PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/8
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Article Effects of Combined Triflow, Deep Breathing and Coughing Exercises on Postoperative Pulmonary Function After Mitral Valve Replacement: A Randomized Controlled Trial(BMC, 2026) Akinci, Naile; Eren, EsraBackground Postoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement. Methods This randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone. Results Postoperative SpO(2) levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group. Conclusion The combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period.Article Machine Learning Model for Predicting Multidrug Resistance in Clinical Klebsiella pneumoniae Isolates(MDPI, 2026) Akkaya, Yuksel; Aydin, Irfan; Tanyildizi-Kokkulunk, Handan; Erturk, Ayse; Kilic, Ibrahim HalilBackground/Objectives: Klebsiella pneumoniae is an opportunistic pathogen increasingly resistant to carbapenems and broad-spectrum antibiotics, complicating timely infection management. In critical cases like septic shock, where initiating effective antibiotics within 3 h improves survival, culture-based resistance testing is often too slow. This study evaluates machine learning (ML) algorithms for faster antimicrobial resistance prediction than conventional methods. Methods: In this retrospective study, antibiogram results of 607 Klebsiella pneumoniae isolates collected between 2017 and 2024 were combined with demographic and clinical information of the patients from whom the isolates were obtained. Four different ML algorithms, namely Decision Tree (DT), Support Vector Classifier (SVC), K-Nearest Neighbors (KNN) and Random Forest (RF), were applied to classify the resistance status for 22 antibiotics. Model performances were evaluated using accuracy, precision, recall, F-score, AUC and feature importance metrics. Results: The RF model showed the highest overall performance in accurately predicting resistance to 22 antibiotics, achieving an average AUC value of 0.96. In particular, it predicted resistance to treatment-critical antibiotics such as Ertapenem (100%), Imipenem (93%) and Meropenem (95%) with high accuracy. Conclusions: ML models, especially RF, offer a powerful tool for rapid antibiotic resistance prediction, supporting accurate empirical treatment decisions and antimicrobial stewardship.Correction Diagnostic Utility of Smartphone-Integrated Gait Analysis in the Assessment of BPPV (Vol 16 , 1728659 , 2025)(Frontiers Media S.A., 2026) Durmus, Kasim; Bora, Adem; Sapci, Baris; Al-Hazzar, Marwan Khaled; Akti, Kerem; Sapci, Melek Kekul; Altuntas, Emine ElifArticle Advances and Strategies in Biosensor-Based Diagnostics for Parasitic Infections: A Comprehensive Scoping Review(Springer, 2026) Aminizadeh, Selva; Alizadeh, Gita; Alizadeh, Zahra; Khalilzadeh, Balal; Abidin, Zurina Zainal; Marzi, Mahdi; Rafiei-Sefiddashti, RahelehParasitic diseases are among the most widespread infections worldwide, causing millions of deaths and illnesses each year. So rapid and accurate diagnosis is essential, requiring highly sensitive and specific tests. Biosensors can provide significant advantages over traditional diagnostic methods because of their specificity, sensitivity, speed, simplicity, ease of use, repeatability, and capacity for early-stage disease detection. Recent advances in modern diagnostic tools for detecting parasitic infections use nanomaterials such as gold nanoparticles, carbon nanofibers, and carbon nanotubes. These developments have significantly lowered detection limits to the picogram and femtogram levels. This review will cover recent advancements in biosensor-based diagnostic techniques in parasitology.Article Montelukast Attenuates Abdominal Aortic Aneurysm in Rats: Anti-Inflammatory and Antioxidant Effects(Elsevier, 2026) Tekin, Gozde; Cevik, Ozge; Cetinel, Sule; Sener, Goksel; Kizilay, MehmetObjective: Oxidative stress and inflammation are widely recognized as central mechanisms in the pathogenesis of abdominal aortic aneurysm. This study sought to examine the potential protective properties of montelukast in a rat model of aortic aneurysm. Methods: Male Sprague-Dawley rats were randomly allocated into three experimental groups. Abdominal aortic aneurysm was induced using the calcium chloride (CaCl2) model, in which gauze soaked in 0.5 M CaCl2 was placed directly onto the adventitial surface of the infrarenal abdominal aorta for 15 minutes. After induction, the treatment group received daily intraperitoneal injections of montelukast (10 mg/kg) for 4 consecutive weeks. At the study end point, animals were euthanized, and infrarenal aortic tissues were harvested for biochemical and histological evaluations. Measured parameters included matrix metalloproteinase (MMP)-2 and MMP-9 expression, myeloperoxidase (MPO) activity, and 8-hydroxy-2 '-deoxyguanosine levels. Antioxidant capacity was assessed through superoxide dismutase (SOD) activity assays. Histopathological examinations were performed, and statistical analysis was conducted using GraphPad Prism v.5. Results: Exposure to CaCl2 triggered pronounced oxidative injury and inflammation, as evidenced by elevated 8-hydroxy-2 '-deoxyguanosine levels, increased MPO activity, reduced SOD activity, and upregulated MMP-2 and MMP-9 expression. Montelukast administration markedly attenuated these changes, normalizing oxidative and inflammatory markers while improving histopathological architecture. Conclusions: Montelukast effectively counteracted CaCl2-induced aortic damage. The protective effects of montelukast appear to be mediated through suppression of MMP activity, restoration of SOD levels, and reduction of MPO-driven oxidative injury. By mitigating both inflammatory and oxidative mechanisms, montelukast contributes to the preservation of aortic wall structure. Clinical Relevance: Abdominal aortic aneurysm remains a major vascular disorder without an effective pharmacological therapy to slow its progression. In this experimental study, montelukast, a leukotriene receptor antagonist widely used in asthma, attenuated abdominal aortic aneurysm formation in rats and was associated with increased superoxide dismutase activity, reduced myeloperoxidase levels, and suppressed matrix metalloproteinase activation. These combined antioxidant, anti-inflammatory, and matrix-stabilizing effects preserved aortic wall integrity. Given montelukast's established safety and clinical availability, these findings support its potential for future clinical investigation as a pharmacological approach to limit aneurysm progression. (JVS-Vascular Science 2026;7:100405.)Article Effectiveness of Individual Psychoeducational Interventions for Caregivers of Stroke Patients: A Systematic Review and Meta-Analysis(Springer/Plenum Publishers, 2025) Kelani, Hesham; Ali, Hossam Tharwat; Naeem, Ahmed; Salamah, Hazem Mohamed; Ismail, Ali; Younes, Youmna Atef; Khandelwal, PriyankStroke is a major cause of disability, and patients who suffer strokes have limited mobility and functional tasks, necessitating daily reliance on caregivers. However, caregivers of stroke patients often experience depression and anxiety, negatively impacting their mental health and reducing their quality of life. Psychoeducational interventions may be a solution to support the well-being of stroke caregivers. This study is performed to assess the overall effectiveness of individual psychoeducational interventions for caregivers of stroke patients. A thorough search of Scopus, PubMed, Web of Science, and Cochrane databases was performed for published studies in English up to June 2023. Clinical trials assessing the efficacy of psychoeducational interventions on quality of life, depression, or care burden among stroke caregivers compared to usual care were included. A total of 18 clinical trials, 16 randomized clinical trials (RCTs), and two non-RCTs, with a total of 2007 patients, were included. The study's pooled results revealed a significant increase in the quality of life in the group receiving psychoeducational interventions compared to the comparison group (SMD = 0.34, 95% CI 0.13-0.55, p value = 0.002), while no significant difference was found in terms of depression (SMD = - 0.05, 95% CI - 0.23 to 0.14, p value = 0.62) or caregiver burden (SMD = - 0.61, 95% CI - 1.65 to 0.44, p value = 0.25). Psychoeducation programs should be considered as a supportive intervention to improve quality of life in caregivers; however, their impact on depression and caregiver burden remains inconclusive. However, further studies with a larger sample size are needed to confirm the results.Article Citation - Scopus: 1Detection of Candida (Candidozyma) Auris by Molecular Methods and Investigation of Clinical Symptoms of Patients in a Tertiary Hospital in Istanbul(K Faisal Spec Hosp Res Centre, 2025) Akkaya, Yuksel; Erdin, Begum Nalca; Aydin, Irfan; Ozel, Ayse Serra; Yilmaz, Ahmet Munir; Cilkiz, Mustafa; Toraman, Zulal AsciBACKGROUND: Candidozyma auris is resistant to many antifungals, spreads rapidly and causes deaths in patient groups with comorbid factors. OBJECTIVES: The aim of this study was to determine the virulence of C. auris, antifungal resistance genes and clinical characteristics of the patients. DESIGN: Retrospective cohort SETTING: Single-center MATERIAL AND METHODS: This study was conducted between August 2022 and December 2023 at & Uuml;mraniye Training and Research Hospital. ITS1-5.8S-ITS2 and ITS1-ITS4 gene regions of the rDNA gene of C. auris isolates identified by VITEK MS v.3.2 were amplified by polymerase chain reaction (PCR) method. These regions were partially sequenced using the Sanger method. The presence of C. aurisspecific CDR1, ERG11, MDR1, ACT1, SAP5, HYR3, ALS5, IFF4, FUR1, PLB3, PGA26 and PGA52 gene regions were determined by PCR. Antifungal susceptibility testing of C. auris was performed with VITEK 2 Compact AST YS08 and SYO. MAIN OUTCOME MEASURES: Variations in C. auris isolates, antifungal resistance and clinical characteristics of patients SAMPLE SIZE: Forty-four isolates from 31 patients RESULTS: According to gene regions, nine different variations were identified in our hospital, with VAR-1 being the most common. Twenty-five (80.6%) of the patients died and isolation of the causative agent was between days 1-30 in 13 (41.9%) patients. Antibiotic use, ICU admission rate, and central venous catheter use in patients were 29 (93.6%), 28 (90.3%), and 21 (67.7%), respectively. Hypertension, diabetes mellitus (DM) and septic shock were found in 14 (45.2%), 13 (41.9%) and 10 (32.3%) patients, respectively. Antifungal resistance rates of the isolates were determined as 97.7% and 84.1% for amphotericin B and fluconazole, respectively. No resistance to micafungin and caspofungin was detected. The survival rate with echinocandin use was 22% (4 patients). CONCLUSION: Identification of gene regions is valuable in determining the pathogenicity of C. auris. . Due to the presence of comorbidi- ties in patients with C. auris, , it is not possible to determine the exact proportion of deaths attributable to C. auris alone. LIMITATIONS: Single center setting; gene regions could not be ex- pressed.Article Consensus Paper on Candida Auris by Türkiye EKMUD, ID-IRI, THSK of Ministry of Health of the Republic of Türkiye, KLIMUD, TMC, TARD, and TYBD(Tubitak Scientific & Technological Research Council Turkey, 2025) Agalar, Canan; Erdem, Hakan; Cag, Yasemin; Arda, Bilgin; Balik, Recep; Bastug, Aliye; Arikan Akdagli, Sevtap; Sarı, Nagehan Didem; Uzun, Omrum; Arikan-akdagli, Sevtap; Utku, Tughan; Kalkanci, AyseCandida auris is an emerging fungal pathogen that has become a critical global health concern due to its high antifungal resistance and potential to cause nosocomial outbreaks. Since its initial identification in Japan in 2009, C. auris has spread rapidly, posing significant treatment challenges across various healthcare settings worldwide. The biofilm formation ability of C. auris enhances its resilience against disinfectants and antifungal agents, complicating infection control in healthcare environments. This consensus report was developed by a collaboration between several Turkish medical societies including the Turkish Society of Infectious Diseases and Clinical Microbiology Specialty (EKMUD), the Turkish Society of Anesthesiology and Reanimation (TARD), the Turkish Intensive Care Society (TYBD), the Infectious Diseases-International Research Initiative (ID-IRI), the Clinical Microbiology Specialist Society (KLIMUD), the Turkish Microbiology Society (TMC), and the Public Health Institution of T & uuml;rkiye (PHIT) under the Ministry of Health. The report provides a comprehensive overview of C. auris and its management, with a focus on the epidemiology, antifungal resistance mechanisms, recommendations for diagnostic and therapeutic challenges, infection control and prevention measures, and surveillance of C. auris. This consensus report aims to establish standardized diagnostic protocols, improve national surveillance systems, and promote effective infection control measures to mitigate C. auris-related health risks in T & uuml;rkiye. It also offers comprehensive national recommendations and addresses the need for interinstitutional collaboration, improve public health, and strengthen the healthcare response to this pathogen.Article Effect of Progressive Muscle Relaxation on Postoperative Pain in Laparoscopic Living Kidney Donors: A Randomized Controlled Trial(BMC, 2025) Akinci, NaileAim This study aimed to evaluate the effect of progressive muscle relaxation on postoperative pain in laparoscopic living kidney donors. Design This was a randomized controlled, single-blind trial. This study was conducted in accordance with the CONSORT statement. Methods This study was conducted between January and September 2023 and included 62 patients (study group = 31, control group = 31) who met the inclusion criteria and underwent laparoscopic living donor nephrectomy in the transplant service of a private hospital in Istanbul province. A power analysis was performed to calculate the sample size and the power of the study (G*Power 3.1). Study data were collected using a patient information form, a postoperative patient follow-up and evaluation form to record the total number of bolus requests and administrations via of boluses with the PCA device and additional analgesic needs, and the Visual Analog Scale (VAS). The data obtained in the study were analyzed on the SPSS 22.0 statistical software. Results Additional analgesic requirements did not differ significantly between groups where progressive muscle relaxation exercises were applied and the VAS score and bolus requirement were significantly lower than in the control group (p < 0.05). Anxiety levels were also significantly reduced in the experimental group compared to both their pre-test scores and the control group (p < 0.05). Although the time to resume oral intake did not differ significantly between the groups (X-2 = 5.020; p = 0.170 > 0.05), the time to start mobilization was significantly earlier in the experimental group (X-2 = 8.808; p = 0.012 < 0.05). As a result of the study, it was found that progressive muscle relaxation exercises reduced postoperative pain, bolus requirements, and anxiety in patients undergoing living donor nephrectomy. Additionally, these exercises facilitated earlier mobilization following surgery.Article Citation - WoS: 2Citation - Scopus: 3Biological Activities of Etodolac-Based Hydrazone, Thiazolidinone and Triazole Derivatives on Breast Cancer Cell Lines MCF-7 and MDA-MB(Wiley, 2025) Sevinc, Sevgi Kocyigit; Cikla-Suzgun, Pelin; Tiber, Pinar Mega; Kucukguzel, S. Guniz; Orun, Oya; Güniz Küçükgüzel, Ş.In this study, several etodolac-based hydrazone, thiazolidinone, and triazole derivatives that we synthesized and characterized in our earlier research were tested against the hormone-responsive breast cell line MCF-7 and the triple-negative MDA-MB-231, as well as the murine origin fibroblast cell line L-929, at varying doses for their effects on cell viability and toxicity and for their inhibitory activity on cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) formation. Cell viability and apoptosis tests were utilized to assess the anti-cancer potential of etodolac and its derivatives after the cells were exposed to varied concentrations of synthesized compounds for three different time periods. ELISA and Western blot methods were used to detect protein levels. All synthesized compounds demonstrated higher anti-cancer activity at significantly lower doses compared to etodolac (half-maximal inhibitory concentration [IC50] of 0-50 mu M range in derivatives versus 0.5-1 mM range in etodolac). Except for SGK 242, which had a major toxic effect on all cells, the chemicals SGK 206 and SGK 217 had a twice-less impact on control murine L-929 fibroblasts. Similar to proliferation, low concentrations of SGK 206 and SGK 217 (25-50 mu M) significantly induced apoptosis in breast cancer cells but not in normal cells. Additionally, they inhibited COX-2 protein expression at 50 mu M, and SGK 206 inhibited PGE2 release more effectively than etodolac in cancer cells. The results of this study suggest that, in comparison to a healthy control group, the thiazolidinone derivative SGK 206 and the thiazolidinone derivative SGK 217 are more effective than etodolac when it comes to the breast cancer cell lines MCF-7 and MDA-MB-231. SGK 206 exhibits a low IC50 value, a distinct dose-response relationship, and strong apoptotic effects, particularly on MDA-MB-231 cells.