Turkish Journal of Medical Sciences最新文献

{"title":"Readability of dermatology patient education materials: a comparative analysis of Turkish Dermatology Association brochures and texts generated by ChatGPT and Gemini.","authors":"Ahmet Kağan Özdemir, Bengü Reyhan Botsali Özdemir, Akın Aktaş","doi":"10.55730/1300-0144.6342","DOIUrl":"10.55730/1300-0144.6342","url":null,"abstract":"<p><strong>Background/aim: </strong>In modern healthcare, patient education materials (PEMs) are essential for bridging the gap between clinical knowledge and patient understanding. However, in Türkiye, where 64.6% of the adult population possesses inadequate or problematic health literacy, traditional medical brochures often exceed recommended reading levels. This study aimed to evaluate and compare the readability of Turkish dermatology PEMs prepared by the Turkish Dermatology Association (TDA) with those generated by artificial intelligence (AI) models.</p><p><strong>Materials and methods: </strong>A total of 68 TDA PEMs were analyzed. Readability was assessed using the Ateşman Readability Index. Responses were generated by AI models to questions extracted from these brochures under two conditions: \"default\" (no specific instructions) and \"low-literacy prompted\" (instruction to write at a sixth-grade level). Statistical comparisons were performed using the Kruskal-Wallis and Mann-Whitney U tests to evaluate differences in readability scores between the original TDA brochures and the four AI-generated groups. Effect size was calculated manually for each pairwise comparison and reported as r values.</p><p><strong>Results: </strong>The original TDA brochures had a mean readability score of 59.08 ± 5.80 (95% CI: 57.69-60.44), categorized as \"medium difficulty.\" All AI-generated groups demonstrated significantly higher readability scores compared with the TDA brochures (p < 0.05). Effect sizes for TDA versus AI group comparisons ranged from r = 0.242 to r = 0.753. In the default condition, Gemini Pro 2.5 produced more readable and consistent texts than ChatGPT-4.5 (66.63 versus 62.66; p = 0.004). While specific prompting significantly improved ChatGPT performance (p < 0.001), no significant change was observed in Gemini scores, which were already high in the default condition. Prompted Gemini achieved the highest overall mean score (68.98 ± 4.66).</p><p><strong>Conclusion: </strong>The linguistic complexity of TDA brochures may create a barrier for patients with limited health literacy. AI models, particularly when prompted with specific instructions, can generate dermatological PEMs with significantly higher readability levels.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"983-990"},"PeriodicalIF":1.4,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866905","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":"Preliminary population genetic analysis of 12 X-STR loci in a sample from Türkiye: allele frequencies, haplotype diversity, and linkage disequilibrium.","authors":"Hızır Asliyüksek, Esra Güzel Tanoğlu, Abdulkadir Can, Muhammed Fevzi Esen, Yusuf Atan","doi":"10.55730/1300-0144.6221","DOIUrl":"10.55730/1300-0144.6221","url":null,"abstract":"<p><strong>Background/aim: </strong>X-chromosomal short tandem repeats (X-STRs) are informative genetic markers in kinship testing and specific forensic contexts, particularly when standard autosomal approaches are less informative. This study aimed to provide preliminary allele frequency, haplotype diversity, and linkage disequilibrium (LD) data for 12 X-STR loci in a sample from Türkiye.</p><p><strong>Materials and methods: </strong>A total of 136 unrelated individuals from Türkiye were genotyped for 12 X-STR loci. Inferential analyses of X-linked loci require diploid genotypes; therefore, allele frequencies, Hardy-Weinberg equilibrium (HWE), LD, and regional comparisons were based primarily on female samples (n = 115), whereas male haplotypes (n = 21) were summarized descriptively only. Female regional subgroup sizes were uneven (southeast Anatolia, n = 39; Marmara, n = 22; Central Anatolia, n = 14; Mediterranean, n = 13; Black Sea, n = 10; Aegean, n = 9; eastern Anatolia, n = 8). Forensic parameters, HWE exact tests, and pooled and region-stratified LD analyses were calculated using Bonferroni-adjusted thresholds; findings were interpreted cautiously given the modest overall sample size and subgroup imbalance.</p><p><strong>Results: </strong>All loci were polymorphic, and locus-level forensic efficiency measures were generally high, with DXS10135 showing the highest informativeness in this dataset. In the female sample, five loci deviated from HWE after Bonferroni correction. In pooled LD analysis, only two of 66 locus pairs remained significant after correction (DXS10146-DXS10134 and DXS8378-DXS10103), whereas no region-specific LD signal remained significant after multiple-testing adjustment. Male haplotype diversity estimates were high across linkage groups, but these estimates were based on a small male subset and should be considered exploratory.</p><p><strong>Conclusion: </strong>This study provides a preliminary X-STR dataset for a sample from Türkiye and suggests that the analyzed panel is informative at the locus level. However, the modest sample size, very limited male subset, uneven regional distribution, and genotype-handling assumptions restrict population-level inference and generalizability. The data may be useful as an initial local reference resource, but broader and more balanced sampling is required before making strong conclusions about national allele distributions, regional structure, or routine forensic implementation.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"872-880"},"PeriodicalIF":1.4,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585225","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":"Changes in T-cell subsets and their association with disease severity in patients with alopecia areata.","authors":"Hatice Türk Daği, Hülya Özdemir, Mehmet Akyürek, Fatma Tunçez Akyürek, Hasibe Artaç","doi":"10.55730/1300-0144.6348","DOIUrl":"10.55730/1300-0144.6348","url":null,"abstract":"<p><strong>Background/aim: </strong>Alopecia areata (AA) is a nonscarring hair loss disorder characterized by genetic susceptibility, environmental triggers, and T-cell-mediated autoimmunity. While various CD4⁺ and CD8⁺ T-cell subsets are implicated in its pathogenesis, the roles of follicular T-cell (Tfh), peripheral T-cell (Tph), and regulatory T-cell (Treg) subsets-particularly within the CD8⁺ population-remain incompletely defined. This study aimed to characterize circulating CD4⁺ and CD8⁺ T-cell subsets in Turkish patients with AA and to evaluate their associations with disease activity, duration, and severity.</p><p><strong>Materials and methods: </strong>A total of 40 patients with AA and 40 healthy controls were enrolled. CD4⁺ and CD8⁺ T-cell subsets-including Th1, Th2, Th17, Th22, Tc1, Tc2, Tc17, Tc22, Treg, Tfh, and Tph cells-were analyzed by flow cytometry based on surface marker expression and intracellular cytokine profiles. Disease severity was assessed using the Severity of Alopecia Tool (SALT) score, and disease activity was evaluated by the hair pull test.</p><p><strong>Results: </strong>Patients with AA exhibited significantly lower frequencies of Tc17 and Tc22 cells than healthy controls. CD4⁺ Tfh cell levels were positively correlated with disease duration. CD4⁺ Tregs, resting Tregs, CD3⁺IL-4⁺ cells, and Tc2 cells were positively associated with SALT scores, whereas CD4⁺ and CD8⁺ Tph cells were inversely associated. CD8⁺ T-cell populations, CD4⁺ Treg subsets, CD3⁺IFN-γ⁺ cells, Th1 cells, and Th2 cells were associated with disease activity, as assessed by the hair pull test.</p><p><strong>Conclusion: </strong>Alopecia areata is associated with alterations in circulating T-cell subsets, particularly Tc17 and Tc22 subsets. Selected cytokine-producing and regulatory T-cell subsets are associated with disease activity. These findings support a heterogeneous and dynamic immune profile in AA and highlight the importance of multivariate approaches in identifying independent immunological correlates. Further studies integrating tissue-level analysis and longitudinal follow-up are needed to clarify the underlying mechanisms.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1040-1053"},"PeriodicalIF":1.4,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865672","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":"Beyond individual willingness: family veto, legal knowledge, and the dynamics of organ donation in Türkiye.","authors":"Hasan Giray Ankara, Hakan Değerli, Semih Baş","doi":"10.55730/1300-0144.6365","DOIUrl":"10.55730/1300-0144.6365","url":null,"abstract":"<p><strong>Background/aim: </strong>The aim was to understand the factors underlying the dynamics of organ donation behavior by focusing on three different aspects. Three models were tested in this regard, namely (i) individual willingness for the donation of one's own organs, (ii) willingness to approve organ donation for close relatives, and (iii) a family veto gap.</p><p><strong>Materials and methods: </strong>A national-level adult sample from the Eurobarometer 72.3 survey (collected in 2009) conducted in Türkiye was utilized. Standard and penalized logistic regression models were employed to conduct the analyses.</p><p><strong>Results: </strong>The results show that discussing organ donation with family members and being aware of the organ donation law were associated with increased willingness to donate organs in all the study models. In addition, being a woman was associated with willingness to donate one's own organs and approval for relatives, and living in an urban area was associated with approving donation for close family members. In the last model (the family veto gap) both family discussions and knowledge of the legal regulations were associated with a higher likelihood of discrepancy between personal willingness and family authorization decisions.</p><p><strong>Conclusion: </strong>Social communication and legal awareness have a pivotal role in shaping organ donation decisions in Türkiye. Therefore, health policies that encourage social conversations and raise public awareness regarding legal regulations on organ donation may help narrow the family veto gap and strengthen societal support for organ donation. Future studies could be beneficial by including cultural and religious factors and using longitudinal approaches to better capture how donation decisions evolve over time.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1208-1219"},"PeriodicalIF":1.4,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866819","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":"Demographic and clinical characteristics of frequent users of emergency medical services in Türkiye.","authors":"Burak Bekgöz, İshak Şan","doi":"10.55730/1300-0144.6343","DOIUrl":"10.55730/1300-0144.6343","url":null,"abstract":"<p><strong>Background/aim: </strong>Overuse of emergency medical services (EMS), particularly unnecessary ambulance requests, places considerable strain on limited healthcare resources and can delay responses to urgent cases. The present study analyzes the demographic characteristics, diagnoses, urgency, and hospital transfer status of frequent users of EMS in Türkiye.</p><p><strong>Materials and methods: </strong>Included in the study were 41,113 patients who requested EMS four or more times within a year (defined as frequent users for the purpose of the study), excluding interhospital transfers. Data were accessed from the Emergency Medical Services Automation System (ASOS) database, which contains details of patient demographics, diagnoses, triage codes, reasons for calls, interventions, time spent at the scene, and hospital destinations.</p><p><strong>Results: </strong>During the study period, frequent users accounted for 282,143 of all ambulance assignments. The mean age was 59.0 ± 23.5 years; those aged ≥65 and above comprised the largest group (50.2%); 50.2% were female, and the mean number of EMS utilizations per patient was 13.4 ± 26.1. Nontraumatic medical reasons accounted for 92.4% of the total ambulance requests, with dyspnea, COVID-19, and nausea/vomiting being the most common in adults, and epilepsy, fever, and nausea/vomiting in pediatric patients. Ambulance teams spent an average of over 50 min per case, and most requests were made between 08:00 and 15:59.</p><p><strong>Conclusion: </strong>Requests for ambulances in non-emergency situations may contribute to delays in the care of other patients. Further research is needed to explore the underlying reasons for frequent EMS utilization and to develop targeted strategies, such as improved chronic disease management and enhanced access to outpatient and home care services, and to optimize EMS resource allocation and patient outcomes.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"991-997"},"PeriodicalIF":1.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866066","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":"Lactate dehydrogenase-to-albumin ratio as a novel prognostic biomarker for 28-day mortality in thoracic trauma: a single-center retrospective cohort study.","authors":"Özgür Ömer Yildiz, Şükrü Yorulmaz, Eray Çinar, Hüseyin Mutlu, Ramiz Yazici, Ayşenur Gür, Medine Akkan Öz, Bensu Bulut, Mustafa Sırrı Kotanoğlu, Hakan Güner","doi":"10.55730/1300-0144.6358","DOIUrl":"10.55730/1300-0144.6358","url":null,"abstract":"<p><strong>Background/aim: </strong>Thoracic trauma accounts for approximately 25% of all trauma-related deaths and remains a significant public health challenge. Early identification of high-risk patients is essential for improving clinical outcomes. The present study evaluates the prognostic value of the lactate dehydrogenase-to-albumin ratio (LDAR) in predicting 28-day mortality in patients with thoracic trauma.</p><p><strong>Materials and methods: </strong>This retrospective observational study was conducted at a Level 1 trauma center between September 2022 and February 2025, and included adult patients presenting with thoracic trauma who underwent thoracic computed tomography. Demographic characteristics, clinical parameters, laboratory values, and 28-day mortality were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminatory power of LDAR and other biomarkers, while multivariate logistic regression was used to identify independent predictors of mortality.</p><p><strong>Results: </strong>A total of 493 patients were included in the study, 46 of whom (9.3%) died within 28 days. White blood cell count, lactate dehydrogenase, lactate, lactate/albumin ratio, LDAR, and Shock Index were statistically higher in the nonsurvivor group, and albumin, pH, and HCO₃ levels were lower (p < 0.001). Furthermore, LDAR was significantly higher in the nonsurvivor group when compared to the survivors (13.51 vs. 7.48, p < 0.001). ROC analysis demonstrated that LDAR had excellent discriminatory power for predicting mortality (AUC = 0.854; 95% CI: 0.795-0.914), with an optimal cutoff value of 11.56 yielding 71.7% sensitivity and 91.5% specificity.</p><p><strong>Conclusion: </strong>LDAR is a reliable and independent prognostic biomarker for predicting in-hospital mortality in patients with thoracic trauma. As a ratio derived from routine laboratory parameters without additional cost, LDAR offers a practical tool for rapid risk stratification and triage optimization in emergency settings. Prospective multicenter studies are warranted to validate these findings.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1141-1151"},"PeriodicalIF":1.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866805","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":"Antiobesity, antidiabetic, and antioxidant activities of selected <i>Rubia</i> species (Rubiaceae) and LC-MS/MS-based chemical profiling.","authors":"Semih Bulut, Ahmet Kahraman, Ayşenur Işik, Mustafa Abdullah Yilmaz","doi":"10.55730/1300-0144.6374","DOIUrl":"10.55730/1300-0144.6374","url":null,"abstract":"<p><strong>Background/aim: </strong><i>Rubia</i> species (Rubiaceae) are recognized as medicinal and industrial plants exhibiting diverse biological activities. This study was conducted to evaluate the antioxidant, antidiabetic, and antiobesity potential of extracts prepared from <i>Rubia davisiana</i> Ehrend. (an endemic species), <i>R. peregrina</i> L., and <i>R. rotundifolia</i> Banks & Sol., which grow naturally in Türkiye.</p><p><strong>Materials and methods: </strong>The antioxidant activity of 80% ethanol extracts prepared from the aerial parts was evaluated using 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonate) (ABTS) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assays, ferric reducing power, metal chelating capacity, and total antioxidant capacity assays. Inhibition assays for α-glucosidase and α-amylase were performed to evaluate antidiabetic activity, whereas a pancreatic lipase inhibition assay was conducted to assess antiobesity activity. Additionally, the quantitative chemical composition of the extracts was determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis.</p><p><strong>Results: </strong>The total phenolic content of the extracts ranged from 52.15 to 66.77 mg GAE/g extract. All extracts exhibited strong DPPH radical scavenging activity at concentrations of 1 and 2 mg/mL. ABTS radical scavenging activity and ferric reducing power increased in a concentration-dependent manner. Among the tested extracts, <i>R. rotundifolia</i> exhibited the highest total antioxidant capacity (147.35 mg ascorbic acid equivalent [AAE]/g extract). <i>R. rotundifolia</i> extract demonstrated stronger α-amylase inhibitory activity than the other extracts at all tested concentrations. At a concentration of 2 mg/mL, <i>R. rotundifolia</i> extract exhibited 74.70% inhibition of α-glucosidase activity. LC-MS/MS analysis revealed that the aerial parts of <i>R. rotundifolia</i> were rich in quinic acid and chlorogenic acid.</p><p><strong>Conclusion: </strong>The antidiabetic and antiobesity activities of extracts obtained from all studied species were evaluated for the first time. In conclusion, the α-glucosidase inhibitory and antioxidant activities of the extract prepared from the aerial parts of <i>R. rotundifolia</i> were more pronounced. Further studies are warranted to investigate fractionation processes and bioactivity-guided isolation of active constituents.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1296-1307"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866796","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":"Pregnancy outcomes in systemic sclerosis before and after diagnosis: a retrospective nationwide cohort study.","authors":"Alper Doğanci, Serdar Can Güven, Nuray Yilmaz Çakmak, Rıfat Bozkuş, Salih Başer, Ekin Doğanci, Neslihan Öztürk, Şuayip Birinci, Naim Ata","doi":"10.55730/1300-0144.6196","DOIUrl":"10.55730/1300-0144.6196","url":null,"abstract":"<p><strong>Background/aim: </strong>Pregnancy outcomes in women with systemic sclerosis (SSc) were evaluated in a nationwide cohort study. The impact of the disease on pregnancy outcomes was further assessed by comparing outcomes before and after the diagnosis of systemic sclerosis.</p><p><strong>Materials and methods: </strong>A retrospective, nationwide, multicenter study was conducted under the supervision of the Ministry of Health. A nationwide cohort was between 1 January 2018, and 31 October 2025, including female patients with at least two recorded ICD codes for SSc (M34 subcategories) at an interval of at least 1 month, who were identified as pregnant before (pre-SSc) or after SSc (post-SSc) based on ICD-10 codes (Z32, Z33, Z34, Z35). The initiation of data collection was set as 1 January 2018, because complete birth outcome records were available in the database from that date onward. Patients were categorized into pre-SSc and post-SSc groups according to the timing of pregnancy relative to the diagnosis of SSc.</p><p><strong>Results: </strong>Among 43,663 patients diagnosed with SSc, data from a total of 4914 pregnancies/pregnancy outcomes were retrospectively examined. Abortion was more frequent in women with SSc (11.70% in the pre-SSc group [relative risk (RR) 1.64, 95% CI 1.33-2.03], and 10.64% in the post-SSc group [RR 1.48, 95% CI 1.11-1.96]). The risk of gestational diabetes was significantly increased in both groups, with a greater increase observed in the pre-SSc group (RR 6.66); similarly, hypertensive disorders of pregnancy were more frequent in the pre-SSc group (RR 8.03). Puerperal complications were observed in 2.54% of the pre-SSc group and 3.12% (n = 22) of the post-SSc group (RR 1.85 and 2.28, respectively, compared with healthy controls).</p><p><strong>Conclusion: </strong>Our results suggest that women with SSc are at increased risk; however, successful pregnancies are possible under appropriate multidisciplinary care.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"624-631"},"PeriodicalIF":1.4,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585080","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":"Cervical conjoined nerve root anomalies: prevalence and impact on posterior cervical surgery.","authors":"Ahmet Eren Seçen, Ayfer Aslan, Musa Onur Özbakir, Uğur Kemal Gündüz, Ali Dalgiç","doi":"10.55730/1300-0144.6353","DOIUrl":"10.55730/1300-0144.6353","url":null,"abstract":"<p><strong>Background/aim: </strong>Anomalous nerve roots (ANRs) are well described in the lumbosacral spine but are rarely reported in the cervical region. The aim of this study was to evaluate the incidence, clinical characteristics, and surgical outcomes of cervical ANRs, with particular emphasis on conjoined nerve roots, in a single-center clinical series.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted of patients who underwent posterior cervical discectomy for cervical disc herniation at our institution between 2010 and 2025. A total of 113 posterior cervical procedures were performed, and seven patients were found to have surgically confirmed cervical ANRs. For these patients, demographic data, clinical presentation, radiological findings, intraoperative observations, and postoperative outcomes were reviewed. Surgical interventions included posterior cervical microdiscectomy and endoscope-assisted discectomy.</p><p><strong>Results: </strong>Among the 113 patients who underwent posterior cervical discectomy, cervical ANRs were identified intraoperatively in seven patients, yielding an incidence rate of 6.19%. These patients included four women (57.1%) and three men (42.9%), with a mean age of 46.0 years (range: 35-54 years). Motor deficits were observed in five patients (71.4%) and sensory deficits were present in four patients (57.1%). Radiologically, cervical disc herniation was identified in all cases, most frequently at the C6-C7 level (71.4%).</p><p><strong>Conclusion: </strong>Cervical ANRs are rare yet likely underrecognized anatomical variants that can pose diagnostic and intraoperative challenges. Awareness of their potential presence, careful preoperative imaging evaluation, and meticulous surgical technique are essential to minimize complications and optimize surgical outcomes.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1096-1104"},"PeriodicalIF":1.4,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866791","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":"Comparison of ultrasound-guided serratus posterior superior intercostal plane block and thoracic paravertebral block for postoperative analgesia after breast surgery: a prospective randomized noninferiority trial.","authors":"Mustafa Sırrı Kotanoğlu, Musa Zengin, Onur Küçük, Atakan Sezgi, İbrahim Topcu, Aras Metin, Zeynep Ersoy, Jülide Ergil","doi":"10.55730/1300-0144.6201","DOIUrl":"10.55730/1300-0144.6201","url":null,"abstract":"<p><strong>Background/aim: </strong>This noninferiority trial aimed to evaluate whether the serratus posterior superior intercostal plane block (SPSIPB) provides noninferior postoperative analgesia compared with the thoracic paravertebral block (TPVB) after unilateral mastectomy.</p><p><strong>Materials and methods: </strong>This prospective, randomized, assessor-blinded, parallel-group noninferiority trial enrolled 60 female patients scheduled for elective unilateral mastectomy. Patients received either ultrasound-guided SPSIPB (n = 30) or TPVB (n = 30) with 30 mL of 0.25% bupivacaine before induction. The primary outcome was visual analogue scale (VAS) pain scores (0-100 mm) at rest and during coughing over 24 h. Noninferiority was assessed using the Hodges-Lehmann median difference with 95% confidence intervals (CIs) and a prespecified margin of 13 mm, corresponding to the validated minimal clinically important difference (MCID). Secondary outcomes included opioid consumption, area under the curve (AUC) for cumulative pain burden, and patient satisfaction.</p><p><strong>Results: </strong>All 60 patients completed the study. At the first postoperative hour, TPVB provided lower VAS scores at rest (median 10.0 vs. 23.0 mm, 95% CI of difference: 0 to 19). For resting VAS, noninferiority was demonstrated at 0 h, 4 h, and 24 h (upper bounds: 11.5 mm, 12.5 mm, and 5.0 mm). The 24-h AUC for resting VAS was comparable between groups (426 mm/h vs. 426.5 mm/h, p = 0.652). SPSIPB produced significantly lower tramadol consumption in the 12-to-24-h interval (median 0 vs. 50 mg, p < 0.001). However, total opioid consumption over the 24 h was comparable (p = 0.070). No block-related complications occurred in either group.</p><p><strong>Conclusion: </strong>Noninferiority of SPSIPB to TPVB was demonstrated for resting pain scores at the majority of postoperative time points after unilateral mastectomy. TPVB provided a transient early-phase analgesic advantage at 1 h and 2 h, while SPSIPB was associated with late-phase opioid sparing. The comparable cumulative pain burden across 24 h suggests that SPSIPB may serve as a periparavertebral alternative to TPVB when sustained analgesia and opioid reduction are clinical priorities.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"674-686"},"PeriodicalIF":1.4,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585427","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}