Turkish Journal of Medical Sciences最新文献

{"title":"Postexposure prophylaxis for HIV among healthcare workers in Türkiye: a descriptive, multicenter retrospective study.","authors":"Veysel Akca, İlkay Akbulut, Gül Ruhsar Yilmaz, Alper Tahmaz, Nefise Öztoprak Çuvalci, İlknur Esen Yildiz, Mehmet Çabalak, Şeyma Topal, Özgür Günal, Bircan Kayaaslan, Fatma Eser, Tuba Damar Çakirca, Deniz Özer, Aliye Baştuğ, Firdevs Aksoy, Hanife Nur Karakoç Parlayan, Beyza Süllü, Damla Verendağ, Hatun Öztürk Çerik, Mehmet Ali Aşan, Ayhan Akbulut, Gülden Eser Karlidağ, Behice Kurtaran, Hüsnü Pullukçu, Turhan Togan","doi":"10.55730/1300-0144.6186","DOIUrl":"https://doi.org/10.55730/1300-0144.6186","url":null,"abstract":"<p><strong>Background/aim: </strong>Postexposure prophylaxis (PEP) for human immunodeficiency virus (HIV) plays a vital role in preventing transmission among healthcare workers following occupational exposure. Despite its clinical importance, epidemiological data regarding PEP implementation in Türkiye remain scarce. This study aimed to assess PEP practices, prophylactic treatment regimens, and follow-up outcomes among healthcare workers at risk of occupational HIV exposure.</p><p><strong>Materials and methods: </strong>This retrospective, multicenter study was conducted between January 2020 and December 2024 across 16 healthcare facilities participating in the National HIV/AIDS Working Group. Healthcare workers aged 18 years and older who presented for evaluation following occupational exposure to HIV were included. Data on demographics, exposure characteristics, source patient test results, PEP initiation timing, regimen preferences, adverse effects, and follow-up outcomes were collected from hospital records and analyzed using SPSS v25.0.</p><p><strong>Results: </strong>A total of 369 healthcare workers were assessed. The PEP initiation rate was 49.1%. Needlestick injuries accounted for 79.4% of occupational exposures, and nurses constituted nearly half of presentations (49.6%). In univariable analyses, PEP initiation was less frequent among nurses than among other healthcare staff. In the multivariable model, male sex and age ≥40 years were independently associated with higher odds of PEP initiation, whereas the nursing profession was associated with lower odds. The median time to PEP initiation was 17.9 h (range: 0-120). Adverse effects were uncommon (3.5%), most frequently nausea and vomiting. No HIV seroconversions were identified among individuals with available follow-up results; however, follow-up testing at the predefined time points was incomplete, which limits the ability to exclude rare late seroconversions.</p><p><strong>Conclusion: </strong>Timely initiation of HIV PEP appears feasible and well tolerated in real-world occupational settings. These findings highlight the need for standardized institutional protocols and improved follow-up strategies for healthcare workers in Türkiye.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"518-530"},"PeriodicalIF":1.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782337","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":"The importance of early intraoperative ultrasonography and the relationship between surgical technique and allograft function in patients with compartment syndrome following renal transplantation surgery.","authors":"Burak Yağdiran, Emre Karakaya, Ravana Ahmadli, Adem Şafak, Yağmur Kurtuluş, Nedim Çekmen, Meriç Yavuz Çolak, Mehmet Haberal","doi":"10.55730/1300-0144.6180","DOIUrl":"https://doi.org/10.55730/1300-0144.6180","url":null,"abstract":"<p><strong>Background/aim: </strong>In rare cases, patients undergoing renal transplantation <b>(</b>RT) may develop renal allograft compartment syndrome (RACS) if the renal volume is larger than the retroperitoneal space prepared in the iliac fossa. In such cases, the optimal treatment is early decompression surgery. The primary aim of the present descriptive and comparative study is not to identify the optimal surgical technique, but rather to evaluate the role of early Doppler ultrasonography (DUSG) in the recognition of renal allograft compartment syndrome and to assess outcomes following timely decompressive interventions.</p><p><strong>Materials and methods: </strong>A total of 275 patients were examined retrospectively for the study, including 247 with muscle and fascia closure and 28 with skin-only closure.</p><p><strong>Results: </strong>Only 28 (10.18%) of the patients with RACS underwent permanent fasciotomy and skin-only closure. No statistically significant difference was observed in the mean urine output between the two groups on any postoperative day, assessed based on the renal artery resistive index and peak systolic velocity.</p><p><strong>Conclusion: </strong>RACS should be considered in patients with large-sized allografts and small parailiac retroperitoneal spaces to address the inherent anatomical restrictions. Although early diagnosis with DUSG is essential for evaluating graft dysfunction in these patients, early decompression surgery should be considered crucial for the preservation of graft function in those with suspected RACS.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"464-470"},"PeriodicalIF":1.0,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782440","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":"Clinical outcome of extremity arterial injuries in the modern era.","authors":"Ali Kuşsan, Selçuk Coşkun, Alp Şener, Ferhat Içme, Pınar Köksal Coşkun, Gülhan Kurtoğlu Çelik","doi":"10.55730/1300-0144.6154","DOIUrl":"https://doi.org/10.55730/1300-0144.6154","url":null,"abstract":"<p><strong>Background/aim: </strong>Extremity arterial injuries (EAIs) present a significant clinical challenge due to the risk of limb ischemia, amputation, and mortality. This retrospective cohort study aimed to delineate the clinical course, treatment strategies, and patient outcomes following trauma-induced EAIs, and to identify independent predictors of adverse outcomes.</p><p><strong>Materials and methods: </strong>Retrospectively analyzed were data from 168 consecutive patients with traumatic EAIs who underwent computed tomography angiography at a tertiary care center between 2019 and 2025. Data extracted from electronic medical records included demographics, injury mechanisms, clinical presentation, laboratory findings, imaging results, treatment modalities (primary repair, grafting, endovascular intervention, conservative management), and patient outcomes (sequelae-free recovery, amputation, mortality).The primary outcome was sequelae-free recovery, while secondary outcomes included amputation, and mortality. The entire patient follow-up period, encompassing all treatment modifications, extended from emergency department admission until the primary or secondary outcome was reached. This period included hospitalization, postdischarge care (if applicable), and all subsequent outpatient clinic visits. Mortality was attributed only when directly causal.</p><p><strong>Results: </strong>The mean age of the patients was 37 ± 15 years, with a male predominance (86%). Penetrating trauma was the primary etiology for upper extremity injuries, while blunt trauma predominated in lower extremity injuries. Clinical presentation varied, with pulsatile bleeding significantly associated with penetrating trauma and hypoesthesia with blunt trauma. Independent predictors of adverse outcomes included hypotension, pulselessness, hypoesthesia, and elevated international normalized ratio (≥1.2). Base deficit was significantly associated with adverse outcomes in upper EAIs. Treatment modalities included primary repair (51.2%), grafting (10.1%), endovascular intervention (8.2%), and conservative management (28%). Amputation rates were 1.3% for upper extremities and 5.3% for lower ones, while mortality rates were 2.6% and 3.3%, respectively.</p><p><strong>Conclusions: </strong>Early diagnosis, prompt surgical intervention, and a multidisciplinary approach are essential for optimizing patient outcomes. Hypotension, pulselessness, and hypoesthesia were identified as significant independent predictors of adverse outcomes. Future multicenter studies are warranted to validate these findings.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"208-217"},"PeriodicalIF":1.0,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435871","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":"Preferences for mechanical ventilation modes among intensivists in Türkiye: a nationwide point-prevalence study.","authors":"Süleyman Yildirim, Nurhayat Kilinç Özgün, Özcan Alpdoğan, Hüseyin Uçar, İmren Taşkiran, Adnan Ata, Özhan Özcan, Kıvanç Öncü, Saba Mukaddes Acarbay, Temel Güner, Pınar Özgün, Zerrin Özçelik, Ayşegül Çinaroğlu, Gizem Kurada, L Serap Avlaği, Onur Gökçe, Özkul Yilmaz Çolak, Fatma Ülger, Melda Işevi, Özgür Kiliç, Rahime Aydin Kayali, Metin Yarici, Berkay Küçük, Fatma Yildirim, Kamil Gönderen, Bişar Ergün, Kutlay Aydin, Kamuran Uluç, Sevda Onuk, Mine Altinkaya Çavuş, Yelda Balik, Ahmet Sari, Hayriye Cankar Dal, Şerife Gökbulut Bektaş, Sema Turan, Ferhan Demirer Aydemir, Murat Güneş, Canan Gürsoy, Hüseyin Oğuz Yilmaz, Kamil Inci, Türkay Akbaş, Hamza Gültekin, Burcu Acar Çinleti, Tuğçe Mengi, Kaniye Aydin, Ferhat Çetinkaya, Selin Eyüpoğlu, Elif Kerimoğlu, Hüseyin Özkök, Selçuk Yaylaci, Havva Kocayiğit, Burak Kaya, Mete Erdemir, Gürhan Taşkin, Kazım Rollas, Hüseyin Özkarakaş, Mensure Çakirgöz, Cenk Kirakli","doi":"10.55730/1300-0144.6138","DOIUrl":"https://doi.org/10.55730/1300-0144.6138","url":null,"abstract":"<p><strong>Background/aim: </strong>Invasive mechanical ventilation (IMV) is a fundamental intervention for patients with respiratory failure in intensive care units (ICUs). This nationwide, multicenter point-prevalence study aimed to describe current mechanical ventilation mode preferences (conventional, adaptive, and biphasic) in Turkish ICUs and to report associated clinical outcomes descriptively, without assessing causal relationships.</p><p><strong>Materials and methods: </strong>A nationwide, multicenter point-prevalence study was conducted on 17 April 2024 and included adult patients (≥18 years) who had been receiving IMV for more than 24 h. Data on patient demographics, ventilation mode distribution, ventilatory parameters, and descriptive clinical outcomes on day 28 (weaning status, tracheostomy, and mortality) were recorded without comparative outcome analysis.</p><p><strong>Results: </strong>A total of 426 patients were included. Conventional modes were used in 84.5% of patients, adaptive modes in 10.6%, and biphasic modes in 4.9%. Synchronized intermittent mandatory ventilation (SIMV) was the most commonly used conventional mode. The primary indication for IMV was acute respiratory failure (61%), with pneumonia being the leading cause. Among the 350 orotracheally intubated patients, 25.6% were in the weaning phase on the study day. A total of 59 (16.9%) patients were extubated, 150 (42.9%) underwent tracheostomy, and 64 (18.2%) remained intubated on day 28. Overall, 185 (43.4%) patients died during their ICU stay, 152 (35.7%) remained in the ICU, and 89 (20.9%) were successfully discharged from the ICU.</p><p><strong>Conclusion: </strong>Conventional ventilation modes, particularly SIMV, were more commonly used in Turkish intensive care units (ICUs), whereas adaptive modes were less frequently applied. These patterns may reflect factors such as clinician familiarity, institutional practices, and equipment availability rather than definitive preferences. Although the impact of ventilation modes on clinical outcomes was not comparatively evaluated in this study, the choice of ventilation mode may still influence patient outcomes. Therefore, further prospective and comparative studies are warranted to better elucidate this relationship.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"60-70"},"PeriodicalIF":1.0,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435868","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":"Tremor modulation: a systematic review of resetting by single-pulse transcranial magnetic stimulation.","authors":"Handan Uzunçakmak-Uyanik, Çağrı Mesut Temuçin","doi":"10.55730/1300-0144.6175","DOIUrl":"https://doi.org/10.55730/1300-0144.6175","url":null,"abstract":"<p><strong>Background/aim: </strong>Tremor arises from mechanical, reflex, or central oscillatory mechanisms. Transcranial magnetic stimulation (TMS) can transiently perturb ongoing tremor and enables the quantitative assessment of phase resetting, offering circuit-level insight into tremor types. Although numerous studies have applied TMS-induced resetting, the findings have not been systematically reviewed. This study systematically reviews human studies evaluating TMS-induced tremor resetting across tremor types.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed and Google Scholar identified human studies using TMS to perturb tremor or rhythmic movement. Search terms included \"tremor resetting,\" \"resetting of tremor,\" \"tremor phase shift,\" \"tremor phase reset,\" \"transcranial magnetic stimulation,\" and \"central oscillator.\" Inclusion criteria were human participants, experimental TMS perturbation, and quantitative tremor phase/resetting outcomes. Exclusion criteria were animal studies, therapeutic repetitive TMS trials without resetting analyses, and isolated case reports. Two researchers independently screened and extracted data. The PRISMA 2020 guidelines were followed.</p><p><strong>Results: </strong>Twenty-one studies were identified, three of which were excluded from the primary synthesis (two case reports and one qualitative-only design). Eighteen studies remained, which addressed essential tremor (ET) (n = 6), Parkinson's disease tremor (PDT) (n = 7), orthostatic tremor (OT) (n = 4), palatal tremor (n = 1), dystonic tremor (DT) (n = 1), and voluntary rhythmic movement (n = 4). M1 stimulation reset ET, postural PDT, OT, palatal tremor, DT, and voluntary rhythmic movements. Rest PDT had inconsistent resetting by M1 stimulation and no resetting by cerebellar stimulation. Cerebellar stimulation reset postural PDT but not ET. The resetting index was associated with the stimulus intensity and duration of the silent period.</p><p><strong>Conclusion: </strong>TMS-induced resetting is a strong physiological tool for differentiating tremor circuits. M1 acts as a major convergence node, while cerebellar involvement is tremor-specific. Methodological heterogeneity and small samples limit the comparability of study results. Advances in targeting technologies and closed-loop and phase-locked protocols could enhance the diagnostic and therapeutic utility of resetting paradigms.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"390-404"},"PeriodicalIF":1.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782424","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":"The burden of knee pain in the operating room: are surgical personnel at greater risk?","authors":"Ömer Faruk Naldöven, Yavuz Karaman, Başak Sinem Sezgin, Şahan Güven, Enejd Veizi, İzzet Bingöl","doi":"10.55730/1300-0144.6150","DOIUrl":"https://doi.org/10.55730/1300-0144.6150","url":null,"abstract":"<p><strong>Background/aim: </strong>This study aimed to determine the prevalence of knee pain among healthcare workers in surgical units and to explore whether the use of knee panels during surgical hand scrubbing is associated with persistent knee pain.</p><p><strong>Materials and methods: </strong>This single-center cross-sectional study was conducted between October 2023 and March 2025. A total of 400 physicians and nurses working in surgical and nonsurgical departments were included. Participants completed a structured and modified Nordic Musculoskeletal Questionnaire, as well as knee pain assessment tools, including a visual analog scale (VAS) and the Kujala score for anterior knee pain-related symptoms. Occupational exposure among surgical staff was additionally evaluated. Data were analyzed using IBM SPSS Statistics.</p><p><strong>Results: </strong>The prevalence of knee pain was 54.8% among surgical personnel and 39.5% among nonsurgical personnel. VAS scores were significantly higher in the surgical group, while there was no significant difference between groups in terms of Kujala scores. Knee panel use was common and more than half of the users reported discomfort during use; however, there was no statistically significant association between panel use and persistent knee pain. Regression analysis identified increasing age, longer duration of surgical experience, and employment in a surgical unit as factors independently associated with knee pain.</p><p><strong>Conclusion: </strong>Employment in a surgical unit is associated with a higher prevalence of knee pain among healthcare workers. However, the use of knee panels during surgical hand scrubbing does not appear to be associated with persistent knee pain. Multicomponent ergonomic interventions should be implemented to prevent musculoskeletal disorders.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"169-175"},"PeriodicalIF":1.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435504","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":"Impact of two sedation protocols on cardiac electrophysiology during spinal anesthesia.","authors":"Selvinaz Durantaş, Burak Nalbant, Fatma Kavak Akelma, Gökhan Erdem, Abdulkadir But","doi":"10.55730/1300-0144.6182","DOIUrl":"https://doi.org/10.55730/1300-0144.6182","url":null,"abstract":"<p><strong>Background/aim: </strong>Perioperative factors such as anesthetic drugs, central blocks, surgical stress, pain, and anxiety can affect cardiac electrophysiology and increase the risk of arrhythmias. Arrhythmia susceptibility can be assessed using ventricular markers such as the QT interval (QT), heart rate-corrected QT interval (QTc), QT dispersion (QTd), time between peak and end of T wave (Tp-e), cardiac electrophysiologic balance index (iCEB), and heart rate-corrected index of cardiac electrophysiologic balance (iCEBc), obtained from noninvasive electrocardiography (ECG) data. This study compared the effects of propofol and dexmedetomidine sedation on these parameters in patients undergoing total knee arthroplasty performed under spinal anesthesia.</p><p><strong>Materials and methods: </strong>This prospective, observational clinical study was conducted at Ankara Bilkent City Hospital between March and August 2023, and included patients scheduled for elective total knee arthroplasty. Patients were divided into two groups based on the clinician's preference: group P received propofol infusion, and group D received dexmedetomidine. All patients underwent spinal anesthesia. The primary outcome was the comparison of iCEB and iCEBc values between the two groups. Secondary outcomes included comparisons of QT, QTc, QTd, and Tp-e values.</p><p><strong>Results: </strong>A total of 74 participants were enrolled, and 70 were included in the final analysis (35 per group). No significant differences were found in demographic data, local anesthetic dose, spinal interventions, sensory block level, or bispectral index values (p > 0.05). QTc increased in both groups after spinal anesthesia; however, group P exhibited significantly higher values at t1 and t15 compared with group D (p = 0.004 and p = 0.046, respectively). iCEBc returned to baseline at t10 in group D and t45 in group P. A significant iCEBc increase from t0 to t1 was observed in group P but not in group D.</p><p><strong>Conclusion: </strong>Compared with propofol, dexmedetomidine sedation under spinal anesthesia was associated with differences in ECG-derived indices related to repolarization duration, homogeneity, repolarization-depolarization balance, and transmural distribution. These findings should be interpreted within the context of the study's observational design and the use of ECG-derived markers rather than clinical arrhythmic endpoints.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"479-488"},"PeriodicalIF":1.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782345","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":"Effects of transversus abdominis and erector spinae plane blocks on postoperative pain control and postpartum depression after cesarean section: a randomized prospective study.","authors":"Hilal Biradli, Feyza Çalişir, Alev Özer","doi":"10.55730/1300-0144.6155","DOIUrl":"https://doi.org/10.55730/1300-0144.6155","url":null,"abstract":"<p><strong>Background/aim: </strong>Effective postoperative pain management after cesarean section is essential for maternal recovery. Poor pain control can lead to complications, including postpartum depression. This study aimed to compare the postoperative analgesic efficacy of erector spinae plane (ESP) and transversus abdominis plane (TAP) blocks following cesarean section, with a particular focus on their potential impact on postpartum depression.</p><p><strong>Materials and methods: </strong>Sixty patients were randomly assigned to receive either an ESP block (Group E, n = 30) or a TAP block (Group T, n = 30) after cesarean section. Pain severity was assessed using a visual analog scale (VAS), and the need for rescue analgesics and patient satisfaction were recorded. Postpartum depression was evaluated using the Edinburgh Postpartum Depression Scale (EPDS) at 4-6 weeks postpartum.</p><p><strong>Results: </strong>There was no significant difference between the groups in analgesic duration (Group E: 15 h, Group T: 14 h, p = 0.314). Group E showed a significantly lower need for rescue analgesics (0 vs. 1, p = 0.049). The VAS score at the first hour was lower in Group E (2 vs. 3, p = 0.032), but no differences were observed at subsequent time points. Postpartum depression rates were not statistically significant.</p><p><strong>Conclusion: </strong>With the ESP block, no significant difference was observed compared to the TAP block in terms of total analgesic duration, opioid consumption, postpartum depression, or patient satisfaction, except for the postoperative 1-h VAS pain score. This suggests that the ESP block does not provide clear superiority over the TAP block.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"218-228"},"PeriodicalIF":1.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435457","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":"Role of novel renal biomarkers in predicting the prognosis of patients with chronic kidney disease: a prospective cohort study.","authors":"Raghavan Padmanabhan, Kaviya Manoharan, Melina Sahay, Pooja Bhujangarao, Luxitaa Goenka, Solai Priya, Kumarasamy Subramaniyan, Damal Kandadai Sriram, Melvin George","doi":"10.55730/1300-0144.6179","DOIUrl":"https://doi.org/10.55730/1300-0144.6179","url":null,"abstract":"<p><strong>Background/aim: </strong>Several biomarkers have been assessed for the diagnosis of chronic kidney disease (CKD). However, limited data are available regarding their ability to predict mortality in CKD. The aim of this study was to assess the ability of lipocalin-2, receptor for advanced glycation end products (RAGE), tissue inhibitor of metalloproteinase 1 (TIMP-1), osteopontin, and trefoil factor 3 (TFF-3) in predicting the prognosis of patients with CKD.</p><p><strong>Materials and methods: </strong>We included patients with CKD as defined by an estimated glomerular filtration rate of <60 mL/min/1.73 m² of either sex who were above the age of 18 years. Patients with a history of acute-on-chronic kidney disease were excluded. The novel markers of interest were estimated from patients' plasma samples using the multiplex enzyme-linked immunosorbent assay. These patients were followed for 1 year to assess mortality.</p><p><strong>Results: </strong>The median (with interquartile range) plasma concentrations of lipocalin-2, RAGE, TIMP-1, osteopontin, and TFF-3 were 56.9 (44.72-64.18) ng/mL, 7.1 (4.92-9.56) ng/mL, 46.44 (33.52-47.56) ng/mL, 60.2 (98.9-167.61) ng/mL, and 4.87 (8.03-15.65) ng/mL, respectively. A combined receiver operating characteristic curve was plotted to determine the ability of the novel renal biomarkers to predict mortality in patients with CKD. The cutoff values for lipocalin-2 and RAGE for predicting mortality were 62.48 ng/mL with sensitivity and specificity of 86% and 78% (area under the curve: 0.814; p = 0.007) and 8.5 ng/mL with sensitivity and specificity of 71% and 72% (area under the curve: 0.738; p = 0.04), respectively.</p><p><strong>Conclusion: </strong>Biomarkers including lipocalin-2 and RAGE were assessed in this study and were found to have good predictive value for mortality outcomes in CKD. Future studies should establish the relationship between these novel renal biomarkers and the progression of CKD.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"454-463"},"PeriodicalIF":1.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782413","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":"Biomechanical analysis of skeletal open bite treatment methods: a comparative finite element study.","authors":"Ömer Faruk Sari, Muhammed Hilmi Büyükçavuş","doi":"10.55730/1300-0144.6191","DOIUrl":"https://doi.org/10.55730/1300-0144.6191","url":null,"abstract":"<p><strong>Background/aim: </strong>The biomechanical effects of zygomatic anchorage plates, vertical chin-caps, and occipital headgear on dentofacial structures in patients with skeletal anterior open bite malocclusion were compared using three-dimensional finite element analysis.</p><p><strong>Materials and methods: </strong>Three-dimensional finite element models were constructed based on computed tomography data obtained from a patient with skeletal anterior open bite. Simulation models representing zygomatic anchorage-supported intrusion, vertical chin-cap, and occipital headgear were generated under fixed orthodontic conditions. In each scenario, a unilateral force of 200 g (1.96 N) was applied along clinically relevant force vectors. Stress distributions in craniofacial bones, sutural structures, teeth, roots, and temporomandibular joint components, as well as displacement patterns of the teeth and roots, were evaluated. Von Mises stress was used to assess craniofacial and dental structures, whereas minimum principal stress was used to evaluate sutural regions.</p><p><strong>Results: </strong>The highest von Mises stress within craniofacial structures was observed in the posterior maxilla in the zygomatic anchorage plate scenario, followed by the vertical chin-cap and occipital headgear scenarios. Across all models, compressive stresses in sutural structures were predominantly concentrated in the zygomaticomaxillary suture, with the greatest magnitude observed in the zygomatic anchorage model. Dental and root stress analyses revealed peak von Mises stress at the mesiobuccal root of the maxillary first molar, particularly in the zygomatic anchorage scenario. The greatest tooth and root displacements along the vertical axis, indicative of intrusion, were also observed in this model. Condylar stress was primarily localized in the superior region of the condyle, with higher peak values observed in the vertical chin-cap simulation.</p><p><strong>Conclusion: </strong>Within the limitations of finite element analysis, zygomatic anchorage-supported intrusion demonstrated greater predicted posterior maxillary intrusion and higher localized stress concentrations than vertical chin-cap and occipital headgear approaches. These findings indicate distinct biomechanical profiles among the appliances, which should be considered when selecting treatment strategies for skeletal anterior open bite.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"585-596"},"PeriodicalIF":1.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782317","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}