Medical Sciences Commons^™

Mutant Kras In Brain Endothelial Cells Promotes Vascular Inflammation And Impairs Vascular Integrity In Brain Arteriovenous Malformation, Jung-Eun Park, Bridger H Freeman, Hyejin Park, Sehee Kim, Adrian E Bafor, Ohnmar Myint, Song Gao, Zhen Xu, Jakob Körbelin, Jaroslaw Aronowski, Peng Roc Chen, Eunhee Kim, Eun S Park

Faculty, Staff and Student Publications

Somatic KRAS (KRASG12V) mutation in endothelial cells (EC) induces brain arteriovenous malformation (bAVM) that could lead to vascular instability and ultimately bleeding. However, the causes of bAVM instability remain unclear. Here we demonstrate that KRASG12V expressing cultured ECs (KRAS-G12V-EC) have increased expression of pro-inflammatory mediators and reduced expression of blood-brain-barrier (BBB) junction constituents. The conditioned medium from KRAS-G12V-EC can activate BV2-microglia (BV2-MG) and conditioned media from this primed BV2-MG can compromise the expression of EC-junction constituents when added to wild-type ECs. In an in vitro BBB model, KRAS-G12V-EC form a dysfunctional EC barrier that is further disrupted, leading to lower …

Sting-Induced Blood-Brain Barrier Opening Combined With Radiotherapy Potentiates Antitumor Response In A High-Grade Glioma Model, Shashwat Tripathi, Hinda Najem, Lisa Hurley, Ruochen Du, Crismita Dmello, Heba Ali, Kathleen Mccortney, Karl J Habashy, Peng Zhang, Craig M Horbinski, Lara Leoni, Ryan J Avery, Rimas V Lukas, Timothy L Sita, David R Raleigh, Sean Sachdev, Roger Stupp, Maciej S Lesniak, David M Ashley, Daniele Procissi, Michael A Curran, Irina Balyasnikova, Amy B Heimberger

Faculty, Staff and Student Publications

Radiation therapy (RT) is the standard of care for glioblastoma but is not curative. Triggering the cGAS/stimulator of interferon genes (STING) pathway with potent agonists, such as 8803, exerts activity across high-grade glioma preclinical models. To determine if the combination of 8803 with RT warrants consideration in the up-front treatment setting and to clarify the underlying mechanisms of therapeutic activity, C57BL/6J mice harboring intracerebral CT-2A or QPP8v gliomas were treated with RT, intratumoral 8803, or both. The treatment with the combination resulted in 80% long-term survival in the CT-2A model but not in the radiation-resistant QPP8v model. This therapeutic effect …

Investigating Tau Pathology In The Retina And Anterior Segment Structures Of The Eye In A 3-Nitropropionic Acid–Induced Tauopathy Mouse Model, Mohamed Sayed Ahmed Abdel-Kader Qasem

Theses and Dissertations

Background and Objectives: Alzheimer's disease, the most prevalent neurodegenerative disorder in older adults, is characterized by accumulation of hyperphosphorylated tau and amyloid-beta (Aβ) plaques in the central nervous system. Given the retina's shared embryological origin with the brain, its direct neural connectivity via the optic nerve, and similarities in vasculature and age-related degeneration patterns, retinal pathology may serve as an early, non-invasive biomarker for Alzheimer's disease. This study employed 3-nitropropionic acid (3NP) as a pathway-specific tauopathy model driven by mitochondrial dysfunction. The study particularly aimed to investigate whether retinal and corneal tau pathology reflects underlying tau-related neurodegeneration triggered by …

Epigenetic Age Acceleration In Young Adults With Congenital Heart Disease, Parag N Jain, Beryl C Zhuang, Joanne Whitehead, Julia L Macisaac, Kristy Dever, Mallory Gahm, Peter Ermis, Thomas W Mcdade, Michael S Kobor, Paul A Checchia

Faculty, Staff and Students Publications

Background: Adults with congenital heart disease (ACHD) having undergone palliative surgery experience chronic stress due to altered physiology and repeated surgical interventions since infancy.

Objectives: To investigate whether ACHD, who had experienced chronic physiological stress from their underlying condition and early-life cardiac surgeries, was associated with epigenetic age acceleration (EAA) and other DNA methylation (DNAm)-based biomarkers, and to assess the potential contribution of derived inflammatory markers to EAA.

Methods: A case-control study comparing ACHD patients and healthy adults. Whole blood DNAm profile was used to estimate DNAm-based blood cell type proportions, multiple epigenetic age measures, and interleukin-6 (IL-6) and C-reactive …

Optimizing Electrode Placement And Information Capacity For Local Field Potentials In Cortex, Jace A Willis, Christopher E Wright, Ruoqian Zhu, Yilan Ruan, Joshua Stallings, Amada M Abrego, Takfarinas Medani, Promit Moitra, Arjun Ramakrishnan, Charles E Schroeder, Anand A Joshi, Nitin Tandon, Richard M Leahy, John C Mosher, John P Seymour

Faculty, Staff and Student Publications

Recent neurosurgery advancements include improved stereotactic targeting and increased density and specificity of electrophysiological evaluation. This study introduces a subject-specific, in silico modeling tool for optimizing electrode placement and maximizing coverage with a variety of devices. The basis for optimization is the Shannon-Hartley information capacity of field potentials derived from dipolar sources. The approach integrates subject-specific MRI data with finite element modeling (FEM) used to simulate the sensitivity of subdural and intracortical devices. Sensitivity maps, or lead fields, from these models enable the comparison of different electrode placements, contact sizes, contact configurations, and substrate properties, which are often overlooked factors. …

Clinical, Genetic, And Familial Features Of Pot1 Tumor Predisposition Syndrome, Courtney D Dinardo, Jennifer Croden, Hiam M Abdel-Salam, Tapan Kadia, Matteo Molica, Alexandre Bazinet, Prithviraj Bose, Abhishek Maiti, Fadi Haddad, Jan Burger, Hagop Kantarjian, William Wierda, Nitin Jain, Alessandra Ferrajoli

Faculty, Staff and Student Publications

Background: Protection of telomere 1 (POT1) tumor predisposition syndrome (POT1-TPD) is a hereditary leukemia syndrome that is identified in ∼5% of patients with chronic lymphocytic leukemia (CLL) and is characterized by a predisposition to other cancers, including gliomas, melanomas, and angiosarcomas. This study reports clinical and genetic characteristics of a large cohort of individuals with POT1-TPD.

Materials and methods: Individuals with pathogenic/likely pathogenic germline POT1 variants referred to the Hereditary Hematologic Malignancy Clinic at The University of Texas MD Anderson Cancer Center were included. Individuals with variants of uncertain significance were included if found to have telomeres >90th percentile of …

Control Arm Overperformance In Phase 3 Oncology Clinical Trials, Ansel P Nalin, Pavlos Msaouel, Adam J Grippin, Ramez Kouzy, Joseph Abi Jaoude, Timothy A Lin, Avital M Miller, Noah S Meimoun, Ethan B Ludmir, Alexander D Sherry

Faculty, Staff and Student Publications

Background: In randomized clinical trials (RCTs), anticipating control arm outcomes is important for power calculations and enrollment goals. Unexpected overperformance of the control arm can underpower RCTs. The objective of this study was to estimate the prevalence of control arm overperformance in phase 3 oncology RCTs.

Methods: The authors conducted a meta-epidemiological study of two-arm, superiority-design, phase 3 oncology RCTs. They reviewed articles/publications and protocols for power calculations, justification, and outcomes. Control arm performance was measured as the ratio of observed control arm outcomes relative to pretrial estimates, and overperformance was defined as a 10% improvement.

Results: In total, 385 …

Antidepressant Use In Older Age Bipolar Disorder (Oabd): Results From The Gage-Bd International Consortium, Christina Rigas, Paola Lavin, P J Chen, Susana G Torres-Platas, Chien-Lin Su, Lisa T Eyler, Andrew T Olagunju, Antonio L Teixeira, Annemieke Dols, Martin Alda, Osvaldo P Almeida, Kursat Altinbas, Vicent Balanzá-Martínez, Izabela G Barbosa, Hilary P Blumberg, Farren B S Briggs, Cynthia V Calkin, Brent P Forester, Orestes V Forlenza, Tomas Hajek, Barthomeus C M Haarman, Esther Jimenez, Beny Lafer, Benoit Mulsant, Stephen O Oluwaniyi, Regan Patrick, Joaquim Radua, Kaylee Sarna, Sigfried Schouws, Christian Simhandl, Jair C Soares, Ashley N Sutherland, Shang-Ying Tsai, Eduard Vieta, Luca M Villa, Nicole Fiorelli, Paula Villela Nunes, Joy M Yala, Martha Sajatovic, Soham Rej, All Gage-Bd Investigators

Faculty, Staff and Student Publications

Background: Antidepressants are still commonly prescribed in bipolar disorders, despite ongoing controversy of the potential risk of inducing hypomania/mania. There is limited knowledge about the characteristics of antidepressant use in older age bipolar disorder (OABD; age ≥50) in the current literature.

Aim: To describe antidepressant use, sociodemographic and clinical correlates of a global sample of OABD individuals.

Methods: The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) consortium provided cross-sectional international data on OABD individuals (n = 746) and younger-age bipolar disorder (YABD, age < 50 years; n = 692) regarding antidepressant use. Multivariate logistic regression was employed to assess the association between AD use with demographic and clinical variables.

Results: Of 1252 participants, 33.1 % of OABD individuals and 38.1 % of YABD individuals …

Charting A New Era To Modernize United States Infant Formula Regulation, Douglas G Burrin, Amy B Hair, Sharon M Donovan

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Primary Membranoproliferative Glomerulonephritis: Natural History, Pathogenesis, And Treatment, Edward J. Filippone, John L. Farber

Division of Nephrology Faculty Papers

Primary membranoproliferative glomerulonephritis (MPGN) is an ultrarare disease characterized by immunofluorescence microscopy as either immune-complex mediated (IC-MPGN) or C3 glomerulopathy (C3), the latter subdivided by electron microscopy to C3 glomerulonephritis (C3GN) and dense deposit disease (DDD). Both IC-MPGN and C3G typically have obvious C3 staining differentiating them from other causes of MPGN histology. Secondary causes must be excluded, including infections, autoimmune disease, and neoplasia. Clinical presentations are variable, including urinary sediment abnormalities, nephrotic syndrome, or a rapidly progressive course. The prognosis is unfavorable with about 50% reaching kidney failure by 10 years. Recurrence following transplantation is frequent, and allograft survival …

First Detection Of Xylazine In Texas Wastewater And Its Association With Fentanyl Use, Katherine M Joseph, Xuan Qin, Dhvani Parikh, Feng Li, John Balliew, Kristina D Mena, Fuqing Wu

Faculty, Staff and Students Publications

Xylazine is a veterinary sedative increasingly found in the U.S. illicit drug supply and is a growing public health concern due to its association with overdose events. To investigate its spatial distribution and relationship with fentanyl use, we analyzed 124 wastewater samples from four treatment plants serving the City of El Paso, Texas, over 13 months (June 2023 to July 2024) using liquid chromatography tandem mass spectrometry. Xylazine detections varied across sewersheds, with detection rates of 29.0%, 12.9%, 9.7%, and 0% and peak loads of 110±40 μg/day/1000 people. Norfentanyl (a primary fentanyl metabolite) was detected in all samples (100%), reaching …

Powering Up Clinical Scholarship In Dental Journal Club On February 13, 2026, Evelyn Wang

HSLIC Faculty and Staff Instructional Resources

Instruction session for a dental journal club introducing common biases through critical appraisal of three article types: a systematic review (observer bias and blinding), a retrospective study (selection bias, information bias, and confounding), and a prospective pre‑post study (lack of a control group and residual confounding) in clinical research.

Erythropoiesis-Inosine Metabolic Axis Failure Underlying Retinal Neurodegeneration In Glaucoma: Novel Diagnoses And Therapies, Yuyu Chou, Wuping Liu, Yanxiu Li, Changhan Chen, Cheng Luo, Shiping Shen, Piaoyu Dai, Lemeng Feng, Wenhao Xiao, Yiyan Wang, Juncheng Wang, Linlin Wan, Zhiyu Yang, Tingting Xie, Yujin Zhang, Rodney E Kellems, Weitao Song, Xiaobo Xia, Yang Xia

Faculty, Staff and Student Publications

Glaucoma, long considered an ocular-limited, age-dependent and hypoxia-driven neurodegeneration, is here reframed as a systemic erythroid-inosine axis failure that originates in the bone marrow yet culminates in retinal ganglion cell (RGC) death. By mining UK Biobank datasets (n = 127,028) and validating our findings in an independent clinical cohort (n = 178), we reveal that glaucoma is preceded by dyserythropoiesis and a compensatory, AMPK-driven metabolic rewiring of mature erythrocytes that hypercatabolizes inosine to enhance oxygen unloading. This adaptation collapses when accelerated erythrocyte inosine metabolism drains systemic pools, starving high-energy demand hematopoietic progenitors, driving retinal microenvironment hypoxia and accelerating RGC loss. …

Heavy Metals As Endocrine Disruptors, Arzu Or Koca

Turkish Journal of Medical Sciences

Heavy metals are widely recognized as endocrine-disrupting agents primarily originating from anthropogenic sources and persisting in soil, air, and water. This review aims to present an updated and comprehensive synthesis of current evidence regarding the endocrine-disrupting effects of heavy metals, with particular emphasis on their roles in the pathogenesis of common endocrine and metabolic disorders. The toxicological impact of these elements depends on the level and duration of exposure, their chemical form, and the biological susceptibility of target tissues. Chronic exposure, even at low doses, has been implicated in the development of diabetes mellitus, obesity, autoimmune thyroiditis, thyroid cancer, pubertal …

Evaluation Of The Relationship Between Pan-Immune Inflammation Value And Prognostic Factors In Germ-Cell Testicular Cancer: Analysis Of Stage, Lymph Node Involvement, And Metastasis, Erdi̇nç Di̇nçer, Orkunt Özkaptan, Cengi̇z Çanakçi, Osman Murat İpek, Alper Coşkun, Ahmet Hali̇l Sevi̇nç

Turkish Journal of Medical Sciences

Background/aim: To evaluate the association between the preoperative pan-immune inflammation value (PIV) and prognostic factors, including stage, lymph node involvement, and metastasis, in patients who underwent radical orchiectomy for germ cell testicular tumors.

Materials and methods: Data from 178 patients who underwent radical orchiectomy for testicular tumors between January 2014 and January 2024 were retrospectively reviewed. Preoperative serum tumor markers, hematologic parameters, and histopathological findings were recorded. Tumor staging was determined based on radiological imaging and serum tumor markers. The PIV was calculated using the formula: (monocyte count × neutrophil count × platelet count) / lymphocyte count. Optimal cut-off values …

Preference Of Mechanical Ventilation Modes Among Intensivists In Türkiye: A National Wide, Point Prevalence Study, Süleyman Yildirim, Nurhayat Kilinç Özgün, Özcan Alpdoğan, Hüseyi̇n Uçar, İmren Taşkiran, Adnan Ata, Özhan Özcan, Kivanç Öncü, Saba Mukaddes Acarbay, Temel Güner, Pinar Özgün, Zerri̇n Özçeli̇k, Ayşegül Çinaroğlu, Gi̇zem Kurada, L. Serap Avlaği, Onur Gökçe, Özkul Yilmaz Çolak, Fatma Ülger, Melda İşevi̇, Özgür Kiliç, Rahi̇me Aydin Kayali, Meti̇n Yarici, Berkay Küçük, Fatma Yildirim, Kami̇l Gönderen, Bi̇şar Ergün, Kutlay Aydin, Kamuran Uluç, Sevda Onuk, Mi̇ne Altinkaya Çavuş, Yelda Balik, Ahmet Sari, Hayri̇ye Cankar Dal, Şeri̇fe Gökbulut Bektaş, Sema Turan, Ferhan Demi̇rer Aydemi̇r, Türkay Akbaş, Hamza Gülteki̇n, Kani̇ye Aydin, Seli̇n Eyüpoğlu, Havva Kocayi̇ği̇t, Gürhan Taşkin, Kazim Rollas, Mensure Çakirgöz, Cenk Kirakli

Turkish Journal of Medical Sciences

Background/aim: Invasive mechanical ventilation (IMV) is a fundamental intervention for patients with respiratory failure in intensive care units (ICUs). This nationwide, multicenter point-prevalence study aimed to describe current mechanical ventilation mode preferences (conventional, adaptive, and biphasic) in Turkish ICUs and to report associated clinical outcomes descriptively, without assessing causal relationships.

Materials and methods: A nationwide, multicenter point-prevalence study was conducted on 17 April 2024 and included adult patients (≥18 years) who had been receiving IMV for more than 24 h. Data on patient demographics, ventilation mode distribution, ventilatory parameters, and descriptive clinical outcomes on day 28 (weaning status, tracheostomy, and …

Validity Of The Turkish Version Of The Oral Frailty Index-8 And Its Relationship With Frailty, Malnutrition, And Sarcopenia In Older Adults, Süleyman Emre Koçyi̇ği̇t, Bi̇lal Kati̇poğlu, Yilmaz Önal, Kübra Bahar Baykan, İlknur Şeker Kaya, Fatma Sena Dost, Özge Dokuzlar, Esra Ateş Bulut, Ali̇ Ekrem Aydin, Derya Kaya, Ahmet Turan Işik

Turkish Journal of Medical Sciences

Background/aim: The Oral Frailty Index-8 (OFI-8) is a reliable screening for oral frailty. In our study, while presenting the Turkish reliability and validity study of the OFI-8, we also aimed to establish a cut-off value for oral frailty in Turkish population.

Materials and methods: Patients who presented to the outpatient clinic between January 2024 and January 2025 were evaluated. The test’s internal consistency and test–retest reliability were assessed. Divergent validity was evaluated using frailty scores, muscle strength, and nutritional status. A receiver operating characteristic (ROC) curve was generated to determine the optimal cut-off values for identifying frailty, malnutrition, and probable …

The Burden Of Knee Pain In The Operating Room: Are Surgical Personnel At Greater Risk?, Ömer Faruk Naldöven, Yavuz Karaman, Başak Si̇nem Sezgi̇n, Şahan Güven, Enejd Vei̇zi̇, İzzet Bi̇ngöl

Turkish Journal of Medical Sciences

Background/aim: This study aimed to determine the prevalence of knee pain among healthcare workers in surgical units and to explore whether the use of knee panels during surgical hand scrubbing is associated with persistent knee pain.

Materials and methods: This single-center cross-sectional study was conducted between October 2023 and March 2025. A total of 400 physicians and nurses working in surgical and nonsurgical departments were included. Participants completed a structured and modified Nordic Musculoskeletal Questionnaire, as well as knee pain assessment tools, including a visual analog scale (VAS) and the Kujala score for anterior knee pain-related symptoms. Occupational exposure among …

Etiologies Of Chronic Cough In Children: A Two-Year Experience From A Tertiary Pediatric Pulmonology Center, Yasi̇n Maruf Ergen, Nagehan Emi̇rali̇oğlu, Ebru Yalçin, Deni̇z Doğru, Uğur Özçeli̇k, Nural Ki̇per

Turkish Journal of Medical Sciences

Background/aim: Chronic cough is a common yet diagnostically challenging symptom in pediatric pulmonology. This study aimed to evaluate the etiologies of chronic cough in children referred to a tertiary center and to analyze the relationship between specific cough characteristics and final diagnoses.

Materials and methods: This retrospective study evaluated patients presenting with chronic cough (duration >4 weeks) at a tertiary pediatric pulmonology center. Demographic data, cough characteristics (wet vs. dry), and diagnostic findings were analyzed.

Results: A total of 62 patients were included. A specific etiology was identified in 95.1% of the patients. Asthma and reactive airway disease were the …

Efficacy Of External Oblique Intercostal Plane Block In Postoperative Analgesia Following Laparoscopic Radical Nephrectomy, Gi̇zem Avci, Yusuf Özgüner, Damla Usalan, Cem Koray Çataroğlu, Habi̇p Yilmaz, Savaş Altinsoy, Jüli̇de Ergi̇l

Turkish Journal of Medical Sciences

Background/aim: The external oblique intercostal plane block (EOIB) is a regional anesthesia technique that may be utilized for the management of postoperative pain following laparoscopic radical nephrectomy. This study aims to evaluate the efficacy of EOIB after laparoscopic radical nephrectomy by comparing 24 h tramadol consumption between groups.

Materials and methods: Initially, 66 patients were enrolled in the study, and after exclusions, 60 were analyzed and divided into two groups: the EOIB group and the control group. Postoperative tramadol consumption, pain scores at rest and during movement, and dermatomal coverage of the block were recorded.

Results: The EOIB group (181.33 …

Cover And Content

Turkish Journal of Medical Sciences

No abstract provided.

Mandibular Extension As A Trigger Of The Proprioceptive Trigeminocardiac Reflex, Massimo Conti, Giovanna Traina, Daniele Tonlorenzi

Turkish Journal of Medical Sciences

The trigeminocardiac reflex (TCR) is a physiological response characterized by a reduction in heart rate and arterial blood pressure following stimulation of any branch of the fifth cranial nerve. This review presents a novel mechanism of TCR induction through proprioceptive activation of the trigeminal nerve via mandibular extension (ME). Accordingly, it is referred to as the “proprioceptive trigeminocardiac reflex” (pTCR). An overview of the existing literature on ME-evoked TCR in humans and animals is presented, with particular emphasis on evidence of cerebral microcirculatory alterations. The magnitude of cardiovascular responses appears to depend on the duration of ME, with repeated applications …

Canakinumab Treatment In Patients With Colchicine-Resistant Familial Mediterranean Fever: A Multicenter Observational Study, Emrah Koç, Mete Pekdi̇ker, Mete Kara

Turkish Journal of Medical Sciences

Background/aim: Anti-interleukin-1 agents have known beneficial effects in the treatment of colchicine-resistant familial Mediterranean fever (cr-FMF); however, studies to date have tended to have small sample sizes and to be based on pooled data. The present study investigates the efficacy of Canakinumab (CAN) in a homogeneous cohort of cr-FMF cases.

Materials and methods: The study included patients who underwent treatment in three tertiary rheumatology departments, whose electronic medical records were reviewed retrospectively. The inclusion criteria were presence of colchicine resistant disease activity or persistent proteinuria secondary to AA-amyloidosis, and treatment with CAN for at least 6 months. Clinical and laboratory …

Sarcopenia In Atrial Fibrillation: A Prospective Study, Mehmet Aki̇f Topçuoğlu, Ezgi̇ Yilmaz, Di̇nç Doğan Öge, Ali̇ Nai̇m Ceren, Ridvan Muhammed Adin, Ethem Murat Arsava

Turkish Journal of Medical Sciences

Background/aim: The link between atrial fibrillation (AF) and lean body mass is unclear. This study presents the effects of AF on sarcopenia indices, including ultrasonographic muscle architecture.

Materials and methods: In this study conducted in neurology units, 72 subjects with AF (mean age: 71 ± 11years, 49% female) were compared with 538 without AF (mean age:66±12years; 53% female) in terms of sarcopenia indices [anthropometry; Short Physical Performance Battery (SPPB); hand grip strength (HGS); bioimpedance analysis (BIA) indices; skeletal muscle mass index (SMMI) normalized to weight, height and body mass index (BMI); and phase angle (PhA)]; muscle ultrasonography [thickness, cross-section area …

Retrospective Evaluation Of Treatment Outcomes Of Gasserian Ganglion Radiofrequency Thermocoagulation In Trigeminal Neuralgia Patients With Multiple Sclerosis, Emel Başar, Nevci̇han Şahutoğlu Bal, Erkan Yavuz Akçaboy

Turkish Journal of Medical Sciences

Background/aim: Trigeminal neuralgia (TN) secondary to multiple sclerosis (MS) is a rare but debilitating condition. Aside from two case reports, there are limited data on the use of Gasserian ganglion radiofrequency interventions in this patient population. This study aims to evaluate the outcomes of combined radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) treatment targeting the Gasserian ganglion in patients with MS-related TN.

Materials and methods: We retrospectively analyzed 12 patients with MS-associated TN who underwent combined Gasserian ganglion RFT and PRF treatment between 1 January 2021 and 1 January 2025. Patients were followed for six months. Visual analog scale (VAS) …

Feeding Time Index And Mortality In Intensive Care Stroke Patients: An Exploratory Cohort Study, Nevzat Mehmet Mutlu, Duygu Karaköse Çalişkan, Tülay Tunçer Peker, Özlem Balkiz Soyal, Ayşe Pinar Ti̇ti̇z, Behi̇ye Deni̇z Kosovali, Göksal Günerhan, Büşra Tezcan

Turkish Journal of Medical Sciences

Background/aim: Stroke is a major cause of morbidity and mortality worldwide, with especially high mortality in intensive care unit (ICU) patients, whose prognosis is worsened by dysphagia, malnutrition, and aspiration risk. The Feeding Time Index (FTI)—defined as the ratio of feeding days to total ICU length of stay—quantified nutritional exposure. This exploratory cohort study aimed to evaluate the association between FTI and mortality in ICU patients with acute ischemic stroke (IS) or hemorrhagic stroke (HS) and to examine the potential role of FTI, together with the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and oral feeding status, …

Inflammation As A Harbinger Of Death: A Retrospective Cohort Study Of Preoperative Biomarker Risk Stratification In Orthopedic Trauma, Serkan Aydin, Burhan Kurtuluş

Turkish Journal of Medical Sciences

Background/aim: This study aimed to evaluate the prognostic significance of preoperative inflammatory markers including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), C-reactive protein (CRP), and procalcitonin in predicting 30-day and 1-year mortality in patients undergoing femur fracture surgery.

Materials and methods: This retrospective, multicenter cohort study included patients who underwent surgical treatment for femur fractures between January 2018 and December 2024. Patients were stratified into survivor and nonsurvivor groups based on 30-day and 1-year outcomes. Demographic characteristics, comorbidities, laboratory parameters, and inflammatory indices were recorded and analyzed. Linear and multivariate logistic regression analyses were performed to identify …

Individualized Respiratory Exercise Device Originated In Türkiye: Design, Prototype, And First Results, Çi̇ğdem Emi̇rza Ci̇lbi̇r, Özge Ertan Harputlu, Hi̇kmet Uçgun, Büşra Ülker Ekşi̇, Sarper Kaya, Esen Kiyan, Gökşen Kuran Aslan, Buket Akinci

Turkish Journal of Medical Sciences

Background/aim: Respiratory muscle training (RMT) and breathing exercises are crucial components in cardiopulmonary rehabilitation. RMT includes inspiratory muscle training (IMT) and expiratory muscle training (EMT); however, existing RMT devices typically support only one of these. Incentive spirometers, which also provide visual feedback for breathing exercises, are frequently used. Achieving an RMT program requires multiple devices, which increases both the cost and complexity of the training regimen. This study aimed to design, calibrate, and test a novel individualized respiratory exercise device that integrates both IMT and EMT functions into a single unit, thereby offering a cost-effective, user-friendly alternative for comprehensive cardiopulmonary …

Preoperative Inflammatory And Molecular Marker Changes In 125 Supratentorial Glioma Cases, Semi̇h Can Çeti̇ntaş, Burak Tahmazoğlu, Tufan Agah Kartum, Rahşan Kemerdere, Taner Tanriverdi̇

Turkish Journal of Medical Sciences

Background/aim: To determine whether there is a possible link between selected preoperative systemic inflammatory markers and molecular pathological indices.Material and methods: For this retrospective study, 125 patients served as subjects. Preoperative systemic inflammatory markers, namely neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR), and postoperative pathological indices, namely mitosis, Ki-67 labeling index (LI), isocitrate dehydrogenase-1 (IDH1) mutation, and 1p/19q codeletion, were obtained from the electronic database.

Results: Results showed that NLR positively correlated with PLR (p = 0.00001), mitotic activity (p = 0.001), and Ki-67 LI (p = 0.00001). On the other …

Proximal Fragment Perfusion Following Hip Arthroplasty With Subtrochanteric Shortening Osteotomy In Patients With Severe Developmental Dysplasia Of The Hip, Vedat Bi̇çi̇ci̇, Hi̇lmi̇ Alkan, Enejd Vei̇zi̇, Şahan Güven, Serkan Ünlü, Eli̇f Özdemi̇r, Tural Talibli, Ahmet Firat

Turkish Journal of Medical Sciences

Background/aim: The changes in proximal femoral blood flow occurring after reconstructive surgery for Crowe types III– IV developmental dysplasia of the hip (DDH) and their impact on healing remain unclear. In the present study, blood flow around the osteotomy site is evaluated with particular focus on the proximal segment in patients who underwent subtrochanteric shortening osteotomy and hip arthroplasty. To this end, single-photon emission computed tomography (SPECT/CT) scans were conducted to evaluate changes in proximal blood flow and to assess the impact on union rates and potential complications.

Materials and methods: A retrospective analysis was conducted of 26 hips from …