Turkish Journal of Medical Sciences最新文献

{"title":"Male osteoporosis: pathophysiology, risk assessment, and evidence-based management.","authors":"Selin Tekin, Alper Gürlek","doi":"10.55730/1300-0144.6337","DOIUrl":"10.55730/1300-0144.6337","url":null,"abstract":"<p><p>Osteoporosis in men is a common yet underrecognized condition associated with substantial fracture-related morbidity and excess mortality. Although men generally attain higher peak bone mass than women, age-related changes in bone microarchitecture, progressive cortical bone loss, declining sex steroid bioavailability, and a high prevalence of secondary causes contribute to a significant lifetime fracture risk. Importantly, a large proportion of fragility fractures in men occur at bone mineral density (BMD) values above the osteoporotic threshold, highlighting the limitations of BMD-based diagnosis alone. This review provides a comprehensive overview of the epidemiology, pathophysiology, and clinical characteristics of osteoporosis in men, with particular emphasis on sex-specific skeletal aging, hormonal regulation, and secondary osteoporosis. Current strategies for fracture risk assessment are critically examined, including the roles and limitations of dual-energy X-ray absorptiometry, vertebral imaging, the Fracture Risk Assessment Tool, and alternative risk prediction tools. We further summarize evidence-based approaches to management, encompassing lifestyle measures, correction of reversible risk factors, and pharmacological therapies. Antiresorptive agents remain the first-line treatment for most men, while anabolic therapies and sequential treatment strategies are increasingly recognized for those at very high risk of fracture. Overall, effective care in cases of male osteoporosis requires an integrated risk-based approach that extends beyond BMD to include clinical risk factors, secondary causes, and functional status. Improved recognition and sex-specific management strategies are essential to reduce the fracture burden and improve long-term outcomes in men.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"931-945"},"PeriodicalIF":1.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866890","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 acne vulgaris patient care in outpatient clinics: guideline adherence and patient education.","authors":"Mefküre Durmuş, Betül Sena Çavdar, İbrahim Etem Arica, Sena Ustaömer, Sena Güzel Karahan, Seçil Çolak, Selcen Şenol","doi":"10.55730/1300-0144.6355","DOIUrl":"10.55730/1300-0144.6355","url":null,"abstract":"<p><strong>Background/aim: </strong>Acne vulgaris, affecting over 85% of adolescents, is the most prevalent chronic inflammatory skin disorder. Its management is severity-based, with specific drug selections and combinations according to guidelines. However, adherence to these guidelines and the adequacy of patient counseling remain uncertain in real-world practice. The aim in this study was to evaluate prescribing patterns in acne management, assess compliance with guidelines, and promote awareness among healthcare professionals.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted in the dermatology outpatient clinic of a tertiary hospital in Türkiye between February and May 2025. Demographic and clinical data were collected, and acne severity was graded according to the Türkiye Dermatology Association (TDA) criteria. Prescriptions were evaluated for guideline concordance with American Dermatology Association (ADA) 2016/2024, National Institute for Health and Care Excellence (NICE) 2021, and TDA 2018. Potential drug-drug interactions and the adequacy of clinical teaching for acne medication were also assessed through a multidisciplinary evaluation. Statistical analyses were performed using descriptive methods, the Kruskal-Wallis test, Pearson's chi-squared test, and Fisher's exact test, as appropriate.</p><p><strong>Results: </strong>Oral isotretinoin, topical retinoids, and topical antibiotics were the most frequently prescribed agents. While isotretinoin use was largely appropriate, deviations from guideline recommendations, particularly oral antibiotic monotherapy, were observed. Some drug-drug interactions and limitations in structured patient counseling were also identified. Among the clinical guidelines, adherence was highest to the ADA guidelines, followed by the TDA guidelines. Moreover, the severity of the disease appeared to influence which guideline was followed.</p><p><strong>Conclusion: </strong>Although treatment largely followed severity-based recommendations, gaps in guideline adherence and patient education highlight the need for improved prescribing practices and interprofessional collaboration in acne management.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1113-1123"},"PeriodicalIF":1.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866573","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":"Optimistic and ambivalent attitudes toward clinical artificial intelligence.","authors":"Sevil Uygun Ilikhan, Sinem Ülke, Mahmut Özer, Matjaž Perc, Yavuz Ayhan","doi":"10.55730/1300-0144.6220","DOIUrl":"10.55730/1300-0144.6220","url":null,"abstract":"<p><strong>Background/aim: </strong>Artificial intelligence (AI) is increasingly being integrated into healthcare systems; however, healthcare professionals' knowledge, attitudes, and perceptions regarding AI remain insufficiently understood. This study aimed to evaluate healthcare professionals' perceptions of AI in clinical practice.</p><p><strong>Materials and methods: </strong>This descriptive cross-sectional study included 260 healthcare professionals, including physicians, nurses, and healthcare technicians working at a tertiary public hospital in Türkiye. Participants completed the Healthcare Professionals and Artificial Intelligence Questionnaire, which assessed demographic characteristics, AI knowledge, workplace AI use, attitudes toward AI applications, ethical and legal concerns, perceived professional impact, and educational needs.</p><p><strong>Results: </strong>Most participants reported limited AI knowledge; 64.6% indicated basic knowledge, whereas 23.1% reported no knowledge. Only 24.6% reported using AI-based systems in clinical practice, while 35.4% were uncertain whether such systems were used in their workplaces. Despite limited experience, attitudes toward recent AI developments were generally positive. Most participants expressed willingness to receive AI-related education (76.9%), although only 6.2% had previously received formal training. Nearly half of the participants believed that the human factor would remain essential in healthcare, whereas a similar proportion considered partial replacement by AI possible. Physicians demonstrated greater confidence in AI usefulness and stronger willingness to integrate AI into clinical decision-making than nurses and other healthcare professionals. Nurses primarily emphasized data security and privacy concerns, whereas physicians highlighted patient safety and misdiagnosis risk. Exploratory psychometric analyses demonstrated a three-factor structure with acceptable sampling adequacy (KMO = 0.765).</p><p><strong>Conclusion: </strong>Healthcare professionals generally perceive AI as a supportive tool rather than a replacement for human judgment. Limited AI literacy, uncertainty regarding legal responsibility, and insufficient training remain important barriers to responsible AI adoption. Profession-sensitive educational strategies and clearer governance frameworks may support safer AI integration into healthcare practice.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"860-871"},"PeriodicalIF":1.4,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585071","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":"Omega-3-rich fish oil lipid emulsions prevent sepsis-driven mesenteric hypoperfusion and multiorgan injury in a murine model.","authors":"Gökşen Öz, Esin Özçelebi, Ayşe Yeşim Göçmen, Cenk Sökmensüer, Selma Yildirim, Arzu Topeli, Alper Bektas Iskit","doi":"10.55730/1300-0144.6224","DOIUrl":"10.55730/1300-0144.6224","url":null,"abstract":"<p><strong>Background/aim: </strong>Parenteral feeding is used in critically ill patients when enteral nutrition is inadequate or intolerable, or when the gastrointestinal tract is nonfunctional. Lipid emulsions play a major role in parenteral nutrition, supplying the necessary fatty acids and providing high-caloric density. We investigated the effects of various parenteral lipid emulsions on mesenteric perfusion, inflammation-induced oxidation, and organ damage in a lipopolysaccharide-induced mouse endotoxemia model.</p><p><strong>Materials and methods: </strong>Organ damage induced by lipopolysaccharide in septic mice was assessed histopathologically and biochemically, and an ultrasonic blood flowmeter was used to measure the impact of lipid emulsions on mesenteric blood flow.</p><p><strong>Results: </strong>Lipopolysaccharide injection significantly reduced mesenteric blood flow when compared to saline controls (3.02 ± 0.10 mL/min vs 1.44 ± 0.10 mL/min, p < 0.05). Only fish oil emulsion treatment significantly abrogated this decrease (2.84 ± 0.39 mL/min, p < 0.05). None of the tested lipid emulsions prevented lipopolysaccharide-induced increases in liver and spleen weights. Fish oil reduced liver damage in septic mice, whereas specific dosages of olive and soybean oils caused significant histopathological liver and spleen damage even in the control animals. Furthermore, soybean and olive oil also significantly increased serum oxidative stress in the healthy control mice (2.55 ± 0.06 vs 4.93 ± 0.38 and 4.28 ± 0.12, p <0.05).</p><p><strong>Conclusion: </strong>Fish oil emulsions with high omega-3 fatty acid content abrogated the decrease in mesenteric blood flow and prevented liver damage in this experimental endotoxemia model.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"897-906"},"PeriodicalIF":1.4,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585109","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":"Association between MRI-based tumor-to-skin distance and axillary lymph node metastasis in breast cancer.","authors":"Hikmet Pehlevan Özel, Seçil Gündoğdu, Eda Şahingöz, Ebru Menekşe, Mesut Tez","doi":"10.55730/1300-0144.6359","DOIUrl":"10.55730/1300-0144.6359","url":null,"abstract":"<p><strong>Background/aim: </strong>Axillary lymph node (ALN) status is a major prognostic factor in breast cancer and influences both survival outcomes and treatment planning. Noninvasive predictors of nodal metastasis are of clinical interest. Tumor-to-skin distance (TSD) has been proposed as a potential anatomical marker; however, standardized data based on magnetic resonance imaging (MRI) remain limited.</p><p><strong>Materials and methods: </strong>This retrospective study included 98 female patients with pathologically confirmed breast cancer who underwent preoperative breast MRI between 2020 and 2025. Patients with prior breast or axillary surgery, distant metastasis, multifocal or multicentric disease, or inadequate MRI quality were excluded. TSD was measured on dynamic contrast-enhanced MRI by a single experienced radiologist blinded to axillary nodal status. Associations between TSD and histopathologically confirmed ALN metastasis were assessed using logistic regression analysis. Diagnostic performance was evaluated by receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Among the 98 patients, 27 (27.6%) had pathologically confirmed ALN metastasis. The median TSD was significantly shorter in the ALN-positive group than in the ALN-negative group (10.0 mm versus 14.0 mm, p = 0.004). In multivariate analysis, TSD was independently associated with nodal metastasis (OR, 0.929; 95% CI 0.864-0.999; p = 0.048). ROC analysis demonstrated moderate discriminatory ability (AUC = 0.69). A cutoff value of 10 mm yielded a sensitivity of 62.9%, specificity of 73.2%, and a high negative predictive value of 83.9%.</p><p><strong>Conclusion: </strong>A shorter TSD measured on preoperative breast MRI is independently associated with ALN metastasis. A 10-mm threshold may help identify patients at low risk of nodal involvement, supporting MRI-based TSD measurement as a complementary tool for preoperative risk stratification. Prospective multicenter studies are warranted for validation.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1152-1159"},"PeriodicalIF":1.4,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866817","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":"Risk of systemic reactions during pediatric allergen-specific immunotherapy: clinical predictors and safety outcomes.","authors":"Figen Çelebi Çelik, Alp Kazancioğlu, Soner Günder, Melike Ocak, Berna Uzunoğlu, Canan Şule Karkiner, Özlem Sancakli, Ayfer Tuncer, Özge Uysal Soyer, Bülent Enis Şekerel, Demet Can, Ümit Murat Şahiner","doi":"10.55730/1300-0144.6347","DOIUrl":"10.55730/1300-0144.6347","url":null,"abstract":"<p><strong>Background/aim: </strong>This study aimed to evaluate the frequency, timing, severity, and clinical predictors of systemic reactions in children receiving subcutaneous allergen-specific immunotherapy (SCIT) with house dust mite (HDM) and grass pollen extracts under real-world clinical conditions.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study included 623 children with moderate-to-severe allergic rhinitis, with or without asthma, who received SCIT between 2006 and 2023 at two tertiary pediatric allergy centers. Clinical characteristics, laboratory findings, immunotherapy protocols, and systemic reactions (SRs) were recorded and graded according to the updated 2024 World Allergy Organization (WAO) systemic reaction scale.</p><p><strong>Results: </strong>SCIT was well tolerated. Systemic reactions occurred in 10.7%, corresponding to 0.27% per injection. Most SRs were mild-to-moderate (WAO grades 1-2), and approximately three-quarters occurred during the maintenance phase. A progressive decline in SR incidence was observed throughout the treatment period. In the pollen SCIT subgroup, asthma was the only independent predictor of SRs (OR, 2.35; 95% CI 1.13-4.88; p = 0.022). No life-threatening reactions or fatalities were observed.</p><p><strong>Conclusion: </strong>Pediatric SCIT with pollen and HDM extracts demonstrated a favorable safety profile, with infrequent and predominantly nonsevere systemic reactions. The association between asthma and SRs in pollen SCIT highlights the importance of optimal asthma control throughout immunotherapy.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1031-1039"},"PeriodicalIF":1.4,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866874","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":"Sarcopenia risk in women with postmenopausal osteoporosis: a SARC-F-based assessment.","authors":"Burak Kamil Turan, Ayşe A Küçükdeveci, Zafer Günendi, Ayşegül Yaman, Oya Özdemir, Jale Meray, F Yeşim Gökçe Kutsal","doi":"10.55730/1300-0144.6352","DOIUrl":"10.55730/1300-0144.6352","url":null,"abstract":"<p><strong>Background/aim: </strong>Osteoporosis and sarcopenia are diseases of bone and muscle tissue, respectively. Studies reported that these disorders were interrelated. However, this relation was explored in older adults and/or with certain comorbidities, and information about nonelderly postmenopausal women is scarce. This study's objectives were to investigate the relationship between osteoporosis and SARC-F-defined sarcopenia risk in postmenopausal women aged ≤70 years and to examine the effect of other factors on this risk.</p><p><strong>Materials and methods: </strong>This multicenter case-control study included postmenopausal women aged 45-70 years. Dual-energy X-ray absorptiometry was utilized to diagnose osteoporosis. Sociodemographic and clinical variables, sarcopenia risk (SARC-F), muscle strength (grip strength and five-times sit-to-stand test: 5T-STS), and physical activity levels (International Physical Activity Questionnaire-Short Form) were compared between osteoporotic and nonosteoporotic participants.</p><p><strong>Results: </strong>A total of 119 osteoporotic (median age: 58 years) and 119 nonosteoporotic (median age: 59 years) participants were recruited. No differences were observed between the osteoporotic and nonosteoporotic groups regarding SARC-F-defined sarcopenia risk (48.7% vs. 38.7%, p = 0.117), probable sarcopenia (14.5% vs. 15.3%, p = 0.876), grip strength (23 vs. 22 kg, p = 0.329), 5T-STS (13.90 vs. 13.96 s, p = 0.986), or physical activity levels (907.5 vs. 792 MET-min/week, p = 0.983). Although educational level [odds ratio (OR): 0.366, 95% confidence interval (CI): 0.189-0.707, p = 0.003], proton pump inhibitor (PPI) use (OR: 2.494, 95% CI: 1.227-5.068, p = 0.012), and physical activity level (OR: 0.966, 95% CI: 0.945-0.988, p = 0.003) were independent predictors of SARC-F-defined sarcopenia risk, osteoporosis was not (p = 0.176).</p><p><strong>Conclusion: </strong>SARC-F-defined sarcopenia risk was not increased in women with postmenopausal osteoporosis aged ≤70 years compared to nonosteoporotic controls. Lower educational status, PPI use, and low physical activity levels were associated with an increased SARC-F-defined sarcopenia risk.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1085-1095"},"PeriodicalIF":1.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866927","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":"Influenza, COVID-19, and pneumococcal vaccination status among adults in Türkiye.","authors":"Gamze Şanlidağ Işbilen, Serap Gençer, Hüsnü Pullukçu, Meltem Taşbakan, İftahar Köksal","doi":"10.55730/1300-0144.6368","DOIUrl":"10.55730/1300-0144.6368","url":null,"abstract":"<p><strong>Background/aim: </strong>Vaccines reduce morbidity and mortality caused by infectious diseases that threaten public health. Lifelong immunization programs are essential for the entire population. This study assessed adult vaccination uptake for influenza, pneumococcal, and coronavirus disease 2019 (COVID-19) vaccines in Türkiye and examined the barriers and factors influencing vaccination decisions.</p><p><strong>Materials and methods: </strong>This cross-sectional survey was designed and conducted by the Immunization Working Group of the Turkish Society of Clinical Microbiology and Infectious Diseases. A 19-item questionnaire was administered to individuals aged 18 years or older to assess influenza, pneumococcal, and COVID-19 vaccination status. The questionnaire collected data on demographic characteristics, healthcare worker (HCW) status, chronic diseases, vaccination history, vaccine preferences, and reasons for nonvaccination.</p><p><strong>Results: </strong>The influenza vaccination rate among all participants was 28%, with the highest rate observed among participants aged ≥65 years (49%). Multivariate analysis revealed that age ≥65 years, HCW status, and the presence of a chronic disease were independently associated with influenza vaccination (p < 0.001). Pneumococcal vaccination rates were higher among individuals with chronic diseases and those aged ≥65 years (p < 0.01). Among chronic diseases, the highest vaccination rate was observed in participants with coronary artery disease. The COVID-19 vaccination rate was 95%. The most common reasons for nonvaccination were the perception that influenza (39%) and pneumococcal (21%) vaccination was unnecessary, whereas unwillingness to be vaccinated (44%) and concerns about side effects (32%) predominated for COVID-19 vaccination.</p><p><strong>Conclusions: </strong>Vaccination coverage remains low in Türkiye, even among high-risk groups. Although vaccination rates increased during the pandemic, greater public awareness and educational efforts are still needed.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1235-1244"},"PeriodicalIF":1.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866862","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":"vNOTES high uterosacral ligament suspension versus laparoscopic lateral suspension in the management of vaginal vault prolapse: initial experience in a single tertiary center.","authors":"Ramazan Adan, Fatih Şahin, Ulya Üskent, Mehmet Gökhan Çulha, Arzu Bilge Tekin","doi":"10.55730/1300-0144.6218","DOIUrl":"10.55730/1300-0144.6218","url":null,"abstract":"<p><strong>Background/aim: </strong>The optimal technique for vaginal vault prolapse correction has yet to be identified. This study aimed to evaluate the anatomic and functional outcomes of women who underwent vaginal natural orifice transluminal endoscopic high uterosacral ligament suspension (vNOTES HUSLS) or laparoscopic lateral suspension (LLS).</p><p><strong>Materials and methods: </strong>This retrospective study included symptomatic women with stage ≥2 vault prolapse who underwent vNOTES HUSLS or LLS between January 2019 and June 2022 at a tertiary center. The surgical efficacy, postoperative outcomes, complication rates, and recurrence frequencies of these procedures were compared. The primary outcomes of the study included anatomical success, patient-reported (subjective) success, and recurrence rates.</p><p><strong>Results: </strong>The study included 64 women, 32 of whom underwent vNOTES HUSLS and 32 of whom underwent LLS. Demographic characteristics and preoperative Pelvic Organ Prolapse Quantification (POP-Q) values were comparable (p > 0.05). The mean Patient Global Impression of Improvement (PGI-I) score did not differ significantly between the groups (1.6 ± 0.8 vs. 1.7 ± 0.7, p = 0.344). Improvements in terms of sexual function scores (p < 0.001) were observed postoperatively in both groups. No difference was observed in postoperative sexual questionnaires scores (p > 0.05). Vault suspension by vNOTES produced better results only for point Ba (most distal portion of the remaining upper anterior side of the vaginal wall) of the POP-Q score (p = 0.03). The incidence rates and types of postoperative complications and recurrences were similar between the groups.</p><p><strong>Conclusion: </strong>Both vNOTES HUSLS and LLS safely support the vault and restore the normal vaginal anatomy with similar effectiveness. Functional results were also similar and satisfactory between the groups.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"838-846"},"PeriodicalIF":1.4,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585240","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":"Pediatric MR cholangiopancreatography: comparison of 3D fast spin-echo and single-shot fast spin-echo thick-slab techniques for pancreaticobiliary anatomy.","authors":"Seda Kaynak Şahap, Suat Fitoz","doi":"10.55730/1300-0144.6222","DOIUrl":"10.55730/1300-0144.6222","url":null,"abstract":"<p><strong>Background/aim: </strong>This study compared thick-slab and three-dimensional (3D) T2-weighted magnetic resonance cholangiopancreatography (MRCP) sequences in pediatric patients with respect to image quality and visualization of the pancreaticobiliary anatomy.</p><p><strong>Materials and methods: </strong>The MRCP examinations of 62 pediatric patients evaluated for suspected pancreaticobiliary pathology were retrospectively reviewed, comprising a total of 69 studies. Thick-slab single-shot fast spin-echo and 3D fast spin-echo MRCP sequences were compared. The visualization of pancreaticobiliary structures was assessed using a qualitative visual scoring system. Image quality was graded as good, moderate, poor, or nondiagnostic. Biliary anatomical variations were also evaluated. Statistical analysis was performed using appropriate nonparametric tests with a significance threshold of p < 0.05.</p><p><strong>Results: </strong>The most common clinical indication for MRCP was screening for primary sclerosing cholangitis. Overall image quality did not differ significantly between thick-slab and 3D MRCP sequences. However, 3D MRCP demonstrated significantly superior visualization of the right and left proximal bile ducts, the cystic duct, and the pancreatic duct in the pancreatic tail compared to thick-slab sequences. Biliary anatomical variations were identified in 29% of patients, with type 3a being the most frequent variation.</p><p><strong>Conclusion: </strong>Compared to thick-slab MRCP, 3D MRCP provides improved visualization of the pancreaticobiliary anatomy in children. Optimized 3D MRCP protocols may enhance diagnostic confidence in pediatric pancreaticobiliary imaging.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"881-889"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585097","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}