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Guven Med and Health Sci
- New concepts in metabolic dysfunction-associated liver diseases: MAFLD and MASH
- D-dimer: Navigating Clinical Pitfalls and Diagnostic Truths
- Effects of Hyperhidrosis on Mental Health
- The New Landscape of Lipid Management: apoB-Centered Strategies and Emerging Therapies
- Endocrine Disrupting Chemicals and Their Carcinogenic Effects
- The New Frontier in Global Health: Steatotic Liver Disease
Guven Medical and Health Sciences
Articles
New concepts in metabolic dysfunction-associated liver diseases: MAFLD and MASH
Authors: Seçil Ak Aksoy, Ulviye Bur Şener, Dilsad Oztaban, Deniz Tuğba Yaylalı
Abstract
Metabolic dysfunction-associated steatohepatitis (MASH), formerly termed non-alcoholic steatohepatitis (NASH), is a significant chronic liver disease that arises from metabolic dysfunction-associated steatotic liver disease (MASLD, previously known as NAFLD). It is characterized by hepatic inflammation and fibrosis and is strongly associated with metabolic disorders such as obesity, type 2 diabetes mellitus, and dyslipidemia. Progressive fibrosis and scarring of liver tissue may lead to cirrhosis and predispose individuals to severe complications, including hepatocellular carcinoma (HCC). Affecting more than 25% of the global population, MASH represents an increasingly prevalent and aggressive liver disease worldwide. In 2023, an international consensus redefined the terminology to better reflect the metabolic basis of the disease: NAFLD was renamed MASLD, and NASH was updated to MASH. This revision emphasizes the metabolic drivers of the condition while also removing the stigma associated with the term “non-alcoholic.” In addition, the updated terminology introduced refinements in diagnostic criteria, enabling a more precise and standardized diagnosis. MASH has a complex and multifactorial pathogenesis. Contributing mechanisms include lipotoxic effects resulting from hepatic lipid accumulation, increased oxidative stress driven by reactive oxygen species (ROS), systemic effects on extrahepatic tissues such as skeletal muscle and the heart, and alterations in the gut microbiota. Genome-wide association studies (GWAS) have identified several single nucleotide polymorphisms (SNPs) that influence disease susceptibility and progression, including variants in PNPLA3, TM6SF2, GCKR, HSD17B13, and MBOAT7. Beyond genetic determinants, epigenetic modifications and diverse signaling pathways also play important roles in disease development and progression. This review provides an overview of the updated classification of MASH and explores its cellular and molecular mechanisms of pathogenesis based on current literature.
DOI: 10.62351/gmhs.2026.0010
D-dimer: Navigating Clinical Pitfalls and Diagnostic Truths
Authors: Ali Uğur Ural
Abstract
D-dimer is an unequivocally useful tool for the diagnosis of venous thromboembolism (VTE). However, it is not specific for thromboembolic disease, as elevated levels can also be observed in a variety of other conditions, ranging from surgical procedures and infections to malignancies. In other words, increased D-dimer levels may occur as part of an inflammatory state or in association with cancer, without necessarily indicating a thromboembolic event.
DOI: 10.62351/gmhs.2026.0011
Effects of Hyperhidrosis on Mental Health
Authors: Berkant Özpolat
Abstract
Axillary and palmar hyperhidrosis is a chronic autonomic disorder with substantial psychological and social consequences. This review evaluates the impact of hyperhidrosis on mental health by synthesizing recent literature. PubMed-indexed studies, including systematic reviews, meta-analyses, cohort studies, and qualitative reports, were analyzed. Key outcomes assessed include anxiety, depression, social anxiety, stigma, quality of life, and the psychosocial effects of medical and surgical interventions. Meta-analytic evidence indicates significantly increased risks of anxiety and depression among individuals with primary hyperhidrosis. Axillary hyperhidrosis is closely associated with stigma and reduced self-esteem, whereas palmar hyperhidrosis predominantly contributes to performance anxiety and social phobia. Medical treatments, including oxybutynin, botulinum toxin A, and microwave therapy, as well as endoscopic thoracic sympathectomy (ETS), have been shown to meaningfully improve both physical symptoms and psychological wellbeing. Hyperhidrosis should be approached as a biopsychosocial condition. Comprehensive management requires integrating psychiatric assessment and quality-of-life evaluation alongside somatic treatment. Preoperative psychosocial evaluation is particularly crucial for candidates undergoing ETS.
DOI: 10.62351/gmhs.2026.0012
The New Landscape of Lipid Management: apoB-Centered Strategies and Emerging Therapies
Authors: Muhammed Bora Demirçelik
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is primarily driven by cumulative lifetime exposure to apolipoprotein B (apoB)–containing lipoproteins. Converging evidence from genetic studies, Mendelian randomization analyses, and large randomized clinical trials has firmly established low-density lipoprotein cholesterol (LDL-C) and apoB particle burden as causal determinants of atherosclerosis. Accordingly, contemporary lipid management has shifted from a traditional statin-centered, stepwise paradigm toward strategies emphasizing earlier initiation, deeper lipid lowering, and individualized treatment based on patient-specific biological risk. Although statins remain the foundation of lipid-lowering therapy, their limitations in very-high-risk populations and in patients with statin intolerance have driven the development of novel therapeutic agents. Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies provide substantial additional LDL-C reduction and have demonstrated significant cardiovascular event reduction in secondary prevention settings. Small interfering RNA (siRNA)–based therapies, particularly inclisiran, offer durable LDL-C lowering with infrequent dosing, addressing challenges related to long-term adherence. Bempedoic acid has emerged as an outcome-proven alternative for statin-intolerant patients, while angiopoietin-like protein 3 (ANGPTL3) inhibition enables LDL receptor–independent lipid lowering, expanding therapeutic options for patients with familial hypercholesterolemia. Beyond LDL-C, lipoprotein(a) [Lp(a)] has gained recognition as a genetically determined, independent, and causal cardiovascular risk factor. Novel antisense oligonucleotide and siRNA-based therapies targeting Lp(a) achieve profound reductions in circulating levels and represent a promising approach to residual cardiovascular risk, with large outcome trials currently underway. Collectively, recent advances in lipid therapeutics support a paradigm shift toward precision lipid management, focused on lifelong reduction of atherogenic particle burden and comprehensive cardiovascular risk modification.
DOI: 10.62351/gmhs.2026.0013
Endocrine Disrupting Chemicals and Their Carcinogenic Effects
Authors: Müge Keskin, Arzu Or Koca, İlhan Yetkin, Mustafa Cesur
Abstract
The role of endocrine-disrupting chemicals (EDCs) in carcinogenesis is multifaceted, encompassing interference with hormone synthesis, secretion, transport, metabolism, and receptor-mediated signaling pathways in hormone-dependent cancers. Accumulating evidence indicates that exposure to EDCs may influence cancer development through epigenetic mechanisms, giving rise to long-term and potentially transgenerational effects. Current evidence suggests that cancer risk associated with EDC exposure is determined not only by the presence of exposure but also by its dose, duration, and, importantly, the developmental timing of exposure. Among endocrine-disrupting chemicals, those classified as Group 1 human carcinogens by the International Agency for Research on Cancer (IARC) include 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), polychlorinated biphenyls (PCBs), and diethylstilbestrol (DES). In real-world settings, exposure to endocrine-disrupting chemicals typically involves simultaneous contact with multiple compounds, highlighting the need for translational studies that integrate mechanistic and epidemiological evidence.
DOI: 10.62351/gmhs.2026.0014
The New Frontier in Global Health: Steatotic Liver Disease
Authors: Barış Doğukan Işıkoğlu
Abstract
Metabolic dysfunction–associated steatotic liver disease (MASLD) has emerged as the most prevalent chronic liver disease worldwide, in parallel with the rising incidence of obesity, insulin resistance, and type 2 diabetes mellitus. MASLD encompasses a broad clinical spectrum, ranging from simple hepatic steatosis to metabolic dysfunction–associated steatohepatitis (MASH), advanced fibrosis, cirrhosis, and hepatocellular carcinoma. The largely asymptomatic nature of the disease, limited disease awareness, and the absence of widely available disease-specific therapies pose significant challenges for early diagnosis and effective management. This narrative review summarizes the current nomenclature, epidemiology, and pathophysiological mechanisms of MASLD and MASH, with a particular focus on metabolic, genetic, and environmental interactions. Current diagnostic approaches, including invasive and non-invasive methods, serum-based scoring systems, and advanced imaging techniques, are discussed in the context of recent clinical practice guidelines. Furthermore, established and emerging treatment strategies, ranging from lifestyle modification and bariatric surgery to novel pharmacological therapies, are comprehensively reviewed. Given the growing burden of hepatic and cardiometabolic complications associated with MASLD, early identification of at-risk individuals and the implementation of individualized management strategies are essential to mitigate disease progression and reduce long-term morbidity and mortality.
DOI: 10.62351/gmhs.2026.0015