Turkish Journal of Medical Sciences最新文献

{"title":"Prognostic significance and clinicopathological associations of tumor budding and poorly differentiated clusters in endometrioid endometrial carcinoma.","authors":"Hanife Seda Mavili, Ömer Atmiş, Fatma Seher Pehlivan, Fatma Sezen Çavdaroğlu Deveci, Ali Rıza Kandiloğlu","doi":"10.55730/1300-0144.6188","DOIUrl":"10.55730/1300-0144.6188","url":null,"abstract":"<p><strong>Background/aim: </strong>Tumor budding (TB) and poorly differentiated clusters (PDCs) are histopathological parameters that have been associated with poor prognosis in various malignancies, particularly colorectal carcinoma. Although numerous studies have demonstrated an association between the microcystic, elongated, and fragmented (MELF) pattern in endometrial carcinomas and lymphovascular invasion as well as lymph node metastasis, the literature regarding TB and PDCs in this context remains limited.This study aimed to investigate the potential associations of the MELF pattern, TB, and PDCs with overall survival, progression-free survival, and clinicopathological parameters in cases of endometrioid endometrial carcinoma (EEC).</p><p><strong>Materials and methods: </strong>A total of 190 cases diagnosed with EEC through hysterectomy specimens between 2010 and 2023, with complete hospital records, were selected from the archives of the Department of Pathology at Manisa Celal Bayar University Faculty of Medicine.</p><p><strong>Results: </strong>The presence of TB and PDCs was significantly associated with high histological grade (p < 0.001), deep myometrial invasion (p < 0.001), lymphovascular invasion (p < 0.001), lymph node metastasis (p < 0.001), cervical stromal involvement (p < 0.001), serosal involvement (p < 0.001), advanced stage (p < 0.001), and larger tumor size (p = 0.042 and p = 0.027, respectively). The presence of TB and PDCs was found to be associated with reduced overall survival (p = 0.001 and p < 0.001, respectively) and reduced progression-free survival (p = 0.043 and p = 0.004, respectively). The MELF pattern was not significantly associated with overall survival (p = 0.772).</p><p><strong>Conclusion: </strong>These findings suggest that the presence of TB and PDCs may be valuable in stratifying prognostic risk in EEC and support the inclusion of these parameters in routine pathology reporting.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"541-553"},"PeriodicalIF":1.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782271","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":"Postexposure prophylaxis for HIV among healthcare workers in Türkiye: a descriptive, multicenter retrospective study.","authors":"Veysel Akca, İlkay Akbulut, Gül Ruhsar Yilmaz, Alper Tahmaz, Nefise Öztoprak Çuvalci, İlknur Esen Yildiz, Mehmet Çabalak, Şeyma Topal, Özgür Günal, Bircan Kayaaslan, Fatma Eser, Tuba Damar Çakirca, Deniz Özer, Aliye Baştuğ, Firdevs Aksoy, Hanife Nur Karakoç Parlayan, Beyza Süllü, Damla Verendağ, Hatun Öztürk Çerik, Mehmet Ali Aşan, Ayhan Akbulut, Gülden Eser Karlidağ, Behice Kurtaran, Hüsnü Pullukçu, Turhan Togan","doi":"10.55730/1300-0144.6186","DOIUrl":"10.55730/1300-0144.6186","url":null,"abstract":"<p><strong>Background/aim: </strong>Postexposure prophylaxis (PEP) for human immunodeficiency virus (HIV) plays a vital role in preventing transmission among healthcare workers following occupational exposure. Despite its clinical importance, epidemiological data regarding PEP implementation in Türkiye remain scarce. This study aimed to assess PEP practices, prophylactic treatment regimens, and follow-up outcomes among healthcare workers at risk of occupational HIV exposure.</p><p><strong>Materials and methods: </strong>This retrospective, multicenter study was conducted between January 2020 and December 2024 across 16 healthcare facilities participating in the National HIV/AIDS Working Group. Healthcare workers aged 18 years and older who presented for evaluation following occupational exposure to HIV were included. Data on demographics, exposure characteristics, source patient test results, PEP initiation timing, regimen preferences, adverse effects, and follow-up outcomes were collected from hospital records and analyzed using SPSS v25.0.</p><p><strong>Results: </strong>A total of 369 healthcare workers were assessed. The PEP initiation rate was 49.1%. Needlestick injuries accounted for 79.4% of occupational exposures, and nurses constituted nearly half of presentations (49.6%). In univariable analyses, PEP initiation was less frequent among nurses than among other healthcare staff. In the multivariable model, male sex and age ≥40 years were independently associated with higher odds of PEP initiation, whereas the nursing profession was associated with lower odds. The median time to PEP initiation was 17.9 h (range: 0-120). Adverse effects were uncommon (3.5%), most frequently nausea and vomiting. No HIV seroconversions were identified among individuals with available follow-up results; however, follow-up testing at the predefined time points was incomplete, which limits the ability to exclude rare late seroconversions.</p><p><strong>Conclusion: </strong>Timely initiation of HIV PEP appears feasible and well tolerated in real-world occupational settings. These findings highlight the need for standardized institutional protocols and improved follow-up strategies for healthcare workers in Türkiye.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"518-530"},"PeriodicalIF":1.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive geriatric assessment identifies multidimensional vulnerabilities in older adults with heart failure.","authors":"Cihan Kiliç, Rengin Demir, Özlem Yilmaz Aykent, Zerrin Yiğit, Pınar Küçükdağli, Banu Özulu Türkmen, Gülistan Bahat, Mehmet Akif Karan","doi":"10.55730/1300-0144.6202","DOIUrl":"10.55730/1300-0144.6202","url":null,"abstract":"<p><strong>Background/aim: </strong>Heart failure (HF) in older adults is frequently accompanied by geriatric syndromes that remain unrecognized in conventional cardiac evaluations. The vulnerabilities of older adults with and without HF in terms of muscle strength, physical performance, functional capacity, frailty, nutritional status, cognition, mood, anxiety, polypharmacy, and comorbidity were investigated using comprehensive geriatric assessment (CGA).</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted in two academic outpatient clinics, enrolling 420 adults aged ≥60 years, including 92 (21.9%) with HF. Data included sociodemographic characteristics, anthropometric measurements, and CGA parameters: handgrip strength, the Five-Times Sit-to-Stand Test (FTSST), the Short Physical Performance Battery (SPPB), activities of daily living (ADL), instrumental ADL (IADL), the FRAIL scale, the Mini Nutritional Assessment-Short Form, the Mini-Cog, the Geriatric Depression Scale-Short Form, and the Generalized Anxiety Disorder-7. Univariate and multivariate regression analyses were performed.</p><p><strong>Results: </strong>HF participants had slower FTSST (12.7 s versus 11.7 s; p = 0.002), and lower SPPB scores (10.0 versus 11.0; p = 0.016). IADL scores were significantly lower in the HF group (median, 7.0 versus 8.0; p < 0.001), indicating a higher prevalence of IADL impairment. Frailty (31.5% versus 18.9%; p = 0.009), malnutrition (6.5% versus 2.1%; p = 0.043), cognitive impairment (29.3% versus 14.3%; p = 0.001), and polypharmacy (88.0% versus 57.9%; p < 0.001) were significantly more prevalent in the HF group. Low lower extremity muscle strength (OR = 3.713), impaired IADL (OR = 4.974), and higher comorbidity burden (OR = 1.603) were identified as independent factors associated with HF in multivariate analysis.</p><p><strong>Conclusion: </strong>Older adults with HF showed substantial deficits across multiple CGA domains, including functional capacity, frailty, nutrition, and cognition. Integration of CGA into HF management may facilitate the identification of previously unrecognized vulnerabilities and support multidisciplinary care planning.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"687-697"},"PeriodicalIF":1.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585436","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":"Thyroid function in children with attention-deficit/hyperactivity disorder and specific learning disorder: a retrospective comparative study.","authors":"Gül Trabzon, Seda Aybüke Sari, Servet Yüce, Şeyma Demiray Güllü","doi":"10.55730/1300-0144.6349","DOIUrl":"10.55730/1300-0144.6349","url":null,"abstract":"<p><strong>Background/aim: </strong>This study analyzes thyroid function parameters (free T₃, free T₄, TSH) in children with attention-deficit/hyperactivity disorder (ADHD), ADHD with specific learning disorder, and healthy controls, to determine whether subtle thyroid dysregulation contributes to the phenotypic heterogeneity of ADHD.</p><p><strong>Materials and methods: </strong>This retrospective, cross-sectional study included 135 children aged 6-18 years: 62 diagnosed with ADHD (38 isolated ADHD and 24 ADHD+SLD) and 73 healthy controls. Demographic, anthropometric, and thyroid function data (free T₃, free T₄, TSH) were extracted from medical records. Group comparisons were conducted using independent samples t-tests, ANOVA, and ANCOVA adjusted for age, sex, and treatment status.</p><p><strong>Results: </strong>Children with ADHD exhibited higher free T₃ (p = 0.003), lower free T₄ (p = 0.020), and higher TSH (p = 0.048) levels than the controls. Subclinical hypothyroidism, isolated T₃ elevation, and euthyroid Hashimoto thyroiditis were more prevalent in the ADHD group (p = 0.032). No significant thyroid parameter differences were observed between isolated ADHD and ADHD+SLD. The direction of these endocrine differences persisted after covariate adjustment, although only free T3 remained statistically significant, suggesting subtle hypothalamic-pituitary-thyroid axis dysregulation in ADHD independent of stimulant treatment.</p><p><strong>Conclusion: </strong>Children with ADHD exhibit subtle alterations in thyroid function, characterized by higher T₃ and TSH and lower T₄ levels, which may reflect compensatory or metabolic imbalance rather than overt thyroid disease. These findings highlight the potential role of neuroendocrine modulation in the pathophysiology of ADHD.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1054-1064"},"PeriodicalIF":1.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of early intraoperative ultrasonography and the relationship between surgical technique and allograft function in patients with compartment syndrome following renal transplantation surgery.","authors":"Burak Yağdiran, Emre Karakaya, Ravana Ahmadli, Adem Şafak, Yağmur Kurtuluş, Nedim Çekmen, Meriç Yavuz Çolak, Mehmet Haberal","doi":"10.55730/1300-0144.6180","DOIUrl":"10.55730/1300-0144.6180","url":null,"abstract":"<p><strong>Background/aim: </strong>In rare cases, patients undergoing renal transplantation <b>(</b>RT) may develop renal allograft compartment syndrome (RACS) if the renal volume is larger than the retroperitoneal space prepared in the iliac fossa. In such cases, the optimal treatment is early decompression surgery. The primary aim of the present descriptive and comparative study is not to identify the optimal surgical technique, but rather to evaluate the role of early Doppler ultrasonography (DUSG) in the recognition of renal allograft compartment syndrome and to assess outcomes following timely decompressive interventions.</p><p><strong>Materials and methods: </strong>A total of 275 patients were examined retrospectively for the study, including 247 with muscle and fascia closure and 28 with skin-only closure.</p><p><strong>Results: </strong>Only 28 (10.18%) of the patients with RACS underwent permanent fasciotomy and skin-only closure. No statistically significant difference was observed in the mean urine output between the two groups on any postoperative day, assessed based on the renal artery resistive index and peak systolic velocity.</p><p><strong>Conclusion: </strong>RACS should be considered in patients with large-sized allografts and small parailiac retroperitoneal spaces to address the inherent anatomical restrictions. Although early diagnosis with DUSG is essential for evaluating graft dysfunction in these patients, early decompression surgery should be considered crucial for the preservation of graft function in those with suspected RACS.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"464-470"},"PeriodicalIF":1.4,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of race-based and race-free CKD-EPI equations on estimated glomerular filtration rate in a multicenter retrospective cohort of autosomal dominant polycystic kidney disease.","authors":"Özgür Akın Oto, Abdulmecit Yildiz, İsmail Koçyiğit, Halil Yazici, Saide Elif Güllülü Boz, Yiğit Kurtuluş, Alparslan Demiray, Müge Doksan, Vafa Suleymanova, Ece Ük, Alper Akin, Bahar Bastani, John C Edwards, Krista Leigh Lentine, Yaşar Kerem Çalişkan","doi":"10.55730/1300-0144.6212","DOIUrl":"10.55730/1300-0144.6212","url":null,"abstract":"<p><strong>Background/aim: </strong>The 2021 revision of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which eliminates race-based coefficients, may significantly influence disease staging and treatment in autosomal dominant polycystic kidney disease (ADPKD). This study was designed to evaluate the impact of the 2021 race-free CKD-EPI equation on estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) staging in a multi-ethnic ADPKD population.</p><p><strong>Materials and methods: </strong>In this multicenter, retrospective cohort study, 597 ADPKD patients were evaluated, including 515 self-identified as Caucasian and 82 as African-American. eGFR values at baseline and final follow-up were calculated using both the 2009 and 2021 CKD-EPI equations. Changes in CKD staging and clinical implications were assessed based on the race-free equation.</p><p><strong>Results: </strong>Among Caucasian patients, the median baseline eGFR increased from 85.0 to 88.6 mL/min/1.73 m² and the final eGFR from 63.1 to 66.1 mL/min/1.73 m² using the 2021 equation (p < 0.001). In contrast, the 2021 equation resulted in decreased eGFR among African-American patients, from 89.3 to 80.3 mL/min/1.73 m² at baseline and from 46.8 to 42.6 mL/min/1.73 m² at final follow-up (p < 0.001). A total of 6.7% of Caucasian patients were downstaged initially and 5.7% at final follow-up. Conversely, 2.3% of African-American patients were upstaged at baseline and 1.8% at final follow-up.</p><p><strong>Conclusion: </strong>The 2021 CKD-EPI equation significantly alters eGFR estimation and CKD staging compared to the 2009 version, with varying impacts across ethnic groups. These findings highlight the importance of careful interpretation of eGFR and individualized clinical decision-making in patients with ADPKD.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"787-793"},"PeriodicalIF":1.4,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcome of extremity arterial injuries in the modern era.","authors":"Ali Kuşsan, Selçuk Coşkun, Alp Şener, Ferhat Içme, Pınar Köksal Coşkun, Gülhan Kurtoğlu Çelik","doi":"10.55730/1300-0144.6154","DOIUrl":"10.55730/1300-0144.6154","url":null,"abstract":"<p><strong>Background/aim: </strong>Extremity arterial injuries (EAIs) present a significant clinical challenge due to the risk of limb ischemia, amputation, and mortality. This retrospective cohort study aimed to delineate the clinical course, treatment strategies, and patient outcomes following trauma-induced EAIs, and to identify independent predictors of adverse outcomes.</p><p><strong>Materials and methods: </strong>Retrospectively analyzed were data from 168 consecutive patients with traumatic EAIs who underwent computed tomography angiography at a tertiary care center between 2019 and 2025. Data extracted from electronic medical records included demographics, injury mechanisms, clinical presentation, laboratory findings, imaging results, treatment modalities (primary repair, grafting, endovascular intervention, conservative management), and patient outcomes (sequelae-free recovery, amputation, mortality).The primary outcome was sequelae-free recovery, while secondary outcomes included amputation, and mortality. The entire patient follow-up period, encompassing all treatment modifications, extended from emergency department admission until the primary or secondary outcome was reached. This period included hospitalization, postdischarge care (if applicable), and all subsequent outpatient clinic visits. Mortality was attributed only when directly causal.</p><p><strong>Results: </strong>The mean age of the patients was 37 ± 15 years, with a male predominance (86%). Penetrating trauma was the primary etiology for upper extremity injuries, while blunt trauma predominated in lower extremity injuries. Clinical presentation varied, with pulsatile bleeding significantly associated with penetrating trauma and hypoesthesia with blunt trauma. Independent predictors of adverse outcomes included hypotension, pulselessness, hypoesthesia, and elevated international normalized ratio (≥1.2). Base deficit was significantly associated with adverse outcomes in upper EAIs. Treatment modalities included primary repair (51.2%), grafting (10.1%), endovascular intervention (8.2%), and conservative management (28%). Amputation rates were 1.3% for upper extremities and 5.3% for lower ones, while mortality rates were 2.6% and 3.3%, respectively.</p><p><strong>Conclusions: </strong>Early diagnosis, prompt surgical intervention, and a multidisciplinary approach are essential for optimizing patient outcomes. Hypotension, pulselessness, and hypoesthesia were identified as significant independent predictors of adverse outcomes. Future multicenter studies are warranted to validate these findings.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"208-217"},"PeriodicalIF":1.4,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for mechanical ventilation modes among intensivists in Türkiye: a nationwide point-prevalence study.","authors":"Süleyman Yildirim, Nurhayat Kilinç Özgün, Özcan Alpdoğan, Hüseyin Uçar, İmren Taşkiran, Adnan Ata, Özhan Özcan, Kıvanç Öncü, Saba Mukaddes Acarbay, Temel Güner, Pınar Özgün, Zerrin Özçelik, Ayşegül Çinaroğlu, Gizem Kurada, L Serap Avlaği, Onur Gökçe, Özkul Yilmaz Çolak, Fatma Ülger, Melda Işevi, Özgür Kiliç, Rahime Aydin Kayali, Metin Yarici, Berkay Küçük, Fatma Yildirim, Kamil Gönderen, Bişar Ergün, Kutlay Aydin, Kamuran Uluç, Sevda Onuk, Mine Altinkaya Çavuş, Yelda Balik, Ahmet Sari, Hayriye Cankar Dal, Şerife Gökbulut Bektaş, Sema Turan, Ferhan Demirer Aydemir, Murat Güneş, Canan Gürsoy, Hüseyin Oğuz Yilmaz, Kamil Inci, Türkay Akbaş, Hamza Gültekin, Burcu Acar Çinleti, Tuğçe Mengi, Kaniye Aydin, Ferhat Çetinkaya, Selin Eyüpoğlu, Elif Kerimoğlu, Hüseyin Özkök, Selçuk Yaylaci, Havva Kocayiğit, Burak Kaya, Mete Erdemir, Gürhan Taşkin, Kazım Rollas, Hüseyin Özkarakaş, Mensure Çakirgöz, Cenk Kirakli","doi":"10.55730/1300-0144.6138","DOIUrl":"10.55730/1300-0144.6138","url":null,"abstract":"<p><strong>Background/aim: </strong>Invasive mechanical ventilation (IMV) is a fundamental intervention for patients with respiratory failure in intensive care units (ICUs). This nationwide, multicenter point-prevalence study aimed to describe current mechanical ventilation mode preferences (conventional, adaptive, and biphasic) in Turkish ICUs and to report associated clinical outcomes descriptively, without assessing causal relationships.</p><p><strong>Materials and methods: </strong>A nationwide, multicenter point-prevalence study was conducted on 17 April 2024 and included adult patients (≥18 years) who had been receiving IMV for more than 24 h. Data on patient demographics, ventilation mode distribution, ventilatory parameters, and descriptive clinical outcomes on day 28 (weaning status, tracheostomy, and mortality) were recorded without comparative outcome analysis.</p><p><strong>Results: </strong>A total of 426 patients were included. Conventional modes were used in 84.5% of patients, adaptive modes in 10.6%, and biphasic modes in 4.9%. Synchronized intermittent mandatory ventilation (SIMV) was the most commonly used conventional mode. The primary indication for IMV was acute respiratory failure (61%), with pneumonia being the leading cause. Among the 350 orotracheally intubated patients, 25.6% were in the weaning phase on the study day. A total of 59 (16.9%) patients were extubated, 150 (42.9%) underwent tracheostomy, and 64 (18.2%) remained intubated on day 28. Overall, 185 (43.4%) patients died during their ICU stay, 152 (35.7%) remained in the ICU, and 89 (20.9%) were successfully discharged from the ICU.</p><p><strong>Conclusion: </strong>Conventional ventilation modes, particularly SIMV, were more commonly used in Turkish intensive care units (ICUs), whereas adaptive modes were less frequently applied. These patterns may reflect factors such as clinician familiarity, institutional practices, and equipment availability rather than definitive preferences. Although the impact of ventilation modes on clinical outcomes was not comparatively evaluated in this study, the choice of ventilation mode may still influence patient outcomes. Therefore, further prospective and comparative studies are warranted to better elucidate this relationship.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"60-70"},"PeriodicalIF":1.4,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tremor modulation: a systematic review of resetting by single-pulse transcranial magnetic stimulation.","authors":"Handan Uzunçakmak-Uyanik, Çağrı Mesut Temuçin","doi":"10.55730/1300-0144.6175","DOIUrl":"10.55730/1300-0144.6175","url":null,"abstract":"<p><strong>Background/aim: </strong>Tremor arises from mechanical, reflex, or central oscillatory mechanisms. Transcranial magnetic stimulation (TMS) can transiently perturb ongoing tremor and enables the quantitative assessment of phase resetting, offering circuit-level insight into tremor types. Although numerous studies have applied TMS-induced resetting, the findings have not been systematically reviewed. This study systematically reviews human studies evaluating TMS-induced tremor resetting across tremor types.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed and Google Scholar identified human studies using TMS to perturb tremor or rhythmic movement. Search terms included \"tremor resetting,\" \"resetting of tremor,\" \"tremor phase shift,\" \"tremor phase reset,\" \"transcranial magnetic stimulation,\" and \"central oscillator.\" Inclusion criteria were human participants, experimental TMS perturbation, and quantitative tremor phase/resetting outcomes. Exclusion criteria were animal studies, therapeutic repetitive TMS trials without resetting analyses, and isolated case reports. Two researchers independently screened and extracted data. The PRISMA 2020 guidelines were followed.</p><p><strong>Results: </strong>Twenty-one studies were identified, three of which were excluded from the primary synthesis (two case reports and one qualitative-only design). Eighteen studies remained, which addressed essential tremor (ET) (n = 6), Parkinson's disease tremor (PDT) (n = 7), orthostatic tremor (OT) (n = 4), palatal tremor (n = 1), dystonic tremor (DT) (n = 1), and voluntary rhythmic movement (n = 4). M1 stimulation reset ET, postural PDT, OT, palatal tremor, DT, and voluntary rhythmic movements. Rest PDT had inconsistent resetting by M1 stimulation and no resetting by cerebellar stimulation. Cerebellar stimulation reset postural PDT but not ET. The resetting index was associated with the stimulus intensity and duration of the silent period.</p><p><strong>Conclusion: </strong>TMS-induced resetting is a strong physiological tool for differentiating tremor circuits. M1 acts as a major convergence node, while cerebellar involvement is tremor-specific. Methodological heterogeneity and small samples limit the comparability of study results. Advances in targeting technologies and closed-loop and phase-locked protocols could enhance the diagnostic and therapeutic utility of resetting paradigms.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"390-404"},"PeriodicalIF":1.4,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of knee pain in the operating room: are surgical personnel at greater risk?","authors":"Ömer Faruk Naldöven, Yavuz Karaman, Başak Sinem Sezgin, Şahan Güven, Enejd Veizi, İzzet Bingöl","doi":"10.55730/1300-0144.6150","DOIUrl":"10.55730/1300-0144.6150","url":null,"abstract":"<p><strong>Background/aim: </strong>This study aimed to determine the prevalence of knee pain among healthcare workers in surgical units and to explore whether the use of knee panels during surgical hand scrubbing is associated with persistent knee pain.</p><p><strong>Materials and methods: </strong>This single-center cross-sectional study was conducted between October 2023 and March 2025. A total of 400 physicians and nurses working in surgical and nonsurgical departments were included. Participants completed a structured and modified Nordic Musculoskeletal Questionnaire, as well as knee pain assessment tools, including a visual analog scale (VAS) and the Kujala score for anterior knee pain-related symptoms. Occupational exposure among surgical staff was additionally evaluated. Data were analyzed using IBM SPSS Statistics.</p><p><strong>Results: </strong>The prevalence of knee pain was 54.8% among surgical personnel and 39.5% among nonsurgical personnel. VAS scores were significantly higher in the surgical group, while there was no significant difference between groups in terms of Kujala scores. Knee panel use was common and more than half of the users reported discomfort during use; however, there was no statistically significant association between panel use and persistent knee pain. Regression analysis identified increasing age, longer duration of surgical experience, and employment in a surgical unit as factors independently associated with knee pain.</p><p><strong>Conclusion: </strong>Employment in a surgical unit is associated with a higher prevalence of knee pain among healthcare workers. However, the use of knee panels during surgical hand scrubbing does not appear to be associated with persistent knee pain. Multicomponent ergonomic interventions should be implemented to prevent musculoskeletal disorders.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"169-175"},"PeriodicalIF":1.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}