Çımen, Ferda Keskın; Çimen, Orhan

Objective: This study aimed to evaluate whether the coronavirus disease-2019 (COVID-19) pandemic caused changes in the severity of gastritis, as assessed by the Sydney criteria, through a retrospective comparison of patients in the pre- and post-pandemic periods. Methods: Pathology reports of 107 pre-pandemic patients until March 2019 and 96 post-pandemic patients until May 2023, who underwent upper gastrointestinal endoscopy for dyspeptic complaints and were diagnosed with gastritis were retrospectively analyzed. Gastritis severity was assessed according to the Sydney criteria. Percentages were calculated and compared. Results: The pre-pandemic group included 62 women and 45 men (mean age 58.6 years). The post-pandemic group included 50 women and 46 men (mean age 57.6 years). No significant demographic differences were observed. According to the Sydney criteria, no permanent effect of COVID-19 on gastritis severity was identified. Conclusion: Our study found no significant differences in gastritis severity between the periods before and after the COVID-19 pandemic. Larger prospective studies are required to further explore potential long-term effects.

Öz, Funda

Pulmonary ischemia-reperfusion (I/R) injury is recognized as a key factor in the development of primary graft dysfunction and remains a major cause of perioperative morbidity and mortality in both lung transplantation and thoracic surgical procedures. This type of injury encompasses several pathological mechanisms, including oxidative stress, inflammation, and fibrosis. Literature indicates that I/R injury begins with tissue hypoxia, reperfusion-induced oxidative stress is closely linked to disruption of the endothelial barrier, contributing to early edema formation and impaired pulmonary compliance. Followed by the excessive generation of reactive oxygen species, and further progresses through an amplified inflammatory response. These observations highlight the essential role of antioxidants in both preventing and managing I/R injury across various tissues and organs.

Levent, Akın; Durmaz, Önder

Objective: Multiparametric magnetic resonance imaging (mpMRI) has transformed prostate cancer (PCa) diagnosis by enabling lesion-targeted biopsies. The optimal biopsy approach—systematic biopsy (SB), MRI-ultrasound fusion targeted biopsy (TB), or their combination (CB)—remains debated, especially in patients with high-risk Prostate Imaging-Reporting and Data System (PI-RADS) 4-5 lesions. This study compared these strategies for detecting overall and csPCa. Methods: This retrospective study included 330 patients who underwent MRI-ultrasound fusion TB with 12-core SB between July 2022 and May 2025. Only lesions classified as PI-RADS v2.1 category 4 or 5 were analyzed. Detection rates of overall PCa and csPCa (Gleason score ≥ 7) were compared among SB, TB, and CB. Subgroup analyses were performed by PI-RADS category and lesion location (anterior, middle, posterior). Logistic regression identified independent predictors of csPCa. Results: A total of 429 lesions were evaluated. Overall, PCa detection rates were 62% for SB, 70% for TB, and 77% for CB (P < 0.001); the corresponding csPCa rates were 47%, 56%, and 63% (P < 0.001). TB detected csPCa more effectively than SB (56% vs. 47%, P < 0.01). PI-RADS 5 lesions had higher detection rates than PI-RADS 4 lesions across all methods. CB achieved the highest rates in all locations, especially in anterior and middle lesions. Age, positive digital rectal examination, prostate-specific antigen density, prior biopsy, and PI-RADS category 5 were independent predictors of csPCa. Conclusion: In PI-RADS 4–5 lesions, combined SB and TB provide the highest detection rate for csPCa. While TB improves selective detection, SB remains essential to avoid missing significant disease.

Babatürk, Andelib; Kaymaz, Esin; Seyfettin, Ayça; Eskalen, Zeynep; Büyükceran, Emre Utkan; Memis, Kemal Bugra; Gültekin, Serap

Objective: To evaluate the relationship between mammographic features of BI-RADS category 4 and 5 breast calcifications and their corresponding pathological diagnoses, and to determine whether specific morphological or distribution patterns are predictive of malignancy. Methods: This retrospective study included 54 patients who underwent biopsy for suspicious breast calcifications between August 2021 and March 2024. Among these patients, 30 underwent stereotactic vacuum-assisted biopsy, and 24 underwent wire-guided localization followed by excisional biopsy. The mammographic morphology and distribution patterns of the calcifications were assessed using the BI-RADS lexicon, and the corresponding histopathological diagnoses were recorded. The association between mammographic features and pathological outcomes was subsequently analyzed. Results: Fine pleomorphic calcifications were the most common morphology (40.7%). A grouped distribution was the predominant pattern (61.1%). Benign lesions were mostly categorized as BI-RADS 4A, B3 lesions as BI-RADS 4B, and DCIS cases as BI-RADS 4C (P = 0.03). The Grouped distribution was more frequent among benign and B3 lesions, whereas DCIS exhibited more frequent linear and segmental patterns (P = 0.01). Malignancy rates were highest for fine linear/branching and fine pleomorphic morphologies. Conclusion: A significant association exists between the mammographic characteristics of BI-RADS 4 and 5 calcifications and their pathological outcomes. In our study, fine pleomorphic morphology and linear or segmental distribution patterns consistently indicated a increased likelihood of malignancy, particularly ductal carcinoma in situ, whereas benign and B3 lesions were more commonly associated with grouped distribution patterns. These results highlight that detailed evaluation of calcification morphology and distribution on mammography can improve diagnostic confidence, aid in distinguishing higher-risk lesions, and contribute to more informed biopsy decision-making.

Kabalci, Halime; Gülmez, Ali Osman

Objective: The truncus pulmonalis, the main pulmonary artery (MPA), originates from the right ventricle at the level of the upper edge of the left third rib cartilage and carries blood to both lungs. After a short course, it branches into two arteries beneath the aortic arch: the right pulmonary artery (RPA) and the left pulmonary artery (LPA). The aorta, the main artery that carries blood to the body, originates from the left ventricle. It is divided into three sections: the ascending aorta (AA), the aortic arch, and the descending aorta. Methods: Between January and December 2023, the files of adult patients who were suspected of having pulmonary embolism and who underwent thoracic CT angiography (CTA) at the Erzincan Mengücek Gazi Training and Research Hospital Emergency Department were reviewed. The patients’ DICOM-format images were exported. These images were uploaded to the 3D-Slicer (version 5.10.0 for Windows) and the MPA, RPA, LPA, and AA diameters were measured in the axial plane. The MPA-to-AA diameter ratio was calculated for each patient and designated PA:A. Results: This study included 52 men and 50 women, for a total of 102 patients. The patients’ average age was 67. No significant difference in vessel diameters was observed between genders. AA, MPA, RPA, and LPA diameters were higher in the >67 age group than in the ≤67 age group. There was no significant difference in the PA:A ratio between age groups. A positive, moderate, and statistically significant correlation was found between age and the diameters of AA, MPA, RPA, and LPA. No significant correlation was found between age and the pulmonary artery-to-aorta (PA:A) ratio. A strong, positive, and statistically significant correlation was found between MPA diameter and the diameters of RPA and LPA. A positive, moderately significant correlation was found between MPA diameter and AA diameter. A strong, significant positive correlation was found between RPA diameter and LPA diameter. Conclusion: Aortic and pulmonary artery diameters have been evaluated using various methods in previous studies. To better understand the clinical importance of aortic and pulmonary artery diameters in cardiopulmonary diseases, it is necessary to know their normal reference values. The Framingham Heart Study reported an average MPA diameter of 25.1 mm and an average PA:A ratio of 0.77. In our study of the Turkish population, the mean AA, MPA, RPA, and LPA diameters were 34.1 mm, 25.9 mm, 21.1 mm, and 20.2 mm, respectively, and the PA:A ratio was 0.78. Further studies in larger populations are needed to establish reference values for aortic and pulmonary artery diameters in healthy individuals.

Ozdemir, Sevki; Sari, Haticetul Kubra

Objective: Evaluating the microvascular structure in rheumatological diseases provides important information for understanding the pathogenesis and clinical management of these diseases. Nail capillaroscopy is a reliable method that allows non-invasive examination of these changes. This study aimed to evaluate nail capillary findings in rheumatological diseases using digital dermoscopy and to compare capillary patterns in different disease groups. Methods: The study included 200 patients diagnosed with rheumatological diseases and 50 healthy volunteers. The nail bed capillaries of all participants were evaluated using a digital dermatoscope. Capillary examination assessed the presence of edema, tortuous, elongated, dilated, and brush-like capillaries, microhemorrhages, and avascular areas. Statistical analyses were performed using appropriate parametric and non-parametric tests, and a P value < 0.05 was considered statistically significant. Results: The frequency of capillary abnormalities was significantly higher in the patient group than in the control group. The most frequently observed findings were edema and tortuous, elongated capillaries. Capillary patterns differed by disease group, with more specific findings particularly prominent in patients with systemic sclerosis. Conclusion: Nail capillaroscopy is an effective, easily applicable, and non-invasive method for evaluating microvascular changes in rheumatological diseases. Capillary patterns observed in different disease groups can provide clinically valuable information for diagnosis and disease monitoring.

Bilgin, Yasin; Kantar, Yusuf; Tanrıverdi, Orhan; Sari, Fatih Mehmet; Çimen, Erdem Yakup; Yurttutan, Abdullah Emre

Objective: To evaluate the demographic and clinical characteristics, reasons for admission, triage distribution, consultation requests, and hospitalization rates of geriatric patients presenting to a tertiary emergency department, and to examine the associations between age groups and emergency department utilization patterns and outcomes. Materials and Methods: This retrospective and descriptive study was conducted among patients aged 65 years and older who presented to the emergency department of Mengücek Gazi Training and Research Hospital between July 1, 2024, and June 30, 2025. Data on demographic characteristics, triage categories, reasons for admission, consultation requests, hospitalization status, emergency department outcomes, and repeat visits were obtained from the hospital information management system. The data were analyzed using descriptive statistical methods. Results: A total of 18,269 geriatric patients were included in the study. The mean age was 74.0 ± 7.2 years, and 54.5% of the patients were female. The highest proportion of admissions was observed in the 65-74 age group. Hospitalization occurred in 11.4% of cases. As age increased, ambulance admissions, repeat emergency department visits, and hospitalization rates increased significantly (P < 0.05). The most common reasons for admission were musculoskeletal, respiratory, and cardiovascular diseases. Conclusion: This study demonstrates that geriatric patients presenting to the emergency department exhibit distinct clinical and utilization characteristics by age group. The findings indicate that patients in older age groups require more complex clinical evaluation and tailored care during management in the emergency department.

Uğurlu, Adem; Taşlı, Nurdan Gamze; Karakurt, Yucel; Somuncu, Ahmet Mehmet; Çiçek, İbrahim

Objective: To compare the syringe preparation time for ranibizumab prefilled syringe versus bevacizumab, ranibizumab, and aflibercept vials in routine retinal practice. Methods: The study was conducted retrospectively between July 2019 and February 2021 at the Ophthalmology Department of the Erzincan Binali Yıldırım University Faculty of Medicine, Türkiye. Syringe preparation times for 157 eyes were collected for the study. For each injection, one independent observer recorded the duration of each step required to prepare the syringe, starting with the removal of the ranibizumab prefilled syringe or bevacizumab, ranibizumab, and aflibercept vials from their respective packaging, and ending at the moment the dose was ready for injection. Injections were excluded if disruptions during the drug administration process were due to external factors or if other errors occurred in measuring preparation time. In addition to preparation time, formation of air bubbles during syringe preparation was qualitatively observed. Results: Forty-five eyes were treated with the ranibizumab prefilled syringe, while bevacizumab, ranibizumab, and aflibercept vials were used to treat 40, 36, and 36 eyes, respectively. The mean injection preparation time was 46.5±4.8 s for the syringe and 66.1±7.2 s, 64.2±5.1 s, and 74.7±8.5 s for the bevacizumab, ranibizumab, and aflibercept vials, respectively. Air bubble formation was more frequently observed in the vial groups, particularly in the aflibercept group, than in the prefilled syringe group. Conclusion: The ranibizumab-prefilled syringe required fewer preparation steps and had a lower incidence of bubble formation compared with other vials. Specifically, when preparing the aflibercept vial for injection, dose adjustment took longer than for the bevacizumab and ranibizumab vials, primarily due to air bubbles.

Gür, Volkan; Akyüz, Sümeyye; Yapici, Furkan; Gülhan, Barış; Doğan, İbrahim; Gökgöz, Mehmet Burak; Ozturk, Akin; Topaluğurlu, Nedim Batuhan; Dündar, Harun

Objective: Rapid identification of causative microorganisms is essential in suspected native septic arthritis and periprosthetic joint infection. This study evaluated the diagnostic performance of the BioFire® Joint Infection Panel and assessed its agreement with conventional culture and systemic inflammatory biomarkers. Methods: Hospital records from January 2025 to April 2026 were retrospectively reviewed. Of 115 screened patients with suspected joint infection, nine were excluded because BioFire® testing had not been performed and only culture results were available. The final analysis included 106 synovial fluid samples. All samples were tested using conventional culture and the BioFire® Joint Infection Panel during the same clinical episode. Demographic data, infection category, localization, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, and white blood cell count were recorded. Agreement was assessed using Cohen’s kappa, discordance using the McNemar test, and diagnostic performance using culture as the reference method. Results: Sixty-five samples (61.3%) were classified as suspected native septic arthritis and 41 (38.7%) as periprosthetic joint infection. BioFire® was positive in 22 samples (20.8%) and culture was positive in 32 (30.2%). Overall agreement was 86.8%, with substantial agreement according to Cohen’s kappa (0.656). Discordance was significant, predominantly due to culture-positive/BioFire®-negative samples (P = 0.013). BioFire® showed 62.5% sensitivity [95% confidence interval (CI): 43.7-78.9), 97.3% specificity (95% CI: 90.6-99.7), 90.9% positive predictive value, 85.7% negative predictive value, and 86.8% accuracy. C-reactive protein, procalcitonin, and white blood cell counts were significantly higher in patients with suspected native septic arthritis. Conclusion: The BioFire® Joint Infection Panel provides rapid and highly specific microbiological support in suspected joint infection. However, its moderate sensitivity and inability to detect off-panel organisms indicate that it should complement rather than replace conventional culture.

Bilgin, Aslı Özbek

Mitochondrial dysfunction plays a central role in the pathogenesis of various liver diseases, ranging from drug-induced liver damage to steatotic liver disease associated with metabolic dysfunction. This review synthesizes recent advances in pharmacological strategies targeting mitochondrial quality control mechanisms. The shift from non-specific antioxidants to mitochondria-targeted agents is highlighted, as are the emerging roles of cardiolipin stabilizers (SS-31), next-generation cyclophilin inhibitors (Rencofilstat, C105SR), and modulation of immunometabolic pathways such as cGAS-STING and NLRP3. The transition of these promising experimental agents to clinical applications is also presented.