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  • ArticleYayıncıda açık erişim2027
    State-specific respiratory signatures for affective and stress recognition: Interpretable respiratory markers, autocorrelation lags, and compact CNN models

    Velichko, Andrei; Huyut, Mehmet Tahir

    Respiratory activity is a direct and interpretable physiological channel for wearable stress and affective-state recognition, yet many studies emphasize classification accuracy without identifying which respiratory properties separate different states. This work reframes RESP-based recognition as a joint predictive and explanatory problem. Using the chest respiratory channel of the WESAD dataset, we analyze 60 s windows under leave-one-subject-out validation and combine two complementary branches: compact raw-signal one-dimensional convolutional neural networks (1D-CNNs) and physically grouped handcrafted respiratory signatures. The primary application task is binary stress versus non-stress detection, while baseline, stress, amusement, and meditation are additionally analyzed in a one-vs-rest setting to reveal state-specific respiratory markers. The feature space is organized into respiratory timing, breath-to-breath variability, waveform statistics, spectral/time–frequency descriptors, and autocorrelation/nonlinear predictability descriptors, with the raw 60 s signal treated as a sixth representation for the CNN branch. We introduce autocorrelation transition lags (Zpm/Zmp) as interpretable markers of respiratory correlation scale and separately evaluate exploratory forecast-error-growth/Lyapunov-like descriptors. In the final CNN refit setting, the raw-signal model achieved the strongest stress-vs-rest performance (accuracy 96.72%, macro-F1 95.30%, MCC 90.61%). In contrast, compact feature models were stronger for baseline (MCC 65.34%), amusement (MCC 35.69%), and especially meditation (MCC 88.65%). Strict nested reanalysis of the auxiliary Top-20 stress search yielded mean MCC=82.29% versus 85.45% originally, indicating modest selection optimism. These results show that CNNs are most useful for the practical stress detector, whereas interpretable respiratory signatures provide stronger and more physiologically transparent state-specific markers for several non-stress conditions.

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  • ArticleYayıncıda açık erişim2026
    Evaluation of Paramedic Pre-hospital's Analgesic Management of Trauma Patients

    Kantar, Y.; Hayme, S.

    Background:Although analgesic management is a critical priority in the guidelines for trauma patients, paramedics' prehospital administration practices vary.Objectives:This study evaluated the paramedics' practices regarding prehospital analgesia administration in trauma patients.Methods:The study was conducted in two phases. In the first phase, the records of patients 18 years and above who were brought to our hospital via ambulance were retrospectively reviewed. A total of 506 patients with trauma were included in this phase of the study. In the second phase, paramedics' practices regarding pre-hospital analgesic administration to trauma patients, such as drugs, and frequency. Data were analyzed using descriptive statistics, and are presented as mean +/- standard deviation for numerical variables and as frequency and percentage for nominal variables. Nominal variables were evaluated using the Pearson Chi-Square test.Results:According to data collected retrospectively in the first phase of the study, prehospital analgesia was administered to only 1% of the 506 patients. In the second phase of the study, when asked about the reasons for not administering prehospital analgesia, it was found that 77.5% of paramedics believed that doing so would interfere with the hospital physician's examination.Conclusion:High rates of interventions such as spinal board immobilization, cervical collar application, and appropriate splinting or dressing have been observed in trauma patients. Paramedics were also found to be quite successful in establishing intravenous access. However, the rates of fluid administration and analgesia were considerably lower compared to the literature.

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  • ArticleAçık Erişim2026
    ATP attenuates olaparib-induced gastric damage in rats

    Fakirullahoglu, Mesud; Temiz, Ayetullah; Yeni, Mustafa; Sezgin, Esra Tuba; Yazici, Gulce Naz; Altuner, Durdu; Gulaboglu, Mine; Suleyman, Halis

    Background Olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor widely used in cancer therapy, has been associated with gastrointestinal adverse effects; however, the underlying mechanisms remain unclear. Previous studies have suggested that oxidative stress may contribute to olaparib-induced tissue injury.Objective This study aimed to investigate the protective effects of adenosine triphosphate (ATP) against olaparib-induced gastric damage in rats.Methods Animals were divided into healthy control (HG), olaparib alone (OLPG), ATP alone (ATPG), and ATP + olaparib (ATOLG) groups. Gastric injury was evaluated by macroscopic assessment of ulcer area and ulcer number. Histopathological alterations were examined using hematoxylin-eosin (H&E) staining, and oxidative stress status was assessed by measuring lipid peroxidation and antioxidant defense parameters.Results Olaparib administration induced marked gastric mucosal injury, characterized by increased ulcer area and ulcer number, severe histopathological damage, and pronounced oxidative stress. In contrast, ATP co-administration significantly attenuated gastric injury, as evidenced by reduced ulcer area and ulcer number, improved histopathological architecture, and restoration of oxidative balance. Compared with the OLPG group, the ATOLG group showed significant improvement in macroscopic, histopathological, and oxidative stress parameters.Conclusion ATP administration attenuated olaparib-induced gastric damage and improved oxidative stress parameters in rats. Although the underlying mechanisms were not directly investigated in the present study, the obtained findings provide preliminary experimental evidence suggesting that ATP may have protective potential against olaparib-induced gastric injury.

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  • ArticleYayıncıda açık erişim2026
    A Rare Cause of Respiratory Failure in an Alzheimer's Patient: Esophagual ForeignBody

    Kantar, Yusuf

    Foreign body impaction in the esophagus is a common emergency, particularly among children; however, unusual presentations in geriatric patients are rarely encountered. The clinical manifestation may vary depending on the type and location of the foreign body and the patient's underlying condition. We report the case of a 79-year-old bedridden male patient with Alzheimer's disease who presented to the emergency department with shortness of breath and audible wheezing. Initial evaluation and imaging studies revealed no acute pulmonary pathology. A lateral neck X-ray demonstrated an image consistent with a foreign body at the cervical level, which was later confirmed by computed tomography to extend along the esophagus. Under sedation with fentanyl and ketamine, the foreign body-a sock-was successfully removed using a laryngoscope and long forceps. The patient recovered uneventfully and was discharged after clinical stabilization. This case is remarkable due to the atypical presentation and the unusual nature of the ingested object. While most esophageal foreign bodies in adults are accidental or intentional, this case resulted from unconscious behavior related to Alzheimer's disease. Emergency physicians should maintain a high index of suspicion when evaluating elderly or cognitively impaired patients presenting with atypical respiratory symptoms, as early recognition and prompt intervention can be lifesaving.

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  • ArticleAçık Erişim2026
    Changes in Gastritis During the COVID-19 Pandemic: A Retrospective Comparative Study According to the Sydney Criteria

    Çımen, Ferda Keskın; Çimen, Orhan

    Objective: This study aimed to evaluate whether the coronavirus disease-2019 (COVID-19) pandemic caused changes in the severity of gastritis, as assessed by the Sydney criteria, through a retrospective comparison of patients in the pre- and post-pandemic periods. Methods: Pathology reports of 107 pre-pandemic patients until March 2019 and 96 post-pandemic patients until May 2023, who underwent upper gastrointestinal endoscopy for dyspeptic complaints and were diagnosed with gastritis were retrospectively analyzed. Gastritis severity was assessed according to the Sydney criteria. Percentages were calculated and compared. Results: The pre-pandemic group included 62 women and 45 men (mean age 58.6 years). The post-pandemic group included 50 women and 46 men (mean age 57.6 years). No significant demographic differences were observed. According to the Sydney criteria, no permanent effect of COVID-19 on gastritis severity was identified. Conclusion: Our study found no significant differences in gastritis severity between the periods before and after the COVID-19 pandemic. Larger prospective studies are required to further explore potential long-term effects.

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  • ArticleAçık Erişim2026
    Association between monocyte/HDL cholesterol ratio and air pollution in a highly polluted region: A disease-specific analysis

    Aydın, Muhammet Raşit; Karahan, Harun

    The monocyte/HDL cholesterol ratio (MHR) is increasingly recognized as a potential marker of inflammation, oxidative stress, and endothelial dysfunction, despite the lack of standardized reference values. This study investigates the association between air pollution and MHR and its relationship with chronic diseases. A retrospective cohort study was conducted with 600 patients admitted to Igdir State Hospital. Patients were grouped by Particulate Matter 10 (PM10) exposure levels (≥50 μg/m³ vs <50 μg/m³). Laboratory data and disease diagnoses were recorded and analyzed. MHR was significantly higher in patients with atherosclerotic cardiovascular disease (ASCVD) (p<0.003) and lower in patients with diabetes mellitus (DM) (p<0.003) on days with PM10≥50 μg/m³. Similar trends were observed on low-pollution days (PM10<50 μg/m³), with a significant positive association between MHR and ASCVD (p<0.012) and cerebrovascular accident (CVA) (p<0.027). A significant correlation was also found between MHR and HbA1c levels (p<0.001). MHR is positively associated with cardiovascular risk and may serve as a low-cost, accessible marker of inflammation in clinical practice.

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  • ArticleYayıncıda açık erişim2026
    In Vitro Analysis of FSH- and LH-Induced Alterations in Progesterone Levels in Human Granulosa–Theca Cells

    Muftuoglu, Sevda Fatma; Bozdag, Gurkan; Mumusoglu, Sezcan; Portakal, Oytun; Coşkun, Neslihan; Sökmensüer, Lale Karakoç; Güneş, Ali Can; Zirh, Selim

    Objective: This study aimed to evaluate whether administration of luteinizing hormone (LH) before the ovulation trigger could modulate elevated progesterone levels. Methods: Human granulosa-theca tissues were obtained from 15 women aged 18–38 years undergoing laparoscopic ovarian cystectomy at the Department of Gynecology and Obstetrics, Hacettepe University. The tissues were cultured in vitro and treated with 12.5 mIU/mL recombinant follicle-stimulating hormone (r-FSH; Group A), 18.75 mIU/mL r-FSH (Group B), or 18.75 mIU/mL r-FSH plus 6.25 mIU/mL recombinant LH (r- LH; Group C). Baseline and post-treatment estradiol (E2) and progesterone concentrations were measured at 0, 24, and 48 hours. Immunofluorescence staining for aromatase, cytochrome P450, and Ki67 was performed to assess steroidogenic activity and cellular proliferation. Results: A mild trend toward reduced progesterone and increased E2 levels was observed following LH supplementation at both time points; however, these changes did not reach statistically significant. No statistically significante differences were observed in progesterone or E2 levels among the treatment groups at 24 h (P=0.891 and P=0.805, respectively) or 48 h (P=0.878 and P=0.505, respectively). Expression levels of aromatase, cytochrome P450, and Ki67 did not differ significantly between groups at 24 h (P=0.665, P=0.932 and P=0.953, respectively) or 48 h (P=0.911, P=0.674 and P=0.202, respectively). Conclusion: These findings suggest that although r-LH addition to high-dose r-FSH does not significantly alter progesterone synthesis, it may exert a subtle regulatory effect on steroidogenesis. Larger studies with extended culture durations are needed to further elucidate the biological and clinical significance of these observations.

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  • ArticleYayıncıda açık erişim2026
    Yoğun bakım hastalarında akut böbrek hasarının mekanik ventilatörden ayırma üzerine etkisinin değerlendirilmesi

    Aydin, Emre; Aydin, Fatma Yilmaz; Kara, Ali Veysel; Kadiroğlu, Ali Kemal; Yilmaz, Zülfükar; Yilmaz, Mehmet Emin; Eynel, Eren; Yildirim, Yasar

    Arka plan: Akut böbrek hasarı (AKI), yoğun bakım ünitesindeki (YBÜ) hastaların %5–30’unu etkiler ve artmış mortalite (%40–90), uzamış YBÜ yatışı ve daha yüksek sağlık maliyetleri ile ilişkilidir. Akciğer ve böbrek hasarı arasındaki karşılıklı etkileşim giderek daha fazla tanınmakla birlikte, AKI’nin mekanik ventilasyondan (MV) ayırma sürecine etkisi yeterince araştırılmamıştır. Bu çalışma, YBÜ hastalarında AKI’nin MV’den ayırma sonuçları üzerindeki etkisini değerlendirmektedir. Yöntemler: Bu retrospektif kohort çalışma, Dahiliye Yoğun Bakım Ünitesi’nde (2010–2015) yürütüldü. Solunum yetmezliği nedeniyle entübe edilen ve en az 48 saat mekanik ventilasyon (MV) altında kalan ≥18 yaş hastalar dâhil edildi. Kronik böbrek hastalığı, kronik akciğer hastalığı veya kalp yetmezliği olan hastalar ile mekanik ventilasyon başladıktan sonra AKI gelişen hastalar çalışma dışı bırakıldı. AKI, KDIGO kriterlerine göre serum kreatinin düzeylerine dayanarak tanımlandı (48 saat içinde ≥0.3 mg/dL artış veya 7 gün içinde ≥1.5 kat artış). Retrospektif veri yapısı nedeniyle idrar çıkışı verileri tüm hastalar için güvenilir şekilde mevcut olmadığından AKI tanımında kullanılmadı. AKI, yoğun bakım sürecinde elde edilen veriler temel alınarak değerlendirildi ve yoğun bakım yatışı sırasında gelişmiş kabul edildi. AKI tanısı olan 100 hasta ile AKI olmayan 100 hasta karşılaştırıldı; demografik veriler (yaş, cinsiyet), laboratuvar parametreleri (kreatinin, albümin, hemoglobin, pH, PaO₂, PaCO₂), SOFA ve APACHE II skorları, sepsis durumu ve ventilatörden ayırma sonuçları analiz edildi. İstatistiksel analizlerde Student t-testi, Ki-kare testi ve çok değişkenli lojistik regresyon kullanıldı. Çok değişkenli modelde AKI durumu, yaş, APACHE II skoru, SOFA skoru, albümin düzeyi ve sepsis değişkenleri yer aldı. Bulgular: Genel MV’den ayırma başarısı %28’di (56/200). AKI grubunda başarı oranı %13 iken AKI olmayan grupta %43 idi (p<0.001). AKI hastalarında kreatinin (2.99±1.3 vs. 0.78±0.22 mg/dL, p<0.001), APACHE II (28.2±5.4 vs. 22.3±4.6, p<0.001) ve SOFA skorları (10.1±3.1 vs. 7.7±2.7, p<0.001) daha yüksekti. Çok değişkenli lojistik regresyon analizinde, AKI olmaması ventilatörden ayırma başarısı ile bağımsız olarak ilişkili bulundu (OR: 2.29, %95 GA: 1.03–5.13, p=0.043). Ayrıca, daha düşük APACHE II skoru da ventilatörden ayırma başarısı ile bağımsız olarak ilişkiliydi (OR: 0.901, %95 GA: 0.820–0.990, p=0.030). Yaş sınırda anlamlılık gösterirken (p=0.081), SOFA skoru, albümin düzeyi ve sepsis ile ayırma başarısı arasında bağımsız bir ilişki saptanmadı (tüm p>0.05). Sonuç: AKI, yoğun bakım hastalarında mekanik ventilasyondan ayırma sürecini anlamlı ölçüde olumsuz etkilemektedir. Hastalık şiddeti için düzeltme yapıldıktan sonra dahi, AKI ventilatörden ayırma başarısızlığının bağımsız bir belirleyicisi olarak kalmaktadır. AKI’nin erken tanınması, klinik yönetimi iyileştirebilir ve başarılı ventilatörden ayırmayı kolaylaştırabilir.

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  • ArticleAçık Erişim2026
    Diagnostic Comparison of MRI/Ultrasound Fusion Biopsy and Systematic Biopsy in PI-RADS 4-5 Prostate Lesions

    Levent, Akın; Durmaz, Önder

    Objective: Multiparametric magnetic resonance imaging (mpMRI) has transformed prostate cancer (PCa) diagnosis by enabling lesion-targeted biopsies. The optimal biopsy approach—systematic biopsy (SB), MRI-ultrasound fusion targeted biopsy (TB), or their combination (CB)—remains debated, especially in patients with high-risk Prostate Imaging-Reporting and Data System (PI-RADS) 4-5 lesions. This study compared these strategies for detecting overall and csPCa. Methods: This retrospective study included 330 patients who underwent MRI-ultrasound fusion TB with 12-core SB between July 2022 and May 2025. Only lesions classified as PI-RADS v2.1 category 4 or 5 were analyzed. Detection rates of overall PCa and csPCa (Gleason score ≥ 7) were compared among SB, TB, and CB. Subgroup analyses were performed by PI-RADS category and lesion location (anterior, middle, posterior). Logistic regression identified independent predictors of csPCa. Results: A total of 429 lesions were evaluated. Overall, PCa detection rates were 62% for SB, 70% for TB, and 77% for CB (P < 0.001); the corresponding csPCa rates were 47%, 56%, and 63% (P < 0.001). TB detected csPCa more effectively than SB (56% vs. 47%, P < 0.01). PI-RADS 5 lesions had higher detection rates than PI-RADS 4 lesions across all methods. CB achieved the highest rates in all locations, especially in anterior and middle lesions. Age, positive digital rectal examination, prostate-specific antigen density, prior biopsy, and PI-RADS category 5 were independent predictors of csPCa. Conclusion: In PI-RADS 4–5 lesions, combined SB and TB provide the highest detection rate for csPCa. While TB improves selective detection, SB remains essential to avoid missing significant disease.

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  • ArticleAçık Erişim2026
    The Relationship Between Mammographic Features of BI-RADS 4 and 5 Calcifications and Pathological Diagnoses

    Babatürk, Andelib; Kaymaz, Esin; Seyfettin, Ayça; Eskalen, Zeynep; Büyükceran, Emre Utkan; Memis, Kemal Bugra; Gültekin, Serap

    Objective: To evaluate the relationship between mammographic features of BI-RADS category 4 and 5 breast calcifications and their corresponding pathological diagnoses, and to determine whether specific morphological or distribution patterns are predictive of malignancy. Methods: This retrospective study included 54 patients who underwent biopsy for suspicious breast calcifications between August 2021 and March 2024. Among these patients, 30 underwent stereotactic vacuum-assisted biopsy, and 24 underwent wire-guided localization followed by excisional biopsy. The mammographic morphology and distribution patterns of the calcifications were assessed using the BI-RADS lexicon, and the corresponding histopathological diagnoses were recorded. The association between mammographic features and pathological outcomes was subsequently analyzed. Results: Fine pleomorphic calcifications were the most common morphology (40.7%). A grouped distribution was the predominant pattern (61.1%). Benign lesions were mostly categorized as BI-RADS 4A, B3 lesions as BI-RADS 4B, and DCIS cases as BI-RADS 4C (P = 0.03). The Grouped distribution was more frequent among benign and B3 lesions, whereas DCIS exhibited more frequent linear and segmental patterns (P = 0.01). Malignancy rates were highest for fine linear/branching and fine pleomorphic morphologies. Conclusion: A significant association exists between the mammographic characteristics of BI-RADS 4 and 5 calcifications and their pathological outcomes. In our study, fine pleomorphic morphology and linear or segmental distribution patterns consistently indicated a increased likelihood of malignancy, particularly ductal carcinoma in situ, whereas benign and B3 lesions were more commonly associated with grouped distribution patterns. These results highlight that detailed evaluation of calcification morphology and distribution on mammography can improve diagnostic confidence, aid in distinguishing higher-risk lesions, and contribute to more informed biopsy decision-making.

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dc.date.accessioned2026-10-20T15:26:00.617842038Z
dc.date.available2026-10-20T15:26:00.617842038Z
dc.identifier.urihttps://rdlopen.rawdatalibrary.net/r/ebyu/22847
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleTıp Fakültesitr
dc.titleFaculty of Medicineen
dspace.entity.typeOrgUnit
organization.identifier.codetip
organization.unitTypefaculty
rdl.unit.alias\bfaculty of medicine\b
rdl.unit.alias\bfac med\b
rdl.unit.alias\bmed(ical)? fac(ulty)?\b
rdl.unit.alias\bschool of medicine\b
rdl.unit.alias\bsch med\b
rdl.unit.alias\btip fakultesi\b
rdl.unit.alias\bfaculty of medical\b
rdl.unit.alias\bmedical school\b