Medeniyet medical journal最新文献

{"title":"Impact of SARS-CoV-2 Infection on Diabetic Ketoacidosis in Children with Newly Diagnosed Type-1 Diabetes: A Prospective Multicenter Study.","authors":"Merve Nur Hepokur, Filiz Tutunculer Kokenli, Hamdi Cihan Emeksiz, Asan Onder Camas, Humeyra Yasar Kostek, Zekiye Kupcu, Deniz Derya Budak, Metin Yildiz, Ferruh Kemal Isman, Aysun Bideci, Peyami Cinaz","doi":"10.4274/MMJ.galenos.2026.55256","DOIUrl":"10.4274/MMJ.galenos.2026.55256","url":null,"abstract":"<p><strong>Objective: </strong>The coronavirus disease pandemic has raised concerns about a possible link between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and both the development of type 1 diabetes (T1D) and increased rates and severity of diabetic ketoacidosis (DKA) at diagnosis. However, existing evidence is largely retrospective and inconclusive. This prospective multicenter study aimed to evaluate the association between SARS-CoV-2 infection and the rate and severity of DKA in children newly diagnosed with T1D and to assess the prevalence of SARS-CoV-2 exposure in this population.</p><p><strong>Methods: </strong>This study included 133 pediatric patients newly diagnosed with T1D across three tertiary centers in Türkiye between April 2021 and April 2022. SARS-CoV-2 status was determined at diagnosis using polymerase chain reaction and serological tests (IgM, IgG); IgG testing was repeated after 21 days. Patients were categorized into three groups: active infection, past infection, and no infection. The prevalence of SARS-CoV-2 exposure was also analyzed.</p><p><strong>Results: </strong>SARS-CoV-2 seropositivity was found in 39% of patients. DKA was present in 76.9% of those with active infection, 66.6% of those with past infection, and 54.3% of those without infection. Although DKA was more frequent in those with SARS-CoV-2 exposure, the difference was not statistically significant (p=0.240). DKA severity also showed no significant variation among groups (p=0.162).</p><p><strong>Conclusions: </strong>DKA was the predominant presentation regardless of SARS-CoV-2 status, with no significant difference in frequency or severity. These findings suggest that increased DKA rates may be more related to healthcare access issues during the pandemic than to direct viral effects.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"41 1","pages":"69-75"},"PeriodicalIF":1.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Modified NIHSS and APUA Scores in Predicting in-Hospital Mortality and Functional Outcome in Acute Ischemic Stroke: A Retrospective Cohort Study.","authors":"Ibrahim Altundag, Fatih Sorgun, Metin Oner, Alperen Sahin, Kaan Yusufoglu, Sinem Dogruyol, Burcu Genc Yavuz, Mustafa Ahmet Afacan, Sahin Colak","doi":"10.4274/MMJ.galenos.2026.12402","DOIUrl":"10.4274/MMJ.galenos.2026.12402","url":null,"abstract":"<p><strong>Objective: </strong>Outcome prediction in acute ischemic stroke (AIS) remains complex due to numerous clinical and laboratory factors. The modified National Institutes of Health Stroke Scale (mNIHSS) is widely used to assess neurological severity, while the age, pulse, urea, albumin (APUA) score has shown potential for predicting mortality in other acute conditions. This study aimed to evaluate the performance of mNIHSS and APUA scores in predicting in-hospital mortality and poor functional outcome in AIS.</p><p><strong>Methods: </strong>This retrospective cohort study included adults presenting with AIS between January 2020 and January 2025. Initial mNIHSS and APUA scores were calculated. Outcomes included in-hospital mortality and poor functional status, defined as an modified Rankin Scale (mRS) score of 3-6 at discharge. Diagnostic performance was assessed using receiver operating characteristic analysis, and area under the curves (AUCs) were compared using the DeLong test.</p><p><strong>Results: </strong>Among 491 patients, 21 (4.3%) died during hospitalization, and 66 (13.4%) had poor functional outcomes. Both scores predicted mortality effectively (AUC: mNIHSS 0.752 vs. APUA 0.791, p=0.150), with optimal cut-offs (mNIHSS ≥6, APUA ≥4) yielding 61.9% sensitivity and >91% specificity. In predicting poor functional outcome, mNIHSS showed significantly greater accuracy (AUC: 0.822 vs. 0.689, p=0.007) and higher sensitivity (68.7% vs. 35.8%). A strong correlation existed between initial mNIHSS and discharge mRS (p<0.001).</p><p><strong>Conclusions: </strong>This study provides the first retrospective assessment of the performance of the APUA score in AIS patients. Both scores effectively predict in-hospital mortality, while mNIHSS better predicts functional outcomes. Combined use of these complementary scores may enhance risk stratification and patient management in AIS care.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"41 1","pages":"87-96"},"PeriodicalIF":1.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming Regorafenib Resistance in Colorectal Cancer: Synergistic Efficacy of Cilengitide in HT29 and WiDr Cells.","authors":"Asiye Busra Boz, Zuhal Semiz, Fikret Yanar","doi":"10.4274/MMJ.galenos.2026.65848","DOIUrl":"10.4274/MMJ.galenos.2026.65848","url":null,"abstract":"<p><strong>Objective: </strong>Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. Regorafenib, a multikinase inhibitor, is approved for the treatment of metastatic CRC; however, the emergence of drug resistance significantly limits its clinical efficacy. Integrins play a key role in tumor progression and therapy resistance, making them attractive therapeutic targets.</p><p><strong>Methods: </strong>Regorafenib-resistant variants of HT29 and WiDr CRC cells were established by long-term exposure to regorafenib. The cytotoxic effects of regorafenib, cilengitide (an αvβ3 and αvβ5 integrin antagonist), and their combination were assessed using MTT assays and clonogenic survival assays. Drug interactions were further evaluated using Chou-Talalay combination index analysis.</p><p><strong>Results: </strong>Resistant cells (HT29-R, WiDr-R) demonstrated markedly elevated IC50 values for regorafenib compared with their parental counterparts. Cilengitide monotherapy reduced clonogenic survival in both parental and resistant lines. Combination treatment with regorafenib and cilengitide showed synergistic inhibition of cell survival (Combination Index <1),particularly in resistant cell lines, suggesting that integrin targeting may restore regorafenib sensitivity.</p><p><strong>Conclusions: </strong>These findings indicate that cilengitide-mediated integrin blockade can overcome resistance to regorafenib in CRC cells, highlighting the therapeutic potential of combining integrin inhibitors with regorafenib in drug-resistant CRC.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"41 1","pages":"42-50"},"PeriodicalIF":1.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Assessment of Clinical and Laboratory Features in Pediatric Neurology Patients Presenting with Vertigo.","authors":"Seyma Sonmez Sahin, Elif Yuksel Karatoprak, Melis Ulak Ozkan, Ahmet Sait Dilbirligi","doi":"10.4274/MMJ.galenos.2026.54007","DOIUrl":"10.4274/MMJ.galenos.2026.54007","url":null,"abstract":"<p><strong>Objective: </strong>It was aimed to retrospectively evaluate the clinical, laboratory, neuroimaging, and electrophysiological characteristics of children presenting with vertigo to a tertiary pediatric neurology outpatient clinic and to assess age-related differences in etiological diagnoses.</p><p><strong>Methods: </strong>Medical records of 272 patients under 18 years of age who presented with vertigo between January 2020 and January 2025 were reviewed. Demographic data, accompanying symptoms, neurological examination findings, laboratory results, electroencephalography (EEG) and magnetic resonance imaging (MRI) reports, consultations, and final diagnoses were collected. Patients were categorized as children (<12 years) or adolescents (≥12 years). Descriptive statistics and appropriate comparative tests were used.</p><p><strong>Results: </strong>The mean age of patients was 12.73±3.68 years; 67.6% were female. The most common accompanying symptoms were visual blackouts (22.1%), headaches (16.2%), nausea and vomiting (11.4%), and syncope (9.2%). Neurological examination was normal in 97.4% of cases. MRI was performed in 84.6% of cases and showed abnormalities in 21.3%; most abnormalities were non-specific, while 4.8% had clinically relevant lesions. EEG was abnormal in 6.3% of cases. The most frequent diagnoses were orthostatic hypotension (23.5%), vestibular migraine (13.6%), psychogenic vertigo (12.9%), benign paroxysmal vertigo of childhood (BPVC) (8.5%), and epilepsy (6.3%). BPVC and epilepsy were more common among children, whereas orthostatic hypotension and psychogenic vertigo were more common among adolescents. No etiology was identified in 13.6% of patients.</p><p><strong>Conclusions: </strong>Most pediatric vertigo cases were benign, with clear age-specific diagnostic patterns. MRI and EEG contributed to the diagnosis in selected cases, but were largely nonspecific. Multidisciplinary evaluation, including assessment of orthostatic intolerance, migraine, psychogenic factors, and reversible metabolic causes, is essential for effective management.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"41 1","pages":"76-86"},"PeriodicalIF":1.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Clinical Impact of Cerebrospinal Fluid Multiplex Polymerase Chain Reaction (PCR) Testing in Children with Suspected Central Nervous System Infection\".","authors":"Shyam Sundar Sah, Abhishek Kumbhalwar","doi":"10.4274/MMJ.galenos.2026.82916","DOIUrl":"10.4274/MMJ.galenos.2026.82916","url":null,"abstract":"","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"41 1","pages":"112-113"},"PeriodicalIF":1.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Combined Effects of Rosmarinic Acid and Cisplatin in Gastric Cancer Cells.","authors":"Ceren Sari, Ceren Sumer, Saniye Koc Ada, Burcu Yucel","doi":"10.4274/MMJ.galenos.2025.47041","DOIUrl":"10.4274/MMJ.galenos.2025.47041","url":null,"abstract":"<p><strong>Objective: </strong>Gastric cancer remains a significant global health concern, necessitating investigation into more effective treatment approaches. This study investigates the combined effects of rosmarinic acid, a polyphenolic compound with known anticancer properties, and cisplatin, a conventional chemotherapeutic agent, on human gastric carcinoma (HGC-27) cells.</p><p><strong>Methods: </strong>Cell viability was evaluated at different concentrations for rosmarinic acid and cisplatin, and inhibitory concentration (IC)50, IC30, and IC10 values were subsequently determined. IC30 and IC10 doses were selected for combination experiments. Thiazolyl Blue Tetrazolium Bromide assay, colony formation assay, <i>in vitro</i> scratch assay, and 3D tumor spheroid growth assay were performed to evaluate the effects of individual and combined treatments.</p><p><strong>Results: </strong>Rosmarinic acid and cisplatin individually reduced cell viability in a dose-dependent manner. Both the IC10 and IC30 dose combinations of the two agents demonstrated significant inhibitory effects on colony formation and cell motility, indicating an additive interaction compared with the control and the individual treatments. The combined treatment also inhibited spheroid growth, although the extent of the reduction was similar to that observed with the individual agents.</p><p><strong>Conclusions: </strong>This study provides initial insights into the potential efficacy of the rosmarinic acid-cisplatin combination. The combination of these agents reduced cell viability, colony formation, and cell motility. The increased cytotoxicity observed in 2D models was not evident in 3D spheroid models, highlighting the importance of 3D systems that more accurately mimic the complex structure of tumors. This finding suggests that differences in drug sensitivity between 2D and 3D models should be considered when evaluating combination therapies.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"241-249"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Success and Predictive Factors for Residual Stones Following Supine Percutaneous Nephrolithotomy in the Galdakao-Modified Valdivia Position.","authors":"Gunal Ozgur, Ersin Gokmen, Yiloren Tanidir, Kamil Cam, Tarik Emre Sener","doi":"10.4274/MMJ.galenos.2025.59265","DOIUrl":"10.4274/MMJ.galenos.2025.59265","url":null,"abstract":"<p><strong>Objective: </strong>Supine percutaneous nephrolithotomy (sPCNL) is widely accepted as a safe and effective treatment for kidney stones. This study aims to assess surgical outcomes and identify predictive factors for residual fragments following sPCNL in the Galdakao-modified Valdivia position (GMV-sPCNL).</p><p><strong>Methods: </strong>We retrospectively evaluated the clinical data of patients undergoing GMV-sPCNL. The primary outcomes were the stone-free rate (SFR) and the complication rate. Demographic, radiologic, and perioperative parameters were also compared between patients with and without residual stones.</p><p><strong>Results: </strong>195 patients [Male:127 (65.1%); Female: 68 (34.9%)] were included. The mean age was 48.6±15.6 years; the mean body mass index (BMI) was 27.4±5 kg/m2. The overall SFR was 83.1%. Residual stones were associated with greater stone burden (number, size, surface area, and volume), longer operative time, and longer hospitalization (p<0.05). Gender, age, BMI, stone laterality, and density were not significantly associated with SFR. The receiver operating characteristic analysis showed that having more than two stones, a stone size ≥26 mm, or a stone volume ≥2639.8 mm3 significantly predicted residual fragments. Stone volume demonstrated the best predictive performance, with sensitivity and specificity of 81.8% and 61.0%, respectively. GMV-sPCNL was associated with a low overall complication rate: 86.2% of patients experienced no or only minor complications, and major complications (Clavien-Dindo ≥3) occurred in just 4.6% of cases.</p><p><strong>Conclusions: </strong>GMV-sPCNL demonstrates high success rates and an acceptable complication profile. Stone burden parameters such as stone number, stone size, and stone volume are important determinants of surgical success.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"217-225"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Exposure to 3.5 GHz Radiofrequency Radiation and Long-Term Skin Histomorphometry: An 18-Month Experimental Rat Study.","authors":"Elif Geleni Dolanbay, Tugay Mert, Reyhan Nur Kurtoglu, Unal Uslu, Suleyman Dasdag","doi":"10.4274/MMJ.galenos.2025.48323","DOIUrl":"10.4274/MMJ.galenos.2025.48323","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate long-term skin histomorphometry at 18 months postpartum in rats exposed in utero to 3.5 GHz radiofrequency radiation (RFR).</p><p><strong>Methods: </strong>Pregnant Wistar Hannover rats were exposed to Global System for Mobile Communications-modulated 3.5 GHz RFR for 2 h/day throughout gestation, while the sham group underwent mock exposure. Offspring (n=5 per group) were not exposed to any further RFR until 18 months after birth. Dorsal skin samples were stained with hematoxylin-eosin and Masson's trichrome, and dermal thickness, adipose tissue area, dermal area, adipose/dermis ratio, and fat percentage were quantified. Specific absorption rate (SAR) was calculated using CST Studio Suite. Data were analyzed using the Student's t-test or the Mann-Whitney U test. Statistical significance was defined as p<0.05.</p><p><strong>Results: </strong>The peak spatial SAR (psSAR) values were 0.06622 mW/g (for 1 g) and 0.03825 mW/g (for 10 g). No statistically significant differences were observed between RFR-exposed and sham groups in dermal thickness (655.32±87.46 μm vs 544.42±135.01 μm); fat area percentage (0.73±0.29% vs 0.66±0.22%); dermal area (1.05±0.17 vs 0.88±0.22); adipose/dermis ratio (1.78 ± 0.24 vs 1.54±0.28); or fat percentage (40.04±11.78% vs 42.96±11.60%) (all p>0.05).</p><p><strong>Conclusions: </strong>Prenatal exposure to 3.5 GHz RFR did not cause significant skin histomorphometric alterations in the dermis of aged female rats. The skin's barrier properties, regenerative capacity, and repair mechanisms may mitigate long-term structural effects of such exposures.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"209-216"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sedentary Behavior Worsens the Adverse Impact of E-cigarettes Smoking on Sleep Quality.","authors":"Mahmoud Awad Alomari, Omar Falah Khabour","doi":"10.4274/MMJ.galenos.2025.82754","DOIUrl":"10.4274/MMJ.galenos.2025.82754","url":null,"abstract":"<p><strong>Objective: </strong>Sleep is vital for homeostasis. Smoking negatively affects sleep quality, whereas regular physical activity and reduced sedentary behavior improve sleep quality. However, the combined effect of e-cigarettes, physical activity, and sedentary behavior remains unknown. Therefore, the current study compared sleep quality according to e-cigarette dependence status among adults with high versus low levels of physical activity and sedentary behavior.</p><p><strong>Methods: </strong>In 644 adults, sleep, e-cigarette dependence, physical activity, and sedentary behavior were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Penn State E-Cigarette Dependence Index, and the International Physical Activity Questionnaire, respectively.</p><p><strong>Results: </strong>The two-way ANCOVA, after controlling for gender, income, and disease status, revealed main effects of e-cigarette dependence (p<0.001) and sedentary behavior (p<0.03), and an interaction effect (p<0.05) on the PSQI. Post hoc comparisons showed significantly greater PSQI scores among adults with heavy e-cigarette dependence and in the high sedentary behavior group (p<0.05). However, the analysis showed no main effect of physical activity on PSQI scores (p>0.05).</p><p><strong>Conclusions: </strong>The results suggest that heavy dependence on e-cigarettes negatively alters sleep quality. These adverse sleep alterations are exacerbated by sedentary behavior. Programs are needed to reduce e-cigarette use and sedentary behavior to enhance sleep quality.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"202-208"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Flow-Controlled Ventilation on Mechanical Power in Laparoscopic Surgeries: A Comparative Analysis with Pressure Controlled Volume Guaranteed and Volume Controlled Ventilation.","authors":"Ayse Sencan, Nurseda Dundar, Bedirhan Gunel, Ahmet Yuksek","doi":"10.4274/MMJ.galenos.2025.66664","DOIUrl":"10.4274/MMJ.galenos.2025.66664","url":null,"abstract":"<p><strong>Objective: </strong>To compare mechanical power (MP) levels among flow-controlled ventilation (FCV), volume-controlled ventilation (VCV), and pressure-controlled volume-guaranteed ventilation (PCV-VG) during laparoscopic surgery and to test the hypothesis that the stable flow dynamics of FCV would reduce MP.</p><p><strong>Methods: </strong>Patients were divided into three groups according to the mechanical ventilation modes applied during laparoscopic surgery: PCV-VG (n=15), VCV (n=14), and FCV (n=15). MP was calculated at four timepoints: baseline (T1), post-induction (T2), during CO₂ insufflation (T3), and post-insufflation (T4). The primary outcome of the study was the comparison of MP in the FCV mode with MP in the other groups during insufflation. Driving pressure (DP), plateau pressure, and peak airway pressure were also analyzed.</p><p><strong>Results: </strong>Baseline MP was highest in PCV-VG (6.9 J/min vs. 5.0 J/min in VCV and 5.1 J/min in FCV; p=0.002). During insufflation (T3), MP increased to a similar extent across groups (PCV-VG: 9.4 J/min, VCV: 8.7 J/min, FCV: 8.6 J/min), with PCV-VG showing the smallest relative rise (p<0.001). DP and plateau pressures increased during pneumoperitoneum, but Bonferroni-adjusted comparisons revealed that these were not statistically significant. PCV-VG maintained higher positive end-expiratory pressure (5 vs. 4 cmH₂O, p<0.001); however, it did not significantly affect peak pressures.</p><p><strong>Conclusions: </strong>Contrary to our hypothesis, FCV did not reduce MP more effectively than either VCV or PCV-VG. However, PCV-VG demonstrated better mitigation of insufflation-induced increases in MP, suggesting potential advantages for lung protection during laparoscopy. Further prospective studies are needed to assess clinical outcomes.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 4","pages":"269-277"},"PeriodicalIF":1.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}