Medeniyet medical journal最新文献

{"title":"Right Coronary Artery Perforation with Subsequent Graft Stent Embolization to the Left Main Coronary Artery: It Never Rains but It Pours!","authors":"Efe Yilmaz, Furkan Karahan, Çağlar Kaya, Kenan Yalta","doi":"10.4274/MMJ.galenos.2025.89021","DOIUrl":"10.4274/MMJ.galenos.2025.89021","url":null,"abstract":"","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"278-279"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety Profile of Roxadustat in Anemic Patients: A Meta-Analysis of 21 RCTs.","authors":"Lokman Hekim Tanriverdi, Ahmet Sarici, Mehmet Ali Erkurt, Hacı Bayram Berktas","doi":"10.4274/MMJ.galenos.2025.44045","DOIUrl":"10.4274/MMJ.galenos.2025.44045","url":null,"abstract":"<p><strong>Objective: </strong>Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor used to treat anemia in patients with chronic kidney disease. We aimed to assess its safety and tolerability profile through a meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic search of the Cochrane CENTRAL, Ovid Medline R, PubMed, and Web of Science databases was conducted up to January 1, 2025 was conducted. RCTs comparing roxadustat with control groups were included. Inverse-variance-weighted random-effects models were used. The primary outcome was the risk of any serious treatment-emergent adverse event (TEAE). Subgroup analyses were based on etiology, comparator, and prior erythropoiesis-stimulating agent (ESA) use.</p><p><strong>Results: </strong>Twenty-one RCTs involving 11.686 patients were included. Roxadustat was not associated with a higher risk of any serious TEAE compared with placebo [risk ratio (RR) =1.37, 95% confidence interval (CI): 0.79-2.37] or with ESA (RR=1.05, 95% CI: 0.99-1.10). Similarly, cardiac serious adverse events (SAEs) did not differ significantly when compared with ESA (RR=1.11, 95% CI: 0.75-1.12) or placebo (RR=1.11, 95% CI: 0.92-1.35). Hyperkalemia incidence was significantly higher compared with placebo (RR=1.25, 95% CI: 1.02-1.53) but not compared with ESA (RR=1.03, 95% CI: 0.77-1.36). There were also no significant differences in the incidence of serious infections (RR=0.74, 95% CI: 0.21-2.59), azotemia (RR=0.96, 95% CI: 0.46-2.00), hypertension (RR=1.06, 95% CI: 0.93-1.21), or pneumonia (RR=0.96, 95% CI: 0.81-1.14) compared with ESA. Notably, withdrawal due to adverse events (RR=2.11, 95% CI: 1.59-2.79) was significantly higher compared with ESA. TEAEs leading to death were similar compared with ESA (RR=0.98, 95% CI: 0.85-1.13) but were increased compared with placebo (RR=1.21, 95% CI: 1.04-1.42). All-cause mortality was significantly lower than with placebo (RR=0.40, 95% CI: 0.28-0.57) but was similar to ESA (RR=0.89, 95% CI: 0.57-1.37). Subgroup analyses for the primary outcome by etiology and prior ESA use were not consistent with the main findings.</p><p><strong>Conclusions: </strong>Roxadustat demonstrated a SAE profile generally comparable to that of ESA, with no significant differences in cardiac SAEs, serious infections, azotemia, hypertension, or pneumonia. Hyperkalemia was more frequent compared with placebo, and withdrawals due to adverse events were more frequent compared with ESA. TEAEs leading to death were similar to ESA but higher than with placebo, whereas all-cause mortality was lower than with placebo and comparable to ESA. Taken together, current evidence supports the overall non-inferiority of roxadustat to ESA in terms of safety.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"250-261"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Interleukin-40 and Soluble CD40 Ligand as Complementary Biomarkers for Disease Activity in Multiple Sclerosis Patients.","authors":"Mustafa Ziyad Neamah, Inas K Sharquie, Gheyath Al Gawwam","doi":"10.4274/MMJ.galenos.2025.48830","DOIUrl":"10.4274/MMJ.galenos.2025.48830","url":null,"abstract":"<p><strong>Objectives: </strong>Multiple sclerosis (MS) is a complex autoimmune disease of the central nervous system for which reliable biomarkers of disease activity remain an unmet need. Interleukin-40 (IL-40) and soluble CD40 ligand (sCD40L) have been proposed to play roles in the pathogenesis of autoimmune diseases. This study aimed to evaluate serum levels of IL-40 and sCD40L as biomarkers of disease activity in MS patients, and to compare their diagnostic and monitoring performance between MS patients and healthy controls.</p><p><strong>Methods: </strong>One hundred twenty MS patients were recruited from the Department of MS at the Baghdad Teaching Hospital and divided into two groups based on disease status: active (n=60) and inactive (n=60). Additionally, 57 matched healthy individuals were included as controls. A sandwich enzyme-linked immunosorbent assay was used to measure the serum levels of IL-40 and sCD40L in blood samples from each participant.</p><p><strong>Results: </strong>Both active and inactive patient cohorts showed significantly higher serum levels of IL-40 (44.25±8.57 ng/mL and 38.98±11.31 ng/mL, respectively) compared with their control group (20.82±14.27 ng/mL) (p=0.005). Likewise, sCD40L concentrations were elevated in both active (2155.59±587.02 pg/mL) and inactive (1885.23±851.32 pg/mL) patients compared with controls (849.79±341.87 pg/mL; p=0.0006). IL-40 correlated positively with sCD40L (r=0.399, p=0.005). The receiver operating characteristic analysis showed high diagnostic performance for IL-40 (area under the curve =0.873; sensitivity 87.5%; specificity 76.7%) and sCD40L (area under the curve =0.901; sensitivity 92.5%; specificity 81.7%).</p><p><strong>Conclusions: </strong>Both IL-40 and sCD40L are significantly elevated in MS and exhibit promising diagnostic validity. These biomarkers may serve as complementary tools for monitoring MS disease activity and progression, offering potential value in clinical practice and therapeutic decision-making.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"226-234"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning-Based Analysis of Serum Interleukin-39 and Interleukin-40 Levels for Differentiating Rheumatoid Arthritis and Systemic Lupus Erythematosus.","authors":"Inas K Sharquie, Faiq Isho Gorial, Zahraa Adnan Al-Ghuraibawi, Amal Mahdi Al Rubaye","doi":"10.4274/MMJ.galenos.2025.95690","DOIUrl":"10.4274/MMJ.galenos.2025.95690","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are both severe autoimmune diseases characterised by immune dysregulation and systemic inflammation. Despite advances in diagnostic tools, distinguishing RA from SLE remains challenging due to overlapping clinical manifestations. Emerging evidence highlights the potential roles of novel cytokines, such as interleukin-39 [(IL)-39] and IL-40, in autoimmune pathogenesis. This study aimed to evaluate the diagnostic utility of serum levels of IL-39 and IL-40 for differentiating RA from SLE using several machine learning (ML) algorithms.</p><p><strong>Methods: </strong>Data from 66 patients with RA and 66 patients with SLE were analysed using previously published serum IL-39 and IL-40 datasets. ML algorithms, namely logistic regression, random forest, decision tree, and support vector machine, were applied. Model performance was evaluated using sensitivity, accuracy, specificity, and area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>SLE patients exhibited significantly higher serum IL-39 and IL-40 levels than those of RA patients (p<0.001). The random forest model achieved an accuracy of 92.4% and an AUC of 0.95. Feature importance analysis revealed that IL-39 and IL-40 contributed 58% and 42%, respectively to the classification performance.</p><p><strong>Conclusions: </strong>ML models based on IL-39 and IL-40 serum levels can effectively differentiate RA from SLE. The findings suggest that integrating artificial intelligence-based analytical approaches with novel cytokine biomarkers may enhance diagnostic precision and support differential diagnosis in autoimmune diseases.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"235-240"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Podocalyxin Level as a Potential Biomarker for Diagnosis of Nephrotic Syndrome and Prediction of Steroid Response.","authors":"Emre Leventoglu, Mustafa Soran, Ummugulsum Can","doi":"10.4274/MMJ.galenos.2025.15043","DOIUrl":"10.4274/MMJ.galenos.2025.15043","url":null,"abstract":"<p><strong>Objective: </strong>Idiopathic nephrotic syndrome (NS) is a common pediatric glomerular disorder. Podocyte damage constitutes a central mechanism in its pathophysiology. Podocalyxin, a major sialoglycoprotein expressed on podocytes, has been found to be elevated in urine samples from patients with glomerular diseases. However, its potential role in serum and its association with steroid responsiveness in NS remain unexplored.</p><p><strong>Methods: </strong>This observational study included 17 children diagnosed with NS and age-matched controls without kidney pathology. Serum podocalyxin levels were measured at diagnosis using enzyme-linked immunosorbent assay. Patients received standard corticosteroid therapy at a dose of 2 mg/kg/day for four weeks, followed by a gradual taper. Based on clinical response, patients were classified as steroid-sensitive or steroid-dependent NS (SDNS). Serum podocalyxin levels were compared between patients and controls, and among subgroups based on treatment response.</p><p><strong>Results: </strong>Serum podocalyxin levels were significantly higher in NS than in the control group [1.87 ng/dL [interquartile range (IQR: 0.87)] vs. 1.54 ng/dL (IQR: 0.29), p=0.031]. All patients initially achieved remission with corticosteroids; however, six patients subsequently developed SDNS. Among these, 4 responded to calcineurin inhibitors, while 2 required rituximab to achieve remission. Current results indicate that serum podocalyxin levels do not provide sufficient predictive value for estimating steroid response or disease course. No significant correlations were found between podocalyxin levels and other laboratory parameters.</p><p><strong>Conclusions: </strong>Serum podocalyxin levels are elevated in pediatric NS and may reflect the degree of podocyte injury. However, current findings indicate that serum podocalyxin levels are insufficient for predicting disease severity or steroid response. Additional studies involving larger patient cohorts are needed to further substantiate findings.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"262-268"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Deaths in Malatya Due to the Earthquake Centered in Kahramanmaras on 6 February 2023.","authors":"Mucahit Oruc, Mehmet Efdal Saydan, Emre Boz, Abdulkerim Yayla, Erkal Gumusboga, Mesut Yilmaz, Osman Celbis","doi":"10.4274/MMJ.galenos.2025.41762","DOIUrl":"10.4274/MMJ.galenos.2025.41762","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to retrospectively examine the cases of individuals who lost their lives as a result of the Kahramanmaraş earthquakes on February 6, 2023, and were brought to the study area designated by the Malatya Forensic Medicine Group Presidency.</p><p><strong>Methods: </strong>A total of 916 cases were referred for identification to the center designated as the study area by the Malatya Forensic Medicine Group Presidency following the earthquakes on February 6, 2023, and were examined retrospectively. The obtained data were coded and entered into IBM SPSS Version 22. Descriptive statistics and frequency tables were generated, and the data were analyzed.</p><p><strong>Results: </strong>Among the 916 cases included in the study, 477 (52.1%) were male and 439 (47.9%) were female; 23.2% were under the age of 18, and 13.8% were over the age of 65. The majority (87.9%) were citizens of the Republic of Türkiye. Most injuries were localized to the head and neck region (37.5%). Body integrity was preserved in 88.3% of cases, and signs of decomposition were observed in 77.1%. Fast Technology for the Analysis of Nucleic Acids blood samples was obtained in 39.5% of cases. All bodies were identified through a combination of primary and secondary identification methods and subsequently delivered to their relatives.</p><p><strong>Conclusions: </strong>In countries facing major disaster risks, forensic medicine units must always be prepared for such events. Postmortem examination and victim identification are multidisciplinary processes that require the coordinated efforts of experts from various fields.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 3","pages":"173-179"},"PeriodicalIF":1.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Estimation Using Patellar Morphometry: Evidence from a Late Roman Population in Anatolia.","authors":"Yarenkur Alkan, Adem Tokpinar","doi":"10.4274/MMJ.galenos.2025.38839","DOIUrl":"10.4274/MMJ.galenos.2025.38839","url":null,"abstract":"<p><strong>Objective: </strong>Accurate sex estimation is a cornerstone in forensic and bioarchaeological investigations. While the pelvis and skull are traditionally used for this purpose, their absence due to taphonomic damage necessitates the use of alternative skeletal elements such as the patellar. This study evaluates the diagnostic potential of patellar morphometry for sex estimation in a Late Roman population.</p><p><strong>Methods: </strong>The study analyzed 146 adult patellar (70 males, 76 females) recovered from the Karlığın Tepesi Necropolis 3^rd-6^th centuries AD in Malatya, Türkiye. Standard osteological methods were used to determine sex. Three patellar dimensions/length (PL), patellar width (PW), and patellar thickness (PT)-were measured. Intraobserver reliability was assessed via technical error of measurement (TEM), relative TEM (rTEM), and the reliability coefficient (R). Stepwise logistic regression and receiver operating characteristic analyses were conducted to identify the best predictors of sex. Area under the receiver operating characteristic (AUROC) values, cut-off thresholds, and effect sizes were reported.</p><p><strong>Results: </strong>Statistically significant differences were found between males and females in PL (p=0.001), PW (p<0.001), and PT (p=0.003). The stepwise logistic regression model using PL and PT produced AUROC values of 0.906 in Step 1 and 0.920 in Step 2, with sensitivity and specificity ranging from 82.85% to 94.73%. All intraobserver reliability metrics (TEM, rTEM, R) indicated excellent measurement precision (R=1.000).</p><p><strong>Conclusions: </strong>Patellar morphometry demonstrates high diagnostic accuracy for sex estimation, particularly when multivariate models are applied. Despite the moderate discriminative power of patella thickness alone, its combination with other parameters enhances overall performance. The study provides the first population-specific discriminant model for sex estimation using the patella in an Anatolian archaeological sample. However, the skewed sex distribution and the possibility of post-depositional changes in ancient skeletal remains should be considered when interpreting results. Additionally, the population-specific nature of the archaeological sample and the lack of external validation on independent datasets limit the generalizability of the model to other contexts.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 3","pages":"166-172"},"PeriodicalIF":1.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor Regarding Our Research Article on \"The Role of Combined C-reactive Protein and Albumin Indices in Predicting Prolonged Hospital Stay in Acute Pancreatitis: A Prospective Observational Study\".","authors":"Abdullah Algin, Serdar Ozdemir, Abuzer Ozkan, Kaan Yusufoglu, Mustafa Ahmet Afacan","doi":"10.4274/MMJ.galenos.2025.10915","DOIUrl":"10.4274/MMJ.galenos.2025.10915","url":null,"abstract":"","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 3","pages":"200-201"},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pi*M Palermo Mutation in Bronchiectasis due to Alpha-1 Antitrypsin Deficiency: A Rare Genetic Cause.","authors":"Beyza Yildirimli, Coskun Dogan, Elif Yilmaz Gulec, Gonul Seven Yalcin","doi":"10.4274/MMJ.galenos.2025.25594","DOIUrl":"10.4274/MMJ.galenos.2025.25594","url":null,"abstract":"<p><p>Bronchiectasis, defined as the permanent dilation of the bronchial wall, is a chronic inflammatory disease with nearly thirty known causes. The most common cause is recurrent and inadequately treated lower respiratory tract infections. Among the rarer causes is alpha-1 antitrypsin (AAT) deficiency, an anti-protease and anti-inflammatory protein deficiency. To date, approximately 500 variants of AAT deficiency have been identified, with the PI*S and PI*Z mutations being the most commonly associated with bronchiectasis. Here, we present a case diagnosed with bronchiectasis secondary to AAT deficiency during an advanced clinical workup, in which the rare Pi*M Palermo mutation was identified. This case is discussed in the context of the existing literature.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 3","pages":"193-197"},"PeriodicalIF":1.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"the Role of Combined C-reactive Protein and Albumin Indices in Predicting Prolonged Hospital Stay in Acute Pancreatitis: A Prospective Observational Study\".","authors":"Rachana Mehta, Ranjana Sah","doi":"10.4274/MMJ.galenos.2025.14265","DOIUrl":"10.4274/MMJ.galenos.2025.14265","url":null,"abstract":"","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 3","pages":"198-199"},"PeriodicalIF":1.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}