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Malaria in Turkey: A comprehensive analysis of diagnosis, treatment, and the impact of COVID-19, ten years after malaria elimination (2012-2023)
(Elsevier Inc., 2025) Şahin, Özgün Ekin; Kalay, Zeynepgül; Sarı, Nagehan Didem; Batırel, Ayşe; Ersöz, Gülden; Tuncer, Ertem Günay; Turunç, Tuba; Gözüküçük, Ramazan; Şimşek Çelener, Funda; Kantürk, Arzu; Süer, Kaya; Özer Balın, Şafak; Sağmak Tartar, Ayşe; Çelebi, Güven; Kuşoğlu, Hülya; Ateş, Selma; Alkan, Sevil; Mıstanoğlu Özatağ, Duru; Berk, Hande; Uzun, Cengiz; Karakoç, Çağla; Erdem, İlknur; Mumcu, Necati; Çölkesen, Fatma; Altunçekiç, Arzu; İnci, Ayşe; Yılmaz Karadağ, Fatma; Türkoğlu Yılmaz, Emine; Arslan, Mustafa; Şahin, Ahmet; Erdoğan, Haluk; Zorbozan, Orçun; Ertabaklar, Hatice; Ertan, Oğuz; Gücer, Lal Sude; Ergönül, Önder
Background: The characteristics, diagnosis, and treatment stages of malaria in Turkey in the last ten years are not known except few case reports. We aimed to describe the details of the diagnosis and treatment practices of malaria cases in various hospitals across Turkey between 2012 and 2023 after the declaration of the elimination of malaria. Methods: We collected the patient data from 30 centers by using Qualtrics Survey Software. The patients were categorized according to the WHO Malaria Severe Disease Symptoms guidelines. Results: We detected 299 malaria cases. Of these patients, 23.7% experienced misdiagnosis, with 77.5% of misdiagnosed cases receiving antibiotics. Among the patients, 9 (3%) had no travel history. Additionally, 28 (9.4%) patients required admission to the intensive care unit (ICU) during hospitalization. There is a significant association between misdiagnosis and subsequent ICU admissions. Additionally, the duration between malaria diagnosis and the initiation of treatment significantly affected ICU admissions. Furthermore, the number of cases with severe malaria (according to WHO criteria) and ICU admissions increased after the COVID-19 period. In multivariate analysis, initial misdiagnosis was found to be associated with ICU admission (OR: 2.8, p < 0.05), while each day's treatment delays post-diagnosis increased ICU admissions (OR: 1.26, p < 0.05). Conclusion: Misdiagnosis is common which delays the treatment and is correlated with higher admissions to ICUs. Post-COVID-19, there was a notable increase in both ICU admissions and cases of severe malaria, suggesting an escalation in disease severity that warrants further investigation. The resurgence of rare malaria cases with no travel history to abroad highlights the necessity of continued vigilance for new malaria cases. Efforts to promptly treat upon diagnosis and improve diagnostic accuracy in Turkey, where malaria is uncommon, are crucial. Enhancing diagnostic methods and treatment strategies remains essential, especially in significant events like COVID-19.
Comparison of conventional and modified sling suture techniques in free gingival graft operations-a randomized controlled clinical trial
(BMC, 2025) Shakiliyeva, Sanubar; Şahin, Demet; Günpınar, Sadiye; Gursel, Mihtikar
Background: The aim of this study was to investigate the effects of conventional suture (CS) and modified sling suture (MSS) techniques, applied in free gingival graft (FGG) surgery using gingival unit graft (GUT) and conventional graft (CG) techniques, on clinical parameters and graft dimensions. Methods: 52 individuals having Cairo Type 2 (RT2) and Type 3 (RT3) gingival recessions in mandibular anterior were divided into four groups as (a) GUT + MSS (n = 13), (b) GUT + CS (n = 13), (c) CG + MSS (n = 13) and (d) CG + CS (n = 13). Keratinized tissue width (KTW), relative gingival recession height (rGRH), and relative vestibule depth (rVD) measurements were recorded using a digital caliper and UNC 15 periodontal probe. Dimensional changes (Δ) of the graft surface area (GSA) was determined by ImageJ software. All measurements were done at baseline, 1st and 3rd months. Results: It was determined that the increase in KTW in the 1st and 3rd months in GUT + CS group was significantly higher than GUT + MSS group (p < 0.05). There was no statistically significant difference in Δ rVD and Δ rGRH values between the groups. When ΔGSA (mm2) values were compared between the groups, the decrease in the 1st and 3rd months in the CG + MSS group was found to be significantly higher than the GUT + MSS and GUT + CS groups (p < 0.05). Conclusion: Within the limits of this study, it can be concluded that keratinized tissue can be obtained successfully with both GUT or CG techniques in FGG surgery, on the other hand, regardless of the suture technique, GUT showed less graft shrinkage than CG.
Investigation of the effect of ultraprocessed food consumption on asthma using pulmonary function tests
(Sage Publishing, 2025) Özçalkap İçöz, Rümeysa; Alpaslan, Mehmet; Tural, Seda
Background: NOVA is a food classification system that classifies foods according to the scope and purpose of food processing, rather than nutrients. Asthma is usually characterized by chronic inflammation and respiratory symptoms such as wheezing, shortness of breath, chest tightness, cough, and variable expiratory airflow limitation. According to the NOVA food classification system, consumption of ultraprocessed foods (UPF) can affect asthma symptoms. Aim: In this study, the relationship between UPF consumption and pulmonary function test (PFT) results of asthma patients in adults aged 18 to 65 was investigated using biochemical parameters. Methods: This study was a cross-sectional study and, was conducted with 339 asthmatic participants diagnosed with asthma and receiving medical treatment. The participants' consumption of UPF was determined using a food frequency questionnaire. The evaluation of forced expiratory volume in one second (FEV1) (L/s) and forced vital capacity (FVC) (L/s) in the respiratory function tests was based on the percentage of the measured and expected values. Results: Although no significant relationship was found between % FEV1 expected value and UPF consumption (P > 0.05), it was concluded that % FVC expected and % FEV1/FVC values decreased with increasing UPF consumption (P < 0.05). Conclusion: It has been concluded that consumption of UPF worsens respiratory function and asthma prognosis. Therefore, replacing UPF and beverage products with healthier foods or food processing methods will play an important role in maintaining health.
A physiotherapeutic approach to a baby with right disgenesis of thumb and left agenesis of upper extremity: A case report
(Prosthetics and Orthotics International, 2024) İnal, Habibe Serap; Reis, Osman
A boy with bilateral congenital anomalies of the upper extremities with transverse absence of the left arm (agenesis) and absence of right thumb (disgenesis), fixed elbow in extension due to humeroradial synostosis thought that the humerus was intact. His wrist could move passively with 50° flexion, 0° extension, and 70° radial deviation. The other 4 fingers were intact, 4-5 metatarsal bones were in synostosis, and the fifth finger was clinodactyly. He was born by normal delivery. The physiotherapist started sensorimotor training to achieve functional movements of the right upper extremity. The exercises for the trunk muscles were emphasized to prevent the future possible thoracolumbar curve due to the absence of loading of the left arm on trunk muscles. Serial splinting was performed to position the wrist and fingers for functional purposes and abduction and internal rotation of the index finger to perform the opposition position until the pollicization surgery. At 1 and a half, his trunk was straight, and the wrist was partially corrected (15° extension; 35° radial deviation). He was able to play with toys and eat food. The mother rated his performance as 8/10 and 10/10, respectively. Both mother and father were satisfied with his performance in activities of daily living according to his age compared with his peers (9/10; 10/10, respectively). Thus, the physiotherapist's sensorimotor training and the positioning splints may be considered as feasible interventions in this case.
Management of microcomplications of diabetes mellitus: Challenges, current trends, and future perspectives in treatment
(MDPI, 2024) Yapışlar, Hande; Gürler, Esra Bihter
Diabetes mellitus is a chronic metabolic disorder characterized by high blood sugar levels, which can lead to severe health issues if not managed effectively. Recent statistics indicate a significant global impact, with 463 million adults diagnosed worldwide and this projected to rise to 700 million by 2045. Type 1 diabetes is an autoimmune disorder where the immune system attacks pancreatic beta cells, reducing insulin production. Type 2 diabetes is primarily due to insulin resistance. Both types of diabetes are linked to severe microvascular and macrovascular complications if unmanaged. Microvascular complications, such as diabetic retinopathy, nephropathy, and neuropathy, result from damage to small blood vessels and can lead to organ and tissue dysfunction. Chronic hyperglycemia plays a central role in the onset of these complications, with prolonged high blood sugar levels causing extensive vascular damage. The emerging treatments and current research focus on various aspects, from insulin resistance to the intricate cellular damage induced by glucose toxicity. Understanding and intervening in these pathways are critical for developing effective treatments and managing diabetes long term. Furthermore, ongoing health initiatives, such as increasing awareness, encouraging early detection, and improving treatments, are in place to manage diabetes globally and mitigate its impact on health and society. These initiatives are a testament to the collective effort to combat this global health challenge.
Comparison of the Results of BAL and ETA Culture in Intubated COVID-19 Patients
(Nigerian Journal of Clinical Practice, 2024) Kılıç, Hasan Hüseyin; Gözüküçük, Ramazan
Background: The isolation of pathogens using bronchoalveolar lavage (BAL) culture or endotracheal aspirate (ETA) culture may enhance the treatment success for secondary pneumonia due to COVID-19, thereby reducing the risk of morbidity and mortality. Aim: This study aimed to retrospectively analyze the results of BAL and ETA cultures in intubated COVID-19 patients and to determine whether BAL has an advantage over ETA. Methods: We routinely perform BAL culture via bronchoscopy or ETA culture within the first 48 h after intubation. We retrospectively reviewed cases that underwent BAL and ETA. The patients were divided into two groups: Group B (BAL) and Group E (ETA). Various parameters were evaluated and compared between the two groups. Results: The demographic data and blood test results were similar between the two groups. However, ICU stay, duration of intubation, and culture positivity were significantly higher in Group B. Although not statistically significant, the mortality rate was higher in Group E. The most commonly isolated microorganisms were Candida species. Conclusion: The observed mortality rates were consistent with the existing literature. Since the microorganism isolation rate is higher with BAL, leading to more effective antimicrobial treatment, early deaths were prevented, and ICU stay durations were prolonged. Conversely, these durations were shorter in the ETA group due to higher mortality. In intubated COVID-19 patients, a more effective treatment process can be achieved by clearing the airway with fiberoptic bronchoscopy and tailoring the treatment based on BAL culture results. This approach may positively impact prognosis and mortality rates.
Combined Minimally Invasive Esthetic Rehabilitation of Dental Fluorosis-5-year Follow-up: Case Report
(2024) Dokumacigil, Gökhan; Korkut, Bora; Yılmaz Atalı, Pınar
Dental fluorosis (DF) is a specific esthetic issue characterized by a persistent condition in which there is a disruption in enamel development, leading to the formation of hypomineralized enamel. The resulting unusual appearance varies in intensity, presenting as mildly white and opaque to dark brown, and significantly impacts individuals' esthetic features and self-confidence. The objective of this case report was to assess the efficacy of microabrasion, dental whitening, and resin infiltration in terms of resolving lesions, tracking the sensitivity of teeth, and evaluating patient satisfaction over a period of time. A minimally invasive treatment approach in a 27-year-old woman with severe DF is detailed. The treatment plan involved enamel microabrasion, in-office bleaching, and two weeks of at-home bleaching, followed by resin infiltration for the affected tooth under rubber dam isolation. After a 5-year follow-up, the assessment of the patient's esthetic appearance indicated a successful treatment of teeth affected by DF.
Predictive values and relationships of serum PSA levels, delta neutrophil index, neutrophil-lymphocyte ratio and other hematological parameters in patients with acute prostatitis
(Urologia, 2024) Uyanık, Bekir Sami; Çakıroğlu, Basri; Gözüküçük, Ramazan
Background: This study aimed to evaluate the predictive values and relationships of serum prostate-specific antigen (PSA) levels, delta neutrophil index (DNI), neutrophil-lymphocyte ratio (NLR), and other hematological parameters in patients diagnosed with acute prostatitis. Methods: Serum PSA levels and hemogram parameters of patients diagnosed with acute prostatitis were retrospectively analyzed. Healthy patients of the same age group were assigned to the control group. WBC, neutrophil, lymphocyte, thrombocyte (PLT), mean platelet volume (MPV), plateletcrit (PCT), NLR, and DNI were determined. Serum total PSA and C-reactive protein (CRP) levels were also assessed. Results: Total PSA levels (3.48 [1.11-6.66]) in the acute prostatitis (AP) group were significantly higher than those of healthy men (0.82 [0.47-1.39]) (p < 0.001). Total CRP levels (3.88 [1.50-22.03]) in the AP group were significantly higher than those in healthy men (1.15 [0.89-2.00]) (p < 0.001). The sensitivity and specificity of PSA at a cutoff value of 1.52 were 68.4% and 79.7%, respectively. The NLR value in the AP group was 2.62 (1.87-4.42), compared to 1.63 (1.18-2.20) in the healthy group (p < 0.001). Differences in WBC, neutrophil, and lymphocyte counts were also statistically significant (p < 0.001). There were no significant differences in PLT, PCT, or DNI values. Significant positive correlations were observed between PSA, CRP, and DNI values (all p < 0.001). Conclusion: This study demonstrated the usefulness of NLR, PSA, CRP, and WBC as predictors of acute prostatitis. NLR is a simple, inexpensive inflammation parameter that correlates well with CRP levels.
Assessment of health literacy and HPV knowledge among university students: An observational study
(Medicine, 2024) Şenocak Taşçı, Elif; Baş, Dilşat; Kayak, Simge; Anik, Sema; Erözcan, Aleyna; Sönmez, Özlem
Health literacy (HL) level is related to promotion of health, improved health behaviors, and early diagnosis of diseases, as well as the appropriate use of health services. Human papillomavirus (HPV) vaccination is the primary method of protection against cervical cancer and recommended for women aged 9 to 27. This study aims to assess the university students' knowledge about HPV and the association between HL and HPV vaccination. In this cross-sectional and descriptive study, an electronic survey was used. Demographic characteristics and anthropometric measurements of the participants were questioned. HPV Knowledge Scale (HPV-KS) and Turkish Health Literacy Scale (THLS-32) were used to evaluate HPV knowledge and HL. Statistical analyzes were performed with SPSS version 26. A total of 361 university students (74% women), aged 21.98 ± 4.72 years, were included in the study. About 52% of the participants were health sciences students. The total THLS-32 score was 34.68 ± 9.37 (95% CI = 33.71-35.65), and the total adequate/excellent HL level was 51%. The mean HPV-KS score of the participants was 10.28 ± 8.15 (95% CI = 9.44-11.12) of a possible 35. Health sciences students had higher rates of HPV awareness (78% vs 65%; P = .007). General HPV knowledge level was significantly better among women (P < .001), >20 years (P = .002), and those with a family history of cancer (P < .001) and significantly lower among students at prep or first year of school (P < .001). There was a weak, positive relation between THLS-32 and HPV-KS score (R = 0.136; P = .01). Participants with higher levels of HPV knowledge (P = .034) and total HPV-KS score (P = .025) were statistically significantly higher in students with adequate/excellent HL. Our results reveal that knowledge about HPV vaccination is closely related to HL levels. Educational interventions on HL may be considered to increase HPV vaccination rates.
Efficacy of the Mediterranean Diet Containing Different Macronutrients on Non-Alcoholic Fatty Liver Disease
(2024) Uluçay Kestane, Vahibe; Baş, Murat
This study aimed to investigate the effects of the typical Mediterranean diet (TMD), low-carbohydrate Mediterranean diet (LCMD), and low-fat Mediterranean diet (LFMD) on biochemical findings, fatty liver index (FLI), anthropometric measurements, and body composition in individuals with obesity with non-alcoholic fatty liver disease (NAFLD) and insulin resistance. This study included 63 participants with obesity with insulin resistance diagnosed with NAFLD by ultrasonography to investigate the effects of an 8-week energy-restricted TMD, LCMD, and LFMD on biochemical findings, FLI, fibrosis-4 index (FIB-4), anthropometric measurements, and body composition. Patients were randomized into three groups and were interviewed face-to-face every week. According to the food consumption records (baseline end), the difference in the amount of sucrose and total fat consumed in the TMD group; the difference in energy intake from sucrose, monounsaturated fatty acids, and oleic acid in the LCMD group; and the difference in energy intake from fiber, sucrose, monounsaturated and polyunsaturated fatty acids, and cholesterol in the LFMD group showed significant correlations with liver enzymes and FLI (p < 0.05). In conclusion, although it has a different macronutrient composition, the Mediterranean diet may positively affect biochemical parameters and FLI in individuals with NAFLD, albeit in different ways.
Immediate Effects of High-Intensity Blood Flow Restriction Training on Muscle Performance and Muscle Soreness
(Routledge Journals, Taylor & Francis Ltd, 2024) Korkmaz Dayıcan, Damla; Ülker Ekşi, Büşra; Yiğit, Şafak; Utku Umut, Gulsena; Özyürek, Burçin; Yılmaz, Hayrettin Emir; Akıncı, Buket
Purpose: The aim was to investigate the immediate effects of high-intensity resistance training with blood flow restriction (HIRT-BFR) on rectus femoris (RF) muscle activity, reaction time, muscular performance, and delayed onset muscle soreness (DOMS) in healthy young adults. Methods: Twenty-four healthy young adults were randomized into the HIRT-BFR group or HIRT group. Both groups performed a single session of training with 80% of 1RM, 8 repetitions, 2 sets, and 3 minutes rest to RF muscle. The activity and reaction time of the dominant extremity RF muscle were evaluated by superficial electromyography (sEMG), muscular performance by single-leg squat test, and DOMS by the Visual Analog Scale. Results: Single-leg squat performance was significantly increased in HIRT-BFR (p = .001) and HIRT group (p = .04). Additionally, in HIRT group resting average (p = .03), resting maximal voluntary contraction % (p = .04), and relaxation minimum (p = .02) values of RF were significantly increased. DOMS level decreased significantly in HIRT-BFR (p < .001) and HIRT group (p = .019). The differences were similar in the groups for sEMG parameters, muscle performance, and DOMS level. Conclusion: We observed that HIRT-BFR and HIRT were similar in terms of muscle activation, reaction time, muscular performance of the RF, and DOMS level.
The role of primary nocturnal enuresis in the aetiology of overactive bladder syndrome
(Polish Urological Assoc, 2023) Çakıroğlu, Basri; Arıkan, Mehmet Gürkan; Taş, Tuncay; Bilir, Burak
Introduction The aim of this study was to investigate the effect of nocturnal enuresis (NE) in childhood on the development and course of overactive bladder (OAB) in adulthood. Material and methods Between January and September 2021, data from patients who visited the Urology Outpatient Clinic with OAB symptoms were collected. Patients with a history of diabetes mellitus, neurological diseases, bladder outlet obstruction, active urinary system infection, or previous medical treatment for OAB and those who did not agree to join the study were excluded. Patients with a diagnosis of NE in childhood were classified as group 1, and patients without a diagnosis of NE were classified as group 2. Demographic data were recorded. Frequency of incontinence, and the number of daytime voids and nocturia were evaluated according to a three-day voiding diary. In addition, the maximum urinary flow ratio (Qmax), bladder wall thickness, and postvoid residual volume were determined using uroflowmetry and pelvic ultrasound. Results After applying the inclusion/exclusion criteria, the mean age of the study group of 103 patients, consisting of 34 women and 69 men, was 32.85 +/- 11.20 years (18-65), and the mean BMI of both groups was 26.62 +/- 3.34 (19.49-39.18). Sixty-five of 103 patients (63.1%) had a history of childhood NE diagnosis. Patients in the group with a history of NE were younger than those without a history of NE. Conclusions The earlier onset and more intense course of OAB symptoms in patients diagnosed with NE in childhood suggests that NE may be a triggering factor in the aetiology of OAB.
Investigation of the Relationship Between Heavy Metals (Cadmium, Arsenic, and Lead) and Metallothionein in Multiple Sclerosis
(Springer Nature, 2024) Keçecioğlu, Can; Sarıkaya, Cansu; Aydın, Ahmet; Charehsaz, Mohammad; Efendi, Hüsnü
Background and aim: Multiple sclerosis (MS) is one of the most common neurological disorders. Metals are important for the maintenance and preservation of homeostasis and dysregulated metal homeostasis has an impact on neurodegeneration. Environmental factors are considered to contribute to MS risk and progression. Heavy metals such as arsenic (As), cadmium (Cd), and lead (Pb) are widely found in the environment and because of their toxic nature, they pose a great danger to human health. Metallothioneins (MTs) play important roles in metal homeostasis and detoxification of heavy metals. Objective: The aim of this study was to investigate the relationship between levels of heavy metals (As, Cd, and Pb) and MT levels in MS patients and also to assess the oxidative stress status of patients. Method: Fifty subjects (20 healthy subjects and 30 MS patients) were included. Demographic characteristics of the patients, plasma MT levels, blood Cd, As, and Pb levels, as well as iron (Fe), copper (Cu), and zinc (Zn) levels, were determined. Malondialdehyde (MDA) levels were investigated as a marker of oxidative stress. Results: MT levels were slightly higher in the MS group (p > 0.05). As Cd and Pb levels were significantly higher in the control subjects. MDA levels were significantly higher in MS patients. Conclusion: Our results support the relevance of MT and MDA levels in MS. Further clinical studies with larger cohorts will provide more insights into these factors.
Preventive Measures for Safer Orthognathic Surgery: Key Points
(Sage Publications Inc, 2024) İsçi, Kemal Devrim; Muluk, Nuray Bayar; Güngör, Enes; Cingi, Cemal
Objectives: The aim of this article is to review safer orthognathic surgery. Methods: The literature survey was performed in PubMed, EBSCO, UpToDate, ProQuest Central databases of Kırıkkale University, and Google and Google Scholar databases. Results: Patients with dentofacial skeletal defects may benefit from orthognathic surgery, which entails surgically modifying parts of the facial skeleton to restore the right anatomic and functional relationship. Careful investigation of the soft tissue via clinical examination and supporting pictures, evaluation of the structure via standardized radiographs, and evaluation of the dental via study dental casts are all necessary to successfully correct maxillofacial abnormalities. Orthognathic surgery can involve either the maxilla, the mandible, or both. Improving the dynamics of nasal airflow may necessitate simultaneous intranasal surgery consisting of septoplasty and reduction of the inferior turbinate. In some patients, a genioplasty and neck liposuction may be recommended to enhance the final result. Le Fort I osteotomy, Le Fort II osteotomy, Le Fort III osteotomy, maxillary segmental osteotomies, sagittal split osteotomy of the mandibular ramus, vertical Ramal osteotomy, inverted L and C osteotomies, and mandibular body segmental osteotomies are all examples of well-established osteotomies that can be used to reposition facial skeletal elements and redefine the face. Conclusion: Preventative strategies for risk-free orthognathic surgery include maintaining blood flow, shielding teeth, bone, and neurovascular systems, and bolstering the patient’s diet.
Health information systems with technology acceptance model approach: A systematic review
(Elsevier Ireland LTD, 2024) Tetik, Gözde; Türkeli, Serkan; Pınar, Sevcan; Tarim, Mehveş
In the rapidly evolving landscape of information technologies, individuals and organizations must adapt to the digital age. Given the diversity in users' knowledge and experience with technology, their acceptance levels also vary. Over the past 30 years, various theoretical models have been introduced to provide a framework for understanding user acceptance of technology. Among these, the Technology Acceptance Model (TAM) stands out as a key theoretical framework, offering insights into why new technologies are either accepted or rejected. Analyzing user acceptance of technology has thus become a critical area of study. Healthcare organizations aim to assess the perceived efficacy and user-friendliness of a given technology. This will help health organisations design and implement HIS that meet users' needs and preferences. In this context, how does the TAM clarify the acceptance and use of Health Information Systems (HIS)? To address this inquiry, a comprehensive literature review will be carried out. The systematic review involved 29 studies issued between 2018 and 2023 and searched the databases Pubmed, Scopus, Wos and Ulakbim TR Index. The PRISMA flowchart was used to identify the included studies. According to the results, some variables stand out in the acceptance and utilisation of HIS. Among the users of HIS, it can be said that the results relating to nurses stand out. In particular, there are studies which emphasise that 'gender' is a crucial factor in explaining the models. Another crucial finding of the current systematic review is the need to train users in the acceptance and use of HIS.
Miliary Pulmonary Tuberculosis After Intravesical BCG Instillation in a Patient with High-Grade Bladder Cancer
(Ankara Microbiology Soc, 2023) Gözüküçük, Ramazan; Çakıroğlu, Basri
Intravesical administration of Bacillus Calmette-Guerin (BCG) vaccine is used in the treatment of superficial bladder cancer. In clinical practice, intravesical BCG immunotherapy after transurethral tumor resection is a highly effective treatment option in preventing tumor recurrence and progression in medium and high risk superficial bladder tumors. Since patients are given live tuberculosis (TB) bacillus, serious side effects such as pneumonia, sepsis and even death can be seen. Lung involvement occurs in less than 1% of patients and most commonly presents as interstitial pneumonia or miliary TB. Miliary TB is difficult to diagnose and is usually based on high clinical suspicion, as Mycobacterium bovis is not isolated in most cases. Treatment is not completely standardized. However, in severe cases, a combination of anti-tuberculosis drugs and corticosteroids is recommended. In this report, a case of miliary tuberculosis, a very rare complication after instillation of BCG into the bladder in a patient with a diagnosis of superficial bladder cancer, was presented. A 73-year-old male patient diagnosed with bladder tumor underwent transurethral resection of bladder tumor, and then weekly intravesical injection of BCG-MEDAC for six weeks had no adverse effects. Three weeks of intravesical BCG supplementation was planned for the patient who had no signs of recurrence when checked three months later by cystoscopy. Two hours after the first dose, the patient, who applied to the emergency department with the complaint of chills and shivering, was hospitalized for further follow-up and treatment. Afterwards, repeat cultures were taken from the patient whose fever continued on the seventh day of treatment with broad-spectrum antibiotics (meropenem and teicoplanin). In addition, when abdominal and thorax computed tomography (CT) were performed, multiple miliary nodular lesions were detected in both lungs and were evaluated in favor of miliary TB. With these findings, the patient was started on miliary TB therapy [isoniazid (INH), rifampicin (RIF), ethambutol (EMB) and streptomycin (STM)] targeting Mycobacterium bovis, since it was an infection that developed after BCG injection. In the third week of the treatment, the patient's fever was under control, and he was discharged on the 25th day of his hospitalization because of significant improvement in infection markers [C-reactive protein(CRP)-procalcitonin]. At the end of two months, there was clear regression of pulmonary abnormalities on control thorax CT. In conclusion, miliary TB developing after intravesical BCG instillation is a very rare condition, the cause of which is not fully understood, the etiology of fever can be easily missed, and the diagnosis is difficult. In addition, this case is presented to draw attention to a critical disease that requires long treatment and follow-up and requires attention.
Effect of the use of remineralization agents before resin infiltration on the treatment of initial enamel lesions: an in-vitro study
(BMC, 2024) Doğu Kaya, Bengü; Manav Özen, Aybike; Yılmaz Atalı, Pınar; Güngör Sarıalioğlu, Ayça; Dalkılıç, Evrim; Alkan, Elif; Tağtekin, Dilek; Türkmen, Cafer
Aim This study aimed to evaluate the effect of the use of remineralization agents before the application of resin infiltration on the treatment of initial enamel lesions. Materials and methods Eighty buccal enamel samples were prepared from human molars, and artificial initial lesions were formed after 96 h of incubation with a demineralizing solution. The samples were randomly divided into 8 groups (n = 10) including a remineralizing agent (Tooth Mousse, Medical Mineral Gel, Remin Pro), resin infiltration (ICON), and a combined treatment of both. Remineralizing agents were applied in pH cycle for 7 days. Baseline, demineralization, and after-treatment fluorescence (FluoreCam and DIAGNOdent Pen), surface microhardness (HMV-2T), surface roughness (M300C), OCT (Maestro-2) and ultrasonic system (Novascope 4500) data were obtained for all groups. The sample surfaces were examined under SEM/EDX (SU3500) at x1000. Data were statistically analyzed using the Two-Way Robust ANOVA and Bonferroni tests (p < 0.05). Results There was no statistically significant difference between the groups for microhardness, roughness, OCT, DIAGNOdent Pen, ultrasound, and FluoreCam size/intensity values (p = 0.582; p = 0.963; p = 0.884; p = 0.923; p = 0.051; p = 0.268; p = 0.793 respectively). The effect of the treatment procedure showed a significant difference (p < 0.001), except for the roughness values (p = 0.984). The lowest Calcium (Ca) ratio (%atomic) was observed in the RI group in the EDX analysis. Conclusion Remineralizing agents and resin infiltration methods may be used in combination or alone in the treatment of initial enamel lesions. Combining remineralizing agents with resin infiltration does not alter the efficacy of the treatment.
Comparison of different methods used in the classification of maxillary gingival phenotype: A diagnostic accuracy study
(WILEY, 2024) Guliyev, Rasul; Lütfioğlu, Müge; Keskiner, İlker
Aims: This study aimed to evaluate the reliability and applicability of novel methods for determining gingival phenotypes and compare them with currently recommended methods. Methods: Six maxillary anterior teeth from 50 systemically and periodontally healthy patients were evaluated using two conventional methods (periodontal probe translucency method [PP] and transgingival measurement with an endodontic file [EF]), and two novel methods (colored biotype probe translucency method [CBP] and transgingival measurement with a Florida probe [FP]). All data were statistically analyzed. Intra-examiner reproducibility and inter-examiner reproducibility for all methods were analyzed using 10 randomly selected patients who were re-evaluated for each analysis. Results: Moderate agreement was found between EF and PP, with statistically significant differences between median gingival thickness (GT) values for thick 0.8 mm (0.5-1.1 mm) and thin 1 mm (0.6-1.7 mm) phenotypes, and a threshold GT value of <= 0.92 mm (p < .001). FP and PP also showed moderate agreement, with statistically significant differences between median GT values for thick and thin phenotypes (0.80 mm [0.40-1.60 mm] and 0.89 mm [0.40-1.60 mm], respectively), and a threshold GT value of <= 0.8 mm (p < .001). PP and CBP values showed a substantial agreement (p < .001). A statistically significant difference was found between median EF values and CBP categories (p < .001); however, paired comparisons showed that the distinction was applicable only between thin and other phenotypes. Conclusion: Although CBP was found to be successful in detecting the thin phenotype, it was not successful in distinguishing between medium, thick, and very thick phenotypes; moreover, it did not appear to offer any advantages over PP. Although FP may be preferable to EF in measuring gingival thickness, the cost of FP is a disadvantage.
Using Cluster Analysis to Identify Metabolic Syndrome Components and Physical Fitness in Patients with Metabolic Syndrome
(2024) Yiğit, Şafak; Akıncı, Buket; Ülker Ekşi, Büşra; Korkmaz Dayıcan, Damla; Çalıkoğlu, Fulya; Çelik, Yusuf; Yeldan, İpek; Satman, İlhan
Background: Metabolic syndrome (MetS) comprises a cluster of cardiovascular risk factors. Physical inactivity and reduced physical fitness are associated with one or more components of MetS. However, MetS has many components, and the unclear relationship between the components and physical fitness parameters can provide a plain and straightforward understanding of the clustering method.Aim: To identify the relationship between physical fitness parameters, physical activity levels, and components of MetS using hierarchical cluster analysis.Methods: One hundred twenty-one patients (mean age = 51.4 +/- 7.1/years, F:90, M:31) who were diagnosed as having MetS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria were included in the study. Fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were analyzed. Systolic and diastolic blood pressures, (SBP and DBP), were evaluated. Body composition (waist and hip circumference, (WC and HC), waist-to-hip ratio (WHR), body mass index (BMI), percent body fat, and visceral fat), upper and lower extremity muscle strength (dynamometer), and functional exercise capacity [6-minute walk test (6MWT)] were assessed as physical fitness parameters. Physical activity levels were assessed using a pedometer and number of steps (NS) was determined.Results: Of the patients, 45.5% were diagnosed as having MetS based on four components. The dendrogram consisted of two main clusters and four subclusters. The main cluster I composed of BMI, HC, WC, visceral fat, HDL-C, percent fat, SBP, DBP, and percent quadriceps. The main cluster II comprised FPG, TG, WHR, handgrip strength, 6MWT, and NS.Conclusion: MetS components clustered with different physical fitness parameters. The clusters in the dendrogram can provide substantial implications for heterogeneous MetS components and physical fitness parameters. Future studies are needed to elucidate the effectiveness of dendrogram-derived exercise programs in MetS.
Comparison of epoprostenol and viscum album efficiencies in the treatment of avascular necrosis of the femoral head: An experimental animal study
(Histology and Histopathology, 2024) Kumbaracı, Mert; Sarsik Kumbaracı, Banu; Doganavsargil Yakut, Basak; Can, Cenk; Başdemir, Gülçin; Aydoğdu, Semih
Background: The aim of our study is to compare the efficacy of epoprostenol and viscum album in the treatment of femoral head avascular necrosis with an experimental study. Our hypothesis is that viscum album, which has similar properties to epoprostenol on the vascular system, is as effective as epoprostenol in the treatment of avascular necrosis. Methods: Avascular necrosis was created on the femoral heads of 45 New Zealand type rabbits by surgical vascular deprivation method. The rabbits were divided into 3 groups. Group 1 was designed as a control group, in group 2 Ilomedin (epoprostenol analogue) was administrated to subjects and in group 3, Helixor (viscum album extract) was administrated. At the end of the study, there were nine subjects in each group. Osteocyte necrosis, bone marrow necrosis, new bone formation and cartilage degeneration were evaluated microscopically. The extent of bone necrosis and repair and involvement of epiphysis, the bone marrow cellularity ratio and trabecular bone volume were investigated. Results: Subchondral necrosis was seen in more animals in the control group (p=0.03). Osteoblastic and osteoclastic activity were more prominent in the Ilomedin group (p=0.25 and 0.07, respectively). It was seen that the cartilages of the subjects in the Helixor and Ilomedin groups were less damaged. In the Ilomedin group, more animals were seen in the chronic phase of the repair process than in the other groups (p=0.07). Bone marrow cellularity was higher in treatment groups (22% and 20,6% for Ilomedin and Helixor, respectively, p=0,04). Trabecular volume was found to be increased in damaged femoral heads in the treatment groups, the highest increased observed in the Helixor group (p=0.01). Conclusion: Viscum album seems to be effective in decreasing the extention of necrosis and protecting the articular cartilage, and epoprostenol in increasing repair and regeneration.

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