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Bilateral circumferential ınternal jugular vein decompression for atlanto-styloid compression syndrome: Report of 14 cases
(Lippincott Williams and Wilkins Ltd., 2026) Aghayev, Kamran; Demir, Hüseyin; Özdöl, Çağatay; Comella, Zachary; Vrionis, Frank D.
BACKGROUND AND OBJECTIVES: External compression of the internal jugular vein (IJV) between the transverse process of the atlas (C1TP) and the styloid process is an emerging nosological entity. Various surgical treatment methods have been used, yet there is no consensus regarding the optimal surgical strategy. In this article, we present a novel surgical technique and clinical outcomes of 14 patients treated with circumferential decompression. METHODS: A retrospective chart review of 14 patients (9 men, 5 women) diagnosed with IJV stenosis between the C1TP and the styloid process was performed. The surgical technique included styloidectomy, C1 transversectomy, myectomy of the styloid muscles and posterior belly of the digastric muscle, transection of the occipital artery, and wide opening of the carotid sheath around the IJV. All but 1 patient underwent bilateral decompression. Clinical evaluation included self-reported improvement on a subjective improvement scale. Radiological assessment was performed by comparison of pre-and postoperative IJV cross-sectional area (CSA) at the point of maximal stenosis. A paired t-test was used for statistical analysis. RESULTS: The mean age was 44.7 yr (25-60), and the mean follow-up duration was 488 days (range 329-761). The right mean IJV CSA increased from 18.3 to 46.1 mm 2 (P = .0058). The left mean IJV CSA increased from 10.1 to 28.8 mm 2 (P = .000076). The IJVs shifted and expanded posteriorly toward the C1TP resection cavities in all cases. Nine patients reported significant and 5 moderate improvements. One patient developed transient trapezius muscle weakness because of XI nerve palsy. CONCLUSION: Bilateral circumferential IJV decompression is a feasible and safe technique and provides maximal IJV decompression.
Robotic eTEP-TAR abdominal wall reconstruction for complex post liver transplant incisional hernia with concomitant inguinal hernia repair: A video vignette
(Springer Nature Link, 2026) Bayrakçeken, Serra; Benlice, Çigdem; Aghayeva, Afag; Kudsi, Omar Yusef; Baca, Bilgi
Introduction Complex incisional hernias after major upper abdominal surgery are technically challenging because of altered anatomical planes, multiple fascial defects, and expected adhesions. Robotic enhanced-view totally extraperitoneal repair with transversus abdominis release may provide a minimally invasive option for selected patients by enabling retromuscular dissection, fascial closure, and wide extraperitoneal mesh reinforcement while limiting intraperitoneal manipulation. Case presentation This video vignette presents an 84-year-old man with multiple incisional hernia defects along a previous Mercedes incision after liver transplantation and a concomitant left direct inguinal hernia. Preoperative imaging demon strated a wide subxiphoid abdominal wall defect and a fat-containing left inguinal hernia. Surgical technique A robotic eTEP-TAR approach was performed. Bilateral retromuscular dissection was completed, the inguinal and incisional hernia contents were reduced, and bilateral transversus abdominis release was performed to facilitate medial fascial advancement and lateral extension of the working space. The fascial and peritoneal defects were closed intra corporeally, and wide mesh reinforcement was achieved using a 30 × 30 cm polypropylene mesh, with additional meshes placed for the inguinal and lower quadrant defects. The postoperative course was uneventful, and the patient was discharged on postoperative day 2. At postoperative day 7 follow-up, he had no complaints, and the wounds were clean. Conclusion This case demonstrates the feasibility of robotic eTEP-TAR abdominal wall reconstruction with concomitant inguinal hernia repair in a selected post-transplant patient with complex abdominal wall defects.
Sex differences in ambulatory blood pressure among patients referred for 24-hour monitoring a retrospective cross-sectional study
(Lippincott Williams and Wilkins Ltd., 2026) Atmaca, Hasan; Gürbüz, Doğaç Çağlar; Erol, Mustafa Kemal; Yetkin, Ertan
Few studies have addressed the differences between hypertensive women and men regarding the diagnosis and control of blood pressure (BP). Accordingly, we aimed to assess the possible discrepancies in BP values between women and men who underwent 24-hour ambulatory blood pressure monitoring. The study population comprised all patients who underwent 24-hour ambulatory blood pressure monitoring, which was retrospectively screened and recorded. Demographic and clinical characteristics of 1204 patients were included in the analysis. Sex-specific analyses of all patients, including those with and without a former diagnosis of hypertension (HT), were performed. Two-thirds of the patients were women. In the general population, both systolic and diastolic BP levels in women were significantly lower than those in men. BP in women was also significantly lower than that in men, both in patients with and without a former diagnosis of HT. Our study demonstrated that women exhibited significantly lower systolic and diastolic BP values than men in this referral cohort, irrespective of a prior diagnosis of HT. While the exact mechanisms remain to be elucidated, this difference highlights the necessity for further research into sex-specific hemodynamic profiles. Consequently, further research is necessary to establish diagnostic thresholds and BP targets to achieve effective and targeted management of BP abnormalities in women.
Multicenter machine learning model using clinical and radiomic features for prediction of postoperative residual status in meningioma
(American Association of Neurological Surgeons, 2026) Şanlıer, Nafiye; Yüce, Murat; Sulaimanov, Umid; Ismayilova, Gular; Hüryol, Çağın; Bozkurt, Hüseyin; Öztürk, Öykü; Öztürk, Fikret; Demir, Hüseyin; Başkaya, Mustafa K.
OBJECTIVE Gross-total resection is the primary surgical objective in meningioma management; however, predicting re sectability preoperatively remains challenging, particularly for meningiomas located in the skull base that exhibit complex anatomical relationships. There is a lack of validated reproducible models that integrate known anatomical factors for surgery; similarly, the value of radiomics as a stand-alone predictor is still unclear. The aim of this study was to develop a machine learning model that combines clinical and radiomic features to estimate early postoperative residual menin gioma. METHODS This retrospective multicenter study included 369 patients who underwent meningioma resection from 2020 to 2024 and had available preoperative contrast-enhanced T1-weighted MRI. Patient data from 3 centers (n = 307) were used to develop the model using leave-one-center-out cross-validation, and an independent cohort (n = 62) was used for external validation. Radiomic features were derived from manually segmented meningiomas, filtered for reproducibility, and integrated with 6 predefined clinical variables. The clinical-only, radiomics-only, and combined models were trained using 4 machine learning classifiers. Model performance was assessed through cross-validation, independent external validation, and receiver operating characteristic analysis. Formal incremental benefit analyses were performed on the common overlap external subset, with predictions available for all compared models. RESULTS Residual meningioma occurred in 23.5% of patients in the development cohort and 14.5% in the external cohort. Lesion location and venous sinus involvement were significantly associated with residual status. Following the feature selection, 2 stable radiomic texture features were retained. In external validation, the combined radiomics-clinical k-nearest neighbors model achieved the highest area under the curve (0.821), with sensitivity of 0.889, specificity of 0.706, and accuracy of 0.733. Clinical variables provided most of the predictive value, whereas radiomic features provided only limited incremental value when added to the clinical model. Decision curve analysis revealed net benefit for the combined model within a narrow range of low thresholds. CONCLUSIONS In this multicenter study, which included external validation, clinical variables provided most of the predictive value for postoperative residual meningioma. Radiomic features alone showed limited discrimination and only modest added value beyond clinical predictors. These combined models could serve as decision-support tools for preoperative risk assessment in meningioma surgery but are not yet suitable for routine stand-alone clinical use.
Risk factors for human papillomavirus positivity in a tertiary care center: A case–control study incorporating genotype distribution, co-infection patterns, and quantitative viral load analysis
(MDPI Publishing, 2026) Karalök, Mete Hakan; Dündar, Bağnu; Parmaksız, Ayhan; Gök Yurttaş, Asiye
Background/Objectives: Human papillomavirus (HPV) is the leading cause of cervical cancer and anogenital malignancies, yet its clinical presentation, genotype distribution, co-infection patterns, and viral load are poorly characterised in tertiary-care referrals. This study aimed to identify predictors of HPV positivity and describe genotype, co-infection, and relative viral copy number (Cq values) in this setting. Methods: A retrospective case–control study of 234 patients (97 HPV-positive, 137 HPV-negative) used a 37-genotype qPCR platform at a tertiary-care hospital between January-December 2025. Demographic data, clinical diagnosis categories, genotype profiles, co-infection patterns, and cycle quantification (Cq) values were recorded, and multivariable logistic regression identified independent predictors of HPV positivity. Results: HPV positivity was 41.5% (97/234). Only the clinical diagnosis category independently predicted HPV status. Compared with non-specific presentations, patients with anogenital or viral warts (aOR: 4.25; 95% CI: 1.49–12.14; p = 0.007) and vaginal or vulvar inflammation (aOR: 2.08; 95% CI: 1.19–3.63; p = 0.010) had higher odds of positivity. High-risk genotypes were the second most frequently detected category (40.00% of detections), after low-risk genotypes (48.21%), with HPV-16 leading among high-risk types. Co-infection occurred in 44.3% of HPV-positive patients, mostly involving mixed-risk genotypes. Patients with anogenital warts had lower Cq values than those with urinary tract complaints (p = 0.011), reflecting higher relative viral copy numbers per swab. Conclusions: HPV positivity and relative viral copy number (as approximated by Cq values) tracked more closely with clinical presentation than with demographic background. The dominance of low-risk and high-risk genotypes and the prevalence of mixed-risk co-infections were consistent with the symptomatic profile of the cohort. These findings support interpreting HPV results in light of clinical presentation and extended genotyping with relative viral copy number quantification in tertiary settings.
Long-term seizure outcomes in patients with drug-resistant mesial temporal lobe epilepsy due to hippocampal sclerosis
(Elsevier, 2026) Gül, Günay; Eren, Fulya; Kandemir Yılmaz, Melek; Yandım Kuşcu, Demet; Keskinkılıç, Cahit; Tuğcu, Bekir
Objective: Resective surgery is a significant therapeutic option for patients with drug-resistant mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). Numerous studies have demonstrated the efficacy of epilepsy surgery in the short to median term. However, studies on long-term outcomes are limited in number. The objective of this study was to document the long-term prognosis and associated factors of patients under going resective surgery for MTLE. Methods: A retrospective analysis was conducted on the data of patients with drug-resistant MTLE due to HS who underwent resective surgery between 2001 and 2013 at our epilepsy centre. The demographics and clinical variables of the patients were documented and analysed in order to ascertain their long-term prognosis. The postoperative outcomes were evaluated in accordance with the Engel classification system. Results: Of the 45 patients (mean age: 44.64 ± 8.96, range: 31–67), 31 (68.89%) were male. The age at onset of epilepsy, age at surgery, and the duration of epilepsy at the time of surgery ranged from 0.25 to 26 years (11.51 ± 7.07), from 12 to 47 years (26.82 ± 8.14), and from 2 to 33 years (16.03 ± 7.85), respectively. The patients were followed up for 10–23 years (17.73 ± 2.96). HS was identified in 23 (51.11%) of the patients on the right side and 22 (48.89%) on the left. The pre-operative EEG recordings revealed temporal discharges in 40 (88.89%) patients unilaterally. 22 patients (48.89%) underwent amygdalohippocampectomy with a temporal lobectomy (AH+ATL), while 23 patients (51.11%) underwent selective amygdalohippocampectomy (SAH). 28 (62.22%) patients were classified as Engel I. The patients did not have any statistically significant difference in terms of gender, age at epilepsy onset, age at surgery, duration of epilepsy at surgery, side of HS, and surgical procedure according to Engel classification (p = 0.64, 0.08, 0.60, 0.25, 0.67, 0.10, respectively). Executive and memory functions were improved after surgery at 5th year. Conclusion: 62% of the patients were classified as Engel I. Although previous studies have suggested that certain factors may influence prognosis, our findings did not yield any statistically significant results in this regard. It is crucial that patients undergo surgical evaluation without delay to achieve seizure control and improve cognitive function.
Investigation of effects of hybrid hyrax-mentoplate treatment in high-angle class III patients: A three-dimensional, retrospective study
(Wiley, 2026) Yıldırım, Gamze; Önem Özbilen, Elvan; Özdemir, Fulya
Objective: This retrospective study evaluated three-dimensional effects of hybrid hyrax-mentoplate (HH-M) orthopaedic treat-ment in high-angle Class III individuals using Cone Beam Computed Tomography (CBCT) images.Materials and Methods: Pre-treatment (T0) and post-treatment (T1) CBCTs of 17 fully compliant high-angle Class III patients(7 males, 10 females, age: 11.7 ± 1.32 years, treatment duration: 12.62 ± 1.7 months) treated with HH-M were analysed. T0 andT1 CBCTs were superimposed from the cranial base using artificial intelligence-based AMASSS module of the 3D Slicer version5.8.1 software (www.slicer.org). Linear and angular changes were analysed in the sagittal, vertical and transverse planes, along-side three-dimensional landmark displacements and volumetric airway measurements. Significance level was set at p < 0.05.Results: Significant increases occurred in SNA, ANB and Occlusal Plane (OP) to Mandibular Plane (MP) angle (p < 0.001,p < 0.001, p = 0.001, respectively), while Sella-Nasion to OP and Palatal Plane (PP) to OP decreased (p = 0.008, p = 0.008, re-spectively). Vertical linear measurements remained stable (p > 0.05). All transverse linear measurements increased (p < 0.05).Upper Molar (UM) to PP, Upper Incisor to PP, Lower Incisor to MP and overjet have significantly increased (p < 0.001, p = 0.018,p = 0.048, p < 0.001, respectively). Overbite remained unchanged (p > 0.05). Nasopharynx (p = 0.008) and Middle Pharynx(p = 0.003) volumes significantly increased.Conclusion: Despite the significant alterations observed in OP and UM-PP, this technique effectively managed to maintain over-all vertical skeletal dimensions without inducing a significant change in other facial height parameters and enhanced the airwayvolume. Significant expansion occurred across maxillary, nasal and zygomatic levels. HH-M represents an effective orthopaedictreatment approach for high-angle Class III patients.
DNA methylation of ANKRD23 as a novel biomarker for early diagnosis of ovarian cancer
(Women's Health and Action Research Centre, 2026) Alizada, Aydan; Şükrüoğlu Erdoğan, Özge; Kılıç Erciyas, Seda; Çelik Demirbaş, Betül; Pasin, Özge; Dinç, Ahmet; Saip, Pınar; Yazıcı, Hülya; Tuncer, Şeref Buğra
Ovarian cancer (OC) is a leading cause of gynecologic cancer-related mortality and is frequently diagnosed at advanced stages due to the absence of effective early detection tools. Epigenetic alterations, particularly DNA methylation, play a critical role in tumorigenesis and represent promising non-invasive biomarkers. This study investigated the methylation status of the ANKRD23 gene in OC and evaluated its diagnostic potential using peripheral blood samples. A total of 385 serous OC patients, 50 individuals with benign ovarian conditions, and 99 healthy controls were included. DNA methylation was assessed using methylation-sensitive restriction enzymes followed by real-time PCR. ANKRD23 methylation was significantly associated with clinical stage (p = 0.029), histological grade (p = 0.009), and ethnicity (p = 0.024). Moreover, methylation levels differed significantly among OC patients, benign cases, and healthy controls (p = 0.026). These findings support blood-based ANKRD23 methylation as a promising biomarker for non-invasive ovarian cancer diagnosis and risk stratification. (Afr J Reprod Health 2026; 30 [15] 16-25).
Is d-dimer associated with disease severity and contralateral slip risk in slipped capital femoral epiphysis?
(Wolters Kluwer, 2026) Kürk, Muhammed Bilal; Albayrak, Kutalmış; Aydın, Abdurrahman; Kayış, Görkem; Akpınar, Evren
Background: To evaluate D-dimer levels in patients with slipped capital femoral epiphysis (SCFE), to investigate their associa tion with disease severity and the development of contralateral slip, and to assess their contribution to existing predictive models. Methods: In this single-center retrospective cohort study, 25 patients with unilateral SCFE diagnosed between January 2020 and April 2024 were included. The control group con sisted of age- and sex-matched obese individuals and healthy subjects with normal body mass index (BMI). Clinical varia bles (age, sex, BMI, stability according to the Loder classi fication, and chronicity); laboratory parameters [complete blood count, neutrophil-to-lymphocyte ratio (NLR), in flammatory markers including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and coagulation pa rameters including prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer]; and radiographic measurements [Southwick angle, interhip angle difference, posterior sloping angle (PSA), and modified Oxford bone score (MOBS)] were analyzed. Subgroup analyses based on stability and chronicity were performed, and correlations between D-dimer levels and clinical, laboratory, and radio graphic parameters were assessed. Multivariable logistic re gression models were constructed to predict contralateral slip, and model performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: D-dimer levels were significantly higher in the SCFE group compared with both obese and healthy control groups (P < 0.001). D-dimer showed positive correlations with CRP and NLR and negative correlations with the MOBS and the interhip Southwick angle difference. Higher D-dimer levels were ob served in unstable and acute-on-chronic cases (P < 0.001). During a mean follow-up of 24 months, patients who developed contralateral slip had significantly higher D-dimer levels (P = 0.002). The addition of Southwick angle difference to a baseline model including age and MOBS increased the AUC from 0.73 to 0.80, while further inclusion of D-dimer improved the AUC to 0.87. However, the increase in AUC after addition of D-dimer was not statistically significant according to the paired DeLong test (P = 0.18). Conclusion: D-dimer levels are associated with disease severity and the risk of contralateral slip in SCFE. Incorporation of D-dimer into established clinical and radiographic parameters improved predictive model performance. These findings support the role of inflammatory and microvascular processes in the pathogenesis of SCFE and suggest that D-dimer may serve as a useful adjunct biomarker for risk stratification.
Postoperative pain after vNOTES versus laparoscopic hysterectomy: A procedure-specific comparative study
(Turkish Society of Obstetrics and Gynecology, 2026) Şahin, Turan; Şahin, Eda Adeviye; Perkyürek, Buse Sahra; Güzeltaş, Gökan; Tekin, Arzu Bilge; Gök, Koray; Şahin, Hanifi
Objective: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is associated with lower postoperative pain, reduced analgesic requirements, and faster early postoperative recovery compared with laparoscopy in patients undergoing hysterectomy for benign indications. To compare postoperative pain and early recovery outcomes between vNOTES and conventional laparoscopy in patients undergoing hysterectomy for benign gynecologic indications. Materials and Methods: This single-center retrospective cohort study included 192 patients who underwent hysterectomy between March 2021 and September 2025. Patients were grouped according to surgical approach (vNOTES vs. laparoscopy). Postoperative pain was assessed using the visual analog scale at 6 and 24 hours. Primary outcomes were pain intensity and the requirement for additional analgesia. Secondary outcomes included operative time, change in hemoglobin, time to first flatus, and length of hospital stay. Multivariable logistic regression analysis was performed to identify predictors of analgesic requirement. Results: Of 192 patients, 75 (39.1%) underwent laparoscopy and 117 (60.9%) underwent vNOTES. Baseline characteristics were similar between groups. The vNOTES group had significantly lower pain scores at 6 and 24 hours (p=0.001) and a reduced need for additional analgesia (23.9% vs. 60.0%, p=0.001). Operative time was shorter and recovery outcomes, including time to first flatus and length of hospital stay, were significantly improved in the vNOTES group (p=0.001). Surgical approach, uterine weight, and operative time were independent predictors of analgesic requirement. Conclusion: In this retrospective cohort study, vNOTES was associated with lower postoperative pain scores, reduced analgesic requirement, and earlier recovery than conventional laparoscopy. These findings should be confirmed in prospective randomized studies.
Association of vestibule depth with peri-implant inflammation and soft tissue stability independent of keratinized mucosa width: A cross-sectional study
(Korean Academy of Periodontology, 2026) İnan, Berkin; Parlak, Hanife Merva; Akçiçek, Gökçen; Güncü, Mustafa Barış; Akman, Abdullah Cevdet; Parmaksız, Ayhan; Keçeli, Hüseyin Gencay; Güncü, Güliz Nigar
Purpose: This study evaluated whether vestibule depth (VD) affects peri-implant inflammation and mucosal margin stability in the posterior mandible independently of keratinized mucosa width (KMW). Methods: A total of 129 patients, each with a single implant in the mandibular premolar or molar region, were included. Clinical variables, including gingival index, plaque index (PI), peri-implant probing depth, clinical attachment level (CAL), gingival bleeding time index (GBTI), VD, KMW, mucosal thickness (MT), mucosal recession (MR), peri-implant soft tissue phenotype, and peri-implant soft tissue dehiscence (PISTD), were assessed. Multiple linear regression analysis was performed to determine the associations of GBTI, MR, and PISTD type with the independent variables PI, KMW, age, implant diameter, sex, function time, implant location, CAL, MT, VD, and phenotype classification. Results: Implants with adequate KMW (≥2 mm) displayed greater VD and MT, less MR, and a thicker phenotype than implants with inadequate KMW (<2 mm) (P<0.001 for all). PISTD class II defects were observed more frequently in the group with adequate KMW, whereas class III defects were more common among the patients with inadequate KMW (P=0.001). Implants with sufficient VD (≥6 mm) showed greater KMW and MT and less MR than implants with insufficient VD (<6 mm) (P=0.026 for MR; P<0.001 for all other comparisons). Based on the multiple regression analysis, KMW was significantly associated with GBTI, MR, and PISTD types and subtypes (P<0.05 for all), whereas VD was not significantly associated with any of these variables. Conclusions: VD was not significantly associated with peri-implant inflammation or soft tissue stability, whereas KMW showed a stronger association with these parameters. These findings suggest that KMW, independent of VD, plays an important role in peri-implant soft tissue health in the posterior mandible.
Effects of rifaximin in fructose-induced steatohepatitis in rats
(Kare Publishing, 2026) Kıyak, Mevlüt
To the Editor, I read with interest the recently published article titled “Effects of rifaximin in fructose-induced steatohepatitis in rats.” The article dis cusses how rifaximin may protect against early liver damage caused by fructose. The researchers showed that rifaximin helps reduce cer tain biochemical markers and promote healing in inflamed tissue, providing insight into the interaction between the gut and liver in fatty liver disease, which plays a role in metabolic disorders.
Gray zone of hypertension thresholds values can be overcome by individualized symptom-oriented approaches
(Lippincott Williams and Wilkins Ltd., 2026) Yetkin, Ertan; Atmaca, Hasan; Gürbüz, Dogaç Çağlar; Yalta, Kenan; Erol, Mustafa Kemal
Dear Editor, We have read with great interest the recently published article of Chung et al. [1]. Briefly, they reassessed the sensitivity, specificity and diagnostic accuracy of home blood pressure monitoring (HBPM) by changing threshold values for the diagnosis of hypertension from 135/85 to 130/80 mmHg in 646 participants who were suspected of having hypertension (office blood pressure ≥140/90 mmHg). Eventually, they have found that lowering the diagnostic threshold of home hypertension from 135/85–130/80 mmHg significantly enhances the diagnostic sensitivity of HMBP.
Does thermoforming setup affect thickness in thermoplastic orthodontic appliances? A comparison of single vs. dual-model fabrication
(MDPI Publishing, 2026) Allaf, Ferdi; Arslan, Meriç; Özcan, Mustafa; Erdem, Buket
Thermoforming remains the predominant fabrication route for clear thermoplastic orthodontic appliances, yet it reduces and redistributes sheet thickness, which governs force delivered to teeth. Simultaneous thermoforming of two models may reduce fabrication time and material waste; however, its effect on final appliance thickness has not been evaluated. This in vitro study compared appliance thickness after thermoforming over a single model or two models simultaneously, using ten commercial aligner brands with different polymer composition and initial thickness. Thickness was measured with a digital caliper at anterior, canine and posterior sites, and analyzed using three-way ANOVA with Tukey post hoc tests. A significant three-way interaction (measurement point × number of models × brand; p < 0.001) was found. Significant single- versus dual-model differences emerged in some brand–region combinations; in most, dual-model appliances were thicker than single-model appliances. Four brands showed no significant difference at any site. Within the limits of this study, simultaneous fabrication of two appliances in a single thermoforming cycle produced appliances with thicknesses comparable to, and often slightly greater than, those fabricated over a single model. Simultaneous thermoforming maintained comparable appliance thickness and may improve manufacturing efficiency.
Experimental sciatic nerve neuropathy caused by diclofenac sodium in rats
(Kare Publishing, 2026) Aykut, Ali Maksut; Kaya, Mustafa Emrah; Oral, Şükrü; Serarslan, Yurdal; Aras, Mustafa; Yılmaz, Atilla; Özgür, Tümay; Doğan, Serdar
OBJECTIVE: 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. METHODS: 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. RESULTS: There was a significant difference in pairwise comparison of the groups in terms of CASPASE-3 values. A statis tically 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. CONCLUSION: Our study demonstrates that intramuscular injections of diclofenac sodium have potential harmful ef fects. We recommend that alternative methods of using diclofenac sodium intramuscularly be preferred whenever possi ble 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.
Fracture resistance of 3D printed resin-based permanent ceramic fixed dental prostheses after thermocycling
(Elsevier, 2026) Özer, Safa; Atasoyu Akgün, Begüm; Çakan, Umut
Objectives: Three-dimensionally (3D) printed resin-based permanent ceramics produced using additive manufacturing have recently gained considerable interest as potential restorative materials for fixed prostheses. However, limited evidence is available regarding their long-term mechanical performance following thermo cycling. The aim of this study was to evaluate the effect of different thermocycling durations on the fracture resistance of 3D-printed bar-type fixed dental prosthesis (FDP) specimens. Methods: Forty-eight bar-shaped, three-unit FDP specimens (5 × 5 × 30 mm), each containing a 4 × 4 mm² U- shaped connector, were fabricated using 3D-printed resin-based permanent ceramic. The specimens were divided into four groups according to ageing duration: unaged, 1, 3, and 12 months of thermocycling. Fracture load (N) data were analysed using non-parametric statistical methods. Group comparisons were performed using the Kruskal–Wallis test with epsilon-squared ( ε ²) effect size estimation, and the Jonckheere–Terpstra test was applied to evaluate the ordered trend across thermocycling durations. Results: Group comparisons showed no statistically significant differences in fracture load among ageing dura tions (Kruskal–Wallis, p = 0.168), with a small effect size ( ε ² = 0.047). However, the Jonckheere–Terpstra test indicated a significant decreasing trend in fracture load with an increase in thermocycling duration (Z = 2.135, p = 0.033). Conclusions: Although no statistically significant group differences were observed, effect size analysis and regression trends indicated that long-term thermocycling may gradually reduce the fracture resistance of 3D- printed resin-based permanent ceramic FDPs. Clinical significance: 3D-printed resin-based permanent ceramic FDPs can provide satisfactory initial fracture resistance; however, the mechanical strength reduction tendency following long-term ageing should be considered for clinical applications over extended durations.
Age-adjusted associations between routine systemic inflammatory markers and anti-müllerian hormone in reproductive-age women: A retrospective cross-sectional study
(MDPI Publishing, 2026) Karalök, Mete Hakan; Dündar, Bağnu; Parmaksız, Ayhan; Elgün, Tuğba; Gündoğan, Gül İpek; Gök Yurttaş, Asiye
Background: Anti-Müllerian hormone (AMH) is widely used as a marker of ovarian reserve and is strongly influenced by chronological age. Although inflammation has been implicated in ovarian aging and follicular dysfunction, whether routinely measured peripheral inflammatory markers provide additional information regarding AMH concentrations remains unclear. Objective: This study aimed to evaluate the age-adjusted associations of C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR) with serum AMH concentrations in reproductive-age women. Methods: This retrospective cross-sectional study included women aged 18–45 years with available AMH, complete blood count, and CRP measurements. After reapplying the prespecified eligibility criteria and excluding confirmed data-entry or analytical errors, 819 women were included in the final analysis. NLR was calculated from absolute neutrophil and lymphocyte counts. Because CRP and NLR showed right-skewed distributions, Box–Cox transformations were applied. Associations with Box–Cox-transformed AMH were evaluated using an age-adjusted left-censored Tobit regression model. Results: The mean age of the participants was 34.07 ± 6.94 years, and the median AMH concentration was 1.07 ng/mL (interquartile range, 0.29–2.50). Chronological age was inversely associated with AMH (β = −0.123, 95% CI: −0.135 to −0.111, p < 0.001). After adjustment for age, neither CRP (β = −0.038, 95% CI: −0.085 to 0.009, p = 0.114) nor NLR (β = −0.012, 95% CI: −0.222 to 0.198, p = 0.912) was independently associated with AMH. Conclusions: In this retrospective outpatient cohort, routine peripheral inflammatory markers did not explain additional variation in AMH beyond chronological age. These results do not exclude a potential role for local ovarian inflammation, which may not be adequately captured by peripheral CRP or NLR measurements.
Anatomical location is associated with clinicopathological features and long-term oncological outcomes in mucinous colorectal adenocarcinoma: A population-based analysis of 40,698 patients from the SEER database
(MDPI Publishing, 2026) Kutlu, Burak; Benlice, Çiğdem
Background: Mucinous adenocarcinoma (MAC) of the colorectum is a biologically distinct histological subtype whose prognostic significance may vary substantially according to primary tumor location. The impact of anatomical site on clinicopathological characteristics and long-term survival in MAC remains incompletely characterized. This study aimed to evaluate the influence of tumor location on oncological outcomes in patients with mucinous colorectal cancer using a large population-based dataset. Methods: Patients diagnosed with mucinous colorectal adenocarcinoma between 2000 and 2023 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Operated patients were stratified by anatomical location into three groups: right colon (cecum, ascending colon, hepatic flexure, transverse colon), left colon (splenic flexure, descending colon, sigmoid colon, rectosigmoid junction), and rectum. The primary endpoints were overall survival (OS) and cancer-specific survival (CSS). Survival analyses were performed using the Kaplan–Meier method with log-rank testing. Multivariable Cox proportional hazards regression was used to assess the independent association of tumor location with survival outcomes, adjusting for age at diagnosis, year of diagnosis, sex, AJCC (American Joint Committee on Cancer) stage, tumor grade, receipt of radiotherapy and chemotherapy. Temporal trends in survival were evaluated across four consecutive diagnostic periods: 2000–2005, 2006–2011, 2012–2017, and 2018–2023. Results: A total of 40,698 patients with mucinous colorectal cancer were identified, of whom 40,174 underwent cancer-directed surgery (right colon n = 25,317; left colon n = 10,408; rectum n = 4449). The right colon was the predominant site of disease (62.9%). Median age was highest in the right colon group (74.0 years) and lowest in the rectum (65.0 years), while female sex predominated in right-sided tumors (55.7%) and male sex in rectal tumors (61.1%). Chemotherapy and radiotherapy utilization were markedly higher in the rectal group (68.6% and 64.5%, respectively) compared with the right colon (28.8% and 1.1%). Median OS was equivalent in the right and left colon groups (87.0 months each) but declined to 80.0 months in the rectal group. All pairwise CSS comparisons were statistically significant (all p < 0.001). On multivariable analysis, using the right colon as reference, the adjusted hazard ratios for CSS were 1.33 (95% CI: 1.28–1.39) for the left colon and 1.45 (95% CI: 1.34–1.57) for the rectum (both p < 0.001). Despite receiving the highest rates of multimodal therapy, rectal MAC demonstrated the worst long-term CSS across all anatomical groups. Temporal analyses revealed consistent CSS improvements in right-sided and left-sided MAC over the study period, whereas rectal MAC showed a non-linear trajectory with a plateau in the most recent diagnostic cohort (2018–2023). Conclusions: Mucinous colorectal adenocarcinoma demonstrates substantial biological and prognostic heterogeneity according to anatomical tumor location. Right-sided MAC was the most prevalent subtype and exhibited superior cancer-specific survival despite older patient age and lower treatment intensity. Rectal MAC demonstrated the worst long-term outcomes despite high utilization of multimodal neoadjuvant therapy, consistent with the established reduced responsiveness of mucinous tumors to conventional chemoradiotherapy. These findings underscore the necessity of incorporating anatomical location and tumor biology into individualized risk stratification and therapeutic planning for patients with mucinous colorectal cancer.
Blood-based RBBP7 and RIBC1 methylation as a candidate epigenetic biomarker for ovarian cancer epigenetic markers RBBP7 and RIBC1 in ovarian cancer
(Springer Nature Link, 2026) Şükrüoğlu Erdoğan, Özge; Kılıç Erciyas, Seda; Çelik Demirbaş, Betül; Dinç, Ahmet; Ünal, Elif; Güngör Uğurlucan, Funda; Akdeniz Ödemiş, Demet; Pasin, Özge; Saip, Pınar Mualla; Yazıcı, Hülya; Tuncer, Şeref Buğra
Background: Ovarian cancer (OC) remains one of the leading causes of gynecological cancer-related mortality, with limited biomarkers for early detection and prognosis. Changes in DNA methylation-stable and detectable in blood-are potential candidates for clinical application. In our earlier genome-wide methylation study involving monozygotic twins where one had ovarian cancer and the other did not, we identified two genes, RBBP7 and RIBC1, as differentially methylated. These findings laid the groundwork for further targeted investigation. Methods and results: Peripheral blood methylation of RBBP7 and RIBC1 was evaluated in 387 ovarian cancer patients, 50 benign ovarian disease patients, and 100 healthy controls using a bisulfite-free, methylation-sensitive restriction enzyme (MSRE)-based qPCR assay. In this approach, DNA is divided into digested and undigested reactions, and methylation levels are calculated from Ct differences. Methylation levels differed across groups, with RBBP7 showing a clearer discriminatory pattern (p < 0.001) and associations with disease severity (p < 0.001) and CA125 levels (p = 0.05). RIBC1 also differed between ovarian cancer and healthy controls (p < 0.001) but showed no significant associations with clinicopathological parameters. Conclusion: RBBP7 methylation appears to be a potential candidate biomarker associated with disease characteristics and progression patterns of ovarian cancer. These findings suggest that RBBP7 methylation may have potential for integration into future multi-marker diagnostic and risk-stratification approaches, pending further validation. While RIBC1 methylation also showed differential patterns, its clinical relevance appears limited and requires further investigation. These findings support the integration of RBBP7 methylation assessment into early-stage diagnostic workflows and risk-stratification strategies for ovarian cancer, enabling more precise clinical decision-making. Future multicenter prospective studies are warranted before clinical implementation.
Between symphony and jungle: Nursing students’ metaphorical representations of teamwork
(Elsevier, 2026) Aydoğdu, Ana Luiza Ferreira; Cortez, Elaine Antunes
Aim: To explore undergraduate nursing students’ perceptions of teamwork through metaphor analysis and discuss the implications for nursing education and collaborative practice. Background: Teamwork is a core competency in nursing education; yet, little is known about how students conceptualise it and how these perceptions shape their readiness for practice. Design: Qualitative descriptive study. Methods: The study was conducted with 68 undergraduate nursing students from Brazil. Data were collected between March 10 and 31, 2026, through an online survey where students were invited to describe teamwork using metaphors. Data were analysed using reflexive thematic analysis, supported by Conceptual Metaphor Theory. Results: Three interrelated themes were identified: (1) Functional and systemic integration: the team as a mechanism; (2) Harmonisation and coordinated leadership: the team as a performance; and (3) Identity, connection and livelihood: the team as a foundation, a shield and a means of survival. These metaphors suggest that students simultaneously conceptualise teamwork as a structured system, a coordinated practice and a source of both support and emotional demand. Conclusions: Undergraduate nursing students develop an early, complex understanding of teamwork that in tegrates technical, relational and emotional dimensions. While this may reflect the effectiveness of educational approaches in fostering teamwork, care coordination and patient safety, metaphors associated with stress and undervaluation may suggest a need to address the emotional and psychosocial dimensions of teamwork within nursing curricula.

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