https://hdl.handle.net/20.500.12809/179 2026-07-10T11:27:07Z https://hdl.handle.net/20.500.12809/11235 Prognostic Role of Inflammatory Indices and Real-World Outcomes in HER2-Positive Metastatic Breast Cancer Treated with Trastuzumab Emtansine Güçlü Kantar, Taliha; Doğan, Tolga; Tanrıverdi, Özgür; Açıkgöz Yıldız, Bedriye Background and Objectives: Reliable pretreatment biomarkers to guide treatment selection in HER2-positive metastatic breast cancer (mBC) remain an unmet need. Systemic inflammatory indices derived from routine blood tests have emerged as accessible prognostic markers. This study evaluated the prognostic value of inflammation-based indices in patients with HER2-positive mBC treated with trastuzumab emtansine (T-DM1). Materials and Methods: In this retrospective single-center cohort study, 50 patients with HER2-positive mBC treated with T-DM1 in the second-line setting were analyzed. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. ROC analysis assessed the prognostic performance of the CRP/albumin ratio (CAO), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Variables associated with PFS were further evaluated using multivariable Cox regression. Results: The median follow-up was 46 months. Median OS from initial diagnosis and median PFS from T-DM1 initiation were 96 and 7 months, respectively. Metastatic pattern (p = 0.010), CNS involvement at T-DM1 initiation (p = 0.025), liver metastasis (p = 0.041), and best radiologic response (p < 0.001) were associated with PFS. ROC analysis showed modest discrimination (CAO AUC 0.694, NLR 0.658, PLR 0.646, and SII 0.653). In multivariable analysis, best radiologic response to T-DM1 was strongly associated with progression risk and appeared to reflect treatment sensitivity rather than acting as a pretreatment predictor. Conclusions: T-DM1 provided meaningful disease control in this real-world cohort. Treatment response was the main determinant of progression, while baseline inflammatory markers offered modest complementary prognostic value. These findings may aid patient selection for T-DM1, particularly in settings with limited access to trastuzumab deruxtecan. 2026-01-01T00:00:00Z https://hdl.handle.net/20.500.12809/11234 Reproductive Health, Sexuality, and Pregnancy Decision-Making in Women with Multiple Sclerosis: A Qualitative Study Kaydırak, Meltem; Deveci, Emrah Emre; Bilge, çiğdem; Küçükkaya, Burcu; Olgun, Aylin; Gürel, Sema Nur ObjectivesMultiple sclerosis is a chronic neurological condition frequently diagnosed during women's reproductive years and may influence sexuality, reproductive health, and pregnancy decision-making. This study aimed to explore the lived experiences of women with multiple sclerosis regarding sexual health, family planning, and pregnancy decisions.MethodsA qualitative descriptive design was employed. In-depth, face-to-face individual interviews were conducted with 30 women aged 18-45 years who had been diagnosed with multiple sclerosis and were receiving care at a Training and Research Hospital's multiple sclerosis outpatient clinic. Participants were recruited using purposive sampling. Data were analyzed using inductive thematic analysis.ResultsThe mean age of the participants was 31.90 +/- 6.91 years, and the mean duration of illness was 7.36 +/- 5.97 years. The thematic analysis revealed six main themes and sixteen sub-themes: (1) lack of knowledge, (2) need for education and counseling, (3) effect of multiple sclerosis on fertility intentions, (4) emotional and psychological reactions, (5) sexual and women's health issues, and (6) family planning methods and preferences. Participants described significant challenges related to sexual functioning, uncertainty about pregnancy outcomes, and limited access to individualized counseling services.ConclusionsWomen with multiple sclerosis experience complex and interconnected sexual and reproductive health needs. Findings highlight substantial gaps in counseling and sexuality-focused support. A holistic, patient-centered, and sexuality-informed care approach is essential to support informed reproductive decision-making in women with multiple sclerosis. 2026-01-01T00:00:00Z https://hdl.handle.net/20.500.12809/11228 Improvement of dynamic pupillary function after cataract surgery in eyes with pseudoexfoliation syndrome: a six-month longitudinal pupillometry study Alaçamlı, Göksü; Kaşıkçı, Murat Purpose Impaired pupillary dynamics are a well-recognized feature of pseudoexfoliation syndrome (PXF), yet little is known about how cataract surgery influences postoperative iris function in these eyes. This study aimed to determine the longitudinal effects of cataract surgery on static pupil diameters and dilation velocity in eyes with pseudoexfoliation syndrome compared with age-matched controls. Methods This longitudinal study included 166 eyes of 166 patients undergoing cataract surgery, comprising 91 eyes with pseudoexfoliation syndrome and 75 control eyes without pseudoexfoliation. Pupillary parameters were measured preoperatively and at six months postoperatively using automated pupillometry. Static pupil diameters were assessed under scotopic (0.04 lx), mesopic (4 lx), and photopic (40 lx) illumination conditions. Dynamic pupillary function was evaluated by measuring dilation velocity (DVel, mm/s) following a standardized light stimulus. Postoperative changes (Delta) were calculated as the difference between preoperative and postoperative measurements. Results Static pupil diameters remained stable in the PXF group across all illumination conditions (p > 0.05). In contrast, the control group demonstrated a significant reduction in scotopic pupil diameter after surgery (p = 0.008), while mesopic and photopic diameters remained unchanged. The most notable finding was observed in pupillary kinetics: dilation velocity significantly increased in the PXF group from 0.13 +/- 0.04 mm/s to 0.17 +/- 0.05 mm/s (p < 0.001), whereas no significant change was detected in the control group. Between-group comparison showed a significantly greater improvement in dilation velocity in PXF eyes (p < 0.001). Cataract morphology was not associated with postoperative pupillary changes. Conclusion These findings suggest that cataract surgery may be associated with measurable changes in dynamic pupillary behavior in PXF eyes, particularly in dilation velocity, while static pupil diameter remains largely unchanged. 2026-01-01T00:00:00Z https://hdl.handle.net/20.500.12809/11226 The effect of canagliflozin on hippocampal dendrite morphology in a model of Alzheimer's disease induced by intracerebroventricular injection of streptozotocin Yazı, Sevdenur; Özen, Berna; Buldu, Bahar; Yalçın, Ebru; Karaköse, Osman; Çakmak, Ozan; Somunkıran, Selenay; Yananlı, Hasan R.; Şehirli, Ümit S.; Kirazlı, Özlem Alzheimer's disease (AD) and diabetes mellitus (DM) share common pathophysiological features. However, the effects of antidiabetic drugs on neurodegeneration are not completely known. Canagliflozin, a novel option for DM treatment, is a dual inhibitor of sodium glucose co-transporter type 2 (SGLT2) and acetylcholinesterase. The aim of this study is to examine the morphological features of dendrites and dendritic spines of pyramidal neurons in hippocampus of AD model treated with canagliflozin. The model of AD was obtained by intracerebroventricular injection of streptozotocin. Then, the rats were divided into 3 groups: vehicle, donepezil, and canagliflozin. The injections were i.c.v. administered for 7 days. Behavioral tests were performed to evaluate memory, anxiety, and motor functions. Brain tissues were processed by Golgi impregnation method. Pyramidal neurons in the CA1 region were examined using Neurolucida software. Dendritic branching, total dendrite length, dendritic spine density, and dendritic spine types were analyzed. Compared to the vehicle group, the donepezil group and the canagliflozin group exhibited significantly higher dendritic branches (p = 0.0273, p = 0.0195) and total dendrite length (p = 0.0171, p = 0.0360), respectively. The total dendritic spine density (p < 0.0001) and the mushroom-type dendritic spine density (p = 0.0001) were significantly low in the donepezil group compared to the vehicle group. However, canagliflozin did not induce any significant alterations in the dendritic spine density. Canagliflozin treatment was as effective as donepezil treatment on hippocampal dendrite morphology. This morphological framework, indicating dendritic plasticity and remodeling, serve to better understand the cellular effects of canagliflozin. Therefore, our study may contribute to the development of novel strategies for therapy of AD. 2026-01-01T00:00:00Z