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Hemimyelomeningocele: A systematic review and meta‑analysis of the literature
(Springer Nature Link, 2026) Adıyaman, Ali Ekrem; Karakaş, Furkan; Hamzaoğlu, Can; Saban, Şevval; Kılınç, Tunahan; Acar, Burak; Nabili, Tabriz; Ekşi, Murat Şakir
Hemimyelomeningocele (HMM) is a rare split cord malformation where only one hemicord forms a myelomeningocele-like sac, and the opposite hemicord undergoes normal neurulation. We aimed to compile all published HMM cases to concisely summarize embryology, presentation, imaging, associated anomalies, management, and outcomes of the disorder. Following PRISMA 2020, we searched PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (1968–Feb 2025) for studies with confirmed human HMM, extracting clinical, radiological, surgical, and follow-up data. Of 688 records screened, 25 articles met inclusion criteria, encompassing 67 patients. Most publications were single-patient case reports. Presentation occurred predominantly in newborns or early infancy. The dysraphic sac was lumbosacral in most cases, and type I split cord malformation with a bony spur outnumbered type II. Hemivertebrae and congenital scoliosis were the common vertebrae anomalies. Nearly all patients underwent surgery combining sac excision, detethering, and bony spur removal. Postopera tive neurological outcomes were favorable: the majority improved, and the other ones remained stable; no surgery-related mortality was reported. HMM can be recognized as a distinct clinic radiological entity within the split-cord spectrum. Early, ideally prenatal diagnosis, timely microsurgical repair, and coordinated multidisciplinary care yield favorable functional outcomes in most patients. This first systematic review compiles the available evidence and provides a practical basis for future diagnostic and treatment decisions.
Lumbar spine: Diagnosis and therapy with neural therapy
(Springer Nature Link, 2026) Ural Nazlıkul, Fatma Gülçin; Nazlıkul, Hüseyin
The lumbar spine, due to its topographical location and the significant load it bears, is frequently a center for chronic and acute conditions. Typical symptoms include pain and movement restrictions caused by various factors such as degeneration, postural imbalances, structural changes, or functional disorders. Neural therapy offers an effective method for both diagnosis and treatment by specifically targeting interference fields and influencing the body’s autonomic regulation. Notably, neural therapy has shown positive results in the treatment of lumbalgia, sciatica, and degenerative diseases of the lumbar spine. It supports tissue regeneration, improves circulation, and reduces pain perception by modulating the autonomic nervous system. These outcomes are achieved through precise injection techniques, such as facet joint injections and spinal nerve injections, allowing for direct and localized treatment. Neural therapy aims to activate the body’s self-healing powers and eliminate interference fields by targeted injections into the autonomic nervous system. By modulating the sympathetic and parasympathetic nervous systems, pain syndromes can be alleviated, and functional disorders corrected. The importance of comprehensive diagnosis, which considers both functional and autonomic factors, is essential to maximize the effectiveness of neural therapy and ensure holistic treatment.
The cervical spine
(Springer Nature Link, 2026) Nazlıkul, Hüseyin; Ural Nazlıkul, Fatma Gülçin
The cervical spine (CSS) is the most mobile part of the spine, consisting of seven vertebrae that connect the head and trunk. Neural therapy and manual medicine offer effective approaches to treating CSS dysfunction through targeted injections and mobilization techniques. These therapies can reduce pain, improve mobility, and normalize autonomic functions. Case studies demonstrate the effectiveness of these combined approaches in treating cervical spine disorders.
The thoracic spine
(Springer Nature Link, 2026) Nazlıkul, Hüseyin; Ural Nazlıkul, Fatma Gülçin
The thoracic spine (TSP) is the longest section of the spine, consisting of 12 vertebrae. It connects the cervical and lumbar spines and is responsible for the motor and sensory innervation of the trunk. Pathological stimuli can be reflexively relayed via the autonomic nervous system (ANS), leading to dysfunctions. Palpation plays an important role in diagnosing TSP dysfunctions. Injections into the spinous processes, facet joints, and intercostal nerves can be used to treat pain and movement disorders.
Rare but critical: Indomethacin-responsive headache with long-lasting autonomic symptoms
(Galenos Publishing House, 2026) Talibov, Tural; İnci, Meltem; Ekizoğlu, Esme; Baykan, Betül
Hemicrania with long-lasting autonomic symptoms (LASH), first described in by Rozen1 , is an extremely rare headache disorder thought to be part of the trigeminal autonomic cephalalgia (TAC) spectrum. However, it is not included in the current International Classification of Headache Disorders, 3rd Edition (ICHD-3).2 Notably, patients with LASH typically respond well to indomethacin.
Sacroiliac joint or ıliosacral joint
(Springer Nature Link, 2026) Nazlıkul, Hüseyin; Ural Nazlıkul, Fatma Gülçin
The sacroiliac joint (SIJ) is often regarded as a controversial and enigmatic structure, serving as a source of explanation for various pain conditions and functional limitations that are otherwise difficult to categorize. This article provides a detailed examination of the SIJ’s anatomy, biomechanics, and the role of the pelvic ring. The SIJ is a synovial joint with limited mobility, crucial for weight transfer from the trunk to the hips. The article emphasizes the significance of ligamentous structures surrounding the SIJ and highlights the diagnostic and therapeutic approaches combining manual medicine and neural therapy, particularly focusing on the treatment of ligamentous structures. Techniques for the injection of ligaments in the SIJ region are discussed, offering effective conservative treatment options for sacroiliac dysfunction. The review also includes detailed examination procedures and identifies the common sources of pain associated with the SIJ.
Use of antidote in poisonings due to xenobiotics taken via inhalation route
(Türkiye Klinikleri Yayınevi, 2025) Gökdağ, Eren; Yılmaz Şahin, Nurdan; Yıldırım, Cuma; Sabak, Mustafa
Industrialization, pesticides, and widespread chemical use have increased the risk of inhalational poisonings. These exposures can cause severe respiratory and systemic effects, yet specific antidotes are not available for all agents. Where available, timely administration of antidotes can be lifesaving. The article reviews antidotes employed in poisonings resulting from inhaled toxic substances, with a focus on their pharmaceutical structures, clinical applications, and adverse effects. Atropine and pralidoxime are used for nerve agents and organophosphate/carbamate poisonings; hydroxocobalamin, sodium nitrite, and thiosulfate for cyanide exposure; naloxone for opioid aerosols; and chelating agents (DMSA, DMPS, BAL, CaNa₂EDTA) for mercury and lead vapors. Conversely, no specific antidote exists for agents such as ammonia, ozone, formaldehyde, methane, and anesthetic gases.
Temporal trends and regional variations in hepatocellular carcinoma etiology: A multinational study across Asia
(Springer Nature Link, 2026) Takeuchi, Yasuto; Tateishi, Ryosuke; Obi, Shuntaro; Otsuka, Motoyuki; Mochizuki, Hitoshi; Jazag, Amarsanaa; Yokosuka, Osamu; Ogasawara, Sadahisa; Örmeci, Necati; Sarin, Shiv Kumar; Omata, Masao
Background Hepatocellular carcinoma (HCC) remains a major health burden in Asia. Advances in antiviral therapies are reshaping the etiological landscape of HCC. This study evaluated temporal shifts in HCC etiology across Asian countries and their clinical implications. Methods This multinational study analyzed 6,261 newly diagnosed HCC patients registered in the APASL Hepatology/ Oncology Consortium (A-HOC) from 19 centers across seven Asian countries and regions between 2013 and 2023. Data on demographics, tumor characteristics, etiology, and treatment patterns were collected. Etiologies included hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), metabolic dysfunction-associated fatty liver disease (MAFLD), MAFLD plus excess alcoholic intake (MAFLD +eAL), autoimmune liver disease, cryptogenic, and others. Temporal trends and regional variations were assessed. Results In many countries, HBV remained predominant (43.3%–69.5%) and relatively stable throughout the period, while HCV showed only modest reductions. In Japan, HCV was the leading cause of HCC (33.1%), with a significant decline over time, accompanied by a rise in MAFLD-related HCC. ALD-related HCC increased in South Korea, and MAFLD-related HCC rose in Turkey. Tumor size and stage at diagnosis varied by etiology and region, affecting treatment strategies. Early stage diagnosis was more frequent in Japan and Taiwan, whereas advanced-stage HCC was common in China and Indonesia. Conclusions Distinct regional patterns and temporal changes in HCC etiology across Asia highlight the need for tailored prevention and surveillance measures. The growing burden of MAFLD-related HCC emphasizes its emerging role in liver cancer development, particularly in regions with declining viral hepatitis.
Axillary mass following BCG vaccination: A rare case diagnosed as lipofibromatosis
(Turkiye Klinikleri Yayınevi, 2025) Özdil Yılmaz, İlkiz Özge
We present a case of a 7-month-old male infant who de veloped a progressive, painless left axillary mass 2 months after Bacil lus Calmette-Guérin (BCG) vaccination. Parents reported that the swelling has increased since the 4th month. Initial ultrasound revealed a 16×26×33 mm hyperechoic subcutaneous lesion with a central cystic area and minimal vascularity, suggesting a complicated lipoma. Due to continuous growth, the mass was surgically excised. Histopathological examination confirmed lipofibromatosis, a rare benign fibro-fatty tumor of infancy. Although axillary lymphadenitis is a common BCG com plication, persistent or atypical lesions should prompt further investi gation to rule out neoplasms. This case emphasizes the importance of considering rare soft tissue tumors like lipofibromatosis in the differ ential diagnosis of post-vaccination axillary masses.
Does combined pulmonary fibrosis and emphysema syndrome affect response to antifibrotic therapy and survival? A single-center retrospective cohort study
(Mattioli 1885, 2025) Teke, Nazlı Hüma; Ağca, Meltem; Türkar, Ayla; Sevim, Tülin; Tuncay, Eylem; Güngör, Sinem; Yıldırım, Elif; Özbaki, Fatma; Gündoğuş, Baran; Arınç, Sibel; Berk Takır, Huriye; Özmen, İpek
Objective: Combined pulmonary fibrosis and emphysema (CPFE) is a clinicoradiological syndrome characterized by upper lobe emphysema and lower lobe fibrosis, most commonly associated with idiopathic pulmonary fibrosis (IPF). This study compared the clinical characteristics, functional parameters, and mortality of patients with CPFE and IPF who received antifibrotic therapy. Methods: Between October 2015 and Au gust 2022, patients with IPF treated with antifibrotics for at least 6 months were retrospectively evaluated and divided into two groups: CPFE (emphysema present) and IPF (emphysema absent). Demographic data, antifi brotic therapy, functional parameters before and after treatment (FEV1%, FVC%, DLco %), clinical outcomes (hospital admissions, mortality) were compared. Results: Of the 204 patients with IPF, 90 (44%) had CPFE. CPFE patients were more often male, had greater smoking history, higher pack-years, and more lung cancer than IPF patients (p < 0.001 for all). Post-treatment FEV1% and FVC% did not significantly differ between the groups, whereas DLco% declined significantly in both (p < 0.001 and p = 0.002). DLco% decreased more in IPF than CPFE, but the difference was not statistically significant [−3 (−11–3) vs. −0.43 (−1.1–0.2), p = 0.36]. The hospital admission rates were similar. Independent risk factors for mortality included CPFE diagnosis (HR: 1.73, 95% CI: 1.06–2.83, p = 0.029), low FVC% (HR: 0.970, 95% CI: 0.96–0.98, p < 0.001), and device use (long-term oxygen therapy [LTOT] or home non-invasive mechanical ventilation [NIMV]) (HR: 2.48, 95% CI: 1.50–4.09, p < 0.001). Mean survival was shorter in patients with emphysema than in those without em physema (5.08 vs. 5.68 years, p = 0.08). Conclusions: Despite a decline in DLco%, changes remained below the futility threshold. Clinical outcomes and mortality were comparable. CPFE diagnosis, low FVC%, and LTOT/ NIMV use independently predicted higher mortality.
More than one century: Intravenous procaine therapy - A systematic review
(Salient Visionary Publications LLC, 2025) Oettmeier, Ralf; Nazlıkul, Hüseyin; Pinilla-Bonilla, Laura Bibiana; Ural Nazlıkul, Fatma Gülçin; Reuter, Rudolf
Procaine, traditionally introduced as a local anaesthetic, has revealed over more than a century a broad spectrum of systemic, pleiotropic pharmacological properties that far exceed its classical use. More than thirty distinct biological mechanisms have now been identified, including anti-inflammatory, vasodilatory, sympatholytic, membrane-stabilising, neuromodulatory, geroprotective, and epigenetically active effects. These actions provide the scientific foundation for its expanding clinical relevance in pain medicine, neuro-regulation, cardiovascular modulation, immune-related and degenerative disorders, and complementary oncology. Within Neural Therapy, Procaine occupies a central and irreplaceable role: its segmental, interference-field–oriented and autonomic-regulatory actions uniquely position it as the primary agent capable of restoring disturbed vegetative patterns, resolving chronic dysfunctions, and re-establishing physiological self-regulation. Beyond its local anaesthetic function, intravenous Procaine—especially in combination with bicarbonate—demonstrates profound regulatory effects on microcirculation, autonomic balance, inflammatory cascades, and mitochondrial and cellular resilience. The so-called “Procaine reset” reflects its capacity to transiently interrupt maladaptive neural patterns, modulate limbic activation, influence neurotransmitter systems, and restore homeostatic regulatory loops. The addition of bicarbonate prolongs Procaine’s plasma availability, enhances its intracellular penetration, and amplifies its eutrophic and anti-inflammatory properties. Although Procaine remains the primary therapeutic molecule in Neural Therapy, Lidocaine has also been utilised in selected clinical contexts. Lidocaine shares certain membrane-stabilising and anti-inflammatory features; however, its pharmacodynamics, autonomic influence, and regulatory depth are comparatively limited. Thus, Lidocaine may complement specific applications but cannot replace the superior vegetative-regulatory potential documented for Procaine. Procaine-Base infusion, when properly adapted to the patient's acid–base balance, represents a cornerstone therapy in regenerative medicine, improving pain thresholds, vascular perfusion, lymphatic drainage, and emotional equilibrium. Its safety profile—documented in hundreds of thousands of applications—is exceptionally favourable, with adverse effects being rare, transient, and mild. Given rising global burdens of chronic inflammatory, neurodegenerative, cardiovascular, metabolic, and oncologic disorders, Procaine emerges as a valuable multi-target regulatory agent capable of reducing symptom burden, complementing multimodal therapeutic strategies, and potentially lowering long-term health-care costs. Future high quality, large-scale studies are warranted to validate its systemic mechanisms, clarify dose–response relationships, and further integrate Procaine-based therapies into modern evidence-based frameworks.
Women’s experiences of breastfeeding during pregnancy: A Turkish descriptive study
(Springer Nature Link, 2025) Bayraktar, Sema; İnce, Zeynep; Yıldız, Nevin; Eski, Nuray; Çoban, Emine Asuman
Background Breastfeeding is generally terminated when the mother becomes pregnant again within two years because there is no clear consensus on how to manage breastfeeding during pregnancy. Additionally, health professionals may not have accurate information about this issue. This study aimed to determine women’s attitudes towards breastfeeding during pregnancy and why they stopped breastfeeding when they became pregnant. Methods This study is a descriptive one, involving pregnant mothers with a breastfeeding infant under 2 years old (n=101). The participants were followed up regarding those who had given birth to a new child and chosen the BDP. The researchers surveyed them after birth. The data were collected using a survey form that included a total of 26 questions created by the researchers, which aligned with the existing literature. Data were collected using a questionnaire that included information about maternal, neonatal, and obstetrical data, as well as breastfeeding experience and problems encountered during pregnancy. Data were handled and analyzed using IBM SPSS Statistics v22.0 (SPSS Inc., Chicago, IL, USA). Results The mean age of the mothers was 29.3 years (SD±4.9), gravidity was 3.2 (SD±1.7), and parity was 2.5 (SD±1.1). The mean age of the breastfed children was 12.6 months (SD±5.3) when the mothers became pregnant again. The reasons for stopping breastfeeding were professional advice (35%, n=34), their own decision (30%, n=30), believing that breastfeeding could have adverse effects on the unborn baby, and social pressure (16%). Only 5% (n=5) of mothers continued breastfeeding between 7 and 9 months after pregnancy. Conclusions Our results indicate that when a mother wishes to breastfeed during pregnancy, providing breastfeeding counseling by healthcare professionals with accurate information is essential to sustain lactation and maintain the well-being of the breastfeeding child without harm to the unborn baby.
Examination of sleep disturbances in parkinson’s disease and other movement disorders
(Elsevier, 2025) Diaconu, Stefania; Murasan, Iulia; Değirmenci, Yıldız; Falup-Pecurariu, Cristian; Bhidayasiri, Roongroj; Falup-Pecurariu, Cristian
From Bedside to Diagnosis: Practical Competencies in Movement Disorders, Volume 10 in the International Review of Movement Disorders, highlights new advances in the field, with this new volume presenting interesting chapters on important topics such as Movement Disorder Examination: Hypokinetic Disorders, Clinical Approach to Abnormal Facial Movements, Advancing Movement Disorder Education: From Courses to Curriculum, Movement Disorder Examination: Hyperkinetic Disorders.
Complementary and integrative medicine for the treatment of tourette’s syndrome
(Wiley, 2025) Pringsheim, Tamara; Deans, Catherine; Anis, Saar; Bhatia, Poonam; Black, Kevin; Değirmenci, Yıldız; Gilbert, Donald; Hartmann, Andreas; Hull, Mariam; Malaty, Irene
Background: There is widespread interest in complementary and integrative medicine (CIM) among people with Tourette's syndrome (TS). Objective: To perform a systematic review of evidence on the use of CIM to reduce tics and improve tic-related quality of life. Methods: We included clinical studies of CIM in children, adolescents and adults with TS and chronic tic disorders, and assessed the change in tic severity and/or tic-related quality of life using validated scales. Risk of bias of randomized controlled trials was assessed using the risk of bias tool of the American Academy of Neurology, which classifies studies into Class I, II, III or IV based on quality criteria. Results: 49 clinical studies and three systematic reviews were included. Most studies were rated Class IV and therefore at high risk of bias. Class I studies demonstrated efficacy of functional MRI neurofeedback, 5-Ling granule, Jingxin Zhidong formula, and Ningdong granule in reducing tic severity. Class II studies suggest efficacy of mindfulness-based intervention for tics, acupuncture combined with atlantoaxial joint bone setting therapy, and art therapy. Systematic reviews summarizing the Chinese literature on acupuncture, acupuncture with herbal medicine and massage therapy suggest greater reduction in tics compared to conventional treatments but there is low confidence in the evidence due to poor methodological quality of included studies. Conclusions: Evidence to support the use of complementary and integrative medicine for TS is limited in methodological quality and widespread applicability. These limitations prohibit evidence-based recommendations for general use among individuals with TS.
A comparative study of deep learning models for automated liver and tumor segmentation in 2d contrast-enhanced MRI images
(IEEE, 2025) Tokatlı, Nazlı; Bilmez, Yakuphan; Bayram, Mücahit; Bayır, Beyzanur; Özalkan, Helin; Tekin, Zeynep; Örmeci, Necati; Altun, Halis
This paper presents a comprehensive investigation into deep learning techniques for the automated segmentation of the liver and tumors from 2D abdominal contrast-enhanced Magnetic Resonance Imaging (MRI) slices. Addressing a significant challenge in medical image analysis, our study leverages the public ATLAS dataset [1], using a selection of 60 3D abdominal MRI scans, from which we extracted approximately 3,750 2D slices for model training and evaluation. The core objective was the precise identification and delineation of both the liver organ and any intrahepatic lesions. A comparative analysis was conducted on three U-Net-based architectures: the standard Attention U-Net model incorporating EfficientNet-b3 and CBAM but without Focal Loss, the Attention U-Net model with integrated Focal Loss, and the ResNet34-Based U-Net model. To optimize performance, we explored the efficacy of different loss functions, namely DiceLoss and a hybrid DiceLoss with Focalcoss. Our findings are promising: Among the evaluated models, the ResNet34-Based U-Net demonstrated the highest performance with a Dice score of 91.36% and an IoU score of 89.52%. It was followed by the Attention U-Net with Focal Loss, which achieved 86.41% Dice and 81.61% IoU scores, and the standard Attention U-Net, which obtained 85.93% Dice and 81.19% IoU scores. These results underscore the significant potential of our 2D-based methodology to enhance the precision and efficiency of liver and tumor detection from abdominal scans, offering a valuable tool to support clinicians in early diagnosis and to alleviate their workload.
What is new in the 2025 APASL guidelines for metabolic dysfunction-associated fatty liver disease?
(AME Publishing Company, 2026) Pan, Ziyan; Örmeci, Necati; Chen, Jinjun; Ghazinian, Hasmik; Payawal, Diana; Eslam, Mohammed
As the global epidemics of obesity and type 2 diabetes mellitus (T2DM) continue to rise, metabolic dysfunction associated fatty liver disease (MAFLD) has become the most common chronic liver disease globally. The Asia-Pacific region is particularly affected, accounting for a significant majority of global liver-related deaths (1). To address this, the Asian Pacific Association for the Study of the Liver (APASL) has released updated clinical practice guidelines in 2025 (2). This article is a commentary focusing on the key changes and new recommendations within those guidelines, which were published in Hepatology International (2). Recognizing the limitations of the exclusionary diagnostic criteria for non-alcoholic fatty liver disease (NAFLD) and emphasizing the key role of metabolic dysfunction in disease pathogenesis, the introduction of the MAFLD definition in 2020 was a milestone in disease research and clinical practice (3-5). This shift reflects a significant evolution in our understanding of the disease, moving away from a diagnosis of exclusion towards one of inclusion based on metabolic dysfunction, recognizing the central role of metabolic factors and introducing the key concept of dual etiology, including alcohol consumption or coexisting liver diseases (6). Over the past 5 years, there have been significant advancements in understanding the disease, culminating in new knowledge, the first approved treatment, and the beginning of a new era of artificial intelligence (AI) with potential promise for hepatology. These changes stimulate the need for an updated document of the APASL guidelines for the diagnosis and management of MAFLD, which was recently released in 2025 (2). This updated guideline provides a comprehensive framework for addressing the growing burden of MAFLD in the Asia-Pacific region. This commentary aims to highlight the key aspects in this landmark document and touch on the main changes from the 2020 version (7).
The african middle east association of gastroenterology (AMAGE) clinical practice guidelines for the diagnosis and management of metabolic dysfunction associated fatty liver disease
(Elsevier, 2026) Fouad, Yasser; Elwakil, Reda; Sanai, Faisal M.; Ojo, Olusegun; Al Awadhi, Sameer; Ocama, Ponsiano; Abdelaty, Nadia; Al-Busafi, Said A.; Örmeci, Necati; Eslam, Mohammed
Over the past few decades, the profile of liver diseases in Africa and the Middle East has undergone significant changes. The incidence of metabolic dysfunction-associated fatty liver disease (MAFLD) has risen to alarming levels. Despite the seriousness of the situation, there is a scarcity of local or regional guidelines established to address it. This document presents the clinical practice guidelines from the African Middle East Association of Gastroenterology (AMAGE) related to the screening, diagnosis, and management of MAFLD. It addresses multiple aspects of managing this condition while taking into account local circumstances and the healthcare system's management requirements. These guidelines are intended for routine clinical use, with a specific focus on particular groups when needed.
Elimination of hepatitis c in Turkey
(IntechOpen, 2025) Örmeci, Necati; Musabaev, Erkin Isakovich
This manuscript examines the epidemiological patterns, transmission routes, and genotypic distribution of hepatitis C virus (HCV) in Türkiye, highlighting national progress toward elimination targets set by the World Health Organization (WHO). The main objective is to evaluate the effectiveness of national screening, diagnostic, and treatment strategies, with a focus on the scale-up of direct-acting antiviral (DAA) therapies and their associated cost-effectiveness. Drawing on recent multicenter and population-based studies, the paper outlines the shifting prevalence of HCV geno types, particularly among high-risk populations such as people who inject drugs (PWID), prisoners, and individuals undergoing hemodialysis. The analysis demon strates that genotype 1b remains predominant, though genotype diversity is increas ing due to migration and changing transmission dynamics. Findings reveal that despite improved availability of DAA treatments and health policy initiatives like the 2018–2023 National Viral Hepatitis Program, gaps persist in diagnostic follow-up and referral. The manuscript emphasizes the dual approach of micro- and macro elimination, advocating for integrated care models, increased physician engagement, and enhanced awareness efforts. Projections suggest that achieving WHO goals is feasible in Türkiye if testing and treatment rates significantly improve. Ultimately, this study underscores the necessity of sustained political commitment, intersectoral collaboration, and targeted public-health interventions to reduce HCV-related mor bidity and mortality by 2030.
Clinical characteristics of peripheral joint disease in axial and peripheral spondyloarthritis: Findings from a multicentre cross sectional study
(2025) Sarıyıldız, Emine; Duruöz, Mehmet Tuncay; Gezer, Halise Hande; Aktaş, İlknur; Akar, Servet; Hizmetli, Sami; Şahin, Nilay; Akgül, Özgür; Alkan Melikoğlu, Meltem; Sezer, İlhan; Ataman, Şebnem; Ural Nazlıkul, Fatma Gülçin; Çapkın, Erhan; Yılmaz, Figen; Kalyoncu, Umut
Peripheral joint disease (PJD) is the most common peripheral manifestation in spondyloarthritis (SpA) patients. This study aimed to determine PJD characteristics and associated factors in patients with axial SpA (AxSpA) and peripheral SpA (pSpA). This cross-sectional and multicenter study involved 13 different rheumatology and physical medicine & reha bilitation clinics, and patients diagnosed with axSpA or pSpA were included in the study. PJD was defined as the ‘ever’ related to SpA according to the physician. Multivariable analyses were conducted to identify factors associated with PJD. A total of 394 patients were enrolled in the study (57.6% male, mean age 40.8 years), of whom 359 (91.1%) were clas sified as AxSpA and 35 (8.9%) as pSpA. Peripheral arthritis was reported in 118 patients (29.9%), comprising 85 (72%) with AxSpA and 33 (28%) with pSpA. Among the whole population with PJD, the main joint involvement pattern was monoarticular (33.9%, n=40) and oligoarticular (49.2%, n=58). The rate of predominantly lower limb and large joint involvement was approximately 60% (n=68) and the major course of PJD was transient (42.4%, n=50) and intermit tent (40.7%, n=48). pSpA patients had a higher rate of persistent (33.3% vs. 14.3%, p=0.021) and progressive arthritis (15.2% vs. 1.2%, p=0.007). The coexistence of PJD with other peripheral involvement and extra-articular manifestations excluding psoriasis was widespread. Dactylitis, enthesitis, and high CRP level were positively associated with PJD; on the contrary, ever alcohol intake, presence of sacroiliitis on MRI, and family history for SpA were negatively associated. PJD was accompanied by both other peripheral involvements and extra-articular manifestations, excluding psoriasis and the course of PJD was more persistent in pSpA patients. This undoubtedly contributes to an increased disease burden.
Evaluation of management strategies for viral upper respiratory tract infections among pediatricians in Türkiye
(Taylor & Francis, 2025) Yıldız, İsmail; Gönüllü, Erdem; Uçkun, Utkucan; Kandemir, İbrahim; Soysal, Ahmet; Karaböcüoğlu, Metin
Background: To evaluate how pediatricians manage viral upper respiratory tract infections (URTIs) in children and their tendencies about the viral URTIs approaches. Materials and Methods: This study was conducted among pediatricians who participated in a descriptive cross-sectional survey. The survey included pediatricians who were willing to participate and who completed the survey forms between June 2023 and February 2024. The survey gathered data on the demographic characteristics of the pediatricians, as well as their diagnostic and treatment approaches for viral URTIs. Demographic data included the physicians’ gender, age, academic title, province of duty, institution of practice, and duration of experience in pediatrics. Results: This study involved 203 pediatricians. The diagnosis of viral URTI based on clinical findings had a negative correlation with pediatricians’ work experience (OR: 0.96 per year) and was more common among those working in private settings (OR: 0.38). Use of medications for symptomatic cough treatment was 2.72 times higher among pediatricians in private practice. Herbal supplement use was more common among pediatricians in private practice (p = 0.021) and those with ≥10 years of experience (p = 0.010). Systemic decongestant use was more frequent among pediatricians without an academic title (p = 0.030). Pelargonium sidoides root extract was used more often by pediatricians in private practice (p = 0.003), and they also preferred honey-containing supplements more frequently (p < 0.05). There was a negative correlation between experience in pediatric practice and multivitamins and minerals prescriptions for prevention of viral URTIs (OR: 0.97 for each year). Conclusion: Pediatricians in private settings and with more experience tend not to make a diagnosis of viral URTIs solely based on physical examination. Pediatricians working in private settings focus more on treatments that relieve cough symptoms. A viral URTI diagnostic and treatment algorithm with proven validity will help physicians in clinical diagnosis and treatment.

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