İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
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Nörodejeneratif hastalıklarda helicobacter pylori’nin spesifik farklı antijenlerine karşı gelişen seropozitifliğin araştırılması ve önemi
No full textIntroduction: It is suggested that Helicobacter pylori (Hp) can reach the brain via the oral-nasal-olfactory route, through Hp-infected monocytes in the disrupted blood-brain barrier (BBB), or through a rapid retrograde neural network leading to neurodegeneration from the gastrointestinal tract (GIS) and may lead to neurodegenerative diseases such as Alzheimer’s (AD), Parkinson’s (PD) and Multiple sclerosis (MS). In this study, we aimed to evaluate the possible immunopathogenesis relationship between Hp-specific antigens and neurodegenerative diseases by determining the frequency of seropositivity against different specific antigens of Hp in diseases such as AD, PD and MS. Methods: In our cross-sectional, retrospective case-control study, the immunoreactivity frequencies of Hp-specific and non-specific CagA (p120), VacA (p95), p75, FSH (p67), UreB (p66), HSP homolog (p57), flagellin (p54), p50, p41, p33, OMP (p30), UreA (p29), p26, OMP (p19), p17 antigens were determined by Western Blot method in 36 AD, 35 PD, 91 MS cases with Hp-IgG reactivity, and 55 controls without a neurodegenerative/demyelinating by ELISA method. Results: No significant difference was found between the immunoreactivity frequencies of Hp antigens between AD and control groups (p>0.05). In the multivariate logistic analysis performed for PD cases, age ≥ 50 and immunoreactivity frequency of p19 were found to be independent risk factors (OR: 36.752, p<0.05) (OR: 5.570, p<0.05). In MS cases, immunoreactivity frequency of p17 antigen was found to be a risk factor (OR: 2.646, p<0.05). In addition, the mean level of Hp-IgG reactivity was found to be negatively associated with MS development (indicating an inverse correlation) in the control group compared to the MS group (OR: 0.585, p < 0.05). Furthermore, logistic regression analysis in the total study group revealed that the immunoreactivity frequency of the p17 antigen was identified as a risk factor for MS (OR: 2.438, p<0.05). Conclusion: Our data on AD cases are insufficient. In PD cases, the significantly higher frequency of immunoreactivity to the Hp-p19 antigen in individuals aged ≥50 years (OR=5.570) is noteworthy. In the MS group, the significantly high detection of Hp p17 antigen and its presence as a risk factor (OR=2.646), and the significantly high detection of p26 antigen suggest the relationship between these antigens and the MS development process. However, it is a fact that new and many prospective cohort-based case-control studies are needed to reveal this more clearly.This study was supported by the İstanbul University- Cerrahpaşa Scientific Research Projects Unit. Project No: TYL-2021-36048
Bu çalışma İstanbul Üniversitesi-Cerrahpaşa Bilimsel Araştırma Projeleri Birimi tarafından desteklenmiştir. Proje No: TYL-2021-3604
Management of plastic wastes: History, current applications, and future perspectives of recycling, upcycling, and reclaiming technologies
No full textPlastic materials possess a variety of structural and physical features and some key characteristics that make them widely used in many applications due to their superior properties such as low density, chemical and mechanical durability, low cost, recyclability, easiness and versatility in processing, thermal and electrical insulating property, colorability. Plastics are used in various applications in many industrial areas and daily-life, including packaging (the largest segment), construction, automotive, electronics, and consumer goods. Since the 1950s, production and consumption of plastics has readily increased, with global production reaching over 370 million metric tons in recent years. This trend is expected to continue, with projections estimating it could reach over 1 billion metric tons by 2030. The highest plastic consumption is found in developed regions like North America, Europe, and parts of Asia. However, emerging economies are rapidly increasing their consumption related to growing industrialization and urbanization in these countries. Overall, while plastics play a crucial role in modern society, their increasing consumption raises important questions about sustainability and environmental health. The rapid increase in plastic production and consumption has led to significant environmental challenges such as pollution, wildlife harm, and waste management issues. An estimated 11 million metric tons of plastic enter the oceans each year. There is a growing push toward a circular economy model, emphasizing the importance of reducing, reusing, and recycling plastics to minimize environmental impact. Managing plastic wastes effectively involves a combination of various strategies aimed at reducing, reusing, recycling, and disposing of plastics in an environmentally responsible manner. Modern societies can significantly reduce plastic waste and its environmental impact, promoting a more sustainable future by integrating these strategies. This chapter comprehensively summarizes and discusses the current applications of recycling, upcycling and reclaiming technologies of plastic wastes. Future perspectives and projections will also be highlighted to manage plastic wastes effectively and establish sustainable development in the world
Effect of agricultural waste-derived biomethanol use on the performance and emission characteristics of a diesel engine
No full textThis study investigates the effects of wheat straw-derived biomethanol–diesel blends on the performance and emission characteristics of a diesel engine. Four fuel blends were tested: pure diesel (D100) and biomethanol blends at volumetric ratios of 5%, 10%, and 15% (B5, B10, B15). Experiments were conducted on a single-cylinder diesel engine under four load conditions (25%, 50%, 75%, and 100%). The results show that although the lower heating value of biomethanol increased specific fuel consumption (from 308 g/kWh to 346 g/kWh at full load), its high oxygen content and latent heat of vaporization significantly improved key emission parameters. Under full load, the B15 blend reduced exhaust gas temperature by 29 °C, soot emissions by 25%, and CO emissions by approximately 21% compared to D100. Conversely, nitrogen oxide (NOx) emissions increased from 2165 ppm to 2420 ppm, attributed to the ignition delay characteristics of biomethanol. Overall, blending biomethanol with diesel is an effective strategy for reducing soot and CO emissions; however, further optimization is required to address the trade-off between NOx emissions and fuel consumption
Comparative analysis of artificial intelligence chatbots in orthodontic emergency scenarios: ChatGPT-3.5, ChatGPT-4.0, Copilot, and Gemini
No full textObjectives To evaluate and compare the accuracy of four AI chatbots, ChatGPT-3.5, ChatGPT-4.0, Copilot, and Gemini, in response to orthodontic emergency scenarios. Materials and Methods Forty frequently asked questions related to orthodontic emergencies were posed to the chatbots. These questions were categorized as fixed orthodontic treatment, clear aligner treatment, eating and oral hygiene, pain and discomfort, general concerns, retention, and sports and travel. The responses were evaluated by three orthodontic experts using a five-point Likert scale, and statistical analysis was conducted to assess variations in accuracy across chatbots. Results Statistical analysis revealed significant differences among the chatbots. Gemini and ChatGPT-4.0 demonstrated the highest accuracy in response to orthodontic emergencies, followed by Copilot, whereas ChatGPT-3.5 had the lowest accuracy scores. Additionally, the “Fixed Orthodontic Treatment” category showed a statistically significant difference (P = .043), with Gemini outperforming the other chatbots in this category. However, no statistically significant differences were found in other categories. Conclusions AI chatbots show potential in providing immediate assistance for orthodontic emergencies, but their accuracy varies across different models and question categories
Impulsivity in parkinson’s disease
No full textIntroduction/Aims: Parkinson’s disease (PD) is a neurodegenerative disease characterized by cardinal motor and nonmotor symptoms. Impulse control disorders are common neuropsychiatric manifestations in patients with PD (pwPD) under dopaminergic therapy. However, impulsivity is an underestimated symptom. Hence, the present study aimed to evaluate the impulsivity in pwPD. Methods: Forty‑seven adults who were diagnosed with having PD according to the Queen Square Brain Bank criteria for PD diagnosis and 30 age‑matched healthy controls were enrolled in the study. The sociodemographic data of the study participants and disease characteristics of the patients were recorded. All participants completed the Barratt impulsiveness scale (BIS). BIS scores were statistically analyzed between the groups. Results: The results revealed no significant differences between the patients and controls in terms of age (P > 0.05) or sex (P > 0.05). The total BIS scores were higher in the PD group than in the healthy controls (t = 2.1, P = 0.038). The items of BIS and attentional impulsivity scores were higher in the pwPD than in the controls (t = 2.8, P = 0.005), but there were no statistically significant differences between the groups in terms of motor and nonplanning impulsivity (z = 1.8, P = 0.07; and t = 1.1, P = 0.31, respectively). Discussion: Our results indicate that attentional impulsivity is an important clinical characteristic of pwPD, even in the absence of impulse control disorders. Conclusion: Further studies are required to confirm these findings in view of personalized PD treatment
APASL clinical practice guidelines on the management of chronic hepatitis b infection: A 2026 update
No full textGlobally, especially in the Asia-Pacific region, chronic hepatitis B infection has led to an undesirable escalating morbidity and mortality with acute-on chronic liver failure, end-staged liver cirrhosis and hepatocellular carcinoma. This has happened despite the past four-decades of major scientific advances made in screening methods, vaccination strategies, highly effective low-cost anti-viral therapies and surveillance strategies for early detection of hepatocellular carcinoma. To address this health threat, APASL has formed a Viral Elimination Taskforce to unite key opinion leaders from its member countries and regions. The ongoing shifts in hepatitis B epidemiology, socioeconomic changes, and advancements in technology are taken into consideration. With the conjoint efforts of all the members of the APASL Viral Elimination Taskforce, this clinical practice guidelines have been formulated aiming to facilitate healthcare professionals, policy makers and patients in making practical and cost-effective management decisions for chronic hepatitis B infection. Altogether, it provides recommendations in thirteen major areas related to screening, vaccination, treatment and HCC surveillance. The implementation of this clinical practice guidelines represents major APASL effort toward elimination of the disease burden due to chronic hepatitis B infection in Asia-Pacific region
Sharps injuries among nursing staff: A qualitative study
No full textBackground: Injuries involving members of the nursing team are not uncommon, with sharps-related incidents being among the most frequent. Previous studies have focused on quantitative outcomes or on healthcare professionals in general, leaving a gap in understanding the subjective experiences and perspectives of nursing staff. This study aimed to explore the opinions and experiences of nursing staff regarding sharps injuries, with the goal of identifying contributing factors, gaps in current prevention strategies, and opportunities to improve occupational safety and injury-prevention practices within healthcare settings. Methods: This qualitative study used a descriptive phenomenological approach and included 38 nursing staff from various regions of Brazil. Participants responded to open-ended online questions between July 26 and September 11, 2025. Findings: Themes emerged: (1) the moment when the injuries occur, (2) factors that trigger the injuries, (3) the period following the injuries, and (4) strategies adopted to prevent new injuries. Twelve subthemes were identified.Conclusions/Applications to Practice:The study addresses a highly relevant issue in healthcare, as nursing staff need to prioritize their own health while caring for others. Although it does not present findings different from previous research regarding the occurrence of such injuries, its importance may lie precisely in highlighting results that remain unchanged. The study also shows that nurses often internalize blame for occupational injuries, viewing them as personal failures rather than system issues. It highlights the need for rigorous monitoring, ongoing training, consistent safety materials, and encouragement of incident reporting to strengthen collective safety and promote a positive safety culture
Hemimyelomeningocele: A systematic review and meta‑analysis of the literature
No full textHemimyelomeningocele (HMM) is a rare split cord malformation where only one hemicord forms a myelomeningocele-like sac, and the opposite hemicord undergoes normal neurulation. We aimed to compile all published HMM cases to concisely summarize embryology, presentation, imaging, associated anomalies, management, and outcomes of the disorder. Following PRISMA 2020, we searched PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (1968–Feb 2025) for studies with confirmed human HMM, extracting clinical, radiological, surgical, and follow-up data. Of 688 records screened, 25 articles met inclusion criteria, encompassing 67 patients. Most publications were single-patient case reports. Presentation occurred predominantly in newborns or early infancy. The dysraphic sac was lumbosacral in most cases, and type I split cord malformation with a bony spur outnumbered type II. Hemivertebrae and congenital scoliosis were the common vertebrae anomalies. Nearly all patients underwent surgery combining sac excision, detethering, and bony spur removal. Postopera tive neurological outcomes were favorable: the majority improved, and the other ones remained stable; no surgery-related mortality was reported. HMM can be recognized as a distinct clinic radiological entity within the split-cord spectrum. Early, ideally prenatal diagnosis, timely microsurgical repair, and coordinated multidisciplinary care yield favorable functional outcomes in most patients. This first systematic review compiles the available evidence and provides a practical basis for future diagnostic and treatment decisions
Anatomic safety profile of a novel mini external fixator for proximal crescentic osteotomy in hallux valgus correction: A cadaveric study
No full textPurpose The proximal crescentic osteotomy is an effective procedure for hallux valgus correction, but stable fixation remains challenging. Our previous biomechanical study suggested that the MEF may offer comparable or greater stability than a specific cannulated screw fixation construct in a cadaveric model. This study aims to evaluate the anatomical safety of the MEF by investigating its relationship with critical neurovascular structures and tendons. Methods An anatomical dissection study was performed on ten foot cadaveric specimens. The MEF was applied using five mini-Schanz pins inserted in predefined positions. Following fixation, a layer-by-layer dissection was conducted to expose the dorsalis pedis artery, superficial cutanous branches of the foot, the superficial venous arch, and the extensor hallucis lon gus and brevis tendons. The distance from each pin to these structures and any iatrogenic injuries were recorded. Results The superficial venous arch was injured at low rates by the medial distal pin (20%), the medial proximal pin (10%), and the lateral distal pin (20%). Tendon injury was more frequent, with the extensor hallucis longus tendon being injured by 20–30% of pins, and the extensor hallucis brevis tendon by the lateral intermediate and distal pins (20% each). Conclusion The application of the MEF for first metatarsal fixation appears anatomically safe with respect to major arteries and nerves. The consistent avoidance of the dorsalis pedis artery and key sensory nerves is a significant advantage over some established techniques. However, surgeons should be aware of the potential risk to the superficial venous arch and extensor tendons during pin placement. These findings support further investigation of the MEF for proximal crescentic osteotomy f ixation
Türkiye’de çocuk ölümleri
No full textTüm halk sağlığı çalışanları kendilerine şu soruyu sormalıdır: Ben bu işi neden yapıyorum? Halk Sağlığının amacı sağlıklılığı korumak ve geliştirmek, sağlığa kavuşturmak, ızdırabı ve endişeyi dindirmektir. Biz başarılı olduğumuz yargısına sıklıkla bebek ölüm hızındaki azalma ve beklenen yaşam süresindeki uzama ile varırız! Ülkemizde bebek ölüm hızı bin canlı doğumda 60,82’den 9,09’a düşürülmüştür. Son yıllarda adeta plato çizmektedir. Bildirilen en düşük değer, 2022’deki binde 8,01’dir. En düşük haliyle bile 1990’da Fransa, Birleşik Krallık, Japonya ve Almanya’dan, 2000’nde bu ülkelere ek olarak Yunanistan’dan daha yüksektir. 2023’te ise bu ülkelerin 1,82 – 5,14 katı arasında fazladır. Bir başka ifade ile ülkemizde başarılan önleme düzeylerine göre binde 4,09 – 7,32 arasında fazladan bebek ölümü olmaktadır. Bebek ölümlerinin bir bölümü önlenememektedir. Ne var ki, önlenebilirlik düzeyini, kimi erişilebilen düzeylerine göre değerlendirmek ve sağlık sistemiyle sınırlı olmayan ödevler yüklenmek zamanıdır. Çocuklara 1990’larda verilen yaşatma sözünü hatırlama ve tutma zamanıdır