Ayşenur Uçar

Aims: The aim of this study is to evaluate the role of De Ritis ratio in predicting intra-hospital mortality in patients treated in intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). The De Ritis ratio is calculated using the formula: aspartate aminotransferase (AST)/alanine aminotransferase (ALT).Methods: Data from 414 patients admitted to the ICU with a diagnosis of COVID-19 at a single-center between March 2020 and March 2022 were retrospectively analyzed. Patients were divided into two groups: survivors and deceased patients. Demographic, clinical, and laboratory data of the patients were compared. Between-group comparisons were performed using the Mann-Whitney U test for continuous variables and Chi-square or Fisher’s exact tests for categorical variables, as appropriate. The performance of the De Ritis ratio in predicting mortality was evaluated using ROC curves, the Youden Index and APACHE-inclusive sensitivity model. Model discrimination was assessed using AUC with bootstrap 95% confidence intervals, calibration using the Brier score and Hosmer-Lemeshow test, multicollinearity using variance inflation factors, and internal validation using bootstrap optimism correction.Results: Of the 414 patients, 211 (51.0%) died. The De Ritis ratio was higher among non-survivors than survivors [median 1.61 (IQR 1.14-2.28) vs 1.17 (IQR 0.86-1.61), p

Background/Objectives: Proton pump inhibitors (PPIs) are widely used, but real-world utilisation data from internal medicine settings remain limited. We estimated the screening-period prevalence of self-reported current PPI use among attendees of two internal medicine outpatient clinics and described treatment patterns among current users. Methods: In this single-centre cross-sectional survey in Adana, Türkiye (August 2025–January 2026), 977 consecutively screened adult outpatients were asked about current PPI use; 178 reported current use, and 149 of them (83.7%) completed an investigator-administered questionnaire. Wilson 95% confidence intervals (CIs) were calculated for the prevalence and three prespecified proportions; exploratory ≤6-versus > 6-month comparisons used exact tests with Holm adjustment. Results: Current use was reported by 178/977 outpatients (18.2%; 95% CI 15.9–20.8%). Among users (mean age 57.5 ± 13.6 years; 61.1% women), median reported duration was 54 months (interquartile range 18–84); 86.6% reported use for >6 months and 34.2% for >5 years. Pantoprazole was most common (31.5%). Gastroprotection during non-steroidal anti-inflammatory drug (NSAID) or antithrombotic therapy (45.0%) and dyspepsia (35.6%) were the leading reasons; 80.6% of those citing gastroprotection reported current NSAID or antithrombotic use. Ongoing upper-gastrointestinal symptoms were reported by 77.9% (59.7% of those citing gastroprotection; 100.0% of those citing reflux). Conclusions: Nearly one in five screened outpatients reported current PPI use, and reported exposure was predominantly prolonged. Ongoing symptoms and prolonged use without a documented indication are signals that should prompt structured, individualised medication review.

Objective: In our study, we aimed to examine the possible relationships between the ABO and Rh blood groups and hypertension, type 2 diabetes mellitus, and hyperlipidemia, which are common chronic diseases.Material and Methods: In this retrospective cross-sectional study, patients diagnosed with hypertension, type 2 diabetes mellitus, and hyperlipidemia were examined. The participants' demographic characteristics and ABO and Rh blood types were retrospectively reviewed. The obtained data were analyzed according to age, gender, and blood type. Categorical variables were expressed as numbers and percentages, and differences between groups were evaluated using the χ² test. The statistical significance level was accepted as p0.05).Conclusion: Our results showed that some blood groups (O Rh– and A Rh– ) may be associated with hypertension. These results suggest that blood group information can be used as an auxiliary variable parameter in hypertension risk assessments.

Background: Several studies have demonstrated that adding semaglutide to the treatment of patients with type 2 diabetes mellitus (T2DM) reduces insulin requirements and glycated hemoglobin (HbA1c) levels. This study aimed to investigate real-world evidence for the effects of semaglutide dose escalation on HbA1c, body weight, dyslipidemia, and insulin dose reduction in patients with T2DM in the Cukurova region of Türkiye. Methods: This retrospective cohort study enrolled 500 patients (255 male, 245 female; mean age 56.1 ± 10.8 years) who initiated semaglutide therapy for T2DM between 2024 and 2025. Patients were grouped according to their maximum semaglutide dose: 0.25 mg (Group I), 0.50 mg (Group II), and 1.00 mg (Group III). The primary endpoint was the change in HbA1c from baseline to end of study (30 weeks) across semaglutide dose escalation groups. Secondary endpoints included changes in body weight, frequency of insulin dose reduction, and effects on lipid parameters. Results: A total of 117 patients (23.4%) discontinued semaglutide therapy, while 383 patients (76.6%) completed the study. The primary endpoint revealed a mean HbA1c reduction of −1.03 ± 0.35% from baseline to end of study (95% CI 0.99–1.07; t = 58.644; p < 0.001). Reductions in HbA1c increased progressively from Group I to Group III (HbA1c: −0.72 ± 0.28, −1.02 ± 0.26, −1.27 ± 0.34%). Insulin dose reduction frequency increased significantly from Group I to Group III (40%, 41%, and 51%, respectively; p = 0.010), with a statistically significant difference only between Group I and Group III. At the end of follow-up, rates of hypoglycemic episodes and gastrointestinal (GI) adverse events were similar across groups. Conclusions: In a real-world population from the Cukurova region of Türkiye, semaglutide dose escalation in T2DM patients achieved clinically meaningful glycemic control, body weight reduction, LDL-cholesterol lowering, and a significant increase in insulin dose reduction frequency, without a significant increase in GI adverse events.

Objective: In this study, the disease control status of patients who came to renew their medication reports was compared with that of patients who visited for follow-up, and home blood pressure measurement habits were evaluated in hypertensive patients.Materials and Methods: The records of outpatients who visited the Internal Medicine Outpatient Clinic-13 of Adana Yüreğir State Hospital between 1 January and 14 February 2025 were retrospectively reviewed. A total of 1,774 patient files were screened, and 389 patients with hypertension and 367 patients with type 2 diabetes were identified. Patients were divided into two groups based on their reason for presentation: those who came to renew their medication prescriptions and those who came for follow-up. Hypertension was considered controlled if systolic blood pressure was

The goal is to provide foundational data that could spearhead more extensive, prospective research into understanding the influences of micronutrient levels on the nocturnal patterns of hypertension, possibly aiding in identifying potential therapeutic strategies to reduce cardiovascular risk in this demographic. The research employed a retrospective design to analyze the micronutrient levels, including ferritin, folic acid, vitamin B12, and vitamin D, in a limited sample size from a single hospital. However, it is worth noting that the study did not scrutinize other potentially relevant micronutrients and biomarkers and lacked information on potential confounding factors such as lifestyle and dietary habits, physical activity levels, and specific details on antihypertensive medications used. The preliminary findings highlight a significant difference in ferritin levels between dipper and non-dipper groups, indicating a potential role in the development of non-dipper hypertension. Surprisingly, no notable difference was observed in vitamin D levels between the groups. The study underscores the increasing prevalence of hypertension and micronutrient deficiencies as age progresses. Despite its limitations, including limited sample size and potential influences from unaccounted variables, the study hints at a potential relationship between micronutrient levels and non-dipper hypertension. It emphasizes the necessity for larger scale, prospective research to delve deeper into the nature of this relationship, potentially fostering new therapeutic approaches in cardiovascular risk management within the elderly population.

Pertuzumab-mediated Cardiotoxicity: A Single Center Study. Objective: Recent clinical trials have shown that adding pertuzumab to trastuzumab improved the cellular response to therapy and provides a survival benefit compared with trastuzumab alone. However, it has raised concerns about additive risk of cardiotoxicity. Real life data on pertuzumab-induced cardiotoxicity are limited. Materials and Methods: Patients a diagnosis of breast cancer who had been treated trastuzumab plus pertuzumab between January 2017 and June 2022 and had undergone regularly transthoracic echocardiography, as a part of control visits, in our medical center were included. We performed descriptive statistical analysis to evaluate the patients’ characteristics and therapies, which could increase the risk of cardiac adverse events. Cardiotoxicity was evaluated by serial left ventricular ejection fraction (LVEF) measuring by 2D echocardiography at baseline and every three months during pertuzumab therapy and was defined as a decrease in LVEF > 10% to below 55%. Results: There were 118 patients fulfilling the inclusion criteria. The median age of the population was 51 (41-60) years. The median duration of pertuzumab therapy was 15 (9–57) weeks. Pertuzumab therapy was discontinued in two patients because of an allergic reaction and in other two patients due to cardiotoxicity. The reduced LVEF did not recover to baseline values in either patient. Conclusion: The incidence of cardiotoxicity (1.69%) in the current study was no higher than expected for trastuzumab alone. Data from previous studies and the results of this study support that pertuzumab causes no increase in cardiotoxicity. Still, large clinical trials are needed to verify the cardiac safety of pertuzumab in a real-world setting.