Van Merkez

This research aims to investigate the frequency of Neuronal Ceroid Lipofuscinosis Type 2 (CLN2) in children aged 2 to 6 who exhibit nonspecific neurological symptoms such as idiopathic seizures, speech disorders, and motor dysfunctions. The study targets children without hypoxic ischemic encephalopathy, head trauma, or developmental brain anomalies who visit Pediatric Metabolism, Neurology, and Developmental Pediatrics clinics over a 12-month enrollment period. It is a multicenter, non-drug screening study designed to better understand CLN2 disease among this population. During the study, demographic data, medical and family history will be collected at the first visit. Assessments will include seizure frequency, cognitive and language development evaluations, physical exams focusing on muscle strength, gait, and coordination, as well as neurological tests such as EEG and MRI scans. Children showing specific neurological signs or imaging findings will have blood samples taken for Tripeptidyl Peptidase 1 enzyme measurement. Those with low enzyme activity will undergo genetic testing to investigate CLN2 disease. Participants will be monitored for disease frequency over one year. Researchers will measure clinical and demographic characteristics including speech impairment, motor symptoms, EEG responses, and brain imaging changes. Safety monitoring includes obtaining informed consent and following up on enzyme and genetic test results. Total participation spans from initial screening through diagnostic testing and data collection during the 12-month study period.

Researchers are evaluating zolbetuximab combined with pembrolizumab and chemotherapy in adults with locally advanced, unresectable, or metastatic stomach or gastroesophageal junction (GEJ) cancer. This study focuses on cancer cells that are HER2-negative but positive for the Claudin 18.2 protein and PD-L1, exploring how well zolbetuximab helps the immune system attack the tumor alongside immunotherapy and chemotherapy. The trial is a phase 3, randomized, double-blind study designed to compare the overall survival of participants receiving zolbetuximab with pembrolizumab and chemotherapy versus those receiving a placebo with pembrolizumab and chemotherapy. Participants receive study treatment in 6-week cycles, with zolbetuximab or placebo given by infusion every 2 or 3 weeks. Chemotherapy regimens include either CAPOX (capecitabine tablets and oxaliplatin infusion) or mFOLFOX6 (infusions of 5-fluorouracil, folinic acid, and oxaliplatin) administered on schedules matching the cycles. Pembrolizumab is infused every 3 or 6 weeks. Treatment continues until cancer worsens, is not tolerated, or another therapy is needed, with pembrolizumab given for up to 2 years. After initial cycles, some chemotherapy drugs are adjusted to only include oral capecitabine or certain infusions. During the study, participants visit the clinic for treatments, health checks, and scans to monitor cancer changes and side effects. Researchers also track medical problems related to the treatments and may collect tumor samples if cancer worsens. After stopping treatment, participants have follow-up visits and scans every 9 to 12 weeks, along with telephone check-ins every 3 months. The primary outcome measured is overall survival up to 72 months, with ongoing monitoring to evaluate safety and treatment effects.

Inguinal hernia repair is a common surgery in general surgery, especially in elderly patients over 65 years old. This research compares two surgical techniques—open repair and laparoscopic repair—to see which is better for older adults. The study aims to help decide whether open surgery using regional anesthesia or laparoscopic surgery, which often requires general anesthesia but allows faster recovery, is preferable for elderly patients who often have other health conditions and take multiple medications. The trial compares two procedures: laparoscopic TEP repair and the open Lichtenstein technique. Both methods are performed to fix inguinal hernias in patients older than 65. The choice of anesthesia and recovery differences between the two approaches are key points under evaluation, focusing on which method is safer and more effective for this age group. Participants will be monitored for outcomes such as postoperative mortality within 24 hours after surgery. The study involves close observation of complications like urinary retention, pain, and relapse of hernia. This careful monitoring helps assess the safety and recovery differences between the two surgical methods in elderly patients.

Inguinal hernia surgery is a common procedure that can be performed using laparoscopic methods, including the laparoscopic extended total extraperitoneal repair (eTEP). This study evaluates the effects of mesh fixation versus no mesh fixation during eTEP repair, focusing on outcomes like mesh displacement, hernia recurrence, chronic pain, hospital stay length, and postoperative complications. The rationale is that while mesh fixation might reduce mesh migration and recurrence, it could also increase postoperative pain, and there are limited studies specifically on mesh displacement in the eTEP technique. Participants will undergo laparoscopic eTEP inguinal hernia repair and be assigned to one of two groups: one with mesh fixation using three tackers, and the other without mesh fixation. The study compares these two procedures to assess clinical outcomes related to the mesh's position and patient recovery. This approach aims to clarify the role of mesh fixation in preventing complications after eTEP repair. During the study, researchers will monitor mesh displacement at 24 hours, 1 month, and 6 months after surgery. They will also track hernia recurrence, chronic pain levels, length of hospital stay, and any postoperative complications. The total participation involves follow-up visits for these assessments to understand the impact of mesh fixation on patient outcomes after laparoscopic eTEP repair.

Researchers are developing a new arterial pressure monitoring set fixation device aimed at improving stability and comfort during invasive arterial pressure measurements in patients. This study focuses on patients undergoing coronary artery bypass graft surgery, evaluating whether this device can enhance patient safety and monitoring accuracy compared to the traditional adhesive tape method. The study includes adult patients aged 18 to 80 who require postoperative invasive arterial pressure and central venous pressure (CVP) monitoring. The study uses an experimental design involving sixty patients who will have the new fixation device applied during the postoperative period. This device is designed to securely stabilize the arterial pressure monitoring set, reducing movement and discomfort that can occur with adhesive tape. The monitoring will continue for 48 hours after surgery, during which fixation stability and hemodynamic parameters, including arterial blood pressure and CVP, will be recorded and analyzed. Participants will be closely observed for the accuracy of invasive blood pressure and CVP measurements within the first 48 hours. Researchers will assess patient comfort and the device’s effectiveness in maintaining stable monitoring. Ethical standards and patient protections are strictly followed throughout the study. This approach aims to contribute to improved clinical outcomes by enhancing monitoring reliability and patient safety during the critical postoperative period.

Researchers are evaluating whether changing the width of the surgical mesh used in transobturator tape (TOT) surgery can improve treatment outcomes for women with stress urinary incontinence (SUI). This single-blind, randomized controlled trial compares a new 1.2 cm wide mesh to the standard 1.0 cm mesh to see if the wider mesh provides better urinary control and fewer complications. The study aims to measure cure rates, symptom improvement, and patient satisfaction over a one-year follow-up period. Participants will be randomly assigned to receive TOT surgery with either the 1.2 cm mesh or the 1.0 cm mesh. All surgeries are performed by a single experienced surgeon using the same surgical technique, anesthesia, and perioperative care to ensure consistency. Follow-up visits will occur at 1 week, 1 month, 6 months, and 1 year after surgery, with assessments conducted by a blinded evaluator. During the study, researchers will assess objective cure defined by a negative stress test at 6 months. Secondary outcomes include symptom improvement, mesh-related complications such as erosion or infection, and patient satisfaction measured through surveys. Participants will undergo various evaluations including clinical tests and questionnaires, with careful monitoring throughout the follow-up to assess safety and effectiveness.

Researchers are evaluating the effectiveness of digital game-based learning compared to traditional theoretical education in teaching surgical site infection prevention to second-year nursing students. This mixed-methods randomized controlled trial aims to improve nursing education by assessing how these teaching methods impact students' knowledge and cognitive load related to evidence-based infection prevention strategies. Participants will be randomly assigned to one of two groups: one will use a digital game-based learning application with interactive activities designed to engage students and reinforce key prevention principles, while the other will receive instructor-led theoretical education using standard teaching methods. The study includes assessments at three time points: before the intervention (baseline), four weeks after, and an eight-week follow-up to measure knowledge retention and cognitive load. Students in the digital game-based learning group will also participate in semi-structured interviews to share their experiences and perceptions of the learning method. Researchers will collect quantitative data on knowledge and cognitive load and analyze qualitative data from interviews to provide a comprehensive understanding of this educational approach. The study's findings may inform future evidence-based strategies for nursing education on surgical site infection prevention.

This research aims to evaluate how listening to Quran recitation affects fatigue and mental well-being in patients diagnosed with multiple sclerosis. The study tests whether Quran recital can reduce fatigue and improve mental health in these patients compared to their usual care without added interventions. Fifty patients will be randomly divided into two groups: one group will listen to Surah Yasin from the Quran for 30 minutes using an mp3 player three times a week (Monday, Wednesday, and Friday) between 9 PM and 10 PM for four weeks. The other group will continue their regular treatment without any additional activities. Researchers will check in with the Quran recital group during the study to confirm their participation. Participants will complete initial assessments before starting the intervention and final evaluations in the hospital after four weeks. Researchers will measure the impact on fatigue and mental well-being. The study includes patients aged 18 to 80 years and monitors adherence and treatment effects throughout the four-week period.

Hemophilia is a genetic bleeding disorder that causes repeated bleeding episodes, mainly into joints and muscles, leading to chronic joint problems and reduced physical function. This study focuses on adults with severe hemophilia A to understand how joint health, pain levels, balance ability, and history of falls affect their quality of life. Although treatments have improved life expectancy, long-term joint damage and mobility limitations continue to impact daily living and well-being. Participants are evaluated for joint health using the Hemophilia Joint Health Score, which measures damage in knees and ankles. Dynamic balance is tested with a computerized platform assessing the ability to control body sway. Pain severity is measured on a numeric scale, and fall history is recorded based on self-report over the past year. Quality of life is assessed using a specialized questionnaire for adults with hemophilia, capturing physical, emotional, and social aspects. The study involves 36 adult men aged 18 to 65 with severe hemophilia A, excluding those who use walking aids or have neurological, psychiatric, or inflammatory conditions or recent leg surgery. Researchers collect baseline data on joint health, balance, pain, and falls to analyze their association with quality of life. These findings aim to identify clinical targets that may help improve rehabilitation and daily functioning for adults living with hemophilia.

Researchers are investigating how the pressures from the tongue, lips, and cheeks affect the development of a narrow upper jaw (maxillary constriction) in individuals aged 12 to 25. The study is based on the Equilibrium Theory, which suggests that teeth stay in place when the inward pressure from lips and cheeks balances the outward pressure from the tongue. This research aims to identify differences in muscle pressure patterns between those with narrow and normal upper jaws to better understand jaw narrowness and improve orthodontic treatment stability. Participants will have their tongue, lip, and cheek pressures measured using a specialized device called the Iowa Oral Performance Instrument (IOPI) before any orthodontic treatment begins. The IOPI uses a small, air-filled bulb placed in the mouth that participants press with their tongue or lips to measure muscle strength in kilopascals. Measurements include tongue pressure against the palate, upper and lower lip strength, and cheek pressure at rest and during function. Each measurement is taken three times with rest intervals. During the study, participants will undergo these non-invasive pressure tests and provide information through detailed anamnesis. The collected data will be statistically analyzed to compare muscle pressures between those with and without maxillary constriction. The main outcome measure is the maximum voluntary tongue pressure recorded before orthodontic treatment. This research could lead to new ways to support stable orthodontic results by considering muscle pressures in treatment planning.