Nevin Manimala

Mov Disord. 2026 Jan 24. doi: 10.1002/mds.70194. Online ahead of print.

ABSTRACT

BACKGROUND: Pain affects up to 87% of people with multiple system atrophy (MSA), but it remains unclear which types of pain contribute most to the overall burden.

OBJECTIVE: To estimate the frequency of different types of pain in MSA individuals.

METHODS: In 2023, individuals with MSA completed a web-based survey that included the King’s Parkinson’s Disease Pain Questionnaire (KPPQ) and additional questions addressing pain related to MSA core features (eg, coat-hanger pain, pain due to bladder-issues, cold extremities, bruises, and pressure sores). Respondents were matched by age, gender, and disease duration with historical cohorts of individuals with Parkinson’s disease (PD) and healthy controls (n = 96 each) who had previously completed the KPPQ.

RESULTS: One hundred and fifty-seven MSA individuals with pain completed the survey. The most frequently reported KPPQ types of pain were nocturnal pain (73%), musculoskeletal pain (63%), and fluctuation-related pain (62%). Common additional pain sources included coat-hanger pain (59%), cold extremities (48%), and bruises (44%). All KPPQ pain types were significantly more frequent in MSA than in healthy controls, except for musculoskeletal pain (63% vs. 66%, P = 0.722). Compared with PD, MSA individuals reported less musculoskeletal (63% vs. 78%, P = 0.023), but more orofacial pain (32% vs. 12%, P < 0.001) on the KPPQ.

CONCLUSIONS: MSA is associated with both non-specific and disease-related pain types, which may be neuropathic, nociceptive, nociplastic, or mixed in nature. These findings inform the development of tailored tools for identifying distinct pain sources in MSA, as each may require a specific therapeutic approach, including targeted treatment of motor and non-motor symptoms. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

PMID:41578842 | DOI:10.1002/mds.70194

Eurasian J Med. 2025 Dec 30;57(4):1-6. doi: 10.5152/eurasianjmed.2025.251160.

ABSTRACT

BACKGROUND: Cognitive flexibility (CF) is an ability to adapt to a changing environment, which is a prominent skill in children at school age. ADHD is a common disorder of childhood and can be accompanied by cognitivedisengagement syndrome (CDS, previously referred to as “sluggish cognitive tempo”). This study aimed to assess CDS’s effect on CF in children with ADHD by using neuropsychological tests.

METHODS: The study sample consisted of 100 ADHD children aged between 6 and 12 years, including 2groups: 60 ADHD-only and 40 CDS+ADHD. ADHD diagnosis and CDS symptoms in participants wereassessed by Diagnostic and Statistical Manual of Mental Disorder Fifth Edition Text Revision (DSM-5-TR)based psychiatric interviews and rating scales. The Neuropsychological Battery, consisting of 4 different tests,Wisconsin Card Sorting Test (WCST), Stroop Color-Word Test, Verbal Fluency Test (VFT), and Color TrailTest, was applied to participants to compare CF of the ADHD-only group to CDS+ADHD.

RESULTS: It was found that the CDS+ADHD group showed lower performance than the ADHD-only groupin the WCST and the Semantic Fluency Test-a subtest of the VFT. However, no significant performancedifferences were found between the groups in other tests.

CONCLUSION: It was revealed that CDS co-occurrence causes lower CF performance in ADHD-diagnosedchildren. A more comprehensive approach is required to understand the nature of this difficulty. Cite this article as: Adak İ, Varan E., Ekinci ., et al. Does cognitive disengagement syndrome affectthe cognitive flexibility of children with ADHD?Eurasian J Med. 2025, 57(4), 1160, doi: 10.5152/eurasianjmed.2025.251160.

PMID:41578829 | DOI:10.5152/eurasianjmed.2025.251160

Eurasian J Med. 2025 Dec 17;57(4):1-6. doi: 10.5152/eurasianjmed.2025.251130.

ABSTRACT

BACKGROUND: Chronic sinusitis with nasal polyp (CSwNP) is a common disease that can be recurrent at a rate of up to 40-60%. Various markers are being investigated to determine the prognosis in the treatment of nasal polyp (NP). Resistin is an inflammatory cytokine that may play a role in the etiology of NP. The aim of the study was to determine the resistin expression in NP epithelium and compare the resistin expression both in normal respiratory epithelium and NP epithelium.

METHODS: The patients who were operated for CSwNP were included as the study group, and the patients without nasal pathology were included as the control group. The operation specimens of the patients were stained with immunohistochemical methods, and the expression of resistin was examined and scored.

RESULTS: Specimens of the 115 patients were included in the study. It was determined that the frequency of asthma (P =. 006), resistin staining percentage (P = .004), resistin staining score (P = .026) and eosinophil percentage (P < .001) were statistically significantly higher in the NP patients than in the control group.

CONCLUSION: It was observed that resistin expression was higher in NP epithelium than in normal respiratory epithelium, and this is the first known study, to the authors’ knowledge, on this subject. Cite this article as: Torun MT, Yılmaz GT. Analysis of resistin expression in nasal polyp tissue. Eurasian J Med. 2025, 57(4), 1130, doi: 10.5152/eurasianjmed.2025.251130.

PMID:41578827 | DOI:10.5152/eurasianjmed.2025.251130

Acta Orthop Traumatol Turc. 2025 Dec 31;59(6):394-404. doi: 10.5152/j.aott.2025.25533.

ABSTRACT

OBJECTIVE: While surgical repair is standard for acute Achilles tendon ruptures, the optimal technique remains debated. This study com pares clinical, functional, and ultrasonographic outcomes between minimally invasive and open surgical approaches, with particular focus on: (1) patient-reported recovery, (2) tendon healing dynamics, and (3) the utility of ultrasound in postoperative monitoring.

METHODS: This retrospective study analyzed 108 consecutive patients undergoing surgical repair for acute Achilles tendon ruptures between 2015-2023, comparing minimally invasive (n = 58; ring forceps technique) and open approaches (n = 50; Krackow technique). Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS), Patient-Reported Outcomes Measurement Information System (PROMIS), and Madrid Sonographic Enthesitis Index (MASEI) scores at standardized 6-, 12-, and 24-month follow-ups, while ultrasonographic evaluations quantified tendon thickness at rupture and insertion sites relative to contralat eral tendons. Complication rates and demographic variables were systematically reviewed, with all patients receiving identical postoper ative rehabilitation protocols.

RESULTS: A total of 108 patients were included in the study, with a mean age of 41.56 ± 13.98 years (range, 18-68). Minimally invasive sur gery was performed in 58 patients (53.7%), while the remaining 50 patients (46.3%) underwent open surgical repair. The mean follow-up duration was 2.4 years (minimum of 2 years of follow-up). Patients in the minimally invasive group reported significantly higher PROMIS scores compared to those in the open surgery group (P < .001). However, no significant differences were observed in AOFAS or MASEI scores between the groups (P > .05). Ultrasonographic evaluation revealed that the mean tendon thickness at the rupture site was signifi cantly greater in the minimally invasive group (1.04 cm; range, 0.93-1.15) than in the open surgery group (0.87 cm; range, 0.77-0.93) (P < .001). Furthermore, the operated-to-intact tendon thickness ratio was 2.13 in the minimally invasive group and 1.78 in the open surgery group, which was also statistically significantly different (P = .006).

CONCLUSION: Minimally invasive achilles tendon repair was associated with potential advantages compared to open techniques, includ ing more favorable patient-reported outcomes (median PROMIS score 80 vs. 76, P < .001), increased tendon thickness (19% greater, P < .001), a potential indicator of differential healing patterns, and lower wound complication rates, while importantly achieving equivalent high-level function as measured by the AOFAS and MASEI scores. The main limitations of this study include its retrospective design and the potential for unmeasured confounding. Ultrasound serves as a critical postoperative tool, objectively quantifying healing progression and informing return-to-sports decisions. These findings suggest potential advantages of minimally invasive approaches and support their consideration as a viable alternative to open repair in selected patients; however, the choice of technique should be individualized based on surgeon experience and patient-specific factors. However, these associative findings require validation in randomized trials. Cite this article as: Yigit O, Erdogan MK, Canbaz SB, et al. Minimally invasive (ring forceps) versus open achilles tendon repair: A retrospective comparison of ultrasonographic and functional outcomes. Acta Orthop Traumatol Turc., 2025;59(6):394-404.

PMID:41578823 | DOI:10.5152/j.aott.2025.25533

Eurasian J Med. 2025 Nov 25;57(4):1-7. doi: 10.5152/eurasianjmed.2025.251024.

ABSTRACT

BACKGROUND: This study examines the impact of trust in science on individuals’ attitudes toward the COVID19 vaccine, with an application to the parallel mediating roles of belief in conspiracy theories and general vaccine hesitancy.

METHODS: A survey of 469 adults in Türkiye was conducted online and paper-based. Direct and indirect effects (IEs) were estimated by parallel mediation analysis using PROCESS Macro Model 4 with 5000 boot strap resamples.

RESULTS: Trust in science was found to influence COVID-19 vaccine attitudes indirectly through 2 distinct psychological mechanisms: reduced belief in conspiracy theories and more positive general vaccine attitudes. Both indirect pathways were statistically significant, confirming their mediating roles. Although the mediation effect through general vaccine attitudes was larger in magnitude, the difference between the 2 IEs was not statistically significant.

CONCLUSION: These results point out 2 separate psychological routes connecting scientific confidence to vac cination acceptance. General vaccine attitudes could be more profound and lasting than crisis-specific ones. This paper provides theoretical and practical insights for creating long-term public health strategies that fos ter trust and combat both misinformation and deep-seated vaccine skepticism by using a parallel mediation approach in the sociocultural setting of Türkiye. Cite this article as: Kara S, Hatipoğlu SS, Arslanoglu NZ, Erdogan Z. The impact of trust in science on COVID-19 vaccine attitudes: parallel mediation through conspiracy beliefs and general vaccine hesitancy. Eurasian J Med. 2025, 57(4), 1024, doi:10.5152/eurasianjmed.2025.251024.

PMID:41578822 | DOI:10.5152/eurasianjmed.2025.251024

Acta Orthop Traumatol Turc. 2025 Nov 25;59(6):428-433. doi: 10.5152/j.aott.2025.25472.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the histopathological and biomechanical effects of intraperitoneal (systemic) and locally applied Papaverine on tendon healing in a rat rotator cuff model in which collagenase – induced tendinopathy was induced.

METHODS: Twenty-four adult male Sprague-Dawley rats were randomly allocated into three groups: Group 1 (control), Group 2 (local papav erine application), and Group 3 (intraperitoneal papaverine application). Supraspinatus tendinopathy was induced by surgical injection of Type I collagenase. Group 2 received local papaverine at the surgical site, while Group 3 received systemic intraperitoneal papaverine. On day 30, the rats were sacrificed, and shoulder tissues were harvested for histopathological and biomechanical analysis.

RESULTS: Histopathological evaluation revealed no significant differences among the groups regarding fiber structure, cellularity, or vascularity (P > .05). In contrast, biomechanical analysis demonstrated that the local papaverine group showed statistically significant superiority over the other groups in tendon breaking force, elongation, and durability (P < .0001).

CONCLUSION: Local application of papaverine improved the biomechanical durability of tendon tissue, although no significant histopatho logical differences were observed. These findings suggest that papaverine may contribute to regenerative processes and could serve as a supportive agent in the treatment of rotator cuff tendinopathy. However, further studies are required to confirm its clinical applicability. Cite this article as: Çelebi ME, Meydaneri S, Çakmak O. Histopathological and biomechanical effects of papaverine application in rotator cuff tendinopathy treatment: An experimental rat model study. Acta Orthop Traumatol Turc., 2025;59(6):428-433.

PMID:41578820 | DOI:10.5152/j.aott.2025.25472

Eurasian J Med. 2026 Jan 10;58(1):1-7. doi: 10.5152/eurasianjmed.2026.25967.

ABSTRACT

BACKGROUND: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease causing pain and functional impairment. Emerging regenerative therapies, including platelet-rich plasma (PRP) and concentrated growth factor (CGF), have shown promise in managing KOA. This study evaluates the short-term efficacy of combined ozone-PRP therapy versus CGF injections in patients with mild to moderate KOA.

METHODS: This retrospective, cross-sectional study analyzed data from 49 patients (94 knees) treated with either ozone-PRP (26 patients, 50 knees) or CGF (23 patients, 44 knees) injections. Pain and function were assessed using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and 1 month after treatment.

RESULTS: Both groups demonstrated significant improvements in VAS and WOMAC scores posttreatment (P < .001). However, inter-group comparisons revealed no statistically significant differences in pain reduction or functional improvement (P > .05). In the CGF group, greater pain reduction was observed compared to ozone-PRP (P = .028), while no between-group differences were found in WOMAC pain, stiffness, function, or total scores (P = .298, P = .066, P = .110, and P = .077, respectively).

CONCLUSION: Both ozone-PRP and CGF injections are effective in reducing pain and improving function in patients with mild to moderate knee osteoarthritis in the short term; however, although CGF provides greater pain reduction, the overall WOMAC outcomes are comparable, and the 2 methods may be used interchangeably based on their respective advantages and clinical considerations. Cite this article as: Ayık B, Sarı.imen G, Bakılan F, Armağan O. Comparative Short-Term Efficacy of Combined Ozone and Platelet-Rich Plasma versus Concentrated Growth Factor in the Treatment of Knee Osteoarthritis. The Eurasian Journal of Medicine 2026, 58(1), 0967, doi: 10.5152/eurasianjmed.2026.25967.

PMID:41578819 | DOI:10.5152/eurasianjmed.2026.25967

Eurasian J Med. 2025 Nov 17;57(4):1-4. doi: 10.5152/eurasianjmed.2025.251038.

ABSTRACT

BACKGROUND: The study aims to evaluate serum endocan (endothelial cell-specific molecule-1) levels in patients with type 2 diabetes mellitus and to determine its relationship with disease activity by comparing it with a control group.

METHODS: Venous blood samples were collected from 63 patients with diabetic retinopathy and healthy indi viduals who visited the policlinic between January 1, 2020, and March 1, 2020. Serum endocan and HbA1c levels were evaluated in the patients.

RESULTS: The mean age of the patient and control groups was 62 ± 10.19 and 60.27 ± 5.53, respectively. No statistically significant difference was observed between the patient and control groups in terms of age and gender. Serum endocan levels were found to be statistically significantly higher in the patient group with diabetic retinopathy (P < .05).

CONCLUSION: It was hypothesized that serum endocan levels could serve as a guiding parameter in assessing the severity of diabetic retinopathy. Cite this article as: Yıldırım M, Çinici E, Çelik M, İçtaş S. Assessment of serum endothelial cell-specific molecule-1 (ESM-1, endocan) levels in patients with diabetic retinopathy. Eurasian J Med. 2025, 57(4), 1038, doi:10.5152/eurasianjmed.2025.251038.

PMID:41578817 | DOI:10.5152/eurasianjmed.2025.251038

Acta Orthop Traumatol Turc. 2025 Dec 31;59(6):470-476. doi: 10.5152/j.aott.2025.25440.

ABSTRACT

OBJECTIVE: Giant cell tumor of the bone (GCTB) is a locally aggressive benign tumor with unpredictable recurrence patterns. While intraos seous recurrences are well-documented, soft tissue recurrence (STR) remains underrecognized. This study aimed to identify risk factors, radiographic features, and histopathological characteristics associated with STR of GCTB.

METHODS: This retrospective study included 69 patients treated for GCTB between 1996 and 2022. Demographic data, tumor location, surgical method, recurrence history, and adjuvant treatments were extracted from medical records. Radiologic assessments were performed using a picture archiving and communication system, and lesions were graded by Campanacci classification. analysis was performed using chi-square, Fisher’s exact, and Mann-Whitney U-tests.

RESULTS: The initial surgical approach was curettage in 55 patients (79.7%), resection in 14 (20.3%). Recurrence occurred in 24 patients (34.8%), and STR was identified in 7 (10.1%). Most STRs were located near the distal femur. Among these, 4 had prior intraosseous recur rence, and 5 had Campanacci grade 3 lesions. No statistically significant association was found between STR and variables including age, sex, tumor volume, Campanacci grade, tumor location, denosumab, or local adjuvant use. H3F3A analysis was performed in 6 out of 7 patients with STR, and positivity was detected in 3 of them. Pulmonary metastasis was documented in 8 patients overall, including 3 of 7 with STR (42.9%) compared with 5 of 62 without STR (8.1%), representing a significant difference.

CONCLUSION: Soft tissue recurrence in GCTB may occur independently or following intraosseous recurrence and is frequently observed in high-grade lesions. Although not statistically significant, the findings suggest a possible association between tumor aggressiveness and STR. Histological features remain consistent with osseous lesions, but the diagnostic value of H3F3A expression in STRs warrants fur ther investigation. Importantly, STR represents a distinct recurrence pattern and may be associated with an increased risk of pulmonary metastasis, underscoring the need for vigilant long-term follow-up and systematic surveillance. Cite this article as: Mirioğlu A, Dalkır KA, Ölke HC, et al. Soft tissue recurrence in giant cell tumor of bone: risk factors and radiological and histopathological features. Acta Orthop Traumatol Turc., 2025;59(6):470-476.

PMID:41578816 | DOI:10.5152/j.aott.2025.25440

Eurasian J Med. 2026 Jan 15;58(1):1-6. doi: 10.5152/eurasianjmed.2026.251104.

ABSTRACT

BACKGROUND: The aim of this study is to evaluate the risk of osteonecrosis of the jaw in patients receiving osteoporosis treatment using C-terminal cross-linked telopeptide of type 1 collagen (CTX-1) values, to analyze follow-ups after drug holidays, and to compare treatment agents and other risk factors to determine the association with CTX-1 results.

METHODS: A total of 273 patients (266 female and 7 male) who received bisphosphonate and denosumab treatment for osteoporosis were included in this retrospective study. Sociodemographic characteristics, vitamin D levels, serum CTX-1 level, presence of diseases affecting CTX-1 levels, type of bisphosphonate, duration of use, presence of drug holidays, and duration of denosumab use (if any) were recorded. The effects of bisphosphonates and denosumab on CTX-1 levels were compared, and differences in the risk of osteonecrosis between them were evaluated.

RESULTS: In this study, a meaningful association was not identified between serum CTX-1 levels and the measured vitamin D values (P = .232). Patients who underwent a drug holiday had significantly higher mean serum CTX-1 levels (266.2 Å} 175.1 pg/mL) compared to those without a drug holiday (199.9 Å} 138.5 pg/ mL; P = .009). Higher CTX-1 levels were observed in individuals receiving ibandronate and alendronate, whereas the lowest values were detected in patients treated with denosumab.

CONCLUSION: Serum CTX-1 levels appeared unaffected by vitamin D. Although the denosumab group exhibited the highest risk of osteonecrosis, the difference compared to zoledronic acid was not statistically significant. These results suggest caution during jaw-related procedures and consideration of drug holidays when necessary. Cite this article as: Ergül EE, Laçin O, Kılıçaslan HÖ, et al. Evaluation of osteonecrosis risk using serum C-terminal cross-linked telopeptide of type 1 collagen (CTX-1) levels in osteoporotic patients: Effects of drug holidays and risk factors. Eurasian J Med. 2026, 58(1), 1104, doi:10.5152/eurasianjmed.2026.251104.

PMID:41578815 | DOI:10.5152/eurasianjmed.2026.251104