Objective: Interest in holistic medicine approaches is increasing, and the role of these methods in medical education and their impact on student attitudes are becoming increasingly important. The aim of this study was to evaluate the effects of holistic medicine education given at the preclinical level on medical students' awareness, attitudes, and perspectives, and to examine their views regarding curriculum integration. Materials and Methods: This qualitative focus group study was conducted with 20 voluntary first-and second-year medical students who had completed the Holistic Healing Methods Special Study Module. Data were collected through two focus group interviews and analyzed using content analysis. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: The analysis yielded five main themes and ten subthemes. The most prominent finding was the development of a patient-centered perspective, reported by 55% of participants (n=11). Students reported reduced initial prejudices toward holistic medicine and increased confidence in scientifically supported practices (40%, n=8). Participants expressed differing views regarding curriculum integration; 45% (n=9) supported the inclusion of holistic medicine education in the medical curriculum, whereas others favored its continuation as an elective component of the curriculum. Conclusion: Holistic medicine education may contribute to increased awareness and more patient-centered, biopsychosocial perspectives among preclinical medical students. Overall, this study may inform future curriculum development and the design of educational initiatives related to holistic medicine, while also enriching ongoing discussions regarding its place within undergraduate medical curricula.
ObjectiveThe objective of this study was to assess the impact of various surface finishing protocols on the surface roughness of resin-based hybrid CAD-CAM materialsMaterials and MethodsThree distinct resin-based CAD-CAM blocks [Bright Crios (BC), Cerasmart (CS), and Vita Enamic (VE) (n = 10)] were used to create 90 specimens (1.5 ± 0.05 mm). Three distinct surface treatments were applied to each group: glazing (G), mechanical polishing (MP), and control (C). One specimen was chosen at random from each group for surface topography analysis, and it was scanned using scanning electron microscopy (SEM) at ×1000 magnification. A profilometer was used to measure the surface roughness values. The normality of the data distribution was evaluated using the Shapiro-Wilk test. The primary and combined impacts of surface treatment and material type on roughness values were assessed using the generalized linear model approach. The Bonferroni test was used for multiple comparisons.Results Surface roughness values showed statistically significant differences among the materials (p < 0.001). The highest mean roughness was observed in the control group of the VE material, while the lowest was found in its glaze group. In the VE and CS groups, the glazing procedure resulted in lower roughness values, with no statistically significant difference between them. In the BC groups, both mechanical polishing and glazing led to low roughness values, with no statistically significant difference between these two procedures.Conclusion The application of glaze material may be an effective technique for achieving smoother surfaces in resin-based hybrid CAD-CAM materials.
Objective: To evaluate the intraoperative effects of controlled hypotensive anesthesia in patients undergoing bimaxillary orthognathic surgery and to compare surgical field quality and operative time between hypotensive and normotensive anesthetic protocols. Materials and Methods: This retrospective comparative cohort study included consecutive adult patients who underwent bimaxillary orthognathic surgery at single center between January 2015 and October 2020. Patients with ASA physical status I-II and complete anesthetic and surgical records were included. According to anesthesia records, patients were allocated to a normotensive group or a controlled hypotensive anesthesia group. All operations were performed by the same department using standardized surgical protocols. The primary outcomes were operative time and intraoperative surgical field quality assessed using the Fromme ordinal scale. Intergroup comparisons were performed using the Mann-Whitney U test and chi-square test, with p < 0.05 considered statistically significant. Results: A total of 28 patients were included: 15 in the normotensive group and 13 in the hypotensive group. Baseline demographic characteristics, including age, sex, body weight, and ASA distribution, were comparable between groups. Mean operative time was significantly shorter in the hypotensive group than in the normotensive group (342.3 +/- 55.8 vs 383.0 +/- 54.3 minutes; p = 0.03). Surgical field quality was also significantly better in the hypotensive group, with a lower mean Fromme score (1.23 +/- 0.92 vs 3.06 +/- 1.03; p <= 0.001). Conclusion: Controlled hypotensive anesthesia was associated with improved intraoperative surgical field quality and shorter operative time in bimaxillary orthognathic surgery. Larger prospective studies are needed for confirmation.
Objective: To evaluate the relationship between radiographic measurements from panoramic images and root resorption of neighboring teeth in patients with a unilateral impacted maxillary canine, with cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: 83 Caucasian patients with unilateral maxillary impacted canines were included. Panoramic parameters, including canine angulation relative to the midline, occlusal plane, and lateral incisor, sector classification, perpendicular distance to the occlusal plane (d distance), and primary canine retention, were measured. Root resorption was assessed using CBCT. Associations were analyzed using univariate tests, binary logistic regression, and receiver operating characteristic (ROC) curve analysis, with significance set at p<0.05. Results: Root resorption was detected in 42.2% of cases, primarily affecting the lateral incisors (82.9%). Univariate analysis revealed that a greater d distance (p=0.004) and patient age (p=0.027) were associated with root resorption, whereas gender, primary canine retention, and angular measurements showed no associations (p>0.05). The d distance was confirmed as a significant independent predictor in the logistic regression model (OR=1.175, p=0.034), with ROC analysis establishing an optimal d distance cut-off of 11.2 mm (AUC=0.685), whereas patient age did not retain significance (p>0.05). Although the regression model indicated a marginally lower risk for Sector III compared to Sector I, sector classification did not demonstrate standalone predictive value (p>0.05). Conclusion: The d distance was the only parameter that independently predicted adjacent root resorption, with 11.2 mm identified as a potential threshold that may assist in risk stratification and support selective referral for CBCT in suspected higher-risk cases.
Objective: To evaluate the global scientific output, collaboration patterns, influential contributors, core publication sources, and thematic trends in urethroplasty research through a comprehensive bibliometric analysis of the literature published between 2000 and 2024. Materials and Methods: This descriptive bibliometric study used the Web of Science Core Collection database. English-language articles and reviews published in the Science Citation Index Expanded between January 1, 2000, and December 31, 2024, were included. Publication and citation data, authors, countries, institutions, journals, and keywords were extracted. Analyses were performed using bibliometrix in R and VOSviewer to assess publication trends, collaboration networks, source patterns, keyword co-occurrence, and thematic structure. Bradford's law was applied to identify core journals. Results: A total of 3661 publications from 489 sources were analyzed. The annual growth rate was 5.47%, the average citation per document was 16.42, and mean document age was 9.98 years. Guido Barbagli was the most productive author, while the United States led in both publication output and citation count. China and India also showed high research productivity. Urology and Journal of Urology were the most productive journals. Collaboration analyses revealed prominent author-and country-level research clusters. Keyword and thematic analyses identified urethroplasty, urethral stricture, and hypospadias as core topics, with graft use, reconstructive techniques, outcomes, and recurrence emerging as major research themes. Conclusion: Urethroplasty research is concentrated around influential authors, institutions, countries, and core journals, while continuing to expand in thematic scope and collaborative structure. These findings may help guide future collaborations and identify areas requiring further research.
Objective: This study aimed to evaluate how different Ti-base abutment heights (3.5 mm and 5.5 mm) affect the retention of monolithic zirconia crowns placed on straight (0 degrees) and angled (15 degrees) implants. Material and methods: Sixty monolithic zirconia crowns were fabricated and assigned to four groups according to implant angle and Ti-base height. After CAD/CAM fabrication and standardized cementation, all specimens underwent a pull-out test using a universal testing machine, and maximum force at cement failure (N) was recorded. Due to variance heterogeneity, Welch ANOVA and Tamhane T2 post-hoc tests were used for analysis. Results: Welch one-way ANOVA revealed a statistically significant difference in maximum load among the four experimental models (Welch F(3, 29.49) = 86.08, p < 0.0001). Tamhane T2 post-hoc analysis showed significant differences between all group pairs (p < 0.05), except between Model 1 (0 degrees, 3.5 mm) and Model 3 (15 degrees, 3.5 mm) (p = 0.862). The highest mean maximum load was observed in Model 4 (15 degrees, 5.5 mm) (969.66 N), followed by Model 2 (0 degrees, 5.5 mm) (736.24 N), while the lowest value was recorded in Model 3 (15 degrees, 3.5 mm) (267.10 N). Overall, specimens restored with 5.5-mm Ti-bases demonstrated approximately a threefold higher maximum load compared with those restored with 3.5-mm Ti-bases. Conclusions: Implant angulation did not affect maximum load capacity in groups with 3.5-mm Ti-base abutments but produced a significant difference between groups with 5.5-mm Ti-base abutments. Overall, increasing Ti-base height significantly enhanced the maximum load capacity for crown retention. Clinically, using the longest appropriate Ti-base height may reduce the risk of crown detachment, especially in angled implant cases.
Objective: Attention-deficit/hyperactivity disorder is a neurodevelopmental disorder. The combination of environmental and genetic factors plays a role in the etiology of ADHD. Caspase-3 (CASP3) is a cysteineaspartate protease that performs apoptosis. After overexpression of hypoxia-inducible factor-1alpha (HIF1A) due to hypoxia, the cell enters apoptosis via a caspase-dependent cascade. It has been observed that the vitamin D receptor (VDR) is also fragmented and inactivated by caspases during apoptosis. This study aimed to reveal the relationship between VDR, HIF1A, and CASP3 gene expressions in ADHD. Materials and Methods: This case-control study included 80 children aged 6-14 years. The ADHD group consisted of 40 patients (15 girls and 25 boys), and the control group included 40 age-and sex-matched participants (15 girls and 25 boys) who were evaluated at the Department of Child and Adolescent Psychiatry. Peripheral blood samples were collected from all participants, and the expression levels of VDR, CASP3, and HIF1A genes were quantified using quantitative real-time PCR (qRT-PCR). Relative gene expression levels were calculated using the 2 Delta Delta Ct method, and group comparisons were performed using appropriate statistical analyses. Results: HIF1A and CASP3 expressions were significantly higher in ADHD children, but there was no appreciable change in the VDR gene expression between ADHD children and healthy participants. In addition, HIF1A and CASP3 were also found to be higher in boys with ADHD. Conclusion: Our findings provide new information to the literature to shed light on the hypoxia and apoptosis cascade in ADHD.
Objective: Our study was to investigate the correlation between metabolic tumor parameters of the primary tumor and programmed cell death protein-1 (PD-1) expression of the tumor cell and the value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging in predicting the PD-1 expression in non-small cell lung cancer (NSCLC). Materials and Methods: A total of 79 patients diagnosed with NSCLC were included in this retrospective study. PD-1 expression of tumors was determined by immunohistochemistry staining. All patients had PET/CT scans available at initial staging. The correlation between PD-1 expression of tumor cells and metabolic PET/CT parameters of the primary tumor was evaluated by Spearman correlation analysis. Whether metabolic PET/CT parameters predicted PD-1 expression was evaluated by Receiver operating characteristic (ROC) Curve analysis. Results: No statistically significant relationship has been detected between the metabolic tumor parameters of the primary tumor and other clinicopathological data, or with PD-1 expression in tumor cells. Conclusion: 18F-FDG uptake rate in tumor cells is a non-invasive method that indicates biomarker status in cancer patients. Clinicians use biomarkers such as PD-1 to help them decide whether to start immunotherapy in their patients. In this study, no relationship was found between the metabolic PET/CT parameters and PD-1 expression.
Objective: This study aimed to examine the relationship between digital fatigue and academic procrastination among preclinical medical students and to evaluate learning-related behavioral patterns such as screen time, study habits, break frequency, and perceived academic achievement. Materials and Methods: This two-center, cross-sectional, quantitative study was conducted among first-to third-year medical students at & Ccedil;ukurova University and & Idot;zmir Katip & Ccedil;elebi University during the 2025-2026 academic year. Data were collected via an online questionnaire. The level of digital fatigue was measured using the Digital Fatigue Scale (DFS), and academic procrastination was assessed with the Turkish short form of the Tuckman Procrastination Scale (TPS). Descriptive statistics, Pearson correlation analysis, independent samples t-test, and one-way analysis of variance (ANOVA) with Tukey post-hoc tests were used for statistical analysis. A significance level of p < 0.05 was adopted. Results: A total of 268 preclinical medical students participated in the study. A strong positive correlation was found between digital fatigue and academic procrastination (r = 0.595, p < 0.001). Among the subscales, the association between digital dependency and academic procrastination was the strongest (r = 0.601, p < 0.001). Students from & Ccedil;ukurova University had significantly higher DFS and TPS scores than those from & Idot;zmir Katip & Ccedil;elebi University (p < 0.01). Students with regular study habits demonstrated significantly lower levels of digital fatigue (p < 0.001). Increasing daily screen time was associated with higher levels of both digital fatigue (r = 0.292, p < 0.001) and academic procrastination (r = 0.221, p < 0.001). Lower perceived academic achievement corresponded to higher DFS and TPS scores (p <= 0.003). No significant difference was found based on neuropsychiatric diagnosis or treatment status (p > 0.05). Although differences across break frequency groups were not statistically significant, an increasing trend in fatigue and procrastination scores was observed with more frequent breaks. Conclusion: There is a strong and significant relationship between digital fatigue and academic procrastination among preclinical medical students. Increased screen exposure, irregular study habits, and lower perceived academic achievement appear to be associated with higher levels of both digital fatigue and procrastination. These findings highlight the importance of educational approaches that enhance students' self-regulation skills and promote digital hygiene practices within increasingly digitalized learning environments.
Objective: This study aimed to evaluate the long-term oncological outcomes and complication profile of therapeutic lateral neck dissection in patients with differentiated thyroid carcinoma (DTC) performed by a single experienced surgeon. Materials and Methods: A retrospective cohort study was conducted including 21 patients who underwent lateral neck dissection for DTC between 2015 and 2020. Clinicopathologic characteristics, surgical details, complications, recurrence data, and follow-up outcomes were analyzed. Results: The mean age of the patients was 42.6 +/- 12.4 years. Lateral neck dissections were performed simultaneously with total thyroidectomy and central neck dissection. The average lymph node yield per patient was 30.7 +/- 10.6. The most commonly involved level was level IV. Transient complications included hypocalcemia (14.3%) and shoulder dysfunction (9.5%), all resolved with conservative management. Recurrence occurred in two patients (9.5%) during a median follow-up of 41 months (IQR: 36-54). Conclusion: Therapeutic lateral neck dissection, when performed by an experienced thyroid surgeon, is associated with low recurrence and acceptable morbidity. Adequate lymphadenectomy and standardized technique are key to optimal long-term oncological outcomes.
Objective: The aim of this study is to compare the linear measurements made on the images obtained from three different inclinations using cone-beam computed tomography (CBCT) from the dry bone mandibles with the anatomical measurements made directly on the dry bone mandibles, to evaluate and discuss the compatibility between these measurements. Materials and Methods: The study included 20 dry bone mandibles, and a total of 60 CBCT images were obtained for each jaw with the mandibular base parallel to the floor (parallel position) as well as +45 degrees (up position) and-45 degrees angle (down position). Linear measurements were made on the images obtained with different inclinations. Results: Statistically significant differences were found between the three positions in CBCT measurements of the distance between the laterals of the right and left condyles, the distance between the right and left coronoid processes, the distance between the left coronoid point and the left mental foramen, and the distances between the left coronoid point and the right mental foramen. Conclusion: The reliability of measurements made on CBCT images using prominent anatomical landmarks does not depend on the experience of the operator. The measurements made on CBCT tend to be slightly less predictive than the anatomical measurements; all the measurements obtained in the down position in the CBCT scan are higher than the measurements in the up and parallel positions. Inclined forward positioning of the mandible may influence vertical measurements depending on mandibular regions.
Objective: Periodontitis causes periodontal inflammation and destruction and is known to increase the risk of occurrence in pregnant women. Boric acid (BA) reduces inflammatory cell infiltration in periodontitis. The aim of the study is to examine the effect of BA at different doses in pregnant rats with experimentally induced periodontitis by ligature. Materials and Methods: Sixty Wistar Albino female rats were divided into six groups: A periodontally healthy, non-pregnant control group (NL,n:10); A periodontally healthy, pregnant control group (NLP,n:10); A periodontitis and pregnant group not administered BA (LP,n:10); A periodontitis, pregnant group administered 1.5 mg/kg/day BA (BA1,n:10); Periodontitis and pregnant group administered 3 mg/kg/day BA (BA3,n:10); Periodontitis and pregnant group administered 6 mg/kg/day BA (BA6,n:10). Blood and tissue samples were taken from rats. Interleukin 33 (IL-33), tumor necrosis factor alpha(TNF-a), interleukin-6(IL-6), interleukin-1 beta(IL-1 beta) and (The receptor activator of NF-kappaB ligand) RANKL expressions were determined by the Enzyme-linked immunosorbent assay(ELISA) and immunohistochemically. Malondialdehyde (MDA) and glutathione (GSH) measurements were performed in liver and placental tissues. Periodontium, liver and placenta tissues were evaluated histopathologically. Results: When the periodontal samples of the groups were compared, BA treatment improved histological appearance and scoring. The significant placental degeneration observed in the LP group was found to decrease in the BA3 group (p<0.05). RANKL expression was strongly positive in the LP and BA6 groups, while it weakened in the BA1 and BA3 groups. Conclusion: 1.5 mg/kg and 3 mg/kg BA were effective in treating periodontitis in pregnant rats. But the 6 mg/kg BA was found to be ineffective.
Objective: This study aimed to compare the clinical efficacy, aesthetic outcomes, and perceived pain levels of current subgingival debridement methods used in the treatment of Stage I-II periodontitis. Materials and Methods: Ninety patients (52 females, 38 males) diagnosed with mild to moderate periodontitis (Stage I-II) were randomly assigned to one of three treatment groups: Conventional Therapy (CT), involving Gracey curettes and sonic scalers followed polishing; Guided Biofilm Therapy (GBT); and Plaque-Disclosed Conventional Therapy (PDCT). Each patient received non-surgical periodontal treatment with the goal of achieving periodontal health (defined as probing depth <4 mm and bleeding on probing <10%). Periodontal parameters including Gingival Index (GI), Plaque Index (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD), aesthetic scores, and pain levels during treatment were recorded at baseline, 1, 3, and 6 months. Results: All treatment groups showed statistically significant improvements in GI, PI, BOP, and PPD at each follow-up time point compared to baseline (p<0.001). Aesthetic scores increased progressively over time in all groups, with the GBT group demonstrating significantly higher scores at 1. month (p=0.042). At the 6-month follow-up, the GBT group had the lowest mean GI, while the CT group had the highest. Significant differences among groups were observed in PI, PPD, and aesthetic scores across the follow-up period. No significant differences were found between the PDCT and GBT groups regarding periodontal parameters at 6 months (p>0.05). All three methods were comparably effective in achieving the desired periodontal health status. There were no statistically significant differences in pain perception among the groups during treatment. Conclusion: Current non-surgical periodontal treatment methods provide similar clinical outcomes in the management of mild-moderate periodontitis when monitored over 6 months. GBT may be preferred for patients with greater aesthetic concerns. The use of plaque disclosing agents to visualize biofilm appears to offer advantages during therapy.
Objective: Epigallocatechin-gallate (EGCG), a tea active ingredient widely consumed worldwide, is offered as a nutritional supplement, considered as a complementary therapeutic agent in the management of various diseases. While commercialized with an emphasis on its beneficial effects on the central nervous system, there are conflicting findings regarding EGCG's blood-brain barrier (BBB) penetration. Materials and Methods: This study investigated the functional effect of EGCG intake on brain oscillations via different routes of administration. Furthermore, the pharmacokinetic properties of EGCG are presented using SwissADME. For this purpose, two different experimental groups were formed, and EGCG was administered to each experimental group using a different method: intraperitoneally (n=6), topically (n=6). Results: In the experimental group that received intraperitoneal EGCG, no change was observed in the power spectrum and band-specific analyses in the electrocorticography recordings taken from the cortex. However, EGCG applied topically to the cerebral cortex caused a significant decrease in basal oscillations. In addition, a significant decrease was observed in delta (0.5-4 Hz), theta (4-8 Hz), and alpha (8-13 Hz) oscillations. It had a reducing effect on beta (13-30 Hz) and gamma (30-50 Hz) oscillations, but these results were not statistically significant. ADME results also supported the inability of EGCG to pass through the BBB based on properties such as molecular size and polarity. Conclusion: In conclusion, EGCG has a significant functional effect on brain oscillations when administered directly to the cerebral cortex, while intraperitoneal injection failed to show any similar effect. These comparative findings clearly show the critical role of the route of administration in achieving therapeutic efficacy. We suggest that nanoencapsulation or combination therapies with other therapeutic agents may be beneficial in ensuring sufficient EGCG crosses the BBB.
Objective: This study examines HER2 status impact on treatment outcomes in advanced gastric cancer patients receiving first-line chemotherapy plus trastuzumab. Materials and Methods: A retrospective analysis of hospital records for 216 metastatic gastric cancer patients from August 2013 to April 2022 was conducted. This single-center study compared clinicopathological characteristics, treatment response, and survival outcomes of patients receiving trastuzumab with chemotherapy as first-line therapy. The research compared two HER2-positive groups: IHC 2+/FISH positive and IHC 3+ status. Results: The cohort had 144 patients, with 45 (31.3%) HER2 positive. Among HER2-positive patients, 12 (26.7%) were IHC 2+/FISH positive, and 33 (73.3%) were IHC 3+. Clinical and pathological characteristics, including patient features and histological variants, as well as treatment and survival data, were evaluated. Findings revealed no significant differences in treatment efficacy between the two HER2-positive groups. Objective response and disease control rates were comparable, with 50% and 75% vs. 54.8% and 80.6%, respectively (p=0.775 and 0.683). Progression-free survival was similar, with a median of 8.5 months (95% CI, 3.6 to 13.4) in the IHC 2+/FISH positive group and 9.6 (95% CI, 5.3 to 13.9) months in the IHC 3+ group (p=0.88). Overall survival showed no statistically significant difference, with median durations of 13.2 (95% CI, 11.2 to 15.2) months and 16.2 (95% CI, 11.8 to 20.6) months for the IHC 2+/FISH positive and IHC 3+ groups, respectively (p=0.38). Conclusion: Results suggest first-line chemotherapy plus trastuzumab efficacy in advanced gastric cancer is comparable across different HER2-positive statuses, indicating equal effectiveness for patients with either IHC 2+/FISH positive or IHC 3+ HER2 status. This information helps clinicians make informed decisions regarding treatment strategies for HER2-positive advanced gastric cancer patients.
Objective: This study aimed to investigate the antimicrobial effects of methanolic leaf and root extracts of S. officinalis against bacteria isolated from the oral microbiota and to evaluate its potential therapeutic use in oral health. Materials and Methods: Plant samples were collected from the Nif Mountain region in & Idot;zmir, Turkiye, and extracted using methanol. Oral bacteria were isolated from healthy individuals and identified by the Vitek MS system. Antimicrobial susceptibility was tested using the broth microdilution method to determine minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC). Results: Streptococcus sanguinis, S. mitis, S. salivarius, S. vestibularis, Rothia aeria, R. mucilaginosa, Neisseria flava, N. subflava, N. cinerea, N. mucosa, Gemella haemolysans strains were isolated from the oral cavity. Minimum inhibitory concentration (MIC) values ranged between 7.8-500 & micro;g/mL in leaf extracts and 15.6-500 & micro;g/mL in root extracts. The lowest MIC value for leaf extracts was 7.8 & micro;g/mL in S. mitis and N. mucosa, while the lowest MIC value for root extracts was 15.6 & micro;g/mL in N. mucosa, N. flava, and N. cinerea. Conclusion: Although there is no standard method in antimicrobial susceptibility tests performed with plant extracts, the results of this study show that S. officinalis leaf and root extracts may have an antibacterial effect against Streptococcus, Rothia and Neisseria species and may be used to protect oral and dental health, preventing infections caused by these bacteria and support treatment of this bacteria.
Objective: The occurrence of crestal bone loss during the healing period of a two-stage implant affects the prognosis of an implant. This study aimed to evaluate the factors associated with early crestal bone loss (ECBL) and identify predictors of early and late implant failures. Materials and Methods: A retrospective analysis was conducted on 884 implants placed in 271 patients treated between November 2021 and September 2024. Panoramic radiographs taken at the time of surgery and the 3-month follow-up were used to assess ECBL. Clinical and radiographic data, including demographic factors, implant characteristics, and systemic health status, were analyzed. Chi-square and logistic regression analyses were performed. Results: The resorption rate was higher in implants placed in males (54.5%) than in females (45.5%). ECBL was found to be 43.1% in implants placed in smokers and 24.4% in non-smokers (p=0.0001). The mean length of the implants was 8.96 mm (+/- 1.8 mm) in the group with resorption and 9.62 mm (+/- 1.63 mm) in the group without resorption (p = 0.0001). Conclusions: Smoking, implant surface type, and implant length are key predictors of early crestal bone loss and implant failure. These factors should be considered during implant planning, particularly in high-risk patients.
Objective: This study aims to evaluate the impact of weekly training frequency on arthroscopically confirmed shoulder pathologies in self-learned recreational swimmers. Materials and Methods: We retrospectively analyzed 112 amateur swimmers (median age = 31.5 years; IQR: 24-37) with chronic shoulder pain who underwent arthroscopy. Patients were divided into three groups based on weekly swimming duration: Low (1-2 h/week), Moderate (>2-5 h/week), and High (>5 h/week). Arthroscopic findings for subacromial impingement, Superior Labrum Anterior to Posterior (SLAP) lesions, supraspinatus tears, and Bankart lesions were recorded. Multivariable logistic regression was used to calculate adjusted odds ratios (aORs), adjusting for age and sex. Results: Subacromial impingement prevalence increased significantly with swimming frequency, reaching 91.2% in the high-frequency group; however, regression analysis identified age as a significant confounder. In contrast, SLAP lesions were most prevalent in low-frequency swimmers (62.5%), who exhibited substantially higher adjusted odds compared with high-frequency swimmers (aOR = 21.486, p < 0.001). High-frequency swimming was independently associated with higher odds of supraspinatus tears (aOR = 3.824, p = 0.046). Bankart lesions were rare and observed only in the low-frequency group. Conclusion: Swimming frequency is associated with distinct patterns of shoulder pathology in self-learned swimmers. While higher volumes are linked to impingement, low-frequency swimming is associated with SLAP lesions, potentially related to poorer neuromuscular control and stroke mechanics. The high prevalence of SLAP lesions in this cohort highlights the value of arthroscopic evaluation compared with conventional imaging.
Objective: Pediatric sepsis remains a leading cause of critical illness and mortality among children admitted to pediatric intensive care units (PICU). Early and accurate diagnosis is essential for timely intervention and improved clinical outcomes. Recent evidence suggests that inflammasome-related biomarkers, including NOD-like receptor family pyrin domain-containing 3 (NLRP3), caspase-1, and interleukin-18 (IL-18), may play important roles in the pathophysiology of sepsis. This study aimed to evaluate the diagnostic utility of NLRP-3 caspase-1, and IL-18 levels in pediatric sepsis. Materials and Methods: This prospective case-control study included 60 pediatric patients admitted to the PICU between November 2022 and January 2023, including 30 with sepsis and 30 non-septic controls. Serum NLRP3, caspase-1, and IL-18 levels were measured by ELISA within 48 hours of diagnosis. Demographic, clinical, laboratory, and PRISM III data were collected and compared between groups. Results: NLRP3, caspase-1, and IL-18 levels were significantly higher in the sepsis group compared to controls (p < 0.001). Among these biomarkers, IL-18 demonstrated the highest diagnostic accuracy, with a sensitivity and specificity of 93.3%. The mean PRISM III score was also significantly elevated in the sepsis Conclusion: NLRP3, caspase-1, and IL-18 were significantly increased in children with sepsis, highlighting the potential diagnostic relevance of inflammasome activation in pediatric sepsis. Of these biomarkers, IL18 showed the best diagnostic performance, suggesting that it may be a valuable candidate for clinical use.
Objective: This retrospective study evaluated anesthesia methods in patients undergoing endovascular repair (EVAR or TEVAR) for ruptured abdominal or thoracic aortic aneurysms, to examine the association between anesthesia choice, patient characteristics, and clinical results. Materials and Methods: Forty-seven consecutive patients treated during the study period treated at our university hospital between 2022 and 2023 were retrospectively analyzed and categorized according to anesthesia technique as general anesthesia (GA) or conscious sedation and local anesthesia (CS-LA). Demographic data, comorbidities, surgical history, perioperative variables, and postoperative outcomes were retrospectively recorded and analyzed. Results: The age distribution showed a median value of 70 years (IQR: 64-76) and five patients were female. COPD showed a higher prevalence in the CS-LA group compared with the GA group (30.4% vs. 8.3%, p = 0.049). An ICU stay longer than one day occurred more frequently in patients receiving GA than in those managed with CS-LA (25% vs. 8.7%, p = 0.045). Groups did not differ significantly with respect to early mortality rates between the anesthesia groups (p > 0.05). When patients were stratified by ICU length of stay, diabetes mellitus was significantly associated with prolonged ICU admission (50% vs. 12.8%, p = 0.033). Conclusion: Anesthesia choice was associated with differences in ICU stay duration and comorbidity distribution. GA was more often selected for patients with prior surgical history, whereas CS-LA was preferentially selected for patients with COPD, suggesting that anesthesia strategy may be tailored to patient characteristics in ruptured EVAR/TEVAR cases.
