İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
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Güncel Gönderiler
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.
The effect of different granulation amounts of kollicoat MAE 30DP® on ODT CQAs using risk assessment
(Marmara University, 2026) Pirinçci Tok, Yağmur; Demiralp, Burcu; Al-Mohaya, Mazen; Özsoy, Yıldız
Orally disintegrating tablets (ODTs) improve patient compliance, but they present challenges in terms of masking the bitter taste of active pharmaceutical ingredients such as dexketoprofen trometamol (DEX). The study aimed to develop palatable DEX ODTs by granulating drug with Kollicoat MAE 30DP® to create a physical barrier. Using a quality by design (QbD) approach, an initial risk assessment identified Prosolv® ODT G2, Emdex®, and Magnasweet® MM100 and tablet compression pressure as critical variables. A Box-Behnken design was employed to prepare 26 formulations, systematically evaluating the impact of these variables across low and high polymer concentrations. The results showed that although high concentrations of Kollicoat MAE 30DP initially delayed the dissolution rate, this barrier effect did not affect the final extent of drug release. Disintegration was predominantly governed by compression pressure, which altered tablet porosity, whereas PROSOLV® ODT G2 significantly influenced the overall dissolution profile. By optimizing the superdisintegrant-to-binder ratio, high-polymer formulations successfully overcame the initial retardation, consistently exceeding an 85% cumulative release at 30 minutes.
Durable patellar stability and high patient‐reported success at minimum 5‐year follow‐up after isolated suture tape MPFL reconstruction
(Wiley, 2026) Erden, Tunay; Ağır, Muzaffer; Kayaalp, Mahmut Enes; Toker, Berkin; Taşer, Ömer
Purpose: To evaluate the mid‐to‐ long‐term clinical and radiological out comes of isolated medial patellofemoral ligament reconstruction (MPFL‐R) using a high‐strength suture tape (HSST) construct in patients with recur rent patellar instability and no major osseous risk factors. Methods: Patients treated with isolated MPFL‐R using HSST and a single knotless femoral anchor between 2015 and 2021 were retrospectively re viewed. Inclusion criteria were recurrent lateral patellar instability (≥2 disloca tions or symptomatic subluxations) refractory to nonoperative treatment and a minimum postoperative follow‐up of 60 months. Patients requiring concomitant bony realignment or presenting with major anatomic risk factors (e.g., high grade trochlear dysplasia, severe patella alta, tibial tubercle–trochlear groove distance >20mm) were excluded. Clinical outcomes were assessed with the International Knee Documentation Committee (IKDC) subjective score, Kujala score and visual analogue scale (VAS) for pain. Patellar tilt was mea sured on axial magnetic resonance imaging (MRI). Postoperative instability events, complications and reoperations were recorded. Clinically meaningful improvements were assessed using minimal clinically important difference (MCID) and patient‐acceptable symptomatic state (PASS) thresholds. Kaplan Meier survival analysis was performed to estimate 5‐year survivorship free from redislocation (primary endpoint) and any postoperative instability (secondary endpoint). Postoperative instability was defined as clinically docu mented redislocation or symptomatic subluxation. Results: Eighty‐one patients (mean age 20.8 years; 31.4% female) were included. At a mean follow‐up of 79.4±14.3 months, one redislocation (1.2%) and two subluxations (2.5%) occurred. Five‐year survivorship free from redislocation was 98.8% (95% confidence interval [CI], 96.4%–100%), and survivorship free from any postoperative instability was 96.3% (95% CI, 92.2%–100%). All patient‐reported outcome measures improved signifi cantly from baseline to final follow‐up (all p<0.001). Ninety‐six percent of patients achieved the PASS threshold for IKDC (95% CI, 89.7%–98.7%), whereas PASS attainment for the Kujala score ranged from 74% to 86% depending on the applied cut‐off. Radiologically, patellar tilt improved substantially on MRI (p<0.001). Postoperative complications were infrequent and manageable, including five cases of arthrofibrosis (requiring manipulation under anaesthesia), one deep infection (treated with arthro scopic debridement) and three cases of implant‐related bursitis at the femoral fixation site. Conclusion: Isolated MPFL reconstruction using an HSST construct pro vided durable patellar stability and significant functional improvement at a minimum 5‐year follow‐up. This technique represents a reliable mid‐to long‐term option for isolated MPFL‐R in appropriately selected patients, especially when graft harvest morbidity and patellar bone preservation are concerns.
A comparative evaluation of conventional composite, high-viscosity glass ionomer cement, and compomer used in primary teeth by finite element stress analysis
(İstanbul Sağlık ve Teknoloji Üniversitesi, Lisansüstü Eğitim Enstitüsü, 2025) Yalvaç, Seda; Özen, Buğra
The aim of this study is to evaluate and compare the stress distributions occurring in Class I and Class II restorations and tooth structures restored with commonly used restorative materials in primary teeth—namely, resin-based composite (Filtek Z350 XT, 3M ESPE, Germany), high-viscosity glass ionomer cement (Equia Forte Fill, GC Corporation, Tokyo, Japan), and compomer (Dyract XP, Dentsply Sirona, Germany)—using the Finite Element Stress Analysis (FESA) method, and to compare the obtained results with those of an unrestored tooth model. Computed tomography images obtained retrospectively from patients who applied to the Department of Pediatric Dentistry at Istanbul Health and Technology University for diagnosis and treatment, and recorded by the Department of Oral and Maxillofacial Radiology for diagnostic purposes, were used in this study. From these, the tomographic image of a caries-free mandibular primary molar was selected, and a three-dimensional digital tooth model was created using computer software. During the modeling process, a total of 13 models were generated: one sound tooth model (control) and twelve restored models prepared with three different restorative materials. In ANSYS software, the occlusal contact points of the second primary molar were considered, and a vertical load of 240 N was applied to simulate maximum bite force, while oblique loads of 100 N at 0°, 45°, and 90° angles were applied to simulate masticatory forces. The maximum Von Mises stress values generated in the enamel, dentin, and restorative materials were calculated. According to the results, oblique loads produced higher stress values than vertical loads in all models. The stresses observed in enamel were higher than those in dentin, and the stress values in Class II MOD cavities were significantly greater compared to Class I and Class II (MO and DO) cavities. When analyzed by material type, the lowest Von Mises stress values in dental tissues were observed in models restored with Filtek Z350 XT composite. The high elastic modulus of this material contributed to a more homogeneous distribution of the applied load. Dyract XP compomer exhibited moderate stress values and, due to its hybrid structure, demonstrated a balanced performance incorporating characteristics of both composite resin and glass ionomer materials. The highest stress levels within the tooth tissues were observed in the models restored with Equia Forte. Consequently, these findings indicate that the loading angle applied to the tooth directly affects the magnitude of stresses generated in the enamel and dentin. More oblique forces, such as at 45°, resulted in an uneven distribution of the load within the tooth structure and led to increased stress accumulation, whereas more horizontal loading angles better preserved the structural integrity of the tooth and produced lower stress values. These findings demonstrate that both material selection and the applied loading conditions play a decisive role in the long term longevity, structural integrity, and functional success of the restoration in clinical treatment planning.”
