Sürdürülebilir Kalkınma Amaçları

• 4

• MakaleAçık Erişim2026/r/kostu/10865
  The role of mood in complex regional pain syndrome: Cause or consequence?

  Ahi, Emine Dundar; Kuculmez, Ozlem

  Aim: Complex Regional Pain Syndrome (CRPS) involves pain and dysfunction in multiple nervous system pathways. Psychological symptoms such as anxiety, depression, and difficulty coping often accompany the physical aspects of the condition. This study sought to examine whether mood-related factors play a causal role in the onset of CRPS or if individuals with pre-existing psychological conditions exhibit increased susceptibility to its development. Materials and Methods: This is a cross-sectional study that included 131 patients with a history of trauma or surgery who were referred for rehabilitation within the first three months following the incident. Among them, 70 patients were diagnosed with CRPS, while 61 patients formed the control group. Each participant underwent evaluation through the Short Form-36, Visual Analog Scale (VAS), Beck Depression Inventory, and the Beck Anxiety Inventory. Results: The study included 62 men and 69 women, with no significant differences in anxiety and depression scores observed between the CRPS group and the control group (p>0.05 for both). However, individuals with CRPS reported notably higher scores on the VAS (p<0.05). In addition, their scores were significantly lower in the Short Form-36 subdomains related to pain intensity (p<0.05), social functioning (p<0.05), and physical role limitations (p<0.05). Conclusion: The results indicate that an individual's baseline mood does not seem to contribute to the development of CRPS. These mood changes may be only the result of the disease, as pain level, social function, and physical role were determined to be worse in these patients.

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• MakaleAçık Erişim2025/r/kostu/10898
  Factors affecting mortality in cases of perinatal asphyxia treated with hypothermia; A 10-year experience: A retrospective cohort study

  Günlemez, Ayla; Dönmez, Tuğrul; Pehlevan, Ozge Serce

  Aim: Birth asphyxia and intrapartum brain injury can cause death or irreversible brain damage. The only known treatment that improves prognosis is therapeutic hypothermia. Our goal was to assess the parameters associated with death in newborns receiving therapeutic hypothermia. Materials and Methods: This retrospective cohort study was conducted in a neonatal intensive care unit (NICU) and included neonates who underwent therapeutic hypothermia due to perinatal asphyxia over 10 years. Patients were categorized into survivors and nonsurvivors based on their in-hospital outcomes. Demographic characteristics, clinical parameters, laboratory findings, and complications were retrieved from the patients’ medical records. Prognostic factors were compared between groups using appropriate statistical methods, and multivariate logistic regression was performed to identify independent predictors of mortality. Results: A total of 114 newborns treated with therapeutic hypothermia were analyzed, of whom 11 (9.6%) died due to perinatal asphyxia (PA). Non-survivors had significantly lower gestational ages (37±2 vs. 38.4±1.6 weeks, p=0.042), lower 5-minute Apgar scores (5 [1--5] vs. 5.5 [4--7], p=0.048), and higher cesarean delivery rates (81.8% vs. 41.7%, p=0.011). Severe findings on aEEG and Sarnat Stage III were more common among nonsurvivors (p<0.001 for both). Nonsurvivors also exhibited significantly lower admission rectal temperatures [33.8°C (32--36) vs. 35.8°C (34.5--36), p=0.023], higher rates of thrombocytopenia (81.8% vs. 42.7%, p=0.013), acute renal failure (90.9% vs. 39.8%, p=0.001), and cranial ultrasound abnormalities (27.3% vs. 3.9%, p=0.019). In the multivariate logistic regression analysis, only a lower rectal temperature at admission remained an independent predictor of mortality (OR: 1.520, 95% CI: 1.061--2.178, p = 0.023). Conclusion: Factors such as lower Apgar scores, acute renal failure, and hypothermia severity on admission are strongly associated with mortality. The early identification and management of these risk factors are critical for improving outcomes in neonates treated with therapeutic hypothermia.

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• MakaleAçık Erişim2025/r/kostu/10887
  Metabolic imaging of head and neck lesions: Differentiating dental and maxillofacial conditions using positron emission tomography/computed tomography

  Medişoğlu, M.Sabri; Öçbe, Melisa

  Aim: Fluorine-18-labeled fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is an essential oncologic imaging modality, but its uptake patterns may also be seen in benign inflammatory or structural oral conditions, leading to diagnostic confusion. This study aims to compare metabolic activity with maximum standardized uptake value (SUVmax) among common dento-maxillofacial conditions---dental artifacts, periodontal infections, maxillary sinus pathologies, and temporomandibular joint (TMJ) disorders---against confirmed malignant lesions, to guide differential diagnosis and improve clinical interpretation. Materials and Methods: A total of 100 FDG-PET/CT scans were retrospectively analyzed. Inclusion criteria comprised pre-treatment scans with available CT or magnetic resonance imaging (MRI) acquired within four weeks. Patients were categorized into five groups: Dental Artifacts (n=19), Periodontal Infections (n=23), Maxillary Sinus Pathologies (n=21), TMJ Pathologies (n=19), and Malignant Dento-maxillofacial Lesions (n=18; control group). All scans were reviewed by an oral and maxillofacial radiologist and a radiologist. SUVmax were calculated using a 42% threshold. Statistical analyses were conducted using Kruskal-Wallis and MannWhitney U tests with Bonferroni correction. Results: Significant differences in SUVmax were observed across all groups (χ² = 77.4, p<0.000001). The malignant lesion group demonstrated the highest metabolic activity (mean SUVmax = 12.5 ± 3.0), significantly greater than all other groups (p<0.000001). Among nonmalignant conditions, maxillary sinus pathologies showed the highest SUVmax (4.2 ± 1.0), followed by periodontal infections (3.5 ± 0.8). TMJ pathologies and dental artifacts exhibited the lowest FDG uptake (2.0 ± 0.6 and 2.5 ± 0.7, respectively), suggesting minimal metabolic activity. Conclusion: This study confirms that malignant dento-maxillofacial lesions exhibit significantly higher FDG uptake compared to inflammatory and mechanical conditions. Understanding these uptake patterns is crucial to avoiding false-positive interpretations, especially in oncologic patients. Multimodal imaging and interdisciplinary evaluation are recommended for accurate differentiation of dental and maxillofacial pathologies in FDG-PET/CT interpretation.

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• MakaleAçık Erişim2024/r/kostu/10930
  Assessment of the impact of anemia on the treatment of acute bronchiolitis cases

  Dönmez, Tuğrul; Dundaroz, Mehmet Rusen

  Aim: Acute bronchiolitis is a clinical condition characterized by inflammation of the bronchioles, primarily caused by viral agents in children under two years of age. The cornerstone of treatment includes hydration and oxygenation, while patients should be closely monitored for potential complications. Our objective is to evaluate the impact of anemia on treatment outcomes in children diagnosed with acute bronchiolitis. Materials and Methods: Children aged 1-24 months diagnosed with mild or moderate acute bronchiolitis in a tertiary pediatric health and disease clinic were retrospectively included in the study. Demographic characteristics and bronchiolitis severity (mild/moderate) were recorded. Pre- and post-treatment clinical severity, respiratory rate, heart rate, oxygen saturation levels, and bronchiolitis clinical scores were analyzed. The clinical findings and treatment responses of anemic and non-anemic patients were compared. A p-value of <0.05 was considered statistically significant in all analyses. Results: A total of 85 patients with a median age of 5.4 months (52.9% male) were included in the study. Anemia was present in 25.9% of the patients. At admission, the respiratory rate (RR) was significantly lower in anemic patients compared to nonanemic patients (median 37 vs 41, p=0.003). No significant differences were observed between anemic and non-anemic groups for clinical respiratory scores (CRS) (median 4.7 vs 4.7, p=0.721), heart rate (HR) (median 135.6 vs 134.3, p=0.798), or oxygen saturation (SaO2) (median 93.1 vs 93.0, p=0.304) at admission. Post-treatment, both groups demonstrated significant improvements in CRS, HR, and SaO2 (p<0.05 for all). However, RR remained lower in the anemic group compared to the non-anemic group (median 32.1 vs 36, p=0.003). The overall change in CRS and other parameters between the anemic and non-anemic groups was not statistically significant (p>0.05). Conclusion: Mild anemia does not affect the response to treatment for hypoxia in children with mild to moderate acute bronchiolitis.

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