Tıp Fakültesi Koleksiyonu
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Article Evaluating the Efficacy and Safety of Carotid Artery Stenting: A Retrospective Analysis(Galenos Publ House, 2025-12-18) Civlan, Serkan; Erbek, Nevzat Dogukan; Tekin, Isik; Arslan, Muhammet; Keskin, Emrah; Asar, Rasim; Peker, Hakki; Yakar, FatihObjective Stroke is the second leading cause of death and the third leading cause of disability globally, with carotid artery stenosis contributing to approximately 20% of cases. Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are effective treatments to reduce stroke risk. While some studies report higher complication rates for CAS compared to CEA, others demonstrate comparable outcomes, emphasizing the importance of patient selection and procedural optimization. This study evaluates the real-world safety and effectiveness of CAS in 52 patients at a single institution. Methods This retrospective analysis included 52 patients who underwent CAS between 2020 and 2024. Inclusion criteria were >= 50% stenosis for symptomatic patients and >60% stenosis for asymptomatic ones. Dual antiplatelet therapy was initiated preoperatively, and distal filter embolic protection was used in all procedures. Neurological assessments and radiological imaging were performed pre- and post-procedure. Complications were categorized as periprocedural or post-procedural, and follow-ups were conducted at three, six, and twelve months. Results The cohort included 52 patients (78.8% symptomatic, mean stenosis rate: 80.3%+/- 12.5%). Periprocedural ischemic stroke occurred in 5.8% of patients, and asymptomatic diffusion-restricted areas were detected in 34.6% of patients. One patient (2.2%) experienced symptomatic intracerebral hemorrhage. The overall periprocedural stroke and death rate was 7.7%. Conclusion CAS is a minimally invasive, effective option for treating carotid artery stenosis when patient selection and procedural protocols are optimized. Ongoing advancements in techniques and devices are anticipated to reduce complications further, supporting CAS as a safe alternative to CEA in selected patients.Article Bibliometric and Visual Analysis of the Top 100 Most Cited Articles on Long-Acting Injectable Antipsychotics(Kare Publ, 2025) Tekin, Selin Balki; Aygun, Danis; Kenar, Ayse Nur InciObjective: Recently, there has been a notable increase in interest in long-acting injectable antipsychotics (LAIAs) and in the number of studies conducted in psychopharmacology. This study aims to identify and analyze the 100 most cited articles on LAIAs. Method: The Web of Science (WOS) Core Collection database was analyzed using VOSviewer software to identify published articles on the subject. Information such as titles, authors, journals and publishers, number of citations, and years of publication was examined. The publications were then ranked according to the number of citations, and the top 100 most cited articles were subjected to further analysis. Results: The total number of citations ranged from 65 to 1,044. The most cited article is the 'International Consensus Study of Antipsychotic Dosing' in 2010, published in The American Journal of Psychiatry, with 1,044 citations. The Journal of Clinical Psychiatry contributed the greatest number of articles to the top 100 most cited articles, with 20 articles, followed by The British Journal of Psychiatry and Schizophrenia Research, which contributed eight and seven articles, respectively. The oldest publication in the top 100 was published in 1998, and the two most recent articles were published in 2022. Conclusion: This analysis allows researchers and clinicians to gain insight into the most recent and impactful work in this field, particularly in identifying potential avenues for future academic research.Article Impact of Patulin on Apoptosis, Autophagy, and Tumor Growth in Human Malignant Mesothelioma and Normal Mesothelial Cells(Biomedpress, 2025-11-30) Akkutlu, Rumeysa; Yuce, Hande; Ozek, Dilan Askin; Berberoglu, Yasemin; Unuvar, SongulPatulin (PAT) is a mycotoxin produced by certain molds, particularly species of the genera Aspergillus and Penicillium. It is found predominantly in apple-derived products and is associated with both acute and chronic toxicities. Although comprehensive data on the anti-cancer properties of PAT are presently lacking, preliminary evidence suggests that it can influence cancer cells by enhancing cellular apoptosis and inducing cytotoxicity. To evaluate the potential of PAT as a therapeutic approach for malignant mesothelioma, we investigated its effects on the malignant mesothelioma cell line H2452 and the non-malignant mesothelial cell line MeT-5A. Cells were exposed to PAT (1-200 mu M). Cell viability was assessed using the MTS assay, and cell migration was evaluated using the wound-healing assay. Expression levels of genes related to autophagy and apoptosis (SQSTM1, Beclin-1, Atg5, Atg7, Bax, Bcl-2) were measured using RT-PCR. PAT produced a dose-dependent decrease in cell viability and exhibited greater cytotoxicity toward mesothelioma cells than toward healthy cells. The wound-healing assay demonstrated that PAT impeded cellular migration, as evidenced by dysregulated wound closure. In cancer cells, PAT down-regulated Bax, Bcl-2, Beclin-1, and SQSTM1, while up-regulating Atg5 and Atg7. In healthy cells, it reduced Bax, Bcl-2, Beclin-1, SQSTM1, and Atg7, and elevated Atg5. It increased apoptosis in both healthy and cancer cells while modulating autophagy pathways in both cell types, potentially attenuating autophagy in cancer cells and disrupting this process in healthy cells. Our findings indicate that PAT may significantly restrict tumor progression in human mesothelial cancer models.Article Differential Myokine Responses To Swimming: Highlighting Meteorin-Like (Metrnl) as a Unique Marker of Adaptation(Istanbul Univ, 2025-12-09) Oskay, Alten; Erkek, Ozgen Kilic; Senol, Hande; Ozen, Mert; Unal, Egem Burcu; Kucukatay, Melek BorObjective: We examined time-dependent changes in the levels of meteorin-like protein (Metrnl), interleukin (IL)-7, IL-8, and follistatin-like 1 (FSTL1) myokines in mouse gastrocnemius-soleus tissue and plasma samples following acute and long-term swimming exercises. Materials and Methods: Seventy 8-12 weeks-old adult male BALB/c mice were classified as control (sedentary) and exercise groups. Either an acute or chronic exercise regime was applied to the exercise group. Samples were collected at 0 h, 3 h, and 48 h. The acute exercise group completed a 30-min single swimming session. The chronic exercise group completed the 30-min swimming exercise every day, 5 days a week, for 6 weeks. Metrnl, IL-7, IL-8, and FSTL1 levels in the m. gastrocnemius-soleus muscle and plasma samples were determined by enzyme-linked immunosorbent method (ELISA) kits. Results: No changes were observed in the Metrnl, IL-7, IL-8, and FSTL1 levels in the gastrocnemius-soleus muscle complex following acute or 6 weeks of swimming exercise (p>0.05). IL-7, IL-8, and FSTL1 levels did not change in the plasma in response to the exercises (p>0.05). Plasma Metrnl levels were higher at 3 h after 6 weeks of chronic exercise compared with the control (sedentary) and the 3 h samples of the acute swimming (3.49 +/- 1.75 ng/mL, 1.75 +/- 0.48 ng/mL, and 1.66 +/- 0.33 ng/mL; p<0.001, respectively) groups. Conclusion: These findings suggest that unlike IL-7, FSTL1, and IL-8, only Metrnl may playa role in mediating adaptation to long-term exercise in mice.Article Investigation of the Effects of Nepeta Italica Subsp. Cadmea Extract on Frozen-Thawed Ankara Buck Spermatozoa(Hellenic Veterinary Medical Soc, 2025-11-05) Boztas, S.; Keskin, N.; Bucak, M. N.; Urganci, B. Er; Bodu, M.; Taspinar, F.Semen cryopreservation causes adverse effects on the sperm structure especially on plasmalem-ma, acrosomes and DNA which results in lowered fertilization capacity. Hereby, cryoprotective antioxidant molecules have been extensively investigated to overcome the deleterious effects of oxidative stress caused by cryopreservation in spermatozoa. In recent years, natural antioxidants rich in flavonoids and phenolic compounds have gained increasing attention to develop as novel cryoprotectants in spermatozoa cryopreservation. Nepeta italica subsp. cadmea (Boiss.) rich in terpenoids and flavonoids is endemic to Turkey. In this study, the effects of three different doses of Nepeta italica subsp. cadmea extract (0.75 mu L/10 mL, 1.5 mu L/10 mL and 6 mu L/10 mL) on motility, acrosome integrity, mitochondrial activity and DNA fragmentation in frozen-thawed Ankara buck spermatozoa were investigated. The plants were harvested during the flowering stage on Honaz Mountain (Denizli, Turkey) and air dried in the shade at room temperature. The extract of the powdered plant was extracted by hydrodistillation using a Clevenger apparatus system, then stored at 4 degrees C in an amber colored glass bottle. The ejaculates taken from the Ankara bucks during the breeding season with an electroejaculator were combined and used in the diluting and freezing of semen. The experomental groups were formed by adding three different doses of Nepeta italica subsp. cadmea extract (0.75 mu L/10 mL, 1.5 mu L/10 mL and 6 mu L/10 mL) to the control extender. The semen was diluted with the different extenders at 35-37 degrees C and loaded into straws. Sperm samples frozen in liquid nitrogen vapors, following equilibration, were stored in liquid nitrogen. The plant extract at the dose of 0.75 mu L/10 mL improved motility, acrosome integrity, mitochondrial activity and DNA fragmentation in post-thawed Ankara buck spermatozoa (p<0.05). As a result, it can be suggested that the most effective dose of 0.75 <mu>L/10 mL of Nepeta italica subsp. cadmea (Boiss.) extract can be used as an effective additive for freezing Ankara buck spermatozoa.Article Komplikasyon Gelişmemiş ve Komplikasyon Gelişmiş Tip 2 DM (Diabetes Mellitus) Hastalarında PADI4 (İnsan Peptidil Arjinin Deiminaz Tip 4) Düzeylerinin İncelenmesi(Pamukkale University, 2025-08-22) Fenkçi, Semin; Senol, Hande; Koluman, Başak Ünver; Çiçek, Esin Avci; Eraydın, Ayten; Köksoy, TubaAmaç: İnsan peptidil arjinin deiminaz 4 (PADI4), histon kuyruklarındaki arginin kalıntılarını sitrüline dönüştürür. Son yıllarda araştırmacılar, PADI4'ün inflamasyon, enfeksiyon, kanser ve otoimmün bozukluklardaki rolünü araştırmaktadır. PADI4 ayrıca, disglisemi ile bağlantılı olan NETosis olarak bilinen bir süreç aracılığıyla nötrofil ekstraselüler tuzaklarının (NET) salınımını da düzenler. PADI4'ün tip 2 diyabet mellitustaki (DM) rolü tam olarak anlaşılamamıştır. Bu çalışmanın amacı, henüz diyabetik komplikasyonları olan ve olmayan tip 2 DM hastalarındaki ve sağlıklı kontrol bireylerindeki PADI4 seviyelerini karşılaştırmaktır. Gereç ve yöntem: Bu çalışma 30-65 yaş aralığındaki üç grup gönüllüden oluşmuştur: sağlıklı bir kontrol grubu, diyabetik komplikasyonları olan ve olmayan tip 2 DM hastaları. Kontrol ve tip 2 DM hastalarından alınan serum örneklerinde tam kan sayımı, biyokimya ve PADI4 (ng/ml) tetkikleri çalışılmıştır. Bulgular: Kontrol, komplike ve komplike olmayan tip 2 DM gruplarında serum PADI4 seviyelerinde anlamlı bir farklılık bulunmamıştır (4,94±5,09 ng/ml (orta: 2,62, IQR: 2,34-3,87), 5,06±6,58 ng/ml (orta: 2,59, IQR: 2,19- 2,99) ve 4,51±4,76 (orta: 2,74, IQR: 2,1-3,71). B12 vitamini seviyeleri komplike tip 2 DM grubunda kontrol grubuna göre anlamlı derecede daha yüksek olarak bulunmuştur (647,83±461,37 vs. 357,32±136,15; p=0,03). Komplike tip 2 DM grubunda nefropati, retinopati veya nöropati ile serum PADI4 arasında anlamlı bir korelasyon bulunamamıştır. Komplike olmayan DM grubunda metformin kullanımıyla istatistiksel olarak anlamlı, negatif ve hafif bir korelasyon saptanmıştır (r=-0,325, p=0,05). Sonuç: Sonuç olarak, komplikasyon gelişmiş veya gelişmemiş tip 2 DM hastaları ve sağlıklı kontrol grubu arasında serum PADI4 seviyelerinde istatistiksel olarak anlamlı bir fark saptanmamıştır. PADI4 birçok hastalık tedavisi ve gözetimi için uygulanabilir bir hedef olarak görülmektedir. Bu konuda daha fazla hasta popülasyonlarını içeren prospektif çalışmalara ihtiyaç vardır.Article Being a Woman in Forensic Medicine: Professional Inequities and Work-Life Challenges in Turkey(Springer, 2025-11-11) Zeybek, Volkan; Ozturk, Hatice Kubra Ata; Acar, Kemalettin; Baltaci, Ayse Seydaogullari; Seydaogulları Baltacı, Ayse; Ata Ozturk, Hatice KubraBackground and objective: Gender discrimination hinders women's career advancement. As in science, technology and mathematics, women in forensic sciences are underrepresented in high-ranking positions. This study aims to gather data on the demographic characteristics, academic goals, job satisfaction, career progression and work-life balance of female forensic medicine specialists and residents in Turkey and reveal their attitudes and experiences regarding gender discrimination. Material and methods: The study population comprised female forensic medicine specialists and residents in Turkey. An email invitation was sent to 109 female members of the Turkish Association of Forensic Medicine Specialists. A total of 85 participants (78%) completed the online survey. The questionnaire consisted of 40 items, including 13 demographic questions and 27 items assessing views and experiences on gender discrimination. Results and conclusion: A total of 43.5% of participants reported experiencing gender discrimination in their professional lives. Those who reported such experiences indicated that being a woman negatively impacted their careers, men were preferred, held more influential roles and were taken more seriously (p < 0.001). In the field of forensic medicine, which is closely related to justice and gender equality, women face challenges related to gender discrimination. This is the first study to analyze the career development and work-life balance of female forensic medicine physicians in Turkey and is expected to guide further research both nationally and internationally.Article Examining 25 Years of Research Trends in Adolescent Suicide: A Bibliometric Analysis(Bentham Science Publ, 2025-11-03) Gavcar; Gorkem, Erdal; Gavcar, Erdal GorkemIntroduction Suicide is a growing public health concern among adolescents worldwide. While many young people transition into healthy adulthood, adolescence remains a period of increased vulnerability for mental health. This study aims to examine scientific research on adolescent suicide and to analyze the major trends that have shaped the field over the past two decades.Methods Data were retrieved from the Web of Science (WoS) database. One thousand five hundred twenty-seven articles published between 2000 and 2024 with the keywords "suicide" and "adolescent/adolescents/adolescence" in their titles, and indexed in SSCI or SCI-E, were included. Network and cluster analyses were conducted using VOSviewer software.Results Publications on adolescent suicide have increased steadily, peaking in 2023 with over 150 articles. Nearly 6,000 researchers from more than 1,900 institutions contributed, and articles originated from 84 countries across 450 journals. Collectively, the publications received over 50,000 citations, averaging 35 per article. Keyword analysis identified more than 2,000 distinct terms, with "adolescent," "suicide," and "suicide attempt" most frequent. Research trends emphasize the identification of risk factors, the prediction of suicidal behaviors, and longitudinal investigations of the post-pandemic period.Discussion The findings revealed a thematic evolution, with a shift from descriptive studies toward predictive and interdisciplinary approaches. Technological advances, particularly machine learning and predictive models, increasingly shape research directions. Reliance on a single database is recognized as a limitation.Conclusion This bibliometric analysis provides a comprehensive overview of adolescent suicide research. The findings highlight the thematic evolution of the field and offer valuable insights to guide future scholarly work.Article No Elevated Genomic Damage Despite High Oxidative Stress and Homocysteine Levels Among ADHD Children(Wiley, 2025-11) Basay, Burge Kabukcu; Yildirim, Hatice Celik; Unal, Egem Burcu; Basay, OmerThis study aimed to examine oxidative stress and DNA damage in medication-na & iuml;ve children with attention deficit hyperactivity disorder (ADHD), focusing on total oxidant and antioxidant levels, homocysteine, vitamin B12 (VB12), folic acid (FA) and vitamin D (VD). Forty-two medication-na & iuml;ve children diagnosed with ADHD and 36 age- and sex-matched healthy controls participated in the study. Biochemical analyses included measurements of total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), homocysteine, VB12, FA and VD levels via ELISA. Genomic DNA damage was evaluated through the comet assay. Children with ADHD exhibited significantly higher TOS, OSI and homocysteine levels, indicating increased oxidative stress (respectively t = 2.956, p = 0.005; t = 3.218, p = 0.002; t = 2.868, p = 0.006). However, contrary to expectations, DNA damage parameters (tail intensity, tail moment and tail migration) were significantly lower in the ADHD group than in controls (respectively t = -3.830, p = 0.000; t = -3.871, p = 0.000; t = -2.340, p = 0.022). VD levels were also higher in the ADHD group (t = 2.313, p = 0.023), while no significant group differences were observed in VB12 or FA (p > 0.05). Despite increased oxidative stress, children with ADHD showed no signs of elevated genomic damage. These findings suggest the presence of compensatory mechanisms such as efficient DNA repair or enhanced antioxidant responses in this population. The unexpected pattern of elevated VD and stable genomic integrity highlights the complexity of biological processes underlying ADHD and the importance of considering adaptive cellular factors in biomarker research.Article Real-World Comparison of Doxorubicin-Ifosfamide Versus Gemcitabine-Docetaxel Regimens in Metastatic Uterine Leiomyosarcoma: A Multicenter Retrospective Study(Springer, 2025-11-17) Tunbekici, Salih; Sahin, Gokhan; Yuksel, Haydar Cagatay; Acar, Caner; Akin, Imge; Aslanhan, Hasan; Isci, Mert; Goker, ErdemBackgroundUterine leiomyosarcoma is a rare and aggressive malignancy with limited responsiveness to standard therapies. We conducted a real-world, multicenter study to compare the clinical efficacy and safety of two commonly used first-line chemotherapy regimens-doxorubicin-ifosfamide and gemcitabine-docetaxel-in patients with metastatic uterine leiomyosarcoma.MethodsThis retrospective cohort included 271 patients with advanced or metastatic uterine leiomyosarcoma treated between 2010 and 2023 across 30 centers in Turkey. Patients received either doxorubicin-ifosfamide (n = 142) or gemcitabine-docetaxel (n = 129) as first-line therapy. The primary endpoint was overall survival; secondary endpoints included progression-free survival, objective response rate, disease control rate, and safety. Adverse events were graded according to the Common Terminology Criteria for Adverse Events version 5.0, while survival outcomes were estimated using the Kaplan-Meier method and further analyzed with Cox proportional hazards models.ResultsMedian overall survival was 19.7 months with doxorubicin-ifosfamide and 20.2 months with gemcitabine-docetaxel (P = .26). Median progression-free survival was 5.5 months with doxorubicin-ifosfamide and 7.0 months with gemcitabine-docetaxel (P = .62). The objective response rate was numerically higher with gemcitabine-docetaxel (35% vs. 26%), although not statistically significant (P = .11). Grade 3-4 neutropenia (16% vs. 12%) and febrile neutropenia (7% vs. 6%) were more frequent with doxorubicin-ifosfamide.ConclusionsIn this largest-to-date real-world cohort of metastatic uterine leiomyosarcoma, doxorubicin-ifosfamide and gemcitabine-docetaxel demonstrated comparable survival outcomes. Gemcitabine-docetaxel, however, was associated with a more favorable hematologic safety profile. These findings support the clinical utility of both regimens while underscoring the need for prospective, biomarker-driven studies to refine treatment selection and improve personalization in this rare malignancy.