PubMed İndeksli Yayınlar Koleksiyonu

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Comparative Clinical Efficiency of Resveratrol, Allopurinol, and Resveratrol Plus Allopurinol in Canine Visceral Leishmaniasis
(American Veterinary Medical Association, 2025) Erdogan, S.; Erdogan, H.; Ural, K.; Pasa, S.; Gultekin, M.; Balikci, C.; Gunal, I.
Objective To assess the clinical and immunological effectiveness of resveratrol alone or combined with allopurinol for treating canine visceral leishmaniasis (CVL). Methods This study included 50 dogs, 30 diagnosed with CVL and 20 healthy controls. Dogs were classified based on their treatment regime (receiving resveratrol [200 mg/dog/d] and/or allopurinol [10 mg/kg/d]). Clinical scores, anti-leishmanial antibody titers, and routine blood parameters were evaluated on days 0, 15, and 30 after treatment. Results Dogs treated with the combination therapy showed the most substantial improvements, with a 75.77% reduction in clinical scores and an 81.25% reduction in antibody titers. Dogs receiving allopurinol exhibited a 56.25% reduction in clinical scores, while those treated with resveratrol showed a 42.82% reduction. Antibody titers were less significantly reduced in the resveratrol group (67.5%) compared to the allopurinol group (45%). Conclusions Combining resveratrol with allopurinol enhances the therapeutic efficacy for CVL, leading to significant clinical improvements and reductions in antibody titers. Resveratrol alone also demonstrates promising anti-leishmanial effects. Clinical Relevance Resveratrol, either alone or in combination with allopurinol, offers a feasible and effective alternative for improving clinical outcomes in CVL. Its incorporation into standard protocols may enhance treatment strategies in veterinary medicine. ©The authors.
Effectiveness of Cardiac Rehabilitation in Enhancing Adherence and Improving Clinical Outcomes Post-Acute Coronary Syndrome: a Randomized Controlled Trial
(Wiley, 2025) Tuner, Hasim; Polat, Fuat; Alic, Enes; Kaya, Ali Nail; Cakmak, Cigdem Bahar; Coskun, Ferhat; Ozbek, Emrah
Background:Acute coronary syndrome (ACS) remains a major contributor to cardiovascular morbidity and mortality. Cardiacrehabilitation programs have shown promise in improving adherence to lifestyle and medical recommendations, yet theirimpact on clinical outcomes and complications requires further investigation. Methods:This prospective, randomized, single-center study evaluated the effects of cardiac rehabilitation on adherence andclinical outcomes in ACS patients. A total of 340 patients were randomized into a Cardiac Rehabilitation Group or ControlGroup. The Cardiac Rehabilitation Group underwent supervised exercise, dietary counseling, and education, while the ControlGroup received standard recommendations. Outcomes, including adherence rates and complications, were assessed over 1 year,with additional interim analyses to evaluate early sustainability of behavioral changes. Results:Patients in the Cardiac Rehabilitation Group demonstrated significant improvements in adherence to dietary rec-ommendations (73.5% vs. 52.4%,p< 0.01) and physical activity (85.3% vs. 68.2%,p< 0.01). Cardiac Rehabilitation Grouppatients also experienced fewer instances of weight gain (22.9% vs. 34.7%,p= 0.017) and access site complications (21.2% vs.40%,p< 0.01). Hospital readmissions were reduced in the Cardiac Rehabilitation Group compared to the Control Group (18.8%vs. 31.2%,p= 0.015). Non-adherence to dietary recommendations (HR: 2.42, 95% CI: 1.08-5.41,p= 0.032) and medical treat-ments (HR: 2.84, 95% CI: 1.32-6.11,p= 0.007) were significantly associated with increased risk of revascularization. Conclusion:Cardiac rehabilitation significantly enhances adherence to medical and lifestyle recommendations, reducescomplications, and improves outcomes in ACS patients. These findings emphasize the critical role of structured rehabilitation inpost-ACS management.
Therapeutic Potential of Young Plasma in Reversing Age-Related Liver Inflammation Via Modulation of Nlrp3 Inflammasome and Necroptosis
(Springer, 2025) Baba, Burcu; Ceylani, Taha; Teker, Hikmet Taner; Keskin, Seda; Genc, Aysun Inan; Gurbanov, Rafig; Acikgoz, Eda
The phenomenon of inflammaging, characterized by an increase in low-grade chronic inflammation, is closely associated with diseases related to liver dysfunction. This study investigated daily plasma exchange between 5-week-old and 24-month-old Sprague Dawley rats for 30 days, focusing on protein secondary structures, NLRP3 inflammasome, and necroptosis. Conformation changes in protein secondary structures were identified by infrared spectroscopy-based pattern recognition analysis. Liver biopsies with histochemical and immunohistochemical staining were used to assess molecules associated with inflammation, necroptosis and NLRP3 inflammasome complex. Expression levels of NLRP3 components were determined by qPCR. Enhanced random coils, 310 helices, beta-turns, and loop structures were identified in old rats and young rats with old plasma. Young rats and old rats with young plasma displayed higher alpha-helices and beta-sheet structures. Young rats with old plasma showed increased NLRP3, ASC, caspase-1, IL-1 beta, and IL-18 mRNA levels, indicating an inflammatory response. Whereas old rats with young plasma exhibited lower inflammation levels. Histological evaluations revealed that young rats receiving aged plasma showed significantly increased levels of NLRP3, ASC, caspase-1, IL-1 beta, TNF-alpha, VEGFR2, RIPK1, and MLKL immunoreactivity, whereas decreased immunoreactivity in aged rats receiving young plasma. These findings suggest that young plasma reduces NLRP3 inflammasome activation and necroptosis in aged rats.
The Negative Effects of Subclinical Pregnancy Toxaemia on Fetal Skeletal Muscle Development and Evaluation of the Protective Effects of Dietary L-Carnitine Supplementation in Sheep
(Wiley, 2025) Turgut, Ali Osman; Kandil, Banu; Bilen, Ebru Karakaya; Koca, Davut; Unver, Ali; Isbilir, Fatma; Wehrend, Axel
This study evaluated the effects of subclinical pregnancy toxaemia (SPT) on fetal skeletal muscle development and assessed the potential protective role of L-carnitine supplementation during gestation. A total of 18 crossbred Hamdani ewes underwent oestrous synchronisation, natural mating and pregnancy confirmation via ultrasonography on day 45 post-mating. The ewes were managed according to NRC (2007) dietary guidelines until day 100 of gestation, after which they were assigned to three experimental groups: subclinical PT group (group 1; G1, n = 6), treatment group (subclinical PT + L-carnitine, group 2; G2, n = 6) and control group (group 3; G3, n = 6). Blood beta-hydroxybutyrate (beta HBA) concentrations were measured on day 100 and 138 of the gestation. Then, all ewes were slaughtered for fetal muscle sampling from the Musculus Longissimus Dorsi (MLD) and Vastus Lateralis (VL). Results indicated a significant reduction in muscle fibre number and fibre diameter in both MLD and VL in the SPT group (G1) compared to the control (G3) (p < 0.05). No significant differences were observed between G1 and G2 or between G2 and G3 for these parameters (p > 0.05). On the other hand, large effect sizes for group and pairwise comparisons imply that SPT may negatively affect prenatal muscle development and L-carnitine supports muscle development during the prepartum period. These findings highlight the negative effects of SPT and protective effects of L-carnitine supplementation on fetal skeletal muscle development in ewes with SPT. The observed deficits may negatively impact postnatal growth, survival rates and meat quality. Further investigations are warranted to optimise maternal nutrition strategies and evaluate therapeutic interventions aimed at mitigating the adverse impacts of SPT on fetal muscle development in ruminants. Furthermore, L-carnitine supplementation may be a useful in compensating for the negative effects of SPT.
Turkish Physicians Approach To Lesbian, Gay, Bisexual, Transgender, and Other Gender and Sexual Minority Individuals and Their Sexual Health
(Oxford Univ Press, 2025) Ceker, Gokhan; Arda, Ersan; Cakici, Ozer Ural; Gul, Murat; Ibis, Muhammed Arif; Kutman, Kerem Gencer; Bal, Harun
Background: Lesbian, gay, bisexual, transgender, and other gender and sexual minority (LGBT+) individuals often face healthcare disparities, and physicians' knowledge, attitudes, and clinical preparedness significantly impact access to competent care. Aim: This study evaluated Turkish physicians' perspectives, knowledge, and clinical approaches to LGBT+ sexual health, highlighting educational and clinical gaps. Methods: A nationwide cross-sectional survey was conducted among physicians from 10 specialties involved in LGBT+ sexual health. The survey, administered anonymously via Google Forms between June 4, 2024, and February 1, 2025, included sociodemographic questions and items assessing attitudes, clinical experience, and guideline familiarity. Statistical analyses included descriptive statistics, chi-square, Fisher's exact tests, and binary logistic regression to identify predictors of physician attitudes and perceived competence. Outcomes The primary outcome was to assess physicians' perspectives, competency, and willingness to provide LGBT+ healthcare, including gender-affirming procedures. Results: Among 745 participants, 58.8% considered LGBT+ identities normal, while 22.9% classified them as psychiatric disorders. Perceiving LGBT+ identities as normal was significantly associated with being female (OR = 3.12, 95% CI: 1.96-4.96, P < .001), prior experience treating LGBT+ patients (OR = 2.22, 95% CI: 1.60-3.07, P < .001), and physician specialty. This view was most common among psychiatrists (P = .012) and child and adolescent psychiatrists (P = .015). Physicians' views were primarily shaped by education (43.2%) and socio-cultural environment (40.9%). Although 63.9% had treated LGBT+ patients, only 28.2% felt competent, and 11.5% were aware of relevant guidelines. Only 18% of surgical specialists supported gender-affirming procedures. The most commonly cited reason for reluctance was lack of surgical experience (44.8%), along with concerns related to religious beliefs, absence of a surgical team, and potential surgical complications. Ethical dilemmas were evident, as 58.3% believed LGBT+ patients face discrimination in healthcare, and 21.9% supported a physician's right to refuse care based on personal beliefs. Clinical Implications: Enhancing physicians' education and competency in LGBT+ healthcare through structured training and standardized guidelines is crucial to improving equitable healthcare delivery. Strengths and Limitations: This study provides novel insights into physicians' attitudes and practices regarding LGBT+ healthcare in Turkey. However, self-reported data may introduce response bias, and findings may not be fully generalizable to other regions. Conclusion: Significant educational and clinical gaps persist in LGBT+ healthcare. Addressing these through structured training programs, standardized protocols, and multidisciplinary collaboration is essential to ensuring competent, inclusive, and ethical medical care.
Bruxism and Stress: Ultrasonographic Masseter Muscle Assessment and Salivary Melatonin-Cortisol Dynamics
(Wiley, 2025) Kaya, Sema; Koc, Alaettin; Huyut, Zuebeyir
BackgroundBruxism is a parafunctional activity characterised by teeth grinding or clenching, often associated with stress and neurophysiological factors. Its aetiology is multifactorial, with recent studies emphasising neurotransmitters and hormonal imbalances, particularly melatonin and cortisol. This study assesses masseter muscle thickness using ultrasonography and examines the relationship between salivary melatonin and cortisol levels in bruxism. ObjectiveThis study aimed to evaluate the ultrasonographic characteristics of the masseter muscle in individuals with bruxism and investigate the association between salivary melatonin and cortisol levels. MethodsThis cross-sectional study included 80 participants (38 bruxists, 42 controls), aged 20-25 years. Bruxism was diagnosed through clinical examination and self-reported questionnaires. Masseter muscle thickness was measured via ultrasonography in relaxed and contracted states. Salivary melatonin and cortisol levels were analysed using enzyme-linked immunosorbent assay (ELISA). Group comparisons were conducted using independent t-tests and ANOVA, with correlation analyses using Pearson's tests. ResultsSalivary melatonin levels showed no significant difference between groups (p = 0.067), while salivary cortisol levels were significantly higher in the bruxism group (p = 0.001). No significant differences in masseter muscle thickness were observed in either state (p > 0.05). A weak but significant positive correlation existed between melatonin and cortisol levels (p < 0.05). ConclusionAlthough not statistically significant, melatonin levels tended to be higher in bruxist patients, possibly due to a negative feedback mechanism to prevent the side effects of cortisol such as oxidative stress or a balancing process of these hormones by cytokines involved such as IL-1 beta.
Morphologic Evaluation of the Coccyx in the Pediatric Population
(Springer France, 2025) Meylani, Nevzat; Ten, Baris; Temel, Gulhan; Yuksek, Hasan Husnu; Comert, Ali Danyal; Beger, Burhan; Beger, Orhan
Purpose This computed tomography study aimed to display the alteration in the coccyx morphology (its ossification process, dimension and angulation) in children with advancing age. Methods Pelvic radiologic scans of 180 children aged 1-18 years were retrospectively evaluated to observe changes in the coccyx morphology with age, and to measure the linear length (LL), curvilinear length (CLL), sacrococcygeal angle (SCA), and intercoccygeal angle (ICA). Results The present study divides the postnatal evolution of the coccyx into three phases as follows: (a) in the first stage when the coccyx is of the shortest, it is completely cartilage until the age of 2 (infancy period) and its first segment begins to ossify by the age of 3 (early childhood period), (b) in the second stage when the coccyx is of medium size, its first segment is completely ossified by the age of 6 (late childhood period) and the ossification of its all segments is completed from the age of 11 (prepubescent period), and (c) in the third stage when the coccyx is of the longest, it reaches to adult size (postpubescent period). Linear functions were calculated as y = 15.647 + 1.145 x age (p < 0.001, R-2 = 0.561) for LL, and as y = 16.829 + 1.243 x age (p < 0.001, R2 = 0.559) for CLL. Conclusion Considering that morphological features of the coccyx, such as ICA, can be used in the diagnosis of coccydynia, our dataset may facilitate the identification of children with suspected coccydynia.
Volatile Organic Compounds Released From Cabbage Plants Infested With Wingless Green Peach Aphid (Myzus Persicae) Attracts More Conspecifics
(John Wiley & Sons Ltd, 2025) Ahmed, Nazeer; Darshanee, Hewa Lunuwilage Chamilla; Smagghe, Guy; Atlihan, Remzi; Al-Mekhlafi, Fahd A.; Wadaan, Mohammed A.; Liu, Tong-Xian
BACKGROUNDPlants release a diverse array of volatile organic compounds (VOCs) that play a role in interactions with other plants and arthropod herbivores. The potential of using plants that emit either repellent or attractive VOCs to help managing insect populations have been shown. However, the response of the green peach aphid (Myzus persicae), a major sucking insect pest worldwide, to VOCs from cabbage and infested with conspecific remains unknown. This study investigated how VOCs released by cabbage infested or uninfested by Myzus persicae influenced host selection in seven different cultivars. and compared under infested and non-infested conditions.RESULTSUsing headspace solid-phase microextraction gas chromatography coupled with mass spectrometry (SPME-GC-MS), we identified 22 VOCs from non-infested cabbage plants and 33 from aphid-infested plants across the seven cabbage cultivars. Infested plants emitted a greater diversity and higher amounts of volatiles, dominated by terpenes and green leaf volatiles. Caryophyllene was the only compound common in both infested and non-infested plants. In olfactometer assays, wingless Myzus persicae showed a significant attraction to conspecific-infested plants with the strongest response to the cultivar QG 80. However, this increased attraction was not consistent across all cultivars, highlighting the need for further studies to understand the ecological implications and potential benefits or drawbacks of this attraction.CONCLUSIONOur findings highlight the potential of using VOC-emitting trap crops for the targeted management of Myzus persicae. By identifying key volatiles that attract aphids, this study provides a foundation for developing eco-friendly pest control strategies. (c) 2025 Society of Chemical Industry.
A Novel Solution To Enhance the Oxidative and Physical Properties of Cookies Using Maltodextrin-Based Nano-Sized Oils as a Fat Substitute
(Amer Chemical Soc, 2025) Meral, Raciye; Ekin, Mehmet Mustafa; Ceylan, Zafer; Alav, Aslihan; Kina, Erol
This study investigated the effects of maltodextrin-based nanoemulsions as fat substitutes in cookies, focusing on the oxidative stability and physical properties. Full-fat cookies (control, C) and 50% fat-reduced cookies with nanoemulsions (FC) were produced. The addition of nanoemulsions increased the cookie diameter from 46.3 mm (control) to 56.1 mm and reduced the thickness, resulting in a desirable texture. Initial hardness values (30.3 and 45.8 N) were lower in nanoemulsion samples and remained reduced over a 90 day storage period. Black cumin oil-loaded nanoemulsions provided the lowest peroxide values (1.7, 2.7, and 2.4 mequiv O2/kg), maintaining oxidative stability during storage. Final free fatty acid (FFA) values ranged from 0.23% to 0.44% after storage. Thiobarbituric acid (TBA) values indicated slower lipid oxidation, with values ranging from 1.47 to 2.51 mg MDA/kg on day 0 and increasing to a maximum of 4.13 mg MDA/kg by day 90 in fat-reduced cookies. Among the tested formulations, nanoemulsions enriched with black cumin oil demonstrated the highest effectiveness, yielding enhanced oxidative stability and improved quality characteristics. This study presents an innovative strategy by utilizing maltodextrin-based nanoemulsions containing naturally antioxidant-rich oils as fat replacers, offering a clean-label alternative to improve the oxidative resilience and physical quality of cookies.
Meaning in Life as a Mediator Between Death Anxiety and Life Satisfaction
(Routledge Journals, Taylor & Francis Ltd, 2025) Yagan, Ferdi; Kaya, Zohre; Kaya, Selim Firat
Research based on Terror Management Theory suggests that death anxiety is a fundamental existential concern that threatens individuals' life satisfaction and that, in the process of coping with this anxiety, individuals tend to seek meaning in life. However, studies directly examining the impact of death anxiety on life satisfaction and the mediating role of meaning are lacking. This study aims to investigate the relationship between death anxiety and life satisfaction among adults and to test the mediating role of meaning in life in this relationship. 396 participants completed online scales measuring death anxiety, life satisfaction, and meaning in life. The findings revealed that death anxiety significantly predicted life satisfaction and that meaning in life partially mediated this relationship. The results suggest that meaning in life may play a buffering role in the association between death anxiety and life satisfaction.
Comparison of Effectiveness of Mulligan Mobilization Technique and Cervical Stabilization Training in Patients With Chronic Neck Pain: a Single-Blinded Randomized Controlled Trial
(Georg Thieme Verlag Kg, 2025) Sekeroz, Serbay; Telci, Emine Aslan; Buke, Meryem; Akkaya, Nuray
Purpose The purpose of the current study was to compare the effectiveness of Mulligan mobilization technique (MMT) and cervical stabilization training (CST) in patients with chronic neck pain. Methods Thirty-six patients with chronic neck pain were randomly assigned to three groups as control, MMT, and CST groups. In the current study, pain intensity, range of motion (ROM), proprioception, head posture, deep neck flexor (DNF) muscle endurance, disability level, and neck awareness were evaluated as outcome measures. Results All variables showed statistically significant changes following treatment in all groups. MMT and CST were found to be more effective than home exercise regimen (control group) in pain intensity (p=0.001), DNF muscle endurance (p=0.0001), and disability level (p=0.007) but they were not superior to each other. MMT was found to be more effective in increasing ROM (p=0.0001) and neck awareness (p=0.018). Also, CST was found to be more effective in improving head posture (p=0.0001) and proprioception (p=0.001). Conclusion The study indicated MMT was more effective in increasing ROM and neck awareness, and the CST was more effective in improving head posture and proprioception. Comprehensive perspective can be acquired for health professionals in this field to select the appropriate rehabilitation approaches for patients with chronic neck pain thanks to our results.
The Effect of Dental Occlusion on Masseter Muscle Thickness in Adolescents: an Ultrasonographic Evaluation
(Springer, 2025) Kaya, Sema; Avci, Burcin
Objectives This study aimed to investigate the relationship between masseter muscle thickness and variables such as age, gender, dental occlusion, and parafunctional habits in adolescents aged 11-15 years using ultrasonographic measurements. Methods A total of 168 adolescents aged 11-15 years who were referred to the Department of Oral and Maxillofacial Radiology at Van Yuzuncu Yil University for routine dental examinations participated in this cross-sectional study. Data on parafunctional habits, age, height, and weight were collected. Dental occlusion and tooth loss were documented during clinical examinations. Masseter muscle thickness was measured bilaterally at rest and during contraction using ultrasonography. Statistical analyses included Kolmogorov-Smirnov, Wilcoxon, and Mann-Whitney U tests, with a significance level of p < 0.05. Results No significant differences in masseter muscle thickness were observed between genders, either at rest or during contraction (p > 0.05). Similarly, muscle thickness did not significantly differ according to dental occlusion or parafunctional habits such as mouth breathing and swallowing (p > 0.05). However, a positive correlation was found between the number of premolar and molar teeth and masseter muscle thickness on the left side during contraction (p = 0.006, r = 0.213). Conclusion Dental occlusion and parafunctional habits appear to have minimal impact on masseter muscle thickness in adolescents. Ultrasonography provides a reliable and non-invasive method for assessing masseter muscle thickness, supporting its utility in clinical practice.
Synthesis of Novel Pyrazino[1,2-A]indol Derivatives as Potent Cholinesterase Inhibitors and Their in Vitro and in Silico Evaluations
(Elsevier Science Inc, 2025) Kuzu, Burak; Demir, Yeliz
The development of effective cholinesterase inhibitors remains a critical strategy in the search for novel therapeutics for Alzheimer's disease (AD). In this work, a series of novel 3-substituted pyrazino[1,2-a]indol-1(2H)-one derivatives were rationally designed, synthesized, and fully characterized through comprehensive spectral analyses. The cholinesterase inhibitory activities of the compounds were systematically evaluated, demonstrating potent inhibition against both acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) at nanomolar concentrations. Notably, compound 16g emerged as the most promising candidate, exhibiting 14.28-fold and 9.7-fold greater potency against AChE compared to tacrine and donepezil, respectively, and 3.39-fold and 2.3fold higher activity against BChE. Molecular docking studies elucidated key binding interactions within the active sites of the enzymes, supporting the observed biological activities and providing mechanistic insights. Furthermore, in silico drug-likeness and pre-ADMET profiling confirmed the favorable predicted pharmacokinetic properties of compound 16g, underscoring its potential as a lead compound. These findings collectively highlight the pyrazino[1,2-a]indol-1(2H)-one core as a promising structural framework for developing next-generation cholinesterase inhibitors aimed at combating AD.
Socio-Demographic and Attitudinal Factors Influencing Household Fruit and Vegetable Purchasing Frequency in Eastern Türkiye
(BMC, 2025) Yalvac, Omer; Keskin, Nurhan; Terin, Mustafa; Hajizadeh, Hanifeh Seyed; Kaya, Ozkan
BackgroundThis study examines the relationship between households' fruit and vegetable purchasing frequency and their socio-demographic characteristics and attitudes, with a focus on Eastern T & uuml;rkiye's Van province, a region underrepresented in existing literature.ObjectiveTo explore how socio-demographic and attitudinal factors influence the frequency of household fruit and vegetable purchases.MethodsMethodologically, the research employs a Chi-square test of independence to compare households' fruit and vegetable purchasing frequencies across four categories: never, twice a month, once a week, and more than once a week. To further analyze the determinants of purchasing frequency, an ordered probit model was utilized. This econometric approach was applied to obtain coefficients used in calculating marginal effects and probabilities.ResultsThe empirical results reveal significant influences of various household characteristics on fruit and vegetable purchasing frequency. Household income, fruit and vegetable expenditure, employment and insurance status of the household head, perception of sufficient fruit and vegetable consumption within the household, and fruit and vegetable consumption by children in the household were found to positively affect the frequency of household fruit and vegetable purchases. Conversely, the age of the household head was found to negatively impact the frequency of fruit and vegetable purchases. Given the behavioral elements involved in food purchasing, this study also incorporates attitudinal and perceptual factors that may reflect bounded rationality beyond classical utility theory.ConclusionThis research contributes to both public health and behavioral economics literature by integrating socio-demographic and psychological variables into the analysis of purchasing behavior. The findings suggest that multifaceted approaches may be necessary to effectively increase fruit and vegetable consumption, including economic interventions, educational programs, and targeted interventions for specific demographic groups such as older adults. The results also offer empirical support for developing regionally tailored strategies in under-studied areas like Van.
Neurosurgery Residency Training and Beyond in Turkey: a National Survey Study
(Thieme Medical Publ inc, 2025) Korkmaz, Taha Sukru; Cetintas, Semih Can; Akkaya, Suleyman; Toklu, Sureyya
Study Aims Training neurosurgery specialists is a challenging and demanding process. This national survey study was conducted to evaluate the infrastructure of neurosurgery residency programs and training clinics in Turkey and to assess how these factors impact specialist practice. Materials and Methods A national survey consisting of 32 questions was distributed to neurosurgeons who had been practicing as specialists for at least two years. The survey was divided into four sections: demographic information, residency training process, hospital where they currently work as specialists, and microsurgical experience. Statistical analyses, including chi-square and logistic regression, were conducted to examine factors influencing surgical performance in specialist practice. Results Regression analyses indicated that performing skin-to-skin surgeries during residency significantly and most effectively increased the likelihood of performing these procedures as a specialist. Additionally, working in anatomy laboratories, attending hands-on cadaver courses, and increased years of practice were all positively associated with surgical performance. It was also found that participants who graduated within the last 5 years were statistically significantly less likely to have attended hands-on courses or visited another clinic for observerships/fellowships compared with those who graduated more than 5 years ago. Conclusions Findings suggest that neurosurgical training in Turkey is affected by disparities in clinical infrastructure and hands-on experience. Standardizing residency experiences and ensuring access to necessary equipment and training resources could enhance neurosurgical competency and consistency in specialist practice.
The Relationship Between Social Support and Maternal Attachment of Adolescent Mothers and Postpartum Depression in Turkey
(BMC, 2025) Bulduk, Mehmet; Can, Emine Kurt; Can, Veysel; Aysin, Nesrullah
Background Adolescent mothers experience more negative conditions, including postpartum depression (PPD), during the postpartum period compared to other mothers. This study aimed to examine the relationship between social support, maternal attachment levels, and postpartum depression among adolescent mothers in the at-risk group. Methods The research was conducted at a hospital in the city center of Van, located in the Eastern Anatolia Region of Turkey. After receiving ethical approval and study permissions from the hospital, the Socio-Demographic Data Form, Multidimensional Scale of Perceived Social Support (MSPSS), Maternal Attachment Inventory (MAI), and Edinburgh Postnatal Depression Scale (EPDS) were administered to mothers who met the study criteria and volunteered to participate. The study was completed with 150 adolescent mothers. Results The parameters influencing the mean EPDS scores were maternal age and the presence of assistance in infant care. The results showed that as the mean scores of MSPSS sub-dimensions (significant other, family, friends), the total MSPSS scores, and the MAI scores increased, the mean EPDS scores decreased. In addition, according to the regression analysis, both MAI (t=-5.206, p < 0.01) and MSPSS (t=-4.221, p < 0.01) have statistically significant effects on EPDS. Conclusion In conclusion, it is recommended that adolescent mothers, as a vulnerable group, should receive support from social networks such as family, spouse, friends, and neighbors during the postpartum period, with special consideration for the cultural context in which they live. More attention should be given to this group during the postpartum period.
Effects of Chronic Kidney Diseaseassociated Pruritus on Quality of Life in Hemodialysis and Non-Dialysis Patients: a Cross-Sectional Study
(Dustri-Verlag Dr Karl Feistle, 2025) Ucar, Abdullah; Dincer, Mevlut Tamer; Mirioglu, Safak; Keskin, Siddik; Karaca, Cebrail
Aims: Chronic kidney diseaseassociated pruritus (CKD-aP) is a common and distressing symptom, particularly in hemodialysis (HD) patients, significantly impacting their quality of life. This study aimed to investigate the effects of CKD-aP frequency and severity on quality of life in both HD and non-HD stage 3-5 CKD patients. Materials and methods: This cross-sectional casecontrol study was conducted from January to May 2024. Pruritus was assessed using the 5-D itch scale, and quality of life was evaluated with the World Health Organization Quality of Life Scale-Short Form (WHO-QoL-BREF) questionnaire. Correlations between pruritus severity and patient characteristics were analyzed. Results: The study involved 169 patients, comprising 80 non-HD stage 3-5 CKD patients and 89 HD patients, with a mean age of 55.2 +/- 16.7 years. Pruritus was significantly more prevalent in the HD group than in the non-HD group (61.8 vs. 41.3%, p = 0.008). HD patients had more pruritic body areas and higher 5-D itch scale scores (0 (0-8.5) vs. 0 (0-3.75), p = 0.002; 9.3 (8.0-14.8) vs. 8.0 (8.0-10.3), p = 0.003). In the HD group, pruritus was associated with lower quality of life in the psychological health, social relationships, and environment domains of the WHOQoL-BREF questionnaire (50.0 (35.4-58.3)% vs. 54.2 (42.7-66.7)%, p = 0.027; 50.0 (33.3-58.3)% vs. 50.0 (41.6-66.7)%, p = 0.046; 53.1 (40.6-65.5)% vs. 56.3 (50.0-68.8)%, p = 0.026, respectively). Pruritus also correlated with lower hemoglobin levels, higher serum creatinine levels, and poorer overall quality of life in both groups, with female sex and erythropoiesis-stimulating agent use as significant contributing factors. Conclusion: Pruritus significantly impairs the quality of life in HD patients.
Experimental Evaluation of Timing and Preference of Surgical Intervention for Crush Syndrome in Disaster Scenarios: Fasciotomy or Amputation? a Rat Model Study
(BMC, 2025) Kaya, Sehmuz; Unal, Yunus Can; Guven, Necip; Dundar, Abdulrahim; Keles, Omer Faruk; Basbugan, Yildiray
Background Crush syndrome is a severe condition caused by the systemic effects of rhabdomyolysis due to prolonged muscle compression. Common in disasters like earthquakes, it poses life-threatening risks, including acute renal failure, hyperkalemia, and metabolic acidosis. Although surgical interventions such as fasciotomy and amputation are critical in its management, the optimal timing and criteria remain unclear. This study investigates the impact of surgical intervention timing on crush syndrome outcomes, providing guidance through the first experimental rat model evaluating fasciotomy and amputation post-injury. Methods Forty-eight Wistar albino rats were divided into six groups. Rhabdomyolysis was induced experimentally, followed by amputation or fasciotomy at 0, 12, or 24 h. The control group underwent rhabdomyolysis induction without surgery. Weekly urine samples were collected during the study, and blood, muscle, and kidney tissues were examined biochemically and histopathologically at the experiment's end. Data analysis focused on the systemic and tissue-specific effects of intervention timing. Results Early intervention groups (0 h) demonstrated minimal muscle inflammation and necrosis, preserved muscle fiber arrangement, and more pronounced regeneration. Late interventions (12 and 24 h) were associated with intense inflammation, necrosis, edema, and hemorrhage in muscle tissue. Immediate amputation (0 h) limited toxic metabolite effects, reducing kidney inflammation and damage. Late interventions showed increased interstitial nephritis and inflammatory cell infiltration in kidney tissue. Biochemical analyses revealed that urinary myoglobin levels decreased and renal function was preserved in the early intervention groups. Conclusions The timing of surgical intervention is critical in managing crush syndrome. Early amputation and fasciotomy minimized necrosis and inflammation in muscle tissue, supported tissue regeneration, and reduced systemic complications by preventing toxic metabolite accumulation in the kidneys. Early amputation particularly showed superior renal protection and lower systemic complication risks compared to late interventions. These findings highlight the importance of timely surgical action and provide valuable insights for developing effective treatment strategies in disaster settings. However, the descriptive nature of the study and the fact that the data obtained from the experimental model cannot be directly applied to clinical practice should be taken into account. Therefore, the findings should be supported by future clinical trials.
Immunohistochemical Evaluation of Sars-Cov Nucleoprotein and Ace2 Markers in Testicular Tumors Diagnosed During the Covid-19 Pandemic
(Sage Publications Ltd, 2025) Balci, Mahi; Aydemir Akkaya, Merva
Background: The incidence of testicular tumors during the COVID-19 pandemic has raised questions about the potential impact of viral infection on tumor development. This study aimed to explore the relationship between COVID-19 and testicular tumors through a retrospective analysis of 32 cases diagnosed before and during the pandemic. Methods: A total of 32 testicular tumors were analyzed, with distribution based on the year of diagnosis. Immunohistochemical studies were conducted to assess SARS-CoV-2 and angiotensin-converting enzyme 2 (ACE2) expression in tumor cells. Results: The highest frequency of tumor diagnoses was observed in 2021 (19.4%), with a notable increase in diagnoses in 2022 compared with pre-pandemic years. No significant correlation was found between COVID-19 infection and tumor types (P = .476). The distribution of seminoma and mixed germ cell tumors (MGCT) was similar in both periods. Strong SARS-CoV-2 antibody positivity was found in 11 cases, with expression primarily in Leydig cells and some in Sertoli and plasma cells. The difference in SARS-CoV-2 expression between periods was statistically significant (P = 0013). The ACE2 expression was observed in all tumor groups, but statistical analysis was not significant. Conclusion: The presence of SARS-CoV-2 nucleoprotein in the tumor microenvironment, particularly during the pandemic, suggests an indirect role of the virus in the development of testicular tumors. Although SARS-CoV-2 does not exhibit direct oncogenic effects, its presence could influence tumorigenesis through mechanisms like inflammation and oxidative stress. The ACE2 expression further supports the hypothesis that the virus may trigger adaptive changes in tumor cells. The SARS-CoV-2 could act as a co-factor in tumor progression, especially in individuals predisposed to testicular tumors.
Patients Diagnosed With Granulomatosis With Polyangiitis: the Journey To Receive Rheumatologist Care
(Mdpi, 2025) Lermi, Nihal; Yagiz, Burcu; Ekin, Ali; Coskun, Belkis Nihan; Dalkilic, Ediz; Pehlivan, Yavuz
Background/Objectives: Granulomatosis with polyangiitis (GPA) is a necrotising vasculitis characterised by granulomatous inflammation involving small vessels. In addition to specific findings for the affected organ, constitutional symptoms and joint and muscle pain can be observed. The prodromal phase, where symptoms last for months before clinical diagnosis, may suggest infection or malignancy. This may cause a delay in GPA diagnosis. The period from the first symptoms to diagnosis may last from one month to three years. In this study, we aimed to demonstrate that, as the time between the onset of symptoms and diagnosis increases, the disease involvement may become more severe, and the possibility of recurrence may increase, indicating the importance of early diagnosis. Methods: For this cross-sectional retrospective study, data from 40 patients with GPA were evaluated. Demographic, clinical, treatment, and follow-up characteristics of the patients were obtained from their medical records. Results: The mean time between the presentation of the first complaints and GPA diagnosis was 7.40 +/- 11.84 (0, 60, 3; mean +/- standard deviation [minimum, maximum, and median]) months. The time between the first complaints and diagnosis was longer for patients with a history of recurrence (11.44 +/- 16.73 [0, 60, 4.5] vs. 4.71 +/- 6.04 [0, 24, 2.5], p value = 0.260). Conclusions: GPA is an inflammatory disease with various clinical presentations. In the management of patients with GPA, awareness of its presentation is important for rheumatologists as well as other clinicians during the initial evaluation, demonstrating the importance of interclinical collaboration.

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