BACKGROUND/AIMS: Time perception is a core cognitive function that relies on distributed neurocognitive systems and may be sensitive to early changes across the cognitive aging continuum, including subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Despite growing interest, the knowledge structure and thematic organization of research linking time perception to age-related cognitive vulnerability have not been quantitatively mapped. This study aimed to characterize publication trends, disciplinary distribution, geographic contributions, and conceptual themes in the literature on time perception in cognitive aging, SCD, and MCI using bibliometric methods. MATERIALS AND METHODS: A bibliometric analysis was conducted using the Web of Science Core Collection. A targeted query combined time-perception constructs in the title field with constructs related to aging, SCD, MCI, and dementia in the topic field. Records were exported in plain-text format and descriptively analyzed with respect to annual production, document types, countries, institutions, and research areas. The thematic structure of the field was examined using a frequency-based analysis of title-derived terms. RESULTS: The final dataset included 64 records published between 1984 and 2025. Publication output remained limited until the mid-2000s and then expanded markedly after 2015, with peak activity concentrated in the last decade. Research output showed a geographically uneven distribution, led by the United States (n=17), France (n=10), China (n=7), Italy (n=6), and Canada and the Netherlands (n=5 each). Research areas were highly interdisciplinary, with the highest representation in neurosciences/neurology and psychology (n=25 each), followed by geriatrics/gerontology (n=11) and psychiatry (n=8). Frequency-based analysis of title-derived terms showed that the literature is centered on core timing concepts, such as time perception and time estimation, with additional emphasis on Alzheimer’s disease, memory, and age-related constructs. CONCLUSION: Research on time perception in cognitive aging and early cognitive decline has expanded rapidly over the last decade and is primarily anchored in neuropsychology and cognitive neuroscience. Thematic mapping suggests that timing paradigms form the conceptual core of the field, whereas clinically framed work on early cognitive decline remains comparatively limited. These findings highlight the need for further methodologically standardized and empirically oriented research in preclinical and prodromal cognitive states.
BACKGROUND/AIMS: To assess five-year seroreactivity trends of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in Northern Cyprus, with emphasis on the coronavirus disease 2019 (COVID-19) and post-pandemic periods. MATERIALS AND METHODS: This retrospective cross-sectional study evaluated 278,016 serological test results for hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV between 2020 and 2024. All tests were carried out using enzyme-linked immunosorbent assay technology on the ARCHITECT Plus ci4100 system (Abbott Laboratories, Chicago, IL, USA). The annual rate of seroreactivity was calculated and compared across years and sex groups. The results were also categorised based on signal-to-cut-off (S/CO) ratios for HCV and HIV and on IU/mL for HBsAg. RESULTS: Overall seroreactivity rates were 1.2% for HBsAg, 0.6% for anti-HCV, and 0.2% for anti-HIV. HBV seroreactivity declined significantly from 1.5% in 2020 to 1.0% in 2023-2024 (p=0.001). HCV prevalence remained below 1%, increasing non-significantly from 0.5% to 0.7% (p=0.192); most positive samples fell within the low S/CO category. HIV prevalence remained stable at 0.2% across the study period (p=0.043). CONCLUSION: HBV seroreactivity exhibited a declining trend over the years; HCV levels remained low but exhibited a rising trend; HIV levels remained stable and low. The results indicate that Northern Cyprus remains a low-endemic region and highlight the importance of sustained surveillance and prevention in the post-COVID-19 era. The results need to be interpreted cautiously, as they may not entirely indicate the levels of infection.
BACKGROUND/AIMS: Urinary leakage after percutaneous nephrolithotomy (PNL) is a clinically relevant complication that may prolong hospitalization and necessitate additional interventions such as ureteral stenting. However, reliable predictors of clinically significant leakage remain insufficiently defined. MATERIALS AND METHODS: This retrospective study included 305 patients who underwent PNL. The primary outcome was urinary leakage requiring double-J stent placement, defined as persistent drainage >24 hours after nephrostomy tube removal. Patients were divided into leakage (n=46) and non-leakage (n=259) groups. Clinical, radiological, and operative variables were analyzed. Univariate and multivariable analyses were performed using Firth penalized logistic regression. Model performance was evaluated using receiver operating characteristic analysis and calibration testing. RESULTS: Urinary leakage occurred in 15.1% of patients. On multivariable analysis, multiple stones [odds ratio (OR)=55.66, p<0.001] and longer operative time (OR=1.017 per minute, p<0.001) were identified as independent risk factors; nephrostomy tube placement was strongly protective (OR=0.059, p<0.001). Lower calyceal stone involvement also remained significant (OR=0.255, p=0.044). The model demonstrated acceptable discrimination (area under the curve=0.798, 95% confidence interval: 0.729-0.865) and good calibration (Hosmer-Lemeshow p=0.754). CONCLUSION: Clinically significant urinary leakage after PNL is primarily associated with stone complexity and operative factors. Multiple stones and prolonged operative time increase the risk, whereas nephrostomy tube placement has a protective effect. The proposed model may assist in perioperative risk stratification and clinical assessment.
BACKGROUND/AIMS: This paper evaluates how tourniquet use and tranexamic acid (TXA) combinations affect blood management in primary total knee arthroplasty (TKA). MATERIALS AND METHODS: Following ethical approval, a retrospective review was conducted of 96 patients who underwent primary TKA between 2014 and 2017. Patients were divided into four groups: Group 1, no tourniquet with intravenous (IV) TXA 15 mg/kg plus intra-articular (IA) TXA 2 g; Group 2, tourniquet only (control); Group 3, tourniquet with IV TXA; and Group 4, no tourniquet with IA TXA. Demographic data, changes in perioperative hemoglobin (Hb) and hematocrit (Hct), intraoperative blood loss, postoperative drainage volume, and transfusion rates were analyzed using ANOVA and Kruskal-Wallis tests. RESULTS: The reduction in Hb and Hct was significantly smaller in patients receivingTXA (p<0.05). Group 1 demonstrated the least perioperative Hb decrease (1.3 +/- 0.8 g/dL) and the lowest transfusion rate (4%), whereas the control group showed the greatest Hb decline (3.5 +/- 1.0 g/dL) and highest transfusion requirement (34%) (p<0.05). The mean drainage volume was 180 +/- 50 mL in Group 1, lower than in other groups (p<0.05). No thromboembolic or wound-related complications were observed in any TXA-treated group. CONCLUSION: Dual-route TXA administered without a tourniquet reduces blood loss and the need for transfusions in TKA without increasing the risk of complications. Tourniquet use alone did not confer any additional hemostatic benefit and may be safely omitted when an optimized TXA protocol is implemented. These findings highlight that pharmacologic antifibrinolytic therapy offers a more effective and safer blood management strategy than mechanical occlusion methods in modern knee arthroplasty practice.
Wyburn-Mason syndrome (WMS) is an extremely rare, non-hereditary congenital disorder characterized by arteriovenous malformations (AVMs) that primarily affect the retina and central nervous system and, less commonly, other structures. Its clinical presentation is highly variable, and management is often challenging due to the high risk of morbidity and mortality, particularly in deep lesions that are not amenable to surgical, endovascular, or radiosurgical treatment. We present the case of a young woman with relevant neurologic and ophthalmologic history who developed a massive subarachnoid hemorrhage secondary to rupture of a basilar artery aneurysm associated with a prepontine AVM, a complication that is poorly documented in the literature. The clinical course and fatal outcome are described. This case highlights the severe neurological complications associated with WMS and underscores the importance of early recognition and long-term monitoring in patients with high-risk vascular malformations.
BACKGROUND/AIMS: This study aimed to investigate the relationships among acromio-humeral distance (AHD), ultrasonographic tendon thicknesses, pain intensity, kinesiophobia, functional status, and postural parameters in individuals with subacromial impingement syndrome (SAPS). MATERIALS AND METHODS: Forty-four individuals diagnosed with SAPS were included in this cross-sectional study. AHD and rotator cuff tendon thicknesses were assessed using ultrasonography. Pain intensity was evaluated using the visual analog scale and the McGill Pain Questionnaire. Upper extremity disability was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) scale, while kinesiophobia levels were evaluated using the Fear-Avoidance Beliefs Questionnaire (FABQ). Postural alignment was analyzed with the AI-based Posture Evaluation and Correction System (R) (APECS (R)) system. Associations among the study variables were analysed using Pearson correlation analysis. RESULTS: No significant relationships were found between AHD and pain intensity, disability, or tendon thickness (p>0.05). However, a weak negative correlation was observed between AHD and the kyphotic posture parameter [APECS-lateral body alignment (LBA)]. Pain intensity and higher FABQ scores were positively associated with greater upper extremity disability (DASH). FABQ showed a moderate-to-strong positive correlation with DASH scores. Among postural parameters, LBA was associated with AHD and with the thicknesses of supraspinatus tendon, infraspinatus tendon, and long head of biceps tendon. Additionally, anterior knee alignment and head tilt were positively correlated with tendon thickness measurements. CONCLUSION: Our findings suggest that postural deviations may be associated with tendon characteristics and subacromial space parameters in individuals with SAPS. Additionally, the observed relationships between kinesiophobia, pain, and disability may highlight the importance of psychosocial factors. However, these findings should be interpreted with caution due to the cross-sectional design, and further longitudinal studies are needed.
Presacral (retrorectal) schwannomas are rare, benign tumors originating from the Schwann cells of the sacral nerve roots. Their deep pelvic location and proximity to major neurovascular structures make surgical management challenging. We report a case of a 57-year-old postmenopausal woman who presented with postmenopausal bleeding, an incidental finding that led to the discovery of the pelvic mass, and who was found to have a giant presacral mass involving the left internal iliac artery. Magnetic resonance imaging revealed a 12 & times;8 & times;12 cm lesion, consistent with a Klimo type III schwannoma arising from the presacral region. The tumor was completely excised through an anterior multidisciplinary surgical approach with intraoperative neuromonitoring, followed by total hysterectomy and bilateral salpingo-oophorectomy. The postoperative course was uneventful, and the patient remained disease-free at 39 months of follow-up. This case highlights the importance of meticulous preoperative imaging, multidisciplinary surgical planning, and intraoperative neuromonitoring for the safe management of large presacral schwannomas with major vascular involvement.
BACKGROUND/AIMS: Gabapentin (GBP) is often prescribed to pregnant women to manage neuropathic pain and epilepsy. However, the impact of antiepileptic drugs on prenatal skeletal development remains controversial. The aim of this study was to investigate, using a rat model, the possible toxic effects of GBP exposure during pregnancy on fetal bone development. MATERIALS AND METHODS: Pregnant Wistar albino rats were randomly assigned to five groups (n=4 each): a control group and four GBP-treated groups receiving 10, 30, 60, or 120 mg/kg/day throughout gestation. Fetuses were collected at term and evaluated using double staining. Ossification lengths and areas of forelimb and hindlimb long bones were quantitatively measured. Immunohistochemical (IHC) analyses were performed on femoral sections to assess the distribution and staining intensity of alkaline phosphatase (AP) and tartrate-resistant acid phosphatase (TRAP), key markers of osteoblastic and osteoclastic activity, respectively. RESULTS: Fetuses exposed to GBP demonstrated reduced body weight and smaller morphometric measurements compared with controls. Quantitative analysis revealed a significant decrease in ossification of both forelimb and hindlimb bones across all treatment groups, with a clear dose-dependent pattern. IHC findings showed diminished AP and TRAP immunoreactivity in GBP-exposed pups, indicating impaired bone formation and resorption . CONCLUSION: Continuous GBP exposure during pregnancy adversely affects fetal skeletal development in rats. Prenatal GBP administration led to lower birth weight, delayed and reduced ossification, and suppressed bone metabolic activity, particularly at higher doses. We believe these findings highlight the potential developmental risks associated with GBP use during pregnancy and underscore the need for caution.
BACKGROUND/AIMS: Both coronavirus disease 2019 (COVID-19) and vitamin D deficiency (VDD) are widespread health problems today. This study was designed to compare serum 25-hydroxyvitamin D [25(OH)D] levels among three groups: patients with COVID-19 pneumonia, patients with non-COVID-19 pneumonia, and healthy volunteers, and to investigate whether vitamin D levels correlate with laboratory findings and infection severity. MATERIALS AND METHODS: This prospective case-control study was carried out at a single tertiary care centre over four consecutive months between May and August 2020. A total of 90 individuals were enrolled and assigned equally to three groups: 30 with COVID-19 pneumonia, 30 with non-COVID-19 pneumonia, and 30 healthy controls. Multiple linear regression modelling was applied to determine independent predictors of serum 25(OH)D levels. RESULTS: Both pneumonia groups exhibited markedly diminished 25(OH)D concentrations relative to healthy controls, with no statistically significant difference observed between the two pneumonia cohorts. In the multivariate regression model, membership in the healthy control group emerged as the sole independent determinant of elevated 25(OH)D levels. No meaningful correlations were identified among vitamin D concentrations, laboratory indices, and illness severity. CONCLUSION: VDD was common in both COVID-19 and non-COVID-19 related pneumonia groups but was not associated with disease severity. Our results indicate that VDD may influence susceptibility to lower respiratory tract infections rather than disease progression.
BACKGROUND/AIMS: The present study investigated whether the triglyceride-glucose (TyG) index could serve as a predictive marker for gestational diabetes mellitus (GDM). MATERIALS AND METHODS: This retrospective case-control analysis included pregnant women who were followed and delivered at our institution between April 2018 and April 2024. Among 1,360 evaluated pregnancies, 64 women diagnosed with GDM were assigned to the study group, while 132 uncomplicated singleton pregnancies were assigned to the control group. Clinical characteristics, obstetric outcomes, and metabolic parameters were compared between groups. First-trimester laboratory measurements, including fasting glucose, triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, body mass index (BMI), TyG index, and TyG-BMI, were obtained from medical records. RESULTS: Women with GDM demonstrated significantly higher BMI values than controls (p=0.021) and delivered at an earlier gestational age (p<0.001). In addition, TG levels, fasting glucose, TG/HDL-C ratio, TyG index, and TyG-BMI index were significantly elevated in the GDM group (p<0.05 for all comparisons). Multivariable logistic regression analysis, adjusted for maternal age, BMI, smoking status, and parity, revealed that the TyG index was independently associated with GDM [adjusted odds ratio: 1.85, 95% confidence interval (CI): 1.14-3.02, p=0.013]. Effect size estimates and CIs supported the clinical relevance of these findings. CONCLUSION: The TyG index may represent a practical and cost-effective marker for identifying women at increased risk of GDM. Incorporating this index into routine antenatal evaluation could support earlier risk stratification and improve preventive care strategies.
BACKGROUND/AIMS: To evaluate the radiological and functional effectiveness of repeated closed reduction in patients who developed early loss of reduction at the 48-hour follow-up after an initially successful closed reduction for fifth metacarpal neck fractures, and to examine its association with surgical treatment decisions. MATERIALS AND METHODS: This retrospective matched cohort study included 200 adult patients with isolated, closed fifth metacarpal neck fractures who underwent closed reduction at a tertiary orthopedic center between January 2023 and December 2024. Patients were divided into two equal groups: the (single reduction group, n=100) and the [re-reduction group (RRG), n=100], based on whether they underwent a second closed reduction due to early loss of initially acceptable radiographic alignment detected at the 48-hour follow-up. Matching was performed 1:1 on the basis of age and sex. Radiological parameters-including dorsal angulation and metacarpal shortening-were measured at six time points during follow-up. Functional outcomes were assessed using Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores, grip strength, and joint range of motion. Surgical conversion rates were analyzed, and multivariate logistic regression was used to identify independent predictors of surgical intervention. RESULTS: Initial angulation and shortening were comparable between the groups. However, the RRG exhibited significantly greater deformity at the 4th and 6th weeks, with higher angulation (p=0.007 and p<0.001, respectively) and more pronounced shortening (p=0.001 and p=0.009, respectively). At 6 weeks, QuickDASH scores were significantly worse in the RRG (p=0.002), though this difference was no longer statistically significant by 6 months. Flexion and extension angles were consistently more restricted in the RRG. Importantly, multivariable firth-penalized logistic regression identified initial shortening as the only independent predictor of surgical intervention, while angulation parameters did not retain statistical significance after adjustment. CONCLUSION: Repeated closed reductions for early loss of alignment do not consistently improve outcomes and may be associated with delayed union. Longitudinal evaluation of angulation and shortening provides better clinical guidance than single-time-point assessments; however, among these parameters, initial shortening appears to be the most reliable independent predictor of eventual surgical intervention.
In this case report we aimed to explain how a severe aortic stenosis patient whom has severe stenosis in the peripherial artery was successfully treated after implanting greft stent to peripherial artery stenosis. After implanting greft stent, transcatheter aortic valve implantation (TAVI) valve can pass easily through the stent by lubricating valve with opaq material and propofol. During challenging anatomy and severe stenosis of iliac artery, predilatation and stenting is very important for successfull TAVI procedure.
BACKGROUND/AIMS: Mandibular fractures are a common type of maxillofacial fracture. Clinical symptoms of mandibular fractures include pain, swelling, difficulty chewing, and malocclusion. Collecting long-term epidemiological data on mandibular fractures can provide essential information for developing and evaluating preventive measures to reduce the incidence of these facial injuries. MATERIALS AND METHODS: Ethical approval for the study was obtained prior to data collection. Patient information was retrieved from hospital records, radiological images, official reports, and the institutional information management system. Data from a single tertiary care center were reviewed, including demographic characteristics, fracture sites, and treatment methods for mandibular fractures in 185 patients treated between February 2014 and February 2024. Only patients with complete clinical and radiographic documentation were included, and the data were independently assessed by two researchers to ensure accuracy and consistency. RESULTS: Among the 185 patients examined, fractures were most frequently observed in the 20-29 age group. Assault was identified as the leading cause of mandibular fractures in men, while falls were the most common cause in women. The incidence of fractures increased during the summer months. The mean number of fractures per person was 1.34. The region most frequently associated with mandibular fractures was the angle of the mandible. CONCLUSION: Mandibular fractures commonly occur in young males. Properly planned treatments for these fractures yield high success rates. The findings of this study provide insights to surgeons, physicians, and health policymakers on addressing mandibular fractures.
BACKGROUND/AIMS: This study aimed to determine the prevalence of thirst distress and its predictors in patients with heart failure (HF). MATERIALS AND METHODS: The study was conducted between April 1, 2024, and July 15, 2025, and included 281 patients hospitalized in the cardiology wards of a training and research hospital in & Idot;stanbul, T & uuml;rkiye. RESULTS: Thirst distress was severe in 26.69% of patients, high in 31.67%, moderate in 30.25%, mild in 8.19%, and absent in 3.2%. The mean thirst distress scale score was 26.15 +/- 8.07, and the mean visual analog scale (VAS) thirst severity score was 5.53 +/- 2.30. Thirst was experienced almost daily by 34.16% of patients and several days per week by 28.47% of patients. 40.21% of patients reported feeling thirsty for one hour or less. The mean thirst distress scores were 29.48 +/- 7.35 for the New York Heart Association (NYHA) IV, 27.38 +/- 7.25 for NYHA III, 24.52 +/- 8.21 for NYHA II, and 22.11 +/- 10.29 for NYHA I patients. A strong positive correlation was observed between thirst-distress scores and VAS. Multiple regression analysis identified longer duration since HF diagnosis, the presence of diabetes and hypertension, and NYHA class III-IV as statistically significant positive predictors of thirst distress. These variables explained 10.2% of the total variance in thirst distress (adjusted R2=0.102). CONCLUSION: Thirst distress is highly prevalent in patients with HF. Longer duration since HF diagnosis, comorbid diabetes and hypertension, and higher NYHA class were predictors of thirst distress.
Chronic obstructive pulmonary disease (COPD) remains among the leading causes of death. The systemic characteristics of COPD are becoming clearer every day, and the importance of comorbidities is increasingly well understood. Comorbidities are one of the main causes of mortality in COPD. Although there are specific guidelines for each disease, there is limited literature explaining the effects of comorbidities on one another. Non-respiratory comorbidities associated with mortality in COPD include cardiovascular disease (CVD), metabolic, musculoskeletal, and psychiatric disorders. Both COPD and these comorbid conditions share a common aetiology and are associated with complex clinical and therapeutic interactions. CVD and metabolic comorbidities are more symptomatic and can be easily recognised by patients and physicians. However, osteoporosis, anxiety, and depression are often asymptomatic, despite the fact that these are more common than other comorbidities. Current data suggest that diagnosis and treatment of comorbidities improve prognosis in COPD. Instead of focusing solely on COPD treatment, we should adopt a holistic approach to patient care. This narrative review aims to summarise the bidirectional relationships between COPD and its most common fatal extrapulmonary comorbidities. Another aim of the study is to compile a substantial body of scattered information to provide clinicians with an overview.
BACKGROUND/AIMS: In animal experiments, carbon tetrachloride (CCl4) is commonly used to produce hepatotoxicity because it induces oxidative stress. Increased production of reactive oxygen species, resulting in oxidative stress, has detrimental effects on several cellular components. Lavandula angustifolia oil has been recognized as an indirect antioxidant that boosts the activity and expression of antioxidant enzymes. Medical ozone therapy, which uses appropriate concentrations of ozone, is being investigated for its potential to treat and prevent hepatotoxicity and other conditions. The effects of medical ozone, lavender, and the combined effects of both therapies on sperm morphology and count in hepatotoxic rats were examined in this study. MATERIALS AND METHODS: CCl4 was used to cause acute hepatotoxicity in Wistar rats and sperm cells were obtained from - extracted epididymal structure. Then, the Spermac Kit (FertiPro Spermac Stain) was used to analyze sperm morphology after medical ozone, lavender, and combined treatment. RESULTS: Adding lavender to the treatment increased sperm count (p<0.001), irrespective of medical ozone. However, the sperm count is unaffected when lavender and medical ozone are combined (p>0.05). However, The total number of defects in the head, neck, and tail varies among the three groups’ sperm morphologies. CONCLUSION: Only the rats who received Lavandula angustifolia oil treatment showed an increase in spermatozoa, suggesting that medical ozone may counteract Lavandula’s effects. Therefore, this study is crucial to understanding the relationship between medical ozone and lavender oil.
BACKGROUND/AIMS: Thestudysoughtto examinethe impact of rosuvastatin and E-arginine, alone or in combination, on hyperglycemia-caused oxidative stress in human umbilical vein endothelial cells (HUVECs). MATERIALS AND METHODS: HUVECs were divided into five groups: (1) control, (2) hyperglycemia, (3) hyperglycemia + rosuvastatin, (4) hyperglycemia + E-arginine, and (5) hyperglycemia + E-arginine + rosuvastatin. The incubation period was 24 hours for all study groups. Cytotoxicity assays were performed for E-arginineand rosuvastatin. After incubation with glucose, E-arginine, and rosuvastatin, malondialdehyde (MDA) level, an oxidative stress marker, and catalase activity were measured. RESULTS: In cytotoxicity tests, the highest non-cytotoxic concentration of E-arginine and rosuvastatin was 12.5 & micro;M. Under hyperglycemic conditions, catalase activity was significantly decreased in HUVECs (p=0.0007 versus control). E-arginine alone (p=0.0016 vs. control) and E-argininecombined with rosuvastatin (p=0.0099 vs. control) resulted in a partial increase in catalase activity. Hyperglycemia caused a significant elevation in MDA levels in HUVECs (p=0.0054 vs. control). E-arginine induced a partial reduction in MDA levels (p=0.03 vs. control), whereas the combination of rosuvastatin and E-arginine restored the altered MDA levels. CONCLUSION: These results indicate that combined incubation with rosuvastatin and E-arginine is more effective in reducing hyperglycemia-induced oxidative stress than administration of either agent alone.
BACKGROUND/AIMS: Anal fissure is a common and painful anorectal disorder that substantially impairs quality of life. While therapeutic strategies have evolved from pharmacological sphincter relaxation and botulinum toxin injections to sphincter-preserving surgical and regenerative approaches, the global research landscape has not previously been assessed through bibliometric methods. MATERIALS AND METHODS: A bibliometric analysis was conducted using the Web of Science Core Collection, covering the period 1980-2025. Publications were retrieved with the keywords "anal fissure*," "fissure-in-ano," "fissura ani," and "anorectal fissure*". Only articles and reviews were included. Network visualization was performed with VOSviewer, geographical mapping with Tableau, and statistical analyses with SPSS. Linear regression was applied to predict future publication trends. RESULTS: A total of 1,504 records were identified, of which 1,241 were included (articles and reviews). The corpus accrued 23,277 citations across 8,572 publications, with an h-index of 71. Annual publications increased steadily, with a projected 78 papers in 2040 (R2=0.864, p<0.001). The United States, Italy, and the United Kingdom were the most productive countries, while T & uuml;rkiye, India, Pakistan, and Egypt demonstrated emerging but peripheral contributions. Collaboration mapping revealed five international clusters, with the United States acting as a global hub. The New England Journal of Medicine and Diseases of the Colon & Rectum were among the most cited journals. Keyword analysis showed a thematic transition from pharmacological therapies (glyceryl trinitrate, diltiazem, nifedipine) to botulinum toxin and sphincter-preserving surgery, with a recent emphasis on wound healing, recurrence, quality of life, and systematic reviews. CONCLUSION: This first bibliometric analysis of anal fissure research highlights a sustained increase in global output and a shift toward patient-centered outcomes and minimally invasive strategies. While high-income countries dominate, emerging economies are contributing more actively. Future research should prioritize multicenter randomized trials, long-term quality-of-lifeand cost-effectiveness studies, and mechanistic investigations of ischemia, microbiota, and systemic factors in fissure chronicity.
BACKGROUND/AIMS: Aging is a chronic, complex and irreversible process that leads to functional deterioration in cells. Structural and functional changes occur in the liver during aging. This study aimed to determine age-related changes in rat liver tissue using histological, biochemical, and gene-expression analyses. MATERIALS AND METHODS: Wistar albino male rats were used in the study; two groups were formed: a young group (10 weeks) and an aged group (18 months). Blood and tissue samples were collected from the subjects while they were under general anesthesia. Liver enzymes were measured in blood samples. Gene expression levels of interleukin-6 (IL-6), nuclear factor kappa B (NF-kB), mammalian target of rapamycin (mTOR) protein complex, and caspase-3 (Cas-3) in liver tissues were evaluated by real-time polymerase chain reaction following total ribonucleic acid isolation and complementary DNA synthesis. Histological scoring was performed on tissues from the groups. Tissues were evaluated with hematoxylin-eosin, Masson’s trichrome, periodic acid-Schiff, and Ki-67 proliferation index stains. RESULTS: Biochemically, significant increases in cholesterol, triglycerides, alanine transaminase, and alkaline phosphatase were observed in the aged group. Light microscopic examination revealed an increased number of Ki-67-positive and binucleated hepatocytes, vacuolization, sinusoidal congestion, bile-duct proliferation, and increased collagen in the aged group. While Cas-3 and mTOR gene expression increased significantly in the aged group, no differences were observed in IL-6 and NF-kB levels. CONCLUSION: Histological, apoptotic, and autophagic changes have been observed during physiological aging, and they are known to influence liver function.
