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Acute-on-chronic liver failure (ACLF): The ‘Kyoto consensus’-steps from Asia
(Springer, 2025) Choudhury, Ashok; Kulkarni, Anand V.; Arora, Vinod; Sood, Ajit; Dökmeci, Abdul Kadir; Chowdhury, Abhijeet; Koshy, Abraham; Duseja, Ajay; Örmeci, Necati; Mishra, Ajay Kumar
Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplanta tion. There have been various defnitions proposed worldwide. The frst consensus report of the working party of the Asian Pacifc Association for the Study of the Liver (APASL) set in 2004 on ACLF was published in 2009, and the “APASL ACLF Research Consortium (AARC)” was formed in 2012. The AARC database has prospectively collected nearly 10,500 cases of ACLF from various countries in the Asia–Pacifc region. This database has been instrumental in developing the AARC score and grade of ACLF, the concept of the ‘Golden Therapeutic Window’, the ‘transplant window’, and plasmapheresis as a treatment modality. Also, the data has been key to identifying pediatric ACLF. The European Association for the Study of Liver-Chronic Liver Failure (EASL CLIF) and the North American Association for the Study of the End Stage Liver Disease (NACSELD) from the West added the concepts of organ failure and infection as precipitants for the development of ACLF and CLIF-Sequential Organ Failure Assessment (SOFA) and NACSELD scores for prognostication. The Chinese Group on the Study of Severe Hepatitis B (COSSH) added COSSH-ACLF criteria to manage hepatitis b virus-ACLF with and without cirrhosis. The literature supports these defnitions to be equally efective in their respective cohorts in identifying patients with high mortality. To overcome the diferences and to develop a global consensus, APASL took the initiative and invited the global stakeholders, including opinion leaders from Asia, EASL and AASLD, and other researchers in the feld of ACLF to identify the key issues and develop an evidence-based consensus document. The consensus document was presented in a hybrid format at the APASL annual meeting in Kyoto in March 2024. The ‘Kyoto APASL Consensus’ presented below carries the fnal recommendations along with the relevant background information and areas requiring future studies.
A little-known vaginitis-like picture: Cytolytic vaginosis
(Clinical Laboratory Publications, 2025) Kömeç, Selda; Aydın, Mustafa Derya
Background: Cytolytic vaginosis (CV) is a condition characterized by an increase in lactobacilli in the vaginal flora, causing complaints of discharge, itching, dyspareunia, and dysuria. Since there are no antimicrobials in the treatment protocols of CV, the diagnostic and therapeutic criteria of which were first defined by Cibley, differential diagnosis of CV from other vaginitis agents will prevent unnecessary use of antimicrobials and recurrent com-plaints. In our study, we aimed to determine the frequency of CV in patients presenting with vaginitis complaints and the diagnostic accuracy of the diagnostic criteria. Methods: In total, 140 women, 103 with vaginitis complaints and 37 without vaginitis complaints, were examined for bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), Trichomonas vaginalis (Tv), and CV. For the diagnosis of CV, vaginal pH ≤ 4.5, the presence of a large number of lactobacilli in Gram staining, the presence of false clue cells, cytolysis in vaginal epithelial cells, leukocyte deficiency or absence, absence of Tv, BV, or VVC were used. Results: Out of 103 patients, 30 (29.1%) had BV, 20 (19.4%) had VVC, 20 (19.4%) had CV, 5 (4.9%) had BV and VVC, and 4 (3.9%) had Tv. The sensitivity and specificity of the diagnostic criteria were 80% and 99% for epithelial cytolysis, 70% and 99% for false clue cells, 100% and 86% for pH ≤ 4.5, and 100% and 56% for numerous lactobacilli, respectively. Conclusions: In Turkey and worldwide, CV is not considered in vaginitis cases. In our study, the high rate of 19.4% in vaginitis cases shows the need for comprehensive research on this subject.
Maternal health experiences on respectful and adequate care of immigrant women: A prospective multicenter study
(Wiley, 2024) Topçu, Elif Göknur; Terzioğlu, Merve; Okumuş, Zihniye Gonca; Şavklı, Ayşe Özge; Demirkıran, Cansu İrem
Objective: Migration of pregnant women can be challenging. Access to adequate and respectful care may not be possible. We aimed to assess the maternity care that im migrant women receive and their satisfaction with the care they experience. Methods: This multicenter prospective study was conducted in a tertiary public hos pital and a private hospital in Istanbul between April 2023 and July 2023. A face-to face questionnaire was completed in the postpartum department by obstetricians and translators. Results: In total, 267 patients participated in this study. A majority of these patients delivered at the public hospital (75%). Approximately 21% of all deliveries in both hos pitals were with foreign mothers. A majority of the patients (82%) in the public hospi tal said they easily reached midwives, nurses, and an obstetrician, while this number rose to 100% in the private hospital. Patients in the private hospital had a higher average number of obstetrician visits compared to those in the public hospital, which was statistically significant (P< 0.05). Patients in the public hospital were significantly less informed about various maternity topics than those in the private hospital group (P< 0.001 for all topics). Most patients said their ideas and thoughts were taken seri ously by the health care providers (80% and 97% in the public and private hospitals, respectively). Almost all patients recommended giving birth in the same hospital (94% vs. 96%, public and private hospitals, respectively), while around 99% recommended giving birth in Turkey. Conclusion: Immigrant women are overall satisfied with the care they receive in both public and private hospitals. They have easier access to obstetricians in private hospi tals, as well as being more informed on maternal health issues. Clinical efforts should focus on patient education in antenatal care.
Ultrasound-assisted enhancement of bioactive compounds in hawthorn vinegar: A functional approach to anticancer and antidiabetic effects
(Elsevier, 2025) Öğüt, Selim; Türkol, Melikenur; Yıkmış, Seydi; Bozgeyik, Esra; Abdi, Gholamreza; Koçyiğit, Emine; Aadil, Rana Muhammad; Seyidoğlu, Nilay; Karakçı, Deniz; Tokatlı, Nazlı
In this study, the effects of ultrasound treatment on bioactive components and functional properties of hawthorn vinegar (Crataegus tanacetifolia) were investigated. Parameters such as total phenolic compound (TPC), total flavonoid content (TFC), ascorbic acid (AA), DPPH radical scavenging activity and CUPRAC reducing capacity were optimised by surface response method (RSM) and 14 min duration and 61.40 % amplitude were determined as the most suitable treatment conditions. The results showed that ultrasound treatment improved the antioxidant properties of hawthorn vinegar by increasing TPC, TFC, DPPH and CUPRAC values. In addition, it was observed that hawthorn vinegar samples exhibited anticancer effects in cell culture experiments. In experiments on A549 (lung), MCF-7 (breast) and HT-29 (colon) cancer cell lines, ultrasound-treated vinegar increased apoptotic effects, suppressed cell migration and reduced necrosis rates in some cell lines. In particular, ultrasound treatment of vinegar resulted in a reduction in the expression of anti-apoptotic genes (BCL-2 and XIAP) and an enhancement in the expression of pro-apoptotic genes (BAX). These findings suggest that ultrasound technology preserves and enhances the bioactive components of hawthorn vinegar, improves its anticancer properties and increases its potential for use as a functional food product.
New 2-indolinone-indole hybrid compounds carrying a benzoyl moiety as tyrosine kinase inhibitors
(Elsevier, 2025) Camcı Eren, Merve; Cinek, Tuğçe; Cihan Üstündağ, Gökçe; Özen Eroğlu, Güneş; Yıldırım, Merve; Genç Akar, Öyküm; Erol Bozkurt, Ayşe; Sancar, Serap; Öztay, Füsun; Soylu Eter, Özge; Bolkent, Şehnaz; Kuruca, Serap
In this study, new 2-indolinone-indole hybrid compounds (4a-s) carrying a benzoyl moiety were synthesized and their cytotoxic effects were examined against pancreatic (MIA-PaCa-2) and colon (HT-29 and HCT-116) cancer cells by MTT assays. Most of the tested compounds exhibited a better inhibitory activity and safety profile than the reference standard sunitinib malate against MIA-PaCa-2 and HCT-116 cancer cells. Compound 4e displayed the greatest cytotoxic effect on HCT-116 cell with an IC50 value of 0.16 µM and a remarkable selectivity profile (SI > 625). Compound 4g exhibited a selective activity against HCT-116 cancer cell (IC50 = 0.34 µM), with no activity against the other cells at the highest concentrations tested. Compound 4b demonstrated a potent inhibitory activity against MIA-PaCa-2 cell (IC50 = 0.54 µM). General tyrosine kinase inhibitor (TKI) activities and apoptotic effects were examined for compounds 4b, 4e and 4g. The tested compounds were observed to significantly reduce general TK activities in HCT-116 cell and induce apoptosis in HCT-116 and MIA-PaCa-2 cells. Lead compound 4e, the most effective general TKI, was determined to have a specific SRC kinase inhibitor effect in HCT-116 cell and the molecular modelling studies were performed to understand the potential binding mode at the ATP-binding domain of SRC kinase.
Quantification of agnuside in human plasma with a novel high-performance liquid chromatographic method and pharmacokinetic study
(Oxford University Press, 2025) Egeli, Derya; Tiris, Gizem; Kepekçi Tekkeli, Şerife Evrim
This study presents a combination of High Performance Liquid Chromatography (HPLC) and ultraviolet (UV) detection that provides the quantification of agnuside in human plasma specimens. Reverse-phase chromatographic separation was carried out with C18 column (150 mm × 4.6 mm × 5 μm), at 25°C with isocratic elution of the mobile phase containing methanol: 0.1% formic acid (35:65 v/v) at 0.6 mL/min flow rate. Experiments were carried out at a wavelength of 258 nm. The retention time of the analyte is 9.70 ± 0.01 min. The developed technique was validated based on the International Conference on Harmonization guideline. The correlation coefficient of the technique was 0.9915, and the calibration range was 5–125 μg/mL. The recovery value of the proposed method was found to be 101.4%, and the precision of the method was calculated as 6.35 with the highest RSD% value. A pharmacokinetic study was performed by administering agnuside to a healthy volunteer.
Toward green and sustainable zinc-ion batteries: The potential of natural solvent-based electrolytes
(Wiley, 2025) Yaman Uzunoğlu, Gülşah; Yüksel, Recep
Zinc-ion batteries (ZIBs) are emerged as a promising alternative for sustainable energy storage, offering advantages such as safety, low cost, and environmental friendliness. However, conventional aqueous electrolytes in ZIBs face significant challenges, including hydrogen evolution reaction (HER) and zinc dendrite formation, compromising their cycling stability and safety. These limitations necessitate innovative electrolyte solutions to enhance ZIB performance while maintaining sustainability. This review explores the potential of natural solvent-based electrolytes derived from renewable and biodegradable resources. Natural deep eutectic solvents (DES), bio-ionic liquids, and biomass-derived organic compounds present unique advantages, including a wider electrochemical stability window, reduced HER activity, and controlled zinc deposition. Examples include DESs based on choline chloride (ChCl), glycerol-based systems, and biomass-derived solvents such as γ-valerolactone (GVL) and aloe vera, demonstrating improved cycling stability and dendrite suppression. Despite their promise, challenges such as high viscosity, cost, and scalability remain critical barriers to commercialization. This review underscores the need for further research to optimize natural solvent formulations, enhance Zn anode compatibility, and integrate these systems into practical applications. By addressing these challenges, natural solvent-based electrolytes can pave the way for safer, high-performance, and environmentally sustainable ZIBs, particularly large-scale energy storage systems.
Viewpoints of nurse auditors regarding the profession: A qualitative study
(Emerald Publishing, 2025) Aydoğdu, Ana Luiza Ferreira
Abstract Purpose – This study aims to understand the experiences of Brazilian nurse auditors in the practice of their profession, exploring the importance, challenges, rewards and strategies related to the occupation. Design/methodology/approach – This is a qualitative descriptive study conducted with 44 nurse auditors. An online, open-ended questionnaire was used. Thematic content analysis was performed. Findings – Five themes were identified: (1) functions of a nurse auditor; (2) skills required for a nurse auditor; (3) learning to be a nurse auditor; (4) advantages of being a nurse auditor and (5) challenges faced by a nurse auditor. Also, a total of 16 subthemes were presented. Research limitations/implications – The study critically examined essential aspects of auditing through the lens of nurse auditors, addressing a relevant topic. However, limitations must be acknowledged, including the use of self-report questionnaires, regional representation disparities, the scarcity of international articles on the topic and potential researcher bias. Practical implications – The study underscores the importance of increasingly integrating nurse auditors into the workforce while emphasizing the need to enhance the capacitation of these professionalsthrough theoretical and practical education. It highlights the significance of educating other multidisciplinary team members about the nurse auditor’s crucial role in fostering teamwork and ensuring the quality of healthcare services. Originality/value – To the best of the author’s knowledge, this is the first study conducted with Brazilian nurse auditors, exploring crucial aspects of auditing from the perspective of these professionals. Understanding the critical role of nurse auditorsinmaintaining and improving healthcare quality can enhance public trust in healthcare systems.
Preconcentration of bismuth using nickel hydroxide nanoflower from water samples and determination by FAAS
(Springer, 2025) Yıldız, Barış; Durukan, İlknur; Şaylan, Meltem; Zaman, Buse Tuğba; Bakırdere, Sezgin
In this study, a preconcentration strategy based on Ni(OH)2 nanofowers (NFs) was developed for the extraction/separation of bismuth ions from environmental water samples before the determination by fame atomic absorption spectrometry (FAAS). The homogeneous coprecipitation method was employed for the synthesis of the fower-shaped Ni(OH)2 and used as an adsorbent for the preconcentration of bismuth. The extraction variables were determined by a univariate optimization strategy to obtain maximum extraction performance. The optimal parameters of the method were as follows: 15 min mechanical shaking at 120 rpm, pH 6.0 bufer solution (1.0 mL), 20 mg of sorbent, and 250 µL of 6.0 M nitric acid for the elution. Under the optimized instrumental and extraction conditions, LOD (limit of detection), LOQ (limit of quantitation), and linear dynamic range were determined as 2.8 µg/L, 9.4 µg/L, and 0.010–0.30 mg/L, respectively. The enhancement factor of the sorbent-based method was calculated as 139.1-folds by comparing the slopes of calibration plots obtained from FAAS and the preconcentration method. To assess the feasibility and reliability of the developed method, tap water and spring water samples were analyzed under optimized conditions. The satisfactory %recoveries were obtained close to 100% using the direct comparison method. The obtained results show that the presented method is a promising candidate for efcient extraction and trace determination of bismuth in several sample mediums.
Green synthesis of zinc oxide nanoparticles including Rosehip (Rosa canina L.) seed extract: Evaluation of its characterization and bioactivity properties
(Wiley, 2024) Bozkurt, Rabia Nur; Şahin, Selin
The use of bioactive compounds in plants as reducing, stabilizing, and capping agents in nanoparticle manufacturing is an exceptionally eco-friendly approach. This work used rosehip seed extract, acquired by automatic solvent extraction, in the microwave-assisted green production of zinc oxide nanoparticles (ZnO NPs). The total phenolic content (TPC), total flavonoid content (TFC), and antioxidant activity of the extracted materials and nanoparticles were assessed using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays. The ideal synthesis parameters were established as 25 mL of extract, pH 12, 360 W of microwave power, and a metal salt concentration of 0.05 M for a duration of 7 minutes. The characterization of the ZnO NPs synthesized under these conditions was performed using X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy with energy dispersive X-ray analysis (SEM-EDX), dynamic light scattering (DLS), zeta potential measurements, and UV-Vis spectrophotometry. High-purity, nano-sized, antioxidant ZnO NPs were manufactured using an ecologically friendly, sustainable, and ecological technique.
Optimization of bioactive compounds and sensory quality in thermosonicated black carrot juice: A study using response surface methodology, gradient boosting, and fuzzy logic
(Elsevier, 2025) Yıkmış, Seydi; Türkol, Melikenur; Paçal, İshak; Duman Altan, Aylin; Tokatlı, Nazlı; Abdi, Gholamreza; Tokatlı Demirok, Nazan; Aadil, Rana Muhammad
This study investigates the optimization of bioactive components in thermosonicated black carrot juice using response surface methodology (RSM) and gradient boosting (GB) modeling techniques. Thermosonication, a combination of ultrasound and heat, was applied to enhance the nutritional quality of black carrot juice, which is rich in anthocyanins, phenolic compounds, and antioxidants. The study examined the effects of temperature, processing time, and ultrasonic amplitude on total carotenoid content (TCC), total anthocyanin content (TAC), ferric reducing antioxidant power (FRAP), and total phenolic content. RSM demonstrated higher prediction accuracy compared to GB, identifying optimal processing conditions at 48.68 °C, 11.15 minutes, and 82.62% amplitude. Thermosonication significantly increased total phenolic content to 414.28 mg GAE/L, surpassing traditional pasteurization. Sensory analysis, conducted via fuzzy logic, indicated improved sensory properties, including aroma, taste, and color, in thermosonicated samples. This study undercomes thermosonication as a promising method for improving both bioactive compounds and sensory quality in black carrot juice. Chemical compounds Chlorogenıc acid (PubChem CD:1794427); caffeic acid (PubChem CD: 689043); vanillin (PubChem CD: 1183); rutin (PubChem CD: 5280805); naringin (PubChem CD: 442428); rosmarinic acid (PubChem CD: 5281792); t-ferulic acid (PubChem CD: 445858); o- coumaric acid (PubChem CD: 637540); (PubChem CD: quercetin 5280459); 4-hyroxybenzoic acid (PubChem CD: 135).
Labiaplasty revision surgery with using clitoral hood flap: A case-cohort study
(Springer, 2024) Şahin, Eda Adeviye; Ağlamış, Özgür; Şahin, Hanifi; Ozan Şahin, Elif; Yılmaz Ergani, Seval
Background: The demand for labia minora reduction surgery has increased due to aesthetic preferences and discomfort caused by labial hypertrophy. This study aims to share experiences with labial reconstruction using clitoral hood flaps in patients who underwent aggressive trim labiaplasty. Methods: Twenty-eight patients who had previously undergone only labiaplasty surgery were included in this study. Surgical techniques focused on preserving blood supply and achieving symmetry. Postoperative care included hospitalization, wound care training, and regular follow-up visits. Complications were monitored and managed as needed. Results: All 28 patients, comprising 23 bilateral and 5 unilateral labiaplasty cases, underwent revision surgery using 49 clitoral hood flaps. Complications occurred in 6 cases, including suture dehiscence, flap necrosis, and infection, all of which were effectively managed. All flaps maintained their viability, and high patient satisfaction was reported. Conclusion: Clitoral hood flap reconstruction following aggressive trim labiaplasty is a viable technique with minimal complications and high patient satisfaction. Further multicenter, long-term studies are necessary to validate these findings and improve surgical outcomes. Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Distribution of branches of anterior choroidal artery in the uncus: An anatomical study
(Springer, 2024) Kaçur, İdil; Nteli Chatzioglou, Gkionoul; Nas, Emine; Şahan, Orhun; Kale, Ayşin; Çakır, Halit; Coşkun, Osman; Gayretli, Özcan
The aim of our study was to examine the relationship between uncus and uncal branches of anterior choroidal artery (AChA) and to observe the morphological and morphometric features of these branches. 124 hemispheres from 62 fresh cadavers were included in the study. Measurement of the length of AChA and the distances of the uncal branches to the origin of AChA were measured by ImageJ software. Morphological variations of uncal branches originating from AChA were observed. The length of AChA was found as mean 26.24 ± 4.34 mm. It was determined that the average distance of these uncal branches arising from the AChA was 13.48 ± 7.31 mm. In 4 out of 124 AChAs, no branches were observed. 594 branches originating from 120 were detected. 130/594 branches appeared to be terminal branches. AChAs of 80/120 hemispheres have been reported to have uncal branches. Thirty of 130 uncal branches were observed to originate as the first branch of AChA. It was found that uncal branches may originate from AChA with a variability between 1 and 4. When evaluated according to the origin of each branch from the AChA, it was observed that the uncal branches originated from the midpoint of the AChA on average. Also, in 64 hemispheres, morophological variations were detected regarding the origin of uncal branches. We believe that the morphological and morphometric data we obtained from the uncal branches of the AChA are of clinical importance in terms of understanding this complex region and minimizing errors in surgical procedures.
RNA splicing aberrations in hereditary cancer: Insights from Turkish patients
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Kılıç, Seda; Şükrüoğlu Erdoğan, Özge; Tuncer, Şeref Buğra; Çelik Demirbaş, Betül; Yalnız Kayım, Zübeyde; Yazıcı, Hülya
The process of RNA splicing is fundamental in contributing to proteomic diversity and regulating gene expression. Dysregulation of splicing is associated with various human disorders, including cancer. Through functional studies, this study sought to examine the potential impact of seven variants within six inherited cancer-related genes on RNA splicing patterns in Turkish cancer patients. Upon detecting variants using Next-Generation Sequencing (NGS), we used Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and Sanger sequencing to elucidate the effects of these variants on splicing. Three of the seven variants demonstrated no discernible effect on RNA, while four exhibited pathogenic characteristics. Specifically, the variants APC c.532-1G>A rs1554072547, BRCA1c.4358-3A>G rs1567779966, BRCA2c.7436-1G>C rs81002830 and MSH3c.1897- 1G>A rs1744149615 were identified as pathogenic, while the variants BLMc.4076+4T>G rs183176301, RB1c.2489+2T>C rs1555294636 and RB1c.1050-2A>G rs? were found to be benign from a splicing perspective. These findings highlight the importance of verifying the precise consequences of splice site variants through experimental analysis, given their potential implications for genetic disorders and cancer predisposition. This research contributes to the understanding of splice-site variants in inherited cancer predisposition, particularly among Turkish cancer patients. It emphasizes the necessity for further exploration into the mechanisms and functional consequences of alternative splicing for potential therapeutic interventions in cancer.
Autologous ovarian tissue transplantation: Preoperative assessment and preparation of the patient
(Wolters Kluwer Health, 2024) Turan, Volkan; Öktem, Özgür
Importance: Ovarian tissue cryopreservation (OTC) is an innovative and established fertility preservation method. More than 150 live births have been reported worldwide to date with the use of this strategy. OTC is one of the options to preserve fertility in prepubertal girls and for women who have time constraints and/or contraindications for ovarian stimulation for oocyte/embryo freezing before cancer treatment. The success rate of the ovarian tissue transplantation (OTT) depends on many interrelated factors. Therefore, preoperative evaluation and preparation of the candidate patients for the procedure are of paramount importance. Objective: In this review, our aim was to provide a guide for the clinicians, which demonstrates step-by-step assessment and preparation of the patients and ovarian tissue samples for transplantation. Evidence Acquisition: We searched for published articles in the PubMed database containing key words, such as OTT, OTC, preoperative assessment, primordial follicle density, and cancer, in the English-language literature until May 2024. We did not include abstracts or conference proceedings. Results: OTT is still a developing method as an effective fertility preservation approach. It is essential to perform a thorough preoperative evaluation of the patient to improve the success rates of transplantation. Conclusions and Relevance: Preoperative evaluation and preparation of women for ovarian transplantation surgery should include safety management to prevent reimplantation of malignant cells, transplanting ovarian tissue with minimum follicle loss and the decision of the best transfer site.
Non‑cirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and management
(Springer Nature, 2024) Shukla, Akash; Rockey, Don C.; Kamath, Patrick S.; Kleiner, David E.; Singh, Ankita; Vaidya, Arun; Koshy, Abraham; Goel, Ashish; Dökmeci, A. Kadir; Meena, Babulal; Philips, Cyriac Abby; Sharma, Chhagan Bihari; Örmeci, Necati; Sarin, Shiv Kumar
Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy. An international working group with extensive expertise in portal hypertension was assigned with formulating consensus guidelines to clarify the definition, diagnosis, histological features, natural history, and management of NCPF/IPH, especially in the context of PSVD. The guidelines were prepared based on evidence from existing published literature. Whenever there was paucity of evidence, expert opinion was included after detailed deliberation. The goal of this manuscript, therefore, is to enhance the current understanding and help create global consensus on the issues surrounding NCPF/IPH.
Comparison of the effects of four laser wavelengths on Medication-Related Osteonecrosis of the Jaw (MRONJ) in a murine model: An in vivo photobiomodulation study
(Ivyspring International Publisher, 2024) Ayhan, Mustafa; Gedik, Betül; Kalelioğlu, Ekrem Emir; Kundakçıoğlu, Abdulsamet; Küçükgergin, Canan; Turgut, Cevat Tuğrul; Kocaelli, Hümeyra; Alatlı, Fatma Canan; İşsever, Halim; Ademoğlu, Evin; Yaltırık, Mehmet
Background: This study aims to investigate the effectiveness of lasers at various wavelengths in treating medication-related osteonecrosis of the jaw (MRONJ) using biochemical, clinical scoring, micro CT analysis, and histopathological methods. The study follows the ARRIVE guidelines to ensure robust and transparent research. Methods: In our study, there were 6 groups, including one SHAM group, one CONTROL group, and four experimental groups, with 8 rats in each individual group. Each rat received antiresorptive drug intraperitoneally for 4 weeks and then had the left second molar in the mandible extracted. All animals were sacrificed at the end of the 12th week. In the experimental groups, lasers at wavelengths of 405nm, 445nm, 660nm, and 808nm were applied to the animals. Parameters such as serum vitamin D levels, bone density and bone volume at the extraction site, new bone formation, dead bone count, inflammatory cell count, and epithelial regeneration were examined. Additionally, clinical scoring was conducted after sacrifice. The laser parameters included power density, area, time, fluence, and mode (continuous wave), and the light was administered using a fiber with a Gaussian profile. Statistical analyses were performed with the NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) package program. The results were evaluated at the p<0.05 significance level. Results: According to the results obtained from our study, new bone formation in all experimental groups was significantly higher than in the SHAM and CONTROL groups. Furthermore, the 660nm and 808nm wavelengths increased serum vitamin D levels significantly. The most successful outcomes were observed in clinical scoring, dead bone count, epithelial cell regeneration, and bone density in the 660nm and 808nm wavelength groups. Conclusions: The combined use of lasers at 660nm and 808nm wavelengths may yield successful results in treating MRONJ.
Komplike olmayan üriner sistem enfeksiyonlarında lokal antibiyotik direncinin çok merkezli taranması: 37 merkezden 1850 hasta
(Ankara Microbiology Society, 2024) Cinislioğlu, Ahmet Emre; Cinislioğlu, Nazan; Öztürk, Metin İshak; Akkaş, Fatih; Aksakallı, Tugay; Atilla, Mustafa Kemal; Atiş, Gökhan; Aydın, Hasan Rıza; Balcı, Uğur; Bayrak, Ömer; Bedir, Selahattin; Biçer, Hüseyin; Çevik, Gökhan; Çift, Ali; Çiftçi, Halil; Coşkun, Burhan; Demirdöğen, Şaban Oğuz; Demirkol, Mehmet Kutlu; Dinçer, Murat; Doğan, Ahmet Emin; Dursun, Murat; Erdemir, Fikret; Erkan, Anıl; Eryıldırım, Bilal; Görür, Sadık; Hızlı, Fatih; Kadıhasanoğlu, Mustafa; Kalkan, Senad; Karabulut, İbrahim; Keskin, Mehmet Zeynel; Kızılay, Fuat; Köse, Osman; Küçük, Eyüp Veli; Odabaş, Öner; Oksay, Taylan; Özbey, Isa; Şefik, Ertuğrul; Sönmez, Mehmet Giray; Tek, Mesut; Tuğlu, Devrim; Tuncay, Ömer Levent; Usta, Mustafa Faruk; Yılmaz, Sercan; Kadıoğlu, Ateş
Bu çalışma, Türkiye’nin yedi farklı coğrafi bölgesinde komplike olmayan üriner sistem enfeksiyonu tanısı olan hastalardan elde edilen ayaktan üriner izolatlara göre en sık izlenen patojenleri tespit etmek ve bu patojenlere karşı kullanılan antibiyotiklerin direnç oranlarının coğrafi bölgelere göre anlamlı farklılık gösterip göstermediğini belirlemek amacıyla yapılmıştır. Mart 2021 ile Ağustos 2022 arasında, Türkiye genelindeki 37 farklı merkezde yapılan tetkikler sonucunda komplike olmayan üriner sistem enfeksiyonu tanısı koyulan ve pozitif idrar kültürleri olan 18 ile 65 yaş arası hastalar çalışmaya dahil edilmiştir. Araştırmaya katılan merkezler, idrar kültürlerinin verilerinin standardizasyonunu sağlamak için mikrobiyoloji laboratuvarlarında Avrupa Antimikrobiyal Duyarlılık Test Komitesi tarafından disk difüzyon yöntemini kullanan merkezlerden seçilmiştir. Bu çalışmaya, dahil edilme kriterlerine uyan toplam 1850 hasta dahil edilmiştir. Escherichia coli izolatlarının antibiyotik direnç oranlarının dağılımının analizi, ampisilin, fosfomisin ve nitrofurantoin dirençlerinde coğrafi bölgelere göre istatistiksel açıdan anlamlı farklılıkların olduğunu saptamıştır (sırasıyla p< 0.05, p< 0.05, p< 0.05). Güneydoğu Anadolu Bölgesi fosfomisin ve trimetoprimsülfametoksazol direncinin en yüksek olduğu bölge olarak tespit edilmiştir (sırasıyla; %27.4 ve %35.3). Bunun yanı sıra nitrofurantoin direncinin en yüksek olduğu bölge %35.7 oranıyla Doğu Anadolu Bölgesi ve siprofloksasin direncinin en yüksek olduğu bölge %51 oranıyla İç Anadolu Bölgesi olarak belirlenmiştir. Çalışma, komplike olmayan üriner sistem enfeksiyonlarının tedavisinde kullanılan antibiyotiklere direncin coğrafi bölgelere göre farklılık gösterdiğini ortaya koymuştur. Bu kapsamlı, ulusal prospektif araştırmanın, komplike olmayan üriner sistem enfeksiyonu için ampirik tedavi planlayan klinisyenlere değerli öngörüler sağlayacağı düşünülmektedir.
The effect of rapamycin treatment on mouse ovarian follicle development in dehydroepiandrosterone-induced polycystic ovary syndrome mouse model
(Zygote, 2024) Yıldırım, Ecem; Önel, Tuğçe; Aguş, Sami; Günalan, Elif; Yılmaz, Bayram; Aydın, Mehmet Şerif; Yaba, Aylin
Polycystic ovary syndrome (PCOS) is a complex reproductive and endocrine disorder affecting 5–10% of women of reproductive age, but the pathophysiology of PCOS still remains unknown. Here, the aim of our study was to analyze the effects of rapamycin treatment that may regulate impaired hormonal levels and folliculogenesis in dehydroepiandrosterone (DHEA)-treated PCOS mouse. We hypothesized that rapamycin may ameliorate the negative effects of PCOS in DHEA-induced PCOS mouse model. The target of rapamycin (TOR) gene product is a serine/threonine kinase that has been implicated in the control of cell growth, proliferation and autophagy, and rapamycin is a potent inhibitor of mTORC1 pathway. In this study, for the first time, mTORC1 and activation products are presented at protein and mRNA levels after rapamycin treatment in DHEA-induced PCOS mouse ovary. We showed that rapamycin treatment may regulate follicular development, hormonal levels and provide ovulation in DHEA-induced PCOS mouse. Additionally, we assessed decreased primordial follicle reserve, increased number of primary and secondary follicles, corpus luteum structure forms again after 10 days of rapamycin treatment. This study presented here suggests rapamycin treatment regulates hormonal phenotype and folliculogenesis in the ovary and also mTOR signalling pathway in granulosa cells of DHEA-induced PCOS mouse ovary which may have potential to attenuate understanding the mechanism of dominant follicle selection and anovulatory infertility.
Perceived social support and depression, anxiety and stress in pregnant women diagnosed with foetal anomaly
(John Wiley & Sons, 2024) Mecdi Kaydırak, Meltem; Balkan, Elif; Bacak, Nilgül; Kızoğlu, Filiz
Aim: To examine the relationship between perceived social support level and depression, anxiety and stress in pregnant women diagnosed with foetal anomaly. Design/Methods: This descriptive and correlational study was conducted in an advanced prenatal evaluation unit of a university hospital between December 2021 and May 2022. The study data collected from 131 pregnant women through a personal information form, depression, anxiety and stress scale (DASS-42) and multidimensional scale of perceived social support (MSPSS). Results: Most of the pregnant women were in the second trimester of pregnancy, and more than half had been advised by a healthcare professional to terminate their pregnancy. Overall, the pregnant women reported moderate levels of social support, while their depression, anxiety and stress levels varied. There was a weak negative correlation between perceived social support from family, friends and multidimensional sources with stress, but the effect rate was low. Conclusion: Most pregnant women diagnosed with foetal anomaly have normal levels of depression, stress and anxiety. There is a weak negative correlation between perceived social support and stress, with family and friend support affecting stress levels at a low rate. Professional support should be provided, and both the woman's mental health and social support mechanisms must be evaluated. Impact: This study highlights the importance of social support in managing stress among pregnant women with foetal anomalies. While most women had normal levels of depression, anxiety and stress, increased social support from family and friends was shown to reduce stress. The findings underscore the need for healthcare professionals to assess and strengthen mental health and social support systems in this vulnerable population, informing interventions to improve psychosocial outcomes. Reporting Method: This descriptive and correlational study adhered to the CONSORT guidelines for reporting non-randomised trials. Patient or Public Contribution: No patient or public contribution.

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