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El impacto de la extensión microscópica extratiroidea en el pronóstico del carcinoma medular de tiroides: un estudio de cohorte multicéntrico
No full textPurpose: Despite several factors are associated with worse disease-free survival (DFS) and prognosis in medullary thyroid carcinoma (MTC) patients, the effect of microscopic extrathyroidal extension (mETE) on the prognosis and DFS is not well understood. This study aims to evaluate the impact of mETE on DFS and prognosis in patients with MTC. Methods: This multicenter study included 208 patients with MTC (17.8% with hereditary disease). Patients with mETE were compared to those without mETE in terms of clinical and histopathological variables. Results: Among the 208 patients, 16.3% (n = 34) had mETE on histopathological analysis. Patients with mETE were more likely to have larger tumors, higher serum calcitonin (CTN) levels before and after surgery, increased rates of neck lymph node (LN) and distant metastasis, multifocal disease, and advanced disease stage. Kaplan–Meier analysis showed a significantly lower DFS in patients with mETE than those without mETE (14.7% vs. 71.3%, log-rank p < 0.001). However, mETE was not an independent contributing factor for persistent/recurrent disease, whereas neck LN involvement was the strongest independent contributing factor for persistent/recurrent disease (HR: 1.1; 95% CI 0.4–1.8, p = 0.76 and HR: 9.6; 95% CI 1.21–76.9, p = 0.03, respectively). Conclusion: mETE in patients with MTC is associated with a lower DFS, larger tumor sizes, a higher likelihood of neck LN and distant metastasis, advanced stage, higher serum CTN levels, multifocality, and persistent/recurrent disease. However, mETE was not an independent predictor of persistent/recurrent disease. Further studies with a larger number of patients with mETE could further clarify the impact of mETE on the prognosis of MTC. © 2025 Elsevier B.V., All rights reserved
On the spectral instability of some cnoidal and snoidal waves of the full Klein-Gordon-Zakharov system
No full textThe full Klein-Gordon-Zakharov system is considered in the space periodic context. We construct cnoidal and snoidal type solutions for the fast scale component. It is shown that in parts of the range, the waves are spectrally unstable with respect to co-periodic perturbations. The result relies on an instability index count for Hamiltonian systems, with self-adjoint portion consisting of a non-standard matrix Hill operator. The spectral analysis of these objects, and in particular the Morse index calculations, is a largely unexplored subject. The method, that we develop herein, might prove useful for other systems and/or second order in time models.NSF [2204788]Stanislavova is partially supported by the NSF, under award #2210867. Stefanov is partially supported by the NSF, under award #2204788
Healthy Lifestyle Behaviours and Associated Factors in Caregivers of Patients With Chronic Mental Illnesses: A Cross-Sectional Study
No full textBackground: According to the community-based model, caregivers play a major role in the care of patients with chronic mental illness. However, caregivers have little time to attend to their own health needs and tend to ignore their health. Caregivers with healthy lifestyle behaviours are likely to achieve greater physical and psychological well-being. Aim: This study aims to assess the healthy lifestyle behaviours and associated factors for the caregivers of patients with chronic mental illnesses. Methods: This cross-sectional study was conducted at the psychiatry outpatient clinic of a hospital in Northwest Turkey, and the sample consisted of 122 caregivers. Data were collected using both a personal information form and the Healthy Lifestyle Behaviours Scale II. Results: The Healthy Lifestyle Behaviours Scale II score of the caregivers was 124.37 +/- 28.02. The mean total Healthy Lifestyle Behaviour Score significantly varied depending on the caregiver's education level, income, caregiving experience and burnout experiences, the number of psychiatric hospitalisations of their patients in their lifetime and the perceived financial impact and social impact of their care (p < 0.05). Conclusion: The results suggest that psychiatric nurses should play a more active role in protecting and improving caregivers' health and well-being by developing psychoeducational programmes that could help caregivers adopt healthy lifestyle behaviours
Respiratory syncytial virus (RSV) infections in adults: Current trends and recommendations for prevention - a global challenge from a local perspective
No full textRespiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections (LRTI) and a major health threat especially for children and older adults. Epidemiological data reveal that RSV-associated global mortality rates in individuals aged >= 70 years exceeded those in children aged < 5 years in 2019. Although effective interventions have decreased RSV-related deaths in children aged < 5 years over time, RSV appears increasingly significant issue for the elderly and adults with underlying health conditions. Furthermore, there is currently no specific treatment for RSV infections in adults, highlighting the importance of prevention. Recently, three vaccines (RSVPreF3, RSVpreF, and mRNA-1345) have been approved for adults to date. In this article, we aimed to review the characteristics of RSV infections in adults and the evidence on the safety and efficacy of RSV vaccines, with a glimpse of the current situation in T & uuml;rkiye- one of the low- and middle- income countries (LMICs).PfizerThis study was sponsored by Pfizer. Medical writing support was provided by Omega CRO, Ankara, Tuerkiye and was funded by Pfizer
Investigating the possible protective effect of caffeic acid phenethyl ester on aquaporin-2 changes in renal ischemia-reperfusion injury in rats
No full textObjective: We aimed to investigate the changes in renal aquaporins (AQP) of rats in renal ischemia-reperfusion (I/R) injury and the protective effects of caffeic acid phenethyl ester (CAPE) against these changes. Methods: Forty-five adult rats were divided into six groups: control, sham (right nephrectomy), I/R (right nephrectomy + left kidney I/R), I/R+CAPE (I/R procedure after i.p. CAPE), sham + CAPE, and sham + dimethyl sulfoxide. Blood urea nitrogen, Cr, and K+ levels were measured in the sera. Tissues were stained with hematoxylin and eosin for histopathological examination. For immunohistochemical analysis, AQP2 was applied using the streptavidin/biotin/peroxidase system. AQP2 gene expression in kidney tissues was examined by polymerase chain reaction (PCR). Results: In the I/R, congestion, inflammation, and necrosis were found to increase compared to the control. In the I/R+CAPE, improvement was observed in necrosis compared to the I/R. There was a decrease in AQP2 expression in the I/R. In PCR, no significant difference was observed in AQP2 gene expression between the I/R and control and between the I/R+CAPE and I/R. Conclusion: Renal I/R inhibits the production of AQP2 in the kidney and causes histological and biochemical damage. CAPE administration before I/R has a protective effect on the kidney
Real-World Insights From Türkiye: Biologic DMARDs Usage in Spondyloarthritis Patients With Chronic Kidney Disease
No full textAimThe objective was to evaluate biologic disease-modifying antirheumatic drugs (DMARDs) and their side effects that hindered the continuation of treatment in a patient population diagnosed with spondyloarthritis (SpA) with a glomerular filtration rate (GFR) <= 60 mL/min, and to compare these side effects between patients with chronic kidney disease (CKD) and those without.MethodsThis multicenter, observational cohort study utilized data from the TReasure database, which records SpA patients in a web-based system across T & uuml;rkiye. A total of 6052 patients being included. SpA patients were categorized into two main groups: non-CKD patients and CKD patients. The clinical characteristics, disease activity, treatment options, drug retention rates, reasons for drug discontinuation, and types of adverse effects were compared between the groups.ResultsBiologics prescription pattern varied between CKD and non-CKD patients. Etanercept was prescribed more frequently (53.1%) in CKD patients. Regarding the number of side effects and drug discontinuations in CKD patients, no statistically significant differences were found between the non-CKD and CKD groups for any of the bDMARDs (adalimumab, etanercept, golimumab, infliximab, ustekinumab, secukinumab, and certolizumab). No statistically significant differences were observed in the duration of drug retention based on CKD status for bDMARDs.ConclusionThis study offers preliminary evidence supporting the effective and safe use of bDMARDs in patients with SpA and CKD
Bâbüssaâde Ağası Bosnevî Hasan Ağa’nın Vakıfları
No full textVakıf, Osmanlı kültür ve medeniyet tarihinin önemli kurumlarının başında gelmektedir. Osmanlı Devleti’nde hayırseverler maddi imkânları nispetinde birçok vakıf kurmuşlardır. Saray mensupları ve devlet ricali, vâkıflar arasında önemli bir yer tutmaktadır. Sultan I. İbrahim (1640-1648) zamanında ser-hazînedâr (hazînedârbaşı), Sultan IV. Mehmed (1648-1687) zamanında ise Bâbüssaâde ağalığı gibi çok önemli devlet vazifelerinde bulunan Bosnevî Hasan Ağa her iki görevi sırasında vakıf kurmuş önemli devlet adamlarındandır. Hasan Ağa’nın hayatı hakkında çok az bilgi vardır. Nerede doğduğu, saraya nasıl geldiği gibi konular hakkında maalesef bir bilgi yoktur. Bu çalışma, Bosnevî Hasan Ağa’nın vakıflarını konu edinmektedir. Hasan Ağa’ya ait 1056 (1646), 1057 (1647) ve 1060 (1650) tarihli üç adet vakfiye bulunmaktadır. Bunlardan ilk ikisi, İstanbul; üçüncüsü Bosna vakıfları hakkındadır. İstanbul’daki vakıf gelirlerinin bir kısmını ailesine, akrabalarına ve âzatlı kölelerine; bir kısmını da inşa ettirdiği mektebin giderlerine vakfetmiştir. Bosna’daki vakfının gelirlerini ise, sadece inşa ettirdiği cami ve mektebin giderlerine vakfetmiştir. Bu çalışmada Hasan Ağa’nın vakfına ait üç vakfiyeden ve Devlet Arşivleri Başkanlığı Osmanlı Arşivi belgelerinden hareketle Hasan Ağa’nın hayrâtı, vakıflarından yararlanacak kimseler, vakıflarının gelir kaynakları, giderleri ve işleyişi üzerinde durulmuş; vakıf görevlilerinin vazifeleri, ücretleri hakkında bilgiler verilmiştir
Perspectives on physical activity among women with fibromyalgia: a qualitative study
No full textAimThis study aimed to understand physical activity (PA) behaviors and beliefs in fibromyalgia (FM) patients to address intervention needs.Subject and methodsA qualitative study was conducted using semi-structured interviews based on five social cognitive theory (SCT) constructs: behavioral capability, outcome expectations, self-efficacy, self-regulation, and social support. Ten female FM patients aged 18-65 were interviewed for 30-60 min. Data were audio recorded, transcribed, and analyzed using content analysis.ResultsFindings organized by SCT constructs revealed eight key themes. For behavioral capacity, participants reported a lack of knowledge about PA and the need for a person-centered approach. Regarding outcome expectations, they focused on perceived health benefits. Self-efficacy was influenced by past negative experiences, environmental barriers, and personal challenges. Integrating PA into daily routines emerged as a form of self-regulation, while positive social interactions were critical for social support.ConclusionThis study identified factors and beliefs related to PA behavior in FM patients, offering suggestions for developing effective PA interventions. Fostering self-efficacy and addressing social support, along with telehealth, can help overcome barriers and enhance long-term PA adherence.Scientific and Technological Research Council of Turkiye (TUBITAK); Higher Education Council-Teaching Staff Training Program (YOK-OYP); Scientific and Technological Research Council of Turkey-TUBITAK BIDEB 2211-A General National PhD Scholarship ProgramThe authors extend their sincere gratitude to all participants for their valuable contributions to this study. Nimet Sermenli is supported by Higher Education Council-Teaching Staff Training Program (YOK-OYP) and The Scientific and Technological Research Council of Turkey-TUBITAK BIDEB 2211-A General National PhD Scholarship Program within the scope of doctoral education.Open access funding provided by the Scientific and Technological Research Council of Turkiye (TUBITAK). This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors
Executive functions in children with ADHD: A comprehensive bibliometric analysis
No full textExecutive functions, which are closely associated with the functioning of the frontal lobes, encompass a set of cognitive processes that enable individuals to better adapt to their environment. It is known that individuals with Attention Deficit Hyperactivity Disorder (ADHD) have deficiencies in executive functions. To the best of our knowledge, no study has used bibliometric analysis to investigate the issue of executive functions in children with ADHD. This study employed the bibliometric analysis software VOS viewer and the statistical computing platform RStudio to examine 905 studies. This study reveals a notable increase in international research on executive functions in children with ADHD over the years. The highest number of publications on executive functions in children with ADHD are the Journal of Attention Disorders, Child Neuropsychology, and Archives of Clinical Neuropsychology. In the early years of this research field, there was a greater emphasis on brain imaging studies, including evoked potentials, transcranial magnetic stimulation, and evoked-related potentials. As time progressed, greater emphasis was placed on variables within the living environment. This research provides a comprehensive examination of global studies on executive functions in children diagnosed with ADHD, considering a multitude of variables. The findings presented here will inform forthcoming studies in this area, which will contribute to the accumulation of knowledge in this field