Northern clinics of Istanbul最新文献

{"title":"Genomic characterization of antifungal resistance patterns in Candida auris clade I: A large-scale analysis of 647 global genomes.","authors":"Ayhan Tosunoglu, Ozleyis Konyali, Mehmet Demirci","doi":"10.14744/nci.2026.40040","DOIUrl":"10.14744/nci.2026.40040","url":null,"abstract":"<p><strong>Objective: </strong>Candidozyma auris has emerged as a global \"urgent threat\" characterized by multidrug resistance and high mortality. While six distinct lineages have been identified, Clade I (South Asian) is the primary driver of global nosocomial outbreaks and exhibits the most profound resistance profiles. This study aims to provide a high-resolution genomic characterization of Clade I, focusing on the consolidation of resistance mechanisms and virulence factors that support its global dominance.</p><p><strong>Methods: </strong>We performed a comprehensive genomic analysis focusing on a cohort of 647 Clade I isolates, selected from a total of 662 global C. auris genomes available in public repositories. Using a standardized bioinformatic pipeline, we conducted core-genome single-nucleotide polymorphisms-based phylogenetic reconstruction, non-synonymous mutation profiling of key resistance genes (TAC1B, FKS1, ERG11/6/3), and functional mapping of virulence-related pathways (ALS4, secretable aspartyl proteases [SAP5], LIP1). The remaining isolates from Clades II to VI were utilized as comparative reference groups to identify clade-specific signatures.</p><p><strong>Results: </strong>Analysis of the Clade I cohort (n=647; 97.73% of the total dataset) revealed a significant consolidation of resistance markers. The Y132F and K143R substitutions in ERG11 were near-ubiquitous, often co-occurring with specific TAC1B variants (A640V, V742A). Notably, 24.32% of the Clade I isolates demonstrated a highly synchronized \"genomic armor,\" characterized by the simultaneous presence of TAC1B (A:YTDQ/A:GSVG), FKS1 (S:SL), and deletions in ERG6/ERG3. Virulence profiling showed high-frequency conservation of biofilm-associated (ALS4) and proteolytic (SAP5) genes, suggesting a synergistic evolution of resilience and pathogenicity.</p><p><strong>Conclusion: </strong>This study delineates the genomic landscape of C. auris Clade I, highlighting how the consolidation of multiple resistance and virulence markers contributes to its clinical success. The high frequency of multidrug-resistant genotypes within this lineage mandates a transition toward genome-led surveillance and personalized antifungal stewardship.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 4","pages":"403-412"},"PeriodicalIF":0.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019396","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":"Predictive value of an intraoperative gallbladder scoring system for surgical difficulty and post-operative outcomes in laparoscopic cholecystectomy.","authors":"Ahmet Baskent, Mehmet Furkan Baskent","doi":"10.14744/nci.2026.82609","DOIUrl":"10.14744/nci.2026.82609","url":null,"abstract":"<p><strong>Objective: </strong>Laparoscopic cholecystectomy (LC) is the gold standard surgical treatment for gallbladder diseases. This study aimed to evaluate the effectiveness of an intraoperative gallbladder scoring system in predicting surgical difficulty and perioperative outcomes in patients undergoing LC.</p><p><strong>Methods: </strong>A total of 798 patients who underwent elective LC for cholecystopathy (symptomatic cholelithiasis, gallbladder polyps, and adenomyomatosis) performed by a single surgeon at our institution between March 2019 and February 2024 were retrospectively analyzed. Demographic characteristics, American Society of Anesthesiologists scores, and predisposing factors were recorded. The degree of intraoperative gallbladder adhesions was graded on a scale from 0 to 4 operative time, drain usage, conversion to open surgery, and post-operative complications were evaluated. The relationship between the intraoperative gallbladder score and surgical outcomes was statistically analyzed.</p><p><strong>Results: </strong>The mean age of the patients was 51 years, and 61% were female. The intraoperative gallbladder score was 1 in 45.9% of patients, 2 in 26.3%, 3 in 15.1%, and 4 in 10.5%. Drain placement was required in 33.1% of cases. The conversion rate to open surgery was 2.1%. The post-operative complication rate was 1.1%. A statistically significant association was found between increasing intraoperative gallbladder scores and drain usage, post-operative complications, and conversion to open surgery (p<0.05). No significant association was observed between the intraoperative score and the need for endoscopic retrograde cholangiopancreatography.</p><p><strong>Conclusion: </strong>The intraoperative gallbladder scoring system is a reliable and practical method for predicting surgical difficulty and adverse perioperative outcomes in LC. Its routine use may support surgical decision-making and improve patient safety and surgical outcomes.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 4","pages":"395-402"},"PeriodicalIF":0.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019342","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":"Ultrasound-guided percutaneous ventriculoatrial shunt placement in pediatric hydrocephalus: Surgical outcomes and thrombotic complications.","authors":"Bekir Can Kendirlioglu, Mert Yavuz, Halit Alioglu, Gulten Arslan, Evren Aydogmus","doi":"10.14744/nci.2026.29825","DOIUrl":"10.14744/nci.2026.29825","url":null,"abstract":"<p><strong>Objective: </strong>Ventriculoatrial shunts (VAS) are increasingly used as a salvage option in pediatric hydrocephalus when ventriculoperitoneal shunts (VPS) fail. Although ultrasound-guided percutaneous techniques facilitate catheter placement and reduce surgical trauma, the incidence and management of thrombotic complications remain insufficiently defined.</p><p><strong>Methods: </strong>We retrospectively analyzed eight pediatric patients who underwent ultrasound-guided percutaneous VAS placement between January 2019 and December 2024. Demographic characteristics, etiology of hydrocephalus, operative details, and post-operative complications were evaluated, with a particular focus on thrombotic events.</p><p><strong>Results: </strong>Patients underwent a mean of 3.8±1.3 VPS revisions before VAS placement. Myelomeningocele was the most common etiology (50%). The mean operative time was 75.6±13.9 min, and the mean intraoperative blood loss was 86.25±43.07 mL. Post-operative complications occurred in 3 patients (37.5%), including thrombotic events in 2 patients (25%) and infection in 1 patient (12.5%). One patient required early shunt removal due to thrombus formation with vegetation, whereas another developed late asymptomatic thrombosis requiring intervention. The internal jugular vein was the most commonly used access site.</p><p><strong>Conclusion: </strong>Ultrasound-guided percutaneous VAS placement is a feasible and minimally invasive alternative in selected pediatric patients. However, thrombotic complications may be more frequent than previously reported and can occur both early and late in the post-operative period. These findings highlight the need for standardized surveillance protocols and further investigation into prophylactic strategies, including antiplatelet therapy.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 4","pages":"367-374"},"PeriodicalIF":0.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019425","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":"Researching impaired heart rate recovery index in patients who have had COVID-19.","authors":"Muhammet Fatih Genisoglu, Zuhal Aydan Saglam, Ece Nur Gezgin, Ahmet Oz","doi":"10.14744/nci.2026.96605","DOIUrl":"10.14744/nci.2026.96605","url":null,"abstract":"<p><strong>Objective: </strong>Heart rate recovery index (HRRI) occurs as a result of vagal reactivation and sympathetic retraction and is an independent risk factor used to assess autonomic nervous system (ANS) function and to determine prognosis in cardiovascular disease and all-cause mortality. It has been shown in various studies that cardiac autonomic dysfunction due to COVID-19 can occur. The aim of our study is to evaluate the effect of COVID-19 on ANS functions in people who have had this disease with HRRI.</p><p><strong>Methods: </strong>In this prospective and observational study, patients proven to have had COVID by molecular methods (polymerase chain reaction positivity) and healthy controls were examined. Electrocardiogram, Transthoracic Echocardiography, Hemogram and Biochemistry tests, and exercise stress test were performed in both groups. HRRIs were calculated by subtracting heart rates at the 1^st, 2^nd, 3^rd, 4^th, and 5^th min during the post-exercise relaxation phase from the peak heart rate during exercise. P<0.05 were considered significant.</p><p><strong>Results: </strong>Study group (n=30) (Female/Male; n=15/15; mean age=39.8±13.3 years; median body mass index=25.9 kg/m²) and control group's (n=33) (Female)/Male; n=16/17; mean age=41.9±13.2 years; median body mass index=27.2 kg/m²). 1^st min and 2^nd min relaxation heart rates in the COVID-19 (+) group were found to be significantly higher than in the control group (p=0.042, p=0.049, respectively). In the COVID-19 (+) group, the 1^st min, 2^nd min, and 3^rd min HRRI were found to be significantly lower than in the control group (p<0.001, p=0.006, p=0.039, respectively).</p><p><strong>Conclusion: </strong>According to the results of our study, HRRI is impaired as an indicator of autonomic dysfunction in people who have had COVID-19. This situation correlates with other studies that have results of ANS dysfunction due to COVID-19, and this may pose a risk factor for increased mortality and morbidity.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"344-350"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611585","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":"Seborrheic dermatitis in intensive care unit patients: A cross-sectional study of prevalence, severity, and associated clinical factors.","authors":"Ozlem Akin, Ozlem Tanriover, Mujge Yucekaya","doi":"10.14744/nci.2026.80270","DOIUrl":"10.14744/nci.2026.80270","url":null,"abstract":"<p><strong>Objective: </strong>Seborrheic dermatitis (SD) is a common inflammatory skin disorder; however, its characteristics in intensive care unit (ICU) patients are not well defined. This study aimed to assess the prevalence and severity of SD, as well as its potential associated factors, in ICU patients.</p><p><strong>Methods: </strong>This cross-sectional study included 102 adult patients admitted to the ICU. SD was assessed with a standardized clinical scoring system. Demographic characteristics, ICU length of stay, Glasgow Coma Scale scores, level of consciousness, sedation status, immunosuppression, immune dysfunction, comorbidities, and medication use were recorded. Patients with and without SD were compared, and a multivariable logistic regression analysis was performed to identify independent factors associated with SD.</p><p><strong>Results: </strong>SD was identified in 39 of 102 patients (38.2%). In multivariable analysis, level of consciousness was independently associated with SD (overall p=0.035). Compared with conscious patients, sedated patients had significantly higher odds of SD (odds ratio=5.05, 95% confidence interval 1.41-18.08; p=0.013). No significant associations were observed for age, sex, ICU length of stay, immunosuppression, or immune dysfunction.</p><p><strong>Conclusion: </strong>SD was common among critically ill patients. Level of consciousness emerged as the only factor independently associated with SD, whereas systemic factors and medication use were not significantly associated. Further studies incorporating detailed assessments of skin care practices, local skin factors, and other potential contributing factors are needed to clarify the mechanisms underlying these associations.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"351-358"},"PeriodicalIF":0.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611564","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":"Mapping publication trends in oral anticoagulation in atrial fibrillation: A bibliometric and thematic analysis of 11,039 publications (2006-2025).","authors":"Senol Coskun, Erkan Tiyekli","doi":"10.14744/nci.2026.28909","DOIUrl":"10.14744/nci.2026.28909","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically map the intellectual evolution, thematic development, and collaborative patterns of oral anticoagulation research in atrial fibrillation (AF) from 2006 to 2025.</p><p><strong>Methods: </strong>This bibliometric study analyzed 11,039 documents indexed in the Web of Science Core Collection (2006-2025) using the Bibliometrix R package (version 4.x) within the R statistical environment (version 4.3.1) for comprehensive science mapping. The analytical workflow comprised descriptive performance analysis, collaboration network analysis, keyword co-occurrence analysis, strategic thematic mapping, and latent Dirichlet allocation (LDA) topic modeling.</p><p><strong>Results: </strong>Publication output increased exponentially from 2 articles per year (2006) to a peak of 960 per year (2021), with subsequent stabilization that may reflect consolidation of the field. The United States produced the highest number of publications (3636; 32.9%). The RE-LY trial received the most citations (n=8788). Thematic mapping revealed two main research clusters: Motor themes (141 keywords), representing direct oral anticoagulant agents, stroke prevention, and clinical outcomes; and emerging/declining themes (43 keywords), including venous thromboembolism and pharmacokinetics. LDA topic modeling identified nine distinct research domains encompassing real-world data, safety reporting, and implementation guidelines.</p><p><strong>Conclusion: </strong>The bibliometric patterns observed are consistent with a maturing research field, characterized by a gradual shift from efficacy-focused randomized trials toward real-world effectiveness studies, implementation science, and personalized anticoagulation strategies. Future research may benefit from increased emphasis on long-term adherence, health-economic outcomes, and personalized approaches integrating genetic, clinical, and patient-centered factors.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 4","pages":"375-386"},"PeriodicalIF":0.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019311","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":"Experimental sciatic nerve neuropathy caused by diclofenac sodium in rats.","authors":"Ali Maksut Aykut, Mustafa Emrah Kaya, Sukru Oral, Yurdal Serarslan, Mustafa Aras, Atilla Yilmaz, Tumay Ozgur, Serdar Dogan","doi":"10.14744/nci.2026.96337","DOIUrl":"10.14744/nci.2026.96337","url":null,"abstract":"<p><strong>Objective: </strong>Our aim in this study is to investigate the total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values of diclofenac sodium, which is a non-steroidal anti-inflammatory analgesic, after sciatic nerve injury, to examine the histopathological changes in the sciatic nerve, and to examine the results and enable important changes in treatment. It is one of the rare studies conducted histopathologically on post-injection sciatic nerve damage of diclofenac sodium, and the parameters of our biochemical approach have not been evaluated before in the literature.</p><p><strong>Methods: </strong>study was divided into 5 main groups as control, sham, trauma, isotonic fluid, and diclofenac sodium. Sham, trauma, isotonic fluid, and diclofenac sodium groups were divided into four subgroups as early stage (day 1, day 3) and late stage (day 7 and day 14). Subjects in each group were evaluated daily by neurological examination according to the Tarlov scale. In all groups except the control group, the sciatic nerve was exposed through appropriate surgical procedures. TAS, TOS, and OSI were run on blood samples biochemically. Nerve tissue samples were evaluated histopathologically and immunohistochemically.</p><p><strong>Results: </strong>There was a significant difference in pairwise comparison of the groups in terms of CASPASE-3 values. A statistically significant difference was found between the groups in terms of myelin thickness and axon diameter. A statistically significant difference was found between the groups in terms of nerve diameter values.</p><p><strong>Conclusion: </strong>Our study demonstrates that intramuscular injections of diclofenac sodium have potential harmful effects. We recommend that alternative methods of using diclofenac sodium intramuscularly be preferred whenever possible due to the potential complications associated with this drug, that healthcare professionals receive necessary training on intramuscular administration, that the procedures be performed more carefully, and that patients be informed about these complications.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"327-335"},"PeriodicalIF":0.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611540","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":"Biochemical and clinical outcomes of once-daily teriparatide in refractory chronic hypoparathyroidism: A single-center experience.","authors":"Aslihan Pekmezci, Sebnem Burhan, Rukiye Dilara Uzman Tekin, Esra Hatipoglu","doi":"10.14744/nci.2026.03780","DOIUrl":"10.14744/nci.2026.03780","url":null,"abstract":"<p><strong>Objective: </strong>Chronic hypoparathyroidism causes disrupted calcium-phosphate balance due to parathyroid hormone (PTH) deficiency. In refractory disease, recombinant PTH (1-34) (teriparatide) can support conventional therapy. This study assessed short-term biochemical and clinical outcomes under real-word of once-daily teriparatide in refractory hypoparathyroidism.</p><p><strong>Methods: </strong>Ten patients with chronic hypoparathyroidism who received subcutaneous teriparatide (20 µg/day) between January 2021 and September 2025 were retrospectively analyzed. The median duration of teriparatide therapy was 9 months (interquartile range: 4-22), with a maximum of 27 months. Clinical records, biochemical parameters, and calcium/vitamin D supplementation requirements were systematically reviewed.</p><p><strong>Results: </strong>Albumin-corrected calcium increased significantly at 3 months (median 7.79 vs. 6.5 mg/dL, p=0.038) but not at 6 months (p>0.05). Phosphorus decreased at 3 months (p=0.012) with a non-significant trend thereafter (p=0.06). No correlation was observed between calcium change and treatment duration (ρ=-0.8, p=0.2). All patients reported symptomatic relief and reduced intravenous calcium requirements, though complete independence was not achieved.</p><p><strong>Conclusion: </strong>Once-daily teriparatide provided transient biochemical improvement and clinical relief in refractory hypoparathyroidism but was insufficient to maintain sustained normocalcemia, suggesting possible pharmacological limitations of once-daily intermittent PTH replacement that warrant further investigation in larger prospective studies. Individualized treatment duration, alternative dosing regimens, and longer-term controlled studies are warranted to optimize therapeutic outcomes.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"336-343"},"PeriodicalIF":0.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610599","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":"Maternal nutritional knowledge and child anthropometric outcomes in preschool children: A cross-sectional study.","authors":"Sebahat Cam, Ozlem Kalaycik Sengul, Atila Kilic","doi":"10.14744/nci.2026.68762","DOIUrl":"10.14744/nci.2026.68762","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the nutritional knowledge levels of mothers of children aged 4-6 years attending pediatric outpatient clinics, analyze knowledge levels according to maternal age, education, and income, and investigate their relationship with children's anthropometric measurements.</p><p><strong>Methods: </strong>This cross-sectional study included 282 mothers of preschool-aged children who attended a pediatric outpatient clinic. Nutritional knowledge was assessed using the Nutritional Knowledge Level Scale for Adults, comprising Basic Nutritional Knowledge (BNK) and food preference (FP) subscales. Mothers also rated Nutrition-Health Awareness (NHA) and Dietary Adequacy Self-Assessment (DAS) on a 0-10 visual scale. Children's height-for-age (HAZ) and weight-for-age (WAZ) z-scores were calculated. Multiple linear regression and correlation analyses were performed.</p><p><strong>Results: </strong>The median maternal age was 34 (interquartile range [IQR]: 29.25-40) years. Median BNK and FP scores were 58 (IQR: 51-69) and 35 (IQR: 30-40), respectively. Educational attainment was the strongest independent predictor of BNK (p=0.006) and DAS (p=0.033). Household income independently predicted FP (p=0.022) and NHA (p=0.026) after adjusting for age and education. Younger maternal age was associated with higher BNK scores. No statistically significant associations were found between maternal nutritional knowledge variables and children's HAZ or WAZ scores (all p>0.05).</p><p><strong>Conclusion: </strong>Most mothers demonstrated adequate BNK; however, this did not consistently translate into FP competence or healthy dietary self-perception. Maternal nutritional knowledge was not directly associated with children's growth outcomes in this cohort, suggesting the pathway from knowledge to child growth is indirect and multifactorial. Nutrition interventions should move beyond knowledge transfer to address practical dietary skills and socioeconomic determinants of eating behavior.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"319-326"},"PeriodicalIF":0.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611578","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":"Clinical and functional outcomes of open reduction and internal fixation for scapular fractures using the modified Judet approach.","authors":"Hakan Batuhan Kaya, Mustafa Murat Hakyoldas, Tolga Kececi, Guray Altun, Savas Camur, Serdar Kamil Cepni","doi":"10.14744/nci.2026.85010","DOIUrl":"10.14744/nci.2026.85010","url":null,"abstract":"<p><strong>Objective: </strong>Displaced scapular fractures are uncommon injuries, and the optimal surgical approach remains controversial. Muscle-preserving techniques may improve post-operative shoulder function by minimizing soft-tissue damage. The purpose of the study was to evaluate the clinical and functional outcomes of open reduction and internal fixation (ORIF) using a muscle-preserving modified Judet approach in displaced scapular fractures and to assess the effect of surgical timing on post-operative shoulder function.</p><p><strong>Methods: </strong>This retrospective study included 12 adult patients who underwent ORIF for displaced scapular fractures between 2015 and 2024 with a minimum follow-up of 12 months. Fractures were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association system and treated using the modified Judet approach. Functional outcomes were evaluated using the Constant-Murley, Disabilities of the Arm, Shoulder, and Hand (DASH), and University of California, Los Angeles (UCLA) scores, and shoulder range of motion was compared with the contralateral side.</p><p><strong>Results: </strong>Mean patient age was 35.3±15.0 years, and mean follow-up was 41.6±37.5 months. Fracture union was achieved in all patients at a mean of 7.5±1.7 weeks. No infections, neurovascular injuries, malunion, or infraspinatus atrophy occurred. Final shoulder motion reached 97% forward flexion, 89% abduction, 93% external rotation, and 90.9% internal rotation compared with the contralateral side. Mean constant, DASH, and UCLA scores were 84.0±8.6, 6.1±8.8, and 31.9±3.4, respectively. All patients returned to work at a mean of 4.7±2.3 months.</p><p><strong>Conclusion: </strong>ORIF using a muscle-preserving modified Judet approach provides reliable union, low complication rates, and satisfactory functional recovery in displaced scapular fractures.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"13 3","pages":"294-302"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610694","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}