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Comparison of quadro‑iliac plane block and erector spinae plane block for postoperative analgesia management after single level lumbar discectomy surgery: A randomized, double‑blind, controlled, prospective, multicenter study
(Springer Nature Link, 2025) Turan, Engin İhsan; Otlu Bıyıkoğlu, Büşra; Özen, Volkan; Alver, Selçuk; Umutoğlu, Tarık; Cücü, Oğuzhan; Çevik, Serdar; Çiftçi, Bahadır; Şahin, Ayça Sultan
Purpose Effective postoperative analgesia management is critical for optimizing recovery and patient satisfaction following lumbar discectomy. Erector Spinae Plane Block (ESPB) is an established regional anesthesia technique with proven efficacy, while the novel Quadro-Iliac Plane Block (QIPB) has shown promise as an alternative approach. This study compares the analgesic efficacy, opioid-sparing potential, and safety of ESPB and QIPB in single-level lumbar discectomies. Method This multicenter, prospective, randomized, double-blind study included 60 patients aged 18–65 years undergoing single-level lumbar discectomy. Patients were randomized into ESPB (n=30) and QIPB (n=30) groups. Both blocks were performed at the end of surgery, before the extubation under ultrasound guidance using 40 ml (0.25%) bupivacaine bilater ally. The primary outcome was postoperative pain assessed by the Numeric Rating Scale (NRS) at 12 h. Secondary outcomes included tramadol consumption, rescue analgesia requirements, hemodynamic parameters, and adverse events. Results The primary outcome, 12-h NRS scores, did not differ significantly between groups (p>0.05), indicating similar anal gesic efficacy. Secondary outcomes—including total tramadol consumption (54.00±49.03 mg for ESPB vs. 44.67±44.16 mg for QIPB, p=0.476), need for rescue analgesia, and incidence of nausea and vomiting—were also comparable. No motor block was observed in either group. Conclusion Although QIPB did not demonstrate superiority over ESPB, it was found to be not inferior in analgesic effect and safety outcomes. These findings suggest that QIPB may be a reliable alternative to ESPB in lumbar discectomy procedures.
Incidence and prognostic factors of isolated para-aortic lymph node metastasis in endometrial cancer: A single-center study
(Minerva Medica, 2025) İbrahimov, Akbar; Boyraz, Gökhan
Para-aortic lymph node metastasis (PALNM) is a key prognostic factor in endometrial cancer (EC). This study aimed to de- termine the incidence and prognostic factors of lymph node metastasis (LNM) and isolated PALNM in endometrioid-type EC patients. METHODS: EC patients treated surgically between 2000 and 2015, staged by FIGO 2009 criteria, were retrospectively analyzed. Included were patients with endometrioid histology grades I-III who underwent pelvic and PALN dissection. Excluded were those without lymph node dissec tion or with non-endometrioid histology. RESULTS: A total of 417 patients met the criteria. Of these, 246 (59%) were grade I, 117 (28.1%) grade II, and 46 (11%) grade III. Pelvic LNM (PLNM) was found in 43 (10.3%), and PALNM in 22 (5.3%). Five patients (1.19%) had isolated PALNM. PALNM was more frequent in patients with stage III, tumors >2 cm, cervical glandular/stromal involvement, deep myometrial invasion, positive peritoneal cytology, adnexal involvement, PLNM, and LVSI. Isolated PALNM was notably higher with adnexal involvement. Independent predictors of PALNM were cer vical glandular involvement and LVSI. Deep myometrial invasion, LNM, PLNM, LVSI, and adnexal involvement were linked to disease-free survival (DFS), while peritoneal cytology, PLNM, and LVSI were linked to recurrence. There was no significant difference in recurrence and DFS between PALNM and isolated PALNM. CONCLUSIONS: Isolated PALNM without PLNM is rare in EC patients but should be assessed for optimal staging and treatment.
Addressing spirituality in counseling: Turkish mental health professionals’ views on a training program for professional competencies
(Springer Nature Link, 2026) Ekşi, Halil; Turgut, Ebru Talibe; Karalı, Fatma Betül; Şen, Hale; Akyol, Havvanur; Aydın, Neslihan; Koç, Yusuf Ziya
The integration of spirituality into counseling has gained increased attention due to its significant impact on psychological well-being. However, mental health profes sionals often face challenges with incorporating spiritual dimensions into therapy, primarily due to inadequate training, conceptual ambiguity, and ethical concerns. This qualitative phenomenological study aims to explore mental health profession als’ perspectives on addressing spirituality in counseling and to assess the necessity of a specialized training program to enhance competencies in this area. We used cri terion sampling to select 11 experienced psychologists, counselors, and academics to, conduct semi-structured interviews, and analyze the data using descriptive analy sis to identify the key themes related to integrating spirituality into counseling. The findings reveal that the current training curricula does not adequately cover spir ituality, which has led to a lack of confidence among mental health professionals. The participants highlighted several barriers, including professional hesitancy, ethi cal concerns, clients’ misunderstandings, and the dominance of secular educational models. Additionally, the study identified the specific competencies needed for inte grating spirituality into counseling and categorized them into knowledge, skills, and attitudes. The professionals emphasized the need for a structured training program that includes conceptual knowledge about spirituality, evidence-based intervention techniques, ethical considerations, and culturally sensitive approaches. Furthermore, recommendations were made regarding the content, format, and evaluation methods for such a training module. The study underscores the urgent need for standardized training to equip mental health professionals with the skills required to address spir ituality in an ethical and culturally competent manner.
Complex ventral hernia repair using botulinum toxin with combination of Fasciotens® after colorectal surgery: A video vignette
(Wiley, 2026) Demirli Atıcı, Semra; Yıldırım, Yasemin; Canda, Aras Emre; Terzi, Mustafa Cem; Arslan, Çigdem; Erenler Bayraktar, İlknur; Bayraktar, Onur; Bisgin, Tayfun
Complex ventral hernia repair using botulinum toxin with combination of Fasciotens® after colorectal surgery: A video vignette
Interfacial bond strength of CAD/CAM resin composites on dentin vs. composite substrates: Influence of dual-cure and self-adhesive resin cements
(MDPI Publishing, 2026) Batgerel, Oyun Erdene; Yazıcıoğlu, Oktay; Kıtın, Emine; Gençel, Burç İhsan; Yamak, Fatih; Ergün Bozdağ, Süreyya; Sasany, Rafat
This in vitro study evaluated the shear bond strength (SBS) of four CAD/CAM (Computer aided design/Computer aided manufacturing) polymer-based indirect composites bonded to dentin and microhybrid composite substrates using two resin cements. Gradia Plus (GP), Ceramage (Ce), Tescera ATL (TA), and Lava Ultimate (LA) were fabricated into cylindrical specimens (3 × 3 mm). Dentin substrates were obtained from extracted molars, while composite substrates were prepared from Filtek Z250 (4 mm × 2 mm). Bonding was performed using either a self-adhesive resin cement (RelyX U200; RU200) or a dual-cure adhesive resin cement (RelyX Ultimate; RU), resulting in 16 experimental groups (n = 12 per group). SBS was measured using a universal testing machine (1 mm/min), and failure modes were assessed under stereomicroscopy. Bond strength was significantly higher on composite substrates than on dentin (p < 0.001), primarily due to favorable polymer– polymer compatibility and matrix interdiffusion, which improved stress accommodation at the adhesive interface. TA and Ce showed superior adhesion when combined with RU, while LA exhibited the lowest values, particularly on dentin bonded with RU200. Overall, the dual-cure adhesive system provided stronger bonding than the self-adhesive system (p < 0.05). These findings highlight the influence of substrate type, composite architecture, and cement chemistry on interfacial performance in indirect polymer-based restorations.
Long-Term endocrine outcomes with special emphasis on the gonadal impact of acute lymphoblastic leukemia treatment in females
(Springer Nature Link, 2026) Karakaş, Hasan; Tarçın, Gürkan; Bayramoğlu, Elvan; Turan, Hande; Ocak, Süheyla; Turan, Volkan; Evliyaoğlu, Olcay; Tiraje, Tiraje; Apak, Hilmi; Ercan, Oya
This study aims to explore the long-term endocrine and gonadal effects of chemotherapy and radiotherapy in female acute lymphoblastic leukemia (ALL) patients. A cohort study included girls diagnosed with ALL and treated between 2000 and 2020. Patients with at least 2 years elapsed since treatment completion were included. Endocrinological evalua tions included anthropometric measures and pubertal status, as well as fasting insulin, glucose, lipid levels, and hormone assessments for adrenal, and thyroid functions. Reproductive functions were evaluated based on gonadotropin, estradiol, and anti-Müllerian hormone (AMH) levels. A total of 51 female patients were included. At the time of study participa tion, the mean age was 14.7 years, and the mean time since treatment completion was 9.4 years. At least one endocrine disorder was present in 39.2% of participants, with dyslipidemia, insulin resistance, and obesity being the most common. Low AMH levels (<1.1 ng/dL) were found in 41.6%, particularly in those who underwent bone marrow transplantation. A significant positive correlation was found between the time elapsed since treatment and AMH levels (p<0.001, r=0.612), while age at diagnosis, risk group (standard, intermediate or high risk), and cranial radiotherapy showed no significant associations. A substantial proportion of ALL survivors developed endocrine complications, with ovarian reserve compro mised in over 40% of cases. Notably, this is the first cohort study to demonstrate a significant positive correlation between AMH levels and the time elapsed since treatment, suggesting a potential for gonadal recovery except in those exposed to intensive chemotherapy or transplantation.
Hemimyelomeningocele: A systematic review and meta‑analysis of the literature
(Springer Nature Link, 2026) Adıyaman, Ali Ekrem; Karakaş, Furkan; Hamzaoğlu, Can; Saban, Şevval; Kılınç, Tunahan; Acar, Burak; Nabili, Tabriz; Ekşi, Murat Şakir
Hemimyelomeningocele (HMM) is a rare split cord malformation where only one hemicord forms a myelomeningocele-like sac, and the opposite hemicord undergoes normal neurulation. We aimed to compile all published HMM cases to concisely summarize embryology, presentation, imaging, associated anomalies, management, and outcomes of the disorder. Following PRISMA 2020, we searched PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (1968–Feb 2025) for studies with confirmed human HMM, extracting clinical, radiological, surgical, and follow-up data. Of 688 records screened, 25 articles met inclusion criteria, encompassing 67 patients. Most publications were single-patient case reports. Presentation occurred predominantly in newborns or early infancy. The dysraphic sac was lumbosacral in most cases, and type I split cord malformation with a bony spur outnumbered type II. Hemivertebrae and congenital scoliosis were the common vertebrae anomalies. Nearly all patients underwent surgery combining sac excision, detethering, and bony spur removal. Postopera tive neurological outcomes were favorable: the majority improved, and the other ones remained stable; no surgery-related mortality was reported. HMM can be recognized as a distinct clinic radiological entity within the split-cord spectrum. Early, ideally prenatal diagnosis, timely microsurgical repair, and coordinated multidisciplinary care yield favorable functional outcomes in most patients. This first systematic review compiles the available evidence and provides a practical basis for future diagnostic and treatment decisions.
Rare but critical: Indomethacin-responsive headache with long-lasting autonomic symptoms
(Galenos Publishing House, 2026) Talibov, Tural; İnci, Meltem; Ekizoğlu, Esme; Baykan, Betül
Hemicrania with long-lasting autonomic symptoms (LASH), first described in by Rozen1 , is an extremely rare headache disorder thought to be part of the trigeminal autonomic cephalalgia (TAC) spectrum. However, it is not included in the current International Classification of Headache Disorders, 3rd Edition (ICHD-3).2 Notably, patients with LASH typically respond well to indomethacin.
Redox-responsive and mucoadhesive nanoparticles: An overlooked synergy in modern drug delivery
(Elsevier, 2026) Küçükertuğrul Çelik, Sibel; Şentürk, Sema; Bal, Kevser; Kaplan, Özlem; Gök, Mehmet Koray
The continuous advancement of therapeutic technologies has intensified the pursuit of drug delivery systems that respond intelligently to physiological and pathological stimuli, thereby enabling precise, localized, and sustained therapeutic outcomes. Among redox-based approaches, systems responsive to intracellular glutathione (GSH) have attracted particular attention due to their ability to trigger disulfide bond cleavage and controlled release within diseased tissues. Mucoadhesive systems, on the other hand, prolong residence time on mucosal surfaces through non-covalent interactions and covalent bond formation, thereby facilitating increased absorption and decreased clearance. Despite their individual successes, the integration of these two mechanisms remains underexplored. This review critically examines the coupling of redox sensitivity and mucoadhesion, highlighting how disulfide-based bonds can simultaneously function as both redox-cleavable and mucoadhesive moieties.
A randomized controlled trial of internet-based cognitive behavioral therapy (iCBT) and EMDR-flash technique (iEMDR-FT) for improving mental health in breast cancer patients
(Springer Nature Link, 2025) Savaş, Esra; Gündoğmuş, İbrahim; Kınık, Çiğdem; Kubilay, Derin; Kavakçı, Önder; Yaşar, Alişan Burak
This study aims to compare the effectiveness of internet-based Cognitive Behavioral Therapy (iCBT) and internet-based Eye Movement Desensitization and Reprocessing (EMDR) Flash Technique (iEMDR-FT) in reducing fear of cancer recur rence, traumatic stress, anxiety, depression, and increasing the quality of life among patients diagnosed with breast cancer. A randomized controlled trial was conducted with a sample of patients, equally divided into two treatment groups. The iCBT program was administered over 7 weeks, while the iEMDR-FT was delivered in three sessions in three days. The participants were given a sociodemographic data form, Posttraumatic Stress Disorder Control List DSM-5 (PCL-5), Fear of Cancer Recurrence Scale, Depression-Anxiety-Stress 21 scale (DASS-21), and World Health Organization Quality of Life Scale Short Form. Participants were assessed before, immediately after, and three months post-intervention. The mean age of the participants was 43.79 (7.45) years. In comparing the two groups, a statistical difference was found only in the age variable (p=0.025). As a result, there was no significant difference between the two groups when sociodemographic and cancer-related ratings were compared (p>0.05). It was determined that the change in iEMDR-FT scores in all scales was not statistically significantly different compared to the iCBT group (p>0.05). Initial analysis indicates that both iCBT and iEMDR-FT resulted in notable decreases in traumatic stress, fear of cancer recurrence, anxiety, and depression among breast cancer patients. However, this therapeutic improvement is similar in both applications. This result supports the argu ment that two methods with similar effectiveness can be used as alternatives to each other in treatment.
ThermoMicrowave-sonication improves the stability and digestive bioaccessibility of phenolic compounds in parsley juice
(Elsevier, 2026) Yıkmış, Seydi; Tokatlı Demirok, Nazan; Duman Altan, Aylin; Paçal, İshak; Türkol, Melikenur; Tokatlı, Nazlı; Paçal, Nurettin; Abdi, Gholamreza; Aadil, Rana Muhammad
These are indications of the effects of ThermoMicrowave Sonication (TMS) on the bioactive compounds of parsley (Petroselinum crispum) juice and their bioaccessibility during in vitro digestion. Total phenolic content (TPC), iron-reducing antioxidant power (FRAP), chlorophyll, and ascorbic acid levels were measured in TMS treated and pasteurized samples. TMS minimized the loss of heat-sensitive proteins and significantly increased the phenolic content and antioxidant structure (p < 0.05). By following simulated oral, gastric, and intestinal digestion, TPC, chlorophyll, and FRAP levels were better in TMS samples than in controls or pasteurized samples. The highest recoverable levels were observed in the intestinal phase, highlighting the role of TMS in supporting functional quality after digestion. Prediction models using linear regression and LASSO showed strong accuracy (R2 > 0.99) for antioxidant capacity. Overall, TMS offers a promising, environmentally friendly, and industrially applicable tool for preserving and ensuring bioaccessibility of bioactive images in parsley juice and valuable information for functional electrical development. Chemical compounds: Gallic acid (PubChem CID:370); flovone (PubChem CID: 10680); vanillic acid (PubChem CID: 8468); rutin (PubChem CID: 5280805); naringin (PubChem CID: 442428); p- coumaric acid (PubChem CID: 637542); o- coumaric acid (PubChem CID: 637540); quercetin (PubChem CD: 5280459); alizarin (PubChem CD: 6293).
Novel 1-benzyl-2-indolinone indole hybrids as tyrosine kinase inhibitors: Design, synthesis, and biological activity evaluation
(Elsevier, 2026) Cihan Üstündağ, Gökçe; Cinek, Tuğçe; Sancar, Serap; Yıldırım, Merve; Genç Akar, Öyküm; Özen Eroğlu, Güneş; Erol Bozkurt, Ayşe; Öztay, Füsun; Soylu Eter, Özge; Bolkent, Şehnaz; Kuruca, Serap; Karalı, Nilgün
In the present study, new 1-benzyl-2-indolinone indole hybrids (4a-s) were synthesized and their cytotoxic ef fects were determined against human breast (MCF-7 and MDA-MB 231), lung (A549), kidney (CAKI-1 and A498), colon (HT-29 and HCT-116), and pancreas (MIA PaCa-2) cancer cells by MTT assay. Some of the tested com pounds showed significantly better inhibitory effects and safety profiles than sunitinib malate against A498 and MIA PaCa-2 cells. Compound 4s showed a selective and significant cytotoxic effect on MIA PaCa-2 cells (IC50 = 0.15 μM; SI > 666.7). Compound 4b displayed significant cytotoxic effects on both A498 (IC50 = 0.87 μM; SI > 58.3) and MIA PaCa-2 (IC50 = 0.13 μM; SI = 390.0) cells. Compound 4b in A498 cells and compounds 4a-c, 4h, and 4s in MIA PaCa-2 cells significantly decreased general tyrosine kinase activity and induced apoptosis, accompanied by reduced ERK signalings. The inhibitory activities of compounds 4a–c, 4h, and 4s against SRC, PDGFR-β, and c-MET kinases were assessed in MIA PaCa-2 cells. Compounds 4a, 4b, 4h, and 4s inhibited PDGFR β, with 4h and 4s additionally targeting c-MET, while 4a, 4b, and 4h also demonstrated SRC inhibition. In this study, lead compounds 4b and 4s were identified as selective cytotoxic agents against human pancreatic car cinoma cells through induction of apoptosis and inhibition of SRC/PDGFR-β/c-MET signaling. Notably, com pounds 4b and 4s demonstrated a significantly better safety profile than sunitinib malate against noncancerous cells, underscoring their broader therapeutic potential. To understand their potential binding modes, molecular modeling studies were performed at the ATP-binding domains of SRC, PDGFR, and c-MET kinases.
Nio nanoflower based sorbent extraction for a novel HPLC–UV method for the determination of solifenacin in human plasma and its application to a prototype pharmacokinetic study
(Springer Nature Link, 2025) Ceylan, Burhan; Önal, Cem; Kurnaz Yetim, Nurdan; Hasanoğlu Özkan, Elvan; Önal, Armağan
Solifenacin is an active pharmaceutical product used in overactive therapy. The main goal of this work was to develop a high-performance liquid chromatographic (HPLC) method with ultraviolet detection for measuring the amount of quanti fied solifenacin in human plasma samples that is rapid, straightforward, and accurate. Prior to chromatographic analysis, a nanomaterial-based sorbent extraction technique utilizing NiO nanoflowers was employed for plasma sample preparation. In this method, NiO nanoflowers were employed, and the adsorption process underwent optimization. Chromatographic separation was carried out using a reversed-phase C18 analytical column (5 µm×4.6 mm×150 mm) with a mobile phase composed of water (0.2% triethylamine) and acetonitrile (30:70 v/v), and the pH was adjusted to 3.5 with ortho-phosphoric acid. The flow rate was set at 1.0 mL/min, and the investigation was performed using UV at 220 nm. The retention time of solifenacin is 3.10±0.01 min. The linear behaviour of the proposed approach was examined in the 0.01–30 ng/mL range (r 2=0.9995). The proposed method is in alignment with the criteria established by the European Medical Agency (EMA) about the accuracy, precision, repeatability, specificity, robustness and detection and quantification. Limit of detection and limit of quantification are determined to be 0.003 and 0.01 ng/mL, whereas relative standard deviation was determined to be less than 2.75% for intra-run and inter-run measurements. The plasma concentration–time profile and pharmacokinetic parameters such as AUC0–t , AUC0–∞, Cmax, tmax, and t1/2, were calculated according to the assays. The proposed method is feasible to investigate the bioequivalence, bioavailability, and routine analysis of the drug in plasma.
Enhancing home-based exercise therapy with telerehabilitation in mild adolescent idiopathic scoliosis: A randomized controlled trial
(MDPI Publishing, 2025) Takinacı, Zuhal Didem; Çelik, Meltem; Yıldız, Şeyda; Talmaç, Mehmet Ali; Dut, Raziye
Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that affects postural alignment, function, and quality of life. Telere habilitation has emerged as a promising approach to enhance accessibility and conti nuity of exercise-based treatment in AIS. This study aimed to compare the effects of telerehabilitation-supported home exercise programs with standard home exercises on posture, pain, body image, and quality of life in adolescents with mild AIS. Materials and Methods: Forty adolescents aged 10–18 years with mild AIS (Cobb angle 10–25◦ , Risser 0–3) were randomly assigned to two groups: study (n = 20) and control (n = 20). Both groups performed an 8-week home-based exercise program. The study group addition ally received weekly online supervision by a physiotherapist. Outcomes included pain severity (VAS), posture (New York Posture Assessment Scale), body image (Walter Reed Visual Assessment Scale), and quality of life (SRS-22 questionnaire). Statistical analyses were performed using non-parametric tests, with a significance level of p < 0.05. Results: Twenty-nine participants completed the study (15 in the study group, 14 in the control group). Significant improvements were observed in the study group in SRS-22 total, pain, and function subscores, as well as posture scores (p < 0.05). In the control group, only the satisfaction subscore improved significantly (p < 0.05). No significant changes were detected in body image (WRVAS) in either group. Between-group comparisons showed greater overall clinical gains in the study group despite similar exercise adherence rates. Conclusions: Supervised telerehabilitation enhances the effectiveness of home-based exer cise programs in adolescents with mild AIS by improving postural alignment, reducing pain, and increasing functional capacity and quality of life. Telerehabilitation represents an accessible and efficient complementary strategy for managing AIS when in-person supervision is limited.
Axillary mass following BCG vaccination: A rare case diagnosed as lipofibromatosis
(Turkiye Klinikleri Yayınevi, 2025) Özdil Yılmaz, İlkiz Özge
We present a case of a 7-month-old male infant who de veloped a progressive, painless left axillary mass 2 months after Bacil lus Calmette-Guérin (BCG) vaccination. Parents reported that the swelling has increased since the 4th month. Initial ultrasound revealed a 16×26×33 mm hyperechoic subcutaneous lesion with a central cystic area and minimal vascularity, suggesting a complicated lipoma. Due to continuous growth, the mass was surgically excised. Histopathological examination confirmed lipofibromatosis, a rare benign fibro-fatty tumor of infancy. Although axillary lymphadenitis is a common BCG com plication, persistent or atypical lesions should prompt further investi gation to rule out neoplasms. This case emphasizes the importance of considering rare soft tissue tumors like lipofibromatosis in the differ ential diagnosis of post-vaccination axillary masses.
Flaxseed-based green electrolyte enabling high electrochemical stability for advanced zinc ion batteries
(Wiley, 2026) Arıkan, Yiğit Berke; Kömürcüoğlu, Gökçe; Adhami, Sadaf; Yaman Uzunoğlu, Gülşah; Yüksel, Recep
This study presents a green and sustainable electrolyte derived from flaxseeds (FS) aimed at enhancing the electrochemical stability of zinc-ion batteries (ZIBs), thereby reducing the occurrence of free water molecules and alleviating the hydrogen evolution reaction (HER) that contributes to the development of zinc (Zn) dendrites. The abundant hydroxyl groups present in polysaccharides and phenolic compounds within the flaxseeds coordinate with Zn2+, modifying the solvation sheath and reducing HER activity. Zn//Zn symmetric cells utilizing the FS-based electrolyte exhibited remarkably stable cycling for 3000 h at a current density of 1.0 mA cm−2 (1.0 mAh cm−2) and 2500 h at 2.0 mA cm−2 (2.0 mAh cm−2). Zn//V2O5 full cells delivered a discharge capacity of 233.8 mAh g−1 at 0.2 A g−1 and excellent rate capability across a wide current density range of 0.2–10 A g−1 . The ex situ SEM and XRD results confirmed uniform Zn deposition along the (002) plane without dendrite formation. This work demonstrates a biomass-derived, low-cost electrolyte formulation strategy that effectively stabilizes Zn interfaces, providing a green and efficient pathway for next-generation zinc-ion batteries.
Sahin transvaginal extracorporeal myomectomy as a novel minimally‑invasive technique for the management of uterine myomas: A retrospective cohort analysis
(Medycyna Praktyczna, 2025) Şahin, Turan; Şahin, Eda A.; Şahin, Hanifi
Introduction: Vaginal myomectomy (VM) is a minimally-invasive surgery to remove uterine fibroids; however, limited exposure, difficulties in suturing, and challenges in achieving hemostasis restrict its wider adoption. To address these limitations, the Sahin transvaginal extracorporeal (STVEC) technique was developed, allowing for complete uterine exteriorization for extracorporeal reconstruction. Aim: We aimed to evaluate the safety, feasibility, and perioperative outcomes of the STVEC technique in women undergoing surgery for symptomatic uterine myomas. Materials and methods: This retrospective cohort included 200 consecutive patients who underwent VM using the STVEC technique between February 2021 and October 2024. Demographic characteristics, myoma features according to the International Federation of Gynecology and Obstetrics (FIGO) classification, operative variables, postoperative outcomes, and complications were analyzed. The complications were graded using the Clavien–Dindo system. Conversion to laparotomy was performed when safe continuation of the STVEC approach was not feasible. Results: Mean (SD) age of the study cohort was 39.1 (6.5) years and mean (SD) body mass index was 27.5 (5.8) kg/m². Mean (SD) myoma count was 1.8 (1.4; range: 1–5) and mean (SD) diameter was 6.7 (2.4; range, 5–10) cm. Intramural myomas (FIGO type 2–5) were the most common (55%). Conversion to laparotomy occurred in 8 patients (4%) due to adenomyotic uteri, adhesions, prior vaginal surgery, or altered cervical anatomy. Median (interquartile range [IQR]) hemoglobin decrease was 1.7 g/dl, median (IQR) estimated blood loss was 180 ml, and mean (SD) operative time was 71.9 (19.5) minutes. Blood transfusion was required in 18 patients (9%). Early complications occurred in 7 participants (3.5%), and all were minor. Conclusions: The STVEC technique appears safe and feasible, offering good bleeding control, low complication rates, and rapid recovery. Further multicenter studies are needed to confirm our findings.
Radiographic medial posterior tibial slope ≥16° predicts multiple revisions after anterior cruciate ligament reconstruction
(Wiley, 2026) Kayaalp, Mahmut Enes; Inoue, Jumpei; Konstantinou, Efstathios; Kahraman, Hamit Çağlayan; Erden, Tunay; Musahl, Volker
Purpose: An increased posterior tibial slope (PTS) has been implicated as a risk factor for anterior cruciate ligament (ACL) graft failure. This matched case–control study aimed to compare radiographic and magnetic reso nance imaging (MRI)‐based PTS measurements between patients under going multiple revision anterior cruciate ligament reconstruction (ACLR) and those with successful primary ACLR and to identify thresholds predictive of high revision risk. Methods: In this matched case–control study, 156 patients were analysed: 78 patients undergoing multiple revision ACLR and 78 patients with suc cessful primary ACLR. Medial PTS was measured on radiographs, while medial, lateral and PTS difference (PTS asymmetry) were measured on MRI. Group differences were assessed using independent t tests and χ2 tests. Receiver operating characteristic (ROC) analysis identified optimal thresholds, and logistic regression quantified odds ratios (ORs) for multiple revisions per 1° increase in radiographic medial PTS, adjusting for body mass index (BMI), sex, side, height and weight. Results: Radiographic medial PTS was significantly higher in the multiple‐ revision group (12.5 ± 3.5° vs. 11.2 ± 3.0°, p = 0.016). ROC analysis identi fied an optimal medial PTS cutoff of 13° (area under the curve = 0.58, sensitivity = 0.49, specificity = 0.65), but only a PTS ≥ 16° was significantly associated with increased multiple revision risk (OR = 3.10, 95% confidence interval [CI]: 1.14–8.40; p = 0.037; specificity = 0.91; positive predictive value [PPV] = 0.70). MRI‐based medial and lateral PTSs, as well as PTS asymmetry, did not differ significantly between groups. Univariate logistic regression demonstrated a 10% increase in odds per 1° increase in radio graphic PTS (OR = 1.10, 95% CI: 1.00–1.22, p = 0.049), remaining signifi cant after adjustment for BMI, sex, side, height and weight (adjusted OR = 1.11, 95% CI: 1.01–1.23, p = 0.034). Radiographic medial PTS cor related moderately with MRI‐based medial PTS (r = 0.49, p < 0.001), but not with lateral PTS (p: n.s.). Conclusion: Radiographic medial PTS showed the strongest differentiation between successful primary ACLR and multiple‐revision ACLR. A PTS ≥ 16° identifies patients at significantly higher risk of multiple revisions, whereas MRI‐based medial PTS, lateral PTS and PTS asymmetry provide no addi tional discriminatory value. Radiographic medial PTS appears practical for preoperative risk stratification, whereas MRI‐based measures do not show similar utility. Level of Evidence: Level III.
Comparative gastric microbiota profiles in non-ulcer dyspepsia and peptic ulcer patients
(Springer Nature Link, 2025) Polat Sarı, Silva; Soylu, Aliye; Peker, Kıvanç Derya; Adaş, Gökhan; Akgül, Özer; Sapmaz, Burcu; Öner, Yaşar Ali; Yüksel Mayda, Pelin; Çalışkan, Reyhan
Background Recent evidence suggests that the human stomach hosts a diverse microbiota beyond Helicobacter pylori, and that shifts in microbial composition may influence gastric health. In particular, oral-origin bacteria may dominate the gastric niche in the absence of H. pylori, yet their specific roles in different gastroduodenal disorders remain unclear. This study aimed to profile and compare the gastric microbiota composition in Turkish patients with non-ulcer dyspepsia (NUD) and peptic ulcer disease (PUD), in order to better understand microbial profiles potentially associated with gastroduodenal disease. Methods Ninety-eight patients underwent endoscopic evaluation and were divided into two groups according to the presence or absence of ulcers. Group 1 (n=52) included individuals with NUD, while Group 2 (n=46) comprised patients with PUD. Gastric biopsy samples from both groups were analyzed for the relative abundance of H. pylori using quantitative real-time PCR (qPCR), and next-generation sequencing was employed for a comprehensive analysis of the gastric microbiota. Results In total, H. pylori DNA was detected in 71.4% (70/98) of the samples, with a significantly higher prevalence in PUD patients (82.6%) compared to NUD patients (61.5%) (p=0.02). Distinct microbial profiles were observed based on H. pylori status. In NUD patients, Alloprevotella showed significantly higher relative abundance in H. pylori negative samples (p<0.05). Among PUD patients, the absence of H. pylori was associated with increased levels of Porphyromonas and Neisseria compared to NUD patients without H. pylori (p<0.05). These genera, typically associated with the oral cavity, appeared to expand opportunistically when H. pylori was absent. Conclusions The absence of H. pylori in gastric disorders was linked to a notable shift in microbiota composition, with increased representation of oral-origin bacteria such as Alloprevotella, Porphyromonas, and Neisseria. These findings, observed in a Turkish patient cohort, may reflect a potentially compensatory or opportunistic microbial shift in H. pylori-negative gastroduodenal disease. As exploratory findings, this study represents the first analysis from Türkiye comparing gastric microbiota profiles in NUD and PUD patients and provides novel regional insight into gastric microbial ecology.
Under-resourced EFL students’ perceptions about the causes and consequences of unfair AI-mediated education
(Taylor & Francis, 2025) Wanga, Yongliang; Lib, Hang; Savaş, Hasan
The use of Artificial Intelligence (AI) technologies in education imposes various social influences on different stakeholders across diverse contexts. However, the voices of under-resourced second language (L2) learners have remained unheard regarding the fairness of AI adoption. To fill this gap, the present qualitative study examined 33 Chinese English as a foreign language (EFL) students’ perceived causes and consequences of unfair AI-mediated education. Thematic analysis of online interviews indicated four causes and four consequences for unfair AI adoption in under-resourced communities. The causes included biased algorithms and databases, digital divide and unequal access, lack of AI-related training and support, and sociocultural mismatch and inappropriateness of AI tools in poor settings. Regarding consequences, it was found that unfair AI adoption may lead to educational inequality, diminished motivation, academic deskilling, and technophobia among under-resourced EFL students. The findings are discussed, and implications for raising AI literacy and readiness of L2 educators and policymakers are enumerated.

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