WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

Permanent URI for this collectionhttps://hdl.handle.net/20.500.14517/18

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Craniofacial Indices and Anthropometric Correlations in Medical Students
(Wiley, 2025) Tekin, A.; Zeybek, N.; Sanliturk, Y. N.; Colak, T.
Promoting Patients' Empowerment in Rheumatic Diseases: The Perspective of the International Society of Behçet's Disease Working Group on Patient Empowerment, Adherence to Therapy and Patients' Education
(Clinical & Exper Rheumatology, 2025) Di Cianni, F.; Marinello, D.; Altenburg, A.; Karacayli, U.; Emmi, G.; Schirmer, M.; Talarico, R.
Behcets' disease (BD) is a rare multi-systemic vasculitis that significantly impacts patients' quality of life. Effective management of BD requires a patient-centred approach that empowers individuals to actively participate in their care. This work explores the importance of patient empowerment, adherence to treatment, and patient education in BD. The impact of BD on quality of life (QOL) is significant, affecting both physical and psychological well-being. QOL measures are essential in capturing the full burden of the disease from the patient's perspective, helping guide interventions that can improve disease management. Moreover, treatment adherence remains a major challenge due to various factors, including medication complexity, fear of side effects, and patient perceptions of their health status. Empowerment strategies, including education and emotional support, are crucial to improving adherence and reducing healthcare costs. Empowering BD patients involves fostering a collaborative relationship between healthcare providers and patients, promoting shared decision-making and enhancing patients' knowledge and skills to manage their condition. Patient education plays a crucial role in empowering patients by providing them with accurate information about the disease, treatment options, and self-management strategies. The International Society for Behcet's Disease Working Group on Patient Empowerment, Adherence to Therapy, and Patient Education aims to address these issues by developing global strategies to empower BD patients, caregivers and healthcare providers. This initiative promotes collaboration across the BD community, ultimately leading to better patient outcomes and serving as a model for similar efforts in other disease areas.
The Role of Neuropeptide W Overexpression on Pancreatic Cancer Cell Behaviour
(Wiley, 2025) Unal, R. R.; Arik, E. Sever; Ceyhan, G. O.; Yapislar, H.
Ekonomi Politika Belirsizliğinin ve Para Politikası Belirsizliğinin Kripto Para Piyasası Üzerindeki Etkisi
(Sosyoekonomi Soc, 2025) Kadooglu-Aydin, Gulden; Kaplan-Yildirim, Ruya; Munyas, Turgay
This study examines how Economic Policy Uncertainty (EPU) and Monetary Policy Uncertainty (MPU) affect the returns often different cryptoassets using Quantile Regression (QR) and Robust Least Squares (RLS) methods. Quantile regression allows a nuanced examination of how these uncertainties affect returns at different levels under market conditions. Using monthly data from January 1, 2018, to June 1, 2024, the analysis shows that MPU has a negative impact on cryptoasset returns under normal and bull market conditions. However, this effect diminishes during bear market periods. Conversely, EPU has a significant negative impact only during bull markets. These results suggest that market conditions critically shape the sensitivity of cryptoassets to uncertainty, with such effects amplified during bull market periods.
Optimization of the Air Pollution Mitigation Model Using Intuitionistic Fuzzy Trapezoidal Preference Relations and Grey Relational Analysis
(Springer India, 2025) Touqeer, Muhammad; Gilani, Syeda Sadia; Ahmadian, Ali; Salimi, Mehdi
Addressing the pressing issue of air pollution requires sophisticated decision-making frameworks that can effectively prioritize mitigation strategies. However, existing literature falls short in providing comprehensive models that integrate intuitionistic fuzzy trapezoidal preference relations (IFTrPRs) with robust ranking methods. This study bridges this gap by introducing a novel framework that synergizes IFTrPRs with Grey Relational Analysis (GRA) and projection methods to derive priority weight vectors and compare alternatives. A key contribution of this research is the development of an optimization model for determining priority weights from IFTrPRs, which ensures multiplicative consistency. By integrating this model with GRA and projection methods, our framework provides a robust decision-making tool that can accurately handle uncertain situations and provide reliable results. The proposed framework is demonstrated in a real-world air pollution mitigation scenario, showcasing its effectiveness and superiority over existing techniques. By integrating IFTrPRs with GRA, this study offers a pioneering approach to tackling environmental challenges, contributing to the development of more effective strategies for air pollution mitigation.
Solow-Swan Model and Growth Dynamics: Moving Forward
(Springer Int Publ Ag, 2025) Ferrara, Massimiliano
This note in the Milestones series is dedicated to the Solow-Swan model. The aim is to examine the historical significance and enduring impact of the Solow-Swan neoclassical growth model, independently developed by Robert Solow and Trevor Swan in 1956. The model revolutionized economic growth theory by introducing a framework explaining long-term growth through capital accumulation, labor growth, and technological progress. We explore the model's theoretical foundations, influence on subsequent literature, empirical applications, and ongoing relevance. The paper presents novel extensions with discrete time delays that provide insights into cyclical economic phenomena, demonstrating how time-to-build technology can generate endogenous fluctuations within the otherwise stable Solow framework.
Search for Rare Decays of the Z and Higgs Bosons to a J/Ψ or Ψ(2s) Meson and a Photon in Proton-Proton Collisions at √s=13 TeV
(Elsevier, 2025) Hayrapetyan, A.; Tumasyan, A.; Adam, W.; Andrejkovic, J. W.; Bergauer, T.; Chatterjee, S.; Banerjee, S.
A search is presented for rare decays of the Z and Higgs bosons to a photon and a J/psi or a psi(2S) meson, with the charmonium state subsequentially decaying to a pair of muons. The data set corresponds to an integrated luminosity of 123 fb(-1) of proton-proton collisions at a center-of-mass energy of 13 TeV collected with the CMS detector at the LHC. No evidence for branching fractions of these rare decay channels larger than predicted in the standard model is observed. Upper limits at 95% confidence level are set: B(H -> J/psi gamma) < 2.6 x 10(-4), B(H -> psi(2S)gamma) < 9.9 x 10(-4), B(Z -> J/psi gamma) < 0.6 x 10(-6), and B(Z -> psi(2S)gamma) < 1.3 x 10(-6). The ratio of the Higgs boson coupling modifiers kappa(c)/kappa(gamma) is constrained to be in the interval (-157, +199) at 95% confidence level. Assuming kappa(gamma) = 1, this interval becomes (-166, +208).
Prevalence of Left Kidney Vein Entrapment Signs on Computed Tomography Angiography Images of Kidney Donors
(Via Medica, 2025) Atli, Eray; Ferhatoglu, Murat Ferhat; Gurkan, Alp
Background: The nutcracker phenomenon (NC-P) is the entrapment of the left kidney vein (LKV) between the superior mesenteric artery and the abdominal portion of the aorta. We aimed to evaluate the frequency of significant left renal vein compression in a healthy population. Materials and methods: The computed tomography angiography images of 131 healthy patients who underwent living kidney donor nephrectomy at our institution were enrolled in this retrospective, descriptive anatomic study. Results: Three (2.3%) cases had severe stenosis, and 26 (19.8) cases had moderate stenosis. The mean aorto-mesenteric angle was narrower in females (p < 0.05). The mean LKV diameter ratio and beak angle were shorter and narrower in females (p < 0.05, p < 0.01, respectively). Thirteen cases (9.9%) showed 3 or 4 positive criteria for NC-P. Younger pateitns and those with body mass index (BMI) < 30 kg/m(2) had increased rates of positive criteria determination (p < 0.05, p < 0.01, respectively). Conclusions: The NC-P criteria were seen with a high frequency in healthy individuals. Female and younger individuals with lower BMI showed a greater prevalence of positive criteria. Revision of the current standards for NC-P with a distinct classification between sex, age, and BMI is required to better assess LKV compression.
Nutritional Approaches and Supplementation in Lipedema Management: A Narrative Review of Current Evidence
(Springernature, 2025) Aydin, Ayca; Bilgic, Pelin
Purpose of Review Lipedema is a painful chronic disease characterized by symmetric fat tissue accumulation in the lower extremities. Inflammation of the subcutaneous adipose tissue causes pain, edema, and various functional limitations, making daily activities difficult and affecting quality of life. Recent Findings Although the pathogenesis of lipedema is not fully known, it is a disease that is associated with the interaction of genetic predisposition, hormonal factors, stressful lifestyle and inflammatory processes. Lipedema, which can often be confused with obesity and lymphedema, causes patients to undergo unnecessary examinations and treatments, while the disease can also create an additional burden on the health system through psychosocial problems. Summary Chronic inflammation of subcutaneous adipose tissue is resistant to weight loss. Since there is no definitively proven treatment method in the literature for the treatment of lipedema, the primary goal is to alleviate the symptoms associated with the disease with a multidisciplinary team. At this point, increasing misinformation content on social networks or difficulties in accessing accurate information emphasize the importance of evidence-based practices and guidelines in the nutritional treatment of lipedema. Ketogenic diet and Mediterranean diet are prominent dietary models in the nutritional treatment of lipedema, as they overlap with the pathophysiology of lipedema with their insulin sensitivity-enhancing and anti-inflammatory effects. The Mediterranean diet, rich in antioxidants, acts by reducing the production of proinflammatory cytokines in the body, while the ketogenic diet with its low carbohydrate content improves the blood glucose profile and insulin resistance, preventing hyperglycemia-induced inflammation supported by lipedema. On the other hand, serum levels of vitamins and minerals, which play important roles in ensuring the physiological functioning of the body, are also important in order not to worsen the clinical picture and reduce inflammation. There is limited data in the literature on the long-term applicability, safety and therapeutic effects of these dietary models. Therefore, more research is needed to expand clinical applications.
PRP and Diced Cartilage-Enhanced Fascia Lata: A Composite Graft for Septal Perforation Repair
(Sage Publications Inc, 2025) Hanci, Deniz; Onaran, Oyku Izel; Altun, Huseyin; Bozer, Berke Berat; Gurpinar, Berk; Obuz, Mert; Uyar, Yavuz
Objective: Nasal septal perforation (NSP) is characterized by defects in the mucosal, cartilaginous, and bony structures of the septum, most commonly resulting from septoplasty. Spontaneous healing of NSPs is rare, necessitating surgical intervention once the condition stabilizes. Numerous techniques have been developed for NSP repair. This study presents a novel technique combining fascia lata grafts, platelet-rich plasma (PRP), and diced septal cartilage harvested from the patient's remaining deviated nasal septum for the repair of medium-sized NSPs.Methods: A retrospective analysis was conducted on 32 patients who underwent NSP repair between July 2022 and July 2023. The repair utilized fascia lata, PRP derived from venous blood, and diced cartilage from residual septal cartilage. The procedure involved an open rhinoplasty approach for graft placement, followed by stabilization using endoscopic techniques.Results: The mean horizontal and vertical diameters of the septal perforations were 12.06 +/- 2.87 mm and 13.12 +/- 2.44 mm, respectively. All patients had medium-sized perforations (0.5-2 cm). The mean follow-up period was 12.03 +/- 1.11 months. Complete closure was achieved in 28 of 32 cases (87.5%). The cohort included 18 males (56.3%) and 14 females (43.8%), with a mean age of 35.47 +/- 5.31 years (range: 25-45). Ten patients (31.3%) were smokers, among whom 4 experienced incomplete closure. Smoking was not significantly associated with repair failure (P = .06).Conclusion: This novel technique combining fascia lata, PRP, and diced septal cartilage offers a reliable and effective approach for the repair of medium-sized NSPs.
The Impact of Climate Change and Environmental Degradation on Agricultural Credit Usage: Evidence from Türkiye with Fourier Approximations
(Kahramanmaras Sutcu Imam Univ Rektorlugu, 2025) Seyranlioglu, Onur; Han, Aysegul; Aydinbas, Gokcen
This study aims to examine the impact of climate change and environmental degradation on agricultural credit utilization using annual data for the period 1988-2023 in T & uuml;rkiye. In this paper, stationarity is tested using the Fourier KPSS stationarity test, long-run relationships are analyzed using the Fourier Shin cointegration method, and long-run coefficients are estimated using the Fourier FMOLS method. Finally, the Fourier Toda-Yamamoto causality test is used to explore causal relationships between variables. The findings show that increases in climate change and environmental degradation reduce agricultural credit utilization. On the other hand, agricultural value added, arable agricultural area, and population growth are found to increase agricultural credit utilization. According to the causality analysis results, a unidirectional causality relationship was found from agricultural credit utilization to climate change, while bidirectional causality relationships were found between agricultural credit utilization and agricultural value added and population growth. The results obtained emphasize the importance of restructuring financial policies for the agricultural sector in consideration of environmental and climatic risks and provide an important contribution to the very limited literature by addressing this interaction with Fourier-based econometric analyses.
Assessment of the Water and Energy Nexus in the Energy Supply Subsystem of Water Stressed Countries like Iran
(Nature Portfolio, 2025) Vahabzadeh, Masoud; Molajou, Amir; Variani, Hossein Akbari; Afshar, Abbas
Iran, situated in the Middle East, is recognized as a prominent energy hub, with its economy heavily reliant on the exportation of energy. Iran currently faces significant water stress, underscoring the importance of examining its Water-Energy (WE) nexus. Hence, it is crucial to examine the Water-Energy (WE) nexus in this nation. This study evaluates Iran's WE nexus from upstream to downstream in its energy subsystem (2007-2017) through an integrated framework combining water footprint analysis, water consumption methodologies, and nexus system modeling. This study assessed the WE nexus from upstream to downstream in Iran from 2007 to 2017. Key findings reveal that steam turbine power plants, particularly Ramin and Neka, exhibit the highest water consumption intensities, approximately 2.04 and 2.65 m3/MWh respectively, making them critical targets for efficiency improvements or retirement. Conversely, combined-cycle plants with dry cooling technology show significantly lower water intensity (0.18 m3/MWh), presenting viable alternatives. The study recommends shifting energy infrastructure towards combined-cycle and gas turbine plants to mitigate water stress, thus providing actionable insights for sustainable energy and water resource management in water-stressed regions.
Neuroprotective Potential of Phillyrea Latifolia L. Leaf Extracts in SH-SY5Y Co-Culture Models: Modulation of Oxidative Stress and Inflammatory Responses
(Elsevier Ireland Ltd, 2025) Guresci, D.; Ockun, M. A.; Kirmizibekmez, H.; Sipahi, H.
Clinical Evaluation of Different Solvent Type and HEMA-Content of Universal Adhesive Systems in Non-Carious Cervical Lesions: A Two-Year Double-Blind Split-Mouth Randomized Clinical Trial
(BMC, 2025) Yurdaguven, Gulsah Yenier; Dogruer, Isil; Cam, Melek; Ulukapi, Hasmet; Aykor, Ayse Arzu
Background Comparative analyses of different adhesive systems have illustrated that variations in the content can substantially influence the effectiveness of bonding. While in vitro studies provide essential insights, it is imperative that clinical recommendations derive from randomized clinical trials to ensure their reliability and validity. This double-blind, split-mouth, randomized clinical trial was conducted to assess the performance of various universal adhesives over a 24-month period, with a specific emphasis on monomer type, HEMA content, and solvent type, using the selective enamel etch approach in non-carious cervical lesion (NCCL) restorations. Materials and methods Thirty-two participants with two-hundred-fifty-six NCCLs were assigned to the two groups (n = 128): G-Premio Bond (GPB; GC) and Single Bond Universal (SBU; 3 M ESPE). The same composite resin (Essentia, GC) was used. Restorations were assessed at baseline, 12-month, and 24-month using the Revised FDI criteria by two blinded calibrated examiners. Statistical analysis included Fisher's Exact Chi-Square test, Continuity (Yates) Correction, and McNemar tests (p < 0.05). Results The 24-month success rate was 98.2%, with the loss of retention in four restorations-two from SBU and two from GPB. Throughout all evaluation periods, no significant differences were identified between the adhesives regarding any criteria (p > 0.05). Both adhesives exhibited a significant decline in marginal adaptation at both the 12-month and 24-month evaluations, as well as an increase in marginal staining at the 24-month interval (p < 0.05). Notwithstanding the observed decrease in marginal adaptation after 24 months, all restorations remained clinically acceptable and were classified as clinically satisfactory. Conclusions A clinical analysis over a 24-month period demonstrated that variations in the composition of universal adhesives-specifically concerning monomer types, HEMA content, and solvent type-did not significantly affect the performance of NCCL restorations. Notably, all retained restorations met clinical acceptability standards.
A New Scoring System for Predicting the Risk for Mitral Regurgitation and Its Severity in Patients with Mitral Valve Prolapse
(Brieflands, 2025) Demir, Hidayet; Tunccer, Mehmet Altug; Sheikhvatan, Mehrdad
Background: Due to the possibility of occurrence and exacerbation of mitral regurgitation (MR) in the context of mitral valve prolapse (MVP) in a significant portion of patients, early and non-invasive prediction of this complication based on clinical and echocardiographic parameters is important and vital. This prediction can essentially be based on the provision of efficient grading systems. Objectives: We aimed to achieve this goal by identifying factors predicting the exacerbation of MR and classifying them in the form of a new scoring system. Methods: One hundred and five patients with suspected MVP were included in this cross-sectional study and assessed by echocardiography. The patients underwent echocardiography, and the severity of the MR, as well as structural changes of valves due to prolapse (leaflets and scallops involvements), was determined. Results: In a multivariable logistic regression model, age > 40 years, posterior mitral valve leaflet (PMVL) involvement, and P2 or A2P2 scallop involvement were identified as the main risk determinants for moderate to severe MR. These factors were structured as a new scoring system (scaled 3 to 10), where a total risk score of less than 6, between 6 to 8, and higher than 8 was considered low, moderate, and high risk for moderate to severe MR, respectively. Conclusions: The scoring system provided for predicting the exacerbation of mitral insufficiency in patients with a prolapsed valve can potentially guide early intervention.
Cancer Rate in Pulmonary Embolism Diagnosed Cases: A Single-Center, Retrospective Study
(Turkish Geriatrics Soc, 2025) Dogan, Demet; Gokce, Kagan
Introduction: The aim of this study was to evaluate the incidence of pulmonary embolism in relation to age, cancer, and other comorbidities; to assess clinical, laboratory, and radiological findings; and to examine the associated mortality rate. Materials and Method: Patients diagnosed with pulmonary embolism were included in this single-center retrospective study. The patients were divided into two age groups: < 60 and > 60 years. The incidence of pulmonary embolism; presence of deep vein thrombosis, cancer, surgical history; other comorbidities; mortality rate; prevalence of embolism; and C-reactive protein and D-dimer levels were evaluated according to age group and sex. Results: Of the 1,281 patients who underwent pulmonary computed tomography angiography for suspected pulmonary embolism, 235 were diagnosed with pulmonary embolism. Of these, 114 were female and 121 were male. The mean age was 62.3 +/- 16.8 years. In the >= 60 age group, the proportion of females was significantly higher than that of males (p < 0.05). Cancer prevalence and C-reactive protein and D-dimer levels were also significantly higher in this group (p < 0.05). No statistically significant differences were observed between the age groups for the other evaluated parameters. Conclusion: The incidence of pulmonary embolism is higher in the elderly population, and the presence of additional conditions, particularly cancer, further increases the risk of pulmonary embolism. Careful monitoring of elderly patients for comorbidities, risk factors, and complications-such as pulmonary embolism-is crucial. Early diagnosis and timely treatment play vital roles in reducing mortality and significantly improving quality of life.
Navigating Dental Care Under Anesthesia: A Comparative Analysis of Patients with Dental Anxiety and Intellectual Disabilities Dental Treatments under General Anesthesia in Adult Patients
(BMC, 2025) Kaynar, Zeynep Buket; Dincer, Gozde Akbal
Introduction The aim of this study was to evaluate dental treatment procedures performed under general anesthesia in adult patient. Methods The clinical records of 94 patients between the ages of 16 and 79, whose dental treatments were completed under general anesthesia between January 2021 and 2023, were evaluated retrospectively. Fisher's Exact Test and Pearson Chi-Square Test were used to compare the obtained data according to groups. The significance level was taken as p<0.050. Results A statistically significant difference was found in the restorative and periodontal treatments performed under general anesthesia between systemic diseases/disabled and healthy groups (p=0.002). A statistically significant difference was found between the duration of general anesthesia of systemic diseases/disabled and healthy groups (p= 0.013). In ASA I and ASA II scoring, a statistically significant difference was found (p=0.001). Conclusion The fact that restorative and periodontal treatments are needed more in unhealthy/disabled individuals has shown that oral hygiene is inadequate in unhealthy/disabled individuals. Systemically healthy patients had more dental treatments under general anesthesia in our hospital than unhealthy patients due to anxiety. Performing dental procedures under general anesthesia in appropriate indications for adult patients is a preferable method today, as dental treatments are completed in a single visit and the possibility of the patient's lack of cooperation in the chair is eliminated.
Impact of Polishing Methods on Surface Roughness and S. Mutans Adhesion in Composite Resins: An in Vitro Study
(BMC, 2025) Cam, Melek; Kaynar, Zeynep Buket; Atalik, Kevser; Kaya, Ayse Demet
Background This study aimed to evaluate the surface roughness and Streptococcus mutans adhesion on two different composite resin materials following the application of various polishing systems. Methods Eighty disk-shaped specimens (8 mm diameter, 2 mm thickness) were fabricated using nanohybrid (Charisma Topaz) and nanofilled (Tokuyama Estelite Asteria) composite resins (n = 40 each). Each material group was further divided into four groups (n = 10) according to the polishing system used: Mylar strip (control), Sof-Lex (TM), Clearfil (TM) Twist Dia, and Opti1Step (TM). After measuring the surface roughness, the sterilized samples were divided into two subgroups as, "artificial saliva-treated samples" and "non-treated samples." For each subgroup, solutions containing S. mutans were added, and the samples were incubated at 35-37 degrees C for 24 h. Determination of adhered bacteria on surfaces depended upon colony counts obtained after incubation, which was presented as CFU/mL. Statistical analyses included two-way ANOVA for surface roughness and three-way ANOVA with Tukey post hoc test for bacterial adhesion. Results SR values ranged from 0.07 +/- 0.01 mu m to 0.09 +/- 0.03 mu m across all groups, remaining well below the clinical threshold of 0.2 mu m, highlighting that the minor surface variations observed are unlikely to have clinical significance regarding plaque retention. (p > 0.05). S. mutans adhesion values ranged between 2.83 +/- 0.25 log CFU/mL and 3.57 +/- 0.32 log CFU/mL. No statistically significant differences were found between polishing methods or saliva conditions (p > 0.05). The three-way ANOVA revealed a statistically significant main effect of composite resin material on S. mutans adhesion (F = 29.895, p < 0.001, partial eta(2) = 0.322), indicating that bacterial colonization varied according to the resin material used. Conclusion While different polishing systems did not significantly affect surface roughness or bacterial adhesion, the composite resin type appears to play a crucial role in S. mutans colonization.
Orbital Compartment Stress Responses Related to Rapid Maxillary Expansion: A Finite Element Analysis
(Galenos Publ House, 2025) Ensarioglu, Aybuke; Demirkaya, Arzu Ari
Objective: This study aimed to use finite element analysis to evaluate the effects of acrylic HYRAX and hybrid HYRAX devices in the treatment of rapid maxillary expansion (RME), particularly on the orbital compartments. Methods: In the present study, a craniofacial model was developed utilizing computed tomography data obtained from the visible human project. A total of four distinct models were generated by designating the sutures in the adult variation as closed and those in the non-adult variation as open while incorporating both expansion devices into the model. Both acrylic and hybrid device models were subjected to expansion forces of 0.25 mm and 5 mm, yielding eight distinct scenarios for comprehensive analysis. Results: Significant stress and displacement were observed, particularly around the orbital compartments in all scenarios. Displacement decreased with increased sutural ossification and the resulting stresses demonstrated elevation. In adult models, the hybrid device generated reduced stress, especially around the orbital compartments. Conclusion: Based on these findings, it is proposed that the orbital compartments may serve as a clinically relevant site for measuring the increased intracranial pressure during RME treatment. To prevent possible side effects, RME should be performed at an early age, and if ossification is suspected to be increased, bone-supported expansion devices are recommended.
A Case Series of Diamine Oxidase Deficiency Misdiagnosed as Anxiety or Panic Attacks in Patients with Tachycardia
(Wolters Kluwer Medknow Publications, 2025) Keskinel, Ilkay
Background:Diamine oxidase (DAO) deficiency, a key marker of histamine intolerance (HIT), often mimics anxiety or panic disorders, leading to a misdiagnoses and delayed treatment.Cases:We present five female patients (aged 25-54) with chronic, non-specific symptoms, including palpitations, nasal congestion, and gastrointestinal disturbances, initially attributed to the anxiety. Serum DAO levels below 10 IU/mL confirmed HIT in all cases. Treatment with a low-histamine diet and DAO supplementation significantly improved symptoms, highlighting the importance of considering HIT in such cases. One patient experienced recurrence after discontinuing treatment, emphasizing the need for long-term management. Genetic testing in one case revealed variants linked to reduced DAO activity, suggesting a potential genetic predisposition.Conclusion:These findings underscore the importance of DAO level assessment in patients with unexplained symptoms and the role of multidisciplinary care in accurate diagnosis and management. Further studies are needed to refine diagnostic criteria and explore long-term strategies for HIT.

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