Turkish Journal of Medical Sciences最新文献

{"title":"Letter to the editor: Telemedicine versus conventional care for nonspecific neck pain: a randomized controlled study.","authors":"Gülsemin Ertürk Çelik","doi":"10.55730/1300-0144.6225","DOIUrl":"10.55730/1300-0144.6225","url":null,"abstract":"","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"907-908"},"PeriodicalIF":1.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sun-macerated <i>Hypericum perforatum</i> oleates in fixed oils: analytical characterization and comparative wound-healing activity.","authors":"Cihan Çapar, Esra Küpeli, Aylin Yaba, Ayhan Parmaksiz, Engin Sümer, Erdem Yeşilada","doi":"10.55730/1300-0144.6190","DOIUrl":"10.55730/1300-0144.6190","url":null,"abstract":"<p><strong>Background/aim: </strong><i>Hypericum perforatum</i> L. oleates prepared in fixed oils have long been used for wound management due to their antiinflammatory, antibacterial, and tissue-regenerative properties. The bioactivity of these oleates is mainly attributed to hypericin, hyperforin, and pseudohypericin. In the present study, the wound-healing potential of <i>H. perforatum</i> oleates prepared in different fixed oils, including <i>Olea europaea</i> L. (olive), <i>Sesamum indicum</i> L. (sesame), <i>Helianthus annuus</i> L. (sunflower), and <i>Nigella sativa</i> L. (black seed), is compared.</p><p><strong>Materials and methods: </strong>Fixed oils were characterized by gas chromatography-mass spectrometry, while oleuropein (olive oil) and thymoquinone (black seed oil) were quantified by high-performance liquid chromatography, and sesamin and sesamol (sesame oil) by spectrophotometry. Oleates were prepared using the traditional sun maceration method. Hypericin, hyperforin, and pseudohypericin were quantified by liquid chromatography-mass spectrometry and ultraviolet spectrophotometry. In vitro and in vivo assays were performed to assess the wound-healing activities of both the fixed oils and their respective oleates.</p><p><strong>Results: </strong>All oleates exhibited significantly greater wound-healing activity than the corresponding fixed oils. The most pronounced synergistic effects were observed with the olive oil and sesame oil oleates.</p><p><strong>Conclusion: </strong>Maceration of <i>H. perforatum</i> in fixed oils enhances the intrinsic therapeutic properties of oils and contributes to improvements in multiple wound-healing parameters. The findings of the present study support the traditional use of <i>H. perforatum</i> oleates and provide a scientific basis for their pharmacological development.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"570-584"},"PeriodicalIF":1.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative normocalcemic hyperparathyroidism: a comprehensive analysis of 510 cases.","authors":"Alparslan Ertenlice, İbrahim Kilinç, Mustafa Oruç","doi":"10.55730/1300-0144.6210","DOIUrl":"10.55730/1300-0144.6210","url":null,"abstract":"<p><strong>Background/aim: </strong>Postoperative normocalcemic hyperparathyroidism (NC-HPT) is defined as elevated parathyroid hormone (PTH) levels despite normal calcium levels after parathyroidectomy for primary hyperparathyroidism (PHPT). This study investigates the demographic, biochemical, and histopathological factors associated with NC-HPT in a large patient cohort and presents the follow-up outcomes.</p><p><strong>Materials and methods: </strong>The initial study sample included 571 patients who underwent surgery for PHPT between January 2018 and January 2024, 510 of whom were analyzed retrospectively after the application of the exclusion criteria. Preoperative and postoperative biochemical parameters, bone mineral density, pathological findings, and follow-up data were evaluated. NC-HPT was defined as postoperative PTH elevation in the presence of normocalcemia. Logistic regression and receiver operating characteristic curve analyses were performed.</p><p><strong>Results: </strong>NC-HPT developed in 104 (20.4%) of the 510 patients analyzed in the study. The condition peaked in the third postoperative month and then gradually declined, with 86.5% of cases resolving by month 30. Univariate analysis revealed elevated preoperative PTH, high alkaline phosphatase (ALP), and parathyroid hyperplasia to be significant predictors. In multivariate analysis, only preoperative PTH level (OR: 1.003; 95% CI: 1.002-1.005; p < 0.001) and hyperplasia (OR: 3.311; 95% CI: 1.277-8.547) remained independent risk factors. ROC analysis identified a preoperative PTH cutoff value of 298 pg/mL with an AUC of 0.665 (95% CI: 0.608-0.723). No significant associations were observed with other demographic, biochemical, or radiological parameters.</p><p><strong>Conclusion: </strong>NC-HPT occurs in approximately 20% of patients undergoing surgery for PHPT but often resolves during follow-up. Elevated preoperative PTH levels and parathyroid hyperplasia are independent predictors of NC-HPT, and patients with these characteristics should be monitored more closely in the postoperative period.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"769-777"},"PeriodicalIF":1.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585100","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":"Skin cancer surgery under local anesthesia: clinicopathologic characteristics and age-stratified outcomes in 533 patients.","authors":"Menekşe Kastamoni Başkan, Süleyman Çeçen, Selçuk Akin, Şaduman Balaban Adim, Güzin Yeşim Özgenel","doi":"10.55730/1300-0144.6198","DOIUrl":"10.55730/1300-0144.6198","url":null,"abstract":"<p><strong>Background/aim: </strong>Skin cancer is the most common malignancy worldwide, particularly among elderly individuals. Many lesions are detected at an early stage because of their visibility and can be excised under local anesthesia, thereby avoiding the risks associated with general anesthesia or sedation. This study aimed to evaluate patient- and tumor-related characteristics in skin cancer surgery performed under local anesthesia, with particular emphasis on age-related outcomes.</p><p><strong>Materials and methods: </strong>This retrospective study included 533 patients with 613 histopathologically confirmed skin cancers excised under local anesthesia between 2019 and 2024. Demographic, histopathological, and surgical variables were recorded, including age, sex, tumor location, measured tumor area, histologic subtype, surgical margin status, reconstruction technique, and comorbid conditions. Patients were stratified into three age groups (<60, 60-80, and >80 years) for subgroup analyses. Statistical analyses were performed using the Mann-Whitney U test, Kruskal-Wallis test, chi-square test, and Spearman correlation analysis (SPSS version 26.0; IBM Corp., Armonk, NY, USA), with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>The mean patient age was 68.5 years. Most lesions (86.1%) were located in the head and neck region. Basal cell carcinoma (65.4%) and squamous cell carcinoma (21.0%) were the predominant histopathological diagnoses. Primary closure (43.8%) and full-thickness skin grafting (25.0%) were the most frequently performed reconstruction methods. Larger tumor area was significantly associated with positive surgical margins (p < 0.01), and tumor type was significantly associated with both surgical margin status and reconstruction method (p < 0.0001). Age showed a statistically significant positive correlation with tumor area (p = 2.22 × 10^-7) and with the presence of comorbidities (p < 0.001). Subgroup analysis demonstrated a higher proportion of squamous cell carcinoma and a larger mean tumor area in patients older than 80 years. No local anesthesia-related complications occurred.</p><p><strong>Conclusion: </strong>Skin cancer surgery performed under local anesthesia appears to be safe and effective across age groups, including elderly and comorbid patients. Tumor type and tumor area were significantly associated with surgical margin status and reconstruction method. These findings support age-conscious and anesthesia-sparing approaches in oncologic dermatologic surgery.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"645-653"},"PeriodicalIF":1.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585242","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":"Multiple organ dysfunction syndrome in pediatric colchicine poisoning: a national cohort study from Türkiye.","authors":"Faruk Ekinci, Dinçer Yildizdaş, Özden Özgür Horoz, Hayri Levent Yilmaz, Sevcan Bilen, İlker Ünal, İkbal Türker, Esra Şevketoğlu, Nihal Akçay, Agop Çitak, Güntülü Şik, Tanıl Kendirli, Merve Havan, Murat Kangin, Mehmet Nur Talay, Nazik Yener, Hatice Albayrak, Edin Botan, Utku Özer, Arzu Oto, Gürkan Bozan, Muhterem Duyu, Başak Nur Akyildiz, Naime Gökay, Elif Çelik, Çapan Konca, Mutlu Uysal Yazici, Oğuz Dursun, Feyza Inceköy Girgin, Hatice Feray Ari, İlknur Arslan, Murat Özkale, Özlem Sandal, Merve Misirlioğlu, Halil Keskin, Sadık Kaya, Arda Kilinç, Ferhat Sari, Fatih Akin, Ayşe Aşik, İbrahim Bingöl, Eda Turanli, Merve Boyraz, Ener Çağrı Dinleyici, Mehmet Akif Dündar, Selver Ceren Özcan, Aygül Kaya Akilli, Emine Akkuzu, Nazan Ülgen Tekerek, Nilüfer Öztürk, Emrah Gün, Yasemin Özkale, Nurettin Onur Kutlu, Zeynelabidin Öztürk","doi":"10.55730/1300-0144.6204","DOIUrl":"10.55730/1300-0144.6204","url":null,"abstract":"<p><strong>Background/aim: </strong>Colchicine poisoning has been associated with systemic toxicity, multiple organ dysfunction syndrome (MODS), and mortality. In the present study, the demographic, clinical, and laboratory characteristics of pediatric colchicine poisoning cases and the incidence of organ failure are investigated to identify potential risk factors associated with MODS.</p><p><strong>Materials and methods: </strong>Included in this retrospective multicenter cohort study were pediatric patients admitted to 28 tertiary-care pediatric intensive care units with a diagnosis of colchicine poisoning. Demographic data, clinical and laboratory findings, and clinical outcomes were extracted from medical records. MODS was defined as dysfunction involving at least two organ systems. Multivariable logistic regression analysis was performed to identify the variables independently associated with MODS.</p><p><strong>Results: </strong>Of the 150 patients included in the study, 40% were younger than 5 years and 52% were older than 13 years. Gastrointestinal symptoms were most prominent, with nausea and vomiting observed in 64.7%, abdominal pain in 36.7%, and diarrhea in 24%. Overall, 66% developed no organ failure, while single-organ failure occurred in 7.3% and 26.7% developed MODS. The coagulation system was most frequently affected (26%), followed by the hematological (19.3%) and immunological (18%) systems. Multivariable logistic regression analysis identified the baseline PRISM III score, ingested colchicine dose per kilogram of body weight, and initial sodium, creatinine, and aspartate aminotransferase (AST) levels as independent predictors of MODS.</p><p><strong>Conclusion: </strong>MODS can develop at ingestion doses lower than 0.5 mg/kg, which have historically been considered safe. Higher ingested doses and elevated PRISM III scores were associated with MODS, although these findings are derived from retrospective observational data and should not be interpreted as causal or as direct clinical recommendations. Further prospective studies are needed to clarify relevant doses, interventions, and prognostic factors in pediatric colchicine poisoning associated with MODS.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"708-717"},"PeriodicalIF":1.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585121","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 repetitive peripheral magnetic stimulation on poststroke ankle spasticity: a double-blind randomized controlled trial.","authors":"Hüseyin Oğuzhan Aslantaş, Şehim Kutlay, Haydar Gök, Semra Özkan, Seçilay Güneş, Atilla Halil Elhan","doi":"10.55730/1300-0144.6197","DOIUrl":"10.55730/1300-0144.6197","url":null,"abstract":"<p><strong>Background/aim: </strong>Repetitive peripheral magnetic stimulation (rPMS) is a noninvasive, painless therapy aimed at improving spasticity, with a proposed mechanism that involves neuromodulation through somatosensory and proprioceptive afferent stimulation. The present study evaluates the effectiveness of rPMS on ankle plantar flexor spasticity in participants with stroke.</p><p><strong>Materials and methods: </strong>Included in this prospective, double-blind, randomized, sham-controlled study were 50 participants with poststroke ankle plantar flexor spasticity graded 1-3 according to Modified Ashworth Scale (MAS). Participants were randomized into rPMS (n = 25) and sham (n = 25) groups. All participated in a conventional rehabilitation program, while the rPMS group received 10 rPMS sessions over 2 weeks and the sham group received sham rPMS. Assessments at baseline, posttreatment (2nd week), and follow-up (4th week) included MAS, Modified Tardieu Scale (MTS), Barthel Index (stair/mobility), and electrophysiological H/M ratio.</p><p><strong>Results: </strong>A total of 46 participants completed the study. No adverse events related to the stimulation were reported. The rPMS group showed significant improvements in MAS score, MTS angle and grade, and Barthel Index, while no significant changes were observed in the sham group. A significantly greater proportion of participants in the rPMS group (40%) demonstrated MAS score reduction compared to the sham group (4.8%) (p = 0.004). Between-group analysis favored rPMS for MAS and MTS posttreatment and at follow-up. No significant changes in H/M ratios were observed within or between the groups.</p><p><strong>Conclusion: </strong>rPMS can be a valuable adjunct to a traditional rehabilitation program, potentially improving poststroke spasticity. The reductions recorded in MAS and MTS scores in the absence of electrophysiological changes suggest that rPMS may reduce the biomechanical rather than neural component of spasticity. There is a need to define optimal treatment protocols.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"632-644"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585380","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":"Bridging the methodological gap in multitrauma literature: a competency-based educational framework and clinical appraisal filter.","authors":"Şakir Hakan Aksu, Burcu Doğan, Merve Yazla","doi":"10.55730/1300-0144.6208","DOIUrl":"10.55730/1300-0144.6208","url":null,"abstract":"<p><strong>Background/aim: </strong>The statistical complexity of contemporary multitrauma literature has increased considerably in recent years, which may pose challenges for clinicians seeking to interpret high-impact research and apply evidence-based practices. Characterizing this methodological landscape and exploring education-oriented approaches may help to improve the interpretability of the literature and support informed clinical decision-making.</p><p><strong>Materials and methods: </strong>A cross-sectional analysis was conducted on the 100 most-cited multitrauma studies published in Science Citation Index Expanded journals indexed in the Web of Science database between January 2018 and November 2025. The statistical methods used in each article were categorized into the three competency levels of introductory, intermediate, and advanced based on a literature-derived classification framework. Associations between methodological characteristics and the journal's impact factor (IF) were examined.</p><p><strong>Results: </strong>Across the 100 studies, a total of 1210 statistical procedures were identified, with a mean of 12.1 ± 3.8 methods per article. Only 8% (n = 8) of the studies could be fully interpreted using introductory-level statistical knowledge, whereas 92% required intermediate (n = 61) or advanced (n = 31) analytical competency. Articles employing advanced statistical methods (mean IF: 9.03), techniques for handling missing data (mean IF: 8.22), and randomized controlled trial designs (mean IF: 18.87) were published in significantly higher-impact journals (p < 0.05).</p><p><strong>Conclusion: </strong>The findings of this study suggest the presence of a methodological gap between high-impact multitrauma literature and the level of statistical training commonly received by clinicians. This gap may complicate the critical appraisal of contemporary research and the translation of evidence into practice. As a potential response, we propose a complementary dual strategy: a practical \"methodological appraisal filter\" to support current clinicians and a structured, competency-based biostatistics curriculum emphasizing regression modeling, survival analysis, and advanced epidemiological methods.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"746-760"},"PeriodicalIF":1.4,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive profiling of gut microbiota in postmenopausal osteoporosis.","authors":"Gülsemin Ertürk Çelik, Sedat Yildiz, Münevver Aksoy Bektaş, Yaprak Engin Üstün","doi":"10.55730/1300-0144.6187","DOIUrl":"10.55730/1300-0144.6187","url":null,"abstract":"<p><strong>Background/aim: </strong>Osteoporosis is a multifactorial skeletal disease that predominantly affects postmenopausal women and is characterized by reduced bone mass and an increased risk of fractures. Growing evidence suggests that the gut microbiota plays a pivotal role in bone metabolism through immunological, endocrine, and metabolic pathways, forming the basis of the so-called gut-bone axis. This study aimed to characterize gut microbiota composition in postmenopausal women with osteoporosis compared with healthy controls.</p><p><strong>Materials and methods: </strong>Forty postmenopausal women aged 55-65 years were classified into osteoporosis (n = 20) and healthy control (n = 20) groups based on dual-energy X-ray absorptiometry T-scores. Fecal samples were collected, and gut microbiota composition was evaluated with full-length 16S rRNA gene sequencing using Oxford Nanopore Technologies.</p><p><strong>Results: </strong>No significant differences were observed in clinical or demographic characteristics between groups, except for the expected lower bone mineral density (BMD) in the osteoporosis group. Alpha-diversity indices showed no statistically significant differences, although a trend toward reduced microbial richness was observed in the osteoporotic participants. Beta-diversity analysis revealed a modest but significant phylogenetic distinction via weighted UniFrac analysis (p < 0.05). Short-chain fatty acid-producing species, including <i>Faecalibacterium prausnitzii</i>, <i>Anaerostipes faecalis</i>, and <i>Lactonifactor longoviformis</i>, were significantly reduced in the osteoporosis group. <i>F. prausnitzii</i> abundance was positively correlated with the femoral neck T-score (r = 0.41, p = 0.018), whereas <i>Oxobacter pfennigii</i> showed a negative correlation with lumbar spine BMD (r = -0.43, p = 0.015).</p><p><strong>Conclusion: </strong>Postmenopausal osteoporosis is associated with a distinct gut microbiota profile marked by reduced antiinflammatory and estrogen-modulating taxa alongside increased proinflammatory species. These alterations may contribute to impaired bone metabolism through disrupted calcium absorption, systemic inflammation, and hormonal dysregulation. These findings further support the gut-bone axis and highlight the potential of gut microbiota as a biomarker and therapeutic target in osteoporosis.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"531-540"},"PeriodicalIF":1.4,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal microvascular and neuroretinal structural changes in pulmonary arterial hypertension assessed by OCTA: a comparative study.","authors":"Murat Erdağ, Tunahan Çalişkan, Hakan Yildirim, Tarık Kivrak, Mehmet Canleblebici, Ali Dal, Mehmet Balbaba","doi":"10.55730/1300-0144.6181","DOIUrl":"10.55730/1300-0144.6181","url":null,"abstract":"<p><strong>Background/aim: </strong>Pulmonary arterial hypertension (PAH) is a progressive disorder with systemic vasculopathy, and noninvasive assessment remains challenging. The retina, sharing anatomical similarities with the cerebral microcirculation, is an accessible site for visualizing systemic vascular compromise. This study quantitatively evaluated retinal microvascular and neuroretinal structural changes in PAH patients compared to healthy controls using optical coherence tomography angiography (OCTA).</p><p><strong>Materials and methods: </strong>In this single-center, cross-sectional case-control study, 40 patients with group 1 PAH and 38 healthy controls were enrolled. For statistical independence, only the right eye of each participant was analyzed (total: 78 eyes). All participants underwent high-resolution OCTA imaging. Key metrics including vascular density (VD) in the superficial (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ) flow density (FD), and neuroretinal thicknesses (ganglion cell complex [GCC] and retinal nerve fiber layer [RNFL]) were quantified and compared using nonparametric tests.</p><p><strong>Results: </strong>Comparison of PAH patients and controls revealed significantly reduced VD in the PAH group. In the SCP, VD was significantly lower in the whole image (p = 0.004) and the ETDRS grid (p = 0.005). Similarly, the DCP showed reduced VD in the whole image (p = 0.006). Quadrant analysis indicated marked reduction in the superior quadrant for both plexuses (p < 0.01). While FAZ area was similar between the groups (p = 0.779), FAZ FD was significantly decreased in PAH patients (p = 0.001). Structurally, mean GCC thickness was significantly reduced (p = 0.006), but RNFL thickness remained preserved (p = 0.267).</p><p><strong>Conclusion: </strong>PAH is associated with significant retinal microvascular density reduction across all plexuses. These findings provide evidence corroborating the systemic nature of PAH vasculopathy. OCTA is a promising noninvasive tool for assessing systemic microvascular involvement in this population. However, further longitudinal studies are needed to validate its utility for disease monitoring.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"471-478"},"PeriodicalIF":1.4,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of vitamin D, oxidative stress markers, and hormonal factors with male infertility: a case-control study in Pakistan.","authors":"Muhammad Tayyab Ihsan, Ayesha Ali Malick, Sher Khan, Muhammad Tahir Khan, Haq Nawaz Khan, Rehana Rehman","doi":"10.55730/1300-0144.6217","DOIUrl":"10.55730/1300-0144.6217","url":null,"abstract":"<p><strong>Background/aim: </strong>Infertility impacts around 15% of couples worldwide, with male factors accounting for approximately 50% of cases. Despite this significant share, male infertility remains understudied, particularly in developing nations such as Pakistan. The present study explores the association between male infertility and seminal plasma concentrations of oxidative stress markers, inhibin B, and vitamin D, along with their relationship with sperm parameters.</p><p><strong>Materials and methods: </strong>The dataset of the study consisted of seminal plasma levels from 30 fertile and 60 infertile males. Total antioxidant capacity (TAC), Vitamin D, malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), lipid peroxide (LPO), superoxide dismutase (SOD), and inhibin B levels were assessed using ELISA kits and the data were analyzed using SPSS (v.23) software. Descriptive statistics for quantitative variables were reported as mean ± standard deviation. Correlations among parameters were assessed using Spearman's rank correlation test. In all analyses, p-values of < 0.05 were considered significant, and < 0.001 as highly significant.</p><p><strong>Results: </strong>Fertile males exhibited higher vitamin D and TAC levels than the infertile males (p-values = 0.00 and < 0.01, respectively). In contrast, higher MDA and 4-HNE levels were observed in infertile males (p-value = 0.00). No statistically significant relationship was identified between the inhibin B and LPO values of the two groups.</p><p><strong>Conclusion: </strong>Elevated oxidative stress markers (MDA, 4-HNE) and reduced vitamin D and TAC levels were associated with infertility in the sample. The dual role of SOD in oxidative stress regulation warrants further investigation to determine the thresholds at which sperm integrity is affected. Vitamin D may play a critical function in spermatogenesis, though its exact mechanisms require further exploration. These findings underscore the role of oxidative stress and nutritional factors in fertility, and highlight the need for targeted interventions to improve reproductive outcomes.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"828-837"},"PeriodicalIF":1.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585309","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}