PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection

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Vaccination in Patients With Cancer: Gaps in Coverage, Barriers, and the Role of Clinician Recommendations
(Taylor and Francis Ltd., 2026) Kayaalp, M.; Akkus, E.; Arslan, C.; Hacioglu, M.B.; Semiz, H.S.; Ürün, Y.
Cancer patients require a tailored vaccination strategy. This study aims to assess the vaccination status of cancer patients, evaluate disease incidence and severity in vaccinated individuals, identify reasons for noncompliance with guideline-recommended vaccines, and explore vaccine hesitancy. A cross-sectional survey, including 36 multiple-choice and 6 open-ended questions, was conducted in across Turkey. A total of 506 patients participated between September 1, 2024, and December 31, 2024. Among the participants, 59% (n = 302) were receiving active treatment. At the time of diagnosis, 90.5% did not have an ongoing vaccination program. Coronavirus Disease 2019 (COVID-19) (86.2%) and influenza (22.0%) were the most frequently received vaccines before treatment.The most common reason for not being vaccinated (except for COVID-19) was the absence of a medical recommendation. Higher education levels were associated with increased vaccination rates for hepatitis B, influenza, 13-valent pneumococcal conjugate vaccine (PCV13), and 23-valent pneumococcal polysaccharide vaccine (PPSV23) (p <.01). No significant relationship was found between disease stage and vaccination rates. The most frequently reported barrier to vaccination was the absence of a medical recommendation, highlighting the pivotal role of clinician engagement in improving vaccine uptake in this vulnerable population. Although international guidelines strongly recommend routine vaccination for patients with cancer, real-world data on vaccination practices, associated barriers, and health system–level implementation in middle-income countries are scarce. To address this evidence gap, this study provides real-world data on vaccination rates, determinants, and perceived barriers among cancer patients receiving care in a Turkish oncology setting. © 2026 The Author(s). Published with license by Taylor & Francis Group, LLC.
Peptide-Nanoparticle Platforms for Antisense Therapeutics: A Coarse-Grained Modeling Approach to Brain Delivery
(Elsevier Ltd, 2026) Uner, B.Y.; Demir, A.; Zhou, P.; Taşkiran, E.Z.; Wassenaar, T.
Traumatic brain injury (TBI) is a leading cause of long-term neurological deficits, often resulting in complex, unresolved molecular and cellular dysfunctions. Among these, gene–circuit disruptions—particularly those affecting neuroinflammation, oxidative stress, and mitochondrial dynamics—have emerged as critical mediators of post-traumatic neuropathology. In this study, we utilized artificial intelligence (AI)-driven proteomics and RNA sequence integration to map altered signaling pathways following TBI. Computational predictions identified specific gene–circuit nodes susceptible to therapeutic intervention, including redox-sensitive mitochondrial regulators and genes involved in the neuroimmune interface. Importantly, although our analyses are derived from rodent models, the conserved signaling pathways and regulatory circuits identified here provide a translational window with strong relevance to human TBI pathophysiology, thereby bridging preclinical findings with potential therapeutic application. Based on these insights, we designed a suite of responsive nanoparticle formulations optimized in silico for targeted delivery to dysregulated brain regions. These carriers incorporated ligands targeting disrupted circuits and incorporated redox-sensitive release mechanisms. Our platform demonstrates the feasibility of a closed-loop, data-guided strategy that integrates AI-based gene network profiling with rational nanocarrier design. This approach provides a scalable framework for precision neurotherapeutics, particularly for complex disorders such as TBI where conventional monotherapies have proven inadequate. © 2026 Elsevier Ltd.
Echoes of the Past: Are E-Cigarettes the New "Light" Cigarettes
(2026) Yıldız, E.; Kilinç, O.; Çuhadaroǧlu, Ç.
Retroperitoneal Vnotes Approach in Early-Stage Endometrial Cancer: a Feasibility Cohort with a Contemporaneous Laparoscopic Comparison
(BioMed Central Ltd, 2026) Haliscelik, M.A.; Oğlak, S.C.; Arkan, K.; Seker, E.; Baǧli, İ.; Erkmen, A.D.; Can, B.
Objective: This study aimed to assess the feasibility, safety, and perioperative outcomes of the retroperitoneal vaginal natural orifice transluminal endoscopic surgery (vNOTES) approach for surgical staging in patients with early-stage endometrial cancer. A secondary objective was to compare perioperative and short-term results with those achieved using conventional laparoscopy performed by the same surgical team. Materials and methods: Between June 2023 and June 2024, a retrospective study was conducted on 98 patients who underwent surgical staging for early-stage endometrial cancer. Patients were allocated to one of two groups: the vNOTES group (n = 49), who underwent retroperitoneal sentinel lymph node (SLN) biopsy, hysterectomy, and bilateral salpingo-oophorectomy (BSO); and the laparoscopic group (n = 49), who underwent the same procedures via a conventional laparoscopic approach. Demographic, surgical, and pathological parameters, as well as short-term follow-up outcomes, were compared between the two groups. Results: The median operative time was significantly shorter in the vNOTES group than in the laparoscopic group (102 vs. 115 min, p < 0.001). SLN detection rates were identical between the groups (97.9% each). Postoperative pain scores on the Visual Analog Scale (VAS) were significantly lower in the vNOTES group at both 6 h (median 3 vs. 5) and 24 h (median 1 vs. 3) (p < 0.001 for both). Patients in the vNOTES group achieved earlier mobilization (median 5 vs. 6 h, p < 0.001) and had a shorter hospital stay (median 2 vs. 3 days, p < 0.001). The incidence of major complications did not differ significantly between the groups, and no recurrences were observed during a median follow-up period of 12 months. Conclusion: The retroperitoneal vNOTES approach appears to be a feasible and safe technique for the surgical staging of early-stage endometrial cancer, providing perioperative benefits including shorter operative time, reduced postoperative pain, and faster recovery. The comparative findings with conventional laparoscopy should be interpreted as exploratory and require validation in larger prospective studies. Oncologic outcomes remain short-term and should be confirmed through long-term follow-up. © The Author(s) 2025.
Prevalence, Clinical Characteristics, and Antibiotic Resistance of Carbapenem-Resistant Klebsiella Pneumoniae in a Tertiary Hospital in Türkiye (2023–2025)
(BioMed Central Ltd, 2026) Mermer, S.; Çağlayan, E.
Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a growing public health threat due to limited treatment options, high morbidity and mortality rates. This study aimed to investigate the prevalence, clinical characteristics, and antibiotic resistance profiles of CRKP isolates identified in a tertiary hospital in Türkiye between 2023 and 2025. Methods: A retrospective observational study was conducted using microbiological and clinical data collected from patients diagnosed with CRKP infections between January 2023 and April 2025. A total of 1588 CRKP isolates were retrospectively analyzed and compared with patient clinical data. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix 100 M50 automated system (Becton Dickinson Company, USA), and results were interpreted in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Results: Among 2376 K. pneumoniae isolates, the overall CRKP prevalence was 66.8%. The annual carbapenem resistance rates were 64.9% in 2023, 69.4% in 2024, and 61.0% in 2025, respectively. Resistance rates among CRKP isolates were as follows: tigecycline 14.7%, colistin 23.0%, fosfomycin 47.6%, ceftazidime-avibactam 50.9%, and amikacin 66.8%. The prevalence of CRKP was significantly higher among inpatients (83.8%) compared to outpatients (26.8%). Of the CRKP-positive samples, 62.5% were collected from patients in intensive care units (ICUs), 12.2% from hematology, and 5.1% from oncology departments. Tracheal aspirates accounted for 43.5% of isolates, followed by urine samples at 25.8%. Conclusions: The study revealed a notably high prevalence of CRKP with substantial resistance to most commonly used antibiotics. Among the tested antibiotics, tigecycline showed the lowest resistance rate, consistent with its limited usage profile. These findings underscore the urgent need for strengthened infection control measures and may guide more effective empirical treatment strategies for CRKP infections in the region. © The Author(s) 2026.
Smartphone Screen Time and Eating Disorder Tendencies in Obese and Normal-Weight Adults: a Cross-Sectional Study From Turkey
(BMC, 2026) Kehribar, Demet Yalcin; Baraz, Lale Saka; Taktuk, Selma; Gunduz, Sudenur; Mistik, Fatma Nur; Demircioglu, Baran; Ozgen, Metin
Objective: This study aimed to investigate the relationships between smartphone screen time, eating disorder tendencies, and self-esteem in obese and normal-weight individuals, and to evaluate potential correlation patterns among these variables. Methods: A cross-sectional, comparative study was conducted with 130 participants (64 obese, 66 normal-weight) at Dokuz Eyl & uuml;l University Obesity and Healthy Life Outpatient Clinic. Anthropometric measurements were obtained, daily smartphone screen time was recorded from device settings, and participants completed the Eating Disorder Examination Questionnaire (EDE-Q-13) and Rosenberg Self-Esteem Scale (RSES). Data were analyzed using descriptive statistics, t-tests, chi-square tests, and correlation analyses. Results: Obese individuals demonstrated significantly higher daily smartphone screen time (6.4 +/- 1.8 vs. 5.5 +/- 1.5 h; p = 0.019) and greater eating disorder symptoms, including higher total EDE-Q-13 scores (24.3 +/- 6.9 vs. 18.7 +/- 5.8; p < 0.001), body dissatisfaction, and weight/shape concerns. No significant differences in self-esteem were observed between groups (p = 0.478). Correlation analyses revealed positive associations between body mass index (BMI) and body dissatisfaction (r = 0.537, p < 0.001) and between smartphone screen time and body dissatisfaction (r = 0.203, p = 0.021). Self-esteem was negatively correlated with body dissatisfaction (r = - 0.244, p = 0.006) and binge eating (r = - 0.229, p = 0.010), but not with smartphone screen time (p > 0.05). Conclusion: Obese individuals exhibited higher smartphone screen time and more pronounced eating disorder-related tendencies, particularly body dissatisfaction and weight concerns, compared to normal-weight individuals. However, self-esteem levels did not differ significantly between groups, suggesting that cultural and psychosocial factors may buffer self-esteem despite obesity. These findings highlight the importance of addressing digital media use and eating behaviors in obesity management and prevention strategies.
Real-World Survival Outcomes Following Metastasectomy in RAS Wild-Type MCRC: Insights From a Multicentre National Cohort Study
(MDPI, 2026) Okten, Ilker Nihat; Baydas, Tuba; Yildirim, Mahmut Emre; Bilir, Cemil; Yalcin, Suayib; Cubukcu, Erdem; Karadurmus, Nuri
Background: Metastasectomy is a cornerstone of multimodal management in metastatic colorectal cancer (mCRC), yet contemporary real-world data focusing specifically on RAS wild-type (RAS-WT) disease remain limited. We aimed to evaluate survival outcomes and prognostic factors associated with metastasectomy in patients with RAS-WT mCRC using a large national multicentre registry. Methods: This retrospective cohort study utilized data from the ONKO-KOLON T & uuml;rkiye registry. A total of 1079 patients with pathologically confirmed KRAS/NRAS wild-type mCRC were identified and categorized according to receipt of metastasectomy. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method and compared with log-rank tests across multiple clinically relevant time origins, including metastatic diagnosis, initial colorectal cancer diagnosis, and time of metastasectomy. Prognostic factors within the metastasectomy cohort were assessed using univariate Cox proportional hazards models. Serum CEA and CA19-9 were analyzed after log10 transformation. Results: Among 1079 patients, 185 (17.1%) underwent metastasectomy. Patients receiving metastasectomy demonstrated significantly longer OS compared with those managed non-surgically when survival was calculated from the time of metastatic diagnosis (hazard ratio [HR] for death 0.36, 95% CI 0.27-0.47; p < 0.001), as well as improved PFS (HR for progression or death 0.39, 95% CI 0.30-0.52; p < 0.001). The survival advantage remained consistent when OS was measured from the time of initial colorectal cancer diagnosis (HR 0.37, 95% CI 0.25-0.50; p < 0.001). Median OS following metastasectomy was 43 months (95% CI 31.4-45.6). In univariate analyses within the metastasectomy cohort, higher baseline CA19-9 levels were significantly associated with inferior OS when analyzed both as a continuous variable (per log10 increase; HR 1.81, 95% CI 1.20-2.75; p = 0.005) and as a categorical variable (above vs. below threshold; HR 0.37, 95% CI 0.16-0.86; p = 0.021). Other clinicopathologic factors, including age, CEA, tumor sidedness, grade, MSI status, and metastatic burden, were not significantly associated with survival. Conclusions: In this large, real-world national cohort of RAS-WT mCRC, metastasectomy was strongly associated with prolonged survival across multiple clinically relevant time frames. Within surgically treated patients, baseline CA19-9 emerged as the most informative prognostic marker, while traditional clinicopathologic variables showed limited discriminatory value. These findings highlight the importance of careful patient selection and support further prospective studies integrating molecular and biomarker-based strategies to refine prognostication and optimize surgical decision-making in RAS-WT mCRC.
Prognostic Value of the Ratio of Globally Sclerotic Glomeruli in Patients With Idiopathic IgA Nephropathy
(Nature Portfolio, 2026) Kazan, Sinan; Ozturk, Savas; Uzerk Kibar, Muge; Ozcan, Seyda Gul; Alcelik Karacan, Raife Dilhan; Eren, Necmi; Tunca, Onur
IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. We assessed whether the Ratio of Globally Sclerotic Glomeruli (RoGSG) on diagnostic biopsy predicts subsequent kidney outcomes in a nationwide, multi-center registry. Among 326 adults with idiopathic IgAN (mean age 39.1 +/- 12.8 years; 60.1% male), 43 patients (13.2%) met a 5 year composite outcome defined as any of: doubling of serum creatinine or >= 50% decline in eGFR from baseline, eGFR < 15 mL/min/1.73 m(2), or initiation of kidney replacement therapy. Receiver operating characteristic analysis identified a RoGSG cutoff of 28.86% for predicting the composite outcome (AUC 0.917, 95% CI 0.885-0.949; sensitivity 93.0%; specificity 84.5%). Using this threshold, 47.6% of patients with RoGSG >= 28.86% versus 1.2% with RoGSG < 28.86% reached the composite outcome. In multivariable models adjusted for clinical and pathologic covariates, high RoGSG, grade 2 tubular atrophy/interstitial fibrosis, and non-response to initial immunosuppression were independent predictors of adverse outcomes. The prognostic association of RoGSG persisted in key subgroups, including those with nephrotic syndrome and those with initial treatment response. These findings support RoGSG as a readily available histopathologic marker that may improve risk stratification in IgAN; however, prospective studies and external validation in independent cohorts are required before any clinical adoption.
Validation of a Multiplex Qrt-PCR Assay for the Detection of RSV, Influenza A/B Virus and SARS-CoV
(BMC, 2026) Bulgurcu, Alihan; Sayiner, Ayca Arzu
The significant burden of viral respiratory diseases necessitates rapid detection of key pathogens. Simultaneous testing for SARS-CoV-2, RSV, and influenza A/B as an initial step, followed by broader panels as needed, offers a cost-effective diagnostic strategy. This study aimed to validate a new commercial multiplex qRT-PCR assay (Diagnovital (R) RTA Laboratories, Turkey) for the simultaneous detection of these viruses. Analytical sensitivity was determined using Probit regression analysis on serial dilutions (10(5)-10(1) copies/ml) for each target virus. Specificity was evaluated with 120 negative samples and 32 positive samples for non-target respiratory viruses. External quality control panels and clinical specimens positive for RSV (n = 39), influenza A/B (n = 71), SARS-CoV-2 (n = 64) were used for accuracy testing. Intra- and inter-assay precision were analyzed using samples near the limit of detection. The performance was compared to routine diagnostic tests. The assay's analytical sensitivity was 420.7, 296.7, 368.6, 1362.6, and 1459.7 copies/ml for SARS-CoV-2 Alpha and Omicron variants, influenza A, influenza B, and RSV, respectively. Analytical specificity was 100%, and precision showed CV% < 5. Detection rates for SARS-CoV-2, influenza A, influenza B, and RSV were 100%, 95.1%, 97.5%, and 94.8%, respectively, with false negatives occurring in samples with Ct > 33. Comparative analysis showed high correlations between assays, with strong agreement (Cohen's kappa ranging from 0.861 to 1). These findings demonstrate the clinical applicability of the Diagnovital (R) assay, though false negatives may occur in low-concentration samples.
Turkish Medical Students' Perspectives on the Advantages and Disadvantages of Telemedicine: Scale Development and Psychometric Evaluation
(BMC, 2026) Aydin, Mevlut Okan; Alper, Zuleyha; Ozkaya, Guven; Caliskan, Suleyman Ayhan
Background The rise of digital technology and the COVID-19 pandemic have accelerated the adoption of telemedicine, yet its integration into medical education remains limited. Understanding the perceptions of future physicians is vital for the sustainable implementation of these services and for developing evidence-based telemedicine training programs. This study aims to assess the awareness and perception of telemedicine among medical students in T & uuml;rkiye and provide empirical evidence to inform curriculum development. Methods This nationwide survey included 810 medical students from six universities in T & uuml;rkiye. A valid and reliable 19-item questionnaire was developed to measure participants' perceptions of telemedicine. The questionnaire used a 5-choice Likert-type scale. The data were analyzed using exploratory and confirmatory factor analysis to determine the scale's validity and reliability. Results The final 11-item scale demonstrated strong validity and reliability, with a two-factor structure: "Advantages of Telemedicine" and "Disadvantages of Telemedicine." The results showed that students largely perceive telemedicine as beneficial, particularly for preventive health services. However, they also expressed concerns, with the highest-rated disadvantage being that telemedicine might create a distance between the doctor and patient. The students rated "increased health inequalities" as the lowest concern. These findings reveal specific competency gaps and training needs that should be addressed in medical curricula. Conclusion The findings suggest that medical students in T & uuml;rkiye hold a generally positive view of telemedicine, recognizing its potential advantages in healthcare. While they are aware of some ethical concerns, such as the potential for a distant doctor-patient relationship, they see telemedicine as a tool to reduce health inequalities. This validated scale provides a foundation for designing targeted telemedicine training programs, assessing educational outcomes, and identifying specific competencies that require emphasis in medical school curricula. We propose a competency-based framework and specific pedagogical approaches to prepare future physicians for effective telemedicine practice.
Stereotactic Radiosurgery-Induced Peritumoral Edema in Asymptomatic Convexity, Parasagittal, and Parafalcine Meningiomas
(Turkish Neurosurgical Soc, 2026) Can, Osman Burak; Ruksen, Mete; Isman, Burcu Durmak; Askeroglu, Mehmet Orbay; Zorlu, Seray; Yuksel, Alper; Akay, Ali
AIM: To evaluate the incidence and identify the risk factors of stereotactic radiosurgery (SRS)-induced peritumoral edema (PTE) in the asymptomatic convexity, parasagittal, and parafalcine meningiomas without pre-existing PTE. MATERIAL and METHODS: We retrospectively analyzed 52 patients with asymptomatic convexity, parasagittal, or parafalcine meningiomas without pre-existing PTE who underwent single-fraction Gamma Knife radiosurgery between 2019 and 2024. The median tumor volume and the maximum tumor diameter were 3.3 cc (range: 0.31-10.2 cc) and 2.0 cm (range: 0.98-3.1 cm), respectively. The median margin dose was 12 Gy (range: 11 Gy-13 Gy). The median radiological and clinical follow-up durations were 21 months (range: 6-65 months) and 26 months (range: 12-66 months), respectively. RESULTS: SRS-induced PTE occurred in 5.8% of patients (n=3), exclusively in elderly individuals (>= 65 years) with parasagittal or parafalcine meningiomas. No cases were observed in convexity meningiomas (0/24). Multivariable analysis revealed a trend toward statistical significance for the association between age and SRS-induced PTE (p=0.074). In the overall cohort, the incidence of SRS-induced PTE was significantly higher in elderly patients compared to younger patients (<65 years) (3/14 vs. 0/38, p=0.016), and this difference remained significant within the parasagittal/parafalcine subgroup (3/7 vs. 0/21, p=0.011).
CONCLUSION: SRS appears to be a safe treatment modality in terms of PTE risk in patients aged below 65 years with asymptomatic convexity, parasagittal, or parafalcine meningiomas without pre-existing PTE. In contrast, elderly patients with parasagittal or parafalcine meningiomas may be more susceptible to SRS-induced PTE, thereby warranting a more cautious approach to SRS in this subgroup. Additional studies involving larger cohorts are warranted to validate these findings.
Turkish Thoracic Society Declaration on Peace and Health the Importance of Breathing in a World Without Ware
(Galenos Publ House, 2026) Cetinkaya, Pelin Duru; Toreyin, Zehra Nur; Ozdemir, Hande Yuce; Yasin, Yesim; Kilinc, Oguz; Yorgancioglu, Arzu; Begic, Erencan
War legitimizes the right to kill for its participants, equating victory with moral justification, however, this perceived legitimacy is largely Constructed on the deaths of civilians and other living beings. Medicine, by its very nature, is grounded in the principles of preserving ife, doing no harm, and adhering to scientific and ethical standards, and is therefore fundamentally opposed to the philosophy of war. Wars lead, directly and indirectly, to desaths, disability, displacement, poverty, and long-term public health disasters. Attacks on health Facilities, restrictions on access to food and water, environmental destruction, and air pollution disproportionately affect vulnerable Dopulations, particularly women and children. The psychological consequences of war often evolve into persistent neuropsychiatric conditions, including post-traumatic stress disorder, depression, and moral injury. Peace is not merely the absence of war, it is a prerequisite for health, environmental sustainability, and social well-being. The concept of positive peace strengthens health indicators hrough well-functioning institutions, equitable resource distribution, and the protection of human rights. Within this framework, health professionals and civil society organizations are critical actors in advocating for peace and in making human rights violations visible The Turkish Thoracic Society regards peace as an indispensable condition for public and respiratory health, affirms its opposition to all wars particularly the ongoing atrocities in Gaza-and reaffirms its commitment to sustained, health-based advocacy for peace,
The Necessity of Bronchiectasis Registries - The Turkish Registry of Bronchiectasis
(Galenos Publ House, 2026) Kizilirmak, Deniz; Martinez-Garcia, Miguel Angel; Cicek, Sedat; Coskun, Aysin Sakar; Kilinc, Oguz; Edis, Ebru Cakir
Smartphone Addiction and Health Promotion Lifestyle in University Students: A Cross-Sectional Analytical Study
(Cambridge University Press, 2026) Serim, Yasin; Limnili, Gizem; Gokdemir, Ozden; Ozcakar, Nilgun
Objectives: Smartphones have become essential, making our daily lives more manageable; however, excessive use may cause problems. University students are particularly vulnerable to smartphone addiction. This study examines the relationship between smartphone addiction and health-promoting lifestyles among university students. Methods: A cross-sectional study was conducted with 911 students at Dokuz Eylul University, Izmir, Turkey. Data were collected via Smartphone Addiction Scale-Short Version (SAS-SV) and Health Promotion Lifestyle Profile II (HPLP II). The printed forms were used, and the researcher administered the survey in person and recorded the responses. Results: Prevalence of smartphone addiction was 34.1%. Several factors were significantly associated, including female gender (p = 0.049), being single (p = 0.042), self-perceived smartphone addiction (p < 0.001), daytime sleepiness (p < 0.001), and poor sleep quality (p < 0.001). Students with smartphone addiction had significantly lower HPLP II scores (p = 0.001). Logistic regression analysis showed that gender was no longer a significant factor. Those without a partner (OR: 1.47, 95% CI: 1.07-2.03), those who considered themselves smartphone addicts (OR: 6.86, 95% CI: 4.99-9.42), and those with daytime sleepiness (OR: 1.52, 95% CI: 1.08-2.14) had higher odds of smartphone addiction. Higher HPLP II scores were protective against smartphone addiction (OR: 0.99, 95% CI: 0.98-0.99). Conclusions: This study highlights that students with smartphone addiction engage in less health-promoting behaviours and experience poor sleep quality and daytime sleepiness. Self-perceived smartphone addiction was strongly associated with actual addiction, while a healthier lifestyle appeared to have a protective effect. There is a need for strategies to promote healthy habits and reduce smartphone addiction among university students.
Glycaemic Control and Complications in Haemodialysis Patients: The Turk-Hemodiab Study
(Oxford University Press, 2026) Gungor, Ozkan; Korucu, Berfu; Oguz, Ebru Gok; Eren, Necmi; Ural, Zeynep; Dheir, Hamad; Arici, Mustafa
Background The most common cause of end-stage kidney disease is diabetes mellitus (DM). The most commonly used renal replacement therapy in Turkey and in many countries around the world is haemodialysis (HD). Glycaemia control is important in these populations. In this study we aimed to screen for glycaemic control and complications in a large population of diabetic HD patients in Turkey. Methods A total of 16 043 patients were screened in 253 dialysis centres in Turkey and 5038 diabetic HD patients were included in the study. At participating centres, patients' diabetes history, complications, medications, haemoglobin A1c (HbA1c) and other laboratory data were reviewed and recorded by nephrologists. Results The average age of the patients was 64.0 +/- 11.2 years and 56% were male. The mean HbA1c was 7.4 +/- 1.5%. Patients were divided into three groups according to the HbA1c level (<6.5%, 6.5-8% and >8%). As the HbA1c levels increased, the mean systolic blood pressure and diastolic blood pressure increased significantly. In addition, as the HbA1c levels increased, the number of patients with coronary artery disease, patients undergoing coronary artery bypass graft surgery and the rate of patients with diabetic retinopathy and vision loss increased. Diabetic foot disease and amputation rates were also higher in the group with poor glycaemic control. The number of patients using intensive or mixed insulin was also higher in the group with high HbA1c levels. In ordinal logistic regression analysis, age significantly decreased and higher body mass index slightly increased the risk of a higher HbA1c. Also, the need for a diabetic diet was greater in those with high HbA1c levels. Conclusion Our study highlights that the target values for diabetic HD patients in Turkey are partially compatible with the 2022 Kidney Disease: Improving Global Outcomes guidelines for diabetes management. Nevertheless, more effort and teamwork are needed to improve patient outcomes.
Prognostic Role of Smoking in Metastatic Renal Cell Carcinoma in Real-World Data From the Turkish Oncology Group Kidney Cancer Consortium (TKCC)
(Nature Portfolio, 2026) Bolek, Hatice; Sertesen Camoz, Elif; Kuzu, Omer Faruk; Karakas, Hilal; Sim, Saadet; Sekmek, Serhat; Urun, Yuksel
Smoking has been implicated as a potential factor influencing cancer progression and outcomes in various malignancies, including metastatic renal cell carcinoma (mRCC). This study aimed to evaluate the effect of smoking status on treatment outcomes in mRCC patients, with a focus on metastatic sites. This retrospective cohort study utilized data from the Turkish Oncology Group Kidney Cancer Consortium (TKCC). The primary endpoint of the study was overall survival (OS) across metastatic sites. A total of 779 patients were included, of whom 464 (58.1%) were former/current smokers. Smoking status did not significantly affect OS in the overall cohort. However, in the bone metastatic subgroup, former/current smokers exhibited worse OS compared to never smokers (33.9 vs. 22.1 months; p = 0.005). Multivariate Cox regression analysis showed that former/current smoking was an independent predictor for OS in patients with bone metastasis (former/current smoker vs never smoker HR 1.44, 95% CI 1.05-1.99; p = 0.026) and bone-only metastasis (former/current smoker vs never smoker HR 4.44; 95% CI 1.27-15.55; p = 0.020) after adjusting for confounding factors. Smoking is an independent predictor of poor survival in mRCC patients with bone metastases, highlighting the organ-specific effects of smoking on cancer progression. Further research is needed to explore underlying mechanisms and evaluate outcomes in the context of modern therapies.
Transdiagnostic Investigation of White Matter Integrity and Cortical Thickness in Cognitive Subgroups Within the Schizophrenia-Bipolar Spectrum
(Elsevier Ireland Ltd, 2026) Verim, Burcu; Demirlek, Cemal; Zorlu, Nabi; Erdeniz, Burak; Akgul, Ozge; Ceylan, Deniz; Bora, Emre
Background: Cognitive deficits are cardinal features of schizophrenia-spectrum disorders (SSD) and bipolar disorder (BD). However, their heterogeneous and overlapping characteristics require a dimensional approach to better understand the neurobiological basis of cognition in the psychosis spectrum. To date, only a few studies have examined the neuroanatomical features of cognitive subgroups in transdiagnostic samples, and white matter microstructural characteristics of these subgroups have not been elucidated. This study aimed to investigate white matter and cortical thickness alterations in cognitive subgroups in the schizophrenia-bipolar spectrum. Methods: Globally Impaired (n = 31) and Near-Normal (n = 28) cognitive subgroups, comprising individuals diagnosed with schizophrenia (SZ), schizoaffective disorder (SAD) or BD, and healthy controls (HCs, n = 29), underwent 3T T1-weighted structural magnetic resonance imaging and diffusion tensor imaging scanning. Fractional anisotropy and cortical thickness measures were compared between the cognitive subgroups and healthy controls. Results: Abnormalities in white matter microstructure were only observed in patients with global cognitive impairment compared to HCs. The Near-Normal subgroup did not differ from HCs in white matter integrity. A bilateral reduction in cortical thickness was observed in both the Globally Impaired and Near-Normal subgroups when compared to HCs. Cortical thickness measures did not differentiate between the cognitive subgroups. Conclusions: While reductions in cortical thickness in frontal and temporal regions appear to be a common feature of SZ and BD, abnormalities in white matter microstructure are associated with global cognitive impairment in the schizophrenia-bipolar spectrum. These original findings may be important in identifying more biologically valid clinical syndromes within the schizophrenia-bipolar spectrum.
Effect of Late-Onset on Multiple Sclerosis Phenotype and Outcome: Evidence From a Multi-National Registry
(Springer Heidelberg, 2026) Souissi, Amira; Patti, Francesco; Spelman, Tim; Chisari, Clara; Gargouri, Amina; John, Nevin; Gouider, Riadh
BackgroundMultiple Sclerosis (MS) severity is influenced by several factors. Understanding the impact of age at disease onset may help to better characterize clinical and disease features across age groups. This study aimed to characterize the clinical features and disability outcomes of late-onset MS (LOMS) and very late-onset MS (vLOMS), compared to adult-onset MS (AOMS).MethodsWe conducted an observational study using data from the MSBase registry and categorized patients based on age at MS onset: AOMS (18-39 years), transition onset (40-49 years), LOMS (50-59 years), and vLOMS (>= 60 years). Disease progression was assessed using the 24 week confirmed disability progression, EDSS4 and 6 milestones, conversion to secondary progressive MS(SPMS), and the first progression independent of relapse activity (PIRA) event. Cox proportional hazard regression models were used to determine unadjusted hazard ratios(HR), and propensity score inverse probability of treatment weighting(PS-IPTW) balanced covariate distributions.ResultsAmong 81,236 patients, 5.2% had LOMS and 1% had vLOMS. Primary progressive MS was more frequent in LOMS and vLOMS (21.7 and 24%, respectively). Patients with LOMS and vLOMS had a significantly increased risk of 24 week confirmed disability progression (HR:LOMS = 1.39, vLOMS = 1.80), EDSS 4 (HR:LOMS = 2.14, vLOMS = 2.95), EDSS 6 (HR:LOMS = 2.33, vLOMS = 6.33), SPMS (HR:LOMS = 1.62, vLOMS = 2.38), and first PIRA event (HR:LOMS = 2.12, vLOMS = 2.93).ConclusionLOMS and vLOMS exhibited a more progressive disease onset and higher disability milestones compared with AOMS.
Risk of Type 2 Diabetes Development in Nurses: Does Shift Work Affect It
(Wiley, 2026) Yel, Pinar; Doner, Nedime Hazal; Akyol, Asiye; Tureyen, Aynur
Shift work systems contribute to chronic disease development. This study examined shift work systems' effect on nurses' risk of developing type 2 diabetes. This descriptive, cross-sectional study of 278 nurses between April 15 and July 15, 2024, used data from an online survey using a "Nurse's demographic form" and the "Finnish Type 2 Diabetes Risk Score." The snowball sampling technique was used. The study found 56.1% of nurses worked 24-h shifts (08:00-08:00), and 39.2% worked eight or more night shifts monthly. A significant relationship existed between shift work duration and type 2 diabetes development (p = 0.005). The risk of type 2 diabetes increased with longer durations of work in different shifts. Nurses with 11-15 years' experience working day shifts and 24-h shifts had a lower risk of type 2 diabetes (p = 0.045). Nurses working 08:00-08:00 shifts in the Emergency Department had a higher diabetes risk than those in other shifts (p < 0.001). Findings suggest shift work may increase type 2 diabetes risk among nurses. Interventions and workplace strategies are needed to mitigate this risk and support nursing health.
Midbrain Dopamine Warps Subjective Time via Threshold Setting But Not Clock Speed
(Soc Neuroscience, 2026) Erdagi, Alihan; Gur, Ezgi; Balci, Fuat
Interval timing is an evolutionarily well-preserved function that presents similar behavioral signatures across different species. However, the neural basis of interval timing remains an open question. For instance, although dopamine has been implicated as a vital component of the internal clock, its precise role is debated due to equivocal findings from various methodologies and their interpretations. We tested this question by optogenetically exciting versus inhibiting tyrosine hydroxylase-positive (TH+) neurons of the substantia nigra pars compacta while male mice produced at least a 3-s-long interval by depressing a lever for reward. Excitation of TH+ neurons shifted their timing behavior to the right, while inhibition led to a shift to the left. Our drift-diffusion timing model-based analysis of the behavioral data clearly showed that TH+ neuron excitation and inhibition heightened and lowered the timing threshold, respectively, without affecting the rate of temporal integration (i.e., clock speed). Our work attributes a clear mechanistic role (i.e., threshold setting) to nigrostriatal dopaminergic function as part of the internal clock.

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