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Nano-Bomaterials in Tissue Repair and Regeneration : Clinical Aspect for Hard Tissues Materials
No full textInvestigation of the Effects of Perfluorooctane Sulfonic Acid (PFOS) and Perfluorooctanoic Acid (PFOA) Exposure on Interleukin-17 Signaling and Poly(I:C)-Induced Lung Injury in Balb/c Mice
No full textThe aim of this study is to investigate the effects ofperfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) on theIL-17 signaling pathway, as well astheir relationship with the severity of Poly I:C-induced lung injury innine-week-old male Balb/c mice. A total of 11 groups were formed, eachcomprising six nine-week-old male Balb/c mice. These included control groups(sham, vehicle, intratracheal Poly I:C, and vehicle combined with intratrachealPoly I:C), groups receiving PFOS+PFOA at doses of 1, 3, or 9 mg/kg/day toassess baseline effects on IL-17 signaling, and groups receiving the same dosesin combination with Poly I:C to evaluate their impact on lung injury severity.For the latter, Poly I:C was administered intratracheally following oralexposure to PFOS+PFOA. The treatment solution was prepared by mixing PFOS andPFOA at a 1:1 (w/w) ratio. Bronchoalveolar lavage fluid was analyzed toquantify cytokine levels. The percentages of T helper (Th) lymphocyte subsetswere determined using flow cytometry. In addition, IL-17-related geneexpression in lung tissue was evaluated by RT-qPCR. Furthermore, lung samplesunderwent histopathological evaluation to assess structural alterationsassociated with inflammation and tissue damage. Poly I:C administrationsignificantly increased the percentages of Th17, Th1, and Th22 cells. Thisincrease was also observed in the combination groups, although the extent ofthe increase was less pronounced compared to the Poly I:C group. Th2 cellpercentages showed a significant increase in the PFOS+PFOA groups, while nosignificant changes were observed in Th9 cell percentages. RT-qPCR and cytokineanalyses confirmed the presence of immune response alterations in the lungtissue. The observed increases in Th1 and Th17 cellsreflect the expected immunological activation by Poly I:C [1,2]. However, thediminished responses in the combination groups modulate the immune system’s abilityto respond appropriately to such stimuli. While Th2 levels tended to decreasein the Poly I:C group, the PFOS+PFOA-induced increase in Th2 cells may indicatea shift toward an allergic or humoral-dominant immune profile [3,4]. Theactivation of Th17 cells at both the flow cytometric and gene expression levelssuggests an imbalance that could contribute to mucosal inflammation [5,6].Changes in Th22 cell populations also point to a potentially complex role intissue inflammation and repair dynamics. PFOS and PFOA are synthetic chemicalsto which humans are widely exposed, particularly through everyday items such ascookware. Our findings suggest that these substances may disrupt pulmonaryimmune responses under infection-like conditions. This immune dysregulation couldincrease the risk of inappropriate inflammatory responses and tissue damage,highlighting the importance of considering environmental toxicants in thecontext of viral pandemics.This work was supported by theScientific Research Projects Coordination Unit of Hacettepe University (ProjectNo: FUK-2022-20117). Eda Nur İnkaya is a recipient of the YÖK 100/2000 Ph.D.Scholarship, funded by the Council of Higher Education (YÖK), Turkey.</p
Between silence and need: Menstrual experiences and communication gaps in coach-athlete relationships in Türkiye
No full textWhile the menstrual cycle is recognized as an important factor in women athletes' health and performance, most research remains Western and biomedical, leaving gaps on how cultural and gender norms shape menstrual experiences and communication in non-Western settings such as T & uuml;rkiye. This study examined the menstrual cycle (MC) experiences of Turkish female athletes, focusing on physical and psychological symptoms, their perceived impact on training and competition, athletes' knowledge of the MC, and communication with coaches. Utilizing a quantitative, cross-sectional survey design, data were collected from 482 elite women athletes. Findings revealed that most athletes experienced multiple MC symptoms, with abdominal pain and mood changes being the most common. Approximately half of the participants stated that the MC negatively affected training and competition performance. Despite these impacts, only 18% consistently communicated the MC symptoms to their coaches, and nearly half perceived their coaches as lacking sufficient knowledge on the topic. Athletes who believed their coach was knowledgeable were more likely to engage in menstrual communication. Furthermore, one-third of the participants had insufficient knowledge of premenstrual syndrome, and awareness of the link between weight loss and amenorrhea was low. A significant majority (89%) supported dialogue between athletes and coaches regarding the MC, emphasizing its relevance to training and athlete well-being. These findings highlight the necessity of destigmatizing menstruation, enhancing education for both athletes and coaches, and promoting individualized, open communication strategies within sports contexts. This study expands understanding of sociocultural influences on women athletes' menstrual experiences in non-Western contexts
Türkiye Romatoloji Derneği - Romatoloji ve Malignite Çalışma Grubu enflamatuvar artrit ve malignite: Sistematik derlemeye dayalı risk değerlendirmesi ve klinik yönetim üzerine fikir birliği raporu
No full textEnflamatuvar artrit (İA), altta yatan kronik enflamasyona bağlı özellikle lenfoma başta olmak üzere bazı malignite türleri için bir risk artışı ile ilişkilidir. İA tedavisinde kullanılan konvansiyonel ve hedefe yönelik tedaviler, immün sistemi modüle etmeleri nedeniyle de novo malignite gelişimi veya var olan malignitenin seyri konusunda endişeler barındırmaktadır. Kanser öyküsü olan İA hastalarının yönetimi, hekimler için en zorlayıcı alanlardan biridir ve bu konudaki uluslararası rehberler mevcut olsa da genellikle daha dar bir kapsama odaklanmıştır. İA ve malignite ilişkisini; temel risk, tedaviye bağlı risk, kanser öyküsü olan hasta yönetimi, aktif kanser sırasında tedavi, premalign lezyonlar ve aile öyküsü gibi geniş bir yelpazede ele alan ilk kapsamlı Türkiye fikir birliği raporudur. Sistematik literatür taramasına dayalı olarak, mevcut uluslararası rehberlerin daha dar kapsamda ele aldığı; aktif tedavi altında kanser gelişimi, premalign lezyonlar ve aile öyküsü gibi günlük pratikte sık karşılaşılan spesifik senaryolar için kanıta dayalı pratik öneriler sunar. Sistematik literatür taramasına dayalı olarak, mevcut uluslararası rehberlerin daha dar kapsamda ele aldığı; aktif tedavi altında kanser gelişimi, premalign lezyonlar ve aile öyküsü gibi günlük pratikte sık karşılaşılan spesifik senaryolar için kanıta dayalı pratik öneriler sunar. Bu rapor, romatologların İA ve malignite birlikteliğindeki karar verme süreçlerini standartlaştırmasına ve daha güvenli adımlar atmasına yardımcı olacaktır. Risklerin bireyselleştirilmesi ve hasta ile hekim arasında paylaşılan karar verme süreçlerinin teşvik edilmesi yoluyla, hem romatizmal hastalığın etkin kontrolünü hem de onkolojik güvenliği gözeten kişiselleştirilmiş tedavi yaklaşımlarını güçlendirecektir.Inflammatory arthritis (IA) is associated with an increased risk for certain malignancies, particularly lymphoma, due to underlying chronic inflammation. Conventional and targeted therapies used in IA modulate the immune system, raising concerns about the development of de novo malignancies or the progression of pre-existing ones. Managing IA patients with a history of cancer remains one of the most challenging areas for clinicians, and while international guidelines exist, they generally focus on a narrower scope. This report is the first comprehensive consensus report from Türkiye to address the relationship between IA and malignancy across a wide spectrum, including baseline risk, treatment-related risk, management of patients with a history of cancer, treatment during active malignancy, premalignant lesions, and family history. Based on a systematic literature review, this report provides evidence-based, practical recommendations for specific scenarios frequently encountered in daily practice—such as cancer development during active treatment, premalignant lesions, and family history—which are often narrowly addressed in existing international guidelines. This report will help rheumatologists standardize decision-making processes regarding the coexistence of IA and malignancy, enabling them to take safer clinical steps. By promoting risk individualization and shared decision-making between patients and clinicians, it will strengthen personalized treatment approaches that ensure both effective control of rheumatic disease and oncologic safety
Unmasking Immune Dysregulation: Is Eosinophilic Esophagitis an Early Clue to Inborn Errors of Immunity?
No full textFare Sistit Modelinde Karbonmonoksitin Agonist ile İndüklenen Detrusor Kasılmaları Üzerindeki Potansiyel Rolü
No full textİmmün Trombotik Trombositopenik Purpura (iTTP) Hastalarının Klinik Bulguları, Tedavi Özellikleri ve Klinik Sonuçlarının Gerçek Yaşam Değerlendirmesi: Türk iTTP Kayıt Çalışması Ara Analizi
No full textAmaç: Bu çalışma, Türkiye genelinde immün trombotik trombositopenik purpura (iTTP) hastalarının klinik bulgularını, tedavi modellerini ve klinik sonuçlarını Türk iTTP kayıt sisteminin ara analizine dayanarak araştırmayı amaçlamıştır. Gereç ve Yöntemler: Bu retrospektif, girişimsel olmayan, gözlemsel çok merkezli iTTP kayıt çalışmasının (ClinicalTrials.gov Identifier: NCT05950750) ara analizine 19 üçüncü basamak hematoloji merkezinden 2001-2023 yılları arasında tanı almış toplam 215 iTTP hastası (ortanca tanı yaşı 41, %58,6’sı kadın) dahil edilmiştir. Hastaların demografik özellikleri, ilk başvurudaki tanı özellikleri, aldıkları tedaviler ve tedavi yanıtları, hastalık alevlenme ve nüks oranları ve sağkalım sonuçları her merkez tarafından elektronik olgu rapor formuna kaydedilmiştir. Bulgular: Tanıdan önceki 3 hafta içerisinde enfeksiyon (%15), yeni ilaç başlanması (%9,7) ve gebelik/postpartum durum (%6,3) en sık gözlenen potansiyel uyarıcı faktörler olarak bulunmuştur. Hastaların en sık sistemik/konstitüsyonel (bitkinlik %68,8; ateş %18,1) ve nörolojik (baş ağrısı %40, vertigo %32,1) semptomlarla geldiği, bunları kanama, gastrointestinal, renal ve kardiyovasküler semptomların takip ettiği gözlenmiştir. Başlangıç PLASMIC risk skorlamasına göre hastaların %77,8’i TTP için yüksek risk kategorisinde idi. Hastaların %64,1’ine (%36,2’sine ilk 24 saat içerisinde) başvuru sonrası ilk 48 saat içerisinde tedavi başlanmıştı. Başlangıç tedavisi plazma değişimi (%92,1) ve steroid (%63,7), yanısıra rituksimab (%15,8) da kullanılmıştı. Hastaların %79,9’unda klinik yanıt, %68,2’sinde ise klinik remisyon sağlanmıştır. ADAMTS13 yanıtı değerlendirildiğinde, sırasıyla %17,7 ve %14,6 hastada kısmi ve tam remisyon elde edilmişti. Ortanca 30 ( 0,1-262,4 ) aylık takipte 35 (%16,3) hastada alevlenme/relaps saptanırken toplam 11 (%5,5) hasta kaybedildi ve ölümlerin 6 (%3)’ünün hastalık ilişkili olduğu tespit edildi. Sonuç: Bu ulusal iTTP kayıt çalışmasının ara analizi Türkiye’deki farklı hematoloji merkezlerinden iTTP tanı ve tedavisine ait çok değerli gerçek-yaşam verisini sağlaması açısından önemlidir.Objective: This study aimed to investigate the clinical manifestations, treatment patterns, and clinical outcomes of patients with immune thrombotic thrombocytopenic purpura (iTTP) across Türkiye via an interim analysis of the Turkish iTTP Registry. Materials and Methods: A total of 215 patients with iTTP (median age at diagnosis: 41 years; 58.6% female) diagnosed between 2001 and 2023 were retrospectively analyzed in the interim analysis of a prospective non-interventional observational multicenter iTTP registry study (ClinicalTrials.gov Identifier: NCT05950750) conducted at 19 tertiary hematology centers. Data on patient demographics, disease characteristics at initial admission, treatment characteristics and responses, exacerbations/relapses, and survival outcome were obtained from electronic case report forms. Results: Infection (15.0%), new drug initiation (9.7%), and pregnancy/postpartum period (6.3%) within 3 weeks before diagnosis were the most prevalent potential triggers. Patients presented most commonly with systemic/constitutional (fatigue: 68.8%; fever: 18.1%) and neurological (headache: 40.0%; vertigo: 32.1%) symptoms, followed by hemorrhagic, gastrointestinal, renal, and cardiovascular manifestations. Based on PLASMIC risk scoring, 77.8% of patients were initially at high risk for TTP. The initial treatment was begun within the first 48 hours of hospital admission for 64.1% of patients (36.2% on the day of admission). Treatment was mainly based on therapeutic plasma exchange (92.1%) and steroids (63.7%), while rituximab was used in 15.8% of patients. The clinical response rate was 79.9% and clinical remission was achieved by 68.2% of patients. Regarding a thrombospondin type 1 motif member (ADAMTS13) 13 levels, partial and complete responses were achieved by 17.7% and 14.6%, respectively. During a median of 30 months (range: 0.1-262.4 months) of follow-up, 35 patients experienced exacerbations/relapses. Mortality occurred in 11 (5.5%) patients and was found to be disease-related in 6 cases (3.0%). Conclusion: This interim analysis of the nationwide Turkish iTTP Registry study provides valuable data on real-world clinical practices in the diagnosis and management of iTTP at different hematology clinics across the country
Bilgilendirici Metinlerdeki Artgönderimlerin Tespiti Üzerine Bir Araştırma
No full textBu araştırma, 7. sınıf ortaokul öğrencilerinin bilgilendirici metinlerdeki artgönderimleri tespit etme durumlarını incelemektedir. Çalışmanın ana amacı, öğrencilerin bu gönderimlerin göndergelerini genel olarak ve belirli türler itibarıyla ne kadar etkili bir şekilde tespit edebildiklerini değerlendirmektir. Bu doğrultuda, Millî Eğitim Bakanlığı tarafından onaylanmış, eski veya hâlâ kullanılmakta olan ders kitaplarında bulunan bilgilendirici metinlerden paragraflar test için kullanılmıştır. Araştırmaya toplam 82 7. sınıf öğrencisi katılmış ve test, 17 paragraf ve 44 anafor içermektedir. Çalışmada, nicel bir araştırma yaklaşımı olan tarama araştırması kullanılmış ve araştırma tasarımı olarak ilişkisel tarama modeli tercih edilmiştir. Bulgular, 7. sınıf öğrencilerinin artgönderimleri tespit etme becerilerinin genel olarak yetersiz olduğunu, özellikle isim artgönderimi dışındaki zamir, sıfat, zarf, fiil ve ek artgönderimlerini tanımlamada güçlük yaşadıklarını ortaya koymuştur. Ayrıca, Türkçe dersinde daha yüksek ortalama başarı gösteren öğrencilerin artgönderim tespit etme konusunda daha yetkin oldukları da belirlenmiştir.This research investigates the ability of 7th-grade secondary school students to detect anaphoras in informative texts. The study's primary objective is to assess how effectively students can resolve these references (identify their referents), both in general and by specific types. To this end, paragraphs from informative texts found in textbooks approved by the Ministry of National Education—whether outdated or currently in use—were used in the test. A total of 82 7th-grade students participated in the study, which involved a test comprising 17 paragraphs and 44 anaphors. The study employed survey research, a quantitative survey approach, a correlational design was used The findings indicate that the overall ability of 7th-grade students to detect anaphoras is inadequate, particularly in identifying pronoun, adjective, adverb, verb, and suffix anaphoras, aside from noun anaphoras. Moreover, students who exhibited higher average success rates in their Turkish course also demonstrated greater proficiency in anaphora detection