Acta Medica

HIV-related stigma: effects on health outcomes and directions for stigma-focused interventions

İlayda Akınkoç, Deniz Gökengin, Bülent Turan — Tue, 18 Mar 2025 00:00:00 +0300

HIV-related stigma is a widespread experience among HIV-affected individuals that may have an impact on the well-being of both people living with HIV (PLWH) and associated individuals. This review examines the multifaceted nature of HIV-related stigma by summarizing its dimensions. Furthermore, it discusses how different dimensions of HIV-related stigma and intersectional stigma due to co-existing stigmatized conditions can lead to differential effects on the mental and physical health outcomes of PLWH. The scope of this review consists of the associations between HIV-related stigma and mental health challenges of depression and anxiety, as well as substance use, with a focus on the cognitive behavioral underpinnings, social isolation, and health behaviors of PLWH. On the other hand, the interplays between HIV-related stigma and immunological parameters, such as CD4 counts and viral loads, were discussed, which may have an effect through behavioral and non-behavioral pathways. This review also discusses possible stigma-informed policies and interventions with a multi-level approach. Specifically, it suggests that the focus of structural-level interventions can constitute policy regulations to ensure reducing HIV-related stigma and stereotype threats in organizational and legal settings. Stigma-informed intrapersonal interventions may focus on providing strategies that can target the cognitive and behavioral experiences of HIV-affected individuals through individual or group therapies. Lastly, interventions that focus on interpersonal and intergroup experiences can underline improving the quality of the contact and relationship between PLWH and HIV-negative individuals to challenge HIV-related stigma and improve the well-being of both populations.

Facial zona zoster following cryotherapy in an immunocompetent patient

Ecem Bostan — Mon, 30 Dec 2024 00:00:00 +0300

Cryotherapy is commonly used in different medical fields including dermatology, urology, oncology and sports medicine. The well-known complications of cryotherapy include dyspigmentation, scar formation and hair loss. Herein, a facial zona zoster case is reported as an unexpected complication of cryotherapy.

The conus artery as a lethee in coronary artery disease

Mustafa Yurtdaş, Zeki Doğan — Tue, 18 Mar 2025 00:00:00 +0300

Collaterals connecting coronary arteries may protect the heart from ischemic attacks, thus mediate in the preservation of myocardial functions. Symptoms and ventricular functions are closely related to the quality of coronary collaterals. In the presence of chronic total occlusion (CTO) in the left anterior descending artery (LAD), collateral circulation from the conus artery to the LAD is rare but may be life-saving. We report a 44-year-old patient with moderate left ventricular dysfunction and multi-vessel coronary disease in whom collateral flow was supplied by the conus artery, connecting to distal to the LAD CTO.

Leptomeningeal carcinomatosis: a rare phenomenon in neurology?

Tue, 18 Mar 2025 00:00:00 +0300

Leptomeningeal involvement may be caused by various conditions, and patients may present with different clinical findings. The causes of this condition may be carcinogenic, infectious, inflammatory and autoimmmunity. The prognosis is dependent upon the underlying cause.
We present three cases of leptomeningeal involvement with different diagnoses and clinical findings.

Nutrition-related infodemic experiences of the adults admitted to a Family Health Center in Ankara, Türkiye

Wed, 26 Mar 2025 00:00:00 +0300

Objective: The infodemic has been a global challenge in almost all aspects of life, including nutrition-related practices. Dissemination of infodemic originating from both online and offline sources might end with risky health behaviors. Defining the case provides an opportunity to manage the infodemic. In this study, we aimed to define the nutrition-related infodemic experiences of the individuals over the age of 18 who applied to a Family Health Center in Ankara.

Materials and Methods: This descriptive study investigated individuals admitted to the Family Health Center in Ankara, Türkiye, with data collected through a questionnaire developed by researchers and face-to-face interviews conducted between May and July 2023. Data analysis utilized SPSS version 23.0, employing binary logistic regression to assess associations between various variables and infodemic management.

Results: The study, involving 222 participants, involved a majority of females (63.1%), married individuals (65.3%), and non-working participants (62.9%). Health-related characteristics indicated that 44.4% had diagnosed diseases, while 64.9% engaged in physical exercise meeting World Health Organization recommendations, and 25.8% reported tobacco use. Infodemic exposure was notable, with 51.8% always checking information sources, and logistic regression revealed a significantly higher infodemic experience among individuals with diagnosed diseases (OR = 3.621, 95% CI 1.244 to 10.545, p = 0.018).

Conclusion: In summary, our study suggests the presence of an infodemic related to nutrition behavior within healthcare environments. Based on these findings, we advocate for proactive measures and structured initiatives to address infodemic challenges in healthcare settings. Moreover, we encourage future investigations to delve deeper into the underlying dynamics of this phenomenon.

Association of HIF-1α and TNFα single nucleotide polymorphisms with periodontal disease in diabetic patients

Tue, 18 Mar 2025 00:00:00 +0300

Objective: Periodontal disease is a prevalent chronic inflammatory condition affecting the supporting structures of teeth and is considered one of the chronic complications of Type 2 diabetes mellitus (T2DM). Both diabetes and periodontal diseases are complex, multifactorial diseases to which genetic factors play a crucial role in susceptibility. The TNF-α/HIF-1 pathway might have a regulatory function in periodontal tissues. Several case-control studies have examined the association between TNF-α G308A or HIF-1α C1772T polymorphisms and diabetes complications, but the results have been inconsistent. We aimed to investigate the association between two specific genetic variants -HIF-1α C1772T and TNF-α G308A- and periodontal disease in patients with type 2 diabetes.

Methods: A total of 109 individuals were enrolled in the study including 24 chronic periodontitis with T2DM (group 1), 35 gingivitis with T2DM (group 2), 26 non-diabetic individuals with chronic periodontitis (group 3) and 24 periodontally healthy non-diabetic individuals (group 4). The normal allelic and genotype distribution of these variants was analyzed in healthy Turkish adults (n: 120), independent of the study cohort. Allele and genotype distribution of group 4 and healthy Turkish adults were similar. Allelic and genotypic comparisons between group 4 and other groups were evaluated by PCR-RFLP. Allelic, dominant, and recessive genetic models were calculated to assess the strength of the association.

Results: We found a significant association between the A allele at TNF-α G308A and the risk of gingivitis in T2DM (OR=3.75, CI:1.015–13.860, p=0.048). There was no association detected between HIF-1α C1772T polymorphisms and risk for periodontal diseases with T2DM.

Conclusion: These results suggest that TNF G308A polymorphism may be involved in the pathogenesis of periodontal disease in diabetics. Future studies may contribute to the investigation of the potential polygenic predisposition of the diseases and reinforce our findings.

Astroviruses and celiac disease: a preliminary study into potential environmental triggers

Tue, 18 Mar 2025 00:00:00 +0300

Objective: Celiac disease (CD) is a chronic, multi-organ, autoimmune disease in which different viruses may play a role in the pathogenesis. human astroviruses (Mamastrovirus) have also been shown to infect enterocytes and replicate in intestinal enteroids. Therefore, astroviruses are thought to be one of the critical environmental factors for celiac patients. This is the the first study investigating relationship between CD and astroviruses.

Materials and Methods: Previously-described PCR protocols for screening and typing of mamastroviruses were modified and optimized. These molecular methods were used for the stool and duodenal biopsy samples of 53 patients; six newly diagnosed CD, three celiac patients with good treatment responses, 23 refractory CD and 21 patients with dyspepsia.

Results: Astroviruses could not be detected in the stool and duodenal biopsy samples of 53 patients.

Conclusion: Although no evidence for the association of Mamastrovirus infection and CD could be demonstrated in this study, this might have been due to limited cohort size. Therefore, comprehensive studies with larger samples with different patient groups are needed.