Medeniyet medical journal最新文献

Objective: Poly (ADP-ribose) polymerase-1 (PARP-1) is a key enzyme in DNA repair pathways and has been implicated in cancer susceptibility. The rs1136410 polymorphism in the PARP-1 gene has shown inconsistent associations with gastrointestinal cancer risk across populations. This meta-analysis aimed to evaluate the association between PARP-1 rs1136410 polymorphism and the risk of colorectal cancer (CRC) and gastric cancer (GC), with a focus on ethnic differences.

Methods: A systematic literature search was performed in PubMed, Scopus, EMBASE, Web of Science, Cochrane Library, BIOSIS, LILACS, CNKI, CBM, Wan Fang, and other regional databases up to February 1, 2025. Eligible case-control studies assessing the association between PARP- 1 rs1136410 polymorphism and CRC or GC were included. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under five genetic models using Comprehensive Meta-Analysis software.

Results: Thirteen case-control studies were included, comprising 3.591 patients and 5.433 controls. For GC (8 studies; 1,784 cases and 2,521 controls), significant associations were observed under multiple genetic models: allele comparison (C vs. T: OR=2.01, 95% CI 1.04-3.91, p=0.039), homozygous comparison (CC vs. TT: OR=1.77, 95% CI 1.24-2.52, p=0.002), heterozygous comparison (CT vs. TT: OR=1.36, 95% CI 1.18-1.57, p<0.001), and recessive comparison (CC vs. CT+TT: OR=1.54, 95% CI 1.08-2.20, p=0.017). No significant association was detected for CRC (5 studies; 1.807 cases and 2.912 controls). Ethnic subgroup analysis revealed a protective effect against CRC in Caucasians but increased susceptibility in Asians.

Conclusion: The PARP-1 rs1136410 polymorphism is associated with elevated GC risk but not CRC, with ethnicity-dependent effects suggesting differential genetic susceptibility. These findings highlight the importance of considering population-specific genetic backgrounds in gastrointestinal cancer risk assessment, prevention, and precision medicine strategies.

Objective: The role of total eosinophil count (EOS) in chronic obstructive pulmonary disease (COPD) remains debated, with studies suggesting both positive and negative impacts on disease progression. This retrospective study aimed to investigate the relationship between stable-state blood EOS levels and clinical outcomes, including hospitalizations, emergency room (ER) visits, and pneumonia, in COPD patients.

Methods: Data from 398 COPD patients were analyzed, focusing on blood EOS counts and percentages acquired during stable periods. Patients were categorized based on EOS thresholds of 150 cells/μL and 2%. The number of hospitalizations, ER visits, and pneumonia diagnoses in the preceding year was retrieved from hospital records and patient reports.

Results: Patients with EOS levels below 150 cells/μL or 2% showed a significantly higher number of hospitalizations. Additionally, patients with EOS percentages below 2% had higher COPD Assessment Test and Modified Medical Research Council scores, indicating greater symptom burden and dyspnea. Logistic regression analysis confirmed that a lower EOS percentage was an independent predictor of increased hospitalizations, similar to its association with lower FEV1% and more than two ER visits.

Conclusions: This study suggests that low blood EOS counts are associated with increased hospitalizations and worse clinical outcomes in COPD patients. This finding highlights the importance of considering EOS levels as a potential biomarker for disease severity and may lead to personalized treatment strategies. Further prospective studies are needed to validate these findings and elucidate the underlying mechanisms.

Objective: HACEK bacteria (Haemophilus parainfluenzae, Aggregatibacter spp., Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) represent a group of fastidious organisms implicated in endocarditis and a range of opportunistic infections. Despite their clinical importance, epidemiological data on HACEK infections remain limited, particularly in Türkiye.

Methods: This retrospective analysis investigated 30 cases of HACEK infections diagnosed at a tertiary care hospital in Istanbul over a seven-year period (2017-2023). Data were collected from electronic medical records and laboratory databases.

Results: Patients ranged in age from 0 to 76 years, with isolates derived from a variety of clinical specimens. Cardiobacterium hominis was notably absent among the identified species. Polymicrobial growth was documented in 20 cases, predominantly involving Gram-positive cocci, particularly Streptococcus spp. Antimicrobial susceptibility testing was performed for four isolates, revealing significant challenges in interpretation due to the absence of standardized guidelines for HACEK pathogens. None of the cases received pathogen-specific therapy; all were managed with empirical antimicrobial regimens. Clinical outcomes were favorable in all but one patient, who succumbed to complications of coronavirus disease-2019. No cases of recurrent HACEK infection or infective endocarditis were observed during follow-up.

Conclusions: These findings underscore the diagnostic challenges associated with HACEK infections and the potential underestimation of their prevalence. Prospective, multicenter studies are needed to clarify the epidemiological and clinical significance of these organisms. Moreover, the development of standardized antimicrobial susceptibility testing protocols and evidence-based therapeutic strategies is essential to optimize patient management and improve clinical outcomes.

Objective: Loneliness has been identified as a subjective unpleasant feeling of emptiness and distress, affecting diverse age groups, particularly retirees. Retirement is a major life event characterized by the cessation of professional activities and the loss of regular income. These phenomena are often combined and their relationship can be complex.

Methods: The research encompassed 75 randomly selected outpatients at the University Hospital Center Zagreb, Department for Psychiatry and Psychological Medicine in Zagreb Croatia with an anxiety disorder who were in remission and met the inclusion criteria. The participants were divided into three groups of 25 respondents: five years before retirement, one year before retirement, and one year after retirement. The participants were tested once using psychological tests: The University of California, Los Angeles (UCLA); and the Mini International Neuropsychiatric Interview.

Results: This study examined loneliness among 75 participants across retirement phases. UCLA Loneliness Scale scores increased significantly from pre to post-retirement (p<0.001), peaking one year after retirement. Emotional loneliness, particularly feelings of isolation, rose sharply, while social loneliness increased gradually. A One-Way Analysis of Variance confirmed a significant effect of retirement on loneliness, F (2.72)=24,561, p<0.001, with an impact level of η²=0.405. A substantial impact is observed on emotional and social well-being.

Conclusions: Study results indicate a significant increase in loneliness among retired individuals. Transition to retirement can have an impact on individuals' emotions and social interactions. There is a need to support retirees in establishing new daily routines.

Objective: To evaluate the predictive ability of indices based on the combination of C-reactive protein (CRP) and albumin, namely the CRP/albumin ratio (CAR), Glasgow prognostic score (GPS), and modified GPS (mGPS), for prolonged hospital stay in patients with acute pancreatitis.

Methods: This prospective observational study was conducted on patients monitored in the emergency department of a tertiary university hospital. The patients' demographic data, vital signs, laboratory parameters, comorbidities, and length of hospital stay were prospectively recorded. Based on their length of hospital stay, the patients were divided into two groups: prolonged stay (>7 days) and non-prolonged stay. The indices were compared between these groups.

Results: There were statistically significant differences in CAR, GPS, and mGPS between the prolonged and non-prolonged hospital stay groups (p<0.001 for all; chi-square test). The area under the curve values of CAR, GPS, and mGPS were calculated as 0.677 [95% confidence interval (CI): 0.601-0.753, p<0.001], 0.637 (95% CI: 0.570-0.704, p<0.001), and 0.671 (95% CI: 0.602-0.740, p<0.001), respectively. According to multivariate analysis, CAR [odds ratio (OR)=1.017, 95% CI (1.003-1.03), p=0.015], GPS [OR=2.894, 95% CI (1.632-5.13), p<0.001], and mGPS [OR=3.757, 95% CI (2.108-6.70), p<0.001] were found to be independent predictors of prolonged hospital stay.

Conclusions: CAR, GPS, and mGPS are independent predictors of prolonged hospital stay in patients with acute pancreatitis. The findings also suggest that incorporating CRP levels into prognostic calculations may yield more accurate results compared to scores based solely on albumin levels.

The transmembrane serine protease 2 (TMPRSS2) gene plays a crucial role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by priming the viral spike protein for membrane fusion and facilitating viral entry into host cells. This review aims to explore the molecular function of TMPRSS2, its genetic variations, and its potential as a therapeutic target in corona virus disease 2019 (COVID-19) and other respiratory viral infections. TMPRSS2 is highly expressed in lung and prostate tissues and is regulated by androgens, which may contribute to sex-based differences in COVID-19 severity. Genetic polymorphisms in TMPRSS2 have been been associated with variability in disease susceptibility and severity across populations. Several TMPRSS2 inhibitors, including serine protease inhibitors, such as camostat mesylate and nafamostat, have demonstarted promise in blocking viral entry. In addition, RNA based strategies such as siRNA and clustered regularly interspaced short palindromic repeats offer potential approaches for downregulating TMPRSS2 expression. However, the development of selective inhibitors that avoid off target effects remains a challenge. The presence of TMPRSS2-ERG gene fusion, commonly found in prostate cancer, has also been linked to altered COVID-19 susceptibility, suggesting a complex interplay between viral infection and cancer biology. This review also discusses future perspectives, including large-scale genomic studies to identify high-risk individuals, the development of next-generation TMPRSS2 inhibitors, and potential broad-spectrum antiviral therapies targeting TMPRSS2.

Objective: The aim of this study is to demonstrate the reliability of Quantitative Ultrasound (QUS) in assessing liver fat content in children, using magnetic resonance imaging proton density fat fraction (MRI-PDFF) values as a reference, and to determine threshold values for QUS in grading hepatosteatosis.

Methods: The study group consisted of pediatric patients under 18 years of age without known liver disease who volunteered to participate. All patients underwent MRI-PDFF scanning, and QUS imaging was performed using the tissue attenuation imaging (TAI) ve tissue scatter distribution imaging (TSI) tools. The cut-off values for MRI-PDFF were set at ≥5%, ≥16.3%, and ≥21.7%, corresponding to mild, moderate, and severe steatosis, respectively. The diagnostic performance of TAI and TSI in detecting various degrees of hepatic steatosis was evaluated using the area under the ROC (AUROC) curves.

Results: The frequencies of hepatosteatosis grading were as follows: S1: 19 (37%), S2: 5 (10%), S3: 22 (43%). The AUROCs for TAI and TSI tools in detecting QUS measurements (MRI PDFF ≥5%) were 0.95 [95% confidence interval (CI): 0.91-0.99] (p< 0.001) and 0.96 (95% CI: 0.93-0.99) (p<0.001), respectively. For distinguishing different degrees of steatosis, TAI showed values of 0.75, 0.86, and 0.96 dB/cm/MHz, corresponding to sensitivities of 88%, 88%, and 100%, respectively, while TSI showed values of 92.44, 96.64, and 99.45, with sensitivities of 90%, 92%, and 91.7%. The correlation test between QUS measurements [TAI, TSI, EzHRI (Hepato-Renal Index with Automated regions of interest Recommendation)] and MR-PDFF indicated a concordance in TAI and TSI values, but not with EzHR.

Conclusions: The TAI and TSI tools can accurately measure liver fat content and can be used reliably in children for the assessment and grading of hepatosteatosis.

Objective: The goal of our study is to evaluate and classify the variations of the anterior communicating artery (AComA) on fresh cadavers from the Türkiye population.

Methods: In this study, 182 fresh cadavers were analysed and classified according to the number, shape and course of the AcomA.

Results: In our study, typical AcomA was the most common with a rate of 86 (47.25%), while variations of the AcomA were found in the remaining 96 (52.75%) cases. Among these variations, in 11.46% (11/96) of cases, AcomA variations were identified as distal and proximal duplications according to the number of branches they represented; 68.75% (66/96) of cases were identified by their shape (X-shaped, single/double fenestration, hypoplasia, or aplasia); and, in 19 cases, it was characterized by course (median artery or oblique course). The rate of variations was 65% (26/40) in females and 49.29% (70/142) in males. In our study, the X-shaped and single fenestration variations were recorded as the most common.

Conclusions: The results of the study are important for cerebrovascular surgery and radiological interventions. It emphasises the importance of recognising and considering variations. The study will contribute to the understanding of cerebrovascular diseases and the development of treatment strategies.

Objective: Schizophrenia is a multifaceted psychiatric disorder that affects about 1% of the world's population and arises from a combination of genetic, environmental, and neurodevelopmental influences. Recent studies highlight the role of immune system disturbances and neuroinflammation in its development, with tumor necrosis factor-alpha (TNF-α) identified as a pivotal cytokine. This meta-analysis aims to clarify the relationship between the TNF-α rs1800629 genetic variant and the risk of schizophrenia by synthesizing data from published research.

Methods: Two independent reviewers systematically searched PubMed, Web of Science, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure for studies published up to January 19, 2024. Odds ratios and 95% confidence intervals were computed using a fixed-effects model, taking into account the absence of significant heterogeneity.

Results: A total of 33 case-control studies were included, encompassing 7,624 individuals with schizophrenia and 8,933 healthy controls from diverse backgrounds (21 studies on Asian populations, 11 on Caucasian, and one on a mixed group) conducted between 2001 and 2020. The pooled analysis did not reveal a significant link between the TNF-α rs1800629 polymorphism and susceptibility to schizophrenia under any genetic model. Further subgroup analyses by ethnicity (Asian, Caucasian), country (China, Poland), genotyping technique, and publication year also yielded no notable associations.

Conclusions: This comprehensive meta-analysis offers strong evidence that the TNF-α rs1800629 variant is not significantly associated with schizophrenia risk, either globally or within specific ethnic groups. These findings indicate that this polymorphism likely does not play a major role in schizophrenia susceptibility, underscoring the importance of future investigations into other TNF-α variants, gene-gene interactions, or alternative inflammatory mechanisms.

Objective: This study investigated the herb-drug interaction between silibinin and carbamazepine (CBZ) and the potential risk of adverse drug reactions (ADR) when silibinin is co-administered with other drugs.

Methods: Primary fresh hepatocytes were cultured, and an methylthiazolyldiphenyl-tetrazolium bromide assay was performed after administration of different concentrations of CBZ, and silibinin. Meanwhile, a retrospective study on hepatic adverse reactions involving the combination of silibinin with other drugs was performed using the Food and Drug Administration Adverse Event Reporting System (FAERS).

Results: The protective effects of silibinin on CBZ do not appear on hepatocytes in a dose-dependent manner. When silibinin (25μM) was co-administered with CBZ (2mM), the cell viability increased from 47.8% to 75.9% (p<0.05), while increasing the silibinin concentration to 50μM with CBZ (2mM), the hepatocyte viability significantly declined from 47.8% to 38.7% (p<0.05). In the FAERS database, the risk of adverse reactions significantly increases when combined with silibinin. The silibinin co-administration was significantly associated with hepatotoxicity reports.

Conclusions: The results of the cell experiment showed that silibinin's liver protective effects were uncertain when it was combined with CBZ. FAERS database analysis revealed elevated risks of ADRs with silibinin co-administration, collectively highlighting the necessity for vigilance against unanticipated herb-drug interactions.