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https://hdl.handle.net/20.500.14619/3617

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Pharmacogenetic testing for predicting methylphenidate treatment outcomes in childhood attention deficit hyperactivity disorder in Turkey: Focus on carboxylesterase 1, latrophilin-3, and catechol-o-methyltransferase.
(John Wiley and Sons Inc., 2025-01-05) Suzer Gamli, Ipek; Van Veggel, Anne; Karaaslan, Rabia Sevcan; Kuerec, Ajla Hodzic; Marzoukah, Zeina; Adak, Ibrahim; Bulut, Gulay; Tunc, Huseyin; Hizel, Candan Perry; Parlayan, Cuneyd; Ekinci, Ozalp; Van Schaik, Ron; Akin, Demet
Pharmacogenetic studies involving Carboxylesterase 1 (CES1), Latrophilin-3 (LPHN3), and Catechol-O-methyltransferase (COMT) revealed individual differences regarding therapeutic response in children with attention deficit hyperactivity disorder (ADHD) under methylphenidate (MPH) treatment. This study aimed to evaluate MPH's association with the adverse effect status in children and its relationship with CES1, LPHN3, and COMT in the Turkish population. The study included 102 children and adolescents with ADHD, who were categorized as responders, or the adverse effect group based on their treatment response. The Naranjo Adverse Drug Reaction Probability Scale evaluated the presence and severity of adverse effects. Saliva sample was taken from the patients and genotype distribution of CES1 rs3815583, CES1 rs2307227, LPHN3 rs6551665, LPHN3 rs1947274, LPHN3 rs6858066, LPHN3 rs2345039, and COMT rs4680 were examined. In the adverse effect group, instances of carrying the GG genotype in CES1 rs2307227, having G vs. T genotype and GG vs. GT were significantly higher. In LPHN3 rs2345039, carrying the C genotype vs. G was associated with a serious adverse effect. In COMT rs4680, individuals with the AA or GG genotype were significantly higher in the adverse effect group. Our study suggests a relationship between genetic polymorphisms and the side effect status in children receiving MPH.
An investigation of the effectiveness of atmospheric pressure cold plasma on sciatic nerve injury in rats
(Via Medica, 2024-05-13) Yilmaz, Nesibe; Deniz, Omur Gulsum; Secgin, Seyda; Secgin, Yusuf; Bozduman, Ferhat
Background: The aim of this study was to evaluate the efficacy of atmospheric pressure cold plasma jet and plasma activated medium (PAM) on sciatic nerve injury (SNI). Materials and methods: Rats were divided into 6 groups (n = 10); group 1 (sham), group 2 (SNI), group 3 (SNI + atmospheric pressure cold plasma jet 5 min), group 4 (SNI + atmospheric pressure cold plasma jet 10 min), group 5 (SNI + PAM 5 min), and group 6 (SNI + PAM 10 min). On days 1, 8, 15, and 22 of the study, atmospheric pressure cold plasma jet was applied to rats in groups 3 and 4, and PAM was applied to rats in groups 5 and 6. A hot plate test was applied to all rats on the same days. On day 28, the experiment was terminated, and sciatic nerve tissues were removed for histopathological evaluation. Results: According to the 4-week average of the hot plate tests, a significant relationship was found between group 2 and group 4 and group 6 (p < 0.05). When evaluated within each week, significant differences were found between group 2 and group 4 in week 1, between group 2 and group 5 and group 6 in week 2, between group 2 and group 4 in week 3, and between group 2 and group 4 and group 6 in week 4 (p < 0.05). As a result of histopathological analysis, except for the control group, the other groups had similar characteristics in terms of axonal degeneration, periaxonal swelling, and axon density. Conclusions: As a result of our study, we found that plasma application showed an improvement in the duration of the hot plate test but did not show any improvement histopathologically.
Outcomes of patients with heart failure in Türkiye
(TUBITAK, 2024-06-14) Şahin, Anıl; Yilmaz, Mehmet Birhan; Çelik, Ahmet; Çöllüoğlu, İnci Tuğçe; Ural, Dilek; Asarcikli, Lale Dinç; Nalbantgil, Sanem; Demir, Emre; Çavuşoğlu, Yüksel; Murat, Selda; Kanik, Emine Arzu; Ata, Naim
Background/aim: Despite Türkiye’s relatively young population, there is an emerging trend of earlier diagnoses of chronic diseases, including heart failure (HF). This study aims to shed light on survival rates, potential influences of guideline-directed therapies, and sex-based differences necessitating personalized management in HF. Materials and methods: We conducted a nationwide retrospective cohort analysis of 2,722,151 patients with HF using deidentified data from the Turkish Ministry of Health’s national electronic database. That cohort included 2,701,099 adult patients with HF. Adult patients were divided into two groups based on their outcomes as those who were deceased and those who survived and were then compared. Multivariate regression analysis was conducted to identify variables predicting mortality. The patients’ hospital admissions and length of hospital stay were analyzed based on survival status and age. Results: Out of 2,722,151 HF patients, the overall mortality rate was 33.7%, with a difference observed according to sex (32.5% in female patients, 35.0% in male patients). Survival rates at 1, 5, and 7 years after the HF diagnosis were detailed. Deceased HF patients had more comorbidities, higher natriuretic peptides, and lower glomerular filtration rates. Hospitalization patterns varied, with 41% experiencing no hospitalization. The average length of hospital stay in 2022 was 6 days, with sex-and age-specific disparities. Conclusion: The survival rate of HF in Türkiye is similar to world data. The survival of female patients is better than that of male patients. Increased survival rates can likely be attributed to the widespread use of guideline-directed therapies. Finally, high healthcare utilization is observed, especially in emergency situations.
Medical and advanced heart failure therapies in Türkiye
(TUBITAK, 2024-05-07) Nalbantgil, Sanem; Demir, Emre; Çelik, Ahmet; Çöllüoğlu, İnci Tuğçe; Ata, Naim; Yilmaz, Mehmet Birhan; Yilmaz, Mehmet Birhan; Kanik, Emine Arzu; Asarcikli, Lale Dinç; Çavuşoğlu, Yüksel
Background/aim: Effective management of heart failure involves evidence-based use of multiple medications and their combinations. Furthermore, dosage escalation of the recommended medications is advised. In cases of advanced heart failure, long-term mechanical assistance devices or heart transplantation surgery may be necessary. Socio-economic disparities create unequal opportunities for people to access these treatments. The study aimed to analyze and compare medical and advanced heart failure treatments recommended by guidelines across various regions in Türkiye. Materials and methods: About 85 million citizens medical treatment records were utilized between January 1, 2016, and December 31, 2022. Medical and heart replacement treatment opportunities for heart failure in Türkiye were evaluated in the general population and across different geographical regions. Results: According to this study, beta-blockers were the most commonly prescribed medication for heart failure in Türkiye. This was followed by angiotensin-converting enzyme inhibitors at 44% and mineralocorticoid receptor antagonists at 38.9%. However, only 0.6% of patients used angiotensin receptor blocker-neprilysin inhibitors. Despite the high incidence of diabetes mellitus among heart failure patients, only 11% used sodium-glucose cotransporter two inhibitors. The study also found that using an implantable cardioverter defibrillator (ICD) was 0.8%, and cardiac resynchronization therapy (CRT) was 0.3% among all intracardiac device treatments. Heart replacement therapies, cardiac transplantation surgery, and long-term left ventricle-assisted device (LVAD) surgery had very low rates. Conclusion: The use of guideline-directed medical therapy is not optimal in Türkiye and varies across different geographical regions. It is a fact that heart transplant or LVAD surgery, CRT, and ICD implantation rates in Türkiye are significantly lower than those in developed countries, regardless of geographical region.
Burden of comorbidities in heart failure patients in Türkiye
(TUBITAK, 2024-05-07) Çavuşoğlu, Yüksel; Murat, Selda; Şahin, Anıl; Çöllüoğlu, İnci Tuğçe; Ural, Dilek; Yilmaz, Mehmet Birhan; Nalbantgil, Sanem; Nalbantgil, Sanem; Ülgü, Mustafa Mahir; Birinci, Şuayip; Demir, Emre; Kanik, Emine Arzu; Asarcikli, Lale Dinç; Çelik, Ahmet
Background/aim: Heart failure (HF) is associated with a wide range of comorbidities that negatively impact clinical outcomes and cause high economic burden. We aimed to evaluate the frequency and burden of comorbidities in HF patients in Türkiye and their relationships with patients’ demographic characteristics. Materials and methods: Based on ICD-10 codes in the national electronic database of the Turkish Ministry of Health covering the entire population of Türkiye (n = 85,279,553) from 1 January 2016 to 31 December 2022, data on the prevalence of comorbidities in HF patients were obtained. The frequency and burden of comorbidities were analyzed separately by age groups, sex, and socioeconomic status (SES). Results: Between 2016 and 2022, there were 2,722,151 patients (51.7% female) of all ages who were diagnosed with HF. In Türkiye, the most common comorbidities of HF patients were hypertension (HT) (97.6%), atherosclerotic cardiovascular disease (ASCVD) (84.9%), dyslipidemia (59.5%), anxiety disorder (48.1%), diabetes mellitus (DM) (45.2%), chronic obstructive pulmonary disease (COPD) (43.6%), anemia (40.6%), and atrial fibrillation (AF) (37.1%). Female patients had higher rates of anemia, DM, HT, and anxiety disorders, while male patients had higher rates of ASCVD, COPD, and dyslipidemia. The most common comorbidity in patients under 20 years of age was congenital heart disease (52.3%). More than 90% of HF patients had ≥2 comorbidities. HF patients with ≥5 comorbidities increased from 18.1% in the group aged 20–49 years to 38.3% in the group aged 50–79 years. Comorbidities were similar across SES groups. Conclusion: The most common comorbidities in cases of HF in Türkiye are HT, ASCVD, dyslipidemia, DM, COPD, anemia, and AF, respectively, and more than 90% of patients have ≥2 comorbidities. While ASCVD and dyslipidemia were more common in male patients, anemia, DM, and anxiety disorders were more common in female patients. The number of comorbid conditions increased with advanced age.
Diagnostic approach to heart failure in Türkiye.
(TUBITAK, 2024-05-07) Ural, Dilek; Asarcikli, Lale Dinç; Çöllüoğlu, İnci Tuğçe; Şahin, Anıl; Çavuşoğlu, Yüksel; Yilmaz, Mehmet Birhan; Nalbantgil, Sanem; Ata, Naim; Ülgü, Mustafa Mahir; Birinci, Şuayip; Murat, Selda; Demir, Emre; Kanik, Emine Arzu; Çelik, Ahmet
Background/aim: Final diagnosis of heart failure (HF) relies on a combination clinical findings, laboratory and imaging tests. The aim of this study was to review the diagnostic approach to HF in Türkiye. Materials and methods: This study is a subanalysis of the nationwide TRends-HF study, based on anonymized data from National Electronic Database between January 1, 2016, and December 31, 2022. Variables including date of birth, sex, socioeconomic development index, place of initial HF diagnosis, comorbidities, investigations, and diagnostic procedures were reported. Laboratory variables, including complete blood count, natriuretic peptides (NP), estimated glomerular filtration rate, uric acid, electrolytes, albumin, lipid profile, ferritin and hemoglobin A1c levels, and other imaging techniques (coronary angiogram [CAG], transthoracic echocardiography [TTE], chest X-ray [CXR], etc.) during the initial diagnosis and/or follow-up of HF patients, were obtained from the National Electronic Database. The diagnostic test usage rates were analyzed according to years, geographical regions, and socioeconomic regions of Türkiye. Results: The study population consisted of 2,722,151 HF patients (51.7% female, mean age 68.33 ± 14.01 years). All HF patients had at least one electrocardiogram and one TTE examination, and all underwent routine biochemical tests at least once during the follow-up period. CXR utilization rate was 93.7%, while CAG utilization rate was 17.9%. Coronary computed tomographic angiography and cardiac magnetic resonance imaging were performed in only 1.8% and 0.3% of patients, respectively. Among all Turkish HF patients, 16.3% had at least one NP measurement. The highest rate of NP use was observed in the Central Anatolia Region (21.0%), while the lowest rate was in the Aegean Region (11.7%). NP measurement during HF diagnosis revealed a rising trend over time (12.3% in 2016 vs. 26.3% in 2021). Conclusion: The widespread use of TTE at the beginning of the diagnosis and during follow-up is important for providing quality care to HF patients in Türkiye. However, detailed laboratory tests and advanced imaging methods are not utilized sufficiently, which could lead to issues in patient management.
Approaching a nationwide registry: analyzing big data in patients with heart failure
(TUBITAK, 2024-05-07) Çöllüoğlu, Tuğçe; Şahin, Anıl; Çelik, Ahmet; Kanik, Emine Arzu
Background/aim: Randomized controlled trials usually lack generabilizity to real-world context. Real-world data, enabled by the use of big data analysis, serve as a connection between the results of trials and the implementation of findings in clinical practice. Nevertheless, using big data in the healthcare has difficulties such as ensuring data quality and consistency. This article aimed to examine the challenges in accessing and utilizing healthcare big data for heart failure (HF) research, drawing from experiences in creating a nationwide HF registry in Türkiye. Materials and methods: We established a team including cardiologists, HF specialists, biostatistics experts, and data analysts. We searched certain key words related to HF, including heart failure, nationwide study, epidemiology, incidence, prevalence, outcomes, comorbidities, medical therapy, and device therapy. We followed each step of the STROBE guidelines for the preparation of a nationwide study. We obtained big data for the TRends-HF trial from the National Healthcare Data System. For the purpose of obtaining big data, we screened 85,279,553 healthcare records of Turkish citizens between January 1, 2016 and December 31, 2022. Results: We created a study cohort with the use of ICD-10 codes by cross-checking HF medication (n = 2,722,151). Concurrent comorbid conditions were determined using ICD-10 codes. All medications and procedures were screened according to ATC codes and SUT codes, respectively. Variables were placed in different columns. We employed SPSS 29.0, MedCalc, and E-PICOS statistical programs for statistical analysis. Phyton-based codes were created to analyze data that was unsuitable for interpretation by conventional statistical programs. We have no missing data for categorical variables. There was missing data for certain continuous variables. Propensity score matching analysis was employed to establish similarity among the studied groups, particularly when investigating treatment effects. Conclusion: To accurately identify patients with HF using ICD-10 codes from big data and provide precise information, it is necessary to establish additional specific criteria for HF and use different statistical programs by experts for correctly analyzing big data.
Epidemiology of heart failure in Türkiye
(TUBITAK, 2024-12-13) Ata, Naim; Çöllüoğlu, İnci Tuğçe; Şahin, Anıl; Yilmaz, Mehmet Birhan; Nalbantgil, Sanem; Birinci, Şuayip; Ülgü, Mustafa Mahir; Kanik, Emine Arzu; Ural, Dilek; Asarcikli, Lale Dinç; Demir, Emre; Çavuşoğlu, Yüksel; Murat, Selda; Çelik, Ahmet
Background/aim: The epidemiological data on heart failure (HF) vary between regions within the same country. We aimed to investigate the epidemiological data on HF in Türkiye across all age groups regarding seven geographical regions. Materials and methods: We included all patients from the Turkish population who received a first diagnosis of HF between January 1, 2016 and December 31, 2022, using ICD-10 codes from the National Electronic Healthcare Database. The data were categorized by seven geographical regions of Türkiye. Results: The median age of index diagnosis of HF was 70 (60–78) years in all age groups and 4 (1–12) years in pediatric population. The prevalence rate of HF was the highest in the Black Sea Region at 3.103%, while the Southeastern Anatolia Region exhibited the lowest at 1.436%. In all age groups, female patients with HF were older and had a higher prevalence rate across all geographical regions than male patients. From 2017 to 2021, incidence rates of HF declined to 3.0 per 1000 person years, with a consistent decrease for each geographical region. The highest incidence rates of HF were seen in the Black Sea Region, while the Southeastern Anatolia Region had the lowest. Evaluating pediatric population with HF, prevalence of HF was 0.81 per 1000 people (female children: 0.77 per 1000 people, male children: 0.84 per 1000 people). Female children with HF demonstrated the highest prevalence in the Central Anatolia Region with a rate of 1.04 per 1000 people, while male pediatric population with HF exhibited the greatest prevalence of HF in the Mediterranean Region, reaching 0.89 per 1000 people. The lowest prevalence of children with HF in both sexes was observed in the Eastern Anatolia Region (female children: 0.62 per 1000 people, male children: 0.48 per 1000 people). Conclusion: Despite regional variations, prevalence of HF in Türkiye’s regions aligns with global trends. Sex-based differences in HF prevalence were evident across all age groups, including pediatric population. Incidence rates of HF in each region exhibited a substantial decline by 2021.
Titanium dioxide-induced fibrotic liver model and the therapeutic effect of resveratrol by modulation of α-SMA and 8-oHdG expressions, oxidative stress, and inflammation
(Elsevier, 2025-01-18) Başak, Feyza; Kuşat, Tansu; Ersan, Yusuf; Kahraman, Tahir
The research sought to assess the therapeutic impact of resveratrol by biochemical, immunohistochemical, and histopathological analyses in a TiO2-induced liver fibrosis model. Titanium dioxide (100 mg/kg body weight) was delivered for 15 days to induce liver fibrosis, either alone or in conjunction with resveratrol (30 mg/kg body weight) therapy for the same duration. Resveratrol has been identified as a crucial therapeutic drug that provides an alternative treatment method for TiO2-induced liver fibrosis by mitigating inflammation, oxidative stress, and the expressions of α-SMA and 8-OHdG. Resveratrol treatment mitigated TiO2-induced liver fibrosis by repairing hepatocellular injury and decreasing plasma AST, ALT, and ALP levels. Resveratrol improves the activity of superoxide dismutase (SOD) and catalase (CAT), crucial enzymes for antioxidant defense, and elevates glutathione peroxidase (GSH-Px) levels, so augmenting antioxidant function. Furthermore, resveratrol decreased hepatic inflammation (IL-6 and IL-1β) and oxidative stress markers. Furthermore, histological alterations and immunohistochemistry expression of α-SMA and 8-OhdG were reinstated after resveratrol administration in the TiO2-induced liver fibrosis model. Our research indicates that resveratrol administration effectively protects against liver fibrosis produced by TiO2.
Increased para-aortic adipose tissue on echocardiography may closely be related with fragmented QRS
(Facultad de Salud de la Universidad del Valle, 2024-10-28) Çakan, Fahri; Akıncı, Sinan; Adar, Adem; Köktürk, Uğur; Akbay, Ertan; Önalan, Orhan
Background: The association of fragmented QRS (fQRS) with many cardiac pathologies such as cardiac fibrosis has been described previously. Paraaortic adipose tissue (PAT) is thought to be associated with many cardiac diseases and there is only one publication on its echocardiographic evaluation. Aims: To describe the possible relationship between fQRS and PAT. Methods: Patients presenting to the cardiology outpatient clinic were evaluated for inclusion in the study. Presence of additional R' wave or notching/splitting of S wave in two contiguous ECG leads was defined as fragmented QRS (fQRS) and patients were divided into two groups according to fQRS status on ECG. The hypoechoic space in front of the ascending aorta was considered as PAT in the parasternal long-axis view. The medical history and routine laboratory parameters of the participants were recorded. Univariate and multivariate binary regression analysis was used to determine the relationship between PAT and fQRS. Results: A total of 221 patients were enrolled and divided into two groups according to fQRS status. PAT was significantly higher in the fQRS group: 9.2 mm (7.1/12.3) vs 6.8 mm (1.2/10.9), p=0.001. Univariate analysis showed significant association between fragmented QRS and PAT size (OR 1.122, p= 0.001). Binary regression analysis revealed an independent and strong association between aortic size (OR 1.4, CI95% 1.012-1.938, p=0.042), paraaortic adipose tissue (OR 1.483, CI95% 1.084-2.029, p=0.014) and fragmented QRS. Conclusions: The presence of fQRS is associated with PAT, a newly defined parameter in echocardiography.
Comparative analysis of TNF-α (-308) gene polymorphism in Turkish patients with type 2 diabetes developing nephropathy and/or neuropathy
(Springer Science and Business Media LLC, 2024-12-30) Gurbuz Can, Venhar; Cesur Gunay, Ozlem; Cesur, Sinem
Type 2 diabetes (T2DM) is a group of chronic and systemic metabolic diseases. Nephropathy (NP) and neuropathy (NR) are two common complications that severely affect the quality of life of patients with T2DM. In this study, our aim was to investigate the association between TNF-alpha (-308) gene polymorphism and the risk of developing NP and NR in patients with T2DM We also aimed to determine the association between TNF-alpha (-308) gene polymorphism and several demographic characteristics and biochemical parameters of patients with T2DM developed NP and/or NR. First, blood samples of patients were collected, and DNA isolation was performed. Then, real-time PCR analysis was used for genotyping the TNF-α (-308) gene utilising fluorescently labelled probes. Patients’ demographical data and biochemical parameters were also obtained. Our study did not detect any significant difference in the frequency of possessing the gene polymorphism (A allele) between the groups. Additionally, no significant difference was detected when the data on various biochemical parameters were evaluated in GG, GA, and AA genotypes.
Impact of implantable cardioverter defibrillators on mortality in heart failure receiving quadruple guideline-directed medical therapy: a propensity score-matched study.
(Springer Nature, 2024-11-18) Sahin, Anil; Celik, Ahmet; Ural, Dilek; Colluoglu, Inci Tugce; Ata, Naim; Kanik, Emine Arzu; Ulgu, Mustafa Mahir; Birinci, Suayip; Yilmaz, Mehmet Birhan
In the contemporary management of heart failure with reduced ejection fraction (HFrEF), the recommended quadruple guideline-directed medical therapy (GDMT) consists of angiotensin receptor-neprilysin inhibitor (ARNI), evidence-based beta-blockers (BB), mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i). This study explored the impact of adding implantable cardioverter-defibrillator (ICD) therapy to this comprehensive regimen in HFrEF patients. Methods: Utilizing deidentified data from the National Electronic Database of the Turkish Ministry of Health, we conducted a nationwide retrospective cohort study on 5450 HFrEF patients receiving quadruple GDMT, including ARNI. Among them, 709 patients underwent additional ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation. Propensity score matching ensured balanced baseline characteristics between groups. Primary endpoint was determined as all-cause mortality. Results: In the matched cohort, all-cause mortality occurred in 108 out of 619 patients (17.4%) in the GDMT group and 101 out of 619 patients (16.3%) in the ICD group, with a hazard ratio (HR) of 0.74 and a 95% confidence interval (CI) ranging from 0.57 to 0.98. The median follow-up time was 1365 days in the matched cohort, 1283 days in the GDMT group. Subgroup analyses consistently demonstrated benefits, particularly among individuals aged 61 years and older (HR: 0.60, 95% CI: 0.42–0.87, p = 0.006), those with sinus rhythm (HR: 0.55, 95% CI: 0.34–0.89, p = 0.013), individuals not using amiodarone (HR: 0.61, 95% CI: 0.42–0.89, p = 0.011), and those with an estimated glomerular filtration rate lower than 61.9 (HR: 0.66, 95% CI: 0.48–0.91, p = 0.011). Conclusions: This study may offer a glimmer of hope that even after achieving the best current optimal medical therapy, the addition of device therapy could still yield positive outcomes in the management of patients with HFrEF. Graphical Abstract: (Figure presented.)
Protection of lutein against the neurotoxicity of cisplatin in the rat brain
(Elsevier, 2024-12-01) Bilgiç, Sedat; Aktaş, İbrahim; Yahyazadeh, Ahmad
One of the biggest problems of cancer treatment is the harmful effects of these drugs on the healthy tissues and organs of the organism. Our study aims to determine the possible protective effects of Lutein (L) against the toxicity of the pharmacological substance Cisplatin (CS), which is used in the treatment of cancer, in the brain of rats, through biochemical and histopathological tests. In our study, lutein (L) (100 mg/kg, orally) was administered for brain toxicity caused by CS (10 mg/kg, intraperitoneal (i.p.)). The study was completed in 7 days with a total of 28 rats from 4 groups, each consisting of 7 subjects. Control, L, CS and CS + L. A decrease in MDA level and an increase in CAT, GSH and SOD levels were observed in the CS + L group compared to the CS group. In histopathological examinations, no significant pathological changes were detected in the cerebrum, while degeneration in Purkinje cells and apoptosis in neurons in the molecular and granular layers in the cerebellum were detected. It is understood from the study that L alleviates the results of oxidative stress, increases antioxidant functions and positively supports brain functions. It also demonstrates the ability of L to prevent CS-induced brain damage. Ultimately, L appears to be a applicable pharmacological agent in this damage.
The effect of music therapy on anxiety and pain scores in patients undergoing retrograde intrarenal surgery (RIRS) under spinal anesthesia: a prospective, randomized controlled clinical trial
(Springer Nature, 2024-10-14) Bürlukkara, Salih; Baran, Özer; Demir, Demirhan Örsan
To prospectively investigate the effect of music therapy on patient’s anxiety and pain level during retrograde intrarenal surgery under spinal anesthesia. 286 patients aged above 18 years, who underwent Retrograde Intrarenal Surgery (RIRS) under spinal anesthesia for renal or ureteral calculi were evaluated between January 2023 and June 2023 by a prospective, randomized, controlled clinical protocol. Patients were randomized into 2 groups. Group 1 included patients, who listened to music, and Group 2 was comprised of patients, who were not allowed to listen to music. Visual Analog Scale (VAS) results and pain sensation, anxiety level, together with the results of State-Trait Anxiety Inventory (STAI), a self-reported anxiety inventory, were captured. The number of patients, who were randomized to the music group (Group 1) and non-music group (Group 2) was 144 and 142, respectively. Mean heart rate in Group 1 and Group 2 was 60 ± 4.19 and 70 ± 8.36, respectively (p = 0.02), indicative of the fact that mean heart rate was significantly lower in the music group. Heart rate measured post-operatively within the first hour subsequent to the procedure was similar in both groups (p < 0.05). The VAS score was significantly lower in Group 1. STAI score in Group 1 and Group 2 was 45.51 ± 2.968 and 49.16 ± 1.88, respectively. Therefore, there was a statistically significant difference (p < 0.001). Music therapy during the RIRS procedure under spinal anesthesia was associated with a significantly decrease in pain and anxiety scores in patients.
Pinealektomize sıçanların beyninde akuaporin 4 ve 1 ekspresyon değişiklikleri: melatoninin rolü
(2024) Demir, Mehmet; Başak, Feyza
Beyinde bir sıvı değişim sistemi olan glenfatik sistem, astrositlerde akuaporin 4 (AQP4) ve ventriküler koroid pleksusta akuaporin 1 (AQP1) su kanalları ile ilişkilidir. Ayrıca beyinde sıvı homeostazının sürdürülmesinde sirkadiyen ritimlerin varlığı bildirilmiştir. Bu çalışmada sirkadiyen ritmi düzenleyen melatonin (pinealektomi ve eksojen melatonin takviyesi) ile AQP4 ve AQP1 arasındaki ilişkinin belirlenmesi amaçlanmıştır. Bu çalışmada 50 adet erkek sıçan beş gruba ayrıldı. Gruplar; Kontrol, Sham Pinealektomi (Sham PX), Melatonin (MEL), Pinealektomi (PX), PX+MEL olarak belirlendi. MEL grubuna 30 gün intraperitoneal MEL (10 mg/kg/gün) enjeksiyonu, PX grubuna ise sadece PX cerrahisi uygulandı. PX cerrahisi (MEL yoksunluğu) ve MEL enjeksiyonlarından sonra beyin dokusunda AQP1 ve AQP4 ifadelerindeki değişiklikler incelendi. AQP1 ve AQP4 seviyelerinde kontrol ve Sham PX grupları arasında istatistiksel olarak anlamlı bir fark yokken, PX grubunda anlamlı derecede bir azalma gözlenmiştir (p<0.001). PX+MEL grubunda AQP4 seviyesinde artış gözlenirken (p<0.001), AQP1 seviyesinin değişmediği tespit edilmiştir. Bu çalışma MEL’in AQP4 aracılığı ile glenfatik sisteme önemli katkı sağladığını ancak bu katkıyı AQP1 ile sağlayamadığını göstermiştir. The brain's glymphatic system, a fluid exchange system, is associated with the aquaporin 4 (AQP4) water channels in astrocytes and aquaporin 1 (AQP1) in the ventricular choroid plexus. Circadian rhythms have also been reported to maintain fluid homeostasis in the brain. In this study, we aimed to determine the relationship between melatonin (pinealectomy and exogenous melatonin supplementation), which regulates circadian rhythm, and AQP4 and AQP1. The study, 50 male rats were divided into five groups (n=10). The groups were determined as Control, Sham Pinealectomy (Sham PX), Melatonin (MEL), Pinealectomy (PX), and PX+MEL. The MEL group received intraperitoneal injection of MEL (10 mg/kg/day) for 30 days, and the PX group received only PX surgery. We examined changes in AQP1 and AQP4 expression in brain tissue after PX surgery (MEL deprivation) and MEL injections. While there was no statistically significant difference in AQP1 and AQP4 levels between the control and Sham PX groups, a significant decrease was observed in the PX group (p<0.001). While an increase in AQP4 level was observed in the PX+MEL group (p<0.001), the AQP1 level did not change. This study demonstrated that MEL significantly contributed to the glymphatic system via AQP4 but not AQP1.
Gender estimation using machine learning algorithms from computed tomography images of clivus
(2024) Yılmaz, Nesibe; Seçgin, Yusuf; Atay, İlayda; Köremezli Keskin, Nevin
The clivus, which is involved in the formation of the skull base, is an important material in gender prediction with its fusion structure. The aim of this study is to predict the gender of adult individuals using Machine Learning (ML) algorithms and Artificial Neural Networks (ANN) with parameters obtained from Computed Tomography (CT) images. The study was performed on CT images of 349 individuals aged 18-65 years. Clivus length, 1/3 upper, middle, and lower 1/3 width were measured on CT images and used in ML entry. As a result of the study, it was found that the clivus length, 1/3 upper, middle, and lower width had a significant difference in terms of gender, and ML algorithms showed accuracy up to 0.74. An accuracy of 0.67 was obtained with the ANN model. The study shows that clivus is a bone material that is open to research in terms of gender estimation and can be obtained with high accuracy. In this respect, we believe that it will guide the studies in forensic sciences.
Serum relaxin-3 and galanin levels in individuals with erectile dysfunction with and without type 2 diabetes mellitus
(2024) Yılmaz, Ümit; Burlukkara, Salih; Demir, Demirhan Orsan
This study was designed to determine the serum relaxin-3 and galanin levels in individuals with erectile dysfunction with and without type 2 diabetes mellitus (T2DM). A total of 154 individuals aged 30-60 were included in the study and the participants were divided into three groups: D-ED group (individuals with T2DM and ED) (n=49), ND-ED group (individuals with ED without T2DM) (n=55), and control group (individuals without T2DM and ED) (n=50). The age, BMI, and IIEF-5 score were recorded for all participants. The HDL, LDL, triglycerides, cholesterol, HbA1c and testosterone were determined from the blood taken from the participants, and galanin and relaxin-3 levels were measured in serum samples by ELISA method. The IIEF-5 score of the D-ED group was statistically lower than that of the ND-ED and control groups, and the IIEF-5 score of the ND-ED group was also lower than that of the control group. Serum testosterone levels in the control group were statistically higher than in the D-ED and ND-ED groups. The galanin level of the D-ED group was elevated than the control and ND-ED groups, but the galanin level of the ND-ED group was lower than the control group. The relaxin-3 levels were decreased in the D-ED and ND-ED groups compared to the control group. Galanin levels increased in individuals with T2DM and ED, however decreased in individuals with ED without T2DM. In addition, reduced relaxin-3 level may play a role in the development of ED.
Investigation of the effect of astaxanthin on autophagy in renal ischemia-reperfusion modeled rats
(2024) Yıldız, Azibe; Kısaoğlu, Ayşegül; Köse, Evren; Yılmaz, Nesibe; Tanbek, Kevser; Yılmaz, Ümit; Cırık, Rümeyza Hilal; Özbağ, Davut
Objective: The aim of this study was to investigate the effect of various astaxanthin (ATX) doses on oxidative damage and autophagy in renal ischemia-reperfusion (I/R) injury-modeled rats. Methods: The rats were divided into five groups: sham group (n=8), I/R (n=8), I/R + 5 mg/kg ATX (n=8), I/R + 10 mg/kg ATX (n=8), and I/R + 25 mg/ kg ATX (n=8) groups. ATX was dissolved in 5 mg/kg, 10 mg/kg, and 25 mg/ kg olive oil for 7 days and administered to the rats in the experimental group. Sham and I/R groups were also administered ATX solution (olive oil) via oral gavage for 7 days. Renal ischemia reperfusion was induced in all rats except the sham group after the last dose was administered on the 7th day. Reperfusion was conducted for 24 hours after 45 minutes of ischemia. Results: Blood samples were collected, and kidney tissue were incised for biochemical and histological analyses. Superoxide dismutase (SOD) and total antioxidant status (TAS) were significantly lower in the I/R group than in the sham group (p<0.05), whereas malondialdehyde (MDA) and total oxidant status (TOS) values were higher (p<0.05). It was determined that SOD and TAS increased and MDA and TOS decreased in the ATX- administration groups compared with the I/R group, independent of the dose (p<0.05). In the 25 mg/kg ATX + I/R group, Beclin-1 and LC3β immunoreactivities were significantly higher than those in the other groups (p<0.05). The lowest p62 immunoreactivity was observed in the 25 mg/kg ATX + I/R group. Conclusions: ATX had a protective effect on kidney function and against oxidative damage. Furthermore, high-dose ATX administration protected kidney tissue via autophagy induction in this study. Amaç: Bu çalışmanın amacı böbrek iskemi-reperfüzyon (İ/R) hasarı olan sıçanlarda astaksantinin (ATX) otofaji üzerine etkisinin araştırılmasıdır. Yöntemler: Sıçanlar 5 gruba ayrıldı: Sham grubu (n=8), İ/R (n=8), ATX 5 mg/kg + İ/R (n=8), ATX 10 mg/kg + İ/R (n=8), ATX 25 mg/kg + İ/R (n=8). Deney grubundaki sıçanlara zeytinyağında çözdürülmüş ATX 5 mg/kg, 10 mg/kg ve 25 mg/kg, Sham ve İ/R grubundaki sıçanlara ise ATX çözücüsü (zeytinyağı) gavaj yoluyla 7 gün boyunca verildi. Sham grubu dışındaki tüm sıçanlara 7. gün son doz uygulandıktan sonra İ/R uygulandı. Kırk beş dakikalık böbrek iskemisinden sonra 24 saat süreyle reperfüzyon yapıldı. Bulgular: Biyokimyasal ve histolojik analizler için kan ve doku örnekleri toplandı. Sham grubunda göre İ/R grubunda süperoksit dismutaz (SOD) ve toplam antioksidan durumu (TAS) anlamlı olarak düşükken (p<0,05), malondialdehid (MDA) ve toplam oksidan durumu (TOS) değerleri daha yüksekti (p<0,05). ATX uygulanan gruplarda doz miktarından bağımsız olarak SOD ve TAS düzeylerinin arttığı, MDA ve TOS düzeylerinin azaldığı tespit edildi (p<0,05). ATX 25 mg/kg + İ/R grubunda Beclin-1 ve LC3β immünreaktiviteleri diğer gruplarla karşılaştırıldığında istatistiksel olarak anlamlı derecede yüksekti (p<0,05). En düşük p62 immünreaktivitesi ATX 25 mg/kg + İ/R grubunda tespit edildi (p<0,05). Sonuçlar: ATX’in böbrek fonksiyonlarını ve oksidatif hasara karşı koruyucu etkisi vardı. Ayrıca bu çalışmada yüksek doz ATX uygulaması böbrek dokularını otofaji indüksiyonu yoluyla korumuştur.
The use of family planning methods by Somali women between the ages of 15-49 living in Turkey and their plans and attitudes towards these methods
(2024) Aweis, Saida Abukar; Bilici, Namık; Cengiz, Mustafa; Ertekin, Rıfat; Ayhancı, Adnan
Family planning (FP): individuals consciously plan the birth interval and regulate its timing. For FP, this effort requires resources such as drugs and devices and specific methods. This scientific research investigated the use of FP methods by Somali women aged 15-49 living in Turkey. Women were interviewed face to-face in 15 provinces with a survey consisting of 60 questions. According to the results of our scientific research, Somali women's cultures, traditions, social lifestyles, incomes, and religious beliefs have changed the use of FP methods at different levels. The pregnancy rate at a child age (<18) is 20%. 1/3 of women do not use any FP method. Belief, tradition, culture, tribe and family pressure are the biggest obstacles to FP. Income status changes the level of FP. As a result, proper planning of education and organized health delivery can reduce Somali women's FP approach and, therefore, obstetric problems. Aile planlaması (FP); bireylerin doğum aralığını planlamak ve zamanlamasını düzenlemek üzere bilinçli çaba göstermeleridir. FP için bu çaba ilaç ve cihaz gibi kaynaklara ve belirli yöntemlere ihtiyaç duyar. Bu bilimsel araştırmada Türkiye'de yaşayan 15-49 yaş arası Somalili kadınların FP yöntemlerini kullanımları araştırıldı. 60 sorudan oluşan bir anket ile 15 vilayette kadınlarla yüz yüze görüşüldü. Bilimsel araştırmamızın sonuçlarına göre, Somalili kadınların kültürleri, gelenekleri, sosyal yaşam tarzları, gelirleri ve dini inançları değişik düzeylerde FP yöntemlerinin kullanımını değiştirmektedir. Çocuk yaşta (<18) gebelik oranı %20 düzeyindedir. Kadınların 1/3'ü hiçbir FP yöntemini kullanmamaktadır. İnanç, gelenek, kültür, kabile ve aile baskısı FP'nin önündeki en büyük engellerdir. Gelir durumu FP düzeyini değiştirmektedir. Sonuç olarak eğiti

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