Dahili Tıp Bilimleri Bölümü Koleksiyonu

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https://hdl.handle.net/20.500.13055/58

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Management of acute variceal bleeding: Updated APASL guidelines
(Springer Nature Link, 2025) Lesmana, Cosmas Rinaldi Adithya; Shukla, Akash; Kumar, Ashish; Shalimar; Qi, Xiaolong; Gani, Rino Alvani; Dökmeci, Abdul Kadir; Örmeci, Necati; Sarin, Shiv Kumar
Acute variceal bleeding (AVB) is a common life-threatening complication of portal hypertension (PHT), having a six-week mortality of 10%-20%. Major advances in the hemodynamic management, risk stratification, pharmacotherapy, endoscopy techniques, hemostatic devices and radiological interventions have led to improved management and outcome of AVB patients in the recent past. Therefore, the APASL Portal Hypertension Working Party, chose a panel of experts, primarily from the Asia–Pacific region, to identify important developments and controversial areas in the field of AVB. They discussed through a pre-defined and structured process, advances in the field and proposed updates to the previous APASL AVB guidelines. These included emphasis on safe transportation, defining time frames for AVB episodes and re-bleeding, reporting of clinical outcomes, optimizing early intervention strategies, pharmacotherapy, medical management, endoscopic therapies, and salvage modalities, including TIPS and self-expanding metal stents. The current updates also cover variceal bleeding in special populations and situations, the skill sets required for managing AVB patients, and the research priorities in the field. The updated guidelines are based on the latest evidence and incorporate emerging trends to provide a contemporary template for management of AVB in both patients with cirrhosis and non-cirrhotic portal hypertension.
MAFLD: A comprehensive review of the link between metabolic dysfunction and cardiovascular risk
(Taylor & Francis, 2025) M. Mostafa, Alaa; Pan, Ziyan; Yu, Ming-Lung; Örmeci, Necati; Fouad, Yasser; Eslam, Mohammed
Metabolic dysfunction-associated fatty liver disease (MAFLD) affects over 30% of the global population. It is a multisystem condition with a strong association with cardiovascular disease (CVD), the leading cause of mortality worldwide. Key shared mechanisms, including insulin resistance, systemic inflammation, oxidative stress, and genetic predisposition, couple MAFLD with increased risks of coronary artery disease, ischemic heart disease, and heart failure. Early detection via non-invasive imaging and biomarkers is crucial for effective risk stratification. Management strategies emphasize lifestyle modifications and the development of targeted pharmacotherapies addressing metabolic and inflammatory pathways. Understanding the interconnected pathogenic mechanisms facilitates personalized interventions to reduce morbidity and improve long-term outcomes. A multidisciplinary approach remains essential to prevent and manage the cardiovascular implications of MAFLD.
Evaluation of posterior segment changes in pediatric asthma patients with and without inhaled corticosteroid therapy
(Springer Nature, 2025) Kıvrak, Ulviye; Çiçek, Fatih; Köle, Mehmet Tolga; Kaya Adaş, Büşra; Kandemir, İbrahim
This study aimed to evaluate and compare changes in the posterior segment of pediatric asthma patients, potentially associated with asthma or inhaled corticosteroids. A retrospective analysis was conducted on children aged 7–17 diagnosed with atopic asthma. The participants were categorized into groups: Group 1 (no inhaled corticosteroids) and Group 2 (inhaled corticosteroid treatment). A control group of healthy children was also included. Demographic data, clinical findings, and laboratory results (e.g., eosinophil count, IgE, CRP levels) were collected. Optical coherence tomography (OCT) and OCT angiography (OCTA) were used to measure posterior segment parameters. Asthma patients demonstrated a statistically significant reduction in subfoveal choroidal thickness, the superficial capillary plexus in the superior and nasal quadrants, the choriocapillaris in the foveal quadrant, and the peripapillary vascular density in the inferior and superior quadrants compared to controls. Inflammation markers such as eosinophil count and CRP showed significant correlations with changes in vascular density. Asthma, as a chronic inflammatory and hypoxic condition, can significantly affect posterior segment parameters, leading to potential visual function impairments in children. Regular monitoring with OCT and OCTA can help detect early microvascular changes, allowing for timely interventions to preserve visual health.
In vivo reflectance confocal microscopy for detecting cutaneous metastasis in breast cancer
(Mattioli 1885, 2025) Duman, Nilay; Yaman, Banu; Oraloğlu, Göktürk; Kararaslan, Işıl
A 45-year-old female with a history of invasive ductal breast carcinoma (IDBC) presented with an asymptomatic erythematous nodule on the right mastectomy scar. Dermos copy revealed erythematous peripheral border, polymor phous and atypical vessels, focal scaling, and multiple white structureless areas appearing as white clods and strands. Reflectance confocal microscopy (RCM) revealed a normal epidermis with a preserved honeycombed pattern, with der mal tumoral clusters of varying sizes consisting of highly polymorphous hyporeflective cells with different sizes and shapes.
Presence of myositis specific autoantibodies including anti synthetase antibodies predict favorable outcomes to rituximab in patients with idiopathic inflammatory myositis: Retrospective observational study
(Elsevier, 2025) Oğuz, Eyüp; Koca, Nevzat; Bektaş, Murat
Background: Idiopathic inflammatory myositis (IIM) is a group of disorders that mainly affect skeletal muscle, joints, skin, and lungs. Objectives: This study aimed to evaluate the autoantibody profile including myositis-associated autoantibodies (MAAs) and myositis-specific autoantibodies (MSAs) and their influence on outcomes, response rates, and associated factors to Rituximab (RTX) treatment in patients with IIM who followed up in a single tertiary center. Methods: Data from the patients with IIM who follow-up between 2019 and 2023 years and met the Bohan and Peter and/or the ACR/EULAR 2017 and/or the ENMC criteria were retrospectively reviewed. RTX was initiated in patients who had an inadequate response to at least one immonomudulatory/immunosuppressive treatment (refractory group) or as a first-line treatment in patients who had critical/severe disease manifestations such as respiratory failure due to severe intertitial lung disease (ILD), respiratory muscle involvement, and dysphagia. RTX was administered at a dose of 1 g every 6 months on days 0-15, and the dose was repeated at month 6 in patients who responded to treatment. Remission was defined as the patients who met all of the following criteria during at least 6 months: i) absence of a sign of muscle inflammation by manual muscle test (normalization of muscle strength in patients without damage) alongside muscle enzymes (normalization in CK and LDH levels), ii) improvement or no progression in respiratory symptoms alongside pulmonary function tests (less than 10% decline in FVC and/or DLCO) in patients who had ILD at baseline, iii) disappearance of active skin lesions among dermatomyositis (DM) patients iv) resolution of other features attributed to several manifestations such as arthritis, heart involvement and gastrointestinal symptoms if present.
Manuel tıp manuel terapi fonksiyonel diyagnoz ve manipülasyon teknikleri
(Ankara Nobel Tıp Kitabevleri, 2025) Nazlıkul, Hüseyin; Ural Nazlıkul, Fatma Gülçin
Bu kitabın yazılması sürecinde, manuel tıbbın mesleki gelişimimdeki yerini ve öne mini bir kez daha derinlemesine anlama fırsatı buldum. Fizik tedavi ve rehabilitasyon alanında uzmanlaşmış bir akademisyen olarak, kas-iskelet sistemi hastalıklarında başarı lı olmanın, bu alanın inceliklerini anlamak ve uygulamakla mümkün olduğunu gördüm. Bu farkındalığımı, manuel tıpla ve nöralterapi ile tanışmama ve bu disiplinleri kazandı ğım bilgi birikimine borçluyum. Klasik tıpta segmental fonksiyon bozukluklarını ve bunların ilgili organlarla ilişkisini çoğu zaman göz ardı ediyorduk. Oysa manuel tıpla doğru tanı koymanın ve hastaya do kunarak muayene yapmanın ne kadar etkili olduğunu fark ettim. Artık basit bir halluks valgus gibi durumlarda dahi radyolojik görüntülerden çok, hastaya dokunmanın önemi ni daha iyi anlıyorum. Basit bir ortopedik problemde dahi hastaya dokunarak muayene yapmak, pek çok sorunun kaynağını hemen ortaya koyabiliyor. Manuel tıp, eklemler, kaslar ve bağ dokular üzerinde elle yapılan tanı ve tedavi yöntem lerini içerir. Bu yaklaşım, hareket sistemindeki fonksiyonel bozuklukların giderilmesine ve ağrının azaltılmasına odaklanır. Nöralterapi ise vücudun sinir sistemini düzenleyerek, ağrı ve fonksiyon bozukluklarını tedavi etmeyi amaçlar. Bu iki yöntemin kombinasyonu, birçok durumda hastaların daha hızlı iyileşmesini sağlar ve tedavi sürecini daha etkili hale getirir. Almanya’da katıldığım ileri düzey manuel tıp ve nöralterapi eğitimleri, mesleğimdeki bakış açımı zenginleştirirken, manuel tıbbın sadece bir tedavi yöntemi değil, aynı zaman da bir hekimlik sanatı olduğunu anlamama vesile oldu. Sevgili hocam Wolfgang von Hey mann, 2019 yılında aramızdan ayrıldı. Onunla birlikte Hüseyin Nazlıkul ile başladığımız bu değerli projeyi tamamlayarak hekimlerle buluşturmak, benim için bir onur kaynağıdır.
Long-term effects of neural therapy in fibromyalgia – A retrospective multicenter analysis effectiveness of neural therapy in patients with fibromyalgia
(Salient Visionary Publications, 2025) Ural Nazlıkul, Fatma Gülçin; Nazlıkul, Hüseyin; Özkan, Neslihan; Acarkan, Tijen; Tamam, Yusuf; Orak, Murat; Bilgin, Mehmet Dinçer
Background: Fibromyalgia syndrome (FMS) is a chronic pain condition associated with widespread musculoskeletal discomfort, persistent fatigue, and diminished quality of life. Many patients show limited response to conventional treatments. Neural therapy (NT), a core modality of regulatory medicine, aims to restore autonomic balance and modulate inflammatory reflexes through targeted injections of local anesthetics. Objective: This retrospective multicenter study evaluates the long-term effectiveness of NT in 565 patients with treatment resistant fibromyalgia who previously failed to respond adequately to standard therapies. Methods: Data were collected from five neural therapy clinics between 2017 and 2024. Standardized outcome measures were assessed at baseline, immediately post-treatment, and at 3, 6, and 12 months: Pain intensity: Visual Analog Scale (VAS) Disease burden: Fibromyalgia Impact Questionnaire (FIQ) Quality of life: Short Form-36 (SF-36), including subdomains (physical function, pain, energy/fatique, social function, general health perception) Statistical analysis employed the Friedman test for repeated measures. Results: VAS scores dropped from a mean of 8.5 to 1.9 post-treatment and remained below 3.0 over 12 months. FIQ scores decreased from a baseline mean of 78.1 to 18.6 and remained significantly improved (mean 24.9 at 12 months). SF-36 physical function increased from 33.5 to 82.0, with sustained gains at all follow-ups. Social functioning, general health perception, pain and vitality domains showed similar sustained improvements. The treatment completion rate was 92.9%, indicating high tolerability and patient satisfaction. Conclusion: Neural therapy produced significant and sustained improvements in pain, physical functioning, energy, and social participation in fibromyalgia patients. Its multimodal effects—autonomic modulation, anti-inflammatory action, and improved microcirculation—support its use in integrative and regulatory pain medicine. This study presents strong evidence for neural therapy as an effective, safe, and cost-efficient option in patients with resistant fibromyalgia. Further randomized controlled trials are needed to confirm these findings and establish standard treatment protocols.
Integrative neural therapeutic approach for migraine with aura – A case report
(Pubtexto Publishers, 2025) Ural Nazlıkul, Fatma Gülçin; Nazlıkul, Hüseyin; Acarkan, Tijen
This case report presents the clinical course of a 37-year-old female patient diagnosed with migraine with aura, who experienced significant and sustained symptom relief following neural therapeutic interventions. The patient had a long-standing history of recurrent, unilateral, pulsating headaches, often preceded by visual aura symptoms such as scintillating scotoma, and accompanied by nausea, photophobia, and phonophobia. Previous pharmacological treatments provided only limited and temporary relief and were associated with side effects. A structured, integrative therapeutic protocol was initiated, comprising neural therapy with 1% procaine administered segmentally at cervical ganglia (C2/C3), the stellate ganglion, tonsillar region, trigeminal pathways, and relevant vegetative-reflex zones. The treatment focused on modulation of the autonomic nervous system and regulation of possible interference fields. After just two sessions, the patient reported a marked reduction in attack frequency and improvement in vegetative symptoms, with further improvement following a total of four sessions. Complementary interventions included a migraine diary to identify individual triggers, nutritional optimization, stress reduction, and patient education to improve early aura recognition and preventive action. Notably, the patient was able to discontinue acute medication use without recurrence of intense episodes, and her quality of life improved substantially. This case underscores the value of neural therapy as a safe, efficient, and individualized approach in managing migraine with aura. The observed therapeutic effects are attributed to autonomic regulation, stabilization of neuroimmunological networks, and treatment of interference fields such as chronic tonsillitis. Importantly, neural therapy allowed for medication sparing and enhanced patient compliance without systemic adverse effects. These findings support the integration of neural therapy into a holistic, patient-centered strategy for chronic migraine conditions. It provides an alternative for patients who seek non-pharmacological treatment options and demonstrates promising potential in reducing migraine burden long-term.
Human papillomavirus vaccines in obstetrics and pediatrics: A comprehensive review
(Medihealth Academy, 2025) Gürbüz, Tuğba; Özdil Yılmaz, İlkiz Özge
This review highlights the epidemiological significance, immunological function, and economic feasibility of Human papillomavirus (HPV) immunization, emphasizing both its benefits and challenges. Addressing vaccine hesitancy, ensuring equitable access, and expanding vaccination coverage for both genders are crucial to maximizing public health benefits. HPV is a highly prevalent infection with significant implications for global public health, particularly in obstetric and pediatric populations. Persistent infection with high-risk HPV genotypes, such as HPV-16 and HPV-18, is a leading cause of cervical cancer, a major contributor to cancer-related mortality worldwide. Beyond cervical malignancies, HPV is etiologically linked to anal, vulvar, vaginal, penile, and oropharyngeal carcinomas. Additionally, it is responsible for benign but distressing conditions such as genital warts, imposing substantial psychosocial and economic burdens. Prophylactic HPV vaccines have significantly improved the prevention of HPV-associated diseases. The currently available bivalent, quadrivalent, and nonavalent vaccines target high-risk oncogenic HPV types and provide near-complete protection against vaccine-included genotypes. These vaccines function by eliciting a robust immune response, effectively neutralizing HPV before it establishes an infection. However, despite their well-documented benefits, challenges such as vaccine hesitancy, misinformation, economic barriers, and global disparities in vaccine access persist. This review provides a comprehensive analysis of HPV immunization within obstetrics and pediatrics, emphasizing its epidemiological impact, immunological mechanisms, efficacy, safety, and implementation strategies. Furthermore, we explore existing barriers to vaccine uptake, disparities in global access, and potential future advancements, including next-generation vaccines and therapeutic interventions. Addressing these challenges through targeted public health initiatives, healthcare provider education, and equitable vaccine distribution strategies is essential to maximizing the public health impact of HPV immunization and reducing the global burden of diseases associated with HPV
Child and adolescent psychiatry consultations during the COVID-19 pandemic
(Springer Nature Link, 2025) Vatansever Pınar, Zeynep; Çimen, İrem Damla; Küçük, Elif; Köle, Mehmet Tolga; Kandemir, İbrahim
This study aimed to identify the biopsychosocial stressors influencing child and adolescent mental health during periods when facetoface education was suspended and to evaluate the psychological sequelae of school closures and related restrictions. We conducted a retrospective observational study at Kartal Dr. Lütfi Kırdar City Hospital, a tertiary care center in İstanbul, reviewing all patients referred to the child and adolescent consultation-liaison psychiatry (CLP) unit between March 2020 and March 2022. We assessed associations between psychiatric diagnoses and health-related stressors, school closure status, age, and sex using both frequentist and Bayesian methods. During the study period, 264,013 pediatric admissions were recorded, of whom 270 (0.10%) required psychiatric consultation. The proportions of suicide attempts and anxiety diagnoses did not differ between periods of open and closed schools (BF10 = 0.21 and 0.138, respectively; moderate evidence for the null). Multivariate analysis showed that the odds of suicide attempts were higher in patients exposed to family or schoolrelated stressors (OR = 6.63, 95% CI 2.72–16.19), in females (OR = 8.10, 95% CI 4.16–15.77), and with increasing age (OR = 1.32 per year, 95% CI 1.16–1.50). Female sex (OR = 4.17, 95% CI 2.03–8.55) and older age (OR = 1.30 per year, 95% CI 1.12–1.50) were also associated with depression. Anxiety was more likely in those facing isolation or healthrelated stressors (OR = 3.91, 95% CI 1.66–9.22). These findings highlight the differential impact of stressor type on internalizing symptoms and may inform resource allocation and crisisresponse planning in child mental health services.
Impact of obesity on metabolic control in type 2 diabetes: Five-year trends of Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes (TEMD Obesity Study, 2017-2022)
(S. Karger AG, 2025) Kıyıcı, Sinem; Demirci, İbrahim; Sönmez, Alper; Haymana, Cem; Mert, Meral; Nuhoğlu, İrfan; Taşçı, İlker; Salman, Serpil; Satman, İlhan; Bayram, Fahri
Background: Türkiye has the highest obesity prevalence in Europe. Obesity not only causes type 2 diabetes mellitus (T2DM) but also impairs glycemic control in patients with T2DM. There is insufficient information about the demographic and clinical differences between individuals with T2DM who are living with or without obesity. Objectives: The second TEMD survey across Türkiye investigated the latest overweight and obesity prevalence in patients with T2DM. The present study evaluated the five-year changes in the prevalence, factors associated with an obesity diagnosis and the association between obesity and metabolic control. Methods: Patients under follow-up in tertiary units specialized for diabetes care were consecutively enrolled. The sociodemographic, anthropometric, and clinical variables were recorded. Metabolic targets were defined as HbA1c <7%, home arterial blood pressure (ABP)<135/85 mmHg, or LDL-C<100 mg/dL or <70 mg/dL or <55 mg/dL according to the risk factors or complications of patients. Metabolic target attainment rates were investigated across normal-weight, overweight and obesity body mass index (BMI) classes. Results: The TEMD Obesity Study enrolled 4935 patients with T2DM (age 58.9±10.1 years; women 59.8%). The prevalence of overweight and obesity was 33.4% and 55.1%, respectively. Obesity was more frequent in women with T2DM than men (66.2% vs. 38.1%; p=<0.001). From 2017 to 2022, the obesity rate decreased from 59.0% to 55.1%, while the overweight rate increased from 31.0% to 33.4%. As BMI class increased, the achievement of three metabolic targets decreased while the incidence of microvascular complications rose. Significant associations were found between obesity and sociodemographic characteristics (age, sex, education level) and lifestyle measures (diet, exercise, smoking) in multivariable logistic regression analysis. Conclusion: The TEMD Obesity study showed a decrease in obesity rates among patients with T2DM between 2017 and 2022. Also, the findings suggest that obesity poses an important barrier to the achievement of metabolic goals.
Çocuk Hastalıklarında Beslenme
(Orient Yayınları, 2025) Haspolat, Yusuf Kenan; Akçay, Teoman; Peltek Kendirci, Havva Nur
Fruktoz: Dost mu düşman mı?
(Orient Yayınları, 2025) Akçay, Teoman
Fruktozun Kimyası ve Kaynakları. Fruktoz, basit bir şeker (monosakkarit) olup, doğada meyvelerde, balda ve bazı sebzelerde bulunur. Glukozdan yaklaşık 1,7 kat daha tatlıdır, bu nedenle gıda endüstrisinde yaygın olarak kullanılır. Ancak, fruktozun metabolizması glukozdan oldukça farklıdır ve bu farklılık, sağlık üzerinde hem olumlu hem de olumsuz etkilere yol açabilir (Tappy & Lê, 2010).
Akdeniz diyeti: Sağlıklı yaşamın sırrı
(Orient Yayınları, 2025) Akçay, Teoman; Akyıldız, Dilek; Haspolat, Yusuf Kenan; Kavak, Vatan
Akdeniz diyeti, Akdeniz bölgesinde yaşayan insanların geleneksel beslenme alışkanlıklarını temsil eder. Bu diyet, özellikle 1950’lerde İtalya, Yunanis tan ve İspanya gibi ülkelerde yaygın olarak uygulanmıştır. Tarihsel olarak, Akdeniz’e kıyısı olan 22 ülkenin çoğunda, ancak hepsinde değil, nişasta içermeyen sebzelerin, asgari düzeyde işlenmiş tam tahıllı tahılların, baklagillerin, kuruyemişlerin ve tohumların bolluğu ve çeşitliliği hem erkekler hem de kadınlar için temel gıdalardı (Şekil 1). Kuzey Amerika ve Avrupa’nın aksine et, balık, süt, peynir ve yumurta lüks gıdalardı. Örneğin, 1950’lerde Güney İtalya’da çok az et yenirdi, genellikle haftada bir veya iki kez yenirdi ve süt, kahve (caffé macchiato) veya bebekler dışında asla kullanılmazdı. Şeker ve beyaz patates çok az miktarda tüketilirdi ve tereyağı veya krema asla kullanılmazdı. Soğuk sıkım sızma zeytinyağı başlıca yağ kaynağıydı. Meyveler ve çok az miktarda yerel peynir, yemeklerde orta düzeyde kırmızı şarap alımıyla birlikte oldukça düzenli olarak tüketilirdi ( Keys A. 1983, Keys A, 1954).
Oyun bağımlılığı ve hipertansiyon: Güncel bir inceleme
(Orient Yayınları, 2025) Akçay, Teoman
Oyun bağımlılığı, dijital oyunların aşırı ve kontrolsüz bir şekilde oynan ması sonucu ortaya çıkan bir davranışsal bağımlılık türüdür (Grüsser et al., 2007). Dünya Sağlık Örgütü (WHO), 2018 yılında “oyun oynama bozukluğu”nu (gaming disorder) Uluslararası Hastalık Sınıflandırması (ICD-11) kapsamına alarak, bu durumun ciddiyetini resmen tanımıştır (WHO, 2018). Gü nümüzde özellikle çocuk ve adolesanlar arasında yaygınlaşan bu durum, bireylerin fiziksel, psikolojik ve sosyal sağlığını olumsuz yönde etkilemektedir (Kuss & Grif fiths, 2012). Yapılan çalışmalar, çocuk ve ergenlerde oyun bağımlılığı prevalansının %5-10 arasında değiştiğini ve bu oranın pandemi döneminde daha da arttığını göstermektedir (King et al., 2020; Paulus et al., 2018). Bu yaş grubunda oyun bağımlılığı, sadece psikolojik sorunlara değil, aynı zamanda fizyolojik sağlık prob lemlerine de yol açabilmektedir
Predicting risk of lymph node metastasis in papillary thyroid cancer using miRNAs and clinicopathological features
(Springer Nature Link, 2025) Ergün, Penbe Gül; Aydoğan, Çağatay; Ceviz, Ayşe Begüm; Candan, Gonca; Batur, Şebnem; Yılmaz Aydoğan, Hülya; Öztürk, Oğuz; Öztürk, Tülin
This study investigates potential prognostic values in models created with clinico pathological features and expression profles of miRNAs known for their critical roles in papillary thyroid carcinoma (PTC) for lymph node metastasis (LNM) in PTC cases. Forty-seven lymph node-metastatic PTC patients and 46 non-metastatic patients were included. Using RT-PCR, miR-21, miR-146b, miR-221, and miR-222 expression was analyzed in carcinoma tissues and metastatic lymph nodes of the same PTC patients and carcinoma tissues of non-metastatic PTC patients. MiR 146b (p<0.001) and miR-221 (p=0.009) were overexpressed in metastatic PTCs compared to non-metastatic PTCs. The miRNA expression profles were similar in the lymph nodes and primary cancer of metastatic PTCs. In the presence of larger tumors (>1 cm) in metastatic PTCs, miR-146b and miR221 were overexpressed in the tumor tissue (p=0.036), while miR-222 was overexpressed in metastatic lymph nodes (p=0.035). miR-146b was also upregulated in lack of peritumoral lympho cyte infltration (p=0.006). In conclusion, our fndings suggest that the overexpres sion of miR-146b and miR-221 in PTC tissues may be associated with lymph node metastasis and a poorer prognosis. Furthermore, the presence of larger tumors and increased levels of intratumoral fbrosis in non-metastatic PTC patients could indi cate a poor prognosis.
Antihypertensive treatment of a patient with normal blood pressure: Case report and call for paying attention
(Wolters Kluwer, 2025) Atmaca, Hasan; Erol, Mustafa Kemal; Yetkin, Ertan
The current 2024 European Society of Cardiology (ESC) guideline for the management of elevated blood pressure and hypertension defines blood pressure less than 115/65 mmHg by ambulatory blood pressure monitoring (ABPM) as nonelevated, blood pressures in-between 115–129 and 65–79 mmHg as elevated blood pressure, and hypertension as ≥130/80 mmHg. There, might be patients seeking medical attention for the symptoms, apparently nonspecific but suggestive of hypertension with optimal, or not elevated, or elevated blood pressure values. A female patient with complaints of headache and dizziness lasting for 2 months has been evaluated in cardiology outpatient clinic and assessed by ABPM. It has been told that she had previously blood pressure of 90–100/50–60 mmHg and was suffering from headache when systolic blood pressure exceeds 110 mmHg. Her 24-h ABPM revealed systolic and diastolic blood pressure as 106/63 mmHg showing nighttime decrease compared with daytime pressures (98/59 mmHg and 108/68 mmHg, respectively). Thereafter, she was instructed to keep continuing the life-style modification and given to beta-blocker (bisoprolol 5 mg) as an antihypertensive treatment. At the end of the 2 weeks of follow-up period, she was headache-free and was feeling comfortable and well with a mean home blood pressure of 98/56 mmHg. We have presented prosperous antihypertensive treatment of a female patient suffering from headache and dizziness with a numerically normal or nonelevated blood pressure. In the presence of symptoms and having not elevated or elevated blood pressure levels, patients’ history on previous measure of blood pressure might facilitate our decision-making process.
Advances in parkinson's disease research: Exploring biomarkers and therapeutic strategies for halting disease progression
(Frontiers Media S. A., 2025) Bougea, Anastasia; Değirmenci, Yıldız
Parkinson's disease (PD) is a multifactorial neurodegenerative disorder, characterized by loss of dopaminergic neurons of substantia nigra (SN) in 1% of people aged above 65 years (Ben-Shlomo et al., 2024). Its complex clinical picture includes motor symptoms such as tremor, bradykinesia, and gait instability, as well as non-motor symptoms (depression, psychosis, cognitive decline) (Schilder et al., 2017;Titova and Chaudhuri, 2017). Current symptomatic therapies have limited long-term efficacy (Aldaajani and Khalil, 2024). A deep analysis of neural network after PD onset could deepen our understanding of the molecular crosstalk and biological processes underlying PD pathogenesis (Tomkins and Manzoni, 2021). However, there is a lack of reliable biomarkers for early diagnosis, presenting barriers to monitoring and developing disease-modifying therapies. There are several different types of biomarkers for PD , such as clinical, neurochemical and genetic (Bougea, 2020). Ten studies provided novel insights into the early detection and monitoring of PD.in the occipital region of the PD group can be usedtilized as a rapid and objective test indicator to screen for depressive symptoms in PD.Zhang et al. identified circadian rhythm genesAK3, RTN3, and LEPR as biomarkers in the progression of PD by regulating NK cells, however, the exact mechanism is not clear.Wang et al. confirmed that authenticated GPR78, CADM3, and CACNA1E were as the biomarkers that mostly mainly participated in pathways, such as the 'cell cycle' and 'hydrogen peroxide catabolic process', and They also found; five types of differential immune cells that differed between PD and control groups were identified. Together, these studies highlight the importance of combination of biomarkers and risk variables into predictive models , improving early diagnosis and monitoring of PD. Sme of them may serve as diagnostics (lncRNAs, P1 amplitude) or predictive (NVU, cathepsin B, APA2, circadian rhythm genesAK3) may shed novel light on the pathogenesis of PD.Both pharmaceutical and non-pharmacological (cognitive training, physical activity, and dietary changes) treatments are used to treat PD symptoms (Degirmenci et al., 2023;Ernst et al., 2024). Seven promising approaches were also highlighted by this showed that acupuncture, cognitive behavioral therapy, exercise and repetitive transcranial magnetic stimulation significantly improved sleep, depression, anxiety, cognition, constipation, and quality of life of PD patients.Studies suggest personalized pharmaceutical and non-pharmacological therapies for PD, with nicotine, Golexanolone, taVNS, acupuncture, and FMT showing promising antiparkinsonian properties, by modulating brain activity. Further research is needed to validate their sustainability, safety, and effectiveness.Bibliometric analysis is a systematic approach to evaluating scientific literature and detecting patterns, and effects by using quantitative tools to filter data from relevant sources (Passas, 2024). This research topic includes two bibliometric studies that significantly expand their respective fields. This research topic combines important studies on the risk factors, treatments, biomarkers and bibliometric analysis. The results of these studies provide a useful guide for clinicians in their practice and to suggest targets for researchers in developing new diagnostics and therapeutic strategies. We conclude that the results of these studies are a useful tool that help clinicians in their practice and motivate researchers to look for new developments.
Management of neuroleptic malignant syndrome induced by paliperidone: A case report of multidisciplinary treatment approaches, including apomorphine and electroconvulsive therapy
(Türk Nöroloji Derneği, 2025) Gültekin, Murat; Benli, Şeyma; Demirel Özsoy, Saliha; Değirmenci, Yıldız
A 34-year-old female patient with a history of bipolar affective disorder, who had been receiving paliperidone 100 mg monthly and biperiden 3 mg daily for the past two years, was admitted to the emergency department with a three-day history of fever, altered consciousness, dysphagia, mutism, rigidity, inability to walk, inability to speak, and vacant, meaningless stares. It was noted that her last paliperidone injection was administered 12 days before the hospitalization. Vital signs revealed a fever of 38.1°C, mild tachycardia, and normal blood pressure. Laboratory tests indicated leukocytosis and an elevated serum creatine kinase (CK) level of 1098 U/L (normal range: 39-308 U/L), suggesting muscle breakdown. Neurological examination revealed excessive sweating, confusion, rigidity, and dysphagia. A written informed consent was obtained from the patient.
Suicide risk in psychiatric patients: An analysis of demographic and psychosocial factors
(SOCIAL SCIENCES STUDIES JOURNAL, 2025) Er, Filiz; Duyan, Veli; Özkan, Cengiz; Taymur, İbrahim
The aim of this study is to assess the likelihood of suicide in patients diagnosed with psychiatric disorders and currently receiving treatment, and to examine the relationship between this likelihood and demographic data, as well as psychosocial factors. Using a descriptive and cross sectional model, the data from 165 participants were collected and evaluated through a personal information form and the Suicide Probability Scale (SPS). The study revealed significant relationships between suicide risk and variables such as age, education level, marital status, place of residence, and types of social support. It was also highlighted that the participants generally had a negative perception of their psychological health, and individuals lacking emotional social support showed higher levels of hopelessness and negative self-concept. Furthermore, individuals receiving low social support were found to have a higher suicide risk. The findings indicate that social work professionals can play a significant role in identifying individuals at risk for suicide and developing preventive measures. These results point to the necessity of strengthening social support systems and improving psychological health services.

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