Acıbadem Üniversitesi

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Acıbadem Sağlık Bilimleri Dergisi
Acıbadem Sağlık Bilimleri Dergisi
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Recent Submissions

Safety and Feasibility of Axillary Artery Cannulation in Robotic Assisted Minimally Invasive Coronary Revascularization
(Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2026-09-16)
Arslanhan, Gökhan
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Özcan, Zeynep Sıla
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Baştopçu, Murat
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Karaağaç, Anıl
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Şenay, Şahin
Purpose: Axillary artery cannulation is associated with safer results and fewer complications compared to femoral artery cannulation in minimally invasive cardiac surgery. Coronary artery bypass surgery patients present with a high atherosclerotic burden, and thus may also benefit greatly from antegrade axillary artery cannulation. The aim of this study was to compare outcomes in axillary and femoral cannulation in robotic-assisted minimally invasive coronary artery bypass surgery. Methods: Between March 2022 and May 2024, 96 consecutive patients underwent on-pump robotic assisted minimally invasive coronary artery bypass surgery at our institution. Preoperative computed tomography scans were assessed for atherosclerosis to guide cannulation strategy. Axillary cannulation was performed in 57 (59.4%) patients and femoral cannulation in 39 (40.6%) patients. Patient demographics and perioperative data were retrospectively analyzed. The primary endpoint of the study was peri-operative complications including stroke and in-hospital mortality. Results: There were no cases of post-operative mortality or stroke in either group. No complications including hematomas, cannulation site infections, emboli, dissection, neurovascular injury or brachial plexus injuries were observed in either group. No other complications were encountered in femoral cannulation patients except for seromas at the cannulation site in 3 (7.7%) of the patients. Conclusions: Direct cannulation of the axillary artery is a safe method for establishment of cardiopulmonary bypass in robotic-assisted minimally invasive coronary revascularization patients. This approach can benefit patients with severe peripheral arterial and aortic calcification or thrombi with safe outcomes in robotic-assisted minimally invasive coronary revascularization.
The Relationship Between Clinical Leadership Perceptions and Teamwork Attitudes: An Analysis in the Context of Emergency Healthcare Services
(Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2026-09-01)
Güney Kavraz, Yaren
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Karabulut, Ahu Tuğba
Purpose:Clinical leadership is closely associated with teamwork effectiveness in emergency healthcare settings, where rapid decision-making, coordination, and communication are essential. The purpose of this study was to examine the relationship between clinical leadership perceptions and teamwork attitudes among healthcare professionals working in emergency healthcare services. Teamwork attitudes are examined within the framework of communication, mutual support, leadership, team structure and situation monitoring dimensions in this study. Methods: This study was conducted with a quantitative research design on 290 healthcare professionals who work in private hospitals and ambulance services in Istanbul. Data were collected using a structured questionnaire consisting of three sections: demographic and work-related questions, the Clinical Leadership Scale, and the Teamwork Attitudes Questionnaire. Frequency distribution analysis, confirmatory factor analysis, correlation, and regression analyses were performed on the collected data by using SPSS and AMOS. Results: Higher perceptions of clinical leadership were positively and significantly associated with all dimensions of teamwork attitudes, including communication, situation monitoring, mutual support, leadership, and team structure. Furthermore, the analysis revealed significant and positive results among these variables. Conclusions: The findings suggest that clinical leadership is closely associated with positive teamwork attitudes in emergency healthcare services. Strengthening clinical leadership competencies and promoting a teamwork-oriented culture may contribute to improving teamwork processes, healthcare quality, and patient safety.
Absence seizures: Update on signaling mechanisms and networks
(Wiley Periodicals LLC, 2025-04-26)
Akman, Ozlem
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Onat, Filiz
Absence seizures (AS) are a hallmark of genetic generalized epilepsies (GGE), characterized by brief episodes of impaired consciousness accompanied by electroencephalographic spike-and-wave discharges (SWDs). Traditionally attributed to cortico-thalamo-cortical (CTC) dysrhythmia, emerging evidence suggests a more intricate pathophysiological framework involving high-order thalamic nuclei, the basal ganglia, limbic structures, and the cerebellum. Rather than arising abruptly from a discrete cortical event, SWDs appear to develop progressively through dynamic network interactions. This paradigm shift underscores the necessity of a network-based approach to comprehensively understand AS pathophysiology. Concurrently, advances in electrophysiology and neuroimaging are refining our understanding of the signaling mechanisms that drive AS generation. This review explores the network dynamics underlying AS, synthesizing recent experimental and clinical findings to provide an integrative framework for future research and the development of novel therapeutic strategies in absence epilepsy. Plain Language Summary: Absence seizures are brief episodes of staring and unresponsiveness, often beginning in childhood, and are caused by abnormal rhythmic activity in the brain. This review summarizes recent research on how specific brain circuits generate and maintain these seizures. While most studies have focused on the cortex and thalamus, we also highlight the contributions of other regions such as the basal ganglia, cerebellum, and limbic structures. Understanding how these brain networks interact may help explain seizure patterns and guide the development of improved treatments.
Neurodevelopmental Alterations in Inhibitory Interneurons of Cortex, Hippocampus, and Striatum of Genetic Absence Epilepsy Rats
(Wiley, 2026-08-19)
Çarçak, Nihan
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Erdeve, Elif Tuğçe
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Wright, Courtney J.
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Keskinöz, Elif
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Anderson, My
Aims Absence seizures, characterized by spike-and-wave discharges (SWDs), are mediated by reciprocal thalamocortical interactions; however, the contribution of developing inhibitory networks to SWDs remains unclear. We investigated the developmental trajectory of inhibitory interneurons in Genetic Absence Epilepsy Rats from Strasbourg (GAERS) by analyzing their distribution across postnatal development in the somatosensory (S1) and motor (M1) cortices, the hippocampus, and striatum. Methods The neurodevelopmental trajectory of parvalbumin-positive (PV+) and somatostatin-positive (SST+) interneurons was quantified at three critical stages: postnatal day 14 (P14), when SWDs were not yet observed, P21 when immature SWDs appear, and adulthood (P90), when mature SWDs are established. Wistar rats served as controls. Brain sections were processed immunohistochemically to quantify interneuron density. Results PV+ interneuron density across S1 and M1 was significantly higher in GAERS at P14 than control. However, this difference was not maintained at P21 and adults. Conversely, SST+ interneurons exhibited a delayed increase in M1. GAERS displayed higher PV+ interneuron density in the dentate gyrus and CA1 at P14, whereas SST+ interneuron density remained unchanged across hippocampal subfields. Striatal PV+ and SST+ interneurons increased at later developmental stages, suggesting altered inhibition in basal ganglia. Conclusion These findings demonstrate a temporally dynamic and region-specific reorganization of interneurons in GAERS that may underlie absence epileptogenesis.
Timing Of MRI in Acute Lateral Ankle Sprain: Impact On Diagnostic Findings And Clinical Interpretation – A Retrospective Observational Cohort Study
(Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2026-08-03)
Özbay, Hakan
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Alpan, Buğra
Background: This study aimed to investigate the impact of magnetic resonance imaging (MRI) timing on radiological findings and diagnostic interpretability in patients with acute lateral ankle sprain. Methods: In this retrospective observational cohort study, 75 adult patients with acute inversion-type ankle sprain were divided into three equal groups based on MRI timing: hyperacute (0–7 days), subacute (8–21 days), and late (>21 days). All MRIs were performed using a 3.0T scanner and evaluated by a blinded musculoskeletal radiologist. Ligament integrity, bone marrow edema, joint effusion, and soft tissue edema were assessed, along with a 3-point diagnostic interpretability scale. Multivariate analyses adjusted for age, sex, and clinical severity. Results: ATFL tear classification differed significantly across groups (p<0.05), with higher rates of complete tears in the hyperacute group. Bone marrow edema and joint effusion were most pronounced in early imaging and progressively decreased over time (p<0.05). Diagnostic interpretability was lowest in the hyperacute group and highest in the subacute group (p<0.05). MRI timing remained an independent predictor of ligament injury classification and edema visibility after adjustment. Conclusion: MRI timing significantly influences both the radiological appearance and interpretability of acute lateral ankle sprain. Subacute imaging appears to provide the most balanced diagnostic clarity, suggesting that MRI should be optimally timed based on clinical objectives. Trial registration: Not applicable (retrospective study)