Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES最新文献

{"title":"Frailty is associated with prolonged hospitalization and inferior patient-reported outcomes after acute quadriceps tendon rupture: A multicenter cohort study.","authors":"Ekrem Ozdemir, Nasuhi Altay, Kenan Sen, Serhat Akcaalan, Yasin Guler, Mustafa Serpi, Cem Yildirim, Hasan Ceylan, Yavuz Sahbat","doi":"10.14744/tjtes.2026.36602","DOIUrl":"10.14744/tjtes.2026.36602","url":null,"abstract":"<p><strong>Background: </strong>Quadriceps tendon rupture is a functionally devastating injury frequently affecting patients with high comorbidity burden and impaired physiological reserve. Frailty represents an age-independent construct of diminished physiological resilience; its impact on hospitalization and long-term functional outcomes after quadriceps tendon rupture remains poorly defined.</p><p><strong>Methods: </strong>We retrospectively analyzed 67 adults who underwent surgical repair or reconstruction for acute quadriceps tendon rupture (≤4 weeks) at four tertiary centers between 2019 and 2023. Pre-operative frailty was quantified using the 5-item modified frailty index (mFI-5) and the 9-point clinical frailty scale (CFS). CFS was assigned retrospectively by two orthopedic surgeons using dual-reviewer consensus (κ=0.82). Primary outcomes were length of hospital stay (LOS) and functional recovery at ≥12 months (Lysholm Knee Scoring Scale); Knee Injury and Osteoarthritis Outcome Score and complications were secondary. Multivariable models were a priori restricted (six predictors for LOS, four for Lysholm; observations-per-predictor ≈11: 1 and ≈17: 1) and adjusted for age, sex, body mass index, comorbidity burden, surgical technique, and follow-up.</p><p><strong>Results: </strong>Mean age was 57.5±12.1 years; 79.1% male. Higher mFI-5 scores were associated with prolonged LOS (r=0.404, p<0.001); in adjusted models, each 1-point increase in mFI-5 predicted a 1.26-day longer stay (95% confidence interval [CI] 0.61-1.90; adjusted R2=0.337). At a mean follow-up of 25.5 months, the mean Lysholm score was 52.2±17.5. CFS was independently associated with poorer recovery (r=-0.328, p=0.007); each 1-point CFS increase corresponded to a 4.32-point decrement in Lysholm (95% CI -6.98 to -1.67; adjusted R2=0.163). A sensitivity analysis excluding reconstruction cases (n=6) yielded essentially unchanged effect sizes (mFI-5 → LOS: β=1.22; CFS → Lysholm: β=-4.18). No significant association was detected between either frailty metric and complications (rate 10.4%, 7 events); however, this analysis was underpowered and should be interpreted with caution.</p><p><strong>Conclusion: </strong>Frailty is associated with prolonged hospitalization and poorer patient-reported outcomes after surgical repair of quadriceps tendon rupture. Integration of mFI-5 and CFS into routine pre-operative evaluation may refine surgical planning, discharge coordination, and rehabilitation intensity.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1267-1277"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial transplantation attenuates apoptosis and improves spermatogenic function following testicular torsion-detorsion injury in rats.","authors":"Cihat Ozcan, Adem Sancı, Umur Deniz Mendeş, Merve Sözer, Öner Ülger, Gülçin Şimşek, Muhammed Mustafa Ayturk, Alper Murat Albayrak, Serap Gür, Cevdet Serkan Gökkaya, Gökhan Burçin Kubat","doi":"10.14744/tjtes.2026.02503","DOIUrl":"10.14744/tjtes.2026.02503","url":null,"abstract":"<p><strong>Background: </strong>Testicular torsion is a urological emergency that may result in irreversible ischemia-reperfusion injury and longterm impairment of spermatogenic function despite timely surgical detorsion. Mitochondrial dysfunction plays a central role in oxidative stress-induced germ cell damage following torsion. This study aimed to investigate the protective effects of isolated intratesticular mitochondrial transplantation in a rat model of testicular torsion-detorsion injury.</p><p><strong>Methods: </strong>Thirty-six adult male Sprague-Dawley rats were randomly allocated into four groups: sham (n=4), torsion (n=10), torsion+vehicle (n=10), and torsion+mitochondria (n=10). Testicular torsion was induced by a 720° rotation for 2 h, followed by surgical detorsion. Isolated mitochondria were administered through intratesticular injection before torsion induction. Histopathological evaluation was performed using hematoxylin-eosin staining and quantified by the Johnsen scoring system. Apoptotic activity was assessed by Caspase-3 immunohistochemistry. Functional outcomes were evaluated through total sperm count, motile sperm count, and detailed sperm motility subtype analysis.</p><p><strong>Results: </strong>The torsion and vehicle groups demonstrated marked histological damage, significantly reduced Johnsen scores, and increased apoptotic activity compared with the sham group. Mitochondrial transplantation significantly preserved seminiferous tubular architecture and resulted in higher Johnsen scores compared with untreated torsion (9.7±0.4 vs. 6.4±1.0, p<0.001). Caspase-3 expression was significantly reduced in the mitochondria-treated group, approaching levels observed in sham animals. Functionally, total and motile sperm counts were significantly higher in mitochondria-treated rats than in torsion and vehicle groups. Detailed motility analysis revealed restoration of progressive sperm motility patterns, whereas progressive motility was completely absent in untreated ischemic groups.</p><p><strong>Conclusion: </strong>Intratesticular mitochondrial transplantation provides significant structural and functional protection against ischemia-reperfusion injury in experimental testicular torsion. By preserving spermatogenic architecture, reducing apoptosis, and restoring progressive sperm motility, mitochondrial therapy represents a promising experimental strategy for fertility preservation in ischemic testicular disorders.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1171-1179"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forensic analysis of medical malpractice claims in major joint dislocations: retrospective analysis of 64 cases.","authors":"Yusuf Atan, Muhammed Fatih Yaman, Ibrahim Uzunlu, Huseyin Cagri Sahin, Muhammed Oduncu, Mehmet Ali Yıldız, Mustafa Bilal Ceylan, Serkan Bayram","doi":"10.14744/tjtes.2026.25500","DOIUrl":"10.14744/tjtes.2026.25500","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the characteristics of medical malpractice claims related to major joint dislocation cases.</p><p><strong>Methods: </strong>Our database was used in the study to analyze major dislocation cases involving medical malpractice that were closed between 2018 and 2024. A complete and detailed dataset was collected for each case. This included information such as patients' demographics (age and sex), the specific anatomical location of the dislocation (ankle, knee, hip, wrist, elbow, shoulder, and acromioclavicular joint), the underlying cause of the dislocation, rationales for the claim, complications, and unique characteristics of each case.</p><p><strong>Results: </strong>This retrospective study analyzed 64 cases of major joint dislocation referred to the Council of Forensic Medicine between 2018 and 2024. The mean age of patients was 30.21±15.3 years, with 60.9% being male and 39.1% being female. Upper extremity dislocations accounted for 78.1% of cases, with the elbow being the most common site. Patients were treated at university hospitals (12.5%), education and research hospitals (57.8%), and private hospitals (19.7%). Complications were observed in 50 patients (78.1%), with restricted joint mobility being the most common complication. The most prevalent complaint was delayed diagnosis (37.5%), followed by inappropriate postoperative management and negligence. The board deemed 35.9% of cases as malpractice, with a significant association between conservative treatment and malpractice. In 22 cases with malpractice rulings, the physician was deemed culpable, whereas in one case, malpractice was assigned to a healthcare worker.</p><p><strong>Conclusion: </strong>The primary causes of malpractice claims in major joint dislocation cases were delayed diagnosis and inadequate postoperative care. Conservative treatment was associated with high rates of medical malpractice. To reduce the risk of medical malpractice, it is necessary to standardize early diagnosis methods and ensure comprehensive postoperative follow-up.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1243-1249"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with radiographic and clinical outcomes after posterior long-segment instrumentation for neurologically intact thoracolumbar fractures: a single-center retrospective study.","authors":"Onur Suer, Anıl Murat Ozturk","doi":"10.14744/tjtes.2026.98448","DOIUrl":"10.14744/tjtes.2026.98448","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aimed to quantify radiographic correction and long-term maintenance, assess pain and health-related quality of life, and identify factors associated with outcomes after standardized posterior long-segment fixation for neurologically intact traumatic thoracolumbar junction fractures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective cohort study included consecutive adults with acute traumatic T11-L2 fractures treated between March 2014 and February 2023 with posterior long-segment pedicle screw instrumentation (two levels above and two levels below, including fracture-level screws) without decompression. Patients required at least 24 months of radiographic follow-up, available pre-operative sagittal computed tomography images, and early post-operative and final lateral radiographs. Imaging parameters were vertebral compression angle (VCA) and anterior/posterior vertebral corpus height. Clinical outcomes were final Visual Analog Scale (VAS) and 36-item short form health survey (SF-36) scores, which were assessed cross-sectionally at final follow-up and therefore reflect final health status rather than change from pre-operative levels. Paired comparisons were used for longitudinal imaging changes, and multivariable linear regression with robust standard errors was used to evaluate factors associated with final outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-eight patients were included (mean age 40.2±13.9 years; 65.4% male), with a median follow-up of 48 months. VCA changed from 11.75° (7.83-16.48) preoperatively to 4.30° (2.55-6.65) early postoperatively and was 6.00° (4.00-8.80) at final follow-up, indicating limited correction loss over time. Restoration of both anterior and posterior vertebral body heights was observed, with partial loss at final follow-up. Final pain levels were low (VAS 1 [interquartile range=1-1]). In adjusted analyses, AO fracture type was associated with greater VCA loss and poorer SF-36 scores across several domains, particularly for AO type C fractures. However, the number of type C fractures was limited (n=9). Superficial wound infection occurred in 5 patients (6.4%) and resolved with local care and antibiotics; no deep infection, implant failure, revision surgery, or junctional complications were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Posterior long-segment fixation for neurologically intact T11-L2 fractures provided substantial early radiographic correction with generally limited long-term loss of alignment and low final pain levels. Nevertheless, radiographic correction did not necessarily translate into complete functional recovery, as reflected by persistent variability in SF-36 domains. Among the variables analyzed, AO fracture type showed the most consistent association with correction loss and patient-reported outcomes. These hypothesis-generating findings suggest that fracture morphology may be associated with outcomes and may help frame post-ope","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1250-1266"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular trauma presentations to a tertiary emergency department: Demographic characteristics, injury mechanisms, and clinical outcomes.","authors":"Hasret Demir, Behcet Al","doi":"10.14744/tjtes.2026.62393","DOIUrl":"10.14744/tjtes.2026.62393","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the demographic characteristics, etiological factors, associated injuries, and clinical outcomes of patients presenting to a tertiary emergency department with ocular trauma.</p><p><strong>Methods: </strong>This retrospective observational study included 6,557 patients who presented to the Emergency Department of Süleyman Yalçın City Hospital with ocular trauma between 2022 and 2025. Demographic data, trauma mechanisms, physical examination findings, associated injuries, need for surgical intervention, and clinical outcomes were evaluated. Categorical variables were analyzed using the chi-square test, while Student's t-test and the Mann-Whitney U-test were used for continuous variables.</p><p><strong>Results: </strong>Of the patients, 85.4% (n=5,598) were male, and 52.9% were aged between 20 and 39 years. The most common reason for presentation was ocular foreign body injury (88.9%), and the most frequent physical examination finding was corneal abrasion (30.9%). Computed tomography (CT) was performed in 8.6% of cases. In 95.9% of patients, ocular trauma occurred without associated injuries, and 1.5% required surgical intervention. Overall, 97.9% of patients were discharged from the emergency department. Ocular foreign body injury (p<0.001), falls (p<0.001), traffic accidents (p=0.004), penetrating or sharp object injuries (p<0.001), and chemical injuries (p=0.002) were more frequent in males. Female sex (p<0.001), age over 60 years (p<0.001), Glasgow Coma Scale (GCS) score below 13 (p<0.001), and the presence of associated injuries (p<0.001) were associated with increased surgical intervention. Female sex (p<0.001), age under 9 years (p<0.001) and over 60 years (p<0.001), GCS score ≤13, presentation due to falls (p<0.001) or traffic accidents (p<0.001), and the presence of orbital or extraocular bone fractures (p<0.001) were associated with higher hospitalization rates.</p><p><strong>Conclusion: </strong>Ocular trauma predominantly affected young males and was most commonly caused by foreign bodies. Corneal abrasion was the most frequent finding. Most cases involved isolated ocular trauma, did not require CT, and were discharged from the emergency department. Female sex, pediatric and geriatric age groups, low GCS scores, and trauma related to falls or traffic accidents were associated with increased surgical intervention and hospitalization.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1201-1210"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting acute biliary pancreatitis severity.","authors":"Sema Ayten","doi":"10.14744/tjtes.2026.74687","DOIUrl":"10.14744/tjtes.2026.74687","url":null,"abstract":"","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1322"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-based evaluation of emergency medicine residents' preparedness for toxic terrorism.","authors":"Abdul Samet Sahin, Aynur Sahin, Vildan Ozer, Ozgen Gonenc Cekic, Selçuk Akturan, Bilge Delibalta, Emily Kiernan, Ebru Turhal, Sinan Pasli, Yunus Karaca, Melih Imamoglu, Ozgur Tatli, Semih Korkut","doi":"10.14744/tjtes.2026.63739","DOIUrl":"10.14744/tjtes.2026.63739","url":null,"abstract":"<p><strong>Background: </strong>Toxic terrorism is a rare but potentially catastrophic threat that can result in mass casualties and overwhelm healthcare systems. Effective management of such incidents requires specialized clinical competencies and preparedness that may be underemphasized in standard emergency medicine training. This study aimed to assess emergency medicine residents' competencies in toxic terrorism preparedness and emergency medical management using a structured simulation-based examination.</p><p><strong>Methods: </strong>Emergency medicine residents working in the emergency departments of two tertiary university hospitals in Trabzon participated in a simulation-based clinical assessment. The examination comprised five realistic, fully immersive objective structured clinical examination (OSCE) stations designed to evaluate diagnostic decision-making and treatment planning in toxic terrorism scenarios. Each station was scored using standardized checklists developed by medical toxicologists. Factors associated with improved performance were also examined.</p><p><strong>Results: </strong>Although 33.3% of participants successfully passed the botulism scenario (Station 3), no participant successfully completed all five stations. The radiation exposure scenario (Station 2) was the most challenging. Higher performance was significantly associated with having more than 24 months of residency training, prior chemical, biological, radiological, and nuclear (CBRN) training, and previous exposure to simulation-based education.</p><p><strong>Conclusion: </strong>These findings suggest that current training may not adequately prepare emergency medicine residents to manage toxic terrorism incidents. Incorporating standardized simulation-based assessments, such as OSCEs, into residency curricula may help identify training gaps and improve preparedness for low-frequency, high-impact events.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1289-1300"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma-related simultaneous asymmetric bilateral hip dislocation: A case report.","authors":"Bedrettin Akar, Yusuf Ozturkmen, Sahabettin Mete, Erhan Sukur, Fatih Ugur","doi":"10.14744/tjtes.2026.15424","DOIUrl":"10.14744/tjtes.2026.15424","url":null,"abstract":"<p><p>Trauma-related simultaneous asymmetric bilateral hip dislocations (SABHDs) are extremely rare cases. High-energy trauma plays a role in their etiology. Traumatic hip dislocations account for 2-5% of all dislocations. Of all hip dislocations, 90% are posterior and 10% anterior. Bilateral traumatic hip dislocation is exceedingly rare. Asymmetric dislocations are even rarer, accounting for approximately 0.01-0.02% of all joint dislocations. This study aimed to evaluate a patient with trauma-related SABHD through a case presentation and discuss therapeutic options. A 27-year-old male patient was diagnosed with dislocation of both hips (left hip anterior and right hip posterior) following high-energy trauma. The patient was prepared for general anesthesia under emergency conditions and was taken to the operating room 2 h after admission to the emergency department without waiting for the fasting period. Under general anesthesia, left anterior and right posterior hip dislocations were reduced using the Allis and Boehler maneuvers. Direct radiography, computed tomography, and spiral tomography performed after the procedure demonstrated a successful reduction in both hips. While no bony pathology was observed in the right hip, a small fracture of the anterior acetabular wall and a non-displaced fissure line in the subcapital region of the femoral head were detected in the left hip; however, surgical intervention was not considered for either pathology. Since SABHD is caused by high-energy trauma, patients should be managed with a multidisciplinary approach. To prevent or minimize potential complications, the dislocations must be reduced as soon as possible.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1315-1318"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of renal failure in earthquake-related crush syndrome: Multicenter intensive care outcomes.","authors":"Zehra Hatipoğlu, Ömer Doğan, Mehmet Gökhan Gök, Kaniye Aydın, Ersel Güleç, Mediha Türktan, Ferhat Çetinkaya, Eda Macit Aydın, Büşra Tezcan, Murat Sayın, Ahu Dudu Akarca, Didem Sözütek, Devrim Söğüt Akdağ, Sinem Bayrakçı, Nazire Ateş Ayhan, İlhan Asude Ağahan, Gamze Koçak, Nihal Deniz Bulut Yüksel, Deniz Yüksel, Ahmet Coşar, Hatice Yağmurdur, Tülay Tuncer Peker, Nilgün Kavrut Öztürk, Vecihe Bayrak, Sedat Kaya, Aliye Esmaoğlu, Nuray Altay, Serhat Atılgan, Yeşim Şerife Bayraktar, Hilal Sipahioğlu, Kamuran Uluç, Yusuf Kemal Arslan, Dilek Özcengiz","doi":"10.14744/tjtes.2026.66645","DOIUrl":"10.14744/tjtes.2026.66645","url":null,"abstract":"<p><strong>Background: </strong>Crush syndrome (CS) is a clinical condition associated with multisystem organ dysfunction that develops after traumatic rhabdomyolysis and primarily affects the kidneys. The aim of this study was to characterize the incidence, risk factors, and treatment patterns of acute kidney injury (AKI) in earthquake victims with CS, with a particular focus on renal replacement therapy (RRT) use and clinical outcomes.</p><p><strong>Methods: </strong>In this retrospective multicenter study, 247 adult patients with earthquake-related CS who were admitted to intensive care units (ICUs) in 22 hospitals after the Kahramanmaraş 2023 earthquakes were analyzed. Demographic data, injury patterns, laboratory parameters, treatment protocols, and outcomes were evaluated during the first 15 days following ICU admission.</p><p><strong>Results: </strong>AKI developed in 78.5% (n=194) of patients, and RRT was required in 62.4% (n=121) of those with AKI. Multiple logistic regression analysis demonstrated that myoglobin and creatinine levels were associated with an elevated risk of developing AKI (odds ratio [OR]: 1.001; 95% confidence interval CI: 1.000-1.001 and OR: 1.735; 95% CI: 1.151-2.615, respectively). Similarly, creatinine level and reasons for ICU admission were identified as factors influencing RRT administration. (OR: 1.7; 95% CI: 1.28-2.15 and OR: 2.9; 95% CI: 1.26-6.90, respectively). The 30-day mortality rate was higher in patients with AKI than in those without AKI. Mortality rates were similar between patients with AKI who received RRT and those who did not.</p><p><strong>Conclusion: </strong>This study demonstrates the high incidence of AKI in earthquake-related CS, underscores the need for improved disaster preparedness with adequate dialysis capacity and early risk stratification using serum myoglobin and creatinine levels for optimal management.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1189-1200"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of intra-abdominal adhesions formation following implantation of synthetic, biosynthetic, and biologic meshes in a rat model.","authors":"Şeref Oray, Atıl Çakmak","doi":"10.14744/tjtes.2026.87933","DOIUrl":"10.14744/tjtes.2026.87933","url":null,"abstract":"<p><strong>Background: </strong>Intra-abdominal adhesions remain a significant challenge in incisional hernia repair, often resulting in complications such as bowel obstruction and chronic pain. Although various prosthetic meshes have been developed, their comparative adhesion profiles have not been fully elucidated. This experimental study aimed to compare the severity of intra-abdominal adhesions and the associated histopathological responses induced by synthetic, biosynthetic, biological, and chemically treated meshes in a standardized rat model.</p><p><strong>Methods: </strong>Fifty Wistar albino rats were randomly assigned to five groups (n=10 each): control, polypropylene mesh (Prolene®), polypropylene mesh impregnated with tissue adhesive (Tisseel®), dual mesh (Gore® DualMesh®), and biological mesh (Permacol®). A standardized 2×2 cm full-thickness abdominal wall defect was created in each animal, followed by intraperitoneal mesh implantation. On post-operative day 30, macroscopic adhesions were assessed using the Modified Diamond Scale. Histopathological evaluation included grading of fibrosis, inflammation, vascular proliferation, and giant cell reaction. Statistical analysis was performed using the Kruskal-Wallis test and post hoc multiple comparison analyses.</p><p><strong>Results: </strong>The Prolene mesh group demonstrated the highest adhesion severity (mean Modified Diamond score: 2.80±1.23), which was significantly greater than that observed in the biological mesh (p=0.010), dual mesh (p=0.002), and tissue adhesive-impregnated Prolene groups (p=0.033). Fibrosis and inflammation were also most pronounced in the Prolene and dual mesh groups, whereas the biological mesh group exhibited milder responses (fibrosis p=0.028; inflammation p=0.033 compared to Prolene). Vascular proliferation and giant cell counts were significantly lower in the biological mesh group (p=0.004 and p<0.001, respectively).</p><p><strong>Conclusion: </strong>Biological and dual meshes, as well as tissue adhesivetreated meshes, were associated with significantly reduced adhesion formation and milder histopathological responses compared to untreated polypropylene mesh. Although no material completely prevented adhesion formation, low-porosity meshes and anti-adhesive strategies appear promising for reducing adhesion-related morbidity in intraperitoneal hernia repair. Further studies are warranted to confirm these findings and optimize mesh selection.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"32 10","pages":"1163-1170"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}