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Öğe Achieving high accuracy in meniscus tear detection using advanced deep learning models with a relatively small data set(2025) Güngör, Erdal; Vehbi, Husam; Cansın, Ahmetcan; Ertan, Mehmet BatuPurpose: This study aims to evaluate the effectiveness of advanced deep learning models, specifically YOLOv8 and EfficientNetV2, in detecting meniscal tears on magnetic resonance imaging (MRI) using a relatively small data set. Method: Our data set consisted of MRI studies from 642 knees—two orthopaedic surgeons labelled and annotated the MR images. The training pipeline included MRI scans of these knees. It was divided into two stages: initially, a deep learning algorithm called YOLO was employed to identify the meniscus location, and subsequently, the EfficientNetV2 deep learning architecture was utilized to detect meniscal tears. A concise report indicating the location and detection of a torn meniscus is provided at the end. Result: The YOLOv8 model achieved mean average precision at 50% threshold (mAP@50) scores of 0.98 in the sagittal view and 0.985 in the coronal view. Similarly, the EfficientNetV2 model obtained area under the curve scores of 0.97 and 0.98 in the sagittal and coronal views, respectively. These outstanding results demonstrate exceptional performance in meniscus localization and tear detection. Conclusion: Despite a relatively small data set, state-of-the-art models like YOLOv8 and EfficientNetV2 yielded promising results. This artificial intelligence system enhances meniscal injury diagnosis by generating instant structured reports, facilitating faster image interpretation and reducing physician workload. Level of Evidence: Level III.Öğe The tdq-60 tr-a picture-naming test to assess anomia in Turkish adults and the elderly: normative data and validation study in alzheimer's disease and mild cognitive impairment(2025) Karalı, Fenise Selin; Tosun, Samet; Eskioğlu, Elif İkbal; Çınar, Nilgün; Macoir, JoëlObjective: Anomia is defined by difficulty in retrieving content words like nouns and verbs from long-term memory, independent of any impairments related to articulatory movements or motor speech execution. The tools for measuring picture naming, the conventional method for assessing anomia, are very limited in Turkey. The aim of this study was to adapt the Test de Dénomination de Québec—60 images/Quebec picture-naming test—60 pictures (TDQ-60), a color picture-naming test for adults and the elderly into Turkish, establish its validity, and develop normative data adapted to the Turkish population to address this gap. Method: We conducted three separate studies. The objective of Study 1 was to culturally adapt the Test de Dénomination de Québec—60 images. In Study 2, we developed normative data for the TDQ-60 Tr adapted to the adult and elderly population in Turkey based on the performance of 414 community residents aged 18 years and older. In Study 3, the known-group validity, the convergent validity, and the test–retest validity of the TDQ-60 Tr were determined. Results: The results show that the TDQ-60 Tr is reliable in distinguishing participants with Alzheimer’s disease and mild cognitive impairment from healthy participants. The TDQ-60 Tr measures the same cognitive construct as the Boston Naming Test and also has a high test–retest reliability. Conclusions: In summary, the TDQ-60 Tr is a valid and reliable instrument for assessing naming abilities in adults and the elderly. The results of this study have significant implications for the assessment of naming ability in Turkish-speaking patients. Our work serves as a crucial connection to address the lack of tools for diagnosing anomia in Turkey.Öğe Anatomical spread of local anesthetic in circumpsoas block: a cadaveric study(2025) Atalay, Yunus Oktay; Sözcü, Semih Burak; Tekin, Bahar; Ansen, Gamze; Cingöz, Gözde; Şakul, Bayram Ufuk; Alıcı, Haci Ahmet...Öğe Trimethylamine n-oxide (tmao) and tnf-α levels in periodontal disease associated with smoking(2025) Bal, İpek; Balcı, Nur; Sorguç, Cem; Uslu Toygar, Hilal; Ceran Serdar, Ceyhan; Kurgan, Şivge; Serdar, MuhittinAims: Trimethylamine N-oxide (TMAO) is a compound involved in the pathogenesis of various systemic inflammatory diseases, including cardiovascular conditions. The aim of this study was to determine differences in saliva and serum levels of TMAO between periodontitis and healthy patients according to smoking status. Methods: The study included four systemically healthy groups: periodontally healthy non-smokers (NS-Control; n = 25), non-smokers with Stage-III-Grade-B periodontitis (NS-Periodontitis; n = 25), periodontally healthy smokers (S-Control; n = 25), and smokers with Stage-III Grade-C periodontitis (S-Periodontitis; n = 25). Periodontal parameters were recorded. TMAO levels were determined in saliva and serum samples using liquid chromatography-mass spectrometry (LC–MS/MS). TNF-α levels were measured by the ELISA method. Results: Salivary TNF-α and TMAO levels were significantly elevated in the smoking periodontitis group compared to other groups (p < 0.001 and p = 0.003, respectively). Serum TMAO levels were also significantly higher in the smoking periodontitis group compared to non-smoking controls and non-smoking periodontitis. TMAO/SFR ratios were notably higher in the smoking periodontitis group compared to other groups, and a strong positive correlation was observed between salivary TMAO and TNF-α levels (r = 0.892, p < 0.001). Conclusion: The data suggested that TMAO and TNF-α are associated with inflammatory mechanisms of periodontitis in cases where periodontitis coexists with smoking. Trial Registration: NCT06580431.Öğe Different cortex activation between young and middle-aged people during different type problem-solving: an EEG&fNIRS study(2025) Sarıcaoğlu, Mevhibe; Yücel, Meryem Ayşe; Budak, Miray; Omurtag, Ahmet; Hanoğlu, LütfüProblem-solving strategies vary depending on the type of problem and aging. This study investigated the hemodynamic response measured by the changes in the oxyhemoglobin concentration (HbO), alpha frequency power, and their interrelation during problem-solving in healthy young and middle-aged individuals, employing combined electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) recordings. The study included 39 young and 30 middle-aged subjects. The brain activation that occurred while answering different questions was recorded using combined EEG and fNIRS. During the EEG & fNIRS recording, four questions (arithmetic, general knowledge, insight, and basic operation) were used for problem-solving. Alpha power (8–13 Hz) and HbO changes were analyzed. The behavioral results indicated significant differences between age groups in various question types. While the middle-aged group performed better on the general knowledge questions, the older group performed better on the insight and four-process questions. The fNIRS results reveal significant differences in brain activation during problem-solving tasks, particularly in regions like DLPFC/TA, STG, pSSC/Wernicke, and STG/angular gyrus Wernicke's area. The young group with the highest HbO was recorded during arithmetic questions, general knowledge questions, and basic operation questions. In contrast, there was no significant highest HbO during insight questions. Similar findings were observed in the middle-aged group, with the highest HbO recorded during general knowledge questions. However, there was no significant HbO in other channels during the solving of other question types in this group. The alpha power varied across different electrodes for various question types in both young and middle-aged groups. The highest alpha frequency band power for different electrodes was recorded while solving general knowledge questions in the young group and insight questions in the middle-aged group. Finally, the EEG and fNIRS correlation results showed positive correlations between HbO and alpha frequency band power in specific brain regions while solving general knowledge questions, particularly in the middle-aged group. The study reveals age-related differences in behavioral performance, brain activation patterns, and neural correlates during various cognitive tasks, showcasing distinct strengths between middle-aged and young individuals in specific question types.Öğe Williams-Beuren syndrome case series with thinner fovea centralis and central corneal thicknesses(2025) Yılmaz, Göksu; Demirci, Göktuğ; Karaman, Sevil; Sargolzaeimoghaddam, Maral; Uluçam, Enes Sedat; Sarg, AryaBackground/aims: To characterize the ocular signs of Williams-Beuren syndrome (WBS) in 3 cases examined at Istanbul Medipol University Ophthalmology Clinic. Methods: Three patients with a diagnosis of WBS underwent comprehensive ophthalmic evaluation at the Istanbul Medipol University Ophthalmology, including best-corrected visual acuity, slit-lamp biomicroscopy, dilated fundus examination, optical coherence tomography, corneal topography and colour fundus imaging. Results: All 3 cases had decreased best corrected visual acuity, decreased ILM-RNFL thicknesses with a persistence of inner retinal layers on the SD-OCT examinations, decreased central corneal thickness yet normal epithelial thickness measurements and retinal arteriolar tortuosity in fundus examination. Conclusion: WBS is a complex multisystem genetic disorder. The ocular findings observed in these cases which are decreased corneal thickness with normal epithelial thickness, decreased ILM-RPE thicknesses, and retinal arteriolar tortuosity may provide future insight into systemic vascular findings affected by a microdeletion of chromosome 7q11.23 which also contains elastin gene in WBS.Öğe Evaluation of the clinical and genetic characteristics of primary ciliary dyskinesia patients with situs inversus totalis(2025) Ustabaş Kahraman, Feyza; Jafarov, Üzeyir; Yazan, Hakan; Yurtsever, İsmail; Çakır, Erkan; Yeşil Sayın, GözdeBackground: Situs inversus totalis (SIT) is present in approximately 40%–50% of patients with primary ciliary dyskinesia (PCD). We evaluated the relationships between novel genetic results and the clinical and radiological characteristics of PCD patients with SIT. Methods: The study included 48 patients diagnosed with PCD and SIT. Demographic and clinical features, disease-related scores (Bhalla, Primary Ciliary Dyskinesia Rule [PICADAR], and American Thoracic Society [ATS]), and genetic analyses were retrospectively assessed. Results: The median age of patients was 13 (6.5–16) years, and parental consanguinity was observed in 43 (89.58%) patients. Bhalla score was available in 31 patients and “moderate and severe” score was observed in 19 (61.29%) patients. The median PICADAR score was 10 (8–11), and 34 (70.83%) patients had a high (≥ 10) PICADAR score. The ATS score was found to be 4 in 24 (50%) patients and 3 in 20 (43.75%) patients. Genetic data were available in 40 patients and mutations were found in 27 (67.5%) patients. The most common pathogenic variants were DNAH5 in 8 (20%), CCDC103 in 4 (10%), and CCDC39 in 3 (7.5%) patients. Subjects with any genetic variants may be older, have a greater frequency of parental consanguinity, higher Bhalla score, and higher ATS score (p < 0.05). DNAH5 mutation was associated with a lower likelihood of neonatal ICU stay and neonatal respiratory distress-related symptoms (p = 0.036 and 0.015, respectively). Conclusions: Situs abnormalities may be a warning sign for the early diagnosis of PCD. Early diagnosis of PCD through genetic analysis is important for preventing chronic lung pathologies and predicting prognosis and may improve the quality of life.Öğe Comparison of Hemiarthroplasty, total hip arthroplasty, and internal fixation for hip fractures in patients over eighty years of age: factors affecting mortality: a nationwide cohort study of fifty three thousand, four hundred and ninety five patients from Türkiye(2025) Uzel, Kadir; Birinci, Murat; Hakyemez, Ömer Serdar; Bostancı, Bilal; Bingöl, İzzet; Öktem, Umut; Azboy, İbrahimPurpose: Hip fractures are a common cause of mortality in elderly patients. This study aimed to determine the predictive factors affecting mortality among patients over the age of 80 who underwent surgical treatment for hip fractures. Methods: We searched the Turkish Ministry of Health’s e-health database to identify patients over 80 years old who had undergone surgery for proximal femoral fractures from 2016 to 2022. This process yielded 53,495 patients. Demographic data as well as comorbidities, blood transfusions, postoperative 90 days medical complications, and mortality was investigated. Multivariate logistic regression analysis was performed to identify risk factors for one year mortality in patients undergoing surgical treatment for proximal hip fractures. Results: The mortality rate was 37.2% in the first year. The mean Charlson comorbidity index(CCI) was 6.8 (range: 4–22). In the postoperative period, 68.6% of the patients received blood transfusions. Logistic regression analysis identified significant predictors of one-year mortality in surgical patients, including male gender, increased age, higher CCI scores, AKI, PE, pneumonia, electrolyte imbalance, gastrointestinal bleeding, blood transfusion, and increased mortality risks with hemiarthroplasty and internal fixation compared to total hip arthroplasty. (p < 0.001 for all). Conclusions: This large cohort study demonstrated that the mortality rate is high and that the type of surgery, male gender, older age, blood transfusion requirements, and high CCI score are associated with mortality in patients over 80 years of age who have undergone surgery for hip fractures. Preoperative optimization and postoperative care are critical for these vulnerable elderly patients.Öğe The impact of circadian rhythm disruption on oxaliplatin tolerability and pharmacokinetics in Cry1-/-Cry2-/- mice under constant darkness(2025) Akyel, Yasemin Kübra; Öztürk Seyhan, Narin; Gül, Şeref; Çelik, Melis; Taşkın, Ali Cihan; Selby, Christopher; Okyar, AlperCircadian rhythms, the 24-h oscillations of biological activities guided by the molecular clock, play a pivotal role in regulating various physiological processes in organisms. The intricate relationship between the loss of circadian rhythm and its influence on the tolerability and pharmacokinetic properties of anticancer drugs is poorly understood. In our study, we investigated the effects of oxaliplatin, a commonly used anticancer drug, on Cry1-/- and Cry2-/- mice (Cry DKO mice) under darkness conditions, where they exhibit free-running phenotype. We administered oxaliplatin at a dosage of 12 mg/kg/day at two distinct circadian times, CT8 and CT16, under constant darkness conditions to Cry DKO mice and their wild type littermates. Our results revealed a striking disparity in oxaliplatin tolerance between Cry DKO mice and their wild-type counterparts. Oxaliplatin exhibited severe toxicity in Cry DKO mice at both CT8 and CT16, in contrast to the wild type mice. Pharmacokinetic analyses suggested that such toxicity was a result of high concentrations of oxaliplatin in the serum and liver of Cry DKO mice after repeated dose injections. To understand the molecular basis of such intolerance, we performed RNA-seq studies using mouse livers. Our findings from the RNA-seq analysis highlighted the substantial impact of circadian rhythm disruption on gene expression, particularly affecting genes involved in detoxification and xenobiotic metabolism, such as the Gstm gene family. This dysregulation in detoxification pathways in Cry DKO mice likely contributes to the increased toxicity of oxaliplatin. In conclusion, our study highlights the crucial role of an intact molecular clock in dictating the tolerability of oxaliplatin. These findings emphasize the necessity of considering circadian rhythms in the administration of anticancer drugs, providing valuable insights into optimizing treatment strategies for cancer patients.Öğe Dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHEDSCs), and periodontal ligament stem cells (PDLSCs) isolation, characterization and the effectiveness of allantoin as bioactive molecule for dental regeneration(2025) Mutlu Özçınar, Betül; Özükoç, Can; Türkmen, Emrah; Çakır, RabiaIntroduction: Dental stem cells are valuable tools in regenerative medicine due to their pluripotency and self-renewal properties. This study aimed to investigate the effects of allantoin (Al) on Dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHEDSCs), and periodontal ligament stem cells (PDLSCs) regarding cytotoxicity, proliferation, wound healing, and osteogenic differentiation. Methods: Human dental stem cells were isolated from three dental tissues using the explant culture method and cultured in DMEM-F12 medium supplemented with 15 % fetal bovine serum (FBS) and antibiotics. The cytotoxicity and proliferation of allantoin were assessed using the XTT cell viability assay at concentrations ranging from 0.25 to 5 mg/mL. Wound healing was evaluated through a scratch assay at 1 mg/mL, and osteogenic differentiation was assessed using Alizarin Red S staining at 0.5 mg/mL and 1 mg/mL. Results: Al exhibited no cytotoxic effects across the tested concentrations. It enhanced cell proliferation, particularly in SHEDSCs at 5 mg/mL. DPSCs also showed significant improvement in wound healing in the scratch assay. At 1 mg/mL, Al inhibited osteogenic differentiation in DPSCs and PDLSCs, as indicated by reduced mineralization. Conclusion: Al shows potential as a non-cytotoxic agent for enhancing the proliferation of dental stem cells, especially SHEDSCs. However, its limited effect on wound healing of SHEDSCs and PDLSCs and inhibition of osteogenic differentiation at higher concentrations suggest that further optimization is required for its application in bone regeneration. Statement of Clinical Relevance: Evaluation of the effects of plant-based therapeutic compounds on various types of dental stem cells may have the potential to increase the success of stem cell-based therapies in clinical applications in regenerative dentistry.Öğe Refining partial gland ablation for localised prostate cancer: the FALCON project(2025) Rodriguez Sanchez, Lara; Cathelineau, Xavier; De Reijke, Theo; Stricker, Phillip; Emberton, Mark; del Pilar Laguna Pes, Maria; Sanchez Salas, RafaelObjectives: To provide a contemporary statement on focal therapy (FT) for localised prostate cancer (PCa) from an international and diverse group of physicians treating localised PCa, with the aim of overcoming the limitations of previous consensus statements, which were restricted to early adopters, and to offer direction regarding the various aspects of FT application that are currently not well defined. Materials and Methods: The FocAL therapy CONsensus (FALCON) project began with a 154-item online survey, developed following a steering committee discussion and literature search. Invitations to participate were extended to a large, diverse group of professionals experienced in PCa management. From 2022 to 2023, a Delphi consensus study consisting of three online rounds was conducted using the Modified Delphi method. A 1–9 Likert scale was used for the survey, which was followed by an in-person expert meeting. The threshold for achieving consensus was set at 70% agreement/disagreement. Six main aspects of FT were covered: (i) patient selection; (ii) energy source selection; (iii) treatment approach; (iv) treatment evaluation and follow-up; (v) treatment cost and accessibility; and (vi) future perspectives. Results: Of 246 initial participants, 148 (60%) completed all three rounds. Based on participant feedback, 27 new statements were added in the second round, and 33 questions related to personal expertise, for which consensus was not necessary, were excluded. After the third and final round, consensus had not been reached for 69 items. These items were discussed at the in-person meeting, resulting in a consensus of 57 additional items. Consensus was finally not reached on 12 items. Given the volume of data, the voting outcomes are summarised in this article, with a detailed breakdown presented in the form of figures and tables. Conclusions: The FALCON project delivered a significant consensus on the approach to FT for localised PCa. Additionally, it highlighted gaps in our knowledge that may provide guidance for future research.Öğe Evaluation of zonulin levels in patients with migraine(2025) Ülfer, Gözde; Polat, Burcu; Yabalak, Ahmet; Çakıcı, ÇağrıBackground: Zonulin regulates permeability in blood–brain and intestinal barriers. The pathophysiology of migraine is based on the effect of neurogenic inflammation. The aim of the current investigation was to examine the serum zonulin level in individuals suffering from migraine. Methods: The sample comprised 40 individuals who had migraine and 40 controls. Disease duration, attack duration, attack frequency, Visual Analog Scale (VAS) scores, and comorbidities were available for the migraine group. Serum zonulin levels were evaluated by using the ELISA method. Results: There were no statistically significant differences between the two groups concerning age or gender (p > 0.05). The zonulin value of patients with migraine was higher when compared to the controls, indicating a significant difference (p = 0.037; p < 0.05). The zonulin level did not correlate with disease duration, attack duration, VAS score, or attack frequency (p > 0.05). The receiver operating characteristic curve analysis of zonulin revealed a cut-off value of 30.58 and above, at which it had 52.50% sensitivity, 77.5% specificity, 70% positive predictive value, and 62% a negative predictive value. The area under the curve was 63.6%, and the standard error value was 6.3%. The analysis also showed a statistically significant correlation between migraine diagnosis and a zonulin level of 30.58 (p = 0.006; p < 0.01). Conclusions: Elevated zonulin levels in patients with migraine support the disruption of the intestinal barrier and neuroinflammation in these patients. The zonulin level may be a predictive biomarker of migraine. Multicenter, randomized trials are needed to evaluate treatments for intestinal permeability and zonulin levels in migraine patients.Öğe BioLake: an RNA expression analysis framework for prostate cancer biomarker powered by data lakehouse(2025) Li, Qiaowang; Gamallat, Yaser; Rokne, Jon George; Bismar, Tarek; Alhajj, RedaBiomedical researchers must often deal with large amounts of raw data, and analysis of this data might provide significant insights. However, if the raw data size is large, it might be difficult to uncover these insights. In this paper, a data framework named BioLake is presented that provides minimalist interactive methods to help researchers conduct bioinformatics data analysis. Unlike some existing analytical tools on the market, BioLake supports a wide range of web-based bioinformatics data analysis for public datasets, while allowing researchers to analyze their private datasets instantly. The tool also significantly enhances result interpretability by providing the source code and detailed instructions. In terms of data storage design, BioLake adopts the data lakehouse architecture to provide storage scalability and analysis flexibility. To further enhance the analysis efficiency, BioLake supports online analysis for custom data, allowing researchers to upload their own data via a designed procedure without waiting for server-side approval. BioLake allows a one-time upload of custom data of up to 500 MB to ensure that researchers avoid issues with data being too large for upload. In terms of the built-in dataset, BioLake applies reactive continuous data integration, helping the analysis pipeline to get rid of most preprocessing steps. The only pre-built-in dataset of BioLake in the first public version is TCGA-PRAD mRNA expression data for prostate cancer research, which is the primary focus of the development team of BioLake. In summary, BioLake offers a lightweight online tool to facilitate bioinformatic mRNA data analysis with the support of custom online data processing.Öğe Frontocentral delta and theta oscillatory responses are sensitive to sleep deprivation during a working memory task(2025) Yırıkoğulları, Harun; Dalmızrak, Esra; Güntekin, BaharSleep deprivation has become a severe public health problem in modern societies. Negative consequences of prolonged wakefulness on cognitive abilities have been demonstrated and working memory is one of the main cognitive functions that can be affected by sleep deprivation. This study aims to investigate the effects of sleep deprivation on working memory through EEG event-related oscillations. Thirty healthy young adult university students and graduates were included in this study (15 rested control – 15 sleep-deprived). A 2-back task was used to evaluate working memory, and both groups performed the task during EEG recording. The sleep-deprived (SD) group was required to stay awake for 24 h, and then the EEG session was conducted. The rested control (RC) subjects participated in the morning after a regular night's sleep. Event-related power and phase-locking analyses were applied, and delta (1–3.5 Hz), theta (4–6.5 Hz) and alpha (8–13 Hz) frequencies were investigated in the time-frequency domain. In the 2-back task, significantly prolonged reaction times were observed in the SD group. However, the decrease in accuracy rate was not significant. The EEG analyses revealed that the SD group had decreased frontocentral event-related delta and theta power responses after the presentation of stimuli. Moreover, task accuracy was positively correlated with the left frontocentral delta power in the SD group, and theta power in the RCs. Thus, we propose that the adverse effects of sleep deprivation on working memory can be observed through low-frequency oscillatory responses in the brain.Öğe Botulinum toxin a augmentation of strabismus surgery for large-angle strabismus a retrospective case series and literature review(2025) Dikkaya Çiçek, Funda; Karaman Erdur, Sevil; Karaaslan, NisaPurpose: To report the results of botulinum toxin A (BTA)–augmented bilateral recession or monocular recession/resection surgery in a case series of patients with large-angle strabismus and review the relevant literature. Methods: This retrospective study reviewed the medical records of 24 patients treated with BTA-augmented strabismus surgery for large-angle horizontal strabismus (55 prism diopters or greater) with a minimum 6-month follow-up. Patients underwent unilateral recession-resection or bilateral rectus muscle recession surgery with intraoperative BTA injection into the recessed muscle(s). Main outcome measures were postoperative angle of deviation and success rate, defined as a final deviation of 10 prism diopters or less. Results: Of 24 patients (20 esotropia, 4 exotropia), the mean age was 9.2 years (range: 1 to 64 years). Mean preoperative deviation was 61.2 prism diopters for esotropia and 66.2 prism diopters for exotropia. Mean final postoperative deviation was 6.6 prism diopters for esotropia and 14.5 prism diopters for exotropia. Successful outcomes were achieved in 75% of patients with esotropia and 50% of patients with exotropia. Conclusions: BTA augmentation of conventional strabismus surgery dosages is a promising approach for managing large-angle strabismus, particularly esotropia. Optimal patient selection and follow-up are needed to maximize surgical success rates.Öğe Mortality associated with surgical site infections following cardiac surgery: insights from the international ID-IRI study(2025) Erdem, Hakan; Ankaralı, Handan; Al Tawfiq, Jaffar; Angamuthu, Kumar; Piljic, Dragan; Karahangil, Kadriye; Giammanco, AnnaObjectives: Surgical site infections (SSIs) after cardiac surgery increase morbidity and mortality rates. This multicenter study aimed to identify mortality risk factors associated with SSIs after heart surgery. Methods: Conducted from January to March 2023, this prospective study included 167 patients aged >16 years with post-heart surgery SSIs. The primary focus was the 30-day mortality. Univariate analysis and multivariate logistic regression utilizing the backward elimination method were used to establish the final model. Results: Several factors significantly correlated with mortality. These included urinary catheterization (odds ratio [OR] 14.197; 90% confidence interval [CI] 12.198-91.721]), emergent surgery (OR 8.470 [90% CI 2.028-35.379]), valvular replacement (OR 4.487 [90% CI 1.001-20.627]), higher quick Sequential Organ Failure Assessment scores (OR 3.147 [90% CI 1.450-6.827]), advanced age (OR 1.075 [90% CI 1.020-1.132]), and postoperative re-interventions within 30 days after SSI (OR 14.832 [90% CI 2.684-81.972]). No pathogens were isolated from the wound cultures of 53 (31.7%) patients. A total of 43.1% of SSIs (n = 72) were due to gram-positive microorganisms, whereas 27.5% of cases (n = 46) involved gram-negatives. Among the gram-positive bacteria, Staphylococci (n = 30, 17.9%) were the predominant microorganisms, whereas Klebsiella (n = 16, 9.6%), Escherichia coli (n = 9, 5.4%), and Pseudomonas aeruginosa (n = 7, 4.2%) were the most prevalent. Conclusions: To mitigate mortality after heart surgery, stringent infection control measures and effective surgical antisepsis are crucial, particularly, in the elderly. The clinical progression of the disease is reflected by the quick Sequential Organ Failure Assessment score and patient re-intervention, and effective treatment is another essential component of SSI management.Öğe Multi-omics characterization of improved cognitive functions in parkinson's disease patients after the combined metabolic activator treatment: a randomized, double-blinded, placebo-controlled phase II trial(2025) Yuluğ, Burak; Altay, Özlem; Hanoğlu, Lütfü; Velioğlu, Halil Aziz; Coşkun, Ebru; Bayraktaroğlu, Zübeyir; Mardinoğlu, AdilParkinson’s disease is primarily marked by mitochondrial dysfunction and metabolic abnormalities. We recently reported that the combined metabolic activators improved the immunohistochemical parameters and behavioural functions in Parkinson’s disease and Alzheimer’s disease animal models and the cognitive functions in Alzheimer’s disease patients. These metabolic activators serve as the precursors of nicotinamide adenine dinucleotide and glutathione, and they can be used to activate mitochondrial metabolism and eventually treat mitochondrial dysfunction. Here, we designed a randomized, double-blinded, placebo-controlled phase II study in Parkinson’s disease patients with 84 days combined metabolic activator administration. A single dose of combined metabolic activator contains L-serine (12.35 g), N-acetyl-L-cysteine (2.55 g), nicotinamide riboside (1 g) and L-carnitine tartrate (3.73 g). Patients were administered either one dose of combined metabolic activator or a placebo daily for the initial 28 days, followed by twice-daily dosing for the next 56 days. The main goal of the study was to evaluate the clinical impact on motor functions using the Unified Parkinson’s Disease Rating Scale and to determine the safety and tolerability of combined metabolic activator. A secondary objective was to assess cognitive functions utilizing the Montreal Cognitive Assessment and to analyse brain activity through functional MRI. We also performed comprehensive plasma metabolomics and proteomics analysis for detailed characterization of Parkinson’s disease patients who participated in the study. Although no improvement in motor functions was observed, cognitive function was shown to be significantly improved (P < 0.0000) in Parkinson’s disease patients treated with the combined metabolic activator group over 84 days, whereas no such improvement was noted in the placebo group (P > 0.05). Moreover, a significant reduction (P = 0.001) in Montreal Cognitive Assessment scores was observed in the combined metabolic activator group, with no decline (P > 0.05) in the placebo group among severe Parkinson’s disease patients with lower baseline Montreal Cognitive Assessment scores. We showed that improvement in cognition was associated with critical brain network alterations based on functional MRI analysis, especially relevant to areas with cognitive functions in the brain. Finally, through a comprehensive multi-omics analysis, we elucidated the molecular mechanisms underlying cognitive improvements observed in Parkinson’s disease patients. Our results show that combined metabolic activator administration leads to enhanced cognitive function and improved metabolic health in Parkinson’s disease patients as recently shown in Alzheimer’s disease patients.Öğe Migrant women's perception toward cervical and breast cancer screening in Türkiye: a qualitative analysis(2025) Altaş, Zeynep Meva; Sezerol, Mehmet AkifIntroduction: This study aims to investigate the knowledge, attitudes, and behaviors of Syrian migrant women regarding breast and cervical cancer screenings in the Sultanbeyli district of Istanbul. Methods: The women were recruited from Extended Migrant Health Centre, which is a primary health care institution in Istanbul. In August 2024, face-to-face interviews were conducted using an open-ended, semi-structured question form administered by a nurse experienced in qualitative research. Sociodemographic information, their thoughts on cancer, information on the types of cancers screened and sources of information, their participation in cancer screenings, and their perspectives on cancer screenings were asked. Results: In depth interviews were conducted with 40 migrant women. Four main themes and thirteen sub-themes were identified. These themes include “Opinions about the cancers and information about the cancer screenings” “Attitudes about the cancer screening program” “Perspectives on preventive measures against cancers” and “Problems in access to health services”. Women mostly described cancer as a serious, incurable, and fatal disease. Despite this perception, almost half of the participants had not attended cancer screening programs. The majority said they did not undergo screening because they had no symptoms. The other main barriers for participation included lack of knowledge, fear of receiving a negative result, or fear of the procedures involved. Conclusions: Based on this study, migrant women have low level of attendance to breast and cervical cancer screening programs. Besides, they lack adequate information about breast cancer and cervical cancer, the screening protocols and preventive measuremets.Öğe A man with recurrent axillary abscess(2025) Durmaz, Gamze; Beycan, Esin; Kaya, Abdurrahman; Mert, Ali...Öğe A tool for the assessment of swallowing safety and efficiency in adults: Turkish adaptation of boston residue and clearance scale(2025) Tosun, Samet; Topbaş, Saime Seyhun; Aksoy, ElifThe objective of this study was to create a Turkish language adaptation of the Boston Residue and Clearance Scale (BRACS), a validated and reliable tool. The BRACS scale was first translated into Turkish and a Turkish version was subsequently developed. Fiberoptic endoscopic examination of swallowing (FEES) was administered to collect data from 25 dysphagic patients who were hospitalized after a stroke. The recorded films were subjected to editing procedures to ensure their appropriateness for the assessment of swallowing disorders and were then dispatched to a panel of five speech and language therapists for evaluation using the adaptation of the BRACS instrument. The scoring by the experts was evaluated using both explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent validity, item reliability, and construct (composite) reliability were measured by calculating the average variance extracted (AVE) values. For the 12 location items, EFA revealed 3 main latent factors: the laryngeal vestibule and the oropharynx and hypopharynx. The Turkish BRACS had excellent inter-rater reliability (Krippendorff’s alpha coefficient values ranged from 0.93 to 0.95) and high internal consistency (Cronbach’s alpha values ranged from 0.88 to 0.93). Inter-rater ICCs for the first and second sessions were 0.83 and 0.85, respectively. CFA showed that all fitted criteria reached acceptable or perfect fit levels. The findings indicated that the proposed factor structure was validated. The AVE values are between 0.61 and 0.73 which was taken as evidence of convergent validity. The Turkish adaptation of the BRACS tool demonstrates both reliablity and validity, rendering it a useful and credible tool for assessing residual severity, particularly in clinical settings.
