Medical Bulletin of Sisli Etfal Hospital最新文献

{"title":"Radiological Evaluation of Distal Trochanteric Transfer in Patients with Proximal Femoral Growth Disturbance.","authors":"Saltuk Bugra Tekin, Mehmet Burak Yalcin, Ata Mert Civilibal, Gazi Zorer","doi":"10.14744/SEMB.2026.70105","DOIUrl":"10.14744/SEMB.2026.70105","url":null,"abstract":"<p><strong>Objectives: </strong>Proximal femoral growth disturbance (PFGD), resulting from conditions such as Legg-Calvé-Perthes disease and developmental dysplasia of the hip, causes femoral head deformity and trochanteric overgrowth. This study evaluates the effectiveness of distal trochanteric transfer (DTT) in anatomical restoration using objective radiological parameters.</p><p><strong>Methods: </strong>Patients with unilateral PFGD who presented with pain, abductor muscle weakness, and Trendelenburg gait and subsequently underwent DTT were retrospectively included in this study. All patients had skeletal growth potential, confirmed by the presence of open growth plates. Patients who had standard anteroposterior pelvic radiographs and anteroposterior and lateral hip radiographs were included, as these imaging modalities were required to evaluate the articular trochanteric distance (ATD), central trochanteric distance (CTD), trochanteric offset (TO), and lever arm ratio (LAR).</p><p><strong>Results: </strong>The study cohort consisted of 13 patients (11 females, 2 males). The mean age at surgery was 10.54±2.11 years, and the mean follow-up period was 7.62±5.25 years. The intraclass correlation coefficient (ICC) was significant for 9 of the 12 total measurements, with three parameters demonstrating statistically non-significant values. Preoperatively, the pathological hips showed a significantly reduced mean ATD of -2.00±8.57 mm compared with the normal hips (17.38±5.58 mm; p=0.001). Postoperative ATD significantly improved to 15.62±6.36 mm (p=0.001). Similarly, the significantly reduced preoperative TO (18.69±6.84 mm) was restored to 24.85±7.03 mm postoperatively (p=0.008). Furthermore, the postoperative LAR (2.83±0.48) was significantly higher than both the preoperative value (2.21±0.46; p=0.012) and the normal hip value (p=0.001). No significant difference was observed for CTD.</p><p><strong>Conclusion: </strong>DTT effectively achieves trochanteric distalization and lateralization, leading to restoration of the abductor muscle mechanism. Our analysis confirms that both ATD and TO are reliable radiographic parameters, as demonstrated by their strong ICC values, for evaluating immediate anatomical results. However, CTD is age-dependent, and both CTD and LAR are inherently influenced by the underlying femoral head anatomy. Future studies are needed to correlate these anatomical improvements with long-term clinical outcomes.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 2","pages":"162-172"},"PeriodicalIF":1.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424902","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":"Multifocal and Multicentric Breast Cancer: Evaluation of Clinicopathological Features and Survival Outcomes.","authors":"Busra Burcu, Isik Cetinoglu, Aziz Sener, Zeynep Gul Demircioglu, Zerin Sengul, Esma Cerekci, Ramazan Ucak, Cemal Kaya","doi":"10.14744/SEMB.2026.82956","DOIUrl":"10.14744/SEMB.2026.82956","url":null,"abstract":"<p><strong>Objectives: </strong>The reported incidence of multifocal breast cancer (MFBC) and multicentric breast cancer (MCBC) varies widely in the literature. This study aimed to compare the clinicopathological characteristics, treatment approaches, and survival outcomes between patients with MFBC/MCBC and those with unifocal breast cancer (UFBC).</p><p><strong>Methods: </strong>Data from 666 female patients aged >18 years who were histopathologically diagnosed with breast cancer and followed up at the Department of General Surgery of a tertiary hospital between January 2018 and January 2025 were retrospectively reviewed. MF and MC were defined based on tumor localization within breast quadrants and the distance between foci. Clinical, pathological, and treatment-related parameters were compared between the groups.</p><p><strong>Results: </strong>Of all patients, 83.5% (n=556) had UFBC and 16.5% (n=110) had MF/MCBC. The mean age was 54.89±12.17 years. Axillary lymph node positivity was significantly higher in the MF/MCBC group (p=0.022). Magnetic resonance imaging (MRI) identified MF/MCBC in 71% of cases, demonstrating greater sensitivity than mammography (MMG) and ultrasonography (USG). Mastectomy was performed in 85.4% of patients with MF/MCBC compared with 45% of those in the UFBC group. The rate of neoadjuvant chemotherapy was also significantly higher among patients with MF/MCBC (p=0.008). There were no significant differences between the groups regarding local recurrence, distant metastasis, or overall survival.</p><p><strong>Conclusion: </strong>Patients with MF/MCBC exhibited higher rates of axillary involvement and more frequent use of neoadjuvant therapy. However, overall survival was comparable to that of patients with UFBC. A multidisciplinary approach remains essential for determining the optimal management strategy in this subgroup.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 2","pages":"141-145"},"PeriodicalIF":1.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424679","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":"Risk Factors for Postoperative Complications after Pneumonectomy in Non-Small Cell Lung Cancer Patients.","authors":"Meral Selin Onay Mahmuti, Melike Ulker, Ayşegul Ciftci, Nisa Yildiz Ilhan, Merve Ekinci Fidan, Ali Cevat Kutluk, Volkan Erdogu, Muzaffer Metin","doi":"10.14744/SEMB.2026.52323","DOIUrl":"10.14744/SEMB.2026.52323","url":null,"abstract":"<p><strong>Objectives: </strong>The impact of preoperative predisposing factors on postoperative complications in patients undergoing pneumonectomy for non-small cell lung cancer (NSCLC) remains a critical issue. Understanding these factors may provide valuable insights into postoperative risks and complications. This study aimed to evaluate the influence of preoperative predisposing factors (comorbidities) on the development of postoperative complications in patients undergoing pneumonectomy for NSCLC. Using the age-adjusted Charlson Comorbidity Index (a-CCI), we sought to identify risk factors that potentially contribute to complications and investigate their impact on survival.</p><p><strong>Methods: </strong>In this retrospective study, 236 patients who underwent pneumonectomy between February 2018 and February 2023 were analyzed. Demographic characteristics, comorbidities based on the a-CCI, surgical details, postoperative complications classified according to the Clavien-Dindo system, and survival outcomes were evaluated.</p><p><strong>Result: </strong>Postoperative complications occurred in 44.1% of patients (n=104). The development of complications was significantly associated with right-sided pneumonectomy (p=0.018), prolonged operative time (p=0.002), and increased intraoperative blood loss (p<0.001). Although the a-CCI failed to predict postoperative complications, it demonstrated a significant association with survival outcomes. Patients with higher a-CCI scores had markedly reduced mean survival times (p=0.001).</p><p><strong>Conclusion: </strong>In patients undergoing pneumonectomy for NSCLC, right-sided resections, prolonged operative duration, and excessive intraoperative blood loss increase the risk of postoperative complications. While the a-CCI is limited in predicting postoperative complications, it serves as a valuable prognostic indicator of survival. Assessing these factors may guide risk stratification and optimize perioperative management strategies in surgical candidates.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 2","pages":"146-153"},"PeriodicalIF":1.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424972","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":"Analysis of Risk Factors Affecting Epilepsy Seizure Frequency with Statistical Models.","authors":"Sirin Cetin, Gokce Yuce Onur, Eylem Topbas, Seda Dagli Sanver","doi":"10.14744/SEMB.2026.87405","DOIUrl":"10.14744/SEMB.2026.87405","url":null,"abstract":"<p><strong>Objectives: </strong>Epilepsy is a chronic disease that can cause cognitive, psychological, and social problems due to recurrent seizures. Knowledge of the risk of seizure recurrence is crucial for patient treatment management. Therefore, we aimed to statistically evaluate the effects of stress, sleep deprivation, fasting/prolonged hunger, and excessive physical activity on seizure frequency, despite conflicting results in the literature.</p><p><strong>Methods: </strong>This study prospectively analyzed data from 40 patients and a total of 60 seizures. The correlation between the proportional hazards assumption and survival rank was investigated using Schoenfeld residuals and correlation tests.</p><p><strong>Results: </strong>This study found that stress, sleep deprivation, fasting/prolonged hunger, and excessive physical activity increased the risk of seizures. However, some additional, unidentified environmental or genetic factors were found to increase seizure risk by 2.7 times within the established model.</p><p><strong>Conclusion: </strong>While our study found that stress, sleep deprivation, fasting/prolonged hunger, and excessive physical activity may increase seizure frequency, it was also determined that some additional, unidentified environmental or genetic factors affect seizure frequency. The limited sample size, heterogeneity of the patient population, and reliance on patients' subjective assessments constitute the primary limitations of this study. Furthermore, objective scales or validated measurement tools for sleep deprivation, fasting, stress, and excessive physical activity were not used. Further studies with larger, more homogeneous groups and objective assessment methods are needed to validate these findings.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 2","pages":"208-212"},"PeriodicalIF":1.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425192","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 \"Abnormal Blood Pressure Dipping Pattern in Women with Hypopituitarism Secondary to Sheehan Syndrome: A Case-Control Study\".","authors":"Neeraj Singh, Monika Srivastav","doi":"10.14744/SEMB.2026.03442","DOIUrl":"10.14744/SEMB.2026.03442","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 2","pages":"293-294"},"PeriodicalIF":1.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425102","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 'Risk Factors Influencing Recurrence Rates Following Open Excision of Wrist Ganglion Cysts: A Retrospective Cohort Study'.","authors":"Kishankumar Mahida, Snehal Rajendra Jagtap","doi":"10.14744/SEMB.2026.47897","DOIUrl":"10.14744/SEMB.2026.47897","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"130-131"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692963","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":"Measles Seroprevalence and Associated Factors among Adult Individuals in the City Center of Şanlıurfa Province.","authors":"Ahmet Gunduzalp, Burcu Beyazgu, Feyyaz Barlas","doi":"10.14744/SEMB.2025.88655","DOIUrl":"10.14744/SEMB.2025.88655","url":null,"abstract":"<p><strong>Objectives: </strong>The aim is to determine measles seroprevalence in adult individuals in Şanlıurfa city center and to evaluate related factors.</p><p><strong>Methods: </strong>The research is of a cross-sectional type. The research was carried out in Şanlıurfa city center between March 2023 and April 2023. The population of the study consisted of individuals over the age of 18 who applied to the Family Health Centers (FHC) in the city center of Şanlıurfa. A 30-cluster sampling method was used to determine the FHCs where the study would be conducted. In this study, the number of people to be included in each cluster was determined as 7, and the total sample size was 210. Thirty FHCs were randomly selected from a total of 80 ASMs in 3 central districts in Şanlıurfa, proportional to the number of units. Blood was drawn from the participants by the researcher. The blood samples were then sent by a private hospital to a private laboratory for testing.</p><p><strong>Results: </strong>A total of 210 adults were included in the study. Fifty-one percent of the participants were women. The measles seropositivity rate of the adults participating in the study was 87.6%, and the measles seronegativity rate was 8.6%. When the participants were examined according to age groups, it was found that the measles seropositivity level was lowest in the 18-21 age group, at 52.63%. In the created logistic regression model, measles seropositivity status in adults: being 33 years or younger reduces it 10 times.</p><p><strong>Conclusion: </strong>This study showed that measles seropositivity in the adult population in Şanlıurfa city center was 87.6%. This suggests the need to reconsider the administration of an extra-dose measles vaccine using the catch-up vaccination method for individuals aged 18-21 and then 22-25, the most susceptible age group in this study.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"53-61"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692731","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 Relationship Between Neutrophil/Lymphocyte Ratio and the Progression and Clinical Features of Alzheimer's Disease.","authors":"Hatice Omercikoglu Ozden, Fatma Seyda Ustuner, Merve Bikem Ucar, Fatma Nazli Durmaz Celik","doi":"10.14744/SEMB.2026.67764","DOIUrl":"10.14744/SEMB.2026.67764","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the relationship between the neutrophil-to-lymphocyte ratio (NLR), a peripheral inflammatory marker, and both baseline clinical features and short-term cognitive progression in patients with Alzheimer's disease (AD). Specifically, we sought to determine whether NLR is associated with disease stage, cognitive performance, vascular comorbidities, and 12-month cognitive decline assessed by the Mini-Mental State Examination (MMSE).</p><p><strong>Methods: </strong>We conducted a retrospective observational study including 100 adults diagnosed with mild, moderate, or severe AD who were followed for at least 12 months at a tertiary memory clinic. Demographic characteristics, clinical data, and serial MMSE scores (baseline, 6 months, and 12 months) were extracted from medical records. Complete blood counts from the same time points were used to calculate NLR. Descriptive statistics summarized clinical variables. Correlations between NLR and MMSE scores were analyzed using Pearson and Spearman methods. Group comparisons across disease stage, sex, and vascular comorbidity were performed using t-tests or ANOVA as appropriate. Statistical significance was defined as p<0.05.</p><p><strong>Results: </strong>The mean age of the cohort was 72.5±9.9 years, and 62% were women. Baseline disease severity was distributed as mild (28%), moderate (26%), and severe (46%). Mean baseline NLR was 2.41±1.17, increasing to 2.87±1.47 at 6 months and 3.75±3.54 at 12 months. Baseline NLR was significantly higher in patients with vascular comorbidities (p=0.008) but did not differ across AD severity categories. Higher baseline NLR was modestly associated with lower baseline MMSE scores (r=-0.24, p=0.021). Unexpectedly, higher baseline NLR correlated with a smaller decline in MMSE over 12 months (r=0.36, p=0.005). Patients with low NLR showed greater cognitive deterioration (-3.72±3.97 points) than those with high NLR (-1.38±4.38 points; p=0.037).</p><p><strong>Conclusion: </strong>NLR was associated with worse cognitive performance at diagnosis and increased gradually over 12 months in AD patients, supporting its role as a marker of systemic inflammation. However, the counterintuitive finding that higher baseline NLR was linked to slower short-term cognitive decline highlights the complexity of inflammatory mechanisms in established AD. These results suggest that while NLR reflects clinically relevant inflammatory status, it should not be used as a standalone predictor of disease progression but rather as part of a broader multimodal biomarker framework.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"24-29"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692748","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":"Author's Reply.","authors":"Uğur Temel, Bülent Arslan, Mehmet Oğuzhan Özyurtkan","doi":"10.14744/SEMB.2026.58259","DOIUrl":"10.14744/SEMB.2026.58259","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"135"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692974","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 Postoperative Cognitive Dysfunction and Its Risk Factors in Elderly Patients Undergoing Elective Non-Cardiac Surgery: A Prospective Observational Study.","authors":"Arzu Ceren Yigit, Tugba Yucel Yenice, Mustafa Altinay, Ayse Surhan Cinar, Leyla Turkoglu Kilinc","doi":"10.14744/SEMB.2025.47700","DOIUrl":"10.14744/SEMB.2025.47700","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the incidence, course, and potential risk factors of postoperative cognitive dysfunction (POCD) in elderly patients undergoing elective non-cardiac surgery.</p><p><strong>Methods: </strong>A prospective observational study was conducted on 35 patients aged 60 years and older who underwent elective non-cardiac surgery under general or regional anesthesia. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) test preoperatively, at 24 hours, and on postoperative day 30. Demographic characteristics, comorbidities, perioperative events, and anesthesia-related factors were recorded.</p><p><strong>Results: </strong>The mean preoperative MoCA score was 20.9±3.2, which decreased significantly to 18.0±2.6 at 24 hours (p<0.001) and improved to 22.7±2.7 by postoperative day 30 (p<0.001). The incidence of cognitive dysfunction (MoCA <21) was 42.9% preoperatively, 85.7% at 24 hours, and 20.0% at day 30. No significant associations were found between POCD and comorbidities, anesthesia type, intraoperative hypotension, bleeding, transfusion, or narcotic use (p>0.05). However, preoperative cognitive performance was lower among patients with lower education levels, and postoperative day-30 scores were significantly lower among smokers (p=0.043).</p><p><strong>Conclusion: </strong>POCD was common in the early postoperative period but largely resolved by day 30. Smoking and low educational level were associated with poorer cognitive outcomes. Larger multicenter studies are needed to further clarify risk factors and long-term neurocognitive trajectories in elderly surgical patients.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"43-52"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692431","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}