Celal Kuş

Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is a significant complication that impairs lung function and increases morbidity. Sarcopenia, characterized by the loss of muscle mass and function, is commonly found in chronic diseases such as systemic sclerosis. This study aimed to evaluate the prevalence of sarcopenia in patients with SSc-ILD and investigate its cross-sectional associations with pulmonary function test parameters, estimated pulmonary artery pressure and quantitative radiological lung involvement. In this cross-sectional study conducted between 2024 and 2025, 40 patients with systemic sclerosis (2013 ACR/EULAR criteria) and high-resolution computed tomography-confirmed interstitial lung disease were evaluated. Patients with overlap myositis, acute infections, severe orthopedic/neurological limitations, and end-stage organ failure were excluded. Sarcopenia was diagnosed based on European Working Group on Sarcopenia in Older People 2 criteria using muscle mass (bioelectrical impedance analysis) and handgrip strength measurements. Pulmonary function tests (FVC, single-breath transfer factor of lung for carbon monoxide), echocardiographic sPAP estimations, and quantitative high-resolution computed tomography lung density analysis were performed. These findings highlight the potential impact of sarcopenia on lung function and the association of sarcopenia with radiological findings in SSc-ILD SSc-ILD. Among the 40 analyzed patients (mean age: 55.8 ± 10.8 years, 85.0% female, mean BMI: 28.7 ± 5.0 kg/m ² ), sarcopenia was identified in 10 patients (25.0%). Patients with and without sarcopenia were compared to analyze its effects on pulmonary function and radiological findings. Patients with sarcopenia had significantly lower lung diffusion capacity (transfer factor of lung for carbon monoxide) and forced vital capacity % values and significantly higher radiological lung involvement compared to those without sarcopenia ( P = .004, P = .023, and P = .035, respectively). Systolic pulmonary artery pressure was also significantly higher in sarcopenic patients ( P = .031). Additionally, fat-free mass index, fat-free mass, muscle mass, and handgrip strength were significantly lower in sarcopenic patients ( P < .001).

Aim: Autism Spectrum Disorder (ASD) is a growing social health issue. Primary healthcare institutions are where children most commonly seek help, and family physicians in primary care play a crucial role in early ASD detection. This study aims to assess the knowledge level, behaviours, and attitudes of family physicians and family medicine residents across Turkey, identify factors affecting their knowledge, and raise awareness among physicians.Subject and Methods: This descriptive cross‐sectional study was conducted between March and June 2022, with the participation of family medicine specialists, residents, and practicing physicians in Turkey. A 50‐question survey was administered face‐to‐face and digitally. The survey comprised 31 questions on sociodemographic information, factors influencing knowledge, attitudes and behaviours about ASD. The second part included a 19‐question “Knowledge about childhood autism among health workers” (KCAHW) questionnaire.Results: The study included 392 physicians with a mean age of 32.8 ± 7.9; 60.7% were women. Among the participants, 50.3% were family medicine residents, 21.7% were family medicine specialists, 17.0% were family physicians and 11.0% were contracted family medicine residents. The physicians' mean KCAHW score was 14.1 ± 2.6. Screening for ASD and following ASD were significantly associated with the perception of knowledge level (p = 0.004; p = 0.028, respectively). A statistically significant relationship was found between paediatric rotation, education about ASD, patient follow‐ups and the KCAHW scores. Moreover, 98.2% of physicians believed children with ASD should receive special education, while 79.6% thought ASD carried a social stigma, and 52% believed an ASD diagnosis could lead to discrimination.Conclusion: The study found that participants lacked knowledge about comorbidities with ASD, atypical presentations of ASD, and guiding individuals with ASD. However, having a paediatric rotation, receiving ASD training and following up on children with ASD were associated with increased knowledge levels. Screening for and following up on children with ASD also boosted physicians' self‐confidence.

Background: Obesity is one of the most important health problems in the world. It affects all systems, especially the respiratory and cardiovascular systems. Laparoscopic sleeve gastrectomy is an effective method in the treatment of obesity and can improve respiratory functions. We aimed to evaluate the effects of surgery on pulmonary function in patients with obesity. Methods: A retrospective analysis was conducted on a group of patients who underwent sleeve gastrectomy. This study assessed pre-operative and long-term pulmonary function in patients who underwent laparoscopic sleeve gastrectomy between 2009 and 2015, with a minimum follow-up of 10 years. Patients were stratified based on smoking status and presence of comorbidities. Results: The study included 51 patients (82.4% female) with a mean age of 51.90 ± 11.57 years. Significant weight loss and reductions in BMI were observed postoperatively. Mean pre-operative BMI was 47.53 ± 6.95 and significantly decreased to 37.75 ± 6.02 post-operatively, BMI reduction rate was %22 (p < 0.001). Pulmonary function tests demonstrated significant improvements in FEV1 (2.65 ± 0.69 to 2.76 ± 0.67, p = 0.044), FEV1% (92.07 ± 15.31 to 97.98 ± 14.45, p = 0.001), PEF (74.01 ± 18.12 to 91.53 ± 24.16, p < 0.001), and MEF25-75 (77.17 ± 22.07 to 108.57 ± 28.11 p < 0.001) after surgery. These improvements were consistent across different subgroups, including smokers, non-smokers, and patients with and without comorbidities. Non-smokers exhibited a greater percentage increase in FEV1 compared to smokers. While there was an increase in FEV1 among patients with comorbidities, this difference was not statistically significant. Conversely, patients without comorbidities demonstrated a significant improvement in FEV1. Conclusion: Bariatric surgery is associated with significant improvements in pulmonary function in obese patients, regardless of smoking status or comorbidities.

Objective: This study was conducted to evaluate the effects of internet-social media use on depression and cognitive functions in individuals aged 50 and over. Method: This research is a cross-sectional descriptive study. The sample of the research consisted of 398 people. Data were collected by face-to-face interview using a questionnaire, Geriatric Depression Scale-Short Form and Montreal Cognitive Assessment Scale. Results: The average age of the participants in the study was determined as 59.8±7.8 years. It was determined that 40.7% of individuals use social media, 23.9% find social media useful, and 37.4% use social media for communication purposes. It was determined that independent variables such as age, education, income level, and whom one lives with at home significantly affected the depression level and cognitive dysfunction parameters (p

Objective: The post-COVID-19 process is not completely understood, as it affects COVID-19 survivors at all levels of disease severity, not all of whom are hospitalized. One of the long-lasting COVID-19 symptom categories, cardiovascular disorders (including acute heart failure, palpitations, hypotension, venous thromboembolic diseases, arrhythmias, myocarditis, and increased heart rate), may derive from a systemic inflammatory response to the viral infection. NETs (neutrophil extracellular traps) that fight invading viruses in extracellular cardiac spaces accumulate due to COVID-19, hyperinflammation and cytokine storms. Our study focuses on cardiovascular disorders as COVID-19 sequelae. To determine the role of NETs in these disorders, we aimed to measure levels of PAD4, MPO, MMP-9, and H3Cit. Methods: In this study, forty people with long-term cardiac complications associated with a history of COVID-19 were recruited along with forty healthy people. Results: We found significant differences in PAD4, H3Cit, and MPO plasma levels between the post-COVID-19 and control groups (p values < 0.05). The expression levels of PAD4 mRNA were lower and MMP-9 mRNA levels was higher in the post-COVID-19 group compared with the control subjects. Conclusion: These findings suggest that PAD4, MPO, MMP-9, and H3Cit are potential biomarkers of NET dysregulation and may cause post-COVID-19 symptoms, especially cardiovascular disorders. Amaç: COVID-19 sonrası süreç, tamamı hastaneye yatırılmayan, hastalık şiddetinin her seviyesindeki COVID-19 mağdurlarını etkilediği için tam olarak anlaşılamamıştır. Uzun süreli COVID-19 semptom kategorilerinden biri olan kardiyovasküler bozukluklar (akut kalp yetmezliği, çarpıntı, hipotansiyon, venöz tromboembolik hastalıklar, aritmiler, miyokardit ve artmış kalp hızı dahil), viral enfeksiyona sistemik bir inflamatuar yanıttan kaynaklanabilir. Hücre dışı kalp boşluklarında istilacı virüslerle savaşan NET'ler (nötrofil hücre dışı tuzakları), COVID-19, hiperinflamasyon ve sitokin fırtınaları nedeniyle birikir. Çalışmamız, COVID-19 sekeli olarak kardiyovasküler bozukluklara odaklanmaktadır. NET'lerin bu bozukluklardaki rolünü belirlemek için PAD4, MPO, MMP-9 ve H3Cit düzeylerini ölçmeyi amaçladık. Yöntemler: Bu çalışmada, COVID-19 öyküsü ile ilişkili uzun süreli kardiyak komplikasyonları olan kırk sağlıklı insanla birlikte çalışmaya alındı. Bulgular: COVID-19 sonrası ve kontrol grupları arasında PAD4, H3Cit ve MPO plazma seviyelerinde anlamlı farklılıklar bulduk (p değerleri < 0,05). PAD4 mRNA'nın ekspresyon seviyeleri, kontrol deneklerine kıyasla COVID-19 sonrası grupta daha düşük ve MMP-9 mRNA seviyeleri daha yüksekti. Sonuç: Bu bulgular, PAD4, MPO, MMP-9 ve H3Cit'in NET düzensizliğinin potansiyel biyobelirteçleri olduğunu ve özellikle kardiyovasküler bozukluklar olmak üzere COVID-19 sonrası semptomlara neden olabileceğini düşündürmektedir.

Objective: The aim of this study is to investigate the society’s approach to violence and to offer solutions to prevent violence in health. Method: This study was conducted in Kahramanmaraş province in February and March 2020. The questionnaire of 50 questions was applied to 1306 people face-to-face. Results: 53.8% of our participants were female. Among the people who had an argument with healthcare providers, 53.0% of them were male. 40.2% of the people who had an argument were aged 25-40. 78.1% have a high school or less education. 86.6% of the ones who considered violence as a tool of demanding justice had high school. Only 19.2% of the people who consider violence as demanding justice had information about code white. 82.9% of the people who state that the most significant reason for the violence is the attitude of healthcare providers had a high school or lower level of education. Participants were asked about the reasons for violence, and 44.0% of them answered that it was the presence of angry and aggressive people. Conclusion: Violence in the health sector has many complicated and intertwined aspects. Its solution is for the people in charge to do their part.

Objective: The most common complaints about chest diseases that we encounter in family practice centers are of asthma and Chronic obstructive pulmonary disease (COPD). Thus, it was aimed to evaluate the attitudes, behaviors and knowledge level of family physicians on asthma and COPD. Methods: Our research is a descriptive cross-sectional study. Our study was conducted between September-November 2019 by including family physicians, family physician research assistants and family physician specialists. 387 physicians participated in the study. The 35-question survey in our study consists of sociodemographic data and consists of questions aiming to evaluate the knowledge level, attitudes and behaviors on asthma-COPD. Results: A total of 387 family physicians including 251 family physicians, 31 family physician specialists and 105 family physician research assistants were included in this study. When the rates of using the spirometry device in suspected asthma-COPD, were compared, the difference between family medicine research assistants and family physicians was found to be statistically significant (p<0.001). When the rates of answer to the “Would you give pneumococcal and influenza vaccines to your patients over 65 years of age?” question were compared, the difference between family medicine specialist and family medicine research assistants and family physicians was found to be statistically significant (p<0.001) Conclusion: According to our study, it was seen that family physicians do not possess sufficient knowledge about asthma-COPD and there are severe shortcomings in diagnosis and treatment stages. Active, applied training seminars should be given importance in primary care, practical guides that physicians can easily reach and communication channels with chest diseases specialists should be increased.