Northern clinics of Istanbul最新文献

{"title":"Diagnostic and predictive value of the hemoglobin-albumin-lymphocyte-platelet score in thyroid nodules: A retrospective analysis of 521 patients.","authors":"Gurkan Degirmencioglu, Deniz Kutuk, M Hanifi Canakci, M Salih Suer, Siddik Solak","doi":"10.14744/nci.2026.79477","DOIUrl":"10.14744/nci.2026.79477","url":null,"abstract":"<p><strong>Objective: </strong>The hemoglobin-albumin-lymphocyte-platelet (HALP) score, an integrated immunonutritional index, has shown significant prognostic value in several aggressive solid tumors. However, its role in the diagnostic workup and predictive stratification of thyroid cancer remains underexplored. This study aimed to comprehensively evaluate the diagnostic efficacy of the pre-operative HALP score and its association with lymph node metastasis (LNM) in patients undergoing thyroidectomy.</p><p><strong>Methods: </strong>We retrospectively reviewed 521 consecutive patients who underwent thyroid surgery between 2022 and 2024. Pre-operative laboratory parameters, including thyroid-stimulating hormone (TSH), fT4, albumin, and complete blood count, were recorded. The HALP score was calculated as (Hemoglobin×Albumin×Lymphocytes)/Platelets. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis in combination with multivariate logistic regression. A subgroup analysis was performed for malignant cases to evaluate predictors of LNM.</p><p><strong>Results: </strong>Of the cohort, 210 (40.3%) patients had malignant pathology. While serum TSH (p<0.001) and fT4 (p=0.043) were significantly higher in the malignant group, the HALP score demonstrated no significant difference (50.8±17.9 vs. 51.2±18.4, p=0.694). ROC analysis yielded an area under the curve of 0.510 for the HALP score, indicating a lack of discriminative power. In multivariate analysis, only Bethesda categories V (odds ratio [OR]: 17.48) and VI (OR: 104.29) were independent predictors of malignancy. For LNM, younger age (p=0.005), higher TSH (p=0.036), and lymphovascular invasion (p<0.001) were significant predictors, whereas the HALP score showed no predictive value (p=0.919).</p><p><strong>Conclusion: </strong>The pre-operative HALP score does not serve as a reliable diagnostic or predictive biomarker for thyroid malignancy or LNM. Pre-operative stratification should remain focused on cytopathology and established clinical-ultrasonographic risk factors.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"313-318"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611370","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 outcomes following a home-based dual-task telerehabilitation program in Parkinson's disease.","authors":"Basak Bilir Kaya, Pinar Gungor Ketenci, Ozlem Oztekin, Naziye Ceyhan, Kemal Memisoglu","doi":"10.14744/nci.2026.96562","DOIUrl":"10.14744/nci.2026.96562","url":null,"abstract":"<p><strong>Objective: </strong>To examine changes in motor and non-motor clinical outcomes following participation in a home-based telerehabilitation program incorporating motor-cognitive dual-task exercises in individuals with Parkinson's disease (PD).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed prospectively recorded clinical data obtained from a government-supported telerehabilitation service implemented at a tertiary physical medicine and rehabilitation center in Istanbul, Türkiye. The study included 60 participants with mild-to-moderate PD (Hoehn and Yahr stages 1-3) who completed a 6-week intervention consisting of 30 supervised sessions (60 min/session, 5 days/week). The program combined motor exercises, cognitive tasks, and integrated dual-task activities delivered through synchronous video-based supervision. Clinical assessments included balance (Berg Balance Scale, Mini-BESTest), balance confidence (Activities-specific Balance Confidence Scale), mobility (Timed Up and Go test), manual dexterity (Nine-Hole Peg Test), quality of life (PD Questionnaire-39), depressive symptoms (Beck Depression Inventory), and self-reported urinary/fecal incontinence.</p><p><strong>Results: </strong>Post-intervention analyses demonstrated statistically significant improvements in all evaluated outcomes (all p<0.001). Participants showed better balance, mobility, and hand dexterity, accompanied by increased balance confidence and improved gait-related performance. Quality-of-life scores improved, while depressive symptom severity decreased following the intervention. The proportion of participants reporting urinary incontinence declined from 40% to 23%, whereas fecal incontinence decreased from 12% to 2%. Effect size analyses demonstrated moderate-to-large improvements across the primary and key secondary outcomes, with the largest effects observed for depressive symptoms, quality of life, and balance-related performance. No intervention-related adverse events were identified during the study period.</p><p><strong>Conclusion: </strong>Participation in a remotely supervised, dual-task-based telerehabilitation program was associated with favorable changes across multiple clinical domains in individuals with PD. The findings suggest that home-based telerehabilitation may represent a feasible and clinically relevant rehabilitation approach within routine practice. Given the retrospective nature of the study and the lack of a control group, the observed findings should be considered preliminary. Prospective randomized controlled trials are needed to confirm these findings and evaluate their long-term clinical significance.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"303-312"},"PeriodicalIF":0.9,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611352","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 the relationship between combined scores derived from pre-operative routine parameters and weight loss following sleeve gastrectomy: A retrospective cohort study.","authors":"Deniz Kutuk, Gurkan Degirmencioglu","doi":"10.14744/nci.2026.89814","DOIUrl":"10.14744/nci.2026.89814","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether pre-operative composite indices derived from routine laboratory parameters, namely the fibrosis-4 (FIB-4) index, the aspartate aminotransferase-to-platelet ratio index (APRI), and the homeostatic model assessment of insulin resistance (HOMA-IR), were associated with post-operative percentage of excess weight loss (%EWL) after laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>This retrospective cohort study included 91 adults who underwent LSG at a tertiary referral center. Pre-operative FIB-4, APRI, and HOMA-IR values were calculated from routinely obtained clinical and biochemical parameters. The primary endpoint was %EWL during post-operative follow-up. Patients were also classified as successful (%EWL ≥50%) or suboptimal (%EWL <50%) responders. Comparative analyses, correlation analyses, and multivariable linear regression were performed.</p><p><strong>Results: </strong>The cohort had a mean age of 39.2±10.0 years and was predominantly female (80.2%). Mean baseline body mass index (BMI) was 45.1±6.3 kg/m². Mean post-operative %EWL was 51.0±20.2%, whereas total weight loss reached 26.5±8.4%. Marked post-operative metabolic improvement was observed, including significant declines in HOMA-IR, fasting glucose, triglycerides, alanine aminotransferase, and glycated hemoglobin. However, neither FIB-4 nor APRI nor HOMA-IR demonstrated a significant linear association with %EWL, and none remained an independent predictor in the regression model adjusted for age and baseline BMI. In subgroup analyses, the suboptimal weight loss group had a significantly higher baseline BMI and a borderline-higher triglyceride level.</p><p><strong>Conclusion: </strong>Pre-operative FIB-4, APRI, and HOMA-IR appear valuable for metabolic and hepatic phenotyping before surgery, but they do not provide sufficient standalone prognostic discrimination for early post-operative %EWL after LSG. Baseline adiposity may remain more informative than these composite indices for identifying patients at risk of suboptimal relative weight loss.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"280-287"},"PeriodicalIF":0.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611323","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":"Association of serum 25-hydroxyvitamin D levels with fatigue severity in adults: A cross-sectional study.","authors":"Serhat Mert Tiril, Servet Emir, Nur Ezgi Tiril","doi":"10.14744/nci.2026.09623","DOIUrl":"10.14744/nci.2026.09623","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study is to evaluate the association between serum 25-hydroxyvitamin D (25[OH]D) levels and fatigue severity.</p><p><strong>Methods: </strong>This single-center, cross-sectional study included 228 participants aged 18-65 years who completed the fatigue severity scale (FSS) questionnaire. Individuals who had received vitamin supplementation within the previous 3 months, had known chronic disease, used regular medication, or had a history of antidepressant/anxiolytic use for depression/anxiety were excluded. Serum 25(OH)D, hemoglobin, ferritin, iron, magnesium, vitamin B12, and folate values were retrieved from the hospital information system. The Mann-Whitney U-test was used for comparisons between genders, and the Spearman correlation test was used for relationships between FSS and biochemical parameters. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 228 participants (57 males and 171 females) were included in the study. Most variables were not normally distributed; therefore, non-parametric analyses were performed. Spearman correlation analysis demonstrated a weak but significant negative correlation between FSS scores and both hemoglobin (p=0.003) and ferritin levels (p=0.001). No significant correlations were found between FSS and vitamin D, vitamin B12, folate, magnesium, or serum iron levels (p>0.05).In group comparisons based on fatigue severity, ferritin levels were significantly lower in the high-fatigue group compared to the low-fatigue group (p<0.001). Hemoglobin levels were also lower in the high-fatigue group (p=0.043). In contrast, vitamin B12 levels were significantly higher in the high-fatigue group (p=0.032). No significant differences were observed between groups in terms of vitamin D, folate, magnesium, or serum iron levels (p>0.05).</p><p><strong>Conclusion: </strong>Serum 25(OH)D levels were not associated with fatigue severity. The observed relationship between fatigue severity and hematological markers (hemoglobin and ferritin) suggests that these parameters should be considered in the clinical evaluation of fatigue.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"288-293"},"PeriodicalIF":0.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611632","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":"Real-world immunosuppressive treatment patterns and disease progression in systemic sclerosis-associated interstitial lung disease.","authors":"Ibrahim Vasi, Ibrahim Karaduman, Rahime Duran, Ibrahim Yahya Cakir, Esma Eseroglu, Burak Karakaya, Busra Koksoy, Ertugrul Cagri Bolek, Hamit Kucuk, Berna Goker, Nilgun Demirci Yilmaz, Mehmet Akif Ozturk, Abdulsamet Erden","doi":"10.14744/nci.2026.03453","DOIUrl":"10.14744/nci.2026.03453","url":null,"abstract":"<p><strong>Objective: </strong>Interstitial lung disease (ILD) is a frequent and prognostically important manifestation of systemic sclerosis (SSc), with a substantial proportion of patients developing progressive pulmonary fibrosis (PPF) despite immunosuppressive treatment. The objective of the study was to compare real-world lung function trajectories and the occurrence of progressive PPF among patients with SSc-ILD receiving commonly used immunosuppressive therapies.</p><p><strong>Methods: </strong>We conducted a retrospective single-center cohort study of adult patients with SSc-ILD receiving immunosuppressive therapy, assessing longitudinal changes in pulmonary function and PPF according to international guideline-based criteria.</p><p><strong>Results: </strong>Among 80 patients with SSc-ILD, mycophenolate mofetil (MMF) was the most frequently used immunosuppressive agent across both first-line and subsequent treatment lines. Despite its extensive use, MMF was associated with relatively low rates of progressive PPF (18.2% in first-line and 25% in second/third-line use) and largely stable forced vital capacity over time, with only modest decline in diffusing capacity for carbon monoxide. Cyclophosphamide (CYC) showed transient improvements in lung function at 1 year, followed by stabilization. In contrast, first-line azathioprine (AZA) use was associated with the highest PPF proportion (55.6%).</p><p><strong>Conclusion: </strong>In this real-world SSc-ILD cohort, MMF emerged as the most frequently used backbone therapy after the scleroderma lung study II, with generally stable lung function trajectories observed during follow-up. Higher proportions of progressive PPF were observed among AZA-treated patients, whereas CYC was mainly used as an induction therapy in selected cases. Rituximab, administered alone or in combination with MMF, was more frequently used in patients with progressive or treatment-refractory disease and was associated with relatively low progression proportions in this cohort. These findings reflect treatment patterns and clinical trajectories observed in routine clinical practice rather than comparative treatment efficacy.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"263-273"},"PeriodicalIF":0.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611575","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":"Structural and microvascular alterations in clinically unaffected fellow eyes of patients with acute central serous chorioretinopathy: An OCT and OCTA study.","authors":"Guzide Akcay, Ulviye Kivrak, Dilber Celik Yaprak, Omer Faruk Bogazliyan, Neslihan Buyukmurat","doi":"10.14744/nci.2026.43403","DOIUrl":"10.14744/nci.2026.43403","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate potential subclinical structural and microvascular changes in the clinically unaffected fellow eyes of patients with acute central serous chorioretinopathy (aCSC) and to compare these findings with age- and sex-matched healthy controls.</p><p><strong>Methods: </strong>In this retrospective study, the fellow eyes of 33 aCSC patients and one randomly selected eye from 40 healthy controls were analyzed. Central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT), and subfoveal choroidal thickness (SFCT) were measured using optical coherence tomography (OCT). OCT angiography was performed to assess vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris plexus (CCP), and peripapillary capillary plexus (PPCP), as well as the foveal avascular zone.</p><p><strong>Results: </strong>No differences were observed in mean CMT or RNFLT between fellow eyes of aCSC patients (faCSC) and controls; however, superior and inferior macular quadrants were significantly thicker in faCSC eyes (p=0.005 and p=0.007, respectively). SFCT was markedly increased in faCSC eyes compared to controls (333.2±93.16 µm vs. 239.8±34.27 µm; p<0.001). While SCP and DCP VDs did not differ significantly, CCP VD was elevated in the foveal, superior, inferior, and temporal regions of faCSC eyes (p<0.001-p=0.005). PPCP VD was also higher in the superior and temporal quadrants (p=0.02 and p=0.01).</p><p><strong>Conclusion: </strong>Clinically, faCSC patients demonstrate increased SFCT, regional macular thickening, and elevated VD in both CCP and PPCP. These findings indicate that CSC is not exclusively a localized retinal disorder but may involve systemic and bilateral choroidal changes. Early subclinical alterations in the fellow eye highlight the importance of careful monitoring for timely intervention and prevention of disease progression.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"274-279"},"PeriodicalIF":0.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611560","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":"Simultaneous pneumocephalus and meningitis as a complication of ozone therapy.","authors":"Sirvan Elmas Dal","doi":"10.14744/nci.2026.97830","DOIUrl":"10.14744/nci.2026.97830","url":null,"abstract":"<p><p>Today, minimally invasive oxygen(O²)-ozone(O₃) intramuscular lumbar paravertebral injections are used to relieve pain in conditions such as low back pain. Repeated paraspinal, peridural, or spinal O₃ injections, when performed under non-aseptic conditions or not performed with proper technique, may carry a risk of parameningeal inoculation of bacteria resulting in meningitis and pneumocephalus. Although this treatment is well tolerated in most cases, the patient may sometimes develop rare but very serious complications. Our study presents a case of pneumocephaly and meningitis due to the injection of an intramuscular O₂-O₃ mixture directed into the subarachnoid space after dural puncture for the treatment of low back pain. Air-density lesions were detected in the temporal and frontal horns of the left lateral ventricle on the patient's computed tomography scan of the brain. The cerebrospinal fluid appeared slightly cloudy, with a leukocyte count of 4000/mm³, protein level of 483 mg/dL, glucose at 40 mg/dL, and chlorine at 113 mmol/L. Ensuring that ozone injection therapy is performed by qualified professionals and that strict aseptic precautions are taken before the procedure will prevent serious iatrogenic complications such as pneumocephalus and meningitis.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"359-362"},"PeriodicalIF":0.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611545","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":"From description to clinical impact: Critical gaps in the evaluation of drug intoxication in the emergency department.","authors":"Mehmet Celegen","doi":"10.14744/nci.2026.64022","DOIUrl":"10.14744/nci.2026.64022","url":null,"abstract":"","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"365-366"},"PeriodicalIF":0.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611588","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 considerations for costoclavicular space evaluation after midshaft clavicle fracture.","authors":"Soner Kocak","doi":"10.14744/nci.2026.26863","DOIUrl":"10.14744/nci.2026.26863","url":null,"abstract":"","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"363-364"},"PeriodicalIF":0.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610699","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":"The impact of post-earthquake anxiety and depression on erectile dysfunction: A cross-sectional study after the February 6, 2023 Earthquakes in Turkiye.","authors":"Muhammet Serdar Bugday, Ender Akdemir, Kerim Ugur, Battal Selcuk Cakmak, Mehmet Levent Akbulut, Hatice Polat","doi":"10.14744/nci.2026.41017","DOIUrl":"10.14744/nci.2026.41017","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effects of the February 6, 2023, earthquakes in Turkiye on anxiety and depression levels and their impact on erectile dysfunction (ED).</p><p><strong>Methods: </strong>A total of 164 men aged 25-55 were enrolled between July 15, 2024, and January 15, 2025. Ninety-seven patients who presented with ED after the earthquakes were included as the study group, and 67 healthy individuals without ED were enrolled as controls. All participants completed the Arizona Sexual Experiences Scale (ASEX), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), World Health Organization Quality of Life-BREF (WHOQOL-BREF), and International Index of Erectile Function (IIEF-5). Statistical analyses were conducted using chi-square, t-tests, and ANOVA.</p><p><strong>Results: </strong>There were no significant differences between the groups regarding age and marital status. Patients with ED had significantly higher ASEX, HAM-A, and HAM-D scores and significantly lower WHOQOL-BREF scores compared to controls (p=0.001). Among ED patients, 52 (53.6%) had severe ED, 40 (41.2%) had moderate, and 5 (5.2%) had mild symptoms. ASEX scores were significantly higher (p=0.01), and WHOQOL-BREF general health scores were significantly lower in patients with severe ED compared to those with milder forms (p=0.001).</p><p><strong>Conclusion: </strong>The February 6 earthquakes were associated with increased anxiety and depression and decreased quality of life in men, which significantly contributed to the prevalence and severity of ED. These findings highlight the importance of addressing sexual health as part of post-disaster psychosocial support.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 2","pages":"162-170"},"PeriodicalIF":0.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978351","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}