Medical Bulletin of Sisli Etfal Hospital最新文献

{"title":"The Effect of Systemic Steroid Use on the Success of Core Decompression in Non-Traumatic Early-Stage Femoral Head Osteonecrosis.","authors":"Gokhan Pehlivanoglu, Osman Cimen, Alper Koksal","doi":"10.14744/SEMB.2025.04207","DOIUrl":"10.14744/SEMB.2025.04207","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic corticosteroid use is a well-established risk factor for non-traumatic osteonecrosis of the femoral head (ONFH). However, its impact on the clinical outcomes of joint-preserving procedures, such as core decompression (CD), remains uncertain. This study aimed to evaluate whether systemic steroid exposure influences the success of CD in patients with early-stage ONFH.</p><p><strong>Methods: </strong>This retrospective cohort study included 49 hips from 41 patients with Ficat stage IIa ONFH who underwent isolated CD between 2013 and 2021. Patients were stratified into two groups according to systemic corticosteroid use within one year prior to diagnosis. Demographic and radiologic data, including modified Kerboul angle and stage, were collected. Treatment success was defined as the absence of femoral head collapse or conversion to total hip arthroplasty at the final radiologic follow-up. Outcomes were compared between steroid users and non-users using t-tests, Mann-Whitney U, chi-square, and Fisher's exact tests, as appropriate.</p><p><strong>Results: </strong>Overall, treatment success was achieved in 63.3% of hips. The success rate was 70.4% in steroid users and 54.5% in non-users, but this difference was not statistically significant (p=0.372). Baseline radiologic parameters, including modified Kerboul angle and stage, did not differ significantly. Sex distribution differed significantly (p=0.003), while age, follow-up duration, and bilaterality were comparable.</p><p><strong>Conclusion: </strong>Systemic corticosteroid use was not significantly associated with worse radiologic outcomes following CD in early-stage ONFH. These findings support CD as a viable joint-preserving treatment in appropriately selected patients, irrespective of prior steroid exposure.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"79-84"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692793","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":"A Rare Cosmetic Lengthening Complication Causing Precice Stryde Nail Failure: A Case Report.","authors":"Muharrem Kanar, Enver Ipek, Suleyman Cakirturk","doi":"10.14744/SEMB.2025.20586","DOIUrl":"10.14744/SEMB.2025.20586","url":null,"abstract":"<p><p>Limb-lengthening surgeries have been described for medical and cosmetic treatment. Innovative surgical procedures and various instrumentation techniques have been developed with advancing technology. Remote-controlled intramedullary lengthening nail systems (RCILNS) are frequently used in limb-lengthening surgery. In the literature, few surgical complications have been reported in limb-lengthening surgery. Here, we present a case of an unexpected complication caused by a filling material previously applied for gluteal augmentation in a patient who underwent cosmetic limb-lengthening surgery.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"120-123"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693026","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":"Perspectives of Surgical Branch Residents on Anatomy Education and Its Importance.","authors":"Zekiye Karaca Bozdag, Ayla Kurkcuoglu, Didem Daymaz Yılmaz, Nazire Kılıç Safak, Buse Naz Candır Gurses","doi":"10.14744/SEMB.2026.52822","DOIUrl":"10.14744/SEMB.2026.52822","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the pre-graduation anatomy training of residents from multiple surgical specialties and to assess their views and needs concerning anatomy during their surgical residency training.</p><p><strong>Methods: </strong>Following the acquisition of the requisite institutional approvals, a questionnaire prepared using the Google Survey platform was circulated online among physicians at various stages of surgical residency training. This multicenter study included participants from multiple hospitals across different cities in Türkiye. Questions about participants' demographic characteristics and experiences with anatomy training during both their undergraduate and specialist training were asked. All responses were analyzed statistically.</p><p><strong>Results: </strong>A total of 143 surgical residents participated in the study. Of the participants, 31.5% were female and 68.5% were male, and the mean age was 28±2.8 years. Of the residents, 67.1% had taken anatomy courses in the first two semesters of medical school, and 67.7% stated that they found their medical education inadequate for surgical residency. During their undergraduate education, 97.2% of the participants received face-to-face anatomy practice training, 47.6% received training with cadavers and plastic models. In addition, those who were trained with cadavers were more supportive of anatomy integration (p=0.031). It was also noteworthy that senior residents (defined as those with ≥2 years of residency training) considered anatomy integration into surgical residency training more necessary (p=0.006).</p><p><strong>Conclusion: </strong>This study highlights the critical role of anatomy knowledge in surgical training and emphasizes its importance in the effective integration of education during surgical residency training.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"9-15"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692745","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":"Immediate Surgery for First Episode PSP: Is It Overtreatment?","authors":"Serkan Uysal","doi":"10.14744/SEMB.2026.95695","DOIUrl":"10.14744/SEMB.2026.95695","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"133-134"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692775","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":"A Novel Marker in Hypogonadal Hypogonadism: Apelin.","authors":"Alperen Akansel Caglar, Engin Sebin, Emine Kartal Baykan, Ayse Carlıoglu","doi":"10.14744/SEMB.2025.92160","DOIUrl":"10.14744/SEMB.2025.92160","url":null,"abstract":"<p><strong>Objectives: </strong>Apelin is a recently identified adipokine with pleiotropic actions in cardiovascular regulation, metabolic homeostasis, bone remodeling, and reproductive physiology. Through binding to the apelin receptor (APJ), apelin has been shown to influence gonadotropin-releasing hormone (GnRH) secretion, which is essential for the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Given its potential role in the hypothalamic-pituitary-gonadal (HPG) axis, alterations in circulating apelin may contribute to hypogonadotropic hypogonadism (HH). This study aimed to investigate whether serum apelin concentrations are altered in patients with HH and to evaluate its potential relevance as a complementary biomarker in the diagnostic approach to HH.</p><p><strong>Methods: </strong>A total of 60 participants were enrolled: 30 newly diagnosed HH patients (untreated for at least one year, with no comorbid chronic diseases) and 30 age- and body mass index (BMI)-matched healthy controls. Individuals with BMI<20 or BMI>30 were excluded to minimize confounding metabolic influences on apelin secretion. Following overnight fasting, venous blood samples were obtained for complete biochemical and hormonal profiles. Serum apelin levels were measured using a validated human ELISA kit (SunRed Biotechnology, China; intra- and inter-assay coefficients of variation<10%). Statistical analysis was performed using SPSS 17.0.</p><p><strong>Results: </strong>Apelin concentrations were significantly lower in HH patients compared with healthy controls (median 35.2ng/L vs. 63.3ng/L, p=0.046). ROC analysis yielded an area under the curve (AUC) of 0.65, with a sensitivity of 76% and a specificity of 64%.</p><p><strong>Conclusion: </strong>These findings demonstrate reduced circulating apelin concentrations in HH, supporting the hypothesis of its involvement in GnRH regulation and the pathogenesis of hypogonadism. Although its diagnostic accuracy is modest, apelin may complement traditional hormonal markers. Further multicenter studies and mechanistic research are required to validate these observations.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"36-42"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693006","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 Role of Bedside Ultrasonography in Neonatal Central Venous Access Applications.","authors":"Adil Umut Zubarioglu, Ali Bulbul, Hasan Sinan Uslu","doi":"10.14744/SEMB.2025.04206","DOIUrl":"10.14744/SEMB.2025.04206","url":null,"abstract":"<p><p>Vascular access in critically ill neonates is crucial for management and is often challenging. Neonatal venous access must allow for the administration of all necessary medications and diagnostic tests. For these purposes, the catheter must be centrally located. Therefore, determining the correct location of the tip of central venous access devices is crucial, and traditionally, this assessment has relied on thoracoabdominal radiography. However, this method has limitations; it is an indirect method that uses radiological landmarks, is postprocedural, can only be used for tip location, and has long-term risks because of ionizing radiation. Current guidelines recommend that the imaging method used in central venous access procedures be real-time, intraprocedural, rapid, accurate, easy to use, noninvasive, reproducible, and inexpensive. Bedside ultrasonography, which possesses all these features, is considered the ideal imaging method. Ultrasonography is used with various catheter types for selecting the appropriate vein for catheterization, during needle insertion, for advancing the catheter in the correct direction, for catheter tip navigation, for determining catheter tip position, for monitoring puncture-site-related complications, and for identifying and monitoring late complications. The goal of this review was to examine the advantages and feasibility of using bedside ultrasonography in central venous catheter insertion procedures, especially in the newborn period.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692773","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":"Mehmet Kostek, Mehmet Uludağ","doi":"10.14744/SEMB.2026.98048","DOIUrl":"10.14744/SEMB.2026.98048","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"138-139"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692936","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 Liver Steatosis and Liver Fibrosis in Patients with Type 1 Diabetes Mellitus Using Non-invasive Scores.","authors":"Zulal Istemihan, Fatih Bektas, Ali Emre Bardak, Cansu Kiziltas, Gamze Kemec, Ziya Imanov, Ibrahim Volkan Senkal, Kanan Nuriyev, Aynura Rustamzade, Sezen Genc Ulucecen, Hulya Hacisahinogullari, Kubilay Karsidag, Bilger Cavus, Aslı Cifcibası Ormeci, Filiz Akyuz, Kadir Demir, Fatih Besisik, Sabahattin Kaymakoglu","doi":"10.14744/SEMB.2026.57777","DOIUrl":"10.14744/SEMB.2026.57777","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and clinically significant fibrosis (CSF) in patients with type 1 diabetes mellitus (T1DM), as well as the factors affecting them, using non-invasive tests based on blood and imaging methods.</p><p><strong>Methods: </strong>Adult T1DM patients who were followed up in the diabetes mellitus outpatient clinic at a tertiary university hospital and who did not have other causes of liver disease were prospectively investigated. MASLD and CSF were evaluated using non-invasive scores based on biochemical tests and FibroScan®. MASLD was defined as a FibroScan® CAP score ≥275 dB/m, and CSF was defined as F≥8 kPa in the absence of any other chronic liver disease or secondary cause of hepatic steatosis in T1DM patients.</p><p><strong>Results: </strong>The prevalence of MASLD and CSF was 12.9% and 5%, respectively. BMI, fasting blood glucose, and waist and hip circumference were significantly higher in patients with MASLD (p<0.05). The rates of hypertension and dyslipidemia were also higher in patients with MASLD (p=0.026 and p=0.012, respectively). According to Pearson's correlation test, LSM was most strongly correlated with Agile 4 (p<0.001, r=0.922) and Agile 3+ scores (p<0.001, r=0.685). CAP was most strongly correlated with the fatty liver index (p<0.001, r=0.514) and the hepatic steatosis index (p<0.001, r=0.404).</p><p><strong>Conclusion: </strong>Components of metabolic syndrome are important risk factors for MASLD in patients with T1DM. There is currently no consensus on screening and diagnostic pathways for MASLD in T1DM, and further research is needed in this area.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"112-119"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692317","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":"Thoracoscopic Bronchovascular (Double) Sleeve Lobectomy to Correct Intraoperative Vascular Injury: A Case Report.","authors":"Volkan Erdogu, Melike Ulker, Merve Ekinci Fidan, Ali Cevat Kutluk, Muzaffer Metin","doi":"10.14744/SEMB.2026.71463","DOIUrl":"10.14744/SEMB.2026.71463","url":null,"abstract":"<p><p>Double sleeve lobectomy, involving both bronchial and vascular reconstruction, is a complex but lung-sparing alternative to pneumonectomy for centrally located tumors. While traditionally performed via thoracotomy, its application through video-assisted thoracoscopic surgery (VATS) remains limited. We report the first known case of a double sleeve lobectomy in Türkiye performed via a VATS approach in a 58-year-old female with a centrally located left upper lobe pleomorphic carcinoma involving both the pulmonary artery and bronchus. This case demonstrates the technical feasibility of VATS double-sleeve lobectomy when performed by experienced surgeons and shows that a mistake made during pulmonary artery division does not necessarily result in pneumonectomy.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"124-129"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692820","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":"Fatty Liver and Pancreatic Steatosis in Patients with Chronic Hepatitis B and C and Wilson's Disease.","authors":"Mehmet Aksoy, Feyza Gelebek, Kemal Ozan Lule, Nezihe Otay Lule, Abdullah Emre Yildirim, Sezgin Barutcu","doi":"10.14744/SEMB.2025.79735","DOIUrl":"10.14744/SEMB.2025.79735","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to determine the presence of fatty liver and pancreatic steatosis in individuals diagnosed with Chronic Hepatitis B (CHB), Chronic Hepatitis C (CHC), and Wilson's Disease (WD) and to evaluate the relationship between the presence of fatty liver and pancreatic steatosis and laboratory parameters.</p><p><strong>Methods: </strong>Forty-eight CHB, fifty-six CHC, and thirty-five WD patients were included in the study. Pancreatic steatosis was measured by three methods: steatosis according to the mean pancreas value, steatosis according to the pancreas/spleen difference value, and steatosis according to the pancreas/spleen density ratio. Hepatic steatosis was measured by noncontrast CT using multi-site attenuation sampling and the Liver Attenuation Index (LAI); steatosis was graded according to predefined LAI cut-offs. Fatty liver and pancreatic steatosis were graded as Grade 1, 2, or 3. Certain laboratory parameters of the patients were also retrospectively reviewed.</p><p><strong>Results: </strong>In 69.1% of all patients, grade 1 fatty liver disease was present. Pancreatic steatosis was absent in 50.3% of patients according to the mean pancreas value, 63.3% according to the pancreas/spleen difference, and 61.9% according to the pancreas/spleen density ratio. Fatty liver disease was positively correlated with high Erythrocyte Sedimentation Rate (ESR) (r=0.255, p=0.002) and Alanine Transaminase (ALT) (r=0.180, p=0.034). ESR (p=0.025) and urea level (p=0.024) were found to be significantly higher in the group with steatosis according to the mean pancreas value. According to the group with steatosis based on the pancreas/spleen density ratio, globulin level was significantly higher (p=0.038). The rates of steatosis according to the pancreas mean value (p=0.003) and the pancreas/spleen density ratio (p=0.039) were significantly more advanced in CHC patients compared with the other patient groups. There was no statistically significant difference between the stage of fatty liver and the stage of fatty pancreas (p>0.05).</p><p><strong>Conclusion: </strong>Although fatty liver and pancreatic steatosis are considered similar pathologies, our findings suggest that these two conditions should not be considered interchangeable. Further studies with larger samples may be useful to better demonstrate the correlation between the two conditions and the investigated parameters.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"62-70"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692805","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}