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Structural and functional impact of lingual frenulum alterations on oral and craniofacial development in children during the mixed dentition stage
(Springer Nature Link, 2026) Vural, Yasemin; Esentürk, Gülce; Önder, Ömer Önder; Cebeci, Nesrin; Özen, Buğra
Background The clinical relevance of ankyloglossia in children remains controversial, largely due to the absence of standardized diagnostic criteria and the predominant reliance on morphological assessment. Evidence linking the combined anatomical and functional characteristics of the lingual frenulum to objective functional outcomes during mixed dentition remains limited. Therefore, this study aimed to evaluate the association between lingual frenulum characteristics and oral and craniofacial functional outcomes in children during the mixed dentition period. Methods In this cross-sectional study, 170 children aged 7–12 years were evaluated. Anatomical and functional characteristics of the lingual frenulum were assessed using the Marchesan Lingual Frenulum Protocol. Oro facial functions, including breathing pattern, mentalis muscle activity, and swallowing, were examined using selected components of the Orofacial Myofunctional Evaluation with Scores (OMES/OMES-E). Upper airway patency was evaluated using the Mallampati and Brodsky classifications, malocclusion was assessed clinically, and postural alignment was analyzed using the New York Posture Scale. Intergroup comparisons were performed (p < 0.05). Multivariate logistic regression analyses were conducted to identify independent predictors of swal lowing dysfunction. Results Maximum mouth opening did not differ significantly between groups (p = 0.137). However, reduced tongue range of motion (≤ 50%) was significantly more frequent in children with an altered frenulum (p < 0.001). No significant differences were observed in respiratory pattern, mentalis muscle activity, Mallampati or Brodsky scores (p > 0.05). Swallowing-related dysfunction, involving lip (p = 0.012) and tongue (p = 0.002) behavioral alterations, as well as malocclusion (p = 0.010), were significantly more prevalent in the altered frenulum group. Regression analyses demonstrated that altered frenulum independently predicted tongue-related swallowing dysfunction (OR = 2.513, p = 0.015), whereas breathing disturbance showed the strongest independent predictor (OR = 5.249, p < 0.001). Conclusion Lingual frenulum morphology was associated with reduced tongue mobility and domain-specific functional impairments, particularly in swallowing. These findings support the integration of functional evalua tion alongside structural assessment in the clinical management of ankyloglossia.
Comprehensive analyses of sox7 provide novel insights on its tumor suppressor role and its target genes with therapeutic implications in multiple myeloma
(MDPI Publishing, 2026) Ceylan, Arda; Hu, Xiaozhou; Hatipoğlu, Tevfik; Nainkwi, Fenangi Chiara; Payzın, Kadriye Bahriye; Özsan, Güner Hayri; Şirinoğlu Demiriz, Itır; Şeker, Ömer; Kakçı, Merve; Küçük, Can
Multiple myeloma (MM) is an incurable hematological malignancy. SOX7, located within the recurrently deleted 8p23.1 region in MM, is suggested to act as a tumor suppressor. We characterized SOX7 through genetic, epigenetic, and functional analyses in MM cell lines. SOX7 was frequently silenced due to deletion and/or promoter hypermethylation. Ectopic SOX7 expression in KMS-18 and MM.1S cell lines caused a progressive decline in SOX7-transduced cells and induced G1 cell cycle arrest and/or apoptosis. Although SOX7 re-expression did not enhance bortezomib efficacy, treatment with the pan-histone deacetylase inhibitor panobinostat induced G1 arrest, promoted apoptosis, and increased SOX7 expression in MM.1S cells. Whole-transcriptome sequencing identified G1/S progression-related Wnt/β-catenin pathway genes as major SOX7-regulated targets, while ChIP-Seq analysis revealed widespread genomic SOX7 occupancy in MM.1S. Flow cytometric analysis of permeabilized bone marrow tumor cells from newly diagnosed and relapsed MM patients demonstrated generally low SOX7 protein expression. Collectively, these results indicate that SOX7 functions as a tumor suppressor in MM, and its inactivation promotes cell cycle progression. The anti-myeloma effects of panobinostat in MM.1S cells may be partially mediated through SOX7 induction.
Prognostic nutritional index versus cally, conut, and car for predicting restenosis after endovascular treatment of superficial femoral artery chronic total occlusion
(Elsevier, 2026) İskender, Hakan; Kılıç, Ömer Abdulbaki; Jabrayilzade, Jabrayil; Veyisoğlu, İbrahim; Toprak, Cüneyt; Çakmak, Ender Özgün
Background: Inflammation- and nutrition-based indices have been associated with adverse outcomes after peripheral endovascular interventions, but their comparative performance re mains unclear. We compared the associations and discriminatory performance of the prognostic nutritional index (PNI), C-reactive protein—albumin—lymphocyte (CALLY) index, controlling nutritional status (CONUT) score, and C-reactive protein-to-albumin ratio (CAR) in relation to 6-month restenosis after endovascular treatment of superficial femoral artery chronic total occlu sion (SFA CTO). Methods: This retrospective cohort included 227 technically successful SFA CTO procedures performed between 2015 and 2021 with imaging-based 6-month restenosis assessment. The 4 indices were compared using receiver operating characteristic analysis and separate multivari able logistic regression models adjusted for clinical and lesion-related factors. Multiplicity correc tion and patient-cluster bootstrap internal validation were performed. Results: Restenosis occurred in 79 procedures (34.8%). PNI showed the highest discrimination (area under the curve [AUC] 0.728; 95% confidence interval [CI]: 0.662—0.794), compared with CONUT (0.625), CALLY (0.582), and CAR (0.568). After multivariable adjustment and multiplic ity correction, PNI (adjusted odds ratio [OR] 2.72 per 1-SD worsening; 95% CI 1.78—4.14) and CONUT (adjusted OR 1.61; 95% CI 1.17—2.22) remained independently associated with reste nosis, whereas CALLY and CAR did not. Adding PNI to the clinical base model increased the AUC from 0.670 to 0.782 and reduced the Brier score from 0.209 to 0.178. The improvement persisted after bootstrap validation (optimism-corrected AUC 0.740).
Clinically relevant depression in patients with type 1 and type 2 diabetes; A nationwide study (TEMD-2 depression)
(Springer Nature Link, 2026) Yüksel Güler, Bağdagül; Demirci, İbrahim; Haymana, Cem; Akbay, Esen; Evren, Bahri; Dizdar, Oğuzhan Sıtkı; Demir, Orhan; Ağbaht, Kemal; Salman, Serpil; Sönmez, Alper
Purpose Depression is a common but underrecognized comorbidity in individuals with diabetes and is associated with adverse clinical outcomes. This nationwide study aimed to determine the prevalence of clinically relevant depression (CRD) among adults with type 1 and type 2 diabetes in Türkiye and to identify clinical and metabolic factors independently associ ated with CRD. Methods This cross-sectional analysis was conducted within the Turkish nationwide survEy of glycemic and other Meta bolic parameters of patients with Diabetes mellitus-2 (TEMD-2), a multicenter study including adults followed in tertiary endocrinology centers across Türkiye. CRD was defined as a Patient Health Questionnaire-9 score ≥ 10 and/or current anti depressant use. Results A total of 5.266 patients were included. The prevalence of CRD was similar in type 1 and type 2 diabetes (29.4% vs. 27.6%, p = 0.345). In both diabetes types, CRD was significantly more common among women. Patients with CRD had higher body mass index, poorer glycemic control, higher rates of hypoglycemia, and lower achievement of metabolic targets. Microvascular and macrovascular complications were more frequent in patients with CRD. In multivariable analyses, female sex, smoking, and polypharmacy were independently associated with CRD in both diabetes types, while obesity, poor glyce mic control, and vascular complications were additional independent associates in type 2 diabetes. Conclusion CRD affects nearly one-third of adults with diabetes, regardless of diabetes type, and is associated with greater comorbidity burden and suboptimal metabolic control. These findings support routine depression screening as an integral component of comprehensive diabetes care. The study is registered at ClinicalTrials.gov (NCT06347445).
Editorial for special issue of deep brain stimulation
(Elsevier, 2026) İşler, Cihan; Değirmenci, Yıldız; Kocabıçak, Ersoy
Dear Colleagues, We are pleased to present the special issue consisting of selected topics that were presented at the fifth Clinical Neuroscience Course held in Atlas University, between 8 and 11 December, 2022. The course was organized by the national Deep Brain Stimulation Society of Turkiye, which is a chapter of the Deep Brain Stimulation Society.
HIV Infection HIV/AIDS in Türkiye: Current challenges and strategic solutions
(Springer Nature Link, 2026) Başarı Omak, Tuğçe; Seydaliyeva, Aytan; Madran, Bahar; Önal, Uğur; Ertürk Şengel, Buket; Tükenmez Tigen, Elif; Sayın Kutlu, Selda; Turan, Janet M.; Korten, Volkan; Ergönül, Önder
Purpose of Review This review aims to present the current status of the HIV epidemic in Türkiye, to identify the barriers to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95–95–95 targets, and to propose strategies to overcome these challenges. Recent Findings In Türkiye, HIV-related diagnostic and treatment services are integrated into the general health insurance system, and most contemporary antiretroviral therapy (ART) are available.Treatment initiation and virological suppression rates that approach international targets. However, challenges remain in early diagnosis and prevention, particularly among key populations. Recent epidemiological data also indicate a marked increase in HIV diagnosesamong women and young people while stigma, discrimination, limited access to testing, and low awareness among both the public and healthcare professionals continue to hinder progress. Summary Controlling the HIV epidemic in Türkiye requires strengthening early diagnosis, ensuring equitable access to ART, expanding prevention strategies such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and implementing multisectoral approaches to reduce stigma and discrimination. Coordinated actions among policymakers, healthcare providers, and community stakeholders will be critical for achieving national and global HIV targets. Highlights ● The number of HIV cases in Türkiye is increasing, with a notable rise among women and young people. ● According to ECDC 2024 data, Türkiye and Poland together reported 70% of all cases in the subregion. ● Reporting on the transmission route is lacking both in Türkiye and Poland. ● Awareness on HIV testing is low among the population and health care professionals. ● Access to HIV testing is limited. ● Access to the newest ART regimens is delayed. ● Among people living with HIV, refugees and irregular migrants are not covered by the national health insurance system.
Sex differences in ambulatory blood pressure among patients referred for 24-hour monitoring a retrospective cross-sectional study
(Lippincott Williams and Wilkins Ltd., 2026) Atmaca, Hasan; Gürbüz, Doğaç Çağlar; Erol, Mustafa Kemal; Yetkin, Ertan
Few studies have addressed the differences between hypertensive women and men regarding the diagnosis and control of blood pressure (BP). Accordingly, we aimed to assess the possible discrepancies in BP values between women and men who underwent 24-hour ambulatory blood pressure monitoring. The study population comprised all patients who underwent 24-hour ambulatory blood pressure monitoring, which was retrospectively screened and recorded. Demographic and clinical characteristics of 1204 patients were included in the analysis. Sex-specific analyses of all patients, including those with and without a former diagnosis of hypertension (HT), were performed. Two-thirds of the patients were women. In the general population, both systolic and diastolic BP levels in women were significantly lower than those in men. BP in women was also significantly lower than that in men, both in patients with and without a former diagnosis of HT. Our study demonstrated that women exhibited significantly lower systolic and diastolic BP values than men in this referral cohort, irrespective of a prior diagnosis of HT. While the exact mechanisms remain to be elucidated, this difference highlights the necessity for further research into sex-specific hemodynamic profiles. Consequently, further research is necessary to establish diagnostic thresholds and BP targets to achieve effective and targeted management of BP abnormalities in women.
Long-term seizure outcomes in patients with drug-resistant mesial temporal lobe epilepsy due to hippocampal sclerosis
(Elsevier, 2026) Gül, Günay; Eren, Fulya; Kandemir Yılmaz, Melek; Yandım Kuşcu, Demet; Keskinkılıç, Cahit; Tuğcu, Bekir
Objective: Resective surgery is a significant therapeutic option for patients with drug-resistant mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). Numerous studies have demonstrated the efficacy of epilepsy surgery in the short to median term. However, studies on long-term outcomes are limited in number. The objective of this study was to document the long-term prognosis and associated factors of patients under going resective surgery for MTLE. Methods: A retrospective analysis was conducted on the data of patients with drug-resistant MTLE due to HS who underwent resective surgery between 2001 and 2013 at our epilepsy centre. The demographics and clinical variables of the patients were documented and analysed in order to ascertain their long-term prognosis. The postoperative outcomes were evaluated in accordance with the Engel classification system. Results: Of the 45 patients (mean age: 44.64 ± 8.96, range: 31–67), 31 (68.89%) were male. The age at onset of epilepsy, age at surgery, and the duration of epilepsy at the time of surgery ranged from 0.25 to 26 years (11.51 ± 7.07), from 12 to 47 years (26.82 ± 8.14), and from 2 to 33 years (16.03 ± 7.85), respectively. The patients were followed up for 10–23 years (17.73 ± 2.96). HS was identified in 23 (51.11%) of the patients on the right side and 22 (48.89%) on the left. The pre-operative EEG recordings revealed temporal discharges in 40 (88.89%) patients unilaterally. 22 patients (48.89%) underwent amygdalohippocampectomy with a temporal lobectomy (AH+ATL), while 23 patients (51.11%) underwent selective amygdalohippocampectomy (SAH). 28 (62.22%) patients were classified as Engel I. The patients did not have any statistically significant difference in terms of gender, age at epilepsy onset, age at surgery, duration of epilepsy at surgery, side of HS, and surgical procedure according to Engel classification (p = 0.64, 0.08, 0.60, 0.25, 0.67, 0.10, respectively). Executive and memory functions were improved after surgery at 5th year. Conclusion: 62% of the patients were classified as Engel I. Although previous studies have suggested that certain factors may influence prognosis, our findings did not yield any statistically significant results in this regard. It is crucial that patients undergo surgical evaluation without delay to achieve seizure control and improve cognitive function.
Effects of rifaximin in fructose-induced steatohepatitis in rats
(Kare Publishing, 2026) Kıyak, Mevlüt
To the Editor, I read with interest the recently published article titled “Effects of rifaximin in fructose-induced steatohepatitis in rats.” The article dis cusses how rifaximin may protect against early liver damage caused by fructose. The researchers showed that rifaximin helps reduce cer tain biochemical markers and promote healing in inflamed tissue, providing insight into the interaction between the gut and liver in fatty liver disease, which plays a role in metabolic disorders.
Coronary heart disease in patients with type 2 biabetes: The role of traditional, behavioral and atherogenic risk factors in a large multicenter study
(Oxford University Press, 2026) Telci Çaklılı, Özge; Demirci, İbrahim; Haymana, Cem; Hacışahinoğulları, Hülya; Kılınç, Faruk; Karakoç, Ayhan; Sarı, Ramazan; Taşçı, İlker; Salman, Serpil; Ersoy, Canan; Bayram, Fahri; Satman, İlhan; Sönmez, Alper
Background Type 2 diabetes mellitus (T2DM) substantially increases the risk of coronary artery disease (CAD) through insulin resistance, inflammation, and related complications. In this large, nationally representative multicenter study, we investigated behavioral and metabolic risk factors associated with CAD in T2DM. Materials and Methods This cross-sectional study was conducted across Türkiye, including 70 endocrine clinics in 36 cities. Adults with T2DM followed at the same center for at least one year were included. Sociodemographic, anthropometric, clinical, laboratory, and lifestyle data were recorded using a standardized web-based system. Results A total of 5707 patients with diabetes were recruited, of whom 4956 (86.8%) had T2DM (mean age 58.9 ± 10.0 years; 59.8% women). CAD status was available in 4750 patients, among whom 1061 (22.3%) had CAD. CAD was more frequent in men than women (30.4% vs 16.9%, P < .001). Patients with CAD were older (62.8 ± 8.6 vs 57.8 ± 10.2 years, P < .001) and had longer diabetes duration (16.1 ± 8.8 vs 12.2 ± 7.7 years, P < .001). Body mass index was lower (31.2 ± 5.8 vs 31.8 ± 6.8 kg/m2, P = .005), whereas waist circumference was higher (106.7 ± 13.7 vs 105.1 ± 14.1 cm, P = .004). Lower income was associated with CAD (23.4% vs 19.5%, P = .003), whereas smoking and exercise were not (P = .219 and P = .977). Hypertension was associated with CAD (28.2% vs 14.5%, P < .001). Systolic blood pressure was higher (126.1 ± 13.6 vs 124.3 ± 13.6 mmHg, P = .004), while diastolic pressure did not differ (P = .603). HbA1c was higher in the CAD group (8.27 ± 1.94 vs 7.84 ± 1.89%, P < .001), and hypoglycemia was more frequent (24.6% vs 20.8%, P = .002). In multivariable logistic regression, independent predictors of CAD were older age (OR 1.04, 95% CI 1.03-1.05, P < .001), male sex (OR 0.39, 95% CI 0.33-0.46, P < .001), current smoking (OR 1.37, 95% CI 1.12-1.66, P = .002), hypertension (OR 2.00, 95% CI 1.68-2.38, P < .001), microvascular complications (OR 1.48, 95% CI 1.26-1.74, P < .001), higher HbA1c (OR 1.12 per %, 95% CI 1.07-1.17, P < .001), longer diabetes duration (OR 1.04 per year, 95% CI 1.02-1.05, P < .001), and lower income (OR 0.74, 95% CI 0.62-0.88, P = .001). Exercise, diet, hypoglycemia, education, and body mass index were not independently associated with CAD (all P > .05). Conclusion In this large national cohort of T2DM patients, CAD was independently associated with classical cardiometabolic risk factors, microvascular complications, and lower income, whereas lifestyle factors were not independently associated after adjustment. These findings highlight dominant role of cumulative metabolic burden and vascular damage in determining CAD risk and emphasize the importance of early, sustained, risk factor–targeted management.
Gray zone of hypertension thresholds values can be overcome by individualized symptom-oriented approaches
(Lippincott Williams and Wilkins Ltd., 2026) Yetkin, Ertan; Atmaca, Hasan; Gürbüz, Dogaç Çağlar; Yalta, Kenan; Erol, Mustafa Kemal
Dear Editor, We have read with great interest the recently published article of Chung et al. [1]. Briefly, they reassessed the sensitivity, specificity and diagnostic accuracy of home blood pressure monitoring (HBPM) by changing threshold values for the diagnosis of hypertension from 135/85 to 130/80 mmHg in 646 participants who were suspected of having hypertension (office blood pressure ≥140/90 mmHg). Eventually, they have found that lowering the diagnostic threshold of home hypertension from 135/85–130/80 mmHg significantly enhances the diagnostic sensitivity of HMBP.
A global consensus on the critical care management of acute‑on‑chronic liver failure patients: The APASL ACLF beijing position paper
(Springer Nature Link, 2026) Chen, Tao; Choudhury, Ashok; Liu, Wei; Zhang, Meng; Wu, Wenhui; Xiang, Huiling; Wang, Xiaojing; Abbas, Zaigham; Örmeci, Necati; Ning, Qin
Background and aims Acute-on-chronic liver failure (ACLF) is a severe syndrome in patients with chronic liver disease, marked by rapid multi-organ failure and high short-term mortality. Managing ACLF requires intensive care, but standard ized global guidelines were previously lacking. The APASL ACLF Research Consortium (AARC) developed this position paper to establish a unified, evidence-based consensus for its critical care management. Methods A global collaboration of 109 experts employed a systematic methodology to address key aspects of ACLF care. Sections were drafted by specialist teams, with recommendations developed using the GRADE system. Draft statements underwent iterative review and refinement, followed by an expert panel consensus process consisting of open show-of-hands voting during the APASL Annual Conference in March 2025 in Beijing and a subsequent anonymous online voting round. Results The consensus delivers 104 position statements. Key recommendations include using prognostic scores (AARC, CLIF-C ACLF, GIC) for ICU transfer and treatment decisions, and aggressively managing precipitating factors or complica tions like infections. It details organ-specific support for liver, kidney, and brain failure, advocating for early, targeted antibi otics and careful fluid management. The role of bridging therapies (plasma exchange, artificial liver systems) and nutritional support is emphasized. For transplantation, the guidelines provide criteria for patient selection and timing, particularly for alcohol-related ACLF. Conclusions The APASL ACLF Beijing Position Paper provides a comprehensive, standardized framework for managing critically sick ACLF patients. Integrating multidisciplinary expertise and current evidence, these guidelines aim to optimize care, inform clinical decisions, and improve survival for this high-risk population. As a few recommendations are supported predominantly by data from different continents, they should therefore be interpreted in local contexts.
Turkish cross-sectional survEy of glycemic and other metabolic parameters in patients with type 2 diabetes in 2023: Comparison with 2018 nationwide data (TEMD-2 study)
(Elsevier, 2026) Sönmez, Alper; Haymana, Cem; Demirci, İbrahim; Çetinarslan, Berrin; Gönen, Mustafa Sait; Akbaş, Emin Murat; Yenidünya Yalın, Gülşah; Avcı, Uğur; Taşcı, İlker; Salman, Serpil; Ersoy, Canan; Bayram, Fahri; Satman, İlhan
Aim: Five years after the first “Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with type 2 Diabetes” (TEMD-1), attainment of glycemic, arterial blood pressure (ABP), and LDL-cholesterol (LDL-C) goals was re-investigated in patients with type 2 diabetes mellitus (T2DM), with an additional focus on therapeutic inertia. Methods: This cross-sectional study consecutively enrolled patients from 70 tertiary endocrine centers across Türkiye (November 2022–January 2023). Metabolic targets were HbA1c <7% (<53 mmol/mol), home ABP <135/85 mmHg, and risk-stratified LDL-C <55, <70, or <100 mg/dL (<1.4, <1.8, or <2.6 mmol/L). Thera peutic inertia was defined as failure to intensify treatment at enrollment. Results: Among the 4956 participants (mean age: 58.9 ± 10.0 years, women: 59.8%), HbA1c, ABP, LDL-C and triple metabolic control target attainment rates were 36.7%, 71.1%, 8.7%, and 2.8%, respectively. Glycemic control rate was found lower than the previous survey (40.0% vs. 36.7%, p < 0.001), while LDL-C control rate improved (7.0% vs. 8.7%, p = 0.002). Patients with established cardiovascular disease (CVD) showed worse outcomes, with triple metabolic control rate of 1.6%. The rate of severely uncontrolled diabetes (HbA1c >9%/ 75 mmol/mol) was 23.6%. Therapeutic inertia was observed by 33.5%, persisting uniformly across subgroups. Younger age, male sex, longer diabetes duration, lower socioeconomic status, and microvascular complications were independently associated with poor glycemic control. Conclusions: Metabolic control remains suboptimal in Turkish T2DM patients, and one-third of patients with severe hyperglycemia showed therapeutic inertia. Systematic interventions and intensified strategies are ur gently needed to improve diabetes outcomes and treatment inertia (ClinicalTrials.gov number NCT06347445).
Resmetirom and semaglutide therapy for patients with MAFLD in the MENA region: Expert panel recommendations
(Taylor & Francis, 2026) Fouad, Yasser; AlNaamani, Khalid M.; Alawadi, Fatheya; Al Hassani, Abdulla; Alkhalidi, Nawal; Hotayt, Bilal; Abaalkhail, Faisal; Rouabhia, Samir; Örmeci, Necati; Eslam, Mohammed
Introduction: Metabolic dysfunction–associated fatty liver disease (MAFLD) affects 25–30% of the global population, with the Middle East and North Africa (MENA) region showing some of the highest prevalence rates, reaching up to 40%. MAFLD is a common cause of cirrhosis and hepatocellular carcinoma and is a leading indication for liver transplantation in this region. Hitherto, there have been no specific pharmacotherapies for MAFLD. However, the recent conditional approval of resme tirom and semaglutide by the FDA for the treatment of non-cirrhotic moderate-to-advanced (fibrosis stages 2 or 3) metabolic-associated steatohepatitis (MASH) offers a much-needed therapeutic option for this largely underserved condition. Areas covered: An expert panel from the MENA region conducted a comprehensive literature search via PubMed and Google Scholar, focusing on clinical trials and international guidelines for resmetirom and semaglutide. This review identifies the target treatment population, proposes criteria for cessation of therapy, outlines monitoring protocols, and addresses regional knowledge gaps. Expert opinion: The approval of the first two drugs for MASH is a milestone. Access to and affordability of these therapies will be the crucial determinants of their actual adoption. Future efforts should consider individualized treatment pathways stratified by cost, regulatory status, and healthcare infra structure, while generating further regional evidence.
Parental awareness, knowledge, and hesitancy toward HPV vaccination for adolescents: A cross-sectional study
(Sociedad Argentina de Pediatria, 2026) Güven, Deniz; Köle, Mehmet Tolga; Örün, Emel; Çaylan, Nilgün; Küçük, Elif; Kandemir, İbrahim; Öztürk, Seval; Kondolot, Meda
Background. Human papillomavirus (HPV) is a prevalent sexually transmitted infection and major cause of cervical and anogenital cancers. This study aimed to assess parental knowledge, vaccine hesitancy, and health beliefs concerning HPV infection and vaccination. Methods. This cross-sectional study was conducted using convenience sampling among parents of adolescents aged 9–18 attending outpatient clinics at a tertiary hospital. The study collected sociodemographic characteristics and used the Health Belief Model Scale for HPV Infection and Vaccination to assess health beliefs, in order to identify factors associated with parental perceptions and vaccination attitudes. Results. A total of 320 parents participated in the study; 82.8% were mothers. Self-reported HPV infection was low (1.9%), and only 3.4% of parents and 2.8% of their children had been vaccinated. Awareness about HPV infection was 75%, and that of the HPV vaccine was 67.2%. However, only 30% of parents were willing to vaccinate their children, while 47.5% were uncertain. The most commonly reported barriers were lack of awareness (33.9%) and concerns about side effects (26.4%). Higher parental education, family income, and prior HPV knowledge were positively associated with both awareness and willingness to vaccinate children, whereas having multiple adolescents was associated with increased vaccine hesitancy. Conclusion. Parental awareness of HPV infection and vaccination was 75% and 67.2%, respectively, while vaccination rates among adolescents were very low. Higher parental education, income, and prior HPV knowledge were associated with favorable perceptions of vaccination. Addressing knowledge gaps and reducing perceived barriers through educational interventions may help increase HPV vaccination uptake among adolescents.
A multisociety consensus statement on a new common definition and diagnostic criteria for PSVD or NCPF
(Elsevier, 2026) Hernandez Gea, Virginia; Paradis, Valerie; Guindi, Maha; Alves, Venancio A.F.; Aqul, Amal; Cerda, Eira; Darwish Murad, Sarwa; Das, Prasenjit; Örmeci, Necati; Rautou, Pierre Emmanuel
Noncirrhotic portal hypertension has historically been described using heterogeneous and region-specific terminology—such as idiopathic portal hypertension (IPH), noncirrhotic portal fibrosis (NCPF), obliterative portal venopathy, and nodular regenerative hyperplasia—leading to substantial variability in diagnosis, reporting, and international research collaboration. Differences in guideline definitions from major societies (AASLD, EASL, and APASL), together with the presence of characteristic histologic lesions in patients without clinically overt portal hypertension, have further complicated disease classification. To address these chal lenges, a large, multisociety, international initiative was convened to harmonize nomenclature and diagnos tic criteria. Representatives from liver, pathology, and pediatric hepatology societies across the Americas, Europe, and Asia participated in a structured consensus process that included specialized working groups and external Delphi validation. The initiative produced a globally harmonized and implementable diagnostic framework. Consensus was reached that the terms porto-sinusoidal vascular disorder (PSVD) and NCPF may be used interchangeably when identical diagnostic criteria are applied, and that they should be written as PSVD or NCPF. The diagnosis was defined as fundamentally clinicopathological, requiring integrated assess ment. Core principles include the need for a high-quality liver biopsy (≥ 10 mm), mandatory exclusion of cir rhosis, and systematic exclusion of specific alternative conditions. Importantly, the consensus recognizes that PSVD or NCPF may be diagnosed even without clinical portal hypertension and may coexist with other liver diseases, provided cirrhosis is excluded. Standard-ized major and minor histologic criteria were devel oped collaboratively by expert pathologists and externally validated. Features of portal hypertension were harmonized into specific and nonspecific categories applicable to routine clinical practice. An integrated diagnostic scoring system incorpo-rating histology, clinical features, associated conditions, and concommi tant etiologies was developed and validated using the Delphi method. This consensus provides the first inter nationally endorsed, unified framework for the diagnosis of PSVD or NCPF. Its global implementation is expected to reduce diagnostic variability, improve comparability across regions, and facilitate the develop ment of robust, internationally harmonized clinical and translational research cohorts.
A multisociety consensus statement on a new common definition and diagnostic criteria for PSVD or NCPF
(Elsevier, 2026) Hernandez Gea, Virginia; Paradis, Valerie; Guindi, Maha; Alves, Venancio A.F.; Aqul, Amal; Cerda, Eira; Darwish Murad, Sarwa; Das, Prasenjit; Örmeci, Necati; Rautou, Pierre Emmanuel
Non-cirrhotic portal hypertension has historically been described using heterogeneous and region-specific terminology, such as idiopathic portal hypertension (IPH), non-cirrhotic portal fibrosis (NCPF), obliterative portal venopathy, and nodular regenerative hyperplasia, leading to substantial variability in diagnosis, reporting, and international research collaboration. Differences in guideline definitions from major societies (AASLD, EASL, and APASL), together with the presence of characteristic histologic lesions in patients without clinically overt portal hypertension, have further complicated disease classification. To address these challenges, a large, multisociety, international initiative was convened to harmonize nomenclature and diagnostic criteria. Representatives from liver, pathology, and pediatric hepatology societies across the Americas, Europe, and Asia participated in a structured consensus process that included specialized working groups and external Delphi validation. The initiative produced a globally harmonized and implementable diagnostic framework. Consensus was reached that the terms porto-sinusoidal vascular disorder (PSVD) and NCPF may be used interchangeably when identical diagnostic criteria are applied, and that they should be written as PSVD or NCPF. The diagnosis was defined as fundamentally clinicopathological, requiring integrated assessment. Core principles include the need for a high-quality liver biopsy (> −10 mm), mandatory exclusion of cirrhosis, and systematic exclusion of specific alternative conditions. Importantly, the consensus recognizes that PSVD or NCPF may be diagnosed even without clinical portal hypertension and may coexist with other liver diseases, provided cirrhosis is excluded. Standardized major and minor histologic criteria were developed collaboratively by expert pathologists and externally validated. Features of portal hypertension were harmonized into specific and nonspecific categories applicable to routine clinical practice. An integrated diagnostic scoring system incorporating histology, clinical features, associated conditions, and concommitant etiologies was developed and validated using the Delphi method. This consensus provides the first internationally endorsed, unified framework for the diagnosis of PSVD or NCPF. Its global implementation is expected to reduce diagnostic variability, improve comparability across regions, and facilitate the development of robust, internationally harmonized clinical and translational research cohorts.
A multisociety consensus statement on a new common definition and diagnostic criteria for PSVD or NCPF
(Springer Nature Link, 2026) Hernandez Gea, Virginia; Paradis, Valerie; Guindi, Maha; Alves, Venancio A.F.; Aqul, Amal; Cerda, Eira; Darwish Murad, Sarwa; Das, Prasenjit; Örmeci, Necati; Rautou, Pierre Emmanuel
Noncirrhotic portal hypertension has historically been described using heterogeneous and region-specific terminology—such as idiopathic portal hypertension (IPH), noncirrhotic portal fibrosis (NCPF), obliterative portal venopathy, and nodular regenerative hyperplasia—leading to substantial variability in diagnosis, reporting, and international research collabora tion. Differences in guideline definitions from major societies (AASLD, EASL, and APASL), together with the presence of characteristic histologic lesions in patients without clinically overt portal hypertension, have further complicated disease classification. To address these challenges, a large, multisociety, international initiative was convened to harmonize nomen clature and diagnostic criteria. Representatives from liver, pathology, and pediatric hepatology societies across the Ameri cas, Europe, and Asia participated in a structured consensus process that included specialized working groups and external Delphi validation. The initiative produced a globally harmonized and implementable diagnostic framework. Consensus was reached that the terms porto–sinusoidal vascular disorder (PSVD) and NCPF may be used interchangeably when identical diagnostic criteria are applied, and that they should be written as PSVD or NCPF. The diagnosis was defined as fundamen tally clinicopathological, requiring integrated assessment. Core principles include the need for a high-quality liver biopsy (≥10 mm), mandatory exclusion of cirrhosis, and systematic exclusion of specific alternative conditions. Importantly, the consensus recognizes that PSVD or NCPF may be diagnosed even without clinical portal hypertension and may coexist with other liver diseases, provided cirrhosis is excluded. Standardized major and minor histologic criteria were developed col laboratively by expert pathologists and externally validated. Features of portal hypertension were harmonized into specific and nonspecific categories applicable to routine clinical practice. An integrated diagnostic scoring system incorporating histology, clinical features, associated conditions, and concommitant etiologies was developed and validated using the Delphi method. This consensus provides the first internationally endorsed, unified framework for the diagnosis of PSVD or NCPF. Its global implementation is expected to reduce diagnostic variability, improve comparability across regions, and facilitate the development of robust, internationally harmonized clinical and translational research cohorts.
Juvenile xanthogranuloma in a congenital melanocytic nevus
(Mattioli 1885, 2026) Duman, Nilay; Yaman, Banu; Oraloğlu, Göktürk; Kararaslan, Işıl
A 6-year-old boy was evaluated for a 6-month history of a 2x1mm yellowish papule that developed within a congenital melanocytic nevus (CMN) located on his back. Dermoscopic examination showed a homogeneous yellowish background with localized pigmented struc tures. In vivo reflectance confocal microscopy revealed an area with sharp borders, characterized by thinning of the epidermis and the absence of rete ridges. At the dermo- epidermal junction, the dermal papillae did not exhibit the typical ringed pattern.
Role of S100B, neuron-specific enolase, and adrenomedullin in differentiating central and peripheral vertigo
(Bayrakol Medical Publisher, 2026) Onur, Bahaeddin; Özdemir, Serdar; Koçak, Mehmet; Ünal Akoğlu, Ebru; Demir, Hasan; Cimilli Öztürk, Tuba; Onur, Özge Ecmel
Aim: This study aimed to evaluate S100B, adrenomedullin (ADM), and neuron-specific enolase (NSE) as diagnostic biomarkers to differentiate central and peripheral vertigo in patients with dizziness. Methods: A prospective cohort study was conducted with 88 patients (58% women) presenting with dizziness. Patients were categorized based on MRI findings into two groups: those with acute lesions (central vertigo) and those without lesions (peripheral vertigo). S100B, ADM, and NSE levels were measured and compared between the groups to assess their diagnostic value for central vertigo. Results: Significant differences were found in S100B, NSE, and ADM levels between the central and peripheral vertigo groups (p=0.003, 0.008, and 0.010, respectively). Factors predicting MRI-detected lesions included age, mean arterial pressure, movement-induced and positional vertigo, neurological findings, history of hypertension, lack of response to symptomatic treatment, and elevated S100B, ADM, and NSE levels. Logistic regression analysis identified the lack of response to symptomatic treatment as the only significant predictor (p=0.0148). Conclusion: S100B, ADM, and NSE levels significantly differ between central and peripheral vertigo, suggesting their potential as diagnostic biomarkers. However, only the lack of response to symptomatic treatment was a significant predictor. Further research is needed to validate these biomarkers alongside clinical assessments and imaging.

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