İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
DSpace@İSTÜN, Üniversite mensupları tarafından doğrudan ve dolaylı olarak yayınlanan; kitap, makale, tez, bildiri, rapor, araştırma verisi gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, Üniversitenin akademik performansını izlemeye aracılık eder, kaynakları uzun süreli saklar ve telif haklarına uygun olarak Açık Erişime sunar.
Güncel Gönderiler
Prognostic significance of lymphovascular space invasion in endometrial cancer and its relationship with other prognostic factors
(Galenos Publishing House, 2026) Nalbant Gürer, Vildan; Küçükbaş, Mehmet; Karateke, Ateş
Objective: To investigate the prognostic significance of lymphovascular space invasion (LVSI) and its relationship with other prognostic factors in patients with endometrial cancer. Material and Methods: Patients with stage IA-IVB endometrial cancer who underwent hysterectomy and/or staging surgery between January 2016 and December 2020 at a tertiary referral center were retrospectively analyzed. Pathological data including histological type, stage, grade, LVSI (lymphatic invasion, vascular invasion), tumor size, depth of myometrial invasion, cervical involvement, lymph node evaluation (pelvic, paraaortic), and peritoneal wash cytology were analyzed using univariate and multivariate methods. Results: The study included 304 patients. Non-endometrioid tumors were associated with a 6.35-fold higher risk of LVSI. Each 1 mm increase in tumor size raised the risk by 1.03-fold. LVSI was present in 53.3% of cases with lymph node metastasis and was 7.2-fold more frequent in deceased patients (odds ratio: 7.209; 95% confidence interval: 3.137-16.570; p<0.001). Multivariate analysis identified tumor grade and survival as independent predictors of LVSI: grade 3 tumors had a 4.88-fold higher risk (p=0.014), and mortality was associated with a 4.16-fold higher risk (p=0.007). Survival was significantly linked to LVSI, tumor size ≥35 mm, and recurrence, but not to age, histological type, lymph node status, or peritoneal cytology. Conclusion: Our results demonstrated that LVSI was significantly associated with histological grade and survival. Furthermore, LVSI, tumor diameter ≥35 mm, and recurrence were found to significantly affect survival, highlighting their prognostic relevance for risk assessment and postoperative management. [J Turk Ger Gynecol Assoc.]
Alignment of integrated management systems with modern management trends: A fact-based review
(Gheorghe Asachi Technical University of Iasi, Romania, 2025) Ergat, Zeynep; Kalender, Zeynep Tuğçe; Vayvay, Özalp
In today's dynamic business environment, organizations are increasingly adopting Integrated Management Systems to streamline their operations and enhance performance across various domains. However, implementing Integrated Management Systems is challenging due to the complexity of integrating various management systems and overcoming cultural resistance within organizations. Additionally, limited understanding of how Integrated Management Systems align with emerging trends such as lean management, sustainability and agile management, hindering organizations' ability to leverage integrated systems to effectively navigate complexities and capitalize on opportunities in the rapidly evolving business landscape. This study synthesizes existing research to examine how Integrated Management Systems can be improved with alignment of the modern management trends by analysing the literature. In this review, the relationship between IMS and sustainability, the impact and contribution of agile and lean management on the environmental, social and economic dimensions of sustainability were determined. The findingsunderscore that while Integrated Management Systems implementation enhances efficiency, its success hinges on overcoming integration complexities and cultural resistance. This review reveals that aligning it with contemporary management trends notonly supports continuous improvement but also strengthens environmental, social, and economic sustainability. Key insights emphasize the importance of agility and risk anticipation, as well as the critical role of human and cultural factors in every process. These findings offer valuable implications for both theory and practice, providing a foundation for future research to foster resilience and adaptability in today's dynamic business environment.
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.
Combination of bilateral rectus sheath and modified BRILMA blocks for postoperative analgesia in pediatric liver transplantation: A tailored approach
(Edizioni Minerva Medica, 2026) Alver, Selçuk; Çiftçi, Bahadır; Büget, Mehmet İlke; Emek, Ertan; Erbiş, Halil; Öztürk, Nadi Nazım; Umutoğlu, Tarık
Combination of bilateral rectus sheath and modified BRILMA blocks for postoperative analgesia in pediatric liver transplantation: A tailored approach
Suboptimal LDL-cholesterol control under the 2019 ESC/EAS dyslipidemia guidelines: Results from the nationwide TEMD-2 study in type 2 diabetes
(Wiley, 2026) Telci Çaklılı, Özge; Haymana, Cem; Demirci, İbrahim; Kebapçı, Medine Nur; Sarıakçalı, Barış; Evren, Bahri; Dizdar, Oğuzhan Sıtkı; Salman, Serpil; Ersoy, Canan; Satman, İlhan; Bayram, Fahri; Sönmez, Alper
Background: Lowering LDL cholesterol (LDL-C) decreases cardiovascular risk substantially in type 2 diabetes. Despite stricter LDL-cholesterol targets in the 2019 ESC/EAS dyslipidemia guidelines, target achievement in clinical practice remains insuffi cient. TEMD-2 is designed to evaluate LDL-cholesterol target attainment in Turkish patients with type 2 diabetes in the context of the updated 2019 ESC/EAS guidelines. Methods: This multicenter cross-sectional study included adults with type 2 diabetes followed in 70 tertiary endocrine clinics across 36 cities between October 2022 and January 2023. Sociodemographic characteristics, comorbidities, lifestyle factors, com plications, laboratory measurements, and lipid-lowering therapies were assessed using standardized questionnaires and clinical evaluations. LDL-C target was assigned according to cardiovascular risk categories. Independent predictors of goal attainment were identified using multivariable logistic regression. Results: Among 4956 adults with type 2 diabetes, 99.5% required statin therapy, whereas 37.1% were on treatment. Overall, 8.3% of the cohort achieved LDL-cholesterol targets, with attainment lowest in those at very high risk (5.8%). Target achievement among statin users was 57.7% in moderate-risk, 18.1% in high-risk, and 9.4% in very-high-risk patients. Individuals on target had lower body mass index, haemoglobin A1c (HbA1c), triglycerides, and a lower prevalence of microvascular complications. Statin therapy was the strongest positive predictor of success (odds ratio 2.39), while smoking, presence of neuropathy, nephropathy, female sex, older age, and higher HbA1c were associated with lower likelihood of achieving LDL-cholesterol goals. Therapeutic inertia was present in 87.2% of patients, defined as no intensification of lipid-lowering therapy despite LDL-cholesterol levels above target.
