Hande Nur Erölmez

Introduction: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cardiovascular disorder and a leading cause of vascular mortality. MicroRNAs (miRNAs) are small endogenous noncoding RNAs that regulate gene expression post-transcriptionally by binding to the target messenger RNAs (mRNAs), inducing mRNA degradation or translational repression. miRNA dysregulation likely contributes to VTE pathogenesis. This review comprehensively summarizes current evidence on miRNAs in VTE, offering a structured overview of the existing literature. Materials and Methods: Eligibility criteria were defined using the Population, Intervention/Exposure, Comparator, Outcomes, and Study design (PICOS) framework. A comprehensive literature search in PubMed and EMBASE was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Given methodological heterogeneity, a narrative synthesis was undertaken. Results: Among the 156 studies included in this review, 99 investigated miRNAs in DVT, 25 examined the role of miRNAs in PE, and 32 evaluated miRNA involvement in VTE. These miRNAs were categorized as prothrombotic, antithrombotic, or unclassified based on their reported functional roles. Conclusions: This systematic review highlights the impact of miRNAs in the pathophysiology of VTE and provides a resource for future mechanistic and translational research. The findings emphasize the need for standardized, large-scale studies focusing on human-specific models to validate miRNAs as diagnostic, prognostic biomarkers, and as therapeutic targets in VTE.

Aims: Human papillomavirus (HPV) infection is among the most prevalent sexually transmitted infections worldwide and a leading cause of cervical dysplasia and cervical cancer. Despite growing public health programs, patient knowledge regarding HPV transmission, prevention, and clinical implications remains inconsistent. Anxiety and sexual concerns may occur in women with HPV positivity and/or cervical dysplasia, but their association with HPV knowledge remains unclear. Methods: This cross-sectional study enrolled 364 patients referred to a gynecological oncology outpatient clinic with HPV positivity and/or cervical dysplasia. Sociodemographic data, including age, marital status, education level, contraceptive use, and smoking status, were collected. HPV knowledge was assessed using the validated Turkish version of the HPV knowledge scale. Anxiety and sexual function were assessed using the Beck Anxiety Inventory (BAI) and the Index of Female Sexual Function (IFSF). Statistical analyses included Pearson and Spearman correlations, simple and multivariate linear regression, and logistic regression. Significance was set at p

The exchange programs organized by the European Young Family Doctors Movement (EYFDM) under the leadership of the World Organization of Family Doctors (WONCA) offer young family physicians the opportunity to learn about primary healthcare systems in different countries. Prior to the Primary Care Show 2025 conference held in Birmingham, UK, on May 14-15, 2025, a two-day exchange was run as part of the Royal College of General Practitioners (RCGP) Primary Care Show 2025 exchange program. The exchange program enabled an insight into the UK's primary healthcare system. General Practitioner (GP) trainees and GPs in their first five years of training across the world were invited to attend a pre-conference exchange. Primary care services observation included preventive healthcare, chronic disease management, women's health services, and vaccination. Significant shared learning and development took place for hosts, exchange delegates, and the organising committee.

Evans syndrome (ES) is a rare autoimmune disorder characterized by the coexistence of immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA).

Background and Objectives: Sarcopenia is a common yet underrecognized condition in cancer patients and is associated with increased treatment-related toxicity, functional decline, and poor clinical outcomes. Practical, rapid, and bedside-applicable tools are needed to detect sarcopenia early in routine oncology practice. This study aimed to evaluate the diagnostic value of rectus femoris muscle ultrasonography within an integrated clinical assessment combining handgrip strength and bioelectrical impedance analysis for the detection of sarcopenia in cancer patients. Materials and Methods: In this prospective cross-sectional study, 147 adult patients with malignancy were evaluated using a multimodal sarcopenia assessment framework. Muscle strength was assessed by handgrip dynamometry, muscle mass was estimated using bioelectrical impedance analysis (BIA)-derived appendicular skeletal muscle mass index (ASMI), and muscle morphology was evaluated using ultrasonographic measurements of the rectus femoris and biceps brachii muscles. Sarcopenia was defined and classified according to the EWGSOP2 criteria. Associations between clinical variables, BIA parameters, and ultrasonographic measurements were analyzed. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of muscle ultrasonography for sarcopenia detection. Results: The mean age of the study population was 60.2 ± 11.2 years, and 51% of participants were male. Confirmed sarcopenia was identified in 12.2% of patients, while 27.2% were classified as having probable sarcopenia. Sarcopenic patients were significantly older (68.5 ± 7.6 vs. 59.0 ± 11.2 years, p = 0.001) and had lower handgrip strength (15.8 ± 6.0 vs. 24.3 ± 8.4 kg, p < 0.001) and ASMI values (5.96 ± 0.64 vs. 7.23 ± 1.18 kg/m², p < 0.001). Rectus femoris muscle thickness was significantly reduced in patients with sarcopenia (6.40 ± 1.42 vs. 8.19 ± 2.21 mm, p = 0.001). Rectus femoris muscle thickness demonstrated good diagnostic performance for sarcopenia detection (AUC = 0.752; 95% CI: 0.650–0.853; p = 0.001), with an optimal cut-off value of ≤7.59 mm (sensitivity 83.3%, specificity 61.2%). Conclusions: Rectus femoris muscle ultrasonography is a practical, rapid bedside assessment for detecting sarcopenia in cancer patients. When integrated with handgrip strength and BIA, this multimodal approach provides a feasible, radiation-free strategy for early sarcopenia screening in routine oncology practice.

Background: Chemotherapy-induced nausea and vomiting (CINV) remains one of the significant challenges in oncology despite guideline-based prophylaxis, particularly in patients receiving highly emetogenic chemotherapy (HEC). While neurokinin-1 (NK-1) receptor antagonists are established as a key component of standard antiemetic regimens, evidence of their phase-specific effectiveness in real-world, homogeneous patient populations remains limited. This study aimed to determine which antiemetic regimen provides optimal control in each CINV phase to support a tailored prophylactic approach. Methods: This single-center, retrospective, real-world study included 260 female patients with stage II–III breast cancer receiving anthracycline–cyclophosphamide-based HEC. All patients had similar demographic and clinical characteristics, forming a relatively homogeneous cohort. Each received a triple antiemetic regimen consisting of a 5-HT₃ receptor antagonist, dexamethasone, and an NK-1 receptor antagonist (either a single-dose intravenous fosaprepitant or a 3-day oral aprepitant). Complete response (no vomiting and no rescue therapy) and no-vomiting rates were assessed in the acute (0–24 h), delayed (24–120 h), and overall (0–120 h) phases. Results: In this relatively homogeneous cohort of high-risk patients, fosaprepitant-based prophylaxis achieved better symptom control during the acute phase, whereas aprepitant-based regimens were more effective in the delayed and overall phases. These findings suggest phase-specific variations in antiemetic effectiveness that reflect pharmacokinetic and administration-route differences rather than population heterogeneity. Conclusions: This real-world analysis demonstrates that antiemetic effectiveness varies by CINV phase, even within a relatively homogeneous, high-risk patient cohort. The results highlight the importance of phase-tailored prophylactic strategies to optimize symptom control and improve patient quality of life in highly emetogenic chemotherapy settings.

Background and Objectives: KRAS genes are among the most prominent oncogenes that trigger tumor formation in colorectal cancer (CRC) and serve as predictive biomarkers for resistance to anti-EGFR therapies in metastatic colorectal cancer (mCRC) patients. However, the prevalence and mutation spectrum of the KRAS gene family in mCRC patients in Turkey have not been sufficiently analyzed. This study investigates the frequency and distribution of mutations in the KRAS gene family across different regions of Turkey and examines gender-related variations. Materials and Methods: This multicenter observational study included 2458 histologically confirmed mCRC patients collected from 52 centers across Turkey. In a central laboratory, KRAS mutations in codons 12 and 13 were analyzed using polymerase chain reaction (PCR). Statistical analyses were performed using chi-square tests and Monte Carlo simulations, with a significance threshold set at p < 0.05. Results: Depending on the region, KRAS mutations were detected in 45% of patients, ranging from 39.6% to 47.5%. The mutation rate was significantly higher in female patients (48.8%) compared to male patients (42.6%) (p = 0.002). Codon 12 mutations were more frequent than codon 13 mutations. G12D, G12V, and G13D mutations accounted for 80% of all detected mutations. The G12V mutation was prevalent in female patients (p = 0.007). Based on region, mutation diversity was similar, and no statistically significant difference was found (p > 0.05). Conclusions: This large-scale, multicenter study provides the most comprehensive dataset of KRAS mutations in mCRC patients in Turkey. This study revealed regional trends, as well as gender differences. The findings highlight the importance of routine KRAS genotyping in guiding personalized treatment strategies, especially regarding candidate selection for anti-EGFR therapies. Further research is required to elucidate the prognostic and therapeutic implications of specific KRAS mutations.

Background and Objectives: CDK4/6 inhibitors (CDK4/6i) have revolutionized the treatment of hormone receptor-positive HER2 negative (HR(+)/HER2(-)) breast cancer. Despite their efficacy, interstitial lung disease (ILD) remains a rare but potentially fatal adverse effect. This study aims to evaluate the incidence and clinical characteristics of ILD associated with CDK4/6 inhibitors in breast cancer patients in Turkey. Materials and Methods: A retrospective multicenter analysis included 464 breast cancer patients treated with CDK4/6 inhibitors between January 2017 and April 2024. Patients receiving ribociclib or palbociclib were evaluated for the development of ILD. Radiological assessments were performed to confirm ILD and exclude other conditions. Clinical characteristics, treatment regimens, and outcomes were analyzed. Results: ILD was identified in 10 patients (2.1%). The average age of the affected patients was 62.5 ± 9.85 years. Hypersensitivity pneumonitis and nonspecific interstitial pneumonia (NSIP) were the most common radiological patterns. Palbociclib was implicated in six cases, while ribociclib was associated with four cases. Grade 3 pulmonary toxicity was observed in eight patients, and Grade 4 toxicity in two patients. One patient who was on palbociclib died due to ILD. No significant correlation was found between ILD and age, smoking status, lung metastases, or prior thoracic radiotherapy. Conclusions: The incidence of CDK4/6 inhibitor-associated ILD in Turkish breast cancer patients appears higher than previously reported in clinical trials. More robust, long-term studies are necessary to identify potential risk factors and mitigate ILD-related mortality.

Objectives: Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality. Despite curative surgery, recurrence is common in Stage I NSCLC, highlighting the need for improved prognostic classification. This study aims to evaluate the key pathological factors affecting recurrence and survival and to investigate the potential benefit of adjuvant chemotherapy (ACT) in patients with Stage I NSCLC. Methods: A retrospective analysis was conducted on patients with Stage I NSCLC who underwent curative surgery between 2010 and 2024. Demographic and disease-related prognostic factors were assessed. The impact of these factors, along with adjuvant chemotherapy (ACT), on overall survival (OS) and disease-free survival (DFS) was analyzed. Results: A total of 95 patients were included in the study, with a median follow-up period of 47 months. Recurrence occurred in 35.8% of patients, and 16.8% died. The five-year OS and DFS rates were calculated as 76.4% and 67.9%, respectively. Spread through air spaces (STAS) was identified as an independent prognostic factor associated with an increased risk of recurrence. While OS was shorter in patients with LVI positivity, it was not determined to be an independent prognostic factor. Visceral pleural invasion (VPI) did not demonstrate a significant prognostic impact on survival or recurrence. The effect of ACT on OS and DFS was evaluated, but no survival advantage was observed. Conclusions: Certain pathological factors influence survival and recurrence in Stage I NSCLC. While STAS was identified as an independent prognostic factor, ACT did not provide a significant benefit for OS or DFS. These findings emphasize the importance of individualized treatment approaches and close oncological follow-up after surgery. Future studies should incorporate novel and effective biomarkers, such as circulating tumor DNA, to optimize adjuvant therapy decisions.

Background and Objectives: Early-onset breast cancer (EOBC), particularly in patients under 40, presents with distinct biological characteristics and worse survival outcomes compared to late-onset cases. Despite intensive treatments, EOBC patients, especially those with hormone receptor-positive, HER2-negative (HR+/HER2-) subtypes, show poorer prognosis. CDK4/6 inhibitors, combined with endocrine therapy (ET) have become the standard for HR+/HER2- metastatic breast cancer, yet younger patients are underrepresented in clinical trials. This study aims to evaluate the efficacy of ribociclib and palbociclib with ET in HR+/HER2- metastatic breast cancer, addressing the critical gap in understanding treatment outcomes in younger patient populations. Materials and Methods: This multicenter, retrospective study evaluated the efficacy and safety of cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors, ribociclib, and palbociclib, in combination with endocrine therapy in patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer. Results: A total of 198 patients treated between 2019 and 2023 were analyzed for progression-free survival, overall survival, and prognostic factors. Very early-onset breast cancer, which is diagnosed before the age of 35, was identified as an independent prognostic factor for poor progression-free survival. Additional factors associated with poorer outcomes included liver metastasis, progesterone receptor negativity, high tumor grade, and the concurrent use of fulvestrant with CDK4/6 inhibitors. Both ribociclib and palbociclib demonstrated similar efficacy, and dose reductions due to treatment-related adverse events did not compromise therapeutic outcomes. Conclusions: This study is the first to focus specifically on the treatment of early-onset breast cancer with CDK4/6 inhibitors, providing critical insights into the unique challenges faced by this patient population. The findings underscore the urgent need for personalized treatment strategies, routine genetic testing, and dedicated clinical trials designed to address the specific needs of these high-risk subgroups. By advancing our understanding of the clinical and molecular landscape of early-onset breast cancer and very early-onset breast cancer, this study lays the groundwork for improving outcomes in these underserved patients through tailored therapeutic approaches.