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Öğe Donor impact on allogeneic transplant outcomes with PTCy for severe aplastic anemia: a study of the SAAWP EBMT(Scientific & Medical Division, 2025) Montoro, Juan; Eikema, Dirk-Jan; Piepenbroek, Brian; Tuffnell, Joe; Halahleh, Khalid; Kulagin, Alexander; AlAhmari, Ali; Adaklı Aksoy, Başak; Remenyi, Peter; Itala-Remes, Maija; Gülbaş, Zafer; McDonald, Andrew; Apte, Shashikant; Kwon, Mi; Rovira, Montserrat; Kharya, Gaurav; Potter, Victoria; Gambella, Massimilano; Schroeder, Thomas; Giammarco, Sabrina; Bazarbachi, Ali; Aljurf, Mahmoud; Ho, Aloysius; Dalle, Jean-Hugues; Vydra, Jan; Sanz, Jaime; Perez-Simon, Jose Antonio; Colita, Anca; Collin, Matthew; Tanase, Alina; Halkes, Constantijn; Kulasekararaj, Austin; Risitano, Antonio; de Latour, Regis PeffaultThe use of post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis in severe aplastic anemia (SAA) remains understudied, particularly beyond haploidentical transplants. We analyzed outcomes of SAA patients who underwent stem cell transplantation (SCT) with PTCy from haploidentical donors (n = 209), HLA-matched sibling donors (MSD, n = 70), and unrelated donors (UD, n = 69) using EBMT data from 2010 to 2022. Median age was 22 years, and median time to transplantation was 8.6 months. For haploidentical, MSD, and UD cohorts, the 100-day cumulative incidence of grade II-IV acute GVHD was 19%, 11%, and 14% (p = 0.15), while grade III-IV was 6%, 3%, and 2% (p = 0.1). Two-year chronic and extensive chronic GVHD were 14%, 13%, and 14% (p = 0.1) and 5%, 6%, and 2% (p = 0.5), respectively. Non-relapse mortality at two years was 24% for haploidentical, 7% for MSD, and 10% for UD (p = 0.003). Two-year overall survival (OS) and GVHD- and relapse-free survival were 66% and 54% for haploidentical, 92% and 70% for MSD, and 81% and 66% for UD (p < 0.001, p = 0.06). In multivariable analysis, MSD and UD were associated with superior OS and GRFS compared to haploidentical. PTCy is safe and effective in SAA patients, though haploidentical SCT had higher NRM, leading to lower survival.Öğe A Cross-sectional Analysis of Immunological and Hematological Parameters in Patients With Chronic Opioid Use(Lippincott Williams & Wilkins, 2025) Ergelen, Mine; Usta Sağlam, Nazife Gamze; Arpacıoğlu, Mahmut Selim; Yalçın, Murat; İzci, FilizBackground and Aim: Previous research has recognized the dual role of opioids [agonists at μ-opioid receptors (MOP-r agonists)] in modulating immunity and neuroinflammation in individuals with opioid use disorder (OUD). This cross-sectional study investigates the interplay between chronic use of MOP-r agonists and inflammatory parameters in individuals with OUD, with the goal of providing insights into the relationship between immunological responses and OUD. Materials and Methods: A cohort of 129 patients with OUD seeking treatment at an addiction detoxification center underwent detailed clinical assessments. Blood samples were collected for analyses of serum alanine aminotransferase, aspartate aminotransferase, and C-reactive protein levels, and a complete blood count. Participants were categorized into inflammation and noninflammation groups based on C-reactive protein levels. Hematological and inflammation indices, along with pain severity, were compared between these groups. Results: Significant differences were observed between the inflammation and noninflammation groups on variables such as duration of MOP-r agonist intake, daily buprenorphine/naloxone dose, consumption route, severity of withdrawal symptoms, and level of self-reported pain. The inflammation group exhibited higher neutrophil counts and an increased neutrophil-to-lymphocyte ratio. The binary logistic regression models revealed that self-reported pain level, daily buprenorphine/naloxone dosage, Beck Depression Inventory scores, and age were significant predictors of inflammation. Conclusions: This study contributes to our understanding of OUD as a chronic inflammatory condition, shedding light on the intricate relationships between MOP-r agonist addiction, inflammatory responses, and withdrawal-related parameters. The findings offer valuable perspectives on effective management, emphasizing the need for further research in diverse populations to enhance understanding of this complex condition.Öğe Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): a randomised, multicentre, open-label, phase 3 trial(Elsevier, 2025) Paz-Ares, Luis; Borghaei, Hossein; Liu, Stephen V.; Peters, Solange; Herbst, Roy S.; Stencel, Katarzyna; Majem, Margarita; Şendur, Mehmet Ali Nahit; Czyzewicz, Grzegorz; Caro, Reyes Bernabe; Lee, Ki Hyeong; Johnson, Melissa L.; Karadurmuş, Nuri; Grohe, Christian; Baka, Sofia; Csoszi, Tibor; Ahn, Jin Seok; Califano, Raffaele; Yang, Tsung-Ying; Kemal, Yasemin; Ballinger, Marcus; Cuchelkar, Vaikunth; Graupner, Vilma; Lin, Ya-Chen; Chakrabarti, Debasis; Bhatt, Kamalnayan; Cai, George; Iannone, Robert; Reck, Martin; IMforte investigatorsBackground: Despite improved efficacy with first-line immune checkpoint inhibitors plus platinum-based chemotherapy for extensive-stage small-cell lung cancer (ES-SCLC), survival remains poor. In this study, we aimed to compare lurbinectedin plus atezolizumab and atezolizumab alone as maintenance therapies in patients with ES-SCLC without progression after induction therapy with atezolizumab, carboplatin, and etoposide. Methods: IMforte was a randomised, open-label, phase 3 trial done at 96 hospitals and medical centres in 13 countries (Belgium, Germany, Greece, Hungary, Italy, Mexico, Poland, South Korea, Spain, Taiwan, Türkiye, the UK, and the USA). Eligible patients were aged 18 years or older with treatment-naive ES-SCLC. Patients received four 21-day cycles of induction treatment (atezolizumab, carboplatin, and etoposide). After completing induction treatment, eligible patients without disease progression were randomly assigned (1:1) using permuted blocks (Interactive Voice/Web Response System) to receive maintenance treatment intravenously every 3 weeks with lurbinectedin (3·2 mg/m2; with granulocyte colony-stimulating factor prophylaxis) plus atezolizumab (1200 mg) or atezolizumab (1200 mg). The two primary endpoints were independent review facility-assessed (IRF) progression-free survival and overall survival, measured from randomisation into the maintenance phase. Efficacy endpoints were assessed in the full analysis set, which included all patients who were randomly assigned to maintenance phase treatment, regardless of whether they received their assigned study treatment. Safety was assessed in all patients who received at least one dose of lurbinectedin or atezolizumab, and was analysed according to the treatment received. This study is registered with ClinicalTrials.gov, NCT05091567, and is closed for recruitment. Findings: Between Nov 17, 2021, and Jan 11, 2024, 895 patients were screened for enrolment, of whom 660 (74%) were enrolled into the induction phase. Between May 24, 2022, and April 30, 2024, 483 (73%) of 660 patients entered the maintenance phase and were randomly assigned to lurbinectedin plus atezolizumab (n=242) or atezolizumab (n=241). At the data cutoff (July 29, 2024), IRF progression-free survival was longer in the lurbinectedin plus atezolizumab group than the atezolizumab group (stratified hazard ratio [HR] 0·54 [95% CI 0·43–0·67]; p<0·0001), as was overall survival (stratified HR 0·73 [0·57–0·95]; p=0·017). 92 (38%) of 242 patients in the lurbinectedin plus atezolizumab group and 53 (22%) of 240 patients in the atezolizumab group had grade 3–4 adverse events. The most common grade 3–4 events in the lurbinectedin plus atezolizumab group were anaemia (20 [8%] of 242 patients), decreased neutrophil count (18 [7%] patients), and decreased platelet count (18 [7%] patients) and the most common events in the atezolizumab group were hyponatremia (five [2%] of 240 patients), dyspnoea (four [2%] patients), and pneumonia (four [2%] patients). Grade 5 adverse events occurred in 12 (5%) of 242 patients in the lurbinectedin plus atezolizumab group and six (3%) of 240 patients in the atezolizumab group. The incidence of myelosuppressive toxicities (eg, neutropenia and leukopenia) was higher in the lurbinectedin plus atezolizumab group than the atezolizumab group. Interpretation: IRF progression-free survival and overall survival were longer in the lurbinectedin plus atezolizumab group than the atezolizumab group for patients with ES-SCLC, albeit with a higher incidence of adverse events. Lurbinectedin plus atezolizumab represents a novel therapeutic option for first-line maintenance treatment in this setting. Funding: F Hoffmann-La Roche and Jazz Pharmaceuticals.Öğe Naples Prognostic Score Predicts New-Onset Atrial Fibrillation in Patients with ST-Elevated Myocardial Infarction Undergoing Primary Angioplasty(Sociedad Brasileira De Cardiologia, 2025) Okşen, Doğaç; Arslan, Şükrü; Heja Geçit, Muhammed; Ertürk Tekin, Esra; Oktay ,Veysel; Abacı, OkayBackground: New-onset atrial fibrillation (NOAF) is a typical complication in patients with ST-segment elevated myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Previous studies have investigated inflammation as a NOAF predictor. The Naples prognostic score (NPS) is a novel marker of inflammation and nutritional status. Objective: The objective of this study was to evaluate the predictive power of the NPS for NOAF. Methods: This study enrolled 1537 consecutive STEMI who underwent pPCI. The patients who presented NOAF during hospital admission and those who remained in sinus rhythm (RSR) were compared in terms of baseline characteristics. Univariate and multivariate analyses were carried out to identify variables predicting NOAF development, and p< 0.05 was considered statistically significant. Results: NOAF was detected in 7.74% (n: 119) of the participants. The mean age (67.03±13.48 vs 57.84±11.31; p <0.001) and NPS (2.53±1.17 vs 2.25±1.10, p=0.008) were significantly higher in the NOAF group. Multivariate analysis revealed age (Odds ratio [OR]: 1.045 for a year, 95% confidence interval [CI]: 1.019–1.071, p=0.001), NPS (OR: 1.645, 95% CI: 0.984–2.748, p=0.037) and left atrial dimensions (OR: 2.542 for cm, 95% CI: 1.488–4.342, p=0.001) as independent predictors of NOAF. Conclusions: The NPS was an independent predictor of NOAF in STEMI patients, in addition to classical factors such as age and left atrial dimensions. This score, mostly related to an inflammatory burden, may help to predict NOAF incidence and select better potential therapies aimed at abating inflammation after myocardial infarction.Öğe Postmortem Inductively Coupled Plasma Mass Spectrometry Analysis Reveals Elevated Heavy Metal Concentrations in Coronary Arteries: A Comparative Autopsy Study Supporting a Toxic Inflammatory Hypothesis for Atherosclerosis(S. Karger, 2025) Yolay, Onur; KAsapbaşı, Emine Esra; Tezcan, Erdem; Küçük, Ceyhun; Karaoğlu, Hasan; Cantürk, Emir; İnan, Bekir; Okşen, Doğaç; Çetinarslan, Özge; Umihanic, Fadil; Albayrak, Serdar Baki; Olcay, AyhanIntroduction: A large number of studies have been carried out for the etiology of atherosclerosis and many risk factors have been identified, including environmental factors and heavy metals, which are related to the pathogenesis. This study aimed to determine the effects of heavy metals, which have activation and inhibition effects on various metabolic pathways, on atherosclerosis by examining coronary arteries obtained from autopsy series. Methods: Coronary arteries of 28 autopsy cases were analyzed by inductively coupled plasma mass spectrometry method. Sixteen of the cases had coronary atherosclerotic plaques and 12 of the coronaries were normal. Twenty trace metal concentrations were examined from the samples obtained. Results: Twenty-eight coronary artery samples (16 with atherosclerosis, 12 normal) were analyzed using ICP-MS. Levels of Mg, K, Ca, P, Fe, Zn, Al, S, As, Pt, Sb, Hg were significantly higher in atherosclerotic arteries (e.g., Ca: 51,384 vs. 1,723 ppm, p = 0.005; P: 30,791 vs. 3,443 ppm, p = 0.003; Hg: 3.2 vs. 0 ppm, p < 0.001). Elements such as lead, cobalt, and cadmium remained below detection limits in both groups. Conclusion: Heavy metals through inflammation, oxidative stress, and disrupted antioxidant pathways are independent risk factors that increase the risk of atherosclerosis. These findings provide tissue-level evidence that heavy metal accumulation may contribute to atherosclerosis through oxidative stress, inflammation, and disruption of antioxidant defenses.Öğe Trastuzumab deruxtecan (T-DXd) plus pertuzumab (P) vs taxane plus trastuzumab plus pertuzumab (THP) for first-line (1L) treatment of patients (pts) with human epidermal growth factor receptor 2-positive (HER2+) advanced/metastatic breast cancer (a/mBC): Interim results from DESTINY-Breast09.(LIPPINCOTT WILLIAMS & WILKINS, 2025) Tolaney, Sara M.; Jiang, Zefei; Zhang, Qingyuan; Barroso-Sousa, Romualdo; Park, Yeon Hee; Rimawi, Mothaffar F.; Saura Manich, Cristina; Schneeweiss, Andreas; Toi, Masakazu; Chae, Yee Soo; Kemal, Yasemin; Chaudhari, Mukesh; Yamashita, Toshinari; Casalnuovo, Monica; Danso, Michael A.; Liu, Jie; Shetty, Jagdish; Herbolsheimer, Pia Maarit; Loibl, Sibylle...Öğe Antimicrobial Lock Therapy: Is it a Real Savior in Pediatric Hematopoetic Stem Cell Transplant (HSCT) Patients?(Turkish Society of Haematology, 2025) Kara, Manolya; Sürçü, Murat; Adaklı Aksoy, Başak; Zengin Ersoy, Gizem; Başoğlu Öner, Özlem; Yaman, Ayhan; Özbek, Ahmet; Bozkurt, Ceyhun; Fışgın, TunçObjective: Central line-associated bloodstream infection (CLABSI) is a significant cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). Antimicrobial lock treatment (ALT), when utilized alongside systemic antibiotics, may be lifesaving when catheter removal (CR) is not feasible. Materials and methods: This retrospective study analyzed the clinical, laboratory, and microbiologic characteristics of CLABSI episodes of pediatric patients who underwent HSCT and applied ALT. Results: There were 137 cases of CLABSI (63.5 male) who were given ALT. The median age was 48 (3-204) months. The most common causative microorganism was Gram-negative bacteria, encountered in 85 patients (62%). Forty-six patients (33.6%) had Gram-positive bacterial growth, whereas 6 had (4.4%) fungal infection. ALT was successful in 77.4% of the patients (n=106). CR was required in 25 patients (18.2%). The CLABSI-related mortality rate was 12.4%. When the outcome of ALT was evaluated, post-transplantation cyclophosphamide (PTCy) use, fungal growth, persistent bacteremia/fungemia, re-HSCT, inappropriate empirical antibiotic use, hypotension, and pediatric intensive care unit admission were significantly more common in the "unsuccessful" ALT group. The patients in the unsuccessful group had higher C-reactive protein [110.2 (1.10-323.5) mg/L] levels when compared to the successful ALT group [58 (0.2-450.3) mg/L] (p=0.029). The presence of hypotension, HLA-mismatch transplantation, and persistent bacteremia/fungemia were independent risk factors for ALT failure. Conclusion: ALT can be an effective catheter-saving strategy in HSCT pediatric patients. Nevertheless, patients should be monitored very closely during ALT, and the presence of certain risk factors should be taken into account.Öğe Detecting subclinical cardiotoxicity during immune checkpoint inhibitor therapy: a combined GLS and ECG repolarization analysis(Frontiers Research Foundation, 2025) Okşen, Doğaç; Geçit, Muhammed Heja; Arslan, Şükrü; Aslan, Muzaffer; Yavuz, Yunus Emre; Seçmeler, Şaban; Oktay, VeyselPurpose: Immune checkpoint inhibitors (ICIs) can induce subclinical cardiac dysfunction that often goes undetected by conventional monitoring. This study evaluated whether echocardiographic global longitudinal strain (GLS) and electrocardiographic (ECG) repolarization parameters could detect early, subclinical cardiotoxicity in patients with cancer and without pre-existing cardiovascular disease undergoing ICI therapy. Methods: A observational cohort study included 74 patients with cancer treated with ICIs between January 2023 and August 2024. Echocardiographic GLS measurements and detailed ECG analyses were performed at baseline and repeated at 6 months. Cardiotoxicity was defined as a significant reduction in GLS or left ventricular ejection fraction. Correlations between GLS and ECG repolarization parameters were statistically assessed. Results: At 6 months, significant subclinical myocardial impairment was observed, with GLS decreasing from 19.40 ± 1.07% to 17.70 ± 1.62% (p<0.001). Notable ECG changes included increased QT dispersion (40.10 ± 10.55 ms to 50.20 ± 15.30 ms, p=0.001), QTc prolongation (420.45 ± 20.60 ms to 430.75 ± 25.40 ms, p=0.013), increased Tp-e interval (80.21 ± 10.45 ms to 85.30 ± 12.40 ms, p=0.021), and elevated heart rate (72.21 ± 8.40 bpm to 75.35 ± 9.15 bpm, p=0.037). GLS was negatively correlated with QT dispersion (r = -0.845, p < 0.05) and Tp-e intervals (r = -0.478, p = 0.052). Conclusion: GLS and ECG repolarization parameters, particularly QT dispersion and Tp-e intervals, effectively detect subclinical myocardial dysfunction in patients with cancer undergoing ICI therapy. These findings underscore the importance of comprehensive cardiac monitoring to enable early intervention and mitigate cardiotoxicity risk during immunotherapy.Öğe Age Is a Crucial Determinant of GFRS with Incidence of Severe Chronic GVHD Reducing over Time in Haemopoietic Cell Transplantation for Transfusion Dependent Thalassaemia: Real World Data from 2010-2021. an Analysis of the European Society for Blood and Bone Marrow Transplantation Hemoglobinopathy Working Party(ELSEVIER, 2024) Baronciani, Donatella; de la Fuente, Josu; Galimard, Jacques-Emanuel; Dalissier, Arnaud; Mousavi, Ashrafsadat; Yeşilipek, Akif; Hashem, Hasan; Öztürk, Gülyüz; Locatelli, Franco; Alahmari, Ali; Gaziev, Javid; Antmen, Ali Bülent; Küpesiz, O. Alphan; Fışgın, Tunç; La Nasa, Giorgio; Lankester, Arjan C.; Goussetis, Eugene; Bremathas, Sandrine...Öğe Early detection of ventricular dysfunction in LADA using novel tissue Doppler parameters: A case-control study(Sherborne Gibbs, 2025) Okşen, Doğaç; Aslan, Muzaffer; Yavuz, Yunus Emre; Kaynak, Çağdaş; Ertürk Tekin, EsraIntroduction & ObjectiveLatent autoimmune diabetes mellitus (LADA), a heterogeneous disease, is much more common in society than thought. Although it has been claimed that LADA is similar to type 2 diabetes mellitus (T2DM) from a cardiovascular perspective, there is no clear consensus. In this context, the objective of this study is to assess subclinical dysfunction in the left and right ventricles in patients with LADA using novel tissue Doppler imaging (TDI) parameters.Materials &MethodsThe sample of this observational case-control study consisted of 57 consecutive patients aged between 30 and 70 years who applied to the endocrinology and metabolism outpatient clinics, were diagnosed with LADA, and were referred to the cardiology clinic for echocardiographic (ECHO) evaluation. The control group consisted of 60 healthy volunteers. Participants' demographic and clinical characteristics and laboratory findings were recorded. All participants underwent ECHO using conventional ECHO and TDI. Subclinical left ventricular dysfunction was assessed using the myocardial performance index (MPI) and isovolumic myocardial acceleration (IVA).ResultsThere were no significant differences between the patient and control groups in terms of conventional ECHO parameters. The left ventricular (LV) MPI was significantly higher in the patient group than in the control group (0.54 ± 0.11 vs 0.47 ± 0.07, p = 0.008). There was no significant difference between the groups in right ventricular (RV) MPI (0.49 ± 0.10 vs 0.46 ± 0.70, p = 0.217). IVA was decreased in both ventricles (IVA mitral: 3.03 ± 1.44 vs 3.78 ± 1.66, p = 0.008 and IVA tricuspid: 2.67 ± 0.88 vs 3.42 ± 0.97, p = 0.034). Both LV IVA and RV IVA were found to be significantly correlated with glutamic acid decarboxylase antibodies' (GADA) levels in the negative direction (R = -0.290, p = 0.005 and R = -0.340, p = 0.001).ConclusionsIt was observed that LADA negatively affected the systolic and diastolic functions of both ventricles, with its effect being more pronounced in the left ventricle. Glycemic control and autoantibody titers were found to be correlated with TDI parameters, emphasizing their relevance in assessing cardiac dysfunction.Öğe Effect of genetic mutations on outcomes of stem cell transplantation in children with hemophagocytic lymphohistiocytosis(2025) Öztürk, Gülyüz; Yeşilipek, Mehmet Akif; Akçay, Arzu; Uygun, Vedat; Özek, Gülcihan; Karasu, Gülsün; Yılmaz, Ebru; Demir Yenigürbüz, Fatma; Öztürkmen, Seda; Aksoylar, Serap; Ok Bozkaya, İkbal; Yalçın, Koray; Adaklı Aksoy, Başak; Ünal, Ekrem; Akıncı, Burcu; Daloğlu, Hayriye; Karagün, Barbaros Şahin; Kansoy, Savaş; Özbek, Namık; İnce, Elif; Demir, Hacı Ahmet; Gündoğdu, Müge; Malbora, Barış; Karakükçü, Musa; Elli, Murat; Akyay, Arzu; Güneş, Adalet Meral; Akbayram, Sinan; Sarper, Nazan; Castello, Buket Erer Del; Hazar, Volkan; Antmen, BülentPrimary hemophagocytic lymphohistiocytosis (p-HLH) can be cured with allogeneic haematopoietic stem cell transplantation (allo-HSCT). It remains unclear whether HSCT outcomes are affected by the presence of different genetic mutations. We used data obtained from children who underwent allo-HSCT for HLH to examine the effects of genetic mutations on HSCT outcomes. Data from 153 paediatric patients in 18 paediatric stem cell centres were retrospectively evaluated. Patients were divided into four groups: 1) with PRF1 mutation (n = 46), 2) with UNC13D mutation (n = 38), 3) with STX11/STXBP2 mutation (n = 25) and 4) with Griscelli syndrome type 2/ Chediak–Higashi syndrome (GS2/CHS) diagnosis (n = 44). Statistical analysis showed no difference between the subgroups in terms of engraftment, VOD, acute GVHD, chronic GVHD, TRM, OS and EFS rates. The most important factor affecting OS and EFS in all genetic subgroups was remission status before HSCT. The 5-year EFS values for children with mutations in PRF1, UNC13D, STX11/STXBP2 and GS2/CHS were 71%, 66.6%, 74% and 66.7, respectively (log-rank >0.05). However, with prospective studies covering more patients, and creating different genetic subgroups by performing more detailed genetic analyses, special approaches for different genetic subgroups can be revealed in the future.Öğe Correction to : The Psychometric Properties of Autism Mental Status Examination (AMSE) in Turkish Sample(2025) Meral, Yavuz; Bıkmazer, Alperen; Örengül, Abdurrahman Cahid; Çakıroğlu, Süleyman; Altınbilek, Esra; Bakır, Fulya; Bıkmazer, Bilgihan; Saleh, Ayman; Görmez, Vahdet...Öğe Gross deletion in KIF11: A de novo occurrence(Springer Nature, 2024) Şentürk, Hilal; Eraslan, Burak; Akbaş, Sinan; Uygur, Türkan; Aslanger, Ayça Dilruba; Karaman, Volkan; Sayın, Gözde Yeşil; Toksoy, Güven; Uyguner, Zehra Oya...Öğe Evaluation of Subclinical Left Ventricular Dysfunction in HIV Patients Receiving Abacavir, Dolutegravir, and Lamivudine Therapy with Novel Tissue Doppler Imaging Techniques(MDPI, 2025) Okşen, Doğaç; Aslan, Muzaffer; Serin, Ebru; Geçit, Muhammed Heja; Yavuz, Yunus Emre; Yerlikaya Zerdali, Esra; Oktay, VeyselBackground/Objectives: Highly active antiretroviral therapy (HAART) effectively suppresses viral load and aids immunological recovery in HIV patients, but may still lead to subclinical myocardial dysfunction. This study assesses left and right ventricular functions in patients on HAART containing abacavir, dolutegravir, and lamivudine using Tissue Doppler Imaging (TDI). Methods: This observational cross-sectional study involved 118 HIV-positive adults on HAART and 80 age- and gender-matched healthy controls. Comprehensive echocardiographic assessments, including TDI, were conducted to evaluate myocardial performance index (MPI) and isovolumic acceleration (IVA). Results: Conventional echocardiographic parameters showed no significant differences; however, TDI indicated significant impairments in ventricular functions in the HAART group, with increased MPI and decreased IVA (p < 0.001). Pulmonary artery pressures were also higher in the HIV group (p = 0.012). There was a strong positive correlation between MPI and HAART duration (r = 0.675, p = 0.002), and a negative correlation with CD4 count (r = −0.545, p = 0.006). Conclusions: TDI reveals significant subclinical ventricular dysfunction in HIV patients on HAART, correlating with therapy duration and immune status. These findings underscore the utility of TDI in detecting myocardial deterioration before clinical symptoms appear.Öğe The Psychometric Properties of Autism Mental Status Examination (AMSE) in Turkish Sample(2025) Meral, Yavuz; Bıkmazer, Alperen; Örengül, Abdurrahman Cahid; Çakıroğlu, Süleyman; Altınbilek, Esra; Bakır, Fulya; Bıkmazer, Bilgihan; Saleh, Ayman; Görmez, VahdetAutism Spectrum Disorder (ASD) is a prevalent neurodevelopmental disorder, and early diagnosis plays a pivotal role in prognosis and management. This study aims to examine the psychometric properties of the Autism Mental Status Exam (AMSE), a tool that shows great promise in terms of clinical utility, within the Turkish population. This study conducted in a cohort of 307 Turkish children aged 17 to 120 months with suspected ASD. Participants underwent a multidisciplinary assessment based on DSM-5 criteria for diagnosis and were categorized into ASD and non-ASD groups. Subsequently, the research team conducted blinded administrations of the AMSE and Childhood Autism Rating Scale (CARS). Additionally, a subset of 61 children underwent retesting for AMSE and CARS after three weeks for temporal stability. The results revealed an optimal cut-off score of 4 for AMSE, yielding sensitivity and specificity rates of 84% and 97%, respectively. Internal consistency, indicated by a Cronbach’s alpha of 0.80, was very good. The test-retest reliability, assessed using the Intraclass Correlation Coefficient (ICC), was excellent (ICC = 0.959). The inter-rater reliability also showed excellent agreement (ICC = 0.997). Furthermore, a significant correlation was observed between the AMSE and CARS scores (r = 0.94, p < 0.001). Notably, the AMSE scores were significantly different between the ASD and non-ASD groups (p < 0.001) with a large effect size (Cohen’s d = 1.40). The findings of this study underscore the utility of AMSE as a valid and reliable tool for Turkish children with robust psychometric properties.Öğe Music Therapy may Decrease Radial Artery Spasm Rates and Increase Satisfaction during Coronary Angiography(2025) Aslan, Muzaffer; Okşen, Doğaç; Yavuz, Yunus Emre; Kaynak, ÇağdaşIntroduction: With the widespread use of the radial artery in catheterization procedures, radial artery spasm (RAS) is frequently considered an undesirable event. It is known that anxiety increases RAS, and listening to music helps individuals control anxiety during the procedure. This study aimed to investigate the effects of music concerts on RAS. Methods: In this prospective study, imaging and interventional coronary catheterization procedures using the radial artery were included. One group listened to a musical recital during the procedure, while the other group was treated in a quiet environment. The demographics, procedural parameters, and complications of both groups were compared. Results: The study included a total of 147 patients, with an average age of 51.6 ± 11.1 years. Of these, 78 patients (53%) listened to music, while 69 patients (46.9%) underwent catheterization in a quiet environment. The impact of music therapy on the RAS was found to be significant (11.5% vs. 20.3%; p=0.035). While music therapy showed a potential to reduce RAS rates, its effect was not statistically significant in multivariate analysis (p=0.055). Conclusion: Music is a feasible, simple, and inexpensive method for reducing anxiety levels in patients. Listening to music during catheterization can reduce procedural discomfort and the frequency of undesirable events by helping people control their anxiety.Öğe Traces of earthquake: traumatic life experiences and their effects on volunteer nurses in the earthquake zone-an interpretative phenomenological study(2025) Çelebi Çakıroğlu, Oya; Tuncer Ünver, Gamze; Çakıroğlu, SüleymanIntroduction: It is crucial to understand the effects that traumatic events related to natural disasters have on individuals in as much detail as possible. However, the literature investigating the traumatic life experiences of nurses, who play a key role in disaster management, is still limited. Objective: The aim of this study was to explore in depth the traumatic life experiences of volunteer nurses who participated in relief efforts after two major earthquakes in the southeastern region of Türkiye. Methods: This qualitative study was conducted using a phenomenological design. The study sample consisted of 16 nurses selected by the purposive and snowball sampling methods. The data were evaluated using interpretative phenomenological analysis in the Maxqda 2020 program. Results: Four themes were generated: (1) shocking facts, (2) coping methods, (3) traumatic stress reactions, and (4) traumatic growth. Conclusion: While traumatic life experiences in the earthquake area led to acute stress reactions in the volunteer nurses, these experiences also contributed to their traumatic growth and development. Healthcare managers and policymakers should develop comprehensive strategies and intervention programs to safeguard the mental health of nurses in the context of natural disasters. It may also be useful to improve clinical education programs and support systems by reviewing international policies and procedures.Öğe Relationship between fibrinogen values and sensitivity and specificity of STS ccore, euroscore for patients undergoing open heart surgery(Forum Multimedia Publishing LLC, 2024) Aydınlı, Bahar; Tekin, Esra Ertürk; Yeşiltaş, Mehmet Ali; Okşen, Doğaç; Özmen, HarunBackground/Aim: Cardiovascular diseases are a leading cause of mortality worldwide, with surgical interventions playing a crucial role in outcomes. Despite technological advancements and improved operator experience, perioperative and postoperative risks remain significant, particularly for high-risk patients. Fibrinogen, an acute-phase reactant, increases during inflammation and plays a role in coagulation. This study investigates the prognostic impact of fibrinogen levels on the outcomes of cardiac surgery and evaluates its relationship with established risk classification systems. Materials and Methods: This observational cohort study included 105 patients who underwent cardiac surgery between May 2018 and December 2023. Patients with coronary bypass grafting and valve surgery were included, while those with transplantation, congenital heart surgery, or other significant conditions were excluded. Patient data, including demographic information, comorbidities, laboratory parameters, and surgical details, were collected. The fibrinogen cutoff value was determined using the Youden index. Statistical analyses were performed using SPSS 23.0, with p-values < 0.05 considered significant. Results: Of the 116 individuals screened, 105 were included in the study. The HighFib group (>3.8 g/dL) showed higher rates of complications, such as low cardiac output, prolonged mechanical ventilation, and atrial fibrillation, compared to the LowFib group (<3.8 g/dL). The HighFib group also had lower preoperative hemoglobin levels and higher Euroscore values. Logistic regression analysis demonstrated that both fibrinogen levels and established risk scores were significant predictors of postoperative complications. Conclusion: Elevated fibrinogen levels are associated with increased postoperative complications in cardiac surgery patients. Fibrinogen, alongside traditional risk scores, can be a valuable predictor of adverse outcomes. Prospective studies are needed to further validate these findings and establish optimal fibrinogen management strategies in cardiac surgery.Öğe Childhood mental traumas and the meaning of life : the mediating role of forgiveness(2024) Arpacıoğlu, Mahmut Selim; Turanlar, Tuğçe; Çakıroğlu, SüleymanChildhood trauma can disrupt one's sense of the meaning of life. Forgiveness can be an important strategy in restoring the meaning of life and gaining a new meaning. In this context, the present study aims to test the theoretical model evaluating the hypothesis that forgiveness repairs the meaning of life deteriorated after traumas and makes positive contributions. A total of 552 individuals, 369 female (66.8%) and 183 male (33.2%), participated in the study. The sample group of the study was found by using a convenience sampling method via online survey. Introductory information form, The Childhood Trauma Questionnaire (CTQ-28), Heartland Forgiveness Scale, and the Meaning in Life Questionnaire were used as data collection instruments. Means and standard deviations of the variables and the correlation coefficients between the variables were calculated using descriptive analysis and Pearson correlation. The hypothesized model was tested by using structural equation modelling. In the model, childhood traumas have a negative and significant direct effect on forgiveness (β:-.362) and meaning in life (β:-.256). Forgiveness has a positive and significant effect on meaning in life (β:.715). Also, the mediating (indirect) effect of forgiveness in the relationship between childhood mental traumas and meaning in life was statistically significant (β:-.259). Structural equation modeling showed that forgiveness was the mediating variable affecting changing meaning in life.Öğe Outcomes of hematopoietic stem cell transplantation in patients with thalassemia major: how do anti-HLA antibodies impact?(Wiley, 2024) Ersoy, Gizem Zengin; Aksoy, Başak Adaklı; Erdem, Melek; Karataş, Lokman; Aydoğdu, Selime; Öner, Özlem Başoğlu; Dikme, Guercan; Bozkurt, Ceyhun; Fışgın, TunçAimTo investigate the effects of anti-human Leucocyte Antigen (HLA) antibody positivity on early hematopoietic stem cell transplantation (HSCT) results in patients with thalassemia major (TM).MethodsOne hundred and twenty-four HLA-matched HSCTs were performed in patients with TM between 2015 and 2022. Ninety-one patients were screened for anti-HLA antibodies by testing panel reactive antigens (PRA). Demographic and transplantation characteristics of patients were recorded. The presence of PRA was tested with the Antibody Testing Assay (Luminex LIFECODES HLA Antibody Identification System).ResultsThe number of PRA-positive patients was 54. There was no relationship between acute graft versus host disease (GVHD), chronic GVHD, grade of GVHD, and viral reactivation of the patients. However, platelet engraftment took around 3 days longer in the PRA-positive group (p = 0.05). The median number of erythrocyte transfusions was significantly higher in PRA-positive patients in the post-transplant period (p = 0.003), as was the median number of platelet transfusions (p = 0.003). Treosulfan conditioning increased the stable mixed chimerism (MC) rate by 3.8-fold (p = 0.011). In contrast, reduced rates of MC were found in patients who received matched unrelated donor cells or peripherally derived stem cells (p = 0.011 and p = 0.039, respectively) in the posttransplantation period in TM patients. PRA-positivity did not affect MC (p = 0.478). However, 80% of patients who had primary graft failure (n = 5; p = 0.59) and 75% of patients who died (n = 4) were PRA positive (p = 0.64), but these results were statistically insignificant due to the low number of patients.ConclusionAnti-HLA antibodies primarily delayed platelet engraftment in TM patients and increased the erythrocyte and thrombocyte transfusion requirements. Although PRA positivity was more common in patients with primary graft failure or who died, there was no statistically significant impact of PRA positivity on chimerism, acute or chronic GVHD, viral activation, or mortality rates.
