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
Radiographic medial posterior tibial slope ≥16° predicts multiple revisions after anterior cruciate ligament reconstruction
(Wiley, 2026) Kayaalp, Mahmut Enes; Inoue, Jumpei; Konstantinou, Efstathios; Kahraman, Hamit Çağlayan; Erden, Tunay; Musahl, Volker
Purpose: An increased posterior tibial slope (PTS) has been implicated as a risk factor for anterior cruciate ligament (ACL) graft failure. This matched case–control study aimed to compare radiographic and magnetic reso nance imaging (MRI)‐based PTS measurements between patients under going multiple revision anterior cruciate ligament reconstruction (ACLR) and those with successful primary ACLR and to identify thresholds predictive of high revision risk. Methods: In this matched case–control study, 156 patients were analysed: 78 patients undergoing multiple revision ACLR and 78 patients with suc cessful primary ACLR. Medial PTS was measured on radiographs, while medial, lateral and PTS difference (PTS asymmetry) were measured on MRI. Group differences were assessed using independent t tests and χ2 tests. Receiver operating characteristic (ROC) analysis identified optimal thresholds, and logistic regression quantified odds ratios (ORs) for multiple revisions per 1° increase in radiographic medial PTS, adjusting for body mass index (BMI), sex, side, height and weight. Results: Radiographic medial PTS was significantly higher in the multiple‐ revision group (12.5 ± 3.5° vs. 11.2 ± 3.0°, p = 0.016). ROC analysis identi fied an optimal medial PTS cutoff of 13° (area under the curve = 0.58, sensitivity = 0.49, specificity = 0.65), but only a PTS ≥ 16° was significantly associated with increased multiple revision risk (OR = 3.10, 95% confidence interval [CI]: 1.14–8.40; p = 0.037; specificity = 0.91; positive predictive value [PPV] = 0.70). MRI‐based medial and lateral PTSs, as well as PTS asymmetry, did not differ significantly between groups. Univariate logistic regression demonstrated a 10% increase in odds per 1° increase in radio graphic PTS (OR = 1.10, 95% CI: 1.00–1.22, p = 0.049), remaining signifi cant after adjustment for BMI, sex, side, height and weight (adjusted OR = 1.11, 95% CI: 1.01–1.23, p = 0.034). Radiographic medial PTS cor related moderately with MRI‐based medial PTS (r = 0.49, p < 0.001), but not with lateral PTS (p: n.s.). Conclusion: Radiographic medial PTS showed the strongest differentiation between successful primary ACLR and multiple‐revision ACLR. A PTS ≥ 16° identifies patients at significantly higher risk of multiple revisions, whereas MRI‐based medial PTS, lateral PTS and PTS asymmetry provide no addi tional discriminatory value. Radiographic medial PTS appears practical for preoperative risk stratification, whereas MRI‐based measures do not show similar utility. Level of Evidence: Level III.
PCOS phenotypes and hematological immune-inflammatory indices: A comparative evaluation
(Elsevier, 2025) Kından, Aykut; Kından, Goncagül; Soysal, Çağanay; Turan, Volkan
To evaluate hematological immune-inflammatory indices across different polycystic ovary syndrome (PCOS) phenotypes and assess their potential as diagnostic biomarkers. This retrospective cross-sectional study included 89 women aged 18–40 years diagnosed with PCOS according to the Rotterdam criteria, stratified into four phenotypes (A–D). Demographic, anthropometric, reproductive, biochemical, and hormonal data were extracted from clinical records. Hematological indices were calculated from complete blood counts. Group comparisons were performed using appropriate statistical tests, correlations with metabolic and hormonal parameters were assessed, and logistic regression analyses were conducted to identify independent predictors. Phenotype A demonstrated significantly higher body mass indeks (BMI), waist circumference, fasting glucose, insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) values compared with other phenotypes (all p < 0.01). Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), and Systemic Immune-Inflammation Index (SII) differed significantly across phenotypes, whereas Platelet-to-Lymphocyte Ratio (PLR) did not. ROC analysis revealed that SII had the highest discriminative ability (AUC=0.822, p < 0.001). NLR (AUC=0.663, p = 0.020) and MLR (AUC=0.642, p = 0.043) also showed moderate predictive value. Correlation analyses indicated positive associations of NLR and SII with total testosterone and Free Androgen Index (FAI), and negative correlations with Sex Hormone-Binding Globulin (SHBG) and High-Density Lipoprotein (HDL) cholesterol. Logistic regression identified BMI, SII, and LH/FSH ratio as independent pre dictors of specific phenotypes, further supporting their role as clinically relevant biomarkers. Hematological immune-inflammatory indices, particularly SII, may serve as cost-effective and accessible biomarkers for dis tinguishing PCOS phenotypes.
Comparative gastric microbiota profiles in non-ulcer dyspepsia and peptic ulcer patients
(Springer Nature Link, 2025) Polat Sarı, Silva; Soylu, Aliye; Peker, Kıvanç Derya; Adaş, Gökhan; Akgül, Özer; Sapmaz, Burcu; Öner, Yaşar Ali; Yüksel Mayda, Pelin; Çalışkan, Reyhan
Background Recent evidence suggests that the human stomach hosts a diverse microbiota beyond Helicobacter pylori, and that shifts in microbial composition may influence gastric health. In particular, oral-origin bacteria may dominate the gastric niche in the absence of H. pylori, yet their specific roles in different gastroduodenal disorders remain unclear. This study aimed to profile and compare the gastric microbiota composition in Turkish patients with non-ulcer dyspepsia (NUD) and peptic ulcer disease (PUD), in order to better understand microbial profiles potentially associated with gastroduodenal disease. Methods Ninety-eight patients underwent endoscopic evaluation and were divided into two groups according to the presence or absence of ulcers. Group 1 (n=52) included individuals with NUD, while Group 2 (n=46) comprised patients with PUD. Gastric biopsy samples from both groups were analyzed for the relative abundance of H. pylori using quantitative real-time PCR (qPCR), and next-generation sequencing was employed for a comprehensive analysis of the gastric microbiota. Results In total, H. pylori DNA was detected in 71.4% (70/98) of the samples, with a significantly higher prevalence in PUD patients (82.6%) compared to NUD patients (61.5%) (p=0.02). Distinct microbial profiles were observed based on H. pylori status. In NUD patients, Alloprevotella showed significantly higher relative abundance in H. pylori negative samples (p<0.05). Among PUD patients, the absence of H. pylori was associated with increased levels of Porphyromonas and Neisseria compared to NUD patients without H. pylori (p<0.05). These genera, typically associated with the oral cavity, appeared to expand opportunistically when H. pylori was absent. Conclusions The absence of H. pylori in gastric disorders was linked to a notable shift in microbiota composition, with increased representation of oral-origin bacteria such as Alloprevotella, Porphyromonas, and Neisseria. These findings, observed in a Turkish patient cohort, may reflect a potentially compensatory or opportunistic microbial shift in H. pylori-negative gastroduodenal disease. As exploratory findings, this study represents the first analysis from Türkiye comparing gastric microbiota profiles in NUD and PUD patients and provides novel regional insight into gastric microbial ecology.
Subjective happiness and academic engagement of undergraduate nursing students: A correlational study
(Gümüşhane University, 2025) Aydoğdu, Ana Luiza Ferreira
Happiness constitutes a fundamental component influencing individuals’ lifelong attitudes and career trajectories. This study aimed to investigate the relationship between subjective happiness and academic engagement among undergraduate nursing students. Employing a descriptive, cross-sectional, and correlational design, the study was conducted with a sample of 350 students. Data were collected through the Subjective Happiness Scale (SHS) and the Utrecht Work Engagement Scale – Short Form for Students (UWES-S-9 ©) and analysed using PSPP version 1.6.2- g78a33a. The mean subjective happiness score was 5.00±1.17, and the mean academic engagement score was 3.75±1.42, indicating moderate levels. Students aged 30 years and older, as well as those with middle or upper-middle income levels, demonstrated significantly higher happiness scores compared to their counterparts aged 20–25 years and those with lower income levels. Furthermore, students who chose the nursing program out of genuine interest and those who indicated a willingness to choose it again exhibited higher scores in both happiness and academic engagement. A significant positive association was observed between subjective happiness and academic engagement. To enhance students’ well-being, implementing social and financial support initiatives, promoting peer mentoring programs, and facilitating experience sharing activities are recommended. Providing comprehensive information about nursing career pathways may also strengthen students’ connection to the profession.
Does combined pulmonary fibrosis and emphysema syndrome affect response to antifibrotic therapy and survival? A single-center retrospective cohort study
(Mattioli 1885, 2025) Teke, Nazlı Hüma; Ağca, Meltem; Türkar, Ayla; Sevim, Tülin; Tuncay, Eylem; Güngör, Sinem; Yıldırım, Elif; Özbaki, Fatma; Gündoğuş, Baran; Arınç, Sibel; Berk Takır, Huriye; Özmen, İpek
Objective: Combined pulmonary fibrosis and emphysema (CPFE) is a clinicoradiological syndrome characterized by upper lobe emphysema and lower lobe fibrosis, most commonly associated with idiopathic pulmonary fibrosis (IPF). This study compared the clinical characteristics, functional parameters, and mortality of patients with CPFE and IPF who received antifibrotic therapy. Methods: Between October 2015 and Au gust 2022, patients with IPF treated with antifibrotics for at least 6 months were retrospectively evaluated and divided into two groups: CPFE (emphysema present) and IPF (emphysema absent). Demographic data, antifi brotic therapy, functional parameters before and after treatment (FEV1%, FVC%, DLco %), clinical outcomes (hospital admissions, mortality) were compared. Results: Of the 204 patients with IPF, 90 (44%) had CPFE. CPFE patients were more often male, had greater smoking history, higher pack-years, and more lung cancer than IPF patients (p < 0.001 for all). Post-treatment FEV1% and FVC% did not significantly differ between the groups, whereas DLco% declined significantly in both (p < 0.001 and p = 0.002). DLco% decreased more in IPF than CPFE, but the difference was not statistically significant [−3 (−11–3) vs. −0.43 (−1.1–0.2), p = 0.36]. The hospital admission rates were similar. Independent risk factors for mortality included CPFE diagnosis (HR: 1.73, 95% CI: 1.06–2.83, p = 0.029), low FVC% (HR: 0.970, 95% CI: 0.96–0.98, p < 0.001), and device use (long-term oxygen therapy [LTOT] or home non-invasive mechanical ventilation [NIMV]) (HR: 2.48, 95% CI: 1.50–4.09, p < 0.001). Mean survival was shorter in patients with emphysema than in those without em physema (5.08 vs. 5.68 years, p = 0.08). Conclusions: Despite a decline in DLco%, changes remained below the futility threshold. Clinical outcomes and mortality were comparable. CPFE diagnosis, low FVC%, and LTOT/ NIMV use independently predicted higher mortality.
