uridine and uridine nucleotides as novel regulators of NUCB2/nesfatin-1 neuron activation: an immunohistochemical study
(Springer, 2025) Hasanoğlu Akbulut, Nursel; Topal, G.; Koç, C.; Coskan, N.; Salman, B.; Cansev, M.; Eyigör, O.
Nesfatin-1, identified as an anorexigenic neuropeptide in the hypothalamus, is activated by glutamatergic agonists and innervated by excitatory and inhibitory neurons. The uridine nucleotide uridine diphosphate was recently identified as a novel regulator of feeding-related neurons. However, the activating effects of uridine and uridine nucleotides on anorexigenic NUCB2/nesfatin-1 neurons are unknown. In this study, the activating effects of intracerebroventricularly administered uridine or uridine nucleotides (UMP, UDP, UTP) on NUCB2/nesfatin-1 neurons localized in the supraoptic (SON), paraventricular (PVN), and periventricular (PeV) nuclei were determined using c-Fos immunohistochemistry. Results were evaluated as the percentage of the ratio of c-Fos-expressing (activated) NUCB2/nesfatin-1 neurons to all NUCB2/nesfatin-1 neurons. It was determined that centrally administered uridine, UMP, and UTP activated a statistically significant number of NUCB2/nesfatin-1 neurons in the SON, PVN, and PeV, compared with the saline group (p < 0.05). At the same time, the slight increase in the neuronal activation seen following UDP application was not found to be significant. The results of this study show that NUCB2/nesfatin-1 neurons respond to uridine and uridine nucleotides in the form of neuronal activation, possibly through pyrimidinergic neurotransmission.
A Comparative Study of Nitrogen Doped Carbon Dots Prepared from Linear Polyethyleneimine (L-PEI) and Branched Polyethyleneimine (B-PEI): Thermal, Optical, Biocompatibility, Sensor, Antibacterial, and Light-Induced Antibacterial Activity
(Springer/Plenum Publishers, 2025) Demirci, Şahin; Sağbaş Suner, Selin; Şahiner, Mehtap; Akçalı, Alper; Güven, Olgun; Şahiner, Nurettin
The N-doped carbon dots (CDs) prepared in the presence of citric acid (CA) as carbon source, using linear poly(ethylene imine) (L-PEI) and branched poly(ethylene imine) (B-PEI) as nitrogen doping agents were prepared via hydrothermal/solvothermal technique at 250 degrees C in a Teflon-lined autoclave. The zeta potentials of L-PEI CDs and B-PEI CDs were determined as + 9.8 +/- 4 and 0.1 +/- 0.5 mV with 47 +/- 3 and 54 +/- 5 nm sizes, respectively. Bandgap values for L-PEI CDs and B-PEI CDs were estimated as 3.06 and 3.37 eV, respectively. The fluorescence intensities of L-PEI CDs and B-PEI CDs were measured as 59,310(a.u.), and 46,370(a.u.) at 474 and 442 nm, respectively, under 400 and 320 nm excitation wavelengths and 700 V PMT voltage. A higher quantum yield% value was observed for L-PEI CDs with 37 +/- 2.9%. Both L-PEI CDs and B-PEI CDs were found biocompatible up to 1000 mu g/mL concentration with > 80% L929 fibroblast cell viability. The limit of detection (LOD) values for Fe3+ by L-PEI CDs and B-PEI CDs were determined as 0.58 and 2.14 mg/mL, respectively. Both L-PEI CDs and B-PEI CDs at 10 mg/mL concentration resulted in 50% bacterial killing for gram-negative E. coli, gram-positive B. subtilis, and yeast C. albicans microorganisms. Also, the light activation of L-PEI CDs and B-PEI CDs induces almost 70 and 40% bacterial killing for gram-positive B. subtilis in 30 min. Moreover, they have a limit of detection (LOD) value of 0.58 mg/mL for Fe3+ ions, in addition to exhibiting biocompatibility and antibacterial properties.
Design, synthesis, characterization, computational analysis, structure-activity relationship, and investigation of the anticancer potential of novel dibromodibenzoazepine-based hybrid structures
(Springer, 2025) Allito, Azza; Önder, Alper; Cömert Önder, Ferah; Erdoğan, Musa
In this study, ten novel dibromodibenzoazepine-substituted triazole hybrid compounds (AZ1-AZ10) were designed via a molecular hybridization approach and synthesized using click chemistry methodology. In the synthesis, the dibromodibenzoazepine derivative (12) was initially synthesized via bromination. Subsequent propargylation yielded the key intermediate, dibromodibenzoazepine-propargyl derivative (13). The Cu (I)-catalyzed azide-alkyne cycloaddition (CuAAC) reaction of propargyl derivative (13) with various substituted azide derivatives afforded the target hybrid compounds in high yields. The structures of these compounds were characterized using various spectroscopic techniques, including H-1 NMR, C-13 NMR, and MS. Among the synthesized compounds, AZ9 was determined to have the highest cytotoxicity on breast and colon cancer cell lines, including BT20, MCF7, MDA-MB-231, and HT29 with the IC50 values of 0.54 +/- 0.09 mu M, 1.83 +/- 0.87 mu M, 3.88 +/- 0.15 mu M, and 5.31 +/- 0.38 mu M, respectively. In addition, AZ8 showed the cytotoxicity on BT20 and HT29 cells below 10 mu M. The cytotoxicity of AZ10 in studied cancer cell lines was calculated below 20 mu M. The compounds were investigated by computational analysis including molecular docking, molecular dynamics (MD) simulations, Molecular Mechanics with Generalized Born and Surface Area Solvation (MM/GBSA), and ADME predictions. As a result, AZ8-AZ10 may be promising anticancer agents targeting SphK1 and CDK6 to provide new perspectives for the design and development of novel click products.
Chronic low back pain and exercise: a molecular perspective on aerobic and anaerobic core training
(Springer, 2025) Aykora, Emrah; Akar, Ali; Eroğlu, Hüseyin Avni
Chronic low back pain (CLBP) remains a significant challenge for clinicians, and a substantial percentage of adults experience it at some point in their lives. Non-pharmacological treatments have gained attention for managing pain through aerobic and anaerobic core exercises. However, studies on humans and animals have yielded conflicting results regarding the type of exercise and its effect on pain sensation. The pain sensitivity of CLBP patients largely depends on their physiological and psychological conditions. The most studied and supported non-drug treatments for managing CLBP are aerobic core workouts. Recently, new research has also shown promising benefits of anaerobic core exercises, which can help reduce discomfort. Both aerobic and core anaerobic exercises have distinct yet complementary roles in managing CLBP. Aerobic training enhances overall health and endurance, while core anaerobic exercises focus on stabilization and muscular support. Understanding how they work individually and together can help create more effective, personalized exercise plans for long-term CLBP management. These exercises are especially effective in correcting postural issues and lowering mechanical stress on the lumbar spine. Although the exact mechanisms are still unknown, both types of exercises have the potential to lessen pain. This scoping review discusses the pathophysiological processes and exercise-induced hypoalgesia related to CLBP therapy. Additionally, it explores the pain-related molecular mechanisms associated with both aerobic and anaerobic core exercises.
Sepsis-associated immunosuppression: mechanistic Insights, Biomarkers, and therapeutic perspectives
(Springer, 2025) Ovalı, Mehmet Akif; Perçin, Şevval
Sepsis is recognized as a major global health concern, characterized by a dysregulated and uncontrolled host response to infection that results in organ dysfunction and high mortality. Clinically, the course of sepsis typically begins with an intense hyperinflammatory phase, which is often followed by an immunosuppressive stage in many patients. This immunosuppressive state significantly increases susceptibility to secondary infections, complicates treatment, and worsens overall survival. The immunopathogenesis of sepsis-associated immune dysfunction involves profound alterations in immune cells, particularly monocytes, macrophages, and T lymphocytes. In addition, metabolic reprogramming through signaling pathways such as mTOR, AMPK, and PI3K-Akt contributes to the imbalance of immune responses and the deepening of immunosuppression. Currently, biomarkers such as HLA-DR expression are employed to monitor immune status and to predict clinical outcomes in septic patients. From a therapeutic perspective, the use of immunostimulatory agents, biomarker-guided monitoring, and personalized immunomodulatory strategies has gained increasing attention. Recent clinical and experimental findings suggest that these approaches may help restore immune competence and improve patient outcomes. The aim of this review is to provide a comprehensive synthesis of current knowledge regarding the cellular, molecular, and metabolic mechanisms underlying sepsis-associated immunosuppression and to discuss their potential implications for the development of targeted therapeutic strategies.
Boron Containing Curcumin-Like Compound as an Acetylcholinesterase Inhibitor and Anticancer Agent: Synthesis, Biological Evaluation, and Computational Insights
(Humana Press Inc, 2025) Cömert Önder, Ferah; Ural, Kadircan; Önder, Alper; Özpolat, Bülent; Ay, Mehmet
Alzheimer's disease (AD) and cancer are significant global health challenges that highlight the need for the development of new therapeutics. Targeting biological mechanisms involved in both AD and cancer could be an effective treatment strategy for developing novel inhibitors. In this study, we investigated the effect of a newly synthesized boron containing curcumin-like compound as a potential acetylcholinesterase (AChE) inhibitor along with its cytotoxic effects on breast and colorectal cancer cell lines. Compound A exhibited a potent AChE inhibitory activity (IC50 = 22.89 +/- 2.32 nM), demonstrating that it was more effective than the known inhibitors donepezil (IC50 = 28.32 +/- 3.27 nM) and tacrine. Compound A showed a moderate cytotoxic activity on MCF-7 and BT20 cells with the IC50 values 40.70 +/- 2.31 mu M and 41.71 +/- 4.51 mu M, respectively. Throughout molecular dynamics (MD) simulations, the RMSD value of the protein was calculated as 1.56 +/- 0.20 & Aring; and 1.65 +/- 0.19 & Aring; for the complexes of compound A and curcumin, respectively. The interactions with specific amino acid residues such as Tyr124, Tyr337, and Trp86 for AChE, and Trp82, His438, and Tyr332 for BChE were obtained. Additionally, MM/GBSA calculations demonstrated that Compound A had the highest binding free energies (-88.89 +/- 8.34 kcal/mol for AChE and -73.25 +/- 8.83 kcal/mol for BChE) compared to curcumin (-67.87 +/- 5.48 kcal/mol for AChE and -51.68 +/- 5.28 kcal/mol for BChE) and tacrine (-56.67 +/- 2.22 kcal/mol for BChE) were calculated. Overall, these findings suggest that Compound A is a promising agent with its potent AChE inhibitory activity and anticancer potential, making it a valuable candidate for further research in neurodegenerative diseases and cancer therapy.
Gold and silver nanoparticle decorated biocompatible and antibacterial xanthan gum/poly (HEMA-co-APTMACl) hydrogels for wound healing
(Springernature, 2025) Savranoğlu Kulabaş, Seda; Atlı, İlknur; Atalay, Hazal Nazlıcan; Boyuneğmez Tümer, Tuğba; Özay, Hava; Özay, Özgür
A delayed skin wound healing process increases the risk of infection and necessitates implementing effective treatment strategies. From this perspective, biocompatible and antibacterial hydrogels stand out as innovative biomaterials that support wound healing. In this research, a semi-interpenetrating polymer network (s-IPN) strategy was used to improve the mechanical strength, cytocompatibility, and antibacterial properties of natural polysaccharide-based hydrogels. In this context, natural polymer-based XG/poly (HEMA-co-APTMACl) hydrogels were synthesized by redox polymerization reaction. The stability of metal nanoparticles was ensured by utilizing the rich polyphenol and flavonoid components of C. Orientalis. The synthesized hydrogels were in situ functionalized with biosynthesized silver (55 nm) and gold (56 nm) nanoparticles to enhance their biocompatibility and biofunctionality. Their antibacterial activity was assessed against P. aeruginosa, S. aureus, B. cereus, and E. faecalis using the disk diffusion method. Hydrogelfilm@Ag inhibited all tested bacterial strains (7.5–8.8 mm), while Hydrogelfilm@Au exhibited stronger antibacterial activity, particularly against E. faecalis (10.3 mm) and B. cereus (9.7 mm). In contrast, the Hydrogelfilm was only effective against S. aureus (7.7 mm). The hydrogel formulations were tested for cytocompatibility and wound healing potential using HUVECs. All hydrogels composites (Hydrogelfilm@Au, @Ag, and @HF) were non-toxic and exhibited enhanced biocompatibility, promoting significant cell proliferation at all tested concentrations (5–20%). In wound healing assays, Hydrogelfilm@HF achieved complete wound closure within 12 h even at a 5% concentration, demonstrating superior regenerative potential. Overall, hydrogels incorporating green-synthesized silver and gold nanoparticles demonstrated excellent antibacterial and wound-healing properties, highlighting their promise as advanced biomaterials for tissue regeneration applications.
Effect of Hydrogen on Pentylenetetrazole-Induced Seizures in Ovariectomized Rats
(Springernature, 2025) Kaya, Miktat; Makav, Mustafa; Karadağ Sarı, Ebru; Yediel Aras, Şükran; Kuru, Mushap; Vural, Abdussamed; Eroğlu, Hüseyin Avni
The aim of the study was to investigate the therapeutic efficacy of hydrogen-rich water in pentylenetetrazol-induced epilepsy. A total of 30 female rats, 6 animals in each group, were used in the study. All groups except the control group were ovariectomized. Hydrogen-rich water Group (HRW) and Epilepsy + HRW Group (E + HRW) were administered intraperitoneally for 14 days. On the 14th day of the study, Epilepsy Group, HRW group and E + HRW group were administered a single dose of pentylenetetrazol intraperitoneally. Afterwards, all animals were recorded with a camera for 30 min and then epilepsy scoring was performed. All animals were then euthanized by cervical dissociation under anesthesia in accordance with ethical rules. Blood and tissue (brain and cerebellum) samples were collected from the animals. Biochemical measurements of MDA, GSH, native thiol, total thiol and disulfide homeostasis were performed. P53 and P27 genes were analyzed by PCR. Histopathological, routine hematoxylin and eosin and immunohistochemically BCL-2 and caspas-3 immunoreagents were examined. MDA data showed a statistically significant increase in the E group. Especially in the cerebellum tissue, a statistical decrease in the E + HRW group compared to the E group is remarkable. When GSH, Total thiol and Native thiol data were analyzed, a statistical decrease was observed in the E group. Especially in blood and cerebellum tissue, statistical increase in E + HRW group compared to E group is remarkable. P53 and P27 genes were statistically but numerically significant. There was also a significant difference in Bcl-2 and Caspas-3 immunoreactivity in the E + HRW group compared to the E group. In conclusion, hydrogen-rich water administration of the E + HRW group showed a therapeutic effect compared to E group. In the light of the results, we suggest that hydrogen-rich water may have a reactive effect in epilepsy.
The Effect of Oleuropein on the Treatment of Allergic Rhinitis
(Georg Thieme Verlag Kg, 2025) Çil, Özge Çağlar; Büyük, Başak; Eroğlu, Hüseyin Avni; Şehitoğlu, Hilal
Introduction Allergic rhinitis is a disease that negatively affects social and work life and sometimes does not respond to many treatments. Therefore, new treatments are needed. For the prevention and treatment of allergies, oleuropein has been emphasized, and positive results have been shown in the literature. Objective To investigate the effects of general and topical oleuropein during the allergic rhinitis period and the histopathological changes in the nasal mucosa compared with steroid nasal sprays and control group in rats. Methods We developed an experimental animal model with 44 rats divided into 6 groups. Except for the control group, the allergic rhinitis in the other five groups was created with ovalbumin. As treatment, saline was administered to group 3, steroids, to group 4, oleuropein, to group 5, and steroids and oleuropein were administered to group 6. The effects of the drugs were examined histopathologically and the levels of immunoglobulin E (IgE) in the blood were compared. Results Considering the symptomatic findings in rats, we could observe that allergic rhinitis occurred. Based on the IgE levels and histopathological findings, we have statistically shown that oleuropein may be effective in treatment of allergy rhinitis. Conclusion Oleuropein has been shown to be useful in the treatment of allergic rhinitis in an animal model, but further studies are needed before it is introduced into the medical practice.
Relationship between work-related musculoskeletal symptoms and burnout symptoms among preclinical and clinical dental students: a cross-sectional study
(Bmc, 2025) Sezer, Berkant; Sıddıkoğlu, Duygu
Background The demanding nature of dental education exposes students to a high risk of burnout symptoms, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Similarly, work-related musculoskeletal symptoms are prevalent among dental students, posing significant occupational health challenges. This study aimed to evaluate the relationship between work-related musculoskeletal symptoms and burnout symptoms among preclinical and clinical dental students. Methods A total of 248 dental students participated in this cross-sectional study, and a three-part questionnaire was administered. The first section included sociodemographic and health-related questions. The second section utilized the Nordic Musculoskeletal Questionnaire, in which participants indicated “yes” or “no” responses regarding the presence of musculoskeletal symptoms in nine specific body regions (neck, shoulders, upper back, elbows, wrists/hands, lower back, hips/thighs, knees, and ankles/feet) over the past 7 days and 12 months. The third section employed the Maslach Burnout Inventory, which assesses three dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Participants responded to items on a 7-point Likert scale. Relationships between work-related musculoskeletal symptoms and burnout symptoms were analyzed using generalized linear models and linear regression analyses. Results The mean age of the participants was 20.73 ± 1.42 years, and 58.9% were female. Statistically significant relationships were found between emotional exhaustion and neck pain experienced in the past 12 months (B = 3.700, p < 0.001), as well as pain-related incapacity in the lower extremities in the past 12 months (B = 2.584, p = 0.002). Depersonalization was significantly associated with lower extremity pain in the past 12 months (B = 1.620, p = 0.001). Additionally, being a clinical dental students was a significant predictor of emotional exhaustion (B = 2.981, p = 0.007). All presented B coefficient estimates were adjusted for age, sex, clinical education level, and work-related musculoskeletal symptoms-related variables. Conclusions The findings revealed significant associations between clinical education level, neck and lower extremity pain in the past 12 months, pain-related incapacity, and burnout symptoms among dental students. These results suggest that emotional exhaustion and depersonalization in dental students may be influenced by work-related musculoskeletal symptoms.
Enhancing pharmacology education through role-play: impact on student attitudes
(Bmc, 2025) Tekeş, Ender; Güngör, Buket; Sılan, Coşkun; Toraman, Çetin
Background Pharmacology is a cornerstone of medical education, essential for rational prescribing and patient safety. However, students often perceive it as abstract and overwhelming due to its memorization-heavy nature and limited clinical relevance. This study aimed to evaluate the impact of a role-play-based clinical pharmacology internship on medical students’ attitudes towards learning the pharmacology course. Methods A mixed-methods interventional design was employed. In the quantitative phase, a one-group pretest-posttest design was used with 97 fifth-year medical students. Participants completed the “Attitude Scale Toward the Pharmacology Course for Medical School Students” before and after a one-week internship focused on rational drug use and structured around role-play activities. Paired sample t-tests were used to assess attitudinal change. In the qualitative phase, semi-structured focus group interviews were conducted with eight students selected based on pre-post changes in attitude scores. Data were analysed using inductive content analysis. Results There was a statistically significant improvement in students’ attitudes following the role-play-based internship (pretest mean = 37.24, posttest mean = 41.15; p < .001), with a large effect size (Cohen’s d = 0.959). Qualitative findings revealed three major themes: (1) pharmacology as difficult but essential, (2) burden of memorization, and (3) the need for clinically relevant, functional learning. Students appreciated the realism and interactivity of role-play, which enhanced their understanding of drug interactions and rational prescribing. However, some still viewed pharmacology as anxiety-provoking and overly burdensome, indicating a need for longitudinal curricular integration. Conclusions Role-play-based clinical pharmacology education significantly improves medical students’ attitudes toward learning pharmacology. Embedding realistic, scenario-based learning within pharmacology curricula may enhance student engagement, promote rational prescribing, and contribute to safer clinical practice. This positive change was supported by a high effect size of Cohen’s d = 0.96, demonstrating the significant educational impact of the intervention.
Different chromatographic techniques and recent advancements for biomedical and pharmaceutical applications
(Health Directorate of Istanbul (HDI), 2025) Coşkun, Özlem; Akbarzadeh, Sama; Güncer, Başak
Chromatography remains a cornerstone analytical technique in pharmaceutical and biomedical sciences, with recent innovations significantly expanding its capabilities. Advances such as fast chromatography, two-dimensional liquid chromatography (2D-LC), supercritical fluid chromatography (SFC), and hyphenated techniques, including liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS), have broadened the scope of its applications. These developments enhance resolution, sensitivity, and efficiency, enabling more robust analysis of complex biological and pharmaceutical samples. These methods address complex analytical challenges, improving precision, speed, and efficiency in separating and analyzing biomolecules. Emerging technologies, including miniaturized liquid chromatography, shear flow chromatography, column arrays, and microfluidic chip-based systems, present exciting opportunities for the future. These developments enhance the capability of chromatography to analyze trace compounds, optimize drug formulations, and ensure the quality control of pharmaceuticals. Chromatography is also increasingly integrated with cutting-edge techniques like metabolomics and proteomics, furthering its impact on biomarker discovery and personalized medicine. This paper reviews recent advancements in chromatographic methods and their practical applications in the pharmaceutical and biomedical fields. It highlights the critical role of chromatography in drug discovery, purification of therapeutic compounds, and metabolite profiling.
Effect of luer-lock access device on hemolysis during blood collection via intravenous catheters in the emergency department
(Walter De Gruyter Gmbh, 2025) Cinpolat, Havva Yasemin; Akman, Canan; Şahin, Eda
Objectives Emergency departments are the units where hemolysis is most frequently observed, and blood collection from intravenous catheters increases the hemolysis rate. This study aimed to compare the effects of two different blood collection methods from an intravenous catheter (an adapter and a syringe) on serum indices, complete blood count, and routine clinical chemistry tests in an emergency department. Methods The study encompassed 104 patients from the yellow and green zones of the Emergency Department at Canakkale Onsekiz Mart University Hospital. Blood samples were obtained from an intravenous catheter with a standard syringe and an adapter into serum separator tubes and dipotassium ethylenediaminetetraacetic acid (K2EDTA) tubes. Serum index, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), potassium, high-sensitivity (hs) troponin T, and complete blood count were evaluated. Passing-Bablok regression analysis was performed, and the mean percentage difference was calculated and compared to target values via a Bland-Altman plot. Results A statistically higher hemolysis rate was observed when blood was collected with a syringe, compared to collecting blood with an adapter (p<0.001). When the results were categorized according to the parameter-specific hemolysis index, AST, CK, potassium, LDH, and hs troponin T results were more affected by hemolysis when blood was collected with a syringe (p<0.001). The mean percentage difference for AST and LDH exceeded the minimum target values based on biological variation. Conclusions Using a catheter-compatible adapter in emergency departments may reduce the rate of hemolysis and provide reliable results for tests frequently affected by hemolysis.
First-trimester prediction of early-onset preeclampsia using PAPP-A and mean arterial pressure
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2025) Beyazıt, Fatma; Pek, Eren; Daş, Murat; Duran, Mehmet Nuri; Ülker Çakır, Dilek; Şen, Başak Nil; Kiraz, Hasan Ali; Ünal Çetin, Ece
Predicting early-onset preeclampsia (EOP) during the initial stages of pregnancy is essential for effective clinical management and enhancing maternal-fetal outcomes. Current methodologies, which include clinical and demographic risk factors, biophysical parameters, and serum biomarkers, exhibit limited efficacy in predicting EOP. This study aimed to evaluate whether the incorporation of pregnancy-associated plasma protein-A (PAPP-A) and mean arterial pressure (MAP) significantly enhances EOP detection. We conducted a retrospective case-control study involving 518 gravidas, of whom 202 developed EOP and 316 experienced normal pregnancies. Logistic regression models were employed to assess EOP predictions, and the predictive accuracy of these statistical models was evaluated using receiver-operating characteristic curve analysis. Our findings indicate that lower PAPP-A levels, higher MAP, and increased body mass index (BMI) are associated with EOP. Notably, in pregnant women between 11+0 and 13+6 weeks of gestation, a 1-point decrease in PAPP-A corresponds to an 84% increase in the likelihood of developing EOP. The predictive performance of PAPP-A improves significantly when combined with other factors such as BMI, MAP, and a history of diabetes mellitus (DM). The risk of EOP is substantially heightened (20.410 times, 95% CI: 11.104-37.515) in patients exhibiting low PAPP-A levels (<0.88) and high BMI (≥35 kg/m²). Additionally, low PAPP-A combined with elevated MAP levels significantly increases EOP risk (adjusted odds ratio [OR]: 114.83). However, after adjustment, the association between low PAPP-A and a history of DM was not statistically significant (adjusted OR: 2.30, p = 0.202). In conclusion, employing a combination of multiple variables for predicting EOP yields a significant improvement over traditional methods that rely solely on individual factors.
Investigation of Therapeutic Efficacy of Intravesical Tigecycline Administration in Rats with Cystitis Induced by Extensively Drug-Resistant (XDR), Tigecycline-Sensitive Acinetobacter baumannii Strain
(Mdpi, 2025) Yüksel, Cihan; Alıravcı, Işıl Deniz; Koşan, Murat; Esen, Sinem; Yenice Aktaş, Sevinç; Kaya Terzi, Neslihan; Berber, Ahmet Ali; Alkan, Sevil; Kaya, Selçuk
Background: This study aimed to evaluate the therapeutic efficacy of intravesical tigecycline administration in a rat model of cystitis induced by a tigecycline-sensitive, extensively drug-resistant (XDR) Acinetobacter baumannii strain. Methods: Thirty-six female Wistar albino rats were inoculated intravesically with XDR A. baumannii to induce cystitis. Twenty-four rats that developed infection were divided into four groups: untreated control, saline irrigation, low-dose tigecycline (6.25 mg/kg), and high-dose tigecycline (25 mg/kg). Microbiological clearance was assessed via urine cultures on days 3 and 5. Bladder tissues were analyzed histopathologically and for genotoxicity using the Comet assay. Results: On day 5, microbiological clearance was significantly higher in tigecycline-treated groups compared to controls (p = 0.028). Histopathology revealed significantly more inflammation in the high-dose tigecycline group (p = 0.029). Genotoxicity was observed in both tigecycline groups, independent of dose (p < 0.05). Conclusions: Intravesical tigecycline demonstrated microbiological efficacy against XDR A. baumannii-induced cystitis. However, its inflammatory and genotoxic potential necessitates further preclinical evaluation.
Machine Learning-Based Validation of LDHC and SLC35G2 Methylation as Epigenetic Biomarkers for Food Allergy
(Mdpi, 2025) Kılıçarslan, Sabire; Hız Çiçekliyurt, Meliha Merve; Kılıçarslan, Serhat; Hassan, Dina S. M.; Samee, Nagwan Abdel; Kurtoğlu, Ahmet
Background: Food allergies represent a growing global health concern, yet the current diagnostic methods often fail to distinguish between true allergies and food sensitivities, leading to misdiagnoses and inadequate treatment. Epigenetic alterations, such as DNA methylation (DNAm), may offer novel biomarkers for precise diagnosis. Methods: This study employed a computational machine learning framework integrated with DNAm data to identify potential biomarkers and enhance diagnostic accuracy. Differential methylation analysis was performed using the limma package to identify informative CpG features, which were then analyzed with advanced algorithms, including SVM (polynomial and RBF kernels), k-NN, Random Forest, and artificial neural networks (ANN). Deep learning via a stacked autoencoder (SAE) further enriched the analysis by uncovering epigenetic patterns and reducing feature dimensionality. To ensure robustness, the identified biomarkers were independently validated using the external dataset GSE114135. Results: The hybrid machine learning models revealed LDHC and SLC35G2 methylation as promising biomarkers for food allergy prediction. Notably, the methylation pattern of the LDHC gene showed significant potential in distinguishing individuals with food allergies from those with food sensitivity. Additionally, the integration of machine learning and deep learning provided a robust platform for analyzing complex epigenetic data. Importantly, validation on GSE114135 confirmed the reproducibility and reliability of these findings across independent cohorts. Conclusions: This study demonstrates the potential of combining machine learning with DNAm data to advance precision medicine in food allergy diagnosis. The results highlight LDHC and SLC35G2 as robust epigenetic biomarkers, validated across two independent datasets (GSE114134 and GSE114135). These findings underscore the importance of developing clinical tests that incorporate these biomarkers to reduce misdiagnosis and lay the groundwork for exploring epigenetic regulation in allergic diseases.
Use of SGLT2 Inhibitors in Patients with Chronic Kidney Disease and Urinary Tract Infection: Is There a Need for Concern?
(Mdpi, 2025) Yavuz, Demet; Cinpolat, Havva Yasemin; Demir, Ayşe Kevser; Kadi, Nezaket; Kal, Öznur; Şahin, İremcan; Alkan, Sevil
Objective: This study aimed to investigate urinary tract infections (UTIs) and associated risk factors in patients with type 2 diabetes mellitus and chronic kidney disease (CKD), with or without treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2i). Methods: We retrospectively analyzed diabetic CKD patients with available urine culture results. Patients were divided into two groups: those receiving SGLT2i therapy and those not receiving it. The groups were compared retrospectively with respect to the development of urinary tract infection at 12-month follow-up, using clinical and laboratory results. Results: A total of 151 patients with T2DM were included, with a median age of 70 years (range: 61-76), and 84 (56%) were female. Among them, 91 (60%) patients were treated with SGLT2i. BMI, plasma glucose levels, and the urine protein/creatinine ratio were significantly lower in the SGLT2i group (p = 0.002, p = 0.049, and p < 0.001, respectively), while serum urea and creatinine levels were significantly higher (p = 0.048 and p = 0.028, respectively). A total of 59 patients (39.1%) had positive urine cultures, 32 of whom (35.2%) were using SGLT2i. There was no statistically significant difference in UTI incidence between SGLT2i users and non-users (p = 0.298). Among patients with positive cultures, Escherichia coli was the most common pathogen, identified in 52.5% (n = 31) of cases. Patients with positive urine cultures were older (p = 0.005), and 39 (66%) were female (p = 0.038). According to logistic regression analysis, advanced age and female sex were identified as independent risk factors for UTI (p = 0.037; Odds Ratio = 2.172, 95% CI: 1.048-4.502 and p = 0.033; Odds Ratio = 2.169, 95% CI: 1.065-4.415, respectively). Conclusions: In diabetic patients with CKD, the use of SGLT2i reduces proteinuria without increasing the risk of urinary tract infections. Advanced age and female sex are independent risk factors for UTI.
A prediction model for lung involvement using circulating angiotensin converting enzyme-2 and renin levels in COVID-19 patients
(J Infection Developing Countries, 2025) Akkan, Cansu; Daş, Murat; Bardakçı, Okan; Şehitoğlu, Müşerref Hilal; Akdur, Gökhan; Akman, Canan; Akdur, Okhan; Beyazit, Yavuz
Introduction: The potential role of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of coronavirus disease 2019 (COVID-19) is controversial, with concerns mainly about the part RAAS peptides play in the prediction of progression to more severe disease. Given the importance of COVID-19 prognostication at early disease stages, we established and validated a multivariable risk stratification tool for COVID-19 associated lung involvement by utilizing a combination of RAAS peptides. Methodology: In this prospective study, circulating renin and angiotensin converting enzyme-2 (ACE-2) levels were measured in 116 COVID-19 patients who were admitted to our hospital from March 30, 2021 to January 24, 2022 and underwent a lung computed tomography (CT) scan. Clinical severity was measured with a national early warning score (NEWS). Associations among RAAS peptides, inflammation-dependent biomarkers, demographic variables, and clinical outcomes were studied using logistic regression and Cox proportional-hazards models. Results: We assessed 116 COVID-19 patients (mean age 45.1 ± 12.6 years; 51.7% male), of whom 66 (56.9%) had COVID-19 associated pneumonia. Baseline circulating ACE-2 (2.63 ± 0.12 ng/mL) and renin levels (85.04 ± 6.8 ng/L) were lower in patients with COVID-19 related pneumonia compared to patients without pneumonia (6.4 ± 0.7 ng/mL and 211.6 ± 21.9 ng/L, respectively) (p < 0.001 for both). Both RAAS components were found to be significantly related to adverse outcomes, including COVID-19 associated pneumonia and intensive care unit (ICU) admission, in both crude and adjusted multivariable logistic regression analyses. Conclusions: Circulating ACE-2 and renin levels can predict lung involvement in COVID-19 patients, and they display good correlation and agreement with NEWS.
Development and Investigation into the Psychometric Properties of the Troy Sleep Scale
(Turkish Sleep Medicine Society, 2025) Akıncı, Erhan; Bolat, Nurullah; Korkmaz, Şükrü Alperen; Toraman, Çetin
Objective A unique and comprehensive self-report scale to help assess sleep in Turkish is needed. This study aimed to develop the Troy Sleep Scale (TSS) and perform validity and reliability analyses. Materials and Methods The study was conducted with 494 medical students and residents. The psychometric properties of the devised scale were evaluated through exploratory and confirmatory factor analyses, Cronbach’s alpha and McDonald’s omega reliability evaluations, and item analyses based on both classical test theory and item response theory (IRT). The reliability assessment of the TSS was carried out through test-retest, and criterion-referenced validity was employed to provide additional validation. Results The TSS consists of 11 items with a 3-factor structure with eigenvalues greater than 2. The factors provided information about (I) dysfunction due to sleep problems, (II) affective symptoms due to sleep problems, and (III) sleep quality. The reliability levels of all three sub-factors and overall scale scores were 0.82 and above. The test-retest reliability level had a correlation value of >0.80. The item analyses conducted in line with the IRT proved that the scale items provided a high level of information and functioned together with the answer set. The correlation between the TSS and the Pittsburgh Sleep Quality Index was analyzed for criterion-referenced validity, yielding a correlation of 0.73. Conclusion The psychometric properties of the TSS indicated that it was valid and reliable, making it suitable for use as a screening test for individuals with sleep-related complaints.

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