Sürdürülebilir Kalkınma Amaçları
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- ArticleAçık Erişim2026The Relationship Between Non-alcoholic Fatty Liver Disease and Epicardial Adipose Tissue Thickness, Carotid Intima Media Thickness, and Aortic Propagation Velocity
Aydin, Sonay; Ozcicek, Fatih; Hayme, Serhat; Coşgun, Muharrem Said; Ozturk, Ersin; Öztürk, Gülay Kızılgün
Objective: Cardiovascular disease is prevalent among individuals diagnosed with non-alcoholic fatty liver disease (NAFLD). Epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), and aortic propagation velocity (APV) are associated with atherosclerosis and cardiovascular disease (CVD). The aim of this study is to determine whether NAFLD is associated with EAT, CIMT, and APV. Methods: Individuals aged ≥18 and <65 years who presented for routine follow-up were included. The study population comprised 75 healthy controls (40 females, 35 males) and 141 patients with NAFLD (68 females, 73 males). Epicardial adipose tissue thickness, carotid intima-media thickness, and aortic propagation velocity were evaluated using transthoracic echocardiography in patients who were diagnosed with hepatosteatosis by ultrasound during routine check-ups at the internal medicine clinic. Results: NAFLD was positively associated with epicardial adipose tissue thickness and carotid intima–media thickness, and negatively associated with aortic propagation velocity. Patients with NAFLD had significantly higher EAT and CIMT values and lower APV values than controls. Logistic regression analysis identified body mass index (BMI) and EAT as independent predictors of hepatosteatosis. Each unit increase in BMI was associated with a 1.29-fold increase in the risk of hepatosteatosis, whereas each unit increase in EAT was associated with a 5.49-fold increase. Conclusion: Given the established associations of CIMT, APV, and EAT with atherosclerosis and cardiovascular disease, assessment of patients with NAFLD using these noninvasive parameters may help identify subclinical cardiovascular risk.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2026Comparison of Intern Doctors and ChatGPT in Emergency Cases Assessment
Kantar, Yusuf; Imamoglu, Melih; Bülbül, Emre; Hayme, Serhat; Eden, Arif Onur; Bilgin, Yasin; Sari, Fatih Mehmet
Objective: Accurate and timely diagnosis in emergency departments is crucial due to the high patient volume and time-sensitive nature of care. Intern doctors, who are nearing the completion of medical school, frequently work in emergency departments in many countries. However, after graduation, physicians are often expected to assume critical patient care responsibilities despite limited experience. Artificial intelligence models can quickly analyze patient data and generate diagnoses, thus assisting inexperienced physicians in enhancing diagnostic accuracy. This study aims to evaluate the diagnostic performance of ChatGPT-4 in emergency department case scenarios and compare its accuracy with that of intern doctors. Materials and Methods: This study involved intern doctors participating in the internship program during the 2024-2025 academic year. A total of 36 case-based questions, categorized by difficulty level, were administered to 155 interns and subsequently presented to artificial intelligence. Descriptive statistics were used to summarize the data, and a one-sample t-test was conducted to compare the diagnostic accuracy between intern doctors and ChatGPT. Statistical significance was set at p<0.05. Results: Intern doctors achieved an overall correct response rate of 58.3%, while ChatGPT achieved a rate of 97.2%. A statistically significant, moderate negative correlation was found between question difficulty and interns' performance (r=-0.684; p<0.001), indicating decreased accuracy as question difficulty increased. ChatGPT consistently demonstrated significantly higher performance across all difficulty levels. Conclusion: ChatGPT-4 may serve as a valuable diagnostic support tool in emergency departments, particularly for newly graduated physicians with limited clinical experience.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2026Multiparametric MRI in Idiopathic Granulomatous Mastitis: Correlation with clinical classification and its potential role in diagnosis and management—A retrospective observational study
Aydin, Hale; Bozkurt, Cansu; Hayme, Serhat; Simsek, Gulcin Guler; Cavis, Tugba; Alp, Emre; Tasar, Mustafa; Yilmaz, Kerim Bora
Background Idiopathic Granulomatous Mastitis (IGM) is a rare, benign inflammatory breast disease with a variable clinical course. While recent clinical classifications provide guidance for management based on disease severity, objective imaging correlates remain limited. Purpose To assess the correlation between multiparametric breast MRI parameters and consensus based clinical types of IGM at presentation. Materials and methods This retrospective observational study included 40 patients with biopsy-proven IGM (age 18–45) who underwent multiparametric breast MRI. Apparent diffusion coefficient (ADC) values, STIR (Short Tau Inversion Recovery) signal intensities, and enhancement patterns were analyzed according to clinical classification. In abscess-forming lesions, separate ADC measurements were obtained from necrotic cores and peripheral walls. Proton MR spectroscopy was performed in 22 patients with indeterminate findings. Statistical analyses included ANOVA with post hoc tests, chi-square, Spearman correlation, and inter-observer agreement using ICC and Cohen’s Kappa. Results STIR signal intensity and ADC values increased significantly from Type 1 to Type 4 disease (p < 0.001). The necrosis-to-wall ADC ratio showed a modest correlation with the consensus-based clinical types (r = 0.35, p = 0.036). MR spectroscopy revealed no significant metabolite differences, although borderline lactate elevation was observed in later clinical types (Types 3–4). Specifically, mean ADC values rose from 1.04 to 1.66 × 10⁻3 mm2/s, while mean STIR signal intensity increased from 154 to 300 a.u. across the clinical types (p < 0.001). Conclusion Clinical classification systems based on disease severity are increasingly emphasized to standardize the diagnosis and management of IGM. Multiparametric breast MRI provides noninvasive imaging correlates of the consensus-based clinical types (Types 1–4) at presentation. ADC values and STIR signal intensity appear to be promising quantitative imaging correlates of consensus-based clinical types at presentation, whereas enhancement patterns should be interpreted mainly as descriptive baseline findings. These findings support the use of multiparametric MRI as an adjunct for baseline characterization of IGM.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2026Assessment of methylene blue and NAD on LPS-induced acute brain injury: effects on neuroinflammation, oxidative stress, and blood–brain barrier integrity in a rat endotoxemia model
Doganay, Songul; Üstündağ, Hilal; Erbaş, Elif; Yanar, Sevinc; Hayme, Serhat; Kurt, Nezahat
Sepsis-induced brain dysfunction remains a significant challenge with limited therapeutic options, warranting exploration of multi-target approaches. Methylene blue (MET) is a phenothiazine derivative with mitochondrial-enhancing and electron transport chain regulatory properties, while nicotinamide adenine dinucleotide (NAD) serves as a crucial cofactor in cellular energy metabolism and redox reactions. This study investigated the therapeutic effects of MET and NAD, individually and in combination, in lipopolysaccharide (LPS)-induced sepsis model. Male Sprague–Dawley rats (n = 35) were randomized into five groups: control, LPS (8 mg/kg), LPS + NAD (250 mg/kg), LPS + MET (15 mg/kg), and LPS + NAD + MET. Brain tissues were analyzed for oxidative stress, inflammation, and blood–brain barrier integrity. The combination therapy demonstrated the most pronounced improvements across clinical parameters, antioxidant capacity evidenced by significantly elevated superoxide dismutase levels (p < 0.001) and cerebral histopathological outcomes. It also significantly reduced myeloperoxidase activity (p < 0.001) compared to the LPS group. Pro-inflammatory cytokines IL-6 and IL-8 were significantly decreased in both MET and NAD monotherapy groups (p < 0.05), while TNF-α showed a decreasing trend without statistical significance. Brain-derived neurotrophic factor levels were maintained in the combination group, comparable to controls, while TGF-β showed differential modulation across treatment groups. Immunohistochemical analysis revealed LPS-induced blood–brain barrier disruption, evidenced by reduced occludin expression (p < 0.01), increased aquaporin-4 expression in perivascular astrocytic end-feet (p < 0.05), and elevated glial fibrillary acidic protein reactivity in protoplasmic astrocytes (p < 0.01). In conclusion, MET and NAD individually provided significant protection against LPS-induced brain injury by reducing neuroinflammation, oxidative stress, and neuronal damage. The combined treatment offered incremental benefits in certain outcomes. These findings suggest that both agents may have therapeutic potential in SAE.
RDL Kalıcı Kaydıİncele - Review ArticleYalnız künye2026Genotype-phenotype correlation of CFTR variants in cystic fibrosis patients
Canitez, Yakup; Ozemri Sag, Sebnem; Nalbant, Nurdeniz; Alemdar, Adem; Hayme, Serhat; Korkmaz, Merve; Demirdogen, Ezgi; Celebi, Solmaz; Hacimustafaoglu, Mustafa Kemal; Ozgur, Taner
Introduction: Cystic fibrosis (CF) is a life-limiting autosomal recessive disorder caused by mutations in the CFTR gene. In Turkiye, high genetic diversity and consanguinity contribute to a heterogeneous CFTR variant spectrum; however, genotype–phenotype data remain limited. Methods: This retrospective study analyzed 92 Turkish CF patients (36 homozygous, 56 compound heterozygous) to characterize CFTR variant diversity and clinical outcomes. Next-generation sequencing (NGS) was performed and confirmed by Sanger sequencing. Clinical data were analyzed using chi-square and nonparametric tests (p < 0.05). Results: A total of 46 distinct CFTR variants were identified. The most frequent were F508del (24%), followed by Y515X (7.33%), G542X (6%), N1303K (5.33%) and D110H (4%). Meconium ileus (p = 0.017) and CF-related diabetes mellitus (p = 0.013) were significantly more frequent among homozygous patients. Pseudomonas aeruginosa and Staphylococcus aureus were the most prevalent pathogens. CFTR modulator therapy eligibility was significantly higher among compound heterozygous patients (p = 0.007). Non-missense variants were associated with higher sweat chloride levels and more frequent severe pancreatic insufficiency and abnormal fecal fat quantification compared with missense variants (p = 0.037; p = 0.001; p = 0.033). Conclusion: This study highlights the heterogeneous CFTR variants in Turkiye and suggests genotype–phenotype correlations. Homozygous patients tended to show more severe gastrointestinal and endocrine involvement, while compound heterozygotes may exhibit comparatively milder disease features and higher treatment eligibility.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2026Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) score as a low-cost adjunct for osteoporosis risk stratification in primary care
Vatansever, Mehmet; Gürsoy, Ersan; Hayme, Serhat
Background: This study aimed to evaluate the hemoglobin, albumin, lymphocyte, and platelet (HALP) score as an exploratory adjunctive marker associated with reduced bone density, particularly in resource-limited settings. Methods: This cross-sectional study was conducted between October 2022 and October 2023 at the Physical Therapy and Rehabilitation Hospital in Trabzon, Türkiye. This study included 267 patients who had not been previously diagnosed with osteopenia or osteoporosis and had undergone a dual-energy X-ray absorptiometry (DEXA) scan within the previous year. The participants were categorized into the normal, osteopenic, and osteoporotic groups according to their DEXA results. Statistical analysis included receiver operating characteristic (ROC) curve assessment, sensitivity and specificity calculations, and multiple logistic regression analysis to evaluate the discriminative performance of the HALP score and its adjusted association with reduced bone density. Results: Patients with reduced bone density (osteopenia or osteoporosis) had substantially lower HALP scores than those with a normal bone density. The area under the curve (AUC) for the HALP score was 0.625, indicating a limited discriminative ability. The HALP score exhibited a sensitivity of 65.36% and a specificity of 55.26% for identifying reduced bone density. In multivariable analysis, higher HALP remained associated with lower odds of osteopenia/osteoporosis after adjustment (OR = 0.757, 95% CI 0.624–0.917, p = 0.004). Conclusion: Given its limited discriminative ability, HALP should not be interpreted as a stand-alone screening test. At most, it may represent a low-cost exploratory adjunctive signal that could help support consideration of confirmatory DEXA in resource-limited settings, pending external validation. Trial registration: Not applicable.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2026Evaluation of Osteonecrosis Risk Using Serum C-Terminal Cross-Linked Telopeptide of Type 1 Collagen (CTX-1) Levels in Osteoporotic Patients: Effects of Drug Holidays and Risk Factors
Ergül, Emine Esra; Laçin, Oğuzhan; Kılıçaslan, Hamide Özge; Bostancı, Fahrettin; Özdemir, Elif Can; Kılıç, Ayşegül; Hayme, Serhat; Ayçiçek, Hilal Büşra
Background: The aim of this study is to evaluate the risk of osteonecrosis of the jaw in patients receiving osteoporosis treatment using C-terminal cross-linked telopeptide of type 1 collagen (CTX-1) values, to analyze follow-ups after drug holidays, and to compare treatment agents and other risk factors to determine the association with CTX-1 results. Methods: A total of 273 patients (266 female and 7 male) who received bisphosphonate and denosumab treatment for osteoporosis were included in this retrospective study. Sociodemographic characteristics, vitamin D levels, serum CTX-1 level, presence of diseases affecting CTX-1 levels, type of bisphosphonate, duration of use, presence of drug holidays, and duration of denosumab use (if any) were recorded. The effects of bisphosphonates and denosumab on CTX-1 levels were compared, and differences in the risk of osteonecrosis between them were evaluated. Results: In this study, a meaningful association was not identified between serum CTX-1 levels and the measured vitamin D values (P = .232). Patients who underwent a drug holiday had significantly higher mean serum CTX-1 levels (266.2 ± 175.1 pg/mL) compared to those without a drug holiday (199.9 ± 138.5 pg/ mL; P = .009). Higher CTX-1 levels were observed in individuals receiving ibandronate and alendronate, whereas the lowest values were detected in patients treated with denosumab. Conclusion: Serum CTX-1 levels appeared unaffected by vitamin D. Although the denosumab group exhibited the highest risk of osteonecrosis, the difference compared to zoledronic acid was not statistically significant. These results suggest caution during jaw-related procedures and consideration of drug holidays when necessary.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2025Assessment of vitamin D and iron supplementation practices and their determinants in Erzincan, Türkiye: A cross-sectional study
Hayme, Serhat; Gürsoy, Ersan; Çakır, Hatice; Eren, Salih; Özdemir, Agah; Karabaş, Bilal
Objective: Vitamin D and iron are crucial micronutrients, particularly for children in phases of rapid growth and development, playing significant roles in bone and dental health, immune function, cognitive development, and energy metabolism. Despite the initiation of prophylaxis programs by the Turkish Ministry of Health, adherence and effectiveness remain variable, highlighting the need for localized research to evaluate these initiatives. This study aims to assess the prevalence and continuity of vitamin D and iron supplementation among families in Erzincan, and identify determinants influencing the sustainability of these practices. Methods: A cross-sectional and descriptive study was conducted among 200 families with children aged 1-5 years in the districts of Erzincan. Participants were recruited from family health centers using a convenience sampling method. Inclusion criteria encompassed families with children who met the age requirement, while exclusion criteria included children with special health conditions requiring high-dose supplementation. Data were collected through structured face-to-face questionnaires assessing supplementation practices, sources of medical advice, parental attitudes, and socio-demographic factors. Descriptive statistics summarized the data. The chi-square test and independent samples t-test assessed categorical and continuous variables, respectively. Multiple logistic regression identified factors influencing adherence, while Kaplan–Meier survival analysis evaluated supplementation duration. Results: High rates of vitamin D (98.5%) and iron (94%) supplementation were observed, albeit with decreased adherence to the recommended durations (82.5% for vitamin D, 75.5% for iron). The absence of parental concern for their children’s health and concurrent use of another type of prophylaxis had a positive effect on prophylaxis use. A pediatrician recommended vitamin D and iron prophylaxis to 33% (n=66) of the participants, a family physician to 49% (n=98), and auxiliary health personnel to 3% (n=6) only, whereas 15% (n=32) were advised by more than one health professional. (p=0.008 for vitamin D prophylaxis; p=0.014 for iron prophylaxis). The multivariable logistic regression analyses revealed that parental concern about their infants’ health significantly impacted the continuity of vitamin D prophylaxis (p=0.010). However, demographic characteristics had no significant impact on supplementation practices. Conclusion: Although vitamin D and iron supplementation rates are high in Erzincan, challenges in sustaining recommended durations suggest areas for improvement in prophylaxis programs. This study underscores the importance of healthcare professional recommendations and parental health perceptions in influencing supplementation practices. Recommendations include enhancing health education and accessibility to prophylaxis programs to improve sustainability and adherence.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025GRIP STRENGTH IN GERIATRIC PATIENTS WITH LYMPHEDEMA FOLLOWING BREAST CANCER TREATMENT
Ergül, Emine Esra; Özdemir, Elif Can; Ayçiçek, Hilal Büşra; Hayme, Serhat; Kemer, Aysel Özge; Sağlam Akkaya, Gonca
Introduction: Grip strength represents a critical, objective indicator of functional capacity in daily activities. This study sought to elucidate the impact of breast cancer-related lymphedema on grip strength and to explore the underlying factors contributing to its decline. Materials and method: This is a retrospective study including patients over the age of 65 who presented to our outpatient clinic after developing lymphedema following breast cancer treatment. Hand grip strength was measured using a hand dynamometer in patients with lymphedema, and data on lymphedema stage and clinical parameters were collected. Results: In older adults with lymphedema, grip strength was significantly reduced on the affected side (median: 8.0 kg [3–21]) compared to the non-affected side (median: 16.5 kg [10–29]; p < 0.001). Patients with more advanced stages of lymphedema were found to have lower grip strength on the affected side compared to those with earlier stages. In older adults with lymphedema, grip strength was also correlated with the subscales of quality of life and with fatigue, both considered important clinical outcomes. Conclusion: Our findings highlight that lymphedema in older adults is associated with clear functional impairment, as evidenced by reduced grip strength on the affected side and a progressive decline across disease stages, underscoring the importance of early intervention to preserve hand function.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Trends in prescribing montelukast in patients with asthma in real-life: Results from the Turkish adult asthma registry
Beyaz, Şengül; Erdinç, Münevver; Hayme, Serhat; Aslan, Ayşe Feyza; Aydın, Ömür; Gökmen, Derya; Buhari, Gözde Köycü; Sözener, Zeynep Çelebi; Gemicioğlu, Bilun; Bulut, İsmet
Montelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 ± 14.3 years), predominantly females (~76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hyper-sensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosi-nusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052–1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041–1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157–1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679–2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712–2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients, particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Neuropathic Pain, Polyneuropathy, and Quality of Life in Patients Receiving Dialysis
Ergül, Emine Esra; Ayçiçek, Hilal Büşra; Hayme, Serhat; Ergül, Çetin; Özdemir, Elif Can; Kara, Ali Veysel
Background: Meuropathic pain and polyneuropathy can affect the quality of life in patients receiving dialysis. The aim of this study was to assess quality of life and to compare electromyography (EMG) findings between patients screened positive and negative for neuropathic pain. Material/Methods: This study was designed as an observational cross-sectional study in which 74 patients receiving hemodialysis were admitted. The Ferrans & Powers Quality of Life Index-Dialysis III Version, Neuropathic Pain Questionnaire (NPQ), and Brief Pain Inventory-Short Form were completed by all patients. Additionally, EMG was performed on all patients regardless of the presence of neuropathic symptoms. Results: According to the NPQ screening results, 51.4% of patients were identified as likely having neuropathic pain, whereas EMG findings revealed polyneuropathy in 89.2% (66 patients). Ferrans & Powers Quality of Life Index total and subgroup scores were compared between the NPQ-positive and NPQ-negative groups based on the screening results. Quality of life was found to be statistically significantly lower in the NPQ-positive group across all subgroups (P<0.001). No statistically significant differences were observed between NPQ-positive and NPQ-negative groups regarding any of the polyneuropathy types identified via EMG (P>0.05). Conclusions: This study explores the association between screening-positive neuropathic pain and quality of life. Given the high prevalence of polyneuropathy on EMG even among patients without symptoms suggestive of neuropathic pain, it can be valuable to assess dialysis patients during the asymptomatic period as well.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Effect of professional commitment on the career plans of intern doctors
Turan, Sema; Hayme, Serhat
Objective: The career choices of medical school graduates are extremely important because of their impact on a country’s medical workforce planning. This study aimed to investigate the impact of medical students’ level of professional commitment (PC) on their career plans. Method: This cross-sectional study was conducted between April 15th and November 15th 2023, in a medical faculty in Erzincan Province in eastern Turkiye. A 16-question questionnaire and the medical students’ PC scale were used. A total of 129 intern doctors (93.5%) participated in the study. The t test, Mann-Whitney U test, and Kruskal-Wallis test were used in the statistical analyses. Results: Students who voluntarily chose medical school, aimed to become specialist doctors, selected specialties with higher occupational risks, and intended to work in Turkiye after obligatory service exhibited higher levels of PC. Notably, those inclined towards family practice specialty demonstrated lower levels of PC, whereas public health specialty, basic sciences, and certain clinical sciences were not preferred by any of the students. Conclusion: The results obtained suggest that PC levels may influence the career plans of medical students. Further research into factors affecting changes in PC throughout medical education and their impact on future career goals will enhance understanding in this area.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2025Distinct characteristics of asthma overlap phenotypes: Insights from the Turkish adult asthma registry
Kepil Ozdemir, Secil; Gemicioglu, Bilun; Yildiz, Fusun; Hayme, Serhat; Alpagat, Gulistan; Bozkurt, Nurgul; Bulut, Ismet; Erdinc, Munevver; Karakaya, Gul; Keren, Metin
Introductıon: Considerable overlaps exist between asthma phenotypes and the clinical significance of these overlaps remains undetermined. The objective of this study is to analyze the characteristics of asthma overlap phenotypes using data from the Turkish Adult Asthma Registry (TAAR). Methods: This cross-sectional registry study included 2053 adult patients (74.8% female) with asthma. Results: Overall, 39.3% (n = 697) had allergic–eosinophilic (AE), 26.0% (n = 461) had allergic–non-eosinophilic (ANE), 21.3% (n = 377) had non-allergic–eosinophilic (NAE), and 13.4% (n = 237) had non-allergic–non-eosinophilic (NANE) asthma. Severe asthma exacerbations and emergency department (ED) visits were more frequent in the AE (28.3%, 31.2%, respectively) and NAE groups (36.0%, 34.0%, respectively) than in the ANE (14.3%, 20.6%, respectively) and NANE groups (12.6%, 16.7%, respectively) (p < 0.001). FEV1 values were significantly lower in the AE group than in the ANE and NANE groups (p < 0.001, p = 0.048, respectively) and in the NAE group than in the ANE group (p < 0.001). Risk factors for poor asthma control included living in rural areas, asthma-related ED visits, FEV1 < 60% in the NAE; being overweight, chronic rhinosinusitis, oral corticosteroids use, age < 40 years in the NANE; FEV1 < 80% in the AE; and severe asthma exacerbations, ED visits for AE and ANE groups. Conclusıon: The considerable overlap between allergic and eosinophilic asthma phenotypes has clinical implications as increased rates of asthma exacerbations and healthcare utilization. The clinical heterogeneity among asthma phenotypes based on a single biomarker highlights the importance of multidimensional asthma phenotyping.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry
Arslan, Bahar; Türk, Murat; Hayme, Serhat; Aydin, Ömür; Gokmen, Derya; Buhari, Gozde Koycu; Sozener, Zeynep Celebi; Gemicioglu, Bilun; Bulut, Ismet; Beyaz, Sengul
Background: Asthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death. Objective: In this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region. Methods: This is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed. Results: Illiteracy (OR:2.687 [95% CI: 1.235–5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002–3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074–1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262–3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085–1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year. Conclusion: As a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Segmental Non-Mass Enhancement Features in Breast Magnetic Resonance Imaging: A Multicenter Retrospective Study of Histopathologic Correlations
Aydin, Hale; Bozkurt, Cansu; Hayme, Serhat; Bilge, Almila Coskun; Oztekin, Pelin Seher; Avdan Aslan, Aydan; Ozcan, Irem; Gultekin, Serap; Eren, Abdulkadir; Durur Subası, Irmak
Background/Objectives: Segmental non-mass enhancement (NME) is the breast MRI distribution pattern with the highest positive predictive value (PPV) for malignancy. Despite its diagnostic relevance, its imaging characteristics have rarely been examined in isolation, leaving uncertainty in clinical practice. This multicenter retrospective cohort study aimed to evaluate multiparametric MRI features—including internal enhancement pattern, dynamic contrast-enhanced (DCE) kinetics, and diffusion restriction—in segmental NME to identify malignancy predictors. Methods: This retrospective cohort review included 14,834 breast MRI reports from five institutions (September 2017–February 2024), identifying 103 women (mean age, 44.4 ± 9.9 years) with segmental NME (70 malignant, 33 benign). MRI was performed at 1.5 T or 3 T using standardized protocols. Two breast radiologists, blinded to pathology, assessed internal enhancement, DCE kinetics, diffusion restriction, and short tau inversion recovery (STIR) features according to BI-RADS. Statistical analyses included chi-square/Fisher’s tests and logistic regression. Results: Clustered ring enhancement (CRE) was significantly associated with malignancy (p = 0.004). Fast initial-phase enhancement (p < 0.001) and delayed-phase washout (p = 0.011) also correlated with malignancy. On multivariate analysis, fast initial-phase enhancement remained an independent predictor (odds ratio [OR] = 5.133, p = 0.031), whereas slow enhancement predicted benignity (OR = 0.194, p = 0.020). Histologies included ductal carcinoma in situ, invasive ductal carcinoma, granulomatous mastitis, and benign hyperplastic lesions. Conclusions: This study, focusing exclusively on segmental NME, identifies CRE, fast initial-phase enhancement, and washout kinetics as reliable imaging biomarkers. Incorporating these features into breast MRI interpretation may improve diagnostic accuracy, risk stratification, and management decisions.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Effect of serum magnesium level on carotid intima media thickness in hemodialysis patients
Kara, Ali Veysel; Ozdemir, Ridvan; Inan, Hamza; Ozdemir, Beyza Ozerten; Hayme, Serhat; Cosgun, Muharrem Said
Background: We aimed to examine whether serum magnesium level is related to cardiovascular events in hemodialysis patients by investigating the relationship between serum magnesium (Mg) level and carotid intima media thickness (CIMT). Methods: In this cross-sectional study, we evaluated 88 hemodialysis patients. The mean CIMT of these patients was measured and recorded by doppler ultrasonography. Patients were divided into two groups according to their serum magnesium level. Correlation analysis and linear regression analysis were used to define the relationship between study parameters. We divided our patients into 2 groups according to Mg value as group 1 (Mg ≥ 2.3 mg/dl) and group 2 (Mg < 2.3 mg/dl). Results: The mean CIMT of patients with group 1 and group 2 were respectively 0.93 ± 0.22 mm and 1.03 ± 0.22 mm. There was statistically significant difference between two groups in terms of the mean CIMT value (p = 0.045). We found negative, low-level, statistically significant correlations between Mg and mean CIMT (r=-0.272; p = 0.010), calcium and mean CIMT (r: -0.221, p: 0.039) and hemoglobin and mean CIMT (r: -0.215, p: 0.044). According to regression analysis, serum magnesium level and age were found independent risk factors for mean CIMT value (p: 0.004 and p: 0.045). Conclusions: We found a significant relationship between serum Mg level and CIMT, which indicates carotid atherosclerosis.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Cultural adaptation and psychometric validation of the university of the West England interprofessional questionnaire (UWE-IP) for Turkish health education programs: a cross-sectional study
Gürsoy, Ersan; Gökmen, Derya; Hayme, Serhat; Eroğlu, Şafak; Nas, Mehmet Akif
Background: The objective of this study was to assess the accuracy and consistency of the University of the West England Interprofessional Questionnaire (UWE-IP) in Turkish health education settings. The aim was to evaluate its efficacy in gauging interprofessional attitudes among students from diverse healthcare fields. Methods: A cross-sectional study was conducted with 391 students from medical, nursing, and home care technician programs who participated in clinical internships. The UWE-IP was utilized to evaluate the psychometric properties of the scale, utilising exploratory factor analysis (EFA) to establish the internal structure and reliability. Results: The original four-factor structure of the UWE-IP scale was refined to a three-factor model, encompassing ‘communication and teamwork,’ ‘interprofessional learning,’ and a combined ‘interprofessional interaction and relationships’ factor. This revised structure demonstrated sound reliability and validity y, with a Cronbach’s alpha of 0.80. The factor loadings varied between 0.044 and 0.746, demonstrating a strong level of support for the scale’s reliability in assessing interprofessional attitudes in the Turkish setting. Conclusions: The study affirms the validity and reliability of the UWE-IP scale for implementation in Turkish health education, highlighting its significance in assessing and improving interprofessional education. The cultural adaptation of the scale represents an important step forward in evaluating multidisciplinary training results, thereby contributing to improved healthcare services and patient outcomes in Turkey.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Re-Examining the Dimensionality of a Disability Assessment Tool Using Exploratory Structural Equation Modeling (ESEM): A Preliminary Study in Low Back Pain
Hayme, Serhat; Gökmen, Derya; Kutlay, Şehim; Küçükdeveci, Ayşe A.
Background: Low back pain (LBP) profoundly impacts daily life, requiring assessment tools that capture its complex effects on the body and mind. This study explores a measurement tool designed to assess LBP disability, testing whether Exploratory Structural Equation Modeling (ESEM) better reveals its multidimensional nature compared to Confirmatory Factor Analysis (CFA). Methods: We analyzed data from 266 LBP patients using CFA and ESEM. The tool, developed from the items from existing scales, included 99 questions on body functions, activities, and participation. Using Mplus 8 software, we compared model fit and item connections. Results: Two main factors; “Body Functions” and “Activity-Participation” identified by CFA were tested using ESEM. While ESEM had slightly better fit compared to CFA model, many items linked across both factors which shows how pain and emotions overlap with daily activities. These results align with the International Classification of Functioning, Disability and Health (ICF) and reflect LBP’s broad impact. Conclusions: ESEM offers a broader understanding of LBP’s multidimensional nature compared with CFA, guiding clinicians to create a holistic management approach that address physical and psychosocial challenges. This preliminary study supports the use of ESEM in disability research, demonstrating its usefulness in identifying the multifaceted nature of LBP, therefore providing a broader perspective for assessment and management.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2025Diagnostic accuracy of GFAP and UCH-L1 for intracranial hemorrhage in blunt head trauma: a prospective study
Bilgin, Yasin; Sari, Fatih Mehmet; Gunay, Murat; Hayme, Serhat; Kantar, Yusuf; Durmus, Ugur
Background: Early and accurate identification of intracranial hemorrhage (ICH) following traumatic brain injury (TBI) is crucial, yet conventional imaging techniques like CT have limitations including radiation exposure and overutilization. This study aimed to evaluate the diagnostic utility of two blood-based biomarkers, Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin Carboxy-Terminal Hydrolase L1 (UCH-L1), in detecting ICH in emergency department patients with blunt head trauma. Methods: This single-center prospective observational study included 442 patients presenting with blunt head trauma at a university emergency department. Plasma GFAP and UCH-L1 levels were measured prior to cranial CT imaging. ROC curve analysis, sensitivity, specificity, and logistic regression were used to assess diagnostic performance and associations between biomarker levels and CT-confirmed ICH. Results: ICH was detected in 6.1% of patients. GFAP and UCH-L1 both demonstrated high diagnostic performance with AUC values of 0.98 and 0.95, respectively. Sensitivity and specificity were 92.6% and 98.8% for GFAP, and 92.6% and 99.0% for UCH-L1. When both biomarkers were concurrently elevated, sensitivity remained at 92.6% with a negative predictive value of 99.5%. Univariate logistic regression revealed strong associations with ICH: GFAP (OR = 1025.0, 95% CI: 189.4–5548.3) and UCH-L1 (OR = 1284.4, 95% CI: 224.4–7352.3), both p < 0.001. Conclusion: GFAP and UCH-L1 are highly sensitive and specific biomarkers for early ICH detection in blunt head trauma. Their combined use may enhance triage accuracy, reduce unnecessary imaging, and support rapid clinical decision-making in emergency settings. Larger multicenter studies are warranted to validate these findings and standardize cut-off values.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2024Development, Validity, and Reliability of the Auditory and Speech Performance Test for Children
Hancer, Hale; Kiziltan, Erhan; Tan, Pinar Civak; Gokmen, Dery; Hayme, Serhat; Yilmaz, Suna Tokgoz
Auditory processing and speech processing disorders negatively affect school -aged children. To minimize these negative effects, individuals in the risk group should benefit from the positive contribution of early intervention with a comprehensive evaluation. The aim of this study was to develop the Auditory and Speech Performance Test for Children and analyze its validity and reliability. In the development of the Auditory and Speech Performance Test for Children, discrimination and recognition subtasks were built for both auditory and speech performance. Meaningful and meaningless minimal pairs were used in the subtasks. A silent background was used for auditory performance, and noise stimuli were combined into minimal pairs for speech performance. Audiovisual materials were integrated into the finger-tapping test. The Auditory and Speech Performance Test for Children was administered to 307 children with typical development and to 80 children with specific learning disabilities. The Auditory and Speech Performance Test for Children calculated children's reaction times for pressing speed and accuracy of pressing the correct key. The data were analyzed for content, construct validity, internal consistency, and test -retest reliability. The content validity index value was found to be high (.89-1.0). The Auditory and Speech Performance Test for Children was explained as a two -factor model using exploratory factor analysis (eigenvalue = 1.92, total variance = 66.65%). It was found to be discriminative according to age, groups, subtests, and 27% bottom and top scores (all were significant atp < .001). Internal consistency (.77-.90) and test -retest values (.89-.93) of the Auditory and Speech Performance Test for Children in the total test scores were calculated within reliable values. In conclusion, we developed a valid and reliable screening tool for auditory and speech performance in children.
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