Northern clinics of Istanbul最新文献

{"title":"The role of BUN/creatinine ratio in determining the severity of gastrointestinal bleeding and bleeding localization.","authors":"Aslihan Calim","doi":"10.14744/nci.2025.34366","DOIUrl":"https://doi.org/10.14744/nci.2025.34366","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to evaluate an established biomarker such as blood urea nitrogen (BUN)/Creatinine ratio in predicting upper gastrointestinal bleeding versus lower GI and stratify its severity. The aim of this study is to evaluate the diagnostic performance in clinical practice and predestination as a prognostic factor, including admission to an intensive care unit (ICU) or mortality rate for BUN/Creatinine ratio.</p><p><strong>Methods: </strong>A total of 300 patients controlled in our hospital between January 2022 and January 2024 were evaluated retrospectively due to hospitalization by acute GI bleeding. Gastroscopy and/or colonoscopy were used to stratify patients into the upper or lower GI bleeding group. Data included demographic information, clinical presentation history and vital signs, comorbidity status, medication use, clinical outcomes and laboratory tests including hemoglobin, hematocrit, urea, creatinine levels and so on. The BUN/Creatinine ratio was determined and correlated with site as well as severity of bleeding. Statistical techniques, such as logistic regression and receiver operating characteristic (ROC) analysis, were used to assess the diagnostic performance of the ratio and to choose a cut-off value.</p><p><strong>Results: </strong>Among the 300 patients, 215 (71.7% had upper GI bleeding, and 85 (28.3% had lower GI bleeding. Hematemesis and melena were significantly associated with upper GI bleeding, whereas hematochezia was more common in lower GI bleeding. Patients with upper GI bleeding had significantly higher BUN, urea, and BUN/Creatinine ratios, while hemoglobin and hematocrit levels were lower. The optimal BUN/Creatinine cut-off value of 23.3 demonstrated high sensitivity (89.3%) and specificity (94.1%) for distinguishing between upper and lower GI bleeding. Multivariate analysis revealed BUN/Creatinine ratio, hematochezia and endoscopic intervention as an independent predictor of bleeding location. Patients with BUN/Creatinine ratio >23.3 showed increased frequency of red blood cell transfusion, endoscopic intervention, and mortality.</p><p><strong>Conclusion: </strong>The BUN/Creatinine ratio is a sensitive, noninvasive biomarker for distinguishing between upper and lower GI bleed and severity. Its introduction into clinical practice may enhance the decision process and patient care, especially in critical care contexts. Additional research is indicated to confirm these results and to define standardized cut-off values for wider use.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"244-252"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016112","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":"Effective new predictors of prognosis and comparison of multidisciplinary treatment options in acute mesenteric ischemia.","authors":"Ahmet Tarik Harmantepe, Enis Dikicier, Ugur Can Dulger, Furkan Kucuk, Emre Gonullu, Hakan Demir, Unal Erkorkmaz","doi":"10.14744/nci.2023.82231","DOIUrl":"https://doi.org/10.14744/nci.2023.82231","url":null,"abstract":"<p><strong>Objective: </strong>It was aimed to compare the prognostic risk factors and multidisciplinary treatments affecting mortality in acute mesenteric ischemia (AMI).</p><p><strong>Methods: </strong>We retrospectively analyzed 111 patients treated for acute mesenteric ischemia between January 2012 and January 2023. Patients were divided into 2 groups as alive and dead for early survey (postoperative 28 days). The characteristics of the two groups were compared and the factors affecting early mortality were investigated. Factors affecting the presence of perioperative ischemia, the length of ischemia, the length of the resected bowel, and the length of the remaining small bowel from the ligament of Treitz were investigated. The results of different treatment processes were analyzed.</p><p><strong>Results: </strong>The mean age was 71.67, years with 64 (57.6%) males and 47 (42.3%) females. Early mortality rate was 47.7%. Envas was applied to 9 (8.1%) patients. EnvasSurg to 19 (17.1%) patients. Surg to 71 (64%) and SurgEnvas to 12 (10.8%) patients during the treatment process. Preoperative D-dimer (p=0.013). lactate (p=0.006). creatine (p=0.001). LAR (p=0.031) were significantly different between the groups when compared according to the treatment process. The resected bowel length was significantly less in patients who underwent EnvasSurg compared to the other groups (p=0.002), CCI (p=0.041), D-dimer (p=0.016), lactate (p<0.001), creatine (p<0.001), LAR (p<0.001) and ischemia length (p<0.001) were found to be significantly different between the groups.</p><p><strong>Conclusion: </strong>The prognosis can be predicted with serum-based blood tests and indicators at the time of diagnosis, and organ loss and prognosis can be changed with the selected treatment process.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"162-172"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056903","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":"Nuclear receptor protein: REV-ERB.","authors":"Mahmud Esad Pence","doi":"10.14744/nci.2023.49225","DOIUrl":"https://doi.org/10.14744/nci.2023.49225","url":null,"abstract":"<p><p>REV-ERB α/β proteins play critical roles in circadian rhythm regulation and are considered to be specialized members of the nuclear receptor family. These so-called \"orphan\" proteins, whose endogenous ligands were initially unidentified, have become exogenously interferable through synthetic agents with the discovery of their endogenous ligands. This feature has made them an important target for clinical research in recent years. Unlike other nuclear receptors, the unique structure of REV-ERB proteins allows them to perform only transcription inhibition, which makes them even more intriguing. This review summarizes the structural features of REV-ERB α/β proteins and their role in the circadian cycle. We also discuss findings in the literature on the function of REV-ERB α/β proteins in the metabolic and immune systems, emphasizing their importance in these systems.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"258-265"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061280","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":"Henoch-Schonlein purpura successfully treated with a milk-free diet, vitamin D and C: First description.","authors":"Jozélio Freire de Carvalho","doi":"10.14744/nci.2024.31799","DOIUrl":"https://doi.org/10.14744/nci.2024.31799","url":null,"abstract":"","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"266-267"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059957","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":"An investigation of serum irisin levels and inflammatory markers in fibromyalgia syndrome.","authors":"Rumeysa Samanci, Sarfinaz Ataoglu, Mustafa Ozsahin, Handan Ankarali, Ozlem Admis","doi":"10.14744/nci.2025.29291","DOIUrl":"https://doi.org/10.14744/nci.2025.29291","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.14744/nci.2019.95676.].</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"268"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049283","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":"Relationship between serum magnesium levels and glycemic control and insulin resistance.","authors":"Osman Erinc, Soner Yesilyurt","doi":"10.14744/nci.2024.75725","DOIUrl":"https://doi.org/10.14744/nci.2024.75725","url":null,"abstract":"<p><strong>Objective: </strong>The role of magnesium in glucose homeostasis, its effects on glycemic control and the causal relationship between them have been the subject of many studies. In this direction, in our study, we aimed to investigate the relationship between serum magnesium (Mg) levels and hemoglobin A1c (HbA1c) and insulin resistance.</p><p><strong>Methods: </strong>Based on their HbA1c levels, 305 participants were split into 3 groups: 121 were in the control group, 85 were in the prediabetes group, and 99 were in the diabetes group. Serum magnesium levels were measured in these three groups. The correlation between Mg and fasting plasma glucose, fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) was also investigated. In addition, patients' demographic data, blood pressure, smoking habits and basic biochemical data were also included in the analysis.</p><p><strong>Results: </strong>There was a significant statistical difference in terms of serum magnesium levels among all the groups (p<0.001). A strong negative correlation was found between serum magnesium levels and HbA1c (r=-0.316, p<0.001). There was also a weak negative relationship between Mg and serum fasting glucose, insulin, and HOMA-IR (r=-0.167 p=0.004, r=-0.167 p=0.003, and r=-0.198 p=0.001, respectively).</p><p><strong>Conclusion: </strong>We observed a statistically significant negative correlation between serum magnesium levels and HbA1c in our study. According to this finding, it would be useful to assess magnesium levels in patients with high HbA1c levels. However, due to conflicting results among studies investigating the relationship between magnesium, glycemic control and insulin sensitivity with increasing interest, more comprehensive, prospective studies with longer follow-up periods are needed.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"239-243"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045731","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":"Is it resistant? A case report of splenic endometriosis and review of the literature.","authors":"Ismail Ahmet Bilgin, Mustafa Bas, Nuray Bassullu, Ozgur Ozkayar, Nur Ramoglu, Ismail Hamzaoglu","doi":"10.14744/nci.2024.86244","DOIUrl":"https://doi.org/10.14744/nci.2024.86244","url":null,"abstract":"<p><p>Endometriosis is an estrogen-dependent benign disease that generally affects women at childbearing age. Despite its high incidence, pathogenesis of endometriosis is poorly clarified. There are several theories explaining the mechanism of disease such as retrograde menstruation, coelomic metaplasia, vascular and lymphatic metastasis. While endometriosis has been described in many intra- and extra-abdominal organs including the ovaries, omentum, colon, liver, lungs and brain, parenchymal splenic endometriosis is a rare situation. In recent years, with reported cases, this rare condition came onto the scene. We also wanted to present our case and question the idea of splenic immunity against endometriosis according to current literature. From now on, splenic endometriosis can be thought of as a differential diagnosis for unidentified lesions of spleen.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"253-257"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051428","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":"Retrospective investigation of patients undergoing splenectomy: Our 8-year clinical experience in a single center.","authors":"Ela Erten, Burak Ucaner, Sebnem Cimen","doi":"10.14744/nci.2025.67503","DOIUrl":"https://doi.org/10.14744/nci.2025.67503","url":null,"abstract":"<p><strong>Objective: </strong>Elective splenectomy is often performed due to hematological diseases. In this study, we aimed to investigate the splenectomy procedures performed in our clinic under emergency and elective conditions by analyzing the surgical techniques applied, surgical indications, and the clinical and demographic data of the patients, while seeking to discuss this subject, which holds a significant place in general surgical practice, in light of current literature.</p><p><strong>Methods: </strong>Patients who underwent splenectomy surgery in the general surgery clinic of a tertiary care hospital between September 2016 and September 2024 were included in the study. Clinical and demographic data of the patients were collected retrospectively through the hospital information management system records.</p><p><strong>Results: </strong>The mean age of 89 patients included in the study was 41.0±18.8 years (18-76 years). The male/female ratio was 1.3/1. The most common indication for splenectomy was trauma (38.2%). This was followed by mass (29.2%), splenomegaly (14.6%), and immune thrombocytopenic purpura (ITP) (14.6%). Of the patients, 62.9% underwent open surgery, while 37.1% were operated on using the laparoscopic technique. Of the patients, 57.3% underwent elective surgery, while emergency surgery was planned for 42.7%.</p><p><strong>Conclusion: </strong>While splenectomy is a life-saving intervention in emergency conditions, it has become the most important treatment in some hematological diseases. Firstly, accurate surgical indication and the selection of an appropriate surgical technique tailored to the patient are of critical importance. There are still controversial issues in the current literature regarding the indications for splenectomy and the surgical technique to be applied.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"231-238"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030518","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":"Clinical efficacy of peroral endoscopic myotomy treatment performed in patients diagnosed with achalasia.","authors":"Bahri Abayli, Ali Ilker Ozer, Adnan Kuvvetli, Serdar Biricik, Begum Seyda Avci, Ozan Demir, Duygu Felek, Ozge Sahan, Mustafa Oguz Tugcan, Hilmi Erdem Sumbul, Akkan Avci","doi":"10.14744/nci.2024.08466","DOIUrl":"https://doi.org/10.14744/nci.2024.08466","url":null,"abstract":"<p><strong>Objective: </strong>Achalasia is a movement disorder of the esophagus that continues with chest pain, dysphagia, weight loss, regurgitation of undigested foods, recurrent aspiration and night cough.</p><p><strong>Methods: </strong>Weight loss, presence of dysphagia, presence of retrosternal pain and regurgitation were recorded before POEM treatment and preoperative Eckardt Score was calculated and recorded. Patients were recorded at the 6^th month after POEM treatment recording weight loss, dysphagia presence, retrosternal pain and regurgitation presence and calculating postoperative Eckardt score.</p><p><strong>Results: </strong>The change between the postoperative and preoperative values of the patients was calculated as ∆ value. As a result of the examination, no significant difference was found between the values ∆weight loss, ∆dysphagia, ∆retrosternal pain, ∆regurgitation and ∆Eckardt score and gender variable (respectively, p=0.112; p=0.412; p=0.619; p=0.171; p=0.092). Postoperative weight loss, dysphagia, retrosternal pain, regurgitation and Eckardt score values were found to be lower than preoperative values. (respectively, p<0.001;p<0.001; p<0.001; p<0.001; p<0.001).</p><p><strong>Conclusion: </strong>Peroral endoscopic myotomy treatment is an effective treatment method with its being more reliable, lower complication risk, being less invasive and with postprocedural and clinical results.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"211-215"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049444","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":"Baseline macular structural and vascular changes as predictive markers of visual improvement in central retinal vein occlusion.","authors":"Ulviye Kivrak, Guzide Akcay","doi":"10.14744/nci.2025.26932","DOIUrl":"https://doi.org/10.14744/nci.2025.26932","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the changes in posterior segment parameters that affect visual prognosis in patients with central retinal vein occlusion (CRVO).</p><p><strong>Methods: </strong>This retrospective study included 58 eyes of 58 CRVO patients. Best-corrected visual acuity (BCVA), intraocular pressure, central macular thickness (CMT), hyperreflective foci (HRF), ellipsoid zone (EZ) loss, disorganization of retinal inner layers (DRIL), intraretinal cystic changes, posterior vitreous detachment (PVD), and macular superficial and deep vascular density (VD), as well as superficial and deep foveal avascular zone (FAZ) areas, were assessed at baseline and 3 months follow-up after treatment. The treatments (intravitreal injections and laser) received were recorded.</p><p><strong>Results: </strong>The mean age was 63.02±9.91 years, 37 (63.8%) were female, and 39 (67.3%) were classified as having non-ischemic CRVO. The mean baseline BCVA was 0.64±0.85 logMAR; at 3 months, it improved to 0.39±0.65 logMAR (p<0.001). The mean baseline CMT was 478.9±82.6 µm, and at 3 months, it reduced to 288.56±72.39 µm (p<0.001). At baseline, HRF in 31% of eyes, EZ disruption in 44.8% of eyes, DRIL in 17.2% of eyes, intraretinal cysts in 55.2% of eyes, and PVD in 43.1% of eyes. A significant decrease in BCVA was observed in patients with EZ loss (p<0.001), while the presence of intraretinal cysts had significant impact on CMT (p=0.007). Furthermore, a statistically significant negative correlation was observed between foveal and superior VD in both the superficial and deep capillary plexus (SCP, DCP) and changes in BCVA (logMAR). In contrast, a positive correlation was found between superficial FAZ area and BCVA (logMAR). Additionally, a statistically significant positive correlation was noted between foveal VD in both the SCP and DCP and changes in CMT.</p><p><strong>Conclusion: </strong>The study emphasizes the importance of structural and vascular changes in predicting functional outcomes and suggests the utility of optical coherence tomography (OCT) and OCT angiography in early visual prognosis and treatment planning.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"12 2","pages":"222-230"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004560","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}