İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
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Dual etiology vs. MetALD: how MAFLD and MASLD address liver diseases coexistence
No full textFatty liver disease associated with metabolic dysfunction has emerged as a significant global health challenge. This condition often coexists with other liver diseases, such as alcohol-related liver disease and viral hepatitis, complicating both diagnosis and management. To address the limitations of the non-alcoholic fatty liver disease (NAFLD) classification, two alternative frameworks have been proposed: metabolic dysfunction-associated fatty liver disease (MAFLD) in 2020 and metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023. A key difference between these definitions is how they consider fatty liver disease in relation to the coexistence of other liver conditions. MAFLD adopts a dual etiology concept, creating a unified classification system that aligns with contemporary clinical and epidemiological needs. In contrast, MASLD introduces a new term, MetALD (metabolic and alcohol-related/associated liver disease), to describe patients who have both metabolic dysfunction and excessive alcohol intake. This review critically examines the clinical, research, and epidemiological implications of the differing approaches of MAFLD and MASLD, offering insights into their potential to enhance the understanding and management of multi-etiology liver diseases
Enhancing the aerodynamic performance of a biomimetic wing with topography optimization
No full textThis paper presents the optimization of the external shape of a model wing obtained from samara (maple seed) by means of biomimicry in order to improve its aerodynamic performance. Samaras, winged seeds of maples, have drawn attention in biomimetic design because of their high lift and low drag properties and autorotation capability. This makes them ideal for winged structures, which can operate in a wide range of wind conditions. This study aims to demonstrate that a samara wing can be modified using mathematical modelling, and different surface geometries can be created by making desired changes in the design parameters. Optimization of the topography of a samara wing model is presented using the results of computational fluid dynamics (CFD). The model wing was divided into three regions, and topography optimization was performed in five steps. Intermediate forms and final forms of the model are presented together with the CFD results. The final form of the model provided an aerodynamic performance increase of up to 28% depending on the angle of attack. In addition, as a result of these improvements, the biomimetic wing has simpler design parameters and a more applicable structure. These results suggest that aerodynamic performance can be enhanced by topography study on a biomimetic wing
The use and efficacy of an innovative virtual reality application in teaching the mechanism of labor: A randomized controlled trial
No full textBackground: In practice, the comprehensibility of physiological events necessitates adequate visu alization. VR can provide a comprehensive learning environment that enhances the understanding of mechanisms and anatomical structures’ three-dimensional relationships, which are difficult to observe from the outside. Nonetheless, evidence supporting its use in midwifery education is scant in the litera ture. This study aimed to evaluate the effectiveness of the ’Virtual Reality Technology Labor Mechanism Application (VRT-LMA)’ developed for teaching the cardinal movements of the baby during the first and second stages of birth in midwifery education. Methods: The study was conducted in a single-blind, randomized manner. Sixty-one midwifery students taking childbirth courses were divided into experimental (n = 30) and control (n = 31) groups. The experimental group received VRT-LMA, the control group received traditional training. After six weeks, both groups were given a posttest. Results: The post-test score of the experimental group was statistically significant compared to the control group (p < .05). Conclusion: VRT-LMA training helped increase students’ knowledge levels and aided in the retention of information. It will be suitable for supplementing traditional teaching methods
Improving oral health in children with disabilities: A preventive home-based care model from Türkiye
No full textBackground: Children with Special Health Care Needs (CSHCN) face significant challenges in maintaining oral hygiene and accessing dental services due to disabilities. It has been reported that, because of these disadvantages, individuals with special needs experience oral health problems at a higher rate compared to the general population. This study aimed to assess factors influencing oral health in CSHCN within the dental home framework and propose preventive strategies. Methods: A total of 1229 children aged 0-8 years with disability health reports in Istanbul were examined through home visits by mobile dental teams. Caries experience was evaluated using combined indices (dfs + DMFS and dft + DMFT). Data on oral hygiene habits, dietary patterns, parental education level and dental visit history were collected through structured questionnaires. Statistical analyses included Mann-Whitney U, Kruskal-Wallis, chi-square and Spearman's correlation tests (significance set at p 45 min to eat had significantly higher dfs + DMFS (1 surface) (p = 0.036) and dft + DMFT values (p = 0.019). Those consuming snacks > 3 times daily showed significantly higher caries indices across all measures (p < 0.01). Moderate/severe plaque accumulation was detected in 50.5% of participants. Lower parental education levels were significantly associated with higher caries indices (p < 0.01). Conclusions: This study highlights the necessity of an interdisciplinary approach to protect the oral health of CSHCN. The widespread implementation of the dental home model and regular dental check-ups will be a significant step in addressing oral health needs.This study was funded by the Istanbul Development Agency (TR10/16/ÇGE/0062) under the Children and Youth Financial Support Program.
Bu çalışma İstanbul Kalkınma Ajansı (TR10/16/ÇGE/0062) Çocuk ve Gençler Mali Destek Programı kapsamında finanse edilmiştir
Neural therapy in migraine: Clinical evidence for a holistic therapeutic approach - analysis of 464 cases
No full textBackground: Migraine is one of the most common neurological disorders and significantly impairs quality of life. While conventional therapies may alleviate symptoms, they often fail to address the underlying causes. Neural therapy is a therapeutic approach in which local anesthetics such as procaine or lidocaine are not primarily used for analgesia but rather to modulate the autonomic nervous system, particularly its sympathetic branch. This method aims to restore functional balance and stabilize dysregulated networks through segmental and systemic reflex pathways, thereby supporting a holistic regulatory effect. Objective: This retrospective study aims to evaluate the effectiveness of neural therapy in 464 migraine patients using a holistic, regulatory medical approach. Methods: Patient history forms were analyzed for hormonal dysregulation, intestinal dysbiosis, temporomandibular dysfunction, C2 vertebral blockage, hydration status, and interference fields. Additionally, clinical treatment progressions were statistically assessed. Results: Over 91% of patients demonstrated clinical improvement, and 60% became symptom-free. The most frequently observed contributing factors were intestinal dysbiosis (89%), hormonal imbalance (71%), and temporomandibular/C2 dysfunctions (43% each). Conclusion: Neural therapy is an effective and regulatory therapeutic option for migraines, particularly in chronic, multifactorial cases. Its integration into a holistic treatment strategy may yield substantial clinical benefits
Kojenerasyon sistemlerinde baca kurulumu ısı ve akış analizi
No full textBu çalışmada kojenerasyon sistemlerinde baca tasarımının enerji verimliliğine etkisi, çevresel sürdürülebilirlik, kullanılan malzemelerin performansı ve atık ısı geri kazanımı üzerinde detaylı bir çalışma sunulmuştur. Bu çalışmanın girdilerini oluşturmak için Türkiye’de önemli tesisleri barındıran İZAYDAŞ Biyogaz Entegre Elektrik Tesisinde atık yönetimi ve enerji geri kazanım süreçleri incelenmiş; bu süreçlerin daha sürdürülebilir ve verimli hale getirilmesine yönelik iyileştirme önerileri üzerinde odaklanılmıştır. Bu çalışmanın baca tasarımı aşamasında kesit hesaplarının yapılması ve optimizasyonu için Kesa Aladin programı kullanılmıştır. Statik hesaplarda ise Ansys programı yapısal analiz modülünden faydalanılmıştır. Böylelikle kojenerasyon sistemlerinde baca tasarımının iyileştirilmesiyle performans artışı sağlama potansiyelini ve verimlilik hedeflerine ulaşmadaki önemini vurgulayarak okuyuculara farkındalık kazandırılması amaçlanmıştır.This study presents a detailed analysis of the impact of chimney design on energy efficiency, environmental sustainability, material performance, and waste heat recovery in cogeneration systems. To gather inputs for this study, waste management and energy recovery processes were examined at İZAYDAŞ Biogas Integrated Power Plant, a key facility in Turkey. The research focused on identifying and proposing improvements to make these processes more sustainable and efficient. For the chimney design phase, the Kesa Aladin software was utilized for cross-sectional calculations and optimization. Additionally, the structural analysis module of Ansys was employed for static calculations. Through this approach, the study aims to highlight the potential for performance enhancement through improved chimney design in cogeneration systems and its critical role in achieving efficiency targets, thereby raising awareness among readers
Utilization and fertility preservation outcomes in women undergoing embryo cryopreservation before breast cancer treatment: A meta-analysis
No full textOur aim was to assess fertility preservation (the proportion of women who had at least 1 live birth) and utilization rates (the proportion of women who utilized their cryopreserved embryos) rates among women who cryopreserved their embryos before breast cancer treatments. PubMed and Cochrane library database were searched until December 2024. We included all studies that reported pregnancy outcomes, the number of women who returned for frozen embryo transfer, and the number of women who preserved their fertility. The primary outcome measures were the utilization and fertility preservation rates. Secondary outcome measures were implantation, clinical pregnancy, and live birth rates. Of the 12 studies, 9 met the criteria, encompassing >2126 women with breast cancer who cryopreserved their embryos for fertility preservation. In 9 studies that reported the total number of attempts, 424 women underwent 863 embryo transfers. Based on those studies, the clinical pregnancy and live birth rates were 50% (95% CI: 35-65, I 2: 80%) and 33% (95% CI: 22-46, I 2: 76%), respectively. The utilization and fertility preservation rates were 18% (95% CI: 9-32, I 2: 95%) and 39% (95% CI: 29-51, I 2: 48%), respectively, all from random-effects models. Fertility preservation success with embryos cryopreserved before breast cancer treatments seems to be promising. However, the utilization rate of cryopreserved embryos is low. Additional studies with larger sample size and longer follow up are required to evaluate the long-term utility rates
The worldwide medical impact of hepatitis D virus infection: Focus to Central Asia
No full textHepatitis D virus (HDV) requires hepatitis B virus (HBV) for its replication. Concurrent infection with HBV and HDV results in more severe disease outcomes than infection with HBV alone, inducing cirrhosis, fulminant hepatitis, and hepatocellular carcinoma, and representing a significant cause of global mortality. Central Asia remains an area of high HDV prevalence but local features of the infection were poorly detailed in the past. Until recently, interferon has represented the only treatment option in patients with chronic hepatitis D; however, it is associated with low efficacy and a high burden of side effects. The discovery of the entry inhibitor bulevirtide has represented a breakthrough in HDV treatment. Other compounds (i.e., lonafarnib, new anti-hepatitis B virus drugs) are under development to provide alternative or combined strategies for HDV cure
Obezite ve meme kanseri arasındaki biyolojik bağlantılar: Hücresel ve moleküler düzeyde etkileşimler
No full textObezite, başta meme kanseri olmak üzere pek çok kanser türünün görülme sıklığını ve ilerleyişini artıran önemli bir risk faktörüdür. Obezite ile meme kanseri arasındaki ilişki, karmaşık ve çok katmanlı biyolojik süreçlerle şekillenir; bu süreçlerin merkezinde metabolik ve immün sistem bozuklukları yer alır. Özellikle beyaz adipoz dokusunda (WAT) ortaya çıkan kronik düşük dereceli inflamasyon, proinflamatuvar sitokinlerde artış, alternatif makrofaj aktivasyonu ve T hücresi işlevlerinde azalma gibi bağışıklık sistemi düzensizliklerine yol açar. Meme dokusunun büyük ölçüde WAT’tan oluşması, gelişmekte olan tümör hücrelerinin obezite ile yeniden programlanmış mikroçevreyle doğrudan etkileşim hâlinde ol masına olanak tanır
Integrative neural therapeutic approach for migraine with aura – A case report
No full textThis case report presents the clinical course of a 37-year-old female patient diagnosed with migraine with aura, who experienced significant and sustained symptom relief following neural therapeutic interventions. The patient had a long-standing history of recurrent, unilateral, pulsating headaches, often preceded by visual aura symptoms such as scintillating scotoma, and accompanied by nausea, photophobia, and phonophobia. Previous pharmacological treatments provided only limited and temporary relief and were associated with side effects. A structured, integrative therapeutic protocol was initiated, comprising neural therapy with 1% procaine administered segmentally at cervical ganglia (C2/C3), the stellate ganglion, tonsillar region, trigeminal pathways, and relevant vegetative-reflex zones. The treatment focused on modulation of the autonomic nervous system and regulation of possible interference fields. After just two sessions, the patient reported a marked reduction in attack frequency and improvement in vegetative symptoms, with further improvement following a total of four sessions. Complementary interventions included a migraine diary to identify individual triggers, nutritional optimization, stress reduction, and patient education to improve early aura recognition and preventive action. Notably, the patient was able to discontinue acute medication use without recurrence of intense episodes, and her quality of life improved substantially. This case underscores the value of neural therapy as a safe, efficient, and individualized approach in managing migraine with aura. The observed therapeutic effects are attributed to autonomic regulation, stabilization of neuroimmunological networks, and treatment of interference fields such as chronic tonsillitis. Importantly, neural therapy allowed for medication sparing and enhanced patient compliance without systemic adverse effects. These findings support the integration of neural therapy into a holistic, patient-centered strategy for chronic migraine conditions. It provides an alternative for patients who seek non-pharmacological treatment options and demonstrates promising potential in reducing migraine burden long-term