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Öğe Beyond nimodipine: advanced neuroprotection strategies for aneurysmal subarachnoid hemorrhage vasospasm and delayed cerebral ischemia(Springer, 2024) Luzzi, Sabino; Bektaşoğlu, Pınar Kuru; Doğruel, Yücel; Güngör, AbuzerThe clinical management of aneurysmal subarachnoid hemorrhage (SAH)-associated vasospasm remains a challenge in neurosurgical practice, with its prevention and treatment having a major impact on neurological outcome. While considered a mainstay, nimodipine is burdened by some non-negligible limitations that make it still a suboptimal candidate of pharmacotherapy for SAH. This narrative review aims to provide an update on the pharmacodynamics, pharmacokinetics, overall evidence, and strength of recommendation of nimodipine alternative drugs for aneurysmal SAH-associated vasospasm and delayed cerebral ischemia. A PRISMA literature search was performed in the PubMed/Medline, Web of Science, ClinicalTrials.gov, and PubChem databases using a combination of the MeSH terms "medical therapy," "management," "cerebral vasospasm," "subarachnoid hemorrhage," and "delayed cerebral ischemia." Collected articles were reviewed for typology and relevance prior to final inclusion. A total of 346 articles were initially collected. The identification, screening, eligibility, and inclusion process resulted in the selection of 59 studies. Nicardipine and cilostazol, which have longer half-lives than nimodipine, had robust evidence of efficacy and safety. Eicosapentaenoic acid, dapsone and clazosentan showed a good balance between effectiveness and favorable pharmacokinetics. Combinations between different drug classes have been studied to a very limited extent. Nicardipine, cilostazol, Rho-kinase inhibitors, and clazosentan proved their better pharmacokinetic profiles compared with nimodipine without prejudice with effective and safe neuroprotective role. However, the number of trials conducted is significantly lower than for nimodipine. Aneurysmal SAH-associated vasospasm remains an area of ongoing preclinical and clinical research where the search for new drugs or associations is critical.Öğe Secondary pituitary abscess: a rare complication of transsphenoidal surgery for pituitary adenoma - description of two new cases and review of the literature(Mary ann liebert, 2024) Başkurt, Ozan; Avinçsal, Benan Baysoy; Diren, Furkan; Kabataş, Serdar; Kuşoglu, Hülya; Kara, Simay; Gazioğlu, NurperiBackground: Pituitary abscess (PA), a rare complication following transsphenoidal (TS) surgery for pituitary adenoma with an incidence of 0.2%, poses a significant risk; carrying potential morbidity, recurrence, and the necessity for reoperation. Timely suspicion, diagnosis, and treatment are imperative.Patients and Methods: We present two cases and provide a literature review on the symptoms, risk factors, diagnosis, treatment, and outcomes associated with secondary PAs following TS surgery for adenoma.Results: We identified 12 articles reporting a total of 45 cases, in addition to our 2 cases. The primary symptoms were headache and visual impairment, with no fever or specific infectious parameters observed. Predominant risk factors identified included cerebrospinal fluid (CSF) leakage and prior radiotherapy (RT). Our first patient, a 45-year-old male, presented 10 weeks after TS surgery with sudden-onset symptoms, whereas our second patient, a 64-year-old female, presented 22 years postoperatively. In the first case, intraoperative CSF leakage, with the patient's history of allergic rhinitis and frequent nasal irrigation possibly contributed to the development of abscess. In the second case, RT was considered a potential risk factor. Severe headache and subclinical signs of infection associated with a cystic lesion of the pituitary gland were common findings. Both patients underwent endoscopic TS drainage and received appropriate antibiotic therapy, resulting in complete recovery without recurrence.Conclusions: When faced with severe headaches in a patient with a history of TS surgery for a pituitary adenoma, coupled with radiological evidence showing a cystic appearance with peripheral enhancement, taking a proactive approach to promptly identify and intervene in secondary PAs is essential for mitigating potential complications and optimizing patient outcomes.Öğe Acanthamoeba keratitis: new hopes for potential interventions for a curable but often refractory disease(Routledge journals, taylor & francis, 2024) Alawfi, Bader Saleem; Khan, Naveed Ahmed; Lloyd, David; Siddiqui, RuqaiyyahIntroductionOften associated with contact lens wear, Acanthamoeba keratitis is an extremely painful blinding infection that has remained significant despite advances in drug discovery and chemotherapies. Current treatment is intricate and demands early diagnosis, aggressive and prolonged application, and may result in infection recurrence. The latter is due to the ability of the parasite to undergo cellular differentiation and transform into a resistant cyst form or infective trophozoite form. Areas coveredHere, we present a review of our current understanding of emerging therapies and priorities tackling Acanthamoeba keratitis. Literature searches were carried out using bibliographic databases and results sifted and reviewed to present recent findings, challenges and novel opportunities in the development of therapeutic interventions and/or preventative measures against Acanthamoeba keratitis. Expert opinionNanomedicine-based theranostics to combine diagnosis and treatment of Acanthamoeba keratitis offer remarkable opportunity in the development of clinical applications in the management of Acanthamoeba keratitis.Öğe Are we where we want to be in undergraduate pathology education?(Federation Turkish Pathology Societies, 2024) Şensu, Sibel; Erdoğan, NusretObjective: This review which aims to examine the recent and current status of pathology education in medical schools, and covers the publications related to undergraduate pathology education published between 2010 January and June 2023. Material and method: A search was performed through PubMed, Google Scholar, Semantic Scholar, and Ulakbim search engines for the Science Citation Index, Science Citation Index Expanded, Emerging Sources Citation Index, Directory of Open Access Journals, Scopus, PubMed as well as TR Dizin indexed articles. The findings are categorized into two periods as 2010 January - 2020 April (pre-COVID-19 pandemic) and May 2020 - 2023 June. A total of 24 reviews/editorials/letters to the editor and 63 research articles in the pre -pandemic period and 11 reviews/ editorials/ letters to the editor and 35 research articles between 2020 May and 2023 June are included in the analysis. Results: Currently, medical education generally depends on core education programs with defined learning objectives and outcomes. Moreover, problem -based, case -based, and team -based interactive learning are being used along with traditional didactic courses. Additionally, digital/ web-based/remote education methods have gained prominence after the COVID-19 pandemic. The virtual or augmented reality and 3D drawing applications are offered as a solution for the autopsy and macroscopy courses. A scarce number of publications are found on measuring and evaluating the effectiveness of learning. Conclusion: Artificial intelligence in pathology education is a topic that looks likely to become important in the near future. National and international comprehensive standardization is a necessity. A joint effort and collective intelligence are needed to achieve the desired goals in undergraduate pathology education.Öğe Theranostics in the management of Acanthamoeba infections(Elsevier B.V., 2025) Siddiqui, Ruqaiyyah; Lloyd, David; Khan, Naveed AhmedTheranostics in the management of Acanthamoeba infectionsÖğe Adjustable gastric banding(AME Publishing Company, 2021) Gündoğdu, Emre; Moran, MünevverGastric banding is based on the principle of forming a small volume pouch near the stomach by wrapping the fundus with various synthetic grafts. The main purpose is to limit oral intake. Due to the fact that it is a reversible surgery, ease of application and early results, the adjustable gastric band (AGB) operation has become common practice for the last 20 years. Many studies have shown that the effectiveness of LAGB has comparable results with other procedures in providing weight loss. Early studies have shown that short term complications after LAGB are particularly low when compared to the other complicated procedures. Even compared to RYGB and LSG, short-term results of LAGB have been shown to be significantly superior. However, as long-term results began to emerge, such as failure in weight loss, increased weight regain and long-term complication rates, interest in the procedure disappeared. The rate of revisional operations after LAGB is rapidly increasing today and many surgeons prefer to convert it to another bariatric procedure, such as RYGB or LSG, for revision surgery in patients with band removed after LAGB. Other bariatric surgical procedures such as LSG, RYGB, OAGB, and SADS attract attention because of their long-term success in weight loss rates and improvement in metabolic diseases and relatively successful long-term complication rates. Especially, the interest in sleeve gastrectomy (SG), another restrictive procedure, caused a significant reduction in the number of gastric bands. © Annals of Laparoscopic and Endoscopic Surgery. All rights reserved.Öğe Gram-stained smear in the diagnosis of acute urethritis: is it coming to an end?(2024) Sarier, M.; Kasap, E.[No abstract available]Öğe The gut microbiome and female health(MDPI, 2022) Siddiqui, Ruqaiyyah; Makhlouf, Zinb; Alharbi, Ahmad M. M.; Alfahemi, Hasan; Khan, Naveed AhmedSimple Summary A plethora of studies have highlighted the profound role of the gut microbiome in human health. However, there is a lack of studies on female health. Given that females may be more likely to be affected by some ailments such as osteoarthritis, heart disease, cancer, and anxiety, it is imperative to study the effect of the gut microbiome and its role in female health. It is evident that the presence/ratio of microbial species is altered in polycystic ovarian syndrome, cancer, pregnancy, and menopause. Thus, potential probiotics should be developed and the administration of certain bacterial species should be considered, as novel independent or adjunct therapies for various female-related pathologies. Strategies such as the modulation of the gut microbiome via diet and through supplementation with pre/pro/postbiotics in various female health-related issues should be undertaken. The possession of two X chromosomes may come with the risk of various illnesses, females are more likely to be affected by osteoarthritis, heart disease, and anxiety. Given the reported correlations between gut microbiome dysbiosis and various illnesses, the female gut microbiome is worthy of exploration. Herein, we discuss the composition of the female gut microbiota and its dysbiosis in pathologies affecting the female population. Using PubMed, we performed a literature search, using key terms, namely: gut microbiome, estrogen, menopause, polycystic ovarian syndrome, pregnancy, and menstruation. In polycystic ovarian syndrome (PCOS), the abundance of Bacteroides vulgatus, Firmicutes, Streptococcus, and the ratio of Escherichia/Shigella was found to be increased while that of Tenericutes ML615J-28, Tenericutes 124-7, Akkermansia, Ruminococcaceae, and Bacteroidetes S24-7 was reduced. In breast cancer, the abundance of Clostridiales was enhanced, while in cervical cancer, Prevotella, Porphyromonas, and Dialister were enhanced but Bacteroides, Alistipes, and members of Lachnospiracea, were decreased. In ovarian cancer, Prevotella abundance was increased. Interestingly, the administration of Lactobacillus acidophilus, Bifidobacterium bifidum, Lactobacillus reuteri, and Lactobacillus fermentum ameliorated PCOS symptoms while that of a mix of Bifidobacterium lactis W51, Bifidobacterium bifidum W23, Lactobacillus brevis W63, Bifidobacterium lactis W52, Lactobacillus salivarius W24, Lactobacillus acidophilus W37, Lactococcus lactis W19, Lactobacillus casei W56, and Lactococcus lactis W58 alleviated vascular malfunction and arterial stiffness in obese postmenopausal women, and finally, while further research is needed, Prevotella maybe protective against postmenopausal bone mass loss. As several studies report the therapeutic potential of probiotics and since the gut microbiota of certain female pathological states has been relatively characterized, we speculate that the administration of certain bacterial species as probiotics is warranted, as novel independent or adjunct therapies for various female pathologies.
