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.
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.
Objective: To evaluate the citation trends and scientific landscape of studies investigating critically ill patients with hematological malignancies (HM) admitted to intensive care units (ICUs) using bibliometric analysis. Methods: The Web of Science Core Collection database was searched on March 14, 2026, for original articles published between 2000 and 2025. Publications related to HM requiring ICU admission were analyzed for citation counts, authorship, journals, countries of origin, international collaborations, and keyword trends. Results: A total of 290 publications were included in the final analysis. These studies received 5,576 citations, of which 5,003 remained after excluding self-citations. The mean number of citations per publication was 19.23. A total of 3,649 citing articles were identified (3,487 excluding self-citations). The most frequent keywords were mortality (n=44), intensive care (n=42), and critical care (n=34), reflecting the primary research focus of the field. Conclusion: Research on critically ill patients with HM has primarily focused on mortality and prognostic evaluation, with a growing emphasis on intensive care management strategies. The increasing number of publications and strong international collaboration networks indicate a rapidly evolving field. Future research should focus on multicenter collaborations and standardized clinical approaches to enhance the generalizability and clinical impact of findings.
Objective: As cesarean section (CS) rates continue to rise, the choice of anesthesia has become increasingly important. Two main anesthetic approaches are commonly used: general anesthesia (GA) and regional anesthesia (RA), the latter comprising spinal anesthesia (SA), epidural anesthesia (EA), and CS-EA. The aim of this study was to evaluate the influence of educational status, prior anesthesia experience, and procedure-related concerns on parturients’ choice of anesthesia for elective CS. Methods: Between January 2019 and December 2019, 275 pregnant women classified as American Society of Anesthesiologists II and scheduled for elective cesarean delivery at a tertiary care hospital were included in this study. Parturients were questioned in the preoperative room about age, educational level, previous birth experiences, knowledge of and concerns about SA. Subsequently, they were transferred to the operating room, where the choice of anesthesia modality was determined according to each parturient’s preference. Results: The study population primarily consisted of women with a low educational level; however, no significant association was found between the type of anesthesia used for the current CS delivery and educational level (P = 0.26). Parturients’ knowledge about SA was limited, and the predominant source of information was friends and relatives. Only 19% of those who have knowledge mentioned “doctor” as the source. A statistically significant relationship was observed between the current anesthesia modality and prior anesthesia experience (P = 0.015). Fear of experiencing pain during the operation was the principal concern expressed by 37.45% of parturients. Conclusion: Parturients preferred SA to GA across all education levels. Prior anesthesia experience led parturients to choose SA. Parturients who had experienced either general or SA prefer SA for the current operation.
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.
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.
Objective: To determine the Mediterranean Fever (MEFV) variant spectrum using whole-gene next-generation sequencing (NGS) in pediatric cases with suspected Familial Mediterranean Fever (FMF). Methods: This retrospective cross-sectional study included 471 pediatric cases referred for MEFV analysis. All exons were analyzed using NGS, and variants were classified according to American College of Medical Genetics and Genomics criteria. Results: At least one MEFV variant was detected in 59.4% of cases. A total of 23 variants were identified, predominantly in exon 10 (43.5%) and exon 2 (34.8%). The most frequent variants were R202Q (43.3%), E148Q (16.3%), and M694V (13.7%). A low-frequency variants of uncertain significance, G150R, was detected in one case. Heterozygous genotypes were the most common (59.6%). Conclusion: Whole-gene sequencing enables the detection of both common and rare MEFV variants that may be missed by limited mutation panels. However, frequently detected variants, such as R202Q, require careful interpretation because of their high population frequency and controversial pathogenicity.
Objective: Eosinophil-derived hematological indices have been proposed as potential prognostic markers for cardiovascular disease; however, their clinical value in acute decompensated heart failure (ADHF) remains unclear. This study aimed to comprehensively evaluate the prognostic significance of eosinophil-based hematological indices, particularly the neutrophil-to-eosinophil ratio (NER), in hospitalized patients with ADHF. Methods: This single-center, retrospective observational study included 245 consecutive adult patients hospitalized for ADHF between January 2023 and January 2024. Patients with conditions known to influence eosinophil counts, including allergic diseases, recent systemic corticosteroid use, active infection, malignancy, chronic inflammatory disorders, end-stage renal failure, and severe liver disease, were excluded. Hematological indices calculated from blood samples obtained within the first 24 h of admission included NER, eosinophil-to-lymphocyte ratio (ELR), eosinophil-to-monocyte ratio (EMR), eosinophil percentage, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII). The primary outcome was all-cause mortality during the one-year follow-up period. Results: During the follow-up period, 93 (38.0%) patients died. Non-survivors were significantly older and exhibited a higher inflammatory burden, with increased C-reactive protein levels, NLR, and SII values. Eosinophil counts, eosinophil percentages, and EMR values were significantly lower in non-survivors, whereas the NER and ELR did not differ between the groups. Receiver operating characteristic analysis demonstrated poor discriminative performance for eosinophil-derived indices, with area under the curve values of ≤ 0.55. In the multivariate logistic regression analysis, only age was an independent predictor of mortality. Conclusion: Eosinophil-based hematological indices have limited prognostic value for mortality in patients hospitalized with ADHF. Although eosinophil suppression is associated with adverse outcomes, these indices do not provide independent prognostic information beyond age.
Objective: The aim of this study was to assess the diagnostic performance and radiation dose of 128-slice dual-source computed tomography (DSCT) angiography in pediatric patients with congenital heart disease (CHD) and to compare its diagnostic accuracy with that of transthoracic echocardiography (TTE). Methods: Fifty-seven pediatric patients (mean age: 34.1 months; range: 0.5-156 months; 25 males and 32 females; mean body weight: 10.3 kg) who underwent thoracic DSCT angiography and TTE for suspected or confirmed CHD were retrospectively evaluated. Surgical findings conventional catheter angiography, alone or in combination, served as the reference standard. Diagnostic performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy, were calculated. Agreement between imaging techniques and the reference standard was assessed using Cohen’s kappa coefficient, and paired comparisons were performed using the McNemar test. Results: A total of 199 cardiovascular anomalies were confirmed, including 67 intracardiac and 132 extracardiac abnormalities. Computed tomography (CT) angiography detected 193 anomalies (96.9%), whereas TTE detected 179 anomalies (89.9%). For CT angiography, sensitivity, specificity, PPV, NPV, and overall diagnostic accuracy were 96.9%, 99.9%, 99.0%, 99.6%, and 99.5%, respectively. The corresponding values for TTE were 89.9%, 99.6%, 96.8%, 98.8%, and 98.5%. CT angiography demonstrated significantly higher overall detection rates than TTE (P = 0.01). Subgroup analysis showed that TTE had higher sensitivity for intracardiac anomalies, whereas CT angiography demonstrated superior performance in identifying extracardiac vascular abnormalities. Conclusion: Dual-source CT angiography enables highly accurate anatomical assessment in pediatric CHD while maintaining acceptable radiation exposure levels. Although echocardiography remains the first-line imaging modality, CT angiography represents a valuable complementary technique, particularly for evaluating extracardiac vascular anomalies.
Objective: Cardiovascular disease is prevalent among individuals diagnosed with non-alcoholic fatty liver disease (NAFLD). Epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), and aortic propagation velocity (APV) are associated with atherosclerosis and cardiovascular disease (CVD). The aim of this study is to determine whether NAFLD is associated with EAT, CIMT, and APV. Methods: Individuals aged ≥18 and <65 years who presented for routine follow-up were included. The study population comprised 75 healthy controls (40 females, 35 males) and 141 patients with NAFLD (68 females, 73 males). Epicardial adipose tissue thickness, carotid intima-media thickness, and aortic propagation velocity were evaluated using transthoracic echocardiography in patients who were diagnosed with hepatosteatosis by ultrasound during routine check-ups at the internal medicine clinic. Results: NAFLD was positively associated with epicardial adipose tissue thickness and carotid intima–media thickness, and negatively associated with aortic propagation velocity. Patients with NAFLD had significantly higher EAT and CIMT values and lower APV values than controls. Logistic regression analysis identified body mass index (BMI) and EAT as independent predictors of hepatosteatosis. Each unit increase in BMI was associated with a 1.29-fold increase in the risk of hepatosteatosis, whereas each unit increase in EAT was associated with a 5.49-fold increase. Conclusion: Given the established associations of CIMT, APV, and EAT with atherosclerosis and cardiovascular disease, assessment of patients with NAFLD using these noninvasive parameters may help identify subclinical cardiovascular risk.
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.
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.
Objective: This study aimed to investigate the influence of gender and bilateral asymmetry on the complex anatomical features of the distal tibiofibular syndesmosis using computed tomography (CT)-generated 3D anatomical models in the Turkish population. Methods: Bilateral non-weight-bearing CT scans of 80 adults (40 females, 40 males), totaling 160 ankles, were analyzed. 3D anatomical models of the tibia and fibula were created using Materialise Mimics. Key morphological parameters were measured, including incisura width, depth, angle, and version; anterior and posterior tibiofibular widths; and tibiofibular overlap. Results: In the male group, all measured parameters in the right ankle and most in the left ankle were significantly higher than those in the female group. Specifically, incisura width, anterior tibiofibular width, posterior tibiofibular width, and incisura version were significantly higher in males. Despite these gender differences, intraclass correlation coefficient analysis demonstrated strong correlations between the right and left ankles across the majority of parameters in both gender groups, including incisura depth and incisura angle. Conclusion: Although gender-based dimensional variations exist, there are no clinically significant differences between contralateral ankles within each gender group. The strong bilateral symmetry confirms that the contralateral ankle may serve as a reliable template for determining syndesmotic integrity or assessing intraoperative reduction quality.
Objective: To evaluate the association between infrapatellar fat pad (IPFP) maximal area, depth, and signal intensity alterations and the presence and severity of patellar chondromalacia on magnetic resonance imaging (MRI). Methods: In this single-center retrospective study, 172 knee MRI examinations with patellar chondromalacia and 78 control examinations were analyzed between January 1, 2024, and January 1, 2025. MRI scans were acquired without contrast using a 1.5-Tesla system (Ingenia Evolution, Philips Medical System, Best, the Netherlands). Alterations in IPFP maximal area, depth, and signal intensity (graded 0-3) were measured on fat-suppressed proton density-weighted images. Chondromalacia was staged using the MRI-adapted Outerbridge classification. Demographic characteristics, medial subcutaneous fat thickness, and IPFP measurements were compared between groups. Correlation analyses were performed to assess associations between IPFP metrics and chondromalacia severity. Parametric and nonparametric tests were applied; P < 0 .05 was considered statistically significant. Results: Patients with chondromalacia were older than controls (50.8 ± 10.1 vs. 38.7 ± 12.7 years; P < 0.001) and included a higher proportion of females (P = 0.009). Medial subcutaneous fat thickness was greater in the chondromalacia group (P < 0.001). Male sex was correlated with larger maximal IPFP area and depth (P < 0.001). No significant correlation was observed between medial subcutaneous fat thickness and IPFP size. The IPFP signal intensity score was positively correlated with age (r = 0.50) and with chondromalacia grade (r = 0.377; P < 0.001 for both). IPFP maximal area and depth showed no significant association with chondromalacia grade, lesion location, or signal intensity score. Conclusion: MRI signal intensity alterations of the IPFP are strongly associated with patellar chondromalacia severity. In contrast, dimensional measurements alone (area or depth) do not reflect disease severity, highlighting the superior diagnostic value of qualitative signal assessment.
Objective: To comparatively evaluate the clinical, functional, radiological, and cost related outcomes of Kirschner wire fixation versus volar locking plate osteosynthesis in the management of intra-articular distal radius fractures. Methods: A retrospective comparative study was conducted in 133 patients who had Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association type C distal radius fractures and who underwent surgical treatment between 2017 and 2023. Patients were allocated to two groups based on fixation technique: Kirschner wire fixation (n=67) and volar locking plate fixation (n=66). Functional outcomes were assessed using the disabilities of the arm, shoulder and hand (DASH) questionnaire and the Mayo Wrist Score at the 1st, 3rd, and 6th postoperative months. Additionally, Wrist range of motion, perioperative variables, and total treatment costs were analyzed. Longitudinal and intergroup comparisons were performed to determine temporal recovery patterns and treatment-related differences. Results: Kirschner wire fixation was associated with significantly shorter operative duration, reduced intraoperative blood loss, shorter hospitalization, and substantially lower overall treatment cost compared with volar plating (all P < 0.001). Conversely, patients treated with volar plate osteosynthesis demonstrated significantly superior functional recovery and greater wrist range of motion during the early postoperative period (P < 0.001). Although both groups exhibited progressive and significant improvement over time (P < 0.001), intergroup differences diminished by the sixth postoperative month. Notably, DASH scores at 6 months indicated slightly better patient-reported outcomes, suggesting comparable mid-term patient-reported functional outcomes with the less invasive technique despite inferior early recovery. Conclusion: Volar locking plate fixation provides enhanced early postoperative functional recovery and wrist mobility in intra-articular distal radius fractures. However, Kirschner wire fixation remains a cost-effective and surgically efficient alternative with comparable mid-term clinical outcomes. These findings support an individualized treatment strategy based on fracture characteristics, patient expectations, surgeon experience, and healthcare resource considerations.
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.
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.
Objective: This study aimed to investigate the relationship between serum leptin, ghrelin, and insulin-like growth factor-1 (IGF-1) levels and bone mineral density (BMD) in patients with ulcerative colitis (UC) to elucidate possible mechanisms underlying impaired bone mineralization in UC. Methods: A total of 38 patients with UC and 38 age- and sex-matched healthy controls were included. Serum levels of leptin, ghrelin, IGF-1, and tumor necrosis factor-alpha (TNF-α) were measured during both the active and remission phases. Bone mineral densitometry was performed using dual-energy X-ray absorptiometry, and vertebral and femoral T- and Z-scores were recorded. The results were compared between disease phases and those of controls. Results: Among UC patients, 27% had normal BMD, 50% were osteopenic, and 23% were osteoporotic. Mean T- and Z-scores were significantly lower in UC patients than in controls (P < 0.05). Serum leptin and IGF-1 levels during the active phase were significantly decreased, while ghrelin and TNF-α levels were significantly elevated, compared with controls (P < 0.05). In remission, ghrelin levels remained higher than in controls (P < 0.05), whereas leptin, IGF-1, and TNF-α levels were similar. A positive correlation was observed between IGF-1 and femoral neck T-scores in the active phase (P < 0.05). Conclusion: BMD is significantly reduced in UC patients, particularly during active inflammation. Decreased secretion of leptin and IGF-1 and elevated ghrelin levels may contribute to bone loss, highlighting the interplay among inflammation, metabolism, and skeletal health in UC.
