Turkish Journal of Medical Sciences最新文献

{"title":"CD20 molecule deficiency and carrier frequency: a village-based screening study.","authors":"Ebru Sümen, Mehmet Ali Karaselek, Serkan Küççüktürk, Tuğçe Duran, Büşra Yüksel, Mustafa Gençeli, Ayşe Sümeyra Engin, Muhammed Furkan Erden, Tuğba Esra Pekcandanoğlu, Bilal Bostan, Mahmut Esad Yurtseven, Nazire Nur Onat, Şükrü Nail Güner, Sevgi Keleş, İsmail Reisli","doi":"10.55730/1300-0144.6157","DOIUrl":"https://doi.org/10.55730/1300-0144.6157","url":null,"abstract":"<p><strong>Background/aim: </strong>CD20 deficiency is an autosomal recessive inborn error of immunity (IEI), and the only known affected individual worldwide has been under follow-up in our clinic. Because the consanguineous parents of the index patient are putative carriers, we hypothesized that additional individuals with reduced CD20 expression might exist within their village population. This study aimed to evaluate clinical features associated with IEI and to identify individuals displaying CD20 mean fluorescence intensity (MFI) patterns consistent with putative carrier status, while also providing appropriate genetic counseling.</p><p><strong>Materials and methods: </strong>This cross-sectional screening study was conducted in December 2024 in Çukurbağ village. Participants completed a questionnaire that included IEI warning signs and information about their familial relationship to the index case. CD19 and CD20 expression in peripheral blood samples was analyzed by flow cytometry. Individuals were classified as putative carriers if their CD20 MFI values were <50% of those of healthy controls.</p><p><strong>Results: </strong>A total of 145 individuals (44 children, 101 adults) from 52 families were screened. Among individuals related to the index case, the consanguinity rate was 39.3%. Jeffrey Modell Foundation scores were significantly higher in children than in adults (p < 0.05). No individuals with CD20 deficiency were identified. Approximately 10% of participants (n = 14) exhibited normal CD19 and CD20 percentages but showed reduced CD20 MFI values consistent with putative carrier status. All putative carriers were relatives of the index case. The proposed CD20-A700 (≤2537) and CD20-FITC (≤7787) MFI thresholds demonstrated high diagnostic performance (sensitivity and specificity values are presented for both parameters).</p><p><strong>Conclusion: </strong>CD20 MFI, rather than CD20 percentage, appears to be a more informative indicator for identifying individuals with flow-cytometric patterns suggestive of putative carrier status. Flow cytometry may serve as a rapid and practical preliminary screening tool in community-based settings; however, confirmation of carrier status requires molecular genetic testing, and genetic counseling should be based on verified genotypic results.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"237-245"},"PeriodicalIF":1.0,"publicationDate":"2026-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A model based on dynamic hematologic parameters to predict short term clinical events in pediatric acute lymphoblastic leukemia.","authors":"Neryal Tahta, Salih Gözmen, Sultan Okur Acar","doi":"10.55730/1300-0144.6183","DOIUrl":"https://doi.org/10.55730/1300-0144.6183","url":null,"abstract":"<p><strong>Background/aim: </strong>Acute lymphoblastic leukemia (ALL) treatment is frequently complicated by infections, emergency visits, and therapy interruptions, yet early prediction of short-term clinical deterioration remains challenging. Traditional prognostic markers rely on static laboratory values, whereas dynamic hematologic fluctuations may provide earlier warning signals. This study presents and internally validates a clinically applicable prediction model based on dynamic hematologic parameters and clinician-documented symptoms for predicting short-term (7-day) clinical events in children with ALL.</p><p><strong>Materials and methods: </strong>Included in this retrospective study were 44 pediatric ALL patients treated with Berlin-Frankfurt-Münster-based protocols between January 2023 and June 2025. Weekly observation units were created by aggregating complete blood count values and clinician-documented symptoms. Dynamic hematologic indices included mean absolute neutrophil count (ANC), coefficient of variation (ANC-CV), and time in target range (ANC-TTR). The composite outcome was defined as any of the following occurring within 7 days: unplanned emergency visit, ≥48-h chemotherapy interruption, or infection requiring systemic antibiotics. Mixed-effects logistic regression was used to account for within-patient clustering. Model performance was assessed using discrimination, calibration, decision curve analysis, and bootstrap internal validation.</p><p><strong>Results: </strong>A total of 1136 weekly observations were analyzed. Composite clinical events occurred in 32.3% of weeks. Event weeks demonstrated lower ANC, higher ANC-CV, reduced ANC-TTR, lower hemoglobin levels, and higher symptom burden (all p <0.01). In the hematology-only model, ANC, ANC-CV, ANC-TTR, hemoglobin levels, and platelet counts were independent predictors (AUROC = 0.77). Adding the symptom score improved discrimination (AUROC = 0.83) and calibration. Decision curve analysis demonstrated greater net clinical benefit for the combined model across threshold probabilities of 10-40%.</p><p><strong>Conclusion: </strong>Dynamic hematologic trajectories and clinician-documented symptoms enable accurate early prediction of short-term clinical events in pediatric ALL. This low-cost, accessible prediction model may support individualized risk stratification and proactive supportive care.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"489-496"},"PeriodicalIF":1.0,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of CALR-mutated essential thrombocythemia as a distinct disease entity compared with JAK2 V617F-mutated and triple-negative patients.","authors":"Gökhan Sami Aydin, Elif Aksoy, İpek Yönal Hindilerden, Aynur Dağlar Aday, Emine Gültürk, Meliha Nalçaci, Fehmi Hindilerden","doi":"10.55730/1300-0144.6184","DOIUrl":"https://doi.org/10.55730/1300-0144.6184","url":null,"abstract":"<p><strong>Background/aim: </strong>Calreticulin (CALR) mutations in essential thrombocythemia (ET) are associated with younger age, higher platelet counts, and lower thrombosis rates. The present study analyzes the demographic, laboratory, and clinical features of the CALR mutation and its prognostic impact.</p><p><strong>Materials and methods: </strong>The clinical impact of CALR mutations was assessed in 391 ET patients.</p><p><strong>Results: </strong>CALR-mutation patients were more commonly male than JAK2 V617F-positive and triple-negative patients. Age at diagnosis was similar across all groups, although patients with type 2 CALR mutations were younger than those with nontype 1/nontype 2 mutations. Compared with JAK2 V617F-positive patients, CALR-mutation patients had lower leukocyte counts (9.6 × 10⁹/L vs. 10.9 × 10⁹/L), lower hemoglobin (Hb) and hematocrit (Hct) levels, higher platelet counts (1078.5 × 10⁹/L vs. 858.1 × 10⁹/L), and lower total thrombosis rates (20.8% vs. 37.8%), while the CALR-mutated and triple-negative patients had lower venous thrombosis rates than in the JAK2 V617F-positive patients. The arterial thrombosis rate before and at the time of diagnosis was lower in the CALR-mutation patients than in the JAK2 V617F-positive patients, and the total venous thrombosis rate in patients aged <60 years at the time of diagnosis was lower in the CALR-mutation and triple-negative patients than in the JAK2 V617F-positive patients. Multivariable analysis revealed cardiovascular (CV) risk to be the only independent predictor of total thrombosis. Female gender, absence of CV risk, and platelet count ≥1000 × 10⁹/L were associated with a lower incidence of arterial thrombosis. Age <60 years was associated with lower risks of arterial and venous thrombosis. Overall, thrombosis-free, and leukemia-free survival were similar across all groups, while myelofibrosis-free survival was longer in the type 2 CALR-mutation group.</p><p><strong>Conclusion: </strong>The CALR mutation was lower among females, and was associated with lower leukocyte counts, and Hb and Hct levels, and with higher platelet counts. In multivariable analysis, the apparent protective association of CALR with thrombosis was not independent.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"497-508"},"PeriodicalIF":1.0,"publicationDate":"2026-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of repetitive peripheral magnetic stimulation and transcutaneous electrical nerve stimulation in upper trapezius myofascial pain syndrome.","authors":"Shahriyar Kalbiyev, Şehim Kutlay, Atilla Halil Elhan, Yeşim Kurtaiş Aytür, Aysun Genç","doi":"10.55730/1300-0144.6178","DOIUrl":"https://doi.org/10.55730/1300-0144.6178","url":null,"abstract":"<p><strong>Background/aim: </strong>In this prospective, randomized, single-blind study, the effects of repetitive peripheral magnetic stimulation (rPMS) and transcutaneous electrical nerve stimulation (TENS) on pain intensity, functional status, and tissue elasticity were evaluated in patients with upper trapezius myofascial pain syndrome (MPS).</p><p><strong>Materials and methods: </strong>A total of 75 female patients were randomly allocated to three groups: rPMS, TENS, and sham rPMS. All participants were provided with an exercise program consisting of cervical range-of-motion (ROM), stretching, and strengthening exercises. Outcome measures included pain intensity assessed using the visual analog scale, pressure pain threshold (PPT), the Neck Disability Index, cervical ROM, SF-36 subscale scores, and ultrasound shear-wave elastography. All data were collected and compared before treatment, immediately after treatment, and 1 month after treatment.</p><p><strong>Results: </strong>Both rPMS and TENS significantly reduced pain intensity, increased PPT, and improved functional outcomes compared with the sham rPMS group. However, rPMS was associated with a greater increase in PPT compared with TENS (p = 0.013). A significant improvement in ROM was observed across all three groups for all neck positions, except for extension in the sham rPMS group. The rPMS group showed significant improvements in four SF-36 subscales compared with the sham rPMS group, whereas the TENS group showed no significant differences. Furthermore, improvements in physical functioning (p = 0.011) and mental health (p = 0.007) scores were significantly greater in the rPMS group than in the TENS group. A significant increase in muscle elasticity was observed only in the TENS group; no significant change was observed in the rPMS or sham rPMS groups.</p><p><strong>Conclusion: </strong>The findings may suggest that rPMS may be a promising noninvasive modality for the management of MPS. It may be used to reduce pain and improve functional outcomes in patients with MPS. Elastography findings may indicate that neurophysiological mechanisms contribute substantially to pain and dysfunction; however, mechanical stiffness cannot be excluded as a contributing factor. Longer follow-up studies are needed to determine the effectiveness of rPMS treatment protocols.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"439-453"},"PeriodicalIF":1.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma data in Türkiye between 2016 and 2022: a nationwide descriptive and observational study covering the entire adult population.","authors":"Kurtuluş Aksu, Gürgün Tuğçe Vural Solak, Naim Ata, Mustafa Hamidullah Türkkani, Mustafa Mahir Ülgü, Şuayip Birinci, Funda Aksu","doi":"10.55730/1300-0144.6185","DOIUrl":"https://doi.org/10.55730/1300-0144.6185","url":null,"abstract":"<p><strong>Background/aim: </strong>Determining the current burden of asthma in countries is important in the diagnosis and follow-up of asthma patients and for the development of national health policies. Our study aimed to clarify the epidemiological and clinical data regarding asthmatic adults in Türkiye.</p><p><strong>Materials and methods: </strong>The study was designed as a nationwide descriptive, observational cross-sectional study. Data on adult patients who were followed with the diagnosis of asthma in all public, private, and university hospitals in Türkiye between January 2016 and December 2022 were obtained from the e-Nabız database of the Ministry of Health and analyzed.</p><p><strong>Results: </strong>The number of patients followed with a diagnosis of asthma in Türkiye between 2016 and 2022 was 2,700,183. The mean age of these patients was 45.70 years (standard deviation: 15.87) and 74.5% of them were female. Of the patients, 92.3% were prescribed dry powder inhalers, 98.41% metered dose inhalers, and 80.38% montelukast. The short-acting beta-2 agonist (SABA) prescription rate was 65.74% and SABA was prescribed as the sole medication for 0.10% of patients. The percentage of patients prescribed nebulized treatment was found to be 69.83%. Among asthmatic adults, the rate of at least one emergency room visit was 12.4%, the rate of hospitalization in the ward was 5.6%, and the rate of intensive care unit admission was 0.1%.</p><p><strong>Conclusion: </strong>Asthma is a major health burden in Türkiye, as is the case around the world. National planning for the diagnosis and follow-up of patients needs to be improved and continued.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"509-517"},"PeriodicalIF":1.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation as a harbinger of death: a retrospective cohort study of preoperative biomarker risk stratification in orthopedic trauma.","authors":"Serkan Aydin, Burhan Kurtuluş","doi":"10.55730/1300-0144.6141","DOIUrl":"https://doi.org/10.55730/1300-0144.6141","url":null,"abstract":"<p><strong>Background/aim: </strong>This study aimed to evaluate the prognostic significance of preoperative inflammatory markers including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), C-reactive protein (CRP), and procalcitonin in predicting 30-day and 1-year mortality in patients undergoing femur fracture surgery.</p><p><strong>Materials and methods: </strong>This retrospective, multicenter cohort study included patients who underwent surgical treatment for femur fractures between January 2018 and December 2024. Patients were stratified into survivor and nonsurvivor groups based on 30-day and 1-year outcomes. Demographic characteristics, comorbidities, laboratory parameters, and inflammatory indices were recorded and analyzed. Linear and multivariate logistic regression analyses were performed to identify independent predictors of mortality. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive performance of the inflammatory markers.</p><p><strong>Results: </strong>A total of 430 patients were included, 310 (72.1%) of whom survived while 120 (27.9%) died during the 1-year follow-up. The 30-day mortality rate was 15% (n = 65) and the 1-year mortality rate was 38% (n = 163). Nonsurvivors were significantly older (81.3 ± 9.6 vs. 75.2 ± 10.1 years, p < 0.001) and had higher rates of diabetes mellitus (45% vs. 30%, p = 0.003), hypertension (80% vs. 40%, p < 0.001), and chronic kidney disease (55% vs. 16%, p < 0.001). Laboratory analysis showed elevated white blood cell count, red cell distribution width, neutrophils, CRP, procalcitonin, NLR, PLR, and MLR, while albumin was lower in nonsurvivors (all p < 0.05). Multivariate analysis identified age, chronic kidney disease, low albumin, elevated creatinine, CRP, the MLR, and hospital stay as independent mortality predictors. The MLR showed the strongest association (OR = 4.12 for 30-day mortality; OR = 3.85 for 1-year). ROC analysis revealed CRP (AUC = 0.811 and 0.783) and the MLR (AUC = 0.765 and 0.751) as the most accurate predictors, followed by the NLR and hospital stay.</p><p><strong>Conclusion: </strong>Preoperative inflammatory markers, particularly the MLR and CRP, were strongly associated with short- and long-term mortality in femur fracture surgery. Their integration into preoperative assessment may enhance risk stratification and guide clinical decision-making.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"90-98"},"PeriodicalIF":1.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sun-macerated <i>Hypericum perforatum</i> oleates in fixed oils: analytical characterization and comparative wound-healing activity.","authors":"Cihan Çapar, Esra Küpeli, Aylin Yaba, Ayhan Parmaksiz, Engin Sümer, Erdem Yeşilada","doi":"10.55730/1300-0144.6190","DOIUrl":"https://doi.org/10.55730/1300-0144.6190","url":null,"abstract":"<p><strong>Background/aim: </strong><i>Hypericum perforatum</i> L. oleates prepared in fixed oils have long been used for wound management due to their antiinflammatory, antibacterial, and tissue-regenerative properties. The bioactivity of these oleates is mainly attributed to hypericin, hyperforin, and pseudohypericin. In the present study, the wound-healing potential of <i>H. perforatum</i> oleates prepared in different fixed oils, including <i>Olea europaea</i> L. (olive), <i>Sesamum indicum</i> L. (sesame), <i>Helianthus annuus</i> L. (sunflower), and <i>Nigella sativa</i> L. (black seed), is compared.</p><p><strong>Materials and methods: </strong>Fixed oils were characterized by gas chromatography-mass spectrometry, while oleuropein (olive oil) and thymoquinone (black seed oil) were quantified by high-performance liquid chromatography, and sesamin and sesamol (sesame oil) by spectrophotometry. Oleates were prepared using the traditional sun maceration method. Hypericin, hyperforin, and pseudohypericin were quantified by liquid chromatography-mass spectrometry and ultraviolet spectrophotometry. In vitro and in vivo assays were performed to assess the wound-healing activities of both the fixed oils and their respective oleates.</p><p><strong>Results: </strong>All oleates exhibited significantly greater wound-healing activity than the corresponding fixed oils. The most pronounced synergistic effects were observed with the olive oil and sesame oil oleates.</p><p><strong>Conclusion: </strong>Maceration of <i>H. perforatum</i> in fixed oils enhances the intrinsic therapeutic properties of oils and contributes to improvements in multiple wound-healing parameters. The findings of the present study support the traditional use of <i>H. perforatum</i> oleates and provide a scientific basis for their pharmacological development.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"570-584"},"PeriodicalIF":1.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive profiling of gut microbiota in postmenopausal osteoporosis.","authors":"Gülsemin Ertürk Çelik, Sedat Yildiz, Münevver Aksoy Bektaş, Yaprak Engin Üstün","doi":"10.55730/1300-0144.6187","DOIUrl":"https://doi.org/10.55730/1300-0144.6187","url":null,"abstract":"<p><strong>Background/aim: </strong>Osteoporosis is a multifactorial skeletal disease that predominantly affects postmenopausal women and is characterized by reduced bone mass and an increased risk of fractures. Growing evidence suggests that the gut microbiota plays a pivotal role in bone metabolism through immunological, endocrine, and metabolic pathways, forming the basis of the so-called gut-bone axis. This study aimed to characterize gut microbiota composition in postmenopausal women with osteoporosis compared with healthy controls.</p><p><strong>Materials and methods: </strong>Forty postmenopausal women aged 55-65 years were classified into osteoporosis (n = 20) and healthy control (n = 20) groups based on dual-energy X-ray absorptiometry T-scores. Fecal samples were collected, and gut microbiota composition was evaluated with full-length 16S rRNA gene sequencing using Oxford Nanopore Technologies.</p><p><strong>Results: </strong>No significant differences were observed in clinical or demographic characteristics between groups, except for the expected lower bone mineral density (BMD) in the osteoporosis group. Alpha-diversity indices showed no statistically significant differences, although a trend toward reduced microbial richness was observed in the osteoporotic participants. Beta-diversity analysis revealed a modest but significant phylogenetic distinction via weighted UniFrac analysis (p < 0.05). Short-chain fatty acid-producing species, including <i>Faecalibacterium prausnitzii</i>, <i>Anaerostipes faecalis</i>, and <i>Lactonifactor longoviformis</i>, were significantly reduced in the osteoporosis group. <i>F. prausnitzii</i> abundance was positively correlated with the femoral neck T-score (r = 0.41, p = 0.018), whereas <i>Oxobacter pfennigii</i> showed a negative correlation with lumbar spine BMD (r = -0.43, p = 0.015).</p><p><strong>Conclusion: </strong>Postmenopausal osteoporosis is associated with a distinct gut microbiota profile marked by reduced antiinflammatory and estrogen-modulating taxa alongside increased proinflammatory species. These alterations may contribute to impaired bone metabolism through disrupted calcium absorption, systemic inflammation, and hormonal dysregulation. These findings further support the gut-bone axis and highlight the potential of gut microbiota as a biomarker and therapeutic target in osteoporosis.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"531-540"},"PeriodicalIF":1.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal microvascular and neuroretinal structural changes in pulmonary arterial hypertension assessed by OCTA: a comparative study.","authors":"Murat Erdağ, Tunahan Çalişkan, Hakan Yildirim, Tarık Kivrak, Mehmet Canleblebici, Ali Dal, Mehmet Balbaba","doi":"10.55730/1300-0144.6181","DOIUrl":"https://doi.org/10.55730/1300-0144.6181","url":null,"abstract":"<p><strong>Background/aim: </strong>Pulmonary arterial hypertension (PAH) is a progressive disorder with systemic vasculopathy, and noninvasive assessment remains challenging. The retina, sharing anatomical similarities with the cerebral microcirculation, is an accessible site for visualizing systemic vascular compromise. This study quantitatively evaluated retinal microvascular and neuroretinal structural changes in PAH patients compared to healthy controls using optical coherence tomography angiography (OCTA).</p><p><strong>Materials and methods: </strong>In this single-center, cross-sectional case-control study, 40 patients with group 1 PAH and 38 healthy controls were enrolled. For statistical independence, only the right eye of each participant was analyzed (total: 78 eyes). All participants underwent high-resolution OCTA imaging. Key metrics including vascular density (VD) in the superficial (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ) flow density (FD), and neuroretinal thicknesses (ganglion cell complex [GCC] and retinal nerve fiber layer [RNFL]) were quantified and compared using nonparametric tests.</p><p><strong>Results: </strong>Comparison of PAH patients and controls revealed significantly reduced VD in the PAH group. In the SCP, VD was significantly lower in the whole image (p = 0.004) and the ETDRS grid (p = 0.005). Similarly, the DCP showed reduced VD in the whole image (p = 0.006). Quadrant analysis indicated marked reduction in the superior quadrant for both plexuses (p < 0.01). While FAZ area was similar between the groups (p = 0.779), FAZ FD was significantly decreased in PAH patients (p = 0.001). Structurally, mean GCC thickness was significantly reduced (p = 0.006), but RNFL thickness remained preserved (p = 0.267).</p><p><strong>Conclusion: </strong>PAH is associated with significant retinal microvascular density reduction across all plexuses. These findings provide evidence corroborating the systemic nature of PAH vasculopathy. OCTA is a promising noninvasive tool for assessing systemic microvascular involvement in this population. However, further longitudinal studies are needed to validate its utility for disease monitoring.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"471-478"},"PeriodicalIF":1.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance and clinicopathological associations of tumor budding and poorly differentiated clusters in endometrioid endometrial carcinoma.","authors":"Hanife Seda Mavili, Ömer Atmiş, Fatma Seher Pehlivan, Fatma Sezen Çavdaroğlu Deveci, Ali Rıza Kandiloğlu","doi":"10.55730/1300-0144.6188","DOIUrl":"https://doi.org/10.55730/1300-0144.6188","url":null,"abstract":"<p><strong>Background/aim: </strong>Tumor budding (TB) and poorly differentiated clusters (PDCs) are histopathological parameters that have been associated with poor prognosis in various malignancies, particularly colorectal carcinoma. Although numerous studies have demonstrated an association between the microcystic, elongated, and fragmented (MELF) pattern in endometrial carcinomas and lymphovascular invasion as well as lymph node metastasis, the literature regarding TB and PDCs in this context remains limited.This study aimed to investigate the potential associations of the MELF pattern, TB, and PDCs with overall survival, progression-free survival, and clinicopathological parameters in cases of endometrioid endometrial carcinoma (EEC).</p><p><strong>Materials and methods: </strong>A total of 190 cases diagnosed with EEC through hysterectomy specimens between 2010 and 2023, with complete hospital records, were selected from the archives of the Department of Pathology at Manisa Celal Bayar University Faculty of Medicine.</p><p><strong>Results: </strong>The presence of TB and PDCs was significantly associated with high histological grade (p < 0.001), deep myometrial invasion (p < 0.001), lymphovascular invasion (p < 0.001), lymph node metastasis (p < 0.001), cervical stromal involvement (p < 0.001), serosal involvement (p < 0.001), advanced stage (p < 0.001), and larger tumor size (p = 0.042 and p = 0.027, respectively). The presence of TB and PDCs was found to be associated with reduced overall survival (p = 0.001 and p < 0.001, respectively) and reduced progression-free survival (p = 0.043 and p = 0.004, respectively). The MELF pattern was not significantly associated with overall survival (p = 0.772).</p><p><strong>Conclusion: </strong>These findings suggest that the presence of TB and PDCs may be valuable in stratifying prognostic risk in EEC and support the inclusion of these parameters in routine pathology reporting.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"541-553"},"PeriodicalIF":1.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}