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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.Öğe Clinical research framework proposal for ketogenic metabolic therapy in glioblastoma(2024) Duraj, Tomas; Kalamian, Miriam; Zuccoli, Giulio; Maroon, Joseph C.; D'Agostino, Dominic P.; Scheck, Adrienne C.; Poff, Angela; Winter, Sebastian F.; Hu, Jethro; Klement, Rainer J.; Hickson, Alicia; Lee, Derek C.; Cooper, Isabella; Kofler, Barbara; Schwartz, Kenneth A.; Phillips, Matthew C. L.; Champ, Colin E.; Zupec-Kania, Beth; Tan-Shalaby, Jocelyn; Serfaty, Fabiano M.; Omene, Egiroh; Arismendi-Morillo, Gabriel; Kiebish, Mİchael; Cheng, Rİchard; El-Sakka, Ahmed M.; Pflueger, Axel; Mathews, Edward H.; Worden, Donese; Shi, Hanping; Cincione, Raffaele Ivan; Spinosa, Jean Pierre; Slocum, Abdul Kadir; İyikesici, Mehmet Salih; Yanagisawa, Atsuo; Pilkington, Geoffrey J.; Chaffee, Anthony; Abdel-Hadi, Wafaa; Elsamman, Amr K.; Klein, Pavel; Hagihara, Keisuke; Clemens, Zsofia; Yu, George W.; Evangeliou, Athanasios E.; Nathan, Janak K.; Smith, Kris; Fortin, David; Dietrich, Jorg; Mokherjee, Purna; Seyfried, Thomas N.Glioblastoma (GBM) is the most aggressive primary brain tumor in adults, with a universally lethal prognosis despite maximal standard therapies. Here, we present a consensus treatment protocol based on the metabolic requirements of GBM cells for the two major fermentable fuels: glucose and glutamine. Glucose is a source of carbon and ATP synthesis for tumor growth through glycolysis, while glutamine provides nitrogen, carbon, and ATP synthesis through glutaminolysis. As no tumor can grow without anabolic substrates or energy, the simultaneous targeting of glycolysis and glutaminolysis is expected to reduce the proliferation of most if not all GBM cells. Ketogenic metabolic therapy (KMT) leverages diet-drug combinations that inhibit glycolysis, glutaminolysis, and growth signaling while shifting energy metabolism to therapeutic ketosis. The glucose-ketone index (GKI) is a standardized biomarker for assessing biological compliance, ideally via real-time monitoring. KMT aims to increase substrate competition and normalize the tumor microenvironment through GKI-adjusted ketogenic diets, calorie restriction, and fasting, while also targeting glycolytic and glutaminolytic flux using specific metabolic inhibitors. Non-fermentable fuels, such as ketone bodies, fatty acids, or lactate, are comparatively less efficient in supporting the long-term bioenergetic and biosynthetic demands of cancer cell proliferation. The proposed strategy may be implemented as a synergistic metabolic priming baseline in GBM as well as other tumors driven by glycolysis and glutaminolysis, regardless of their residual mitochondrial function. Suggested best practices are provided to guide future KMT research in metabolic oncology, offering a shared, evidence-driven framework for observational and interventional studies.Öğe Outcomes of hematopoietic stem cell transplantation in patients with thalassemia major: how do anti-HLA antibodies impact?: the impact of anti-HLA antibodies on transplantation outcomes in thalassemia major(2024) Ersoy, Gizem Zengin; Aksoy, Başak Adaklı; Erdem, Melek; Karataş, Lokman; Aydoğdu, Selime; Başoğlu Öner, Özlem; Dikme, Gürcan; Bozkurt, Ceyhun; Fışgın, TunçAim: To 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). Methods: One 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). Results: The 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. Conclusion: Anti-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.Öğe Predicting postoperative atrial fibrillation after cardiac surgery using the Naples prognostic score(Lippincott Williams and Wilkins, 2024) Okşen, Doğaç; Güven, Barış; Dönmez, Ayça; Yeşiltaş, Mehmet Ali; Koyuncu, Ahmet Ozan; Gülbudak, Seran; Oktay, VeyselIntroduction The Naples prognostic score (NPS) is a novel indicator of nutritional and inflammatory statuses in cancer patients. Development of atrial fibrillation after cardiac surgery (POAF) is a common complication that increases the incidence of adverse events. Numerous studies have investigated predictors of POAF. Yet, this study is the first to evaluate the prognostic value of NPS in predicting the development of POAF. Materials and methods The population of this retrospective single-center case-control study consisted of all consecutive patients who underwent cardiac surgery between January 2021 and December 2023. The patients included in the study sample were divided into two groups according to whether they had POAF (group POAF) or remained in sinus rhythm (group RSR). Univariate and multivariate analyses were conducted to identify the variables that significantly predicted the development of POAF. Results This study consisted of 860 patients with a mean age of 61.77 ± 9.13 years and 77.5% (n = 667) were male. The incidence of POAF in the sample was 24.8% (n = 214). NPS was significantly higher in group POAF than in group RSR (2.18 ± 0.99 vs. 1.96 ± 1.02, P = 0.008). Multivariate analysis revealed age [odds ratio (OR): 1.242, 95% confidence interval (CI): 1.020-1.304, P < 0.001] and high NPS (OR: 1.698, 95% CI: 1.121-1.930, P < 0.010) as independent predictors of POAF. Conclusion High NPS values, along with advanced age, were found to be strongly associated with an increased risk of developing POAF. Therefore, it is concluded that NPS is a significant and independent predictor of POAF in patients undergoing cardiac surgery.Öğe Sociodemographic and clinical factors of dropout from inpatient detoxification treatment in patients with opioid use disorders(Pacini Editore Srl, 2024) Çetiner Akgül, Rahime Dicle; Ergelen, Mine; Arpacıoğlu, Selim; Yalçın, MuratBackground: Completing detoxification treatment and receiving maintenance treatment are crucial for long term fa-vorable results. However, dropout rates in addiction treatment are quite high. This study was designed to determine the rate of remaining in inpatient detoxification treatment in patients with opioid use disorder (OUD) and to examine the sociodemographic and clinical characteristics associated with dropout from treatment, thereby providing more effective management of the treatment process. Methods: We conducted a prospective short-term follow-up study with 115 patients diagnosed with OUD and receiving inpatient treatment. Sociodemographic Data Form, SCID-I, Addiction Profile Index (API), Substance Craving Scale (SCS) and Perceived Stress Scale (PSS) were administered to the patients. Results: 44.6% of the patients dropped out of the inpatient treatment program. No significant difference was found in terms of sociodemographic characteristics between patients who dropped out and those who remained in the treatment. In terms of clinical characteristics, the rate of dropout from the treatment was significantly higher in those with comorbid psychiatric conditions, and those without regular outpatient clinic visits (p<0.05). The API “Severe Craving” subscale was significantly higher in the group that dropped out and was predictive for dropout from the treatment. Conclusions: The results of our study provided important conclusions in terms of understanding the clinical conditions and risk factors associated with dropout from inpatient detoxification treatment for OUD patients in our country. We believe that these results con-tribute to the evaluation and treatment processes of OUD patients to increase treatment compliance.Öğe Using parenteral fish oil from birth may improve short and long term outcome in preterm infants(Mashhad University of Medical Sciences, 2024) Ergon, Ezgi Yangın; Özdemir, Senem Alkan; Çolak, Rüya; Yıldırım, Tülin Gökmen; Çalkavur, ŞebnemBackground: Lipids are a crucial component of parenteral nutrition in its entirety. This study aimed to compare the short—and long-term outcomes of lipid solutions containing fish oil and standard parenteral lipid solutions in total parenteral nutrition of premature neonates. Methods: Preterm infants weighing less than 1500 grams or 32 weeks gestation admitted to Dr. Behçet Uz Children's Diseases and Surgery Training and Research Hospital Neonatal Intensive Care Unit between January 2018 and January 2020 were included in this retrospective cross-sectional study. Infants receiving only 3 g/kg/day Clinoleic were enrolled in Group 2; infants receiving 1 g/kg/day Omegaven plus 2 g/kg/day Clinoleic were enrolled in Group 1. Weight at discharge, laboratory data (liver enzymes, bilirubin levels), and long-term results were compared. Results: The study comprised 70 newborns, and 35 of them were in Group 1. Group 1 had a considerably lower direct bilirubin level (d bil p valueu; 1st week p=0.03, 2nd week p=0.87, 3rd week p=0.02). The omegaven group had a considerably higher weight upon discharge (p=0.02). Long-term neurodevelopmental results did not differ across the groups (MDI score p=0.33, PDI score p=0.11, NDI positivity p=1.00, MDP p=0.81). Conclusion: We demonstrated that the weight at discharge and laboratory measurements improved with Omegaven support. Early exposure to very high levels of oxidative stress may cause infants to employ their antioxidant system as a parenteral support system.Öğe Turkish validity and reliability study of the maternal attitudes questionnaire(Istanbul Universitesi, 2024) Şenyaşar-Meterelliyoz, Kumru; Yazar, Menekşe Sıla; Çobanoğlu-Saf, Perihan; Saf, CoşkunObjective: The aim of our study was to determine the psychometric evaluation of the Maternal Attitudes Questionnaire (MAQ) in the Turkish population by adapting it to Turkish. Methods: State and Trait Anxiety Inventory (STAI), Dysfunctional Attitudes Scale (DAS), the Edinburgh Postnatal Depression Scale (EPDS), and MAQ were used in data collection. The research sample comprised 359 women in the perinatal period. To evaluate test–retest reliability, MAQ was administered to 20 participants again after 4 weeks. Results: Four items with item–total–item correlations below 0.3 were removed from the questionnaire, and analysis was continued on 10 items. In the factor analysis, a two-factor structure was obtained, explaining 45.59% of the variance. The Cronbach α coefficient of the questionnaire in our sample was found as 0.664. For test–retest reliability, the Pearson correlation coefficient was found as 0.804 after a 4-week period. Maternal Attitudes Questionnaire correlated significantly with EPDS, STAI, and DAS. Conclusion: According to the results of our study, the Turkish version of the MAQ is a valid and reliable measurement tool in the perinatal period.Öğe Neoadjuvant pembrolizumab plus chemotherapy in early-stage triple-negative breast cancer: a nationwide retrospective Turkish oncology group study(2024) Karcı, Ebru; Bilici, Ahmet; Bayram, Buket; Celayir, Melisa; Özyurt, Neslihan; Oyan Uluc, Başak; Eken, Aynur; Başaran, Gül; Demirci, Umut; Kemal, Yasemin; Oruncu, Mehmet Berk; Ölmez, Ömer Fatih; Selçukbiricik, Fatih; Korkmaz, Taner; Ertürk, İsmail; Bilgetekin, İrem; Çelik, Serkan; Türkel, Alper; Alkan, Ali; Sakin, Abdullah; Can, Orçun; Günaldı, Meral; Esin, Ece; Yıldız, ÖzcanBackground/Objectives: Following the results of the phase 3 KEYNOTE-522 trial, the U.S. Food and Drug Administration approved pembrolizumab, a humanized IgG4 kappa monoclonal antibody, in combination with neoadjuvant chemotherapy as a new standard of care for high-risk early-stage triple-negative breast cancer (TNBC). This retrospective, multicenter study in Türkiye assessed the real-world efficacy and safety of neoadjuvant pembrolizumab combined with chemotherapy in early-stage TNBC. Methods: The study included 108 patients treated between 2021 and 2023 across 14 oncology centers. Three distinct neoadjuvant regimens incorporating pembrolizumab were administered at the discretion of the treating physicians. The primary outcomes were the pathological complete response (pCR) rate after neoadjuvant therapy and the 2-year event-free survival (EFS) and overall survival (OS) rates. Results: The observed pCR rate was 63.9%, closely mirroring the 64.8% reported in the KEYNOTE-522 trial. At the two-year mark, the EFS rate was 87.2% and the OS rate was 92.3%. Multivariable analysis identified pCR as the sole independent predictor of both EFS and OS. The safety profile was consistent with previous clinical trial data, with most adverse events being of grade 1-2 in severity. Conclusions: These findings provide valuable real-world confirmation of the efficacy and safety of neoadjuvant pembrolizumab-chemotherapy in early-stage TNBC, complementing evidence from randomized trials.Öğe Reliability and validity study of the Obsessive-Compulsive Inventory-Child Version (OCI-CV)(Kare Publishing, 2024) Görmez, Vahdet; Bıkmazer, Alperen; Çakıroğlu, Süleyman; Meral, Yavuz; Ertaş, Erdem; Derin, Songül; Demirci, Burak; Sürücü, TubaObjective: The lack of self-rating multidimensional questionnaires to assess obsessive-compulsive disorder (OCD) in children and adolescents poses a problem for monitoring clinical practices and implementing academic research. This study aimed to empirically examine the psychometric properties of the OCI-CV in a Turkish clinical sample of children and adolescents diagnosed with OCD alongside a control group for comparative analysis. Method: The OCI-CV was administered alongside other measures to a clinical sample of 232 participants aged 8–18 years (mean±SD=13.35±2.68; female/male: 46.1%/53.9%) and a control group. Results: According to the results of the item analysis, corrected item-total correlation coefficients were found to be between 0.36 and 0.62. Confirmatory factor analysis confirmed the original six-factor model with acceptable fit indices (Minimum Discrepancy per Degree of Freedom (CMIN/df)=1.734, Root Mean Square Error of Approximation (RMSEA)=0.056, Comparative Fit Index (CFI)=0.919, Standardized Root Mean Square Residual (SRMR)=0.067, Incremental Fit Index (IFI)=0.921, Normed Fit Index (NFI)=0.835, Root Mean Residual (RMR)=0.034). The standardized factor loadings of the scale items varied between 0.39 and 0.90. According to the Pearson correlation results, a significant positive correlation (p<0.001) was found within the scope of the concurrent validity of the OCI-CV. The Cronbach α coefficient of the six-dimensional 21-item scale was found to be 0.88, and that of the sub-dimensions of the scale ranged between 0.63 and 0.81. Conclusion: The present study demonstrated the psychometric properties of the Child Version of the Obsessive-Compulsive Inventory (OCI-CV), and the results showed that the measure is valid and reliable for use in a clinical sample of Turkish children and adolescents.Öğe Cognitive distortions as barriers to seeking smoking cessation treatment: a comparative study(2024) Arpacıoğlu, Selim; Erzincan, Erkal; Ergelen, Mine; Arpacıoğlu, Beyza; Paltun, Salih Cihat; Yalçın, Murat; Bilici, RabiaBackground/Objectives: Despite the availability of effective pharmacotherapy and evidence-based treatments, a substantial proportion of smokers do not seek treatment. This study aims to explore the cognitive distortions associated with not seeking evidence-based smoking cessation treatment and to identify cognitive barriers. Methods: The research conducted in Istanbul between October and December 2017 employs a cross-sectional design and includes two groups: a treatment-seeking group comprising 156 patients diagnosed with tobacco use disorder and a non-treatment seeking group of 78 patients with tobacco use disorder who had never sought professional help for smoking cessation. A comprehensive data collection process was used, including sociodemographic information, cognitive distortion assessment using the cognitive distortions scale, a smoking-related cognitive distortions interview and the Fagerström Test for Nicotine Dependence. Results: While no significant sociodemographic differences were observed between the treatment-seeking and non-treatment-seeking groups, the study found that higher nicotine dependence was associated with a higher likelihood of seeking treatment. The treatment-seeking group displayed significantly higher levels of "all-or-nothing thinking" cognitive distortions related to smoking and smoking cessation. Conversely, the non-treatment-seeking group exhibited elevated levels of cognitive distortions such as "labeling", "mental filtering", "should statements" and "minimizing the positive" regarding receiving smoking cessation treatment. Conclusions: Understanding the cognitive distortions associated with treatment-seeking behavior for tobacco use disorder is crucial for developing targeted public-based interventions, public service announcements for tobacco use prevention and encouraging individuals to seek evidence-based treatment. Addressing these cognitive distortions can also potentially enhance the effectiveness of smoking cessation programs and reduce the global burden of tobacco-related diseases and mortality.Öğe The combined role of metacognition and mindfulness in social anxiety symptoms: a path model(2024) Obuca, Faruk; Aydın, Orkun; Çakıroğlu, Süleyman; Ünal-Aydın, PınarAlthough social anxiety disorder (SAD) is widespread and associated with significant distress, its etiology is not yet fully explored. We aimed to examine how metacognitions and mindfulness interact with SAD symptoms. 531 college students were enrolled in this study. Participants completed the Liebowitz Social Anxiety Scale (LSAS), the Metacognition Questionnaire-30 (MCQ-30), and the Five-Facet Mindfulness Questionnaire (FFMQ). A path analysis was run to explore the associations between test variables. A positive correlation was found between metacognition and SAD symptoms, while mindfulness negatively correlated with SAD symptoms and metacognition. In the established path model, metacognition had an indirect effect on SAD symptoms, which is partially mediated by mindfulness. Our findings imply that metacognitions and mindfulness may influence SAD symptoms among young adults. Mindfulness seems to have a prominent role in regulating metacognition's effects on SAD symptoms. Therefore, interventions that accurately target these factors may alleviate the symptoms of this debilitating psychological disturbance.Öğe Impact of oxidative stress on myocardial performance in patients with diabetes: a focus on subclinical left ventricular dysfunction(2024) Okşen, Doğaç; Aslan, MuzafferIntroduction: Oxidative stress is known to affect left ventricular functions negatively. There is a strong bidirectional connection between diabetes mellitus (DM) and oxidative stress. In parallel, left ventricular dysfunction is observed more frequently, even in patients with DM without other risk factors. In this context, the objective of this study is to comparatively investigate the potential relationship between oxidative stress and subclinical left ventricular dysfunction (SCLVD) assessed by Myocardial Performance Index (MPI) in patients with and without DM. Research design and methods: The sample of this observational cross-sectional single-center study consisted of 151 patients who were evaluated for oxidative stress and SCLVD by tissue Doppler echocardiography. Patients' total oxidant status (TOS), total antioxidant status (TAS), and Oxidative Stress Index (OSI) values were calculated. The effects of oxidative stress and DM on MPI were analyzed. Results: There were 81 patients with DM (mean age: 46.17±10.33 years) and 70 healthy individuals (mean age: 45.72±9.04 years). Mean TOS and OSI values of the DM group were higher than healthy individuals (5.72±0.55 vs 5.31±0.50, p = <0.001; and 4.92±1.93 vs 1.79±0.39, p = <0.001; respectively). The mean TAS value of the DM group was significantly lower than the healthy group (1.21±0.40 vs 3.23±0.51, p = <0.001). There was a significant correlation between OSI and MPI mitral in the DM group (R 0.554, p = <0.001) but not in the healthy group (R -0.069, p=0.249). Conclusions: Both oxidative stress and myocardial dysfunction were found to be more common in patients with DM. The study's findings indicated the negative effect of oxidative stress on myocardial functions. Accordingly, increased oxidative stress caused more significant deterioration in MPI in patients with DM compared with healthy individuals.Öğe Real-world evaluation of nivolumab in patients with non-nasopharyngeal recurrent or metastatic head and neck cancer: a retrospective multi-center study by the Turkish Oncology Group (TOG)(2024) Akyıldız, Arif; Güven, Deniz Can; Köksal, Barış; Karaoğlan, Beliz Bahar; Kıvrak, Derya; Ismayilov, Rashad; Aslan, Fırat; Sütçüoğlu, Osman; Yazıcı, Ozan; Kadıoğlu, Ahmet; Alan, Özkan; Majidova, Nargiz; Erciyestepe, Mert; Özcan, Erkan; Akdağ, Goncagül; Taban, Hakan; Kaya, Ali Osman; Guliyev, Murad; Yıldırım, Nilgün; Sakalar, Teoman; Yazılıtaş, Doğan; Ünal, Çağlar; On, Sercan; Biter, Sedat; Demirci, Nebi Serkan; Şenler, Filiz Çay; Kemal, Yasemin; Halil, Ömer Diker; Güllü, İbrahim; Aksoy, SercanObjectives: Head and neck cancers (HNCs) represent a significant global health concern due to high morbidity and mortality rates. Despite therapeutic advances, the prognosis for advanced or recurrent cases remains challenging. Nivolumab obtained approval for recurrent or metastatic HNC based on the Phase III CheckMate 141 trial. This study aimed to evaluate the real-world outcomes of nivolumab in patients with non-nasopharyngeal HNC. Design: In this multicenter retrospective study, we analyzed 124 patients with recurrent or metastatic non-nasopharyngeal HNC who received nivolumab in the second-line setting and beyond. Data were collected from 20 different cancer centers across Turkey. The effectiveness and safety of the treatment and survival outcomes were evaluated. Results: Nivolumab exhibited favorable clinical responses, yielding an objective response rate of 29.9% and a disease control rate of 55.7%. Safety assessments revealed a generally well-tolerated profile, with no instances of treatment discontinuation or mortality due to side effects. Survival analysis disclosed a median overall survival (OS) of 11.8 (95% CI 8.4-15.2) months. Multivariate analysis revealed that ECOG-PS ≥ 1 (HR: 1.64, p = 0.045), laryngeal location (HR: 0.531, p = 0.024), and neutrophil-to-lymphocyte ratio > 3.5 (HR: 1.97, p = 0.007) were independent predictors of OS. Conclusions: Nivolumab is an effective and safe treatment option for patients with recurrent or metastatic non-nasopharyngeal HNC in real-world settings. Further studies are needed on factors affecting response to treatment and survival outcomes.Öğe The wear-off phenomenon of repeated botulinum toxin injection for chronic migraine treatment: A retrospective study(Turkish Neurosurgical Society, 2024) Ruşen, Emir; Hafez, Gaye; Tunç, YeşimObjectives: This study aimed to evaluate the efficacy, predictors of response, clinical considerations, and analysis of patient-reported wear-off events during injection periods of onabotulinumtoxinA (Onabot-A). Patients and methods: This retrospective study was conducted with 30 adult chronic migraine patients (26 females, 4 males; mean age: 37.9±9.3 years; range, 24 to 72 years) followed between January 2017 and December 2022. All patients received Onabot-A injections at different frequencies throughout their treatment and responded to Onabot-A. The duration between cycles was 3 months in 26 patients, and this period varied in four patients. The Visual Analog Scale scores were measured before and after the injection, all patients responded to Onabot-A. Results: Nine patients stated that they experienced wear-off at least once during their treatment cycles. In some patients, the duration of action lasted less than 12 weeks, resulting in a wear-off phenomenon. Although sex and age were not significant variables in terms of the presence or absence of wear-off phenomenon, the number of Onabot-A injections (Onabot-A treatment cycles) among patients was found to be a statistically significant variable in terms of the presence of wear-off (p<0.011). Conclusion: Repeated treatments using Onabot-A appear to be safe and well-tolerated, but the effectiveness of the drug appears to be affected by wear-off phases that may occur during long-term treatment with Onabot-A.Öğe COVID-19 disease in children and adolescents following allogeneic hematopoietic stem cell transplantation: A report from the Turkish pediatric bone marrow transplantation study group(2024) Bozkurt, Ceyhun; Hazar, Volkan; Malbora, Barış; Küpesiz, Alphan; Aygüneş, Utku; Fışgın, Tunç; Karakükçü, Musa; Kuşkonmaz, Barış; Kılıç, Suar Çakı; Bayırlı, Derya; Bilir, Özlem Arman; Yalçın, Koray; Gözmen, Salih; Uygun, Vedat; Elli, Murat; Sarbay, Hakan; Küpesiz, Funda Tayfun; Şaşmaz, Hatice İlgen; Aksoy, Başak Adaklı; Yılmaz, Ebru; Okur, Fatma Visal; Tekkeşin, Funda; Yenigürbüz, Fatma Demir; Özek, Gülcihan; Atay, Abdullah Avni; Bozkaya, İkbal Ok; Çelen, Suna; Öztürkmen, Seda; Güneş, Adalet Meral; Gürsel, Orhan; Güler, Elif; Özcan, Alper; Çetinkaya, Duygu Uçkan; Aydoğdu, Selime; Özbek, Namık Yaşar; Karasu, Gülsün; Sezgin, Gülay; Doğru, Ömer; Albayrak, Davut; Öztürk, Gülyüz; Aksoylar, Serap; Daloğlu, Hayriye; Al, Işık Odaman; Evim, Melike Sezgin; Akbayram, Sinan; Öncül, Yurday; Zengin, Emine; Albayrak, Canan; Timur, Çetin; Kar, Yeter Düzenli; Çakmaklı, Hasan Fatih; Tüfekçi, Özlem; Töret, Ersin; Antmen, BülentBackground: Data on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited. Objectives: The study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection. Method: In this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022. Results: The median time from HSCT to COVID-19 infection was 209.0 days (IQR, 111.7-340.8; range, 0-3845 days). The most common clinical manifestation was fever (58.7%). While most patients (78.8%) had asymptomatic/mild disease, the disease severity was moderate in 9.2% and severe and critical in 4.4% and 7.6%, respectively. The overall mortality was 10.9% (n: 20). Deaths were attributable to COVID-19 in nine (4.9%) patients. Multivariate analysis revealed that lower respiratory tract disease (LRTD) (OR, 23.20, p: .001) and lymphopenia at diagnosis (OR, 5.21, p: .006) were risk factors for ICU admission and that HSCT from a mismatched donor (OR, 54.04, p: .028), multisystem inflammatory syndrome in children (MIS-C) (OR, 31.07, p: .003), and LRTD (OR, 10.11, p: .035) were associated with a higher risk for COVID-19-related mortality. Conclusion: While COVID-19 is mostly asymptomatic or mild in pediatric transplant recipients, it can cause ICU admission in those with LRTD or lymphopenia at diagnosis and may be more fatal in those who are transplanted from a mismatched donor and those who develop MIS-C or LRTD.Öğe Outcomes of HLA-mismatched HSCT with TCR?ß/CD19 depletion or post-HSCT cyclophosphamide for inborn errors of immunity(2024) Lum, Su Han; Albert, Michael H.; Gilbert, Patrick; Sirait, Tiarlan; Algeri, Mattia; Muratori, Rafaella; Fournier, Benjamin; Laberko, Alexandra; Karakükcü, Musa; Ünal, Ekrem; Ayas, Mouhab F.; Yadav, Satya Prakash; Fışgın, Tunç; Elfeky, Reem; Fernandes, Juliana Folloni; Faraci, Maura; Cole, Theresa; Schulz, Ansgar S.; Meisel, Roland; Zecca, Marco; Ifversen, Marienne; Biffi, Alessandra; Diana, Jean-Sebastien; Vallee, Tanja C.; Giardino, Stefano; Ersoy, Gizem Zengin; Moshous, Despina; Gennery, Andrew R.; Balashov, Dmitry; Bonfim Carmem M. S.; Locatelli, Franco; Lankester, Arjan C.; Neven, Benedicte; Slatter, Mary A.HLA-mismatched transplants with either in vitro depletion of CD3+TCRαβ/CD19 (TCRαβ) cells or in vivo T-cell depletion using post-transplant cyclophosphamide (PTCY) have been increasingly used for patients with inborn errors of immunity (IEI). We performed a retrospective multicenter study via the EBMT registry on 306 children with IEI undergoing first transplant between 2010-2019 from an HLA-mismatched donor using TCRαβ (n=167) or PTCY (n=139). Median age at HSCT was 1.2 years (range, 0.03-19.6 years). The 3-year overall survival (OS) was 78% (95% confidence interval (CI), 71-84%) after TCRαβ and 66% (57-74%) after PTCY (p=0.013). Pre-HSCT morbidity score (hazard ratio (HR) 2.27, 1.07-4.80, p=0.032) and non-Busulfan/Treosulfan conditioning (HR 3.12, 1.98-4.92, p<0.001) were the only independent predictors of unfavorable OS. The 3-year event-free survival (EFS) was 58% (50-66%) after TCRαβ and 57% (48-66%) after PTCY (p=0.804). Cumulative incidence of severe acute GvHD was higher after PTCY (15%, 9-21%) than TCRαβ (6%, 2-9%, p=0.007), with no difference in chronic GvHD (PTCY, 11%, 6-17%; TCRαβ, 7%, 3-11%, p=0.173). The 3-year GvHD-free EFS was 53% (44-61%) after TCRαβ and 41% (32-50%) after PTCY (p=0.080). PTCY had significantly higher rates of veno-occlusive disease (14.4% versus TCRαβ 4.9%, p=0.009), acute kidney injury (12.7% versus 4.6%, p=0.032) and pulmonary complications (38.2% versus 24.1%, p=0.017). Adenoviraemia (18.3% versus PTCY 8.0%, p=0.015), primary graft failure (10%, versus 5%, p=0.048), and second HSCT (17.4% versus 7.9%, p=0.023) were significantly higher in TCRαβ. In conclusion, this study demonstrates that both approaches are suitable options in IEI patients, although characterized by different advantages and outcomes.
