İrEm Kirac Utku

Background/Objectives: Comparative real-world evidence on early body-weight changes during semaglutide and tirzepatide treatment remains limited, particularly in populations with unequal and irregularly timed follow-up. To compare longitudinal percentage changes in body weight between adults initiating semaglutide and those initiating tirzepatide and to describe changes in anthropometric measures, weight-loss responses, and exploratory metabolic outcomes. Methods: This retrospective, single-center, real-world longitudinal cohort study included adults aged ≥18 years initiating semaglutide or tirzepatide for weight management, with a body mass index (BMI) ≥30 kg/m² or ≥27 kg/m² with a weight-related comorbidity. Patients with type 2 diabetes and concomitant obesity were eligible. Participants were naïve to incretin-based therapy; pregnancy, previous bariatric surgery, and active malignancy were exclusion criteria. Anthropometric and laboratory data were extracted from clinical records. Percentage body-weight change over days 1–230 was analyzed using a linear mixed-effects model incorporating exact follow-up time and adjusting for age, sex, baseline BMI, and diabetes status. Scheduled-visit and sensitivity analyses were also performed. Results: The cohort included 184 patients: 94 (51.1%) receiving semaglutide and 90 (48.9%) receiving tirzepatide. Overall, mean age was 41.7 ± 12.0 years, baseline weight was 97.0 ± 17.9 kg, and 139 patients (75.5%) were female. The longitudinal analysis included 345 measurements from 148 patients (80.4%). The treatment-by-time interaction was significant (p = 0.002). Adjusted weight changes with semaglutide versus tirzepatide were −3.39% versus −4.44% at month 1 (p = 0.116), −8.38% versus −11.52% at month 3 (p < 0.001), and −14.40% versus −15.06% at month 6 (p = 0.699). Sensitivity analyses yielded consistent findings. Only four tirzepatide-treated patients had measurements within the month 6 visit window; therefore, the month 6 estimate for this group relied primarily on the model and requires cautious interpretation. Conclusions: Both semaglutide and tirzepatide were associated with early reductions in body weight. Tirzepatide was associated with larger model-adjusted weight loss at month 3 (between-group difference, −3.14 percentage points; 95% CI, −4.55 to −1.74; p < 0.001), whereas no statistically significant between-group difference was observed at month 1 (p = 0.116). Only four tirzepatide-treated patients had measurements within the month 6 visit window, limiting the reliability of this comparison. Longer-term comparisons require cohorts with more balanced follow-up and more observations at later time points.

Brucellosis is a zoonotic infection with a wide clinical spectrum, ranging from nonspecific symptoms to severe focal involvement. Focal involvement significantly affects disease prognosis, yet early prediction remains challenging. Easily accessible inflammatory markers may provide a practical solution for early risk stratification. The aim of this study was to evaluate clinical and laboratory factors associated with focal involvement in brucellosis and to investigate the predictive value of inflammatory markers, particularly C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). This retrospective observational study included adult patients diagnosed with brucellosis between January 2021 and December 2025 at a tertiary care center. Focal involvement was defined based on clinical findings confirmed by imaging modalities. Demographic, clinical, epidemiological, and laboratory data were collected. Patients were divided into focal and non-focal groups. Multivariate logistic regression analysis was performed to identify independent predictors. Receiver operating characteristic (ROC) analysis was used to assess predictive performance and determine optimal cut-off values. A total of 173 patients were included, of whom 54 (31.2%) had focal involvement. Osteoarticular involvement, particularly spondylodiscitis, was the most common presentation. Patients with focal involvement were older and had significantly higher CRP, erythrocyte sedimentation rate, NLR, and MLR levels (p < 0.05). In multivariate analysis, CRP (OR 1.015, 95% CI 1.004-1.028, p = 0.003) and NLR (OR 1.341, 95% CI 1.012-1.778, p = 0.041) were identified as independent predictors. The combined CRP-NLR model demonstrated moderate discriminative ability (AUC: 0.714). Optimal cut-off values were 42 mg/L for CRP and 1.62 for NLR. Focal involvement in brucellosis is more closely associated with systemic inflammatory response than epidemiological factors. CRP and NLR may serve as cost-effective and clinically useful markers for early identification of patients at risk. Their combined use may support early decision-making and guide the need for further diagnostic evaluation. Larger prospective studies are needed to validate these findings. Not applicable.

Aims: Urinary incontinence (UI) is a highly prevalent condition among geriatric women and represents a major public health concern due to its negative effects on quality of life, functional status, and healthcare utilization. This study aimed to comprehensively evaluate the scientific literature on UI in geriatric women using bibliometric analysis. Methods: Bibliographic data were retrieved from the Web of Science Core Collection, including English-language journal articles published between 1965 and 2025 that focused on UI in geriatric women. Bibliometric indicators such as publication trends, citation patterns, prolific authors, journals, countries, and international collaboration networks were analyzed using the Bibliometrix package in R and VOSviewer software.Results: A total of 2,430 articles published in 580 journals were included, comprising 9,808 unique authors and 2,862 keywords. The mean number of citations per article was 27.5. The United States was the leading country in terms of publication output and international collaboration. Dumoulin was the most prolific author, while Burgio demonstrated the highest h-index and total citation count. Keyword analysis revealed that “UI,” “menopause,” and “overactive bladder” were the most frequently occurring terms, indicating a strong focus on clinical and hormonal aspects of the condition.Conclusion: This bibliometric analysis demonstrates a substantial growth in research on UI among geriatric women, with scientific productivity concentrated in a limited number of countries and journals. The findings provide an overview of global research trends and highlight important gaps to guide future studies in geriatric women’s health.

Introduction: This study aimed to evaluate patient characteristics, reasons for admission, and clinical outcomes, with a particular focus on comparing the one-month mortality rates of adult patients with and without cancer admitted to a palliative care unit.Methods: A total of 513 adult patients admitted to the Palliative Care Center of Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul, Turkey, between January 2020 and January 2022 were retrospectively analyzed. Data collected included demographic characteristics, length of hospital stay, primary diagnoses, reasons for admission, and discharge outcomes. The one-month mortality rates of patients with malignant versus non-malignant conditions were compared.Results: The mean age of the patients was 73.2 ± 14.9 years; 54% were male and 46% were female. The most frequent reasons for admission were nutritional problems (48.9%), pain (27.4%), and the need for caregiver support (13.4%). The mean duration of hospitalization was 13.05 ± 16.2 days. Among all patients, 11.6% were transferred to the intensive care unit (ICU), 20.6% died during hospitalization, and 67.8% were discharged. Lung cancer was the most prevalent malignancy (20.4%), representing 37.2% of all cancer cases. The overall one-month mortality rate was 31.9%. Patients with malignant disease had a significantly higher one-month mortality rate (49.7%) compared with those with non-malignant disease (21.4%) (p = 0.001).Conclusion: The majority of patients admitted to the palliative care facility were elderly, with pain, nutritional problems, and caregiver support needs being the primary reasons for admission. Patients with malignancy demonstrated substantially higher one-month mortality rates. These results emphasize the importance of initiating palliative care at earlier stages in cancer patients.

Aims: Osteosarcopenia, the coexistence of osteoporosis and sarcopenia, is increasingly recognized as a key geriatric syndrome associated with frailty, falls, fractures, disability, and mortality. We aimed to map worldwide publication trends and thematic evolution in osteosarcopenia research.Methods: We performed a bibliometric analysis of Web of Science Core Collection publications from 2001 to October 2025, restricted to English-language open-access articles with a geriatric and musculoskeletal focus. Analyses included annual scientific production, source and country productivity, keyword co occurrence, thematic mapping, thematic evolution, and multiple correspondence analysis (MCA). Results: A total of 1,514 articles were identified, with a marked growth in publications after 2017. The most productive countries were China, the United States, and Japan. Core themes centered on sarcopenia, osteoporosis, bone mineral density, and muscle, while thematic analyses highlighted both clinical epidemiological domains and emerging mechanistic topics. MCA suggested a dual-axis conceptual structure linking clinical foundations with biological mechanisms. Conclusion: Osteosarcopenia research has expanded rapidly since 2017 and evolved into a multidisciplinary domain. These findings support the need to integrate osteosarcopenia into geriatric risk stratification and preventive strategies.

Aims: To evaluate the clinical characteristics, multidisciplinary service utilization, and psychosocial experiences of older adults receiving care from a community-based Healthy Aging Centre (YAŞAM) in Turkiye.Methods: This mixed-methods study included adults aged ≥75 years who received services between August 2023 and August 2025. Quantitative data from 383 participants were analyzed to describe sociodemographics, Comprehensive Geriatric Assessment findings, and patterns of multidisciplinary service use. For the qualitative component, semi-structured interviews were conducted with eight purposefully selected participants and analyzed using Braun and Clarke’s thematic approach. Results: Participants were predominantly very old adults with multimorbidity, moderate frailty, and partial dependence in daily activities. Dietitian, physiotherapy, psychology, and social work services were used more frequently by individuals with malnutrition risk, IADL dependency, frailty, depressive symptoms, or limited social support. Older age alone (≥80 years) did not predict higher service utilization. Thematic analysis revealed six key themes: satisfaction and gratitude; feelings of safety and support; feeling valued and respected; loneliness and the need for socialization; acceptance of aging; and inner change and self-awareness. Emotional security, accessible support, and respectful communication emerged as core strengths of the model. Conclusion: The YAŞAM model meets both medical and psychosocial needs by providing integrated, community-based geriatric care, reinforcing safety, dignity, and social connectedness. These findings highlight the value of multidisciplinary, community oriented services in supporting functional and emotional well-being in aging populations.

Candida species are important causes of morbidity and mortality, with increasing antifungal resistance representing a major clinical challenge. Guideline a

Background and Objectives: Rapid physiological decline in terminal cancer is frequently accompanied by accelerated skeletal muscle loss. Although bedside ultrasonography (US) is practical and feasible in palliative care settings, the prognostic relevance of short-term muscle change remains unclear. This study aimed to evaluate whether the rate of muscle loss over a 10-day period, assessed by serial ultrasound, is associated with survival duration in terminally ill cancer patients. Materials and Methods: This single-center retrospective cohort study included 87 inpatients with end-stage cancer who underwent bedside ultrasound measurements of the biceps brachii (BB) and rectus femoris (RF). Baseline US was performed within the first three days of admission, followed by a repeat assessment 10 days after baseline (day-10 follow-up ultrasound). Muscle thickness (MT) measurements were normalized by height squared (m²), and 10-day changes were calculated as delta (Δ) indices, defined as baseline minus day-10 values. Because the exposure of interest (Δ) can only be determined after completion of the day-10 assessment, survival timing analyses were anchored to this prespecified landmark. Survival duration was defined as the number of days from the day-10 follow-up ultrasound to death among patients who died within one year. Associations between muscle changes and survival duration were evaluated using correlation analyses and multivariable linear regression adjusted for age, sex, body mass index, Eastern Cooperative Oncology Group (ECOG) performance status, and nutritional risk. The primary analyses focused on survival timing among decedents. Results: Significant muscle loss was observed over the 10-day interval between baseline and 10 days after baseline. Among the 58 patients who died within one year, greater short-term biceps muscle loss, reflected by higher Δ BB muscle thickness index (Δ BB MT-I), was moderately associated with shorter survival duration (r = −0.437, p = 0.0006). In multivariable linear regression analysis, Δ BB MT-I remained independently associated with survival duration (β = −701.19; 95% CI: −1102 to −301; p = 0.0006), whereas RF muscle changes and baseline clinical variables were not statistically significant. Conclusions: Short-term biceps muscle loss assessed by serial ultrasound, as reflected by Δ BB MT-I, is associated with shorter survival duration in terminally ill cancer patients. These findings suggest that dynamic muscle changes, rather than single-time-point measurements, may provide clinically meaningful insight into short-term survival timing. Serial bedside muscle ultrasound may serve as a low-burden adjunct for prognostic communication in palliative care, although prospective time-to-event studies are required for validation.

Aims: This study aimed to evaluate the relationship between neutrophil-to-lymphocyte ratio (NLR) and short-term (30-day) and long-term (1-year) mortality in palliative inpatients without evidence of infection; to assess the correlation between NLR and time to death; and to determine whether NLR predicts short-term mortality independent of age, functional status, and nutritional risk. Methods: Medical records of patients admitted between January 1, 2019 and January 1, 2021 were retrospectively analyzed. Patients with clinical or laboratory evidence of infection or receiving immunosuppressive therapy were excluded, yielding 335 patients. Demographics, diagnoses, laboratory values, ECOG scores, and NRS-2002 were recorded. NLR was calculated from admission blood counts. Group comparisons used Mann–Whitney U, correlations used Spearman, and predictors of 30-day mortality were tested with multivariate logistic regression including age, NLR, ECOG, and NRS-2002; ROC analysis provided AUC and optimal cut-off. Results: Mean age was 72.3±15.2 years; 54.9% were male; 40.8% had malignancy. NLR was higher in those dying within 30 days (median 9.33 vs. 4.00; p=0.001) and 1-year (median 6.78 vs. 4.01; p=0.001), and correlated with day of death at 30 days (ρ=0.316; p=0.0016). Multivariate analysis identified NLR as an independent predictor of 30-day mortality (OR=1.18; 95% CI: 1.12–1.25; p