Turkish Journal of Medical Sciences最新文献

{"title":"Evaluation of teachers' knowledge and awareness about autism spectrum disorder.","authors":"Hamit Harun Bağci, Abide Aksungur, Gülsüm Öztürk Emiral, Erhan Şimşek","doi":"10.55730/1300-0144.6051","DOIUrl":"10.55730/1300-0144.6051","url":null,"abstract":"<p><strong>Background/aim: </strong>Teachers play an essential role in the early identification of autism spectrum disorder (ASD) and associated difficulties in children. Increasing teachers' knowledge of ASD can be helpful in identifying these children and making the necessary referrals. This study aimed to assess teachers' knowledge and awareness of ASD and the factors affecting them.</p><p><strong>Materials and methods: </strong>This is a cross-sectional study conducted among school counsellors. A total of 171 school counsellors were contacted; school visits were arranged by prior appointment, and the purpose of the study was explained. Data were collected using a questionnaire prepared by the researchers and the autism awareness scale (AAS).</p><p><strong>Results: </strong>Most teachers had heard of the concept of ASD, but the concept of shadow teaching was less familiar. Women and those with lower perceived income levels had statistically significantly higher scores on the ASD awareness scale. Participants who had received ASD-related training or had individuals diagnosed with ASD in their environment had higher ASD scores. Women had statistically significantly higher scores than men in the subdimensions of \"causes of autism\", \"friendship relationships in autism\", and \"basic elements in the intervention process in autism\".</p><p><strong>Conclusion: </strong>This study shows that sex and previous contact with individuals diagnosed with ASD may contribute to intervention processes beyond autism identification. In particular, teachers need to be aware of early identification and referral to intervention programs in schools with pupils diagnosed with ASD. Teachers are likely to come into contact with individuals diagnosed with ASD in a variety of settings. It is, therefore, vital that they have sufficient knowledge and awareness of autism to be able to interact effectively with individuals diagnosed with ASD.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"982-991"},"PeriodicalIF":1.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041293","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":"Ultrasonographic and elastographic evaluation of plantar fascia and Achilles tendon alterations in type 2 diabetes mellitus.","authors":"Rıfat Bozkuş, İhsaniye Süer Doğan, Berna Turhan, Sümeyya Duran Kaymak, Mustafa Hulusi Kurt, Rasime Pelin Kavak","doi":"10.55730/1300-0144.6042","DOIUrl":"10.55730/1300-0144.6042","url":null,"abstract":"<p><strong>Background/aim: </strong>The primary aim of this study was to compare the thickness and stiffness of the plantar fascia (PF) and Achilles tendon (AT) between healthy volunteers and patients with type 2 diabetes mellitus (T2DM). A secondary objective was to explore the correlations between the thickness and stiffness of the PF and AT and diabetes duration (in months) and hemoglobin A1c (HbA1c) levels in T2DM patients without peripheral neuropathy or foot ulcers, with peripheral neuropathy, or with foot ulcers.</p><p><strong>Material and methods: </strong>A total of 289 participants, including 117 healthy volunteers (Group A) and 172 T2DM patients (59.5%), matched for age, sex, and body mass index, were included. The T2DM cohort was stratified into three subgroups: Group B (without peripheral neuropathy or foot ulcers), Group C (with peripheral neuropathy), and Group D (with foot ulcers). Ultrasonography (USG) and shear wave elastography (SWE) were used to assess PF and AT properties, and correlations with diabetes duration and HbA1c levels were analyzed.</p><p><strong>Results: </strong>T2DM patients exhibited significantly greater PF and AT thickness, and lower stiffness compared to healthy controls (p < 0.001). Among subgroups, Group D had the greatest PF and AT thickness and the lowest stiffness, followed by Group C and then Group B (p < 0.001 for all comparisons). Positive correlations were observed between diabetes duration, HbA1c levels, and tendon thickness, while negative correlations were identified with stiffness (p < 0.001 for all).</p><p><strong>Conclusion: </strong>USG and SWE revealed significant alterations in PF and AT properties in T2DM patients compared to healthy individuals, with these changes correlating with diabetes severity and duration.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"893-903"},"PeriodicalIF":1.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041352","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":"Treadmill-based submaximal VO₂ estimation in patients with coronary artery disease: can a model derived from healthy individuals be valid?","authors":"Levent Karataş, Esra Sena Orbak Yenidünya, Nesrin Demirsoy","doi":"10.55730/1300-0144.6046","DOIUrl":"10.55730/1300-0144.6046","url":null,"abstract":"<p><strong>Background/aim: </strong>Existing treadmill-based VO₂ prediction models may not accurately estimate submaximal VO₂ in patients with coronary artery disease (CAD), as they are often derived from healthy populations. This study aimed to develop and validate a submaximal VO₂ prediction model derived from healthy individuals and tested for generalizability in CAD patients by incorporating clinically relevant parameters.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted with 101 participants (54 healthy, 47 CAD patients) undergoing cardiopulmonary exercise testing using the modified Bruce protocol. To better represent the submaximal VO₂ reached during exercise, the average VO₂ in the last minute of each stage was used. The model was developed using data from healthy individuals and subsequently validated in the CAD cohort. A linear mixed-effects model was employed to predict VO₂ based on speed, grade, and other confounders, including peak VO₂, body weight, and body mass index (BMI). The model's performance was evaluated and compared with previously published equations using Bland-Altman plots, mean absolute error (MAE), root mean square error (RMSE), and Lin's concordance correlation coefficient (CCC).</p><p><strong>Results: </strong>The final model, including speed, grade, and peak VO₂, achieved an R² of 0.83 (95% CI: 0.79, 0.86; f² = 4.88). For CAD patients, the predicted-actual VO₂ difference was -0.05 ± 1.8 mL/kg/min, with MAE and RMSE values of 1.4 and 1.8 mL/kg/min, respectively. The model outperformed reference equations, achieving the highest accuracy (CCC = 0.923) and minimal bias. Incorporating peak VO₂ effectively accounted for exercise response differences between healthy individuals and CAD patients.</p><p><strong>Conclusion: </strong>A submaximal VO₂ estimation model derived from healthy individuals and validated in CAD patients demonstrated high accuracy. Incorporating peak VO₂ effectively bridged physiological differences, supporting individualized exercise prescriptions in cardiac rehabilitation. However, larger prospective cohorts are warranted to confirm external validity.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"930-939"},"PeriodicalIF":1.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041355","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":"Sinapic acid alleviates renal ischemia-reperfusion injury by regulating oxidative stress, apoptosis, and inflammation.","authors":"Mustafa Can Güler, Fazile Nur Ekinci Akdemir, Ersen Eraslan, Ayhan Tanyeli, Derya Güzel Erdoğan, Behzat Tebrizi","doi":"10.55730/1300-0144.6052","DOIUrl":"10.55730/1300-0144.6052","url":null,"abstract":"<p><strong>Background/aim: </strong>Acute kidney injury (AKI) is a major clinical issue, frequently resulting from ischemia-reperfusion (I/R) injury. Sinapic acid (SA), a natural phenolic molecule included in numerous plant-based foods, exhibits antiapoptotic, antioxidant, and antiinflammatory properties. This study aimed to investigate the renoprotective effects of SA in an I/R-induced acute kidney injury (AKI) model.</p><p><strong>Materials and methods: </strong>Sprague-Dawley male rats (n = 32) were randomly assigned to four groups: sham, I/R, SA 20 mg/kg, and SA 40 mg/kg. SA was administered intraperitoneally before reperfusion. Renal tissues were examined using biochemical, histopathological, and immunohistochemical methods, focusing on oxidative stress, cytokine expression, and apoptosis markers.</p><p><strong>Results: </strong>I/R induced significant oxidative stress, elevated proinflammatory cytokines, and tubular damage. Treatment with SA, particularly at 40 mg/kg, significantly improved antioxidant defenses, reduced inflammatory cytokine levels, and attenuated tubular necrosis and apoptosis, as confirmed by decreased caspase-3 and HAVCR1 (also known as KIM-1) expression.</p><p><strong>Conclusion: </strong>SA significantly ameliorated renal I/R injury by modulating apoptosis, inflammation, and oxidative stress. These findings support the therapeutic efficacy of SA in AKI and highlight the need for further translational research.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"992-1002"},"PeriodicalIF":1.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041326","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":"Diagnostic accuracy and potential triage utility of the Shetty test in foot and ankle trauma: a cross-sectional study.","authors":"Burcu Doğan, Seval Komut, Erdal Komut, Nezih Kavak, Osmancan Güneş, Anılcan Tahsin Karahan","doi":"10.55730/1300-0144.6041","DOIUrl":"10.55730/1300-0144.6041","url":null,"abstract":"<p><strong>Background/aim: </strong>Foot and ankle trauma represents a common reason for emergency department visits. While the majority of cases involve soft tissue injuries, radiographic imaging is frequently overutilized due to concerns about missed fractures, leading to increased costs and emergency department crowding. The Shetty test, a recently introduced clinical decision rule, may serve as a simpler alternative to established tools such as the Ottawa ankle rules. This study aimed to assess the diagnostic accuracy of the Shetty test and its potential role as a supportive tool within existing triage systems for patients presenting with foot and ankle trauma.</p><p><strong>Materials and methods: </strong>In this cross-sectional study, 229 adult patients with isolated foot or ankle trauma were evaluated in the emergency department. All participants underwent the Shetty test and standard radiographic imaging. The Shetty test was performed by trained emergency physicians prior to imaging; a positive result was defined as an inability to apply downward pressure due to pain. Diagnostic accuracy metrics-including sensitivity, specificity, positive predictive value, and negative predictive value-were calculated using radiographic findings as the reference standard.</p><p><strong>Results: </strong>Fractures were identified in 25.3% of cases. The Shetty test demonstrated a sensitivity of 77.6%, specificity of 60.8%, positive predictive value of 40.2%, and a high negative predictive value of 88.9%. Among patients with confirmed fractures, 77.6% had a positive test result. The test performed best in ruling out displaced and incomplete fractures, and results showed significant correlation with both physical findings and imaging outcomes.</p><p><strong>Conclusion: </strong>The Shetty test exhibited moderate sensitivity and specificity, alongside a high negative predictive value, supporting its use as a reliable rule-out tool for foot and ankle fractures. Its simplicity, ease of application, and diagnostic potential make it a promising triage adjunct to optimize emergency department resource use. Prospective multicenter validation is warranted before broad clinical adoption.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"887-892"},"PeriodicalIF":1.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040863","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":"Evaluation of rheumatic causes underlying childhood-onset arthritis.","authors":"Seher Şener, Erdal Atalay, Ezgi Deniz Batu, Cansu Ayten Tatar, Özge Başaran, Yelda Bilginer, Seza Özen","doi":"10.55730/1300-0144.6034","DOIUrl":"10.55730/1300-0144.6034","url":null,"abstract":"<p><strong>Background/aim: </strong>Childhood-onset arthritis may result from various rheumatic diseases. This study aimed to systematically evaluate their distribution and characteristics in a large pediatric cohort.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed all pediatric patients who presented with arthritis to the pediatric rheumatology clinic between January 2000 and January 2023.</p><p><strong>Results: </strong>A total of 1713 pediatric patients who presented with arthritis were included in this study (median age at diagnosis: 6.8 years; F/M = 1.2). Most of the patients (n = 859, 50.1%) had juvenile idiopathic arthritis (JIA) (especially oligoarticular JIA). Patients with familial Mediterranean fever, comprising 277 individuals (16.2%) presented with arthritis. The majority of them (n = 203, 73.3%) had short-lasting recurrent oligoarthritis (mostly monoarthritis) attacks. While arthritis was observed in 236 (13.8%) patients with vasculitis, immunoglobulin A vasculitis was the most common cause among them (n = 166, 70.3%). Most of the vasculitis patients had oligoarthritis (n = 221, 93.6%). Reactive arthritis was present in 147 patients (8.6%, mostly monoarthritis). Acute rheumatic fever was another cause of arthritis (4.7%, mostly polyarticular and migratory). Among autoimmune diseases (mostly systemic lupus erythematosus), arthritis was detected in 82 patients (4.8%, oligoarthritis or polyarthritis).</p><p><strong>Conclusion: </strong>In our study, we focused on the rheumatic etiologies underlying childhood arthritis. Given the heterogeneity of etiologies, clinical evaluation should be comprehensive, considering systemic features beyond joint involvement.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"826-836"},"PeriodicalIF":1.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041290","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":"Diagnosis of knee joint invasion in patients with osteosarcoma: the value of direct and indirect MRI findings.","authors":"İpek Tamsel, Hüseyin Kaya, Orkhan Aghamirzayev, Oğuz Dimdork, Başak Doğanavşargil, Mehmet Argin, Dündar Sabah","doi":"10.55730/1300-0144.6009","DOIUrl":"10.55730/1300-0144.6009","url":null,"abstract":"<p><strong>Background/aim: </strong>Osteosarcoma is the most common primary malignant bone tumor in adolescents, and the evaluation of joint invasion with MRI is important for treatment planning. This study aimed to investigate the diagnostic value of MRI findings (direct and indirect) for joint invasion in patients diagnosed with osteosarcoma of the knee region.</p><p><strong>Materials and methods: </strong>The MRI evaluations of 50 knee osteosarcoma patients who underwent surgical resection between 2006 and 2018 were reviewed retrospectively by two radiologists and an orthopedic oncologist. The presence of intrasynovial tumor tissue, intra-articular destruction of cartilage or bone, and invasion of the capsular and cruciate ligament insertions were evaluated as direct findings in the diagnosis of joint invasion on MRI. Indirect findings included tumor size, adjacent epiphyseal bone signal changes- bone marrow infiltration and edema, synovial contrast enhancement, and joint effusion. These findings were scored separately on a 5-point Likert scale and statistically compared with histopathologic results.</p><p><strong>Results: </strong>The mean age of the patients was 22 years and the gender distribution was 21 females and 29 males. The best predictors for joint invasion were direct visualization of capsular insertion invasion (p < 0.05) and destruction of intraarticular bone (p < 0.05). MRI findings with statistically significant sensitivity and specificity: intrasynovial tumor tissue specificity 76%, sensitivity 58%; intra-articular cartilage destruction specificity 84%, sensitivity 56%; intra-articular bone destruction sensitivity 84%, specificity 48%; capsular insertion invasion sensitivity 92%, specificity 48%. Synovial effusion and contrast enhancement were the most sensitive indirect signs but lacked specificity.</p><p><strong>Conclusion: </strong>Joint invasion by osteosarcoma can reliably be assessed on preoperative MR images with high sensitivity and specificity. Particularly direct visualization of intrasynovial tumor tissue, capsular insertion invasion, and destruction of intraarticular bone and cartilage, a combination of highly specific direct signs was valuable, while indirect signs were less predictive and specific.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 3","pages":"622-631"},"PeriodicalIF":1.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675817","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":"Janus kinase inhibitors in localized scleroderma: a systematic literature review.","authors":"Seher Şener, Yusuf Ziya Şener, Ezgi Deniz Batu, Alper Sari, Ali Akdoğan","doi":"10.55730/1300-0144.6000","DOIUrl":"10.55730/1300-0144.6000","url":null,"abstract":"<p><strong>Background/aim: </strong>Reports on the use of Janus kinase (JAK) inhibitors in the treatment of localized scleroderma are increasing in the literature. In this review, we examined the published studies regarding the use of JAK inhibitors in patients with localized scleroderma.</p><p><strong>Materials and methods: </strong>We searched MEDLINE and Scopus for articles on patients with localized scleroderma treated with JAK inhibitors. The search included articles from the inception of these databases through August 1^st, 2024.</p><p><strong>Results: </strong>Our literature search showed 11 articles describing 17 patients with localized scleroderma treated with JAK inhibitors. Generalized morphea (47.1%) was the most common type of localized scleroderma in patients treated with JAK inhibitors. The most frequently used JAK inhibitor was tofacitinib (64.7%). In some cases, baricitinib (17.6%) and ruxolitinib (17.6%) were also preferred. All JAK inhibitors were mainly preferred for the treatment of resistant/progressive skin disease in these patients (60.7%). The improvement rate associated with JAK inhibitors was 88.2%. Relapse occurred in 33.3% of patients treated with JAK inhibitors. Side effects were reported in 18.2% of patients: one patient was diagnosed to have diffuse large B-cell lymphoma (n = 1) while on tofacitinib.</p><p><strong>Conclusion: </strong>JAK inhibitors could be considered as a therapeutic option, especially in patients with refractory localized scleroderma, but more extensive clinical trials are needed to clarify questions regarding their efficacy and safety data.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 3","pages":"533-539"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675891","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":"Discontinuation of hydroxychloroquine due to suspected retinal toxicity in systemic lupus erythematosus and the role of multimodal imaging.","authors":"Burak Ince, Mehmet Bedii Oğurel, Zafer Cebeci, Yavuz Burak Tor, Yasemin Yalçinkaya, Ahmet Gül, Murat Inanç, Bahar Artim-Esen","doi":"10.55730/1300-0144.6035","DOIUrl":"10.55730/1300-0144.6035","url":null,"abstract":"<p><strong>Background/aim: </strong>To evaluate the effect of hydroxychloroquine (HCQ) on disease activity and damage in patients with systemic lupus erythematosus (SLE) in whom HCQ had previously been discontinued due to retinal toxicity, and to examine and reevaluate toxicity findings through a detailed ophthalmological examination.</p><p><strong>Materials and methods: </strong>Patients with SLE who had been on HCQ for at least 3 years after achieving lupus low disease activity state (LLDAS) following remission induction, and were followed up for at least 3 years after HCQ discontinuation due to retinal toxicity diagnosed by visual field testing, were analysed. Disease activity, the number and severity of flares and damage were recorded whilst on HCQ and after cessation. All patients were examined by two ophthalmologists using multimodal imaging techniques to further analyse toxicity.</p><p><strong>Results: </strong>Sixty-one patients (age at diagnosis 33.4 ± 10.5, 88.5% female) were included. The percentage of visits maintaining LLDAS was significantly higher during HCQ treatment (p = 0.001). A significant number of patients experienced flares after HCQ discontinuation, with the mild-moderate type predominating (p = 0.006 and p = 0.026). Mean damage scores were higher at the end of the study period (p = 0.001). In the ophthalmologic examination (mean duration after drug cessation: 70.3 ± 52.3 months), signs of HCQ toxicity were not detected in 40 patients (65.6%), and HCQ was reinitiated for these patients. Of 21 (34.4%) patients who had visual field defects in reexamination, only five (8.2%) had typical retinal toxicity by multimodal imaging. Sixteen (26.2%) patients had macular atrophy due to other causes.</p><p><strong>Conclusion: </strong>Hydroxychloroquine is effective in controlling disease activity and preventing damage in SLE, and the opportunity for remedication is valuable. More than half of the patients who could restart HCQ after reexamination show the importance of performing multimodal imaging to diagnose retinal toxicity and to distinguish macular pathologies with different aetiological background.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"837-845"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041248","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":"Evaluation and validation of 3D-printed anatomical urinary system model and virtual reality RIRS simulators in RIRS training: a comparative study.","authors":"Mehmet Ezer, Tahsin Batuhan Aydoğan, Lazaros Tzelves, Andreas Skolarikos, Mehmet Uslu, Kemal Sarica, Emre Huri","doi":"10.55730/1300-0144.6022","DOIUrl":"10.55730/1300-0144.6022","url":null,"abstract":"<p><strong>Background/aim: </strong>This study evaluates the use of a 3D-printed anatomical urinary system model (3D-AUSM) and a Virtual Reality RIRS Simulator (VRRS), for training in RIRS, based on real user feedback.</p><p><strong>Materials and methods: </strong>The 3D-AUSM was created using cadaver CT and MRI scans, and the data was transferred to a VR environment for simulation. A total of 43 inexperienced urology trainees participated in the theoretical phase of the RIRS training program. Of these, 32 trainees (Group T) who passed a proficiency exam proceeded to the hands-on training phase with the 3D-AUSM and VRRS models. Additionally, 17 experienced surgeons (Group S) were included in the study for validation purposes. Skill scores and procedure times were recorded for both groups, and participants completed surveys to evaluate content, face, and construct validation of the models.</p><p><strong>Results: </strong>Group S completed the procedures faster and achieved higher skill scores than Group T in both models. Group T, however, performed better with VRRS compared to 3D-AUSM. The most challenging steps for both groups were \"exposing the intrarenal collecting system\" and \"relocating the stone\". Both groups rated the models highly for content and face validation, though experienced surgeons gave lower overall satisfaction scores to VRRS compared to 3D-AUSM.</p><p><strong>Conclusion: </strong>3D-printed models and VR simulators are safe, cost-effective tools for developing essential surgical skills. While 3D-AUSM provides realistic anatomical feedback, VRRS offers unlimited practice opportunities. Both models are valuable in surgical education, promoting standardized, effective training.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 3","pages":"733-742"},"PeriodicalIF":1.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675885","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}