Memis, Kemal Bugra; Kızılgöz, Volkan; Aydın, Sonay; Sunar, Mukadder; Gökgöz, Mehmet Burak; Durmaz, Önder; Gülmez, Ali Osman; Özkan, Berna Hatun; Kantarci, Mecit

BACKGROUND This study aimed to establish normative values for the femoral inclination angle (FIA) and medial proximal femoral angle (MPFA) using magnetic resonance imaging (MRI), which minimizes projectional and rotational errors, in a large cohort. Sex-based and side-to-side comparisons, as well as correlations with age, were also investigated for these proximal femoral angle measurements. MATERIAL AND METHODS After exclusion of patients with trauma, infection, prior surgery, advanced osteoarthritis, femoroacetabular impingement, avascular necrosis, coxa vara, coxa valga, and low-quality magnetic resonance images, 631 pairs of proximal femurs were retrospectively evaluated for FIA and MPFA measurements. All measurements were performed by consensus between 2 radiologists, then analyzed regarding sex and side differences and correlations with age. RESULTS The mean FIA was 128.53±4.62°, whereas the mean MPFA was 86.62±3.40°. No significant differences were observed between men and women (FIA: P=0.057, MPFA: P=0.050) or between right and left sides (FIA: P=0.178, MPFA: P=0.853). Age was not significantly correlated with either proximal femoral angle measurement. No significant association was found between age and FIA (right: P=0.554, left: P=0.321) or MPFA (right: P=0.954, left: P=0.935). CONCLUSIONS This large MRI-based study provides normative reference values for FIA and MPFA. Neither angle was significantly influenced by sex, side, or age, suggesting that these parameters remain relatively stable across adult populations. These findings may serve as useful reference values for assessment of proximal femoral morphology and preoperative orthopedic planning.

Kara, Ali Veysel; Ozturk, Ersin V.; Islamoglu, Mahmut Sami; Ozdemir, Ridvan V.; Hayme, Serhat V.

Background: Material/Methods: Results: Conclusions: Artificial intelligence (AI) is increasingly explored as a clinical decision-support tool in nephrology; however, its real-world applicability for dialysis decision-making in emergency and intensive care unit (ICU) settings remains insufficiently studied. Hemodialysis initiation and prescription are complex, time-sensitive, and dynamic processes that require expert clinical judgment. This retrospective observational study evaluated agreement between AI-generated (ChatGPT) and nephrologistmade dialysis decisions in emergency and ICU settings. Adult patients undergoing first-time dialysis were included. Agreement was assessed for dialysis initiation, modality selection, and key prescription parameters. To ensure clinical relevance, continuous prescription variables were categorized into predefined ranges. Agreement was quantified using Gwet’s AC1 coefficient and Cramér’s V statistic. Eighty-four patients were included. AI demonstrated 100% agreement with nephrologists regarding dialysis initiation. Overall agreement for dialysis modality selection was 92.9% (Cramér’s V=0.87, P<0.001). Agreement for core dialysis prescription parameters – including blood flow rate, dialysate sodium, potassium, and calcium concentrations – was high across modalities (all P<0.001). Lower agreement was observed for ultrafiltration-related parameters, particularly ultrafiltration duration, reflecting the individualized and dynamic nature of volume management during dialysis. AI-assisted decision support demonstrated high agreement with nephrologist decisions for initial dialysis initiation, modality selection, and core prescription parameters in emergency and ICU settings. Discrepancies were primarily confined to ultrafiltration-related decisions, underscoring the necessity of ongoing bedside clinical judgment. These findings support the role of AI as a decision-support tool rather than a replacement for clinician-led dialysis management.

Ergül, Emine Esra; Ayçiçek, Hilal Büşra; Hayme, Serhat; Ergül, Çetin; Özdemir, Elif Can; Kara, Ali Veysel

Background: Meuropathic pain and polyneuropathy can affect the quality of life in patients receiving dialysis. The aim of this study was to assess quality of life and to compare electromyography (EMG) findings between patients screened positive and negative for neuropathic pain. Material/Methods: This study was designed as an observational cross-sectional study in which 74 patients receiving hemodialysis were admitted. The Ferrans & Powers Quality of Life Index-Dialysis III Version, Neuropathic Pain Questionnaire (NPQ), and Brief Pain Inventory-Short Form were completed by all patients. Additionally, EMG was performed on all patients regardless of the presence of neuropathic symptoms. Results: According to the NPQ screening results, 51.4% of patients were identified as likely having neuropathic pain, whereas EMG findings revealed polyneuropathy in 89.2% (66 patients). Ferrans & Powers Quality of Life Index total and subgroup scores were compared between the NPQ-positive and NPQ-negative groups based on the screening results. Quality of life was found to be statistically significantly lower in the NPQ-positive group across all subgroups (P<0.001). No statistically significant differences were observed between NPQ-positive and NPQ-negative groups regarding any of the polyneuropathy types identified via EMG (P>0.05). Conclusions: This study explores the association between screening-positive neuropathic pain and quality of life. Given the high prevalence of polyneuropathy on EMG even among patients without symptoms suggestive of neuropathic pain, it can be valuable to assess dialysis patients during the asymptomatic period as well.

Karakurt, Yücel; Aktaş, Nurdagül; Somuncu, Ahmet Mehmet; Uğurlu, Adem; Çiçek, İbrahim

Background: The 6-item Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a method for evaluating disease activity in ankylosing spondylitis (AS). This study included 78 patients with active and inactive AS and aimed to evaluate anterior and posterior segment ocular changes. Material/Methods: Seventy-eight patients and 70 control subjects were enrolled in this study. All participants underwent a complete ophthalmic evaluation. The patients were subdivided into 2 groups according to their BASDAI scores: the active group (BASDAI34) (n: 38) and the inactive group (BASDAI<4) (n: 40). Results: Endothelial cell density (ECD) and hexagonality (HEX) decreased, while coefficient of variation (CV) and average cell size (AVG) increased significantly in AS patients compared with the control cases (P 0.001). However, there was no statistically significant difference between active and inactive groups related to these parameters. Central corneal thickness (CCT) and corneal volume were significantly lower in AS patients (P 0.001, P 0.04), without any statistically significant difference between active and inactive groups. Tear break-up time (TBUT) and Schirmer test results were lower and the findings of corneal fluorescein staining and ocular surface disease index scores (OSDI) were higher in AS patients compared with the control cases, without any significant differences between the active and inactive groups (P 0.001). Choroidal thickness was significantly higher in all 5 points investigated – subfoveal (P 0.018), 1000 Nasal (N) (P 0.003), 2000 N (P 0.001), 1000 Temporal (T) (P 0.007), and 2000 T (P 0.013) in AS patients compared with the control group. Conclusion: AS can cause anterior and posterior changes, even in the absence of uveitis. Therefore, more attention should be paid to ocular surgery and follow-up of ocular diseases in AS patients.

Taş, Hakan Gokalp; Taş, Mehmet Bilge Han; Yildiz, Eyyup; Aydin, Sonay

Background: This study used CT imaging analyzed with deep learning techniques to assess the diagnostic accuracy of lung metastasis detection in patients with breast cancer. The aim of the research was to create and verify a system for detecting malignant and metastatic lung lesions that uses YOLOv10 and transfer learning. Material/Methods: From January 2023 to 2024, CT scans of 16 patients with breast cancer who had confirmed lung metastases were gathered retrospectively from Erzincan Mengücek Gazi Training and Research Hospital. The YOLOv10 deep learning system was used to assess a labeled dataset of 1264 enhanced CT images. Results: A total of 1264 labeled images from 16 patients were included. With an accuracy of 96.4%, sensitivity of 94.1%, specificity of 97.1%, and precision of 90.3%, the ResNet-50 model performed best. The robustness of the model was shown by the remarkable area under the curve (AUC), which came in at 0.96. After dataset tuning, the GoogLeNet model’s accuracy was 97.3%. These results highlight our approach’s improved diagnostic capabilities over current approaches. Conclusions: This study shows how YOLOv10 and transfer learning can be used to improve the diagnostic precision of pulmonary metastases in patients with breast cancer. The model’s effectiveness is demonstrated by the excellent performance metrics attained, opening the door for its application in clinical situations. The suggested approach supports prompt and efficient treatment decisions by lowering radiologists; workload and improving the early diagnosis of metastatic lesions.

Duman, Hakan; Ipek, Emrah; Durak, Hüseyin; Şahin, Müjgan Ayşenur; Ergül, Elif; Yilmaz, Ahmet Seyda; Bakirci, Eftal Murat

Background: This study assessed the association between a novel inflammatory marker, uric acid (UA)-to-albumin ratio (UAR), and preprocedural intracoronary artery thrombus (ICAT) in ST elevation myocardial infarction (STEMI). Material/Methods: A total of 171 STEMI patients treated by primary percutaneous coronary intervention between February and December 2023 were evaluated prospectively in this cross-sectional study. The patients were stratified into 2 groups as low (grades 1 to 3) and high-(ICAT) groups (grades 4 and 5). To determine the independent predictors of lower and higher ICAT, multivariate regression analysis was performed. Results: C-reactive protein (CRP), UA, and UAR were significantly higher in the high ICAT group (1.11 (0.3-2.8) vs 0.80 (0.10-2.8), P=0.037; 5.4 (3.5-7.2) vs 4.9 (3.4-5.6), P<0.001; 1.78 (0.82-3) vs 1.48 (0.77-2.57), P<0.001, respectively). However, albumin levels were similar between groups (3.1 (2.1-4.4) vs 3.3 (2.1-4.4), P=0.243). Higher UAR (OR: 3.95% CI: 1.23-12.7, P=0.021), lower left ventricular ejection fraction (LVEF) (OR=0.802; 95% CI 0.7537-0.872; P<0.001), longer pain-wire crossing time (OR=1; 95% CI: 1-1.02; P<0.001), and diabetes mellitus (OR=0.181; 95% CI 0.46-0.7; P<0.001) were independent predictors of ICAT. Conclusions: UAR, a marker of inflammation, is an independent predictor of ICAT in patients with STEMI.

Karakurt, Yucel; Ucak, Turgay; Taslı, Gamze; Agcayazı, Burcu; İcel, Erel; Yılmaz, Hayati

Background: The aim of this study was to compare the alterations in intraocular pressure (IOP) values during the early postoperative period after intravitreal ranibizumab, aflibercept, or dexamethasone implant injections. Material/Methods: In this retrospective study, a total of 188 patients were grouped into 3 groups: the ranibizumab group, the aflibercept group, and the dexamethasone group. Ocular axial length (AXL) and anterior chamber depth (ACD) were measured in the pre-injection period. IOP was measured just before the injection at 1 minute,10 minutes, 1 hour, 1 day, and 1 month after injection. Results: There was a transient peak in the ranibizumab group and the aflibercept group at 1 minute that started to decrease at 10 minutes and IOP values returned to preoperative values at approximately 1 hour. Similar alterations were also determined for the dexamethasone group with a lesser increase noted. In the correlation analysis, only alterations in IOP levels at 1 minute were negatively correlated with preoperative AXL values. There was not any correlation between preoperative AXL or ACD values and IOP alterations at any other time points. Conclusions: There was a sudden, transient increase in IOP values after intravitreal ranibizumab or aflibercept injections; which return to normal values in a short time without requirement of any medical treatments. This transient peak was determined to be negatively correlated with the preoperative AXL.

Biçer, Şenol; Gürsul, Cebrail; Sayar, İlyas; Akman, Orhan; Çakarlı, Seçil; Aydın, Merve

Background: Cryptorchidism is the most common developmental abnormality of the male reproductive system. If left untreated, it results with infertility and testicular cancer. According to current evidence, surgery is the mainstay of treatment, and hormonal therapy approaches are still under investigation. For the protection of testicular functions, antioxidants have emerged as novel options. This study aimed to evaluate the protective properties of ozone, a strong antioxidant, on testicular tissue. Material/Methods: Thirty-five male Wistar-albino rats, 1-month-old, were used for the study. Groups were formed as follows: 1) control, 2) sham surgery (cryptorchidism), 3) cryptorchidism plus ozone, 4) cryptorchidism plus human chorionic gonadotropin (hCG), and 5) ozone plus hCG. Surgical procedures were performed on all rats except the control group. All rats except the control group were used to create an experimental cryptorchidism model, and left testes of animals were surgically placed into the abdomen. After 1 month of surgery, groups 3, 4, and 5 were given corresponding treatments intraperitoneally for 4 weeks. At the end of the study period, testicular atrophy index (TAI) and testicular sperm motility (TSM) were assessed and biochemical, histopathological, and immunohistochemical tests were performed. Results: TAI and TSM were higher in the ozone, hCG, and ozone plus hCG groups than in the sham surgery group (p=0.001). TSM in the ozone group was significantly higher than in the hCG and ozone plus hCG groups. In biochemical analyses, the parameters of oxidative stress (GPx1, MDA, CAT, GSH, SOD) indicated increased oxidative activity in cryptorchidism, which was resolved by applying ozone and hCG (p=0.001). In addition, apoptotic markers, Caspase 3 and bcl-2 were significantly decreased by applying ozone and hCG (p=0.001). Conclusions: Results of this study suggest that ozone therapy, either as a single agent or in combination with hCG, is a promising approach for protection of testicular functions.

Onk, Didem; Özçelik, Fatih; Onk, Oruç Alper; Günay, Murat; Ayazoğlu, Tülin Akarsu; Ünver, Ethem

Background: The present study sought to assess the renal and liver protective effect of N-acetylcysteine through NH3 and urea metabolism in patients with chronic obstructive pulmonary disease who were scheduled for coronary artery bypass grafting surgery. Material/Methods: Patients with chronic obstructive pulmonary disease (COPD) who were scheduled for coronary artery bypass grafting were divided into 2 groups so as to receive (Group 1, n=35) or not receive (Group 2, n=35) 900 mg/day of n-acetylcysteine for 7 days before the operation starting from their admission to the service by a pulmon-ologist with the purpose of treating COPD until the day of surgery. Both groups were subjected to the same anesthesia protocol. Blood samples were taken preoperatively, within the first 15th minute following cessation of the cardiopulmonary bypass, at postoperative 24th hour, and at postoperative 48th hour. Blood tests included ammonia (NH3), lactate, blood urea nitrogen, creatinine, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), troponin I (Tn I), and creatinine kinase-muscle brain (CKMB). Results: There was a significant difference between the groups’ NH3 and lactate levels after cardiopulmonary bypass, postoperative 24th hour, and postoperative 48th hour (respectively, NH3: 39.0±8.8 vs. 55.4±19.6 and 40.1±8.4 vs. 53.2±20.2 mcg/dl, lactate: 1.7±0.9 vs. 2.1±1.2 and 1.2±0.5 vs. 1.8±1.4 mmol/L; p<0.01). Creatinine and BUN levels in Group 2 were found to be significantly higher at the postoperative 48th hour compared to the levels of Group 1 (P<0.05). Conclusions: N-acetylcysteine pretreatment appears to improve renal and hepatic functions through regulation of ammonia and nitrogen metabolism and reduction of lactate in patients with chronic obstructive pulmonary disease who undergo coronary artery bypass grafting surgery. We found that N-acetylcysteine improved kidney and/or liver functions.

Sayar, İlyas; Gökçe, Aysun; Demirtas, Levent; Eken, Hüseyin; Çimen, Ferda Keskin; Çimen, Orhan

Background: There is a need to identify new prognostic factors that may be used in addition to the known risk factors in gastrointestinal adenocarcinomas. In this study, we aimed to determine the expression of Necl 4 and RNase 5 biomarkers in gastric and colon adenocarcinomas, as well as the prognostic efficacy of these biomarkers in gastric and colon adenocarcinomas. Material/Methods: Ninety-two cases resected due to stomach and colon adenocarcinoma were included in the study. The expression of Necl 4 and RNase 5 biomarkers was evaluated by immunohistochemical staining of the stomach and colon normal mucosa and adenocarcinoma areas. Results: In colon adenocarcinomas, there was a significant association between Necl 4 and lymphovascular invasion, vascular invasion, and perineural invasion (p<0.05). There was a significant association between RNase 5 and histological differentiation in colon adenocarcinomas (p<0.05). There was no association between RNase 5 and Necl 4 in gastric or colon adenocarcinomas. Conclusions: Necl 4 may have prognostic value in colon adenocarcinomas, but it is difficult to ascertain in gastric adenocarcinomas.