Turkish Journal of Medical Sciences最新文献

{"title":"The long-term efficacy of nusinersen on respiratory functions in children with symptomatic spinal muscular atrophy type 1.","authors":"Mehmet Akif Kiliç, Fulya Kürekçi, Osman Kipoğlu, Orhan Coşkun, Burçin Nazlı Karacebey, Selahattin Katar, Rıdvan Avci, Hülya Maraş Genç, Erkan Çakir, Edibe Pembegül Yildiz","doi":"10.55730/1300-0144.6018","DOIUrl":"10.55730/1300-0144.6018","url":null,"abstract":"<p><strong>Background/aim: </strong>Available data regarding the effects of nusinersen on respiratory function in the real-world setting are uncertain. We aimed to evaluate the impact of nusinersen on respiratory outcomes over a follow-up period of up to 72 months in patients with symptomatic spinal muscular atrophy type 1 (SMA type 1).</p><p><strong>Materials and methods: </strong>Respiratory status was defined similarly to previous studies: spontaneous breathing, noninvasive ventilatory support for ≤16 h per day, and permanent assisted ventilation. The planned evaluation time was day 180 (after the fourth dose), day 300 (after the fifth dose), and after the last injection for patients who received nusinersen for 2 years or more.</p><p><strong>Results: </strong>Our cohort consisted of 32 patients. The mean age at treatment initiation was 6.6 months (range: 2.5-16 months). Twenty-eight of 32 patients were eligible for evaluation after the fourth dose. Twenty-three of 28 patients were eligible for assessment after the fifth dose of nusinersen. Eight <i>patients</i> received nusinersen for 2 years or more (range: 26-72 months). At the last assessment, four patients did not require ventilatory support between the ages of 30 and 81 months. One was successfully weaned from invasive ventilatory support after the tenth dose of nusinersen. The respiratory status of most patients remained stable or worsened following the fourth and fifth doses of nusinersen. There were no significant differences in respiratory status between patients who received nusinersen at 6 months of age or younger and those older than 6 months, after the fourth and fifth doses of nusinersen (p > 0.05).</p><p><strong>Conclusion: </strong>Improvement in respiratory function in patients treated with nusinersen for 2 years or more is generally not expected in the natural course of the disease. However, in our cohort, patients treated with nusinersen mainly maintained their current respiratory status, and many patients required ventilatory support despite treatment with nusinersen. Therefore, our findings may reflect the limited efficacy of nusinersen in symptomatic patients.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 3","pages":"702-709"},"PeriodicalIF":1.2,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing knowledge levels of intensive care unit nurses and doctors regarding drug administration via enteral feeding tubes: a survey study.","authors":"Ayşe Gül Koçoğlu Kinal, Yunus Emre Ayhan, Aslınur Albayrak","doi":"10.55730/1300-0144.5957","DOIUrl":"10.55730/1300-0144.5957","url":null,"abstract":"<p><strong>Background/aim: </strong>Knowledge deficiency regarding appropriate drug administration through enteral feeding tubes (EFTs) is common in intensive care units (ICUs). The aim of this study is to evaluate the knowledge levels of nurses and doctors in ICUs about drug administration via EFTs.</p><p><strong>Materials and methods: </strong>This study was conducted as a cross-sectional online survey. Survey questions were created using Google Forms and distributed to nurses and doctors in various ICUs across hospitals in İstanbul, Türkiye. The researchers designed the survey questions based on literature reviews and existing examples. The survey consisted of three sections and a total of 25 questions: the first section included seven demographic questions, while the second and third sections focused on participants' knowledge regarding drug administration via EFT and the selection of appropriate dosage forms, respectively.</p><p><strong>Results: </strong>The online survey form was sent to 400 healthcare workers in ICUs, and 221 (55.2%) completed the survey. Among the participants, 66 (29.9%) were male, and 112 (50.6%) were doctors. There was no significant difference in the mean (± SD) of correct answers to 9 questions on drug administration between doctors (5.4 ± 1.3) and nurses (5.3 ± 1.4) (p = 0.471). In the mean (± SD) of correct answers to 9 questions on dosage form selection, doctors (3.9 ± 2.1) had higher scores than nurses (2.7 ± 1.9) (p < 0.001). The mean (± SD) of the responses given to all questions was found to be higher in doctors (9.4 ± 2.9) than in nurses (8 ± 2.7) (p < 0.001).</p><p><strong>Conclusion: </strong>In ICUs, the knowledge of nurses and doctors about drug administration and dosage form selection via EFT is at a low to moderate level. Enhancing collaboration among healthcare professionals may be effective in bridging this knowledge gap.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"193-202"},"PeriodicalIF":1.2,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus paper on <i>Candida auris</i> by Türkiye EKMUD, ID-IRI, THSK of Ministry of Health of the Republic of Türkiye, KLIMUD, TMC, TARD, and TYBD.","authors":"Canan Ağalar, Hakan Erdem, Yasemin Çağ, Bilgin Arda, Recep Balik, Aliye Baştuğ, Burcu Dalyan Cilo, Nurettin Erben, Esma Eryilmaz Eren, Gülşen Iskender, Ayşe Kalkanci, Nilgün Karabiçak, Zeliha Koçak Tufan, Emine Parlak, Nagehan Didem Sari, Murat Sayin, Seniha Şenbayrak, Recep Tekin, Ayşegül Ulu Kiliç, Tuğhan Utku, Ömrüm Uzun, Göknur Yapar Toros, Sevtap Arikan Akdağli","doi":"10.55730/1300-0144.6059","DOIUrl":"10.55730/1300-0144.6059","url":null,"abstract":"<p><p><i>Candida auris</i> 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, <i>C</i>. <i>auris</i> has spread rapidly, posing significant treatment challenges across various healthcare settings worldwide. The biofilm formation ability of <i>C</i>. <i>auris</i> 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 Türkiye (PHIT) under the Ministry of Health. The report provides a comprehensive overview of <i>C</i>. <i>auris</i> 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 <i>C</i>. <i>auris</i>. This consensus report aims to establish standardized diagnostic protocols, improve national surveillance systems, and promote effective infection control measures to mitigate <i>C</i>. <i>auris</i>-related health risks in Türkiye. It also offers comprehensive national recommendations and addresses the need for interinstitutional collaboration, improve public health, and strengthen the healthcare response to this pathogen.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"1039-1062"},"PeriodicalIF":1.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro anticancer, antioxidant and chelating activities of natural organosulfur compounds originated from Türkiye: an investigation on breast and colorectal cancer cells.","authors":"Ümmügülsüm Polat Korkunç, Hilal Çalik, Leyla Polat Köse, Rabia Çakir Koç, Emine Karakuş","doi":"10.55730/1300-0144.5970","DOIUrl":"10.55730/1300-0144.5970","url":null,"abstract":"<p><strong>Background/aim: </strong>Taşköprü garlic, cultivated in the Taşköprü region of Kastamonu Province, is highly renowned in Türkiye. This study aimed to determine the anticancer and antioxidant effects of extracts from Kastamonu Taşköprü garlic on human breast cancer and colorectal cancer cells.</p><p><strong>Materials and methods: </strong>Taşköprü garlic, which contains natural organosulfur compounds (OSCs), has a geographical registration. Garlic contains oil- and water-soluble OSCs known to exhibit anticancer activity by interfering with MCF-7 and Caco-2 proliferation and tumor metastasis. This study assessed the antiproliferative activity of oil- and water-soluble garlic extracts with and without glutathione at different concentrations using the XTT assay on NIH/3T3, MCF-7, and Caco-2 cell lines over 24 h. In addition, the reducing capacity, radical scavenging activity, and metal chelation activity of OSCs in Taşköprü garlic were analyzed.</p><p><strong>Results: </strong>Both oil- and water-soluble garlic extracts significantly inhibited the proliferation of MCF-7 and Caco-2 in a dose-dependent manner after 24 h of incubation. The half-maximal inhibition concentration (IC₅₀) values of OSCs and positive controls for N,N-dimethyl-p-phenylenediamine cation (DMPD^.+) radical removal and 2,2'-bipyridyl-Fe²⁺ chelation activity were 129.593-1004.346 and 165.065-495.195 μg/mL, respectively. Furthermore, the reducing impact of OSCs and positive controls were evaluated based on their cupric ion (Cu²⁺) reducing capabilities. All results were compared with the respective positive controls.</p><p><strong>Conclusion: </strong>The findings revealed that oil-soluble garlic extracts exhibited anticancer properties against both Caco-2 and MCF-7 cancer cells, without inducing any cytotoxicity in non-cancerous NIH/3T3. In addition, water-soluble extracts have higher antiproliferative activity on Caco-2 and MCF-7 cells in a dose-dependent manner compared to oil-soluble extracts. However, they also exhibited notable cytotoxicity on fibroblast cells. OSCs showed limited activity in reduction and radical scavenging assays but demonstrated strong chelating activity. These results suggest that both water-soluble and oil-soluble garlic extracts hold promising anticancer potential against both MCF-7 and Caco-2.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"287-298"},"PeriodicalIF":1.2,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural and patient-related factors play differential roles in postdural puncture headache.","authors":"Ece Yanik, Doğa Vuralli, Tuğba Tunç","doi":"10.55730/1300-0144.5987","DOIUrl":"10.55730/1300-0144.5987","url":null,"abstract":"<p><strong>Background/aim: </strong>The incidence of postdural puncture headache varies depending on the multifactorial nature of the risk factors. Patient-related and procedure-related risk factors are still controversial. In this prospective observational study, we aimed to evaluate the risk factors for postdural puncture headache, the effect of previous headache features on the development of postdural puncture headache, and the risk factors for the immediate or delayed postdural puncture headache.</p><p><strong>Materials and methods: </strong>We prospectively analyzed 116 patients who underwent lumbar puncture for diagnostic or therapeutic purposes. All clinical and laboratory findings, previous headache history, and the features and information related to the lumbar puncture procedure were evaluated.</p><p><strong>Results: </strong>We found that the presence of longer and more frequent attacks, independent of the type of the prior headache, and a history of migraine accompanied by osmophobia are independent risk factors for postdural puncture headache. A lower volume of cerebrospinal fluid collected, higher frequency of previous headache attacks, diagnosis of idiopathic intracranial hypertension, and acetazolamide use were risk factors for the immediate-onset postdural puncture headache.</p><p><strong>Conclusion: </strong>This is the first study to detail the previous headache features in the development of postdural puncture headache and to extensively examine the risk factors for immediate and delayed postdural puncture headache. It was shown for the first time that patient-related factors may be more important in terms of the development of postdural puncture headache, and procedure-related factors gain importance in terms of its time of occurrence.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 2","pages":"432-442"},"PeriodicalIF":1.2,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency of cervical cerclage and pessary in addition to vaginal progesterone to prevent preterm birth in twin pregnancies: a case-control study from a tertiary center.","authors":"Göksun Ipek, Atakan Tanaçan, Ilım Demet, Zahid Ağaoğlu, Ezgi Başaran, Özgür Kara, Dilek Şahin","doi":"10.55730/1300-0144.5968","DOIUrl":"10.55730/1300-0144.5968","url":null,"abstract":"<p><strong>Background/aim: </strong>This study evaluated the efficiency of cervical cerclage and pessary in addition to vaginal progesterone to prevent preterm birth in twin pregnancies.</p><p><strong>Materials and methods: </strong>This retrospective case-control study included 46 cases of twin pregnancy with cervical insufficiency delivered at Ankara Bilkent City Hospital between January 2022 and January 2024. Patients were grouped as those receiving cervical cerclage in addition to vaginal progesterone (n = 10), cervical pessary in addition to vaginal progesterone (n = 11), and only vaginal progesterone (n = 25). Patients' data were obtained from the hospital's database. Obstetric parameters (gravidity, parity, abortion, artificial reproductive technologies, second-trimester abortion) and ultrasound parameters (cervical length, intraamniotic sludge) were recorded. Gestational week at birth, latency period (diagnosis to delivery), and delivery after 34 weeks were evaluated for effectiveness. All parameters were compared between groups and evaluated for effectiveness as an independent factor for preterm birth.</p><p><strong>Results: </strong>The primary effectiveness parameters of latency period, birth week, and delivery after 34 weeks did not differ statistically between groups. When the parameters were evaluated independently of treatment groups for their effects on delivery after 34 weeks with multivariate regression analysis, the presence of intraamniotic sludge was found to be a negative independent factor for delivery after 34 weeks (p = 0.03).</p><p><strong>Conclusion: </strong>Cervical cerclage or pessary in addition to vaginal progesterone had no additional benefit for achieving birth after 34 gestational weeks. The only factor that had a negative effect on birth after 34 gestational weeks was the presence of intraamniotic sludge. Our clinical experience with twin pregnancies may provide insight into treatment options for clinicians.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"271-276"},"PeriodicalIF":1.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytopathological evaluation of pericardial effusions: 192 cases from a tertiary-level healthcare center.","authors":"Ayşegül Aksoy Altinboğa, Nur Kivrak","doi":"10.55730/1300-0144.5986","DOIUrl":"https://doi.org/10.55730/1300-0144.5986","url":null,"abstract":"<p><strong>Background/aim: </strong>There are many different benign and malignant etiologies of pericardial effusions (PEs), which can compress the heart and large vessels emerging from the heart and cause significant clinical findings. The aim of this study was to cytologically examine the underlying diseases causing PEs and to conduct detailed evaluations of underlying cancers in cases of malignant PE, both within the whole study population and according to sex.</p><p><strong>Materials and methods: </strong>All PE samples obtained between 2019 and 2024 were reevaluated and categorized as nondiagnostic, negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM), or malignant according to the 2020 International System for Serous Fluid Cytopathology.</p><p><strong>Results: </strong>A total of 192 PE samples from 184 patients were analyzed, with 137 categorized as NFM (71.4%), 6 as AUS (3.1%), 5 as SFM (2.6%), and 44 as malignant (22.9%). In the NFM group, PE most often developed secondary to cardiac diseases or cardiac operations (61/137, 44.5%). In the malignant group, pulmonary carcinoma metastasis was most common within the whole population (54.5%) followed by breast carcinoma metastasis (15.9%). Lung carcinoma metastasis (69%) was most common among male patients, followed by gastric carcinoma metastasis (23%), and breast carcinoma (38.9%) followed by lung carcinoma metastasis (33.3%) were most common among female patients as the causes of malignant PE. Among patients who were followed for malignancy, malignant PE was found in 64.2% (43/67). In this study, PE had sensitivity of 95.7%, specificity of 100%, positive predictive value of 100%, negative predictive value of 98.5%, and accuracy of 98.9%.</p><p><strong>Conclusion: </strong>When PE develops in patients being followed for malignancy, there is an extremely high possibility of malignant PE secondary to pericardial metastasis. Cytological evaluation of PE, which has extremely high sensitivity and specificity, is of clinical importance in patient diagnosis and follow-up.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 2","pages":"423-431"},"PeriodicalIF":1.2,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The abdominal compliance index and postoperative pain after laparoscopic gynecologic surgery: a preliminary observational cohort study.","authors":"Ebru Akgün Şarer, Mustafa Tahtaci, Umut Cahit Ersoy, Mehtap Honca","doi":"10.55730/1300-0144.5969","DOIUrl":"10.55730/1300-0144.5969","url":null,"abstract":"<p><strong>Background/aim: </strong>In gynecology, laparoscopic surgery has the advantages of reduced scarring, less postoperative pain, faster recovery, and lower risk of complications. Despite these advantages, shoulder pain still remains a major concern, affecting up to 90% of patients undergoing gynecologic laparoscopic surgery. Use of the abdominal compliance index (ACI) may offer the benefit of increased space for safer surgery and may prevent the drawback of high insufflation pressures. The aim of this study was to investigate the relationship between shoulder pain, abdominal pain, and analgesic use with the recently advised ACI, a surrogate index of abdominal expansion in patients undergoing gynecologic laparoscopic surgery.</p><p><strong>Materials and methods: </strong>Thirty-one patients with American Society of Anesthesiologists scores of 1-3 who underwent elective gynecologic laparoscopic surgery were included. The insufflation pressure was set to 12 mmHg. ACI, defined as insufflated intraabdominal volume (L) per body surface area (m²), was used to estimate the relationship between abdominal compliance and postoperative pain.</p><p><strong>Results: </strong>The 31 patients were separated into two groups based on median ACI level (range 1.37-2.73 L/m²), with those having values of 2.16 L/m² or lower as group 1 and those with higher values as group 2. Abdominal visual analogue scale (VAS) scores at 30 min postoperative were significantly higher in group 2 than in group 1 (p < 0.001). Shoulder pain VAS scores at 24 h and 36 h postoperative were also significantly higher in group 2 than in group 1 (p = 0.021 and p = 0.002, respectively). The total amount of analgesic infusion and additional analgesic requirements were lower in group 1 than in group 2 (p = 0.049 and p = 0.001, respectively). ACI did not differ with patient demographic characteristics or history of abdominal/laparoscopic surgery, parity, abdominal drainage, and pneumoperitoneum time.</p><p><strong>Conclusion: </strong>ACI, a surrogate index of abdominal expansion capacity, may be used to guide individualization of insufflation pressures by identifying female patients under risk of higher postoperative pain.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"277-286"},"PeriodicalIF":1.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradigm shift in obesity treatment: an extensive review of current pipeline agents.","authors":"Ecesu Çetin, Brian Pedersen, Mehmet Furkan Burak","doi":"10.55730/1300-0144.5938","DOIUrl":"10.55730/1300-0144.5938","url":null,"abstract":"<p><p>Obesity is a multifaceted disease that poses a significant public health challenge. Recent discoveries in understanding the biological pathways that regulate satiety and metabolism have led to a shift in the treatment paradigm for obesity. Thus, the gap between pharmacological and surgical interventions has diminished. The latest approved antiobesity medications help to achieve weight loss comparable to surgery. These GLP-1 analog-based therapies not only cause substantial weight loss but also improve obesity-associated comorbidities. However, there are still unmet needs in obesity care, and treatment options with alternative pathways are necessary. Whether achieved through lifestyle changes or medication, weight loss often leads to muscle mass loss and reduced energy expenditure, resulting in rebound weight gain. Moreover, addressing severe obesity and comorbidities, such as metabolic-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatohepatitis (MASH), heart failure with preserved ejection fraction, and obstructive sleep apnea, necessitates the development of additional therapeutic strategies. Various antiobesity medications with novel mechanisms of action are currently in the pipeline. Myostatin-activin pathway inhibitors are under development to preserve muscle mass, and combination therapies with glucagon agonists address MAFLD and MASH. Amylin agonists offer a promising alternative to those unable to tolerate GLP-1 analogs. Mitochondrial uncouplers are under investigation for enhancing energy expenditure, NLRP-3 inhibitors for reducing inflammation, and GWAS targets for additional weight loss benefits. Combination therapies, such as dual or triple hormonal receptor agonists, are being developed to maximize weight loss and optimize tolerability. These emerging medications in the clinical trial pipeline show promise for more tolerable and sustainable obesity management.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"1-16"},"PeriodicalIF":1.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between bleeding risk and arterial stiffness in patients with cerebral aneurysms.","authors":"Mehmet Selim Gel, Hasan Çağrı Postuk, İskender Samet Daltaban, Savaş Özer, Ercan Aydin, Emrah Keskin","doi":"10.55730/1300-0144.5959","DOIUrl":"10.55730/1300-0144.5959","url":null,"abstract":"<p><strong>Background/aim: </strong>A comprehensive risk factor assessment evaluating the susceptibility of cerebral aneurysms (CAs) to rupture has not yet been established. Therefore, the clinical management of unruptured CAs remains uncertain. This study aimed to assess whether arterial stiffness was associated with rupture risk in patients with CAs.</p><p><strong>Materials and methods: </strong>Following magnetic resonance angiography, 49 patients with CAs and subarachnoid haemorrhage and ruptured CAs (confirmed via digital subtraction angiography) were included in the study. Arterial stiffness was measured using the VaSera VS-1000 vascular scanning system and expressed as cardio-ankle vascular index (CAVI) values. The CAVI values were compared between the patient groups.</p><p><strong>Results: </strong>The mean age of the cerebrovascular aneurysm group was 51 ± 11 years, while that of the cerebrovascular aneurysmal haemorrhage group was 58 ± 12 (p = 0.308) years. Left and right CAVI values were significantly higher in the cerebrovascular aneurysm group (p < 0.05 for both). The CAVI values were positively correlated with haemorrhagic CA (p < 0.05).</p><p><strong>Conclusion: </strong>This study revealed that increased arterial stiffness was associated with an increased risk of haemorrhage in patients with CAs. This result demonstrates the importance of evaluating arterial stiffness as an informative parameter for treatment and follow-up decisions in patients with CAs.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"209-214"},"PeriodicalIF":1.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}