Papers by Journal of Clinical Practice and Research
Journal of Clinical Practice and Research, 2025
Sepsis is a global health concern and a medical emergency, defined as the systemic immunological ... more Sepsis is a global health concern and a medical emergency, defined as the systemic immunological response of the body to an infection, which can lead to severe organ dysfunction and death. This understanding has evolved partly due to advancements in our knowledge of its pathophysiology. The aim of this review is to examine recent advancements in sepsis treatment. Accordingly, the authors reviewed the current literature on sepsis, analyzing advancements in its definitions, treatment guidelines, and management strategies. Sepsis can severely impair immune system functionality, leading to distinct subphenotypes of immunosuppression that increase patients' susceptibility to infections. These subphenotypes exhibit varying clinical features and responses to treatment, underscoring the necessity of understanding immunosuppression for the advancement of personalized treatment strategies. A transformative shift in sepsis management includes the early recognition of at-risk cases and the prompt, effective use of antibiotics, hemodynamic management, source control, and appropriate supportive care. Although current Surviving Sepsis Campaign guidelines recommend early fluid resuscitation, prompt antibiotic therapy, and monitoring lactate clearance, the authors discuss the objections raised by the Infectious Diseases Society of America regarding these recommendations. In conclusion, initial resuscitation is a critical component of managing sepsis and septic shock, significantly impacting patient outcomes. As our understanding of sepsis continues to evolve, ongoing research and discussions surrounding these guidelines remain essential for improving treatment protocols and enhancing patient care. Given the crucial role of the immune response in sepsis pathophysiology, future research on sepsis management will likely focus on anti-inflammatory mechanisms.
Journal of Clinical Practice and Research, 2025
Objective: CD19 is a cellular receptor belonging to the immunoglobulin (Ig) superfamily and serve... more Objective: CD19 is a cellular receptor belonging to the immunoglobulin (Ig) superfamily and serves as a critical signaling component in B-cells differentiation and activation. This study investigates gene expression changes in the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways in patients with CD19 deficiency. The role of CD19 in B-cell function was explored, along with its potential impact on these signaling pathways and the overall immune response. Materials and Methods: RNA samples were obtained from three patients diagnosed with CD19 deficiency, as well as heterozygous carriers and healthy controls. Gene expression profiles related to the PI3K/AKT axis and NF-κB pathway were analyzed using quantitative polymerase chain reaction (PCR). Results: The study revealed significant alterations in the expression of signaling pathway components, including PI3K, phosphoinositide-3-kinase regulatory subunit 1 (p85), TNF receptor-associated factor 2 (TRAF2), forkhead box O1 (FOXO1), and NF-κB, in CD19deficient patients. While PI3K and NF-κB expression were significantly downregulated in these patients, CD19, p85, FOXO1, and TRAF2 expression were markedly upregulated. These changes suggest impaired B-cell function, leading to weakened immune system responses. Conclusion: CD19 deficiency disrupts B-cell receptor signaling, resulting in significant alterations in the PI3K/AKT axis and NF-κB pathways. These disruptions impair B-cell maturation and survival, ultimately leading to compromised immune responses. This study provides the first detailed molecular insights into the effects of CD19 deficiency, enhancing our understanding of how these signaling pathways regulate immune function.
Journal of Clinical Practice and Research, 2025
Objective: Measuring adolescents' attitudes toward passive exposure to tobacco smoke is crucial d... more Objective: Measuring adolescents' attitudes toward passive exposure to tobacco smoke is crucial due to its negative effects on their health. This methodological study aimed to develop a reliable and valid instrument for assessing high school students' attitudes toward passive exposure to tobacco smoke. Materials and Methods: The research sample consisted of 1,000 students enrolled in seven different high schools. The "Descriptive Information Form" and the "Passive Exposure to Tobacco Smoke Attitude Scale" were used to collect data. Descriptive statistics, content validity index, correlation analysis, Cronbach's alpha, exploratory factor analysis, and confirmatory factor analysis were applied. Results: The content validity index of the scale was determined to be 0.94. The Kaiser-Meyer-Olkin measure for exploratory factor analysis was calculated as 0.929, and Bartlett's test of sphericity yielded significant results. A three-factor structure was identified, with factor loadings ranging from 0.636 to 0.802, accounting for 58.728% of the total variance. Fit indices were as follows: χ²/df=2.33, Comparative Fit Index=0.96, Root Mean Square Error of Approximation=0.05, Goodness of Fit Index=0.94, Adjusted Goodness of Fit Index=0.92, and Root Mean Square Residual=0.06. Additional fit indices included Normed Fit Index=0.93, Tucker-Lewis Index=0.95, and Incremental Fit Index=0.96. Cronbach's alpha coefficient values were 0.903 for the Attitude Toward Smoke Exposure sub-dimension, 0.710 for the Attitude Toward Passive Exposure With Friends sub-dimension, 0.693 for the Attitude Toward Passive Exposure in Open Spaces sub-dimension, and 0.906 for the entire scale. The test-retest result was 0.926. Conclusion: The Passive Exposure to Tobacco Smoke Attitude Scale was determined to be a reliable and valid measurement tool with a 16-item, three-factor structure.
Journal of Clinical Practice and Research, 2025
Objective: Oleuropein has previously been reported to provide neuroprotection in ischemia/reperfu... more Objective: Oleuropein has previously been reported to provide neuroprotection in ischemia/reperfusion injury and to alleviate allodynia in neuropathic pain models. This study aims to assess the therapeutic potential of oleuropein, a polyphenolic compound found in olive trees, on sciatic nerve damage induced by chronic constriction injury (CCI) in male rats by comparing its efficacy with gabapentin, a widely used antiepileptic drug for the treatment of neuropathic pain. Materials and Methods: Adult male Wistar rats were randomly allocated into control, neuropathic pain (NP), NP treated with 15 mg/kg oleuropein, and NP treated with 100 mg/ kg gabapentin groups. The neuropathic pain model was induced by CCI via ligation of the sciatic nerve at four different locations, each separated by an interval of 1 mm. Treatments were administered via oral gavage for 14 days. Nociceptive behavior in response to thermal stimuli and the sciatic functional index (SFI) were assessed weekly. Nerve conduction velocity, sciatic nerve histology, and the level of thiobarbituric acid reactive substances were evaluated at the end of treatment. Results: Sciatic CCI led to a reduction in nerve conduction and function, increased oxidative stress, and altered neuronal integrity, accompanied by decreased myelin sheath thickness and myelinated fiber diameter. Oleuropein administration significantly increased nerve conduction velocity, improved SFI values over time, significantly reduced oxidative stress, and enhanced neuronal integrity and myelination, surpassing the effects of gabapentin administration. Conclusion: These findings highlight the therapeutic potential of oleuropein in nerve constriction injury and nerve damage, warranting further investigation into its use for nerve injury treatment.
Journal of Clinical Practice and Research, 2025
Objective: This study aimed to enhance transverse rectus abdominis musculocutaneous (TRAM) flap s... more Objective: This study aimed to enhance transverse rectus abdominis musculocutaneous (TRAM) flap survival using non-invasive transcutaneous electrical nerve stimulation (TENS) in an experimental rat model. Materials and Methods: Fifty male rats were divided into four groups. The Control group, consisting of 12 rats, underwent flap surgery only. The Surgical Delay group, also with 12 rats, received skin incisions and superior epigastric artery ligation seven days before flap surgery. The Sham group, comprising 12 rats, had electrodes attached for seven days without stimulation. The TENS group, which included 13 rats, underwent electrical stimulation for seven days before flap surgery. Post-surgery, perfusion was measured, vascular endothelial growth factor (VEGF) levels and vessel counts were assessed, and flap viability was evaluated after seven days. Results: The TENS group demonstrated higher flap viability compared to the other groups (p=0.097), with viability rates of 17.4±19.80% in the Control group, 18.1±25.70% in the Surgical Delay group, 25.22±29.02% in the Sham group, and 40.44±30.92% in the TENS group. There were no significant differences in perfusion percentages among the groups. The Surgical Delay group exhibited a higher vessel count. VEGF levels were elevated in the TENS and Control groups compared to the Surgical Delay and Sham groups. Significant correlations were observed between perfusion percentages and flap viability. Conclusion: TENS has been shown to effectively enhance flap viability when used as a preconditioning method in this experimental flap model with axial blood flow. It may be considered a simple preconditioning strategy for high-risk flap designs in clinical settings.
Journal of Clinical Practice and Research, 2025
Objective: Ovarian hyperstimulation syndrome (OHSS) is an undesired outcome of controlled ovarian... more 
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Papers by Journal of Clinical Practice and Research