Category: Statistics

Turk J Med Sci. 2025 Oct 8;56(1):344-350. doi: 10.55730/1300-0144.6168. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: The protein kinase RNA-like endoplasmic reticulum kinase (PERK) pathway plays a critical role in preventing the accumulation of misfolded or unfolded proteins within the endoplasmic reticulum. In this study, the role of the PERK signaling pathway was evaluated in newly diagnosed, treatment-naïve patients with acute myeloid leukemia (AML).

MATERIALS AND METHODS: Plasma levels of eukaryotic translation initiation factor 2-alpha kinase 3 (eIF2AK3), glucose-regulated protein 78 (GRP78), activating transcription factor 6 (ATF6), CCAAT/enhancer-binding protein homologous protein (CHOP), hypoxia-inducible factor-1 alpha (HIF-1α), and caspase 3 were measured by enzyme-linked immunosorbent assay in peripheral blood samples obtained from AML patients and healthy controls.

RESULTS: A total of 40 individuals were included, comprising 19 (47%) AML patients and 21 (53%) healthy controls. HIF-1α, eIF2AK3, GRP78, ATF6, CHOP, and caspase 3 levels were significantly higher in the AML group than in the control group (p = 0.019, 0.005, <0.001, 0.006, <0.001, and <0.001, respectively). No significant differences were observed in HIF-1α, GRP78, ATF6, CHOP, and caspase 3 levels between diagnosis and the 30th day of remission-induction therapy in the AML group, whereas a significant decrease was observed in eIF2AK3 levels (p = 0.049). At diagnosis, a strong positive correlation was found between GRP78 and CHOP levels (r = 0.740, p < 0.001), and a moderate positive correlation was detected between CHOP and caspase 3 levels (r = 0.514, p = 0.024) in the AML group. In the Cox regression analysis of the AML cohort, no statistically significant association was identified between overall survival and age, risk category, or biomarker levels (HIF-1α, eIF2AK3, GRP78, ATF6, CHOP, and caspase 3).

CONCLUSION: PERK and ATF6 signaling pathways were activated in patients with AML. Targeting the unfolded protein response pathway may represent a promising therapeutic strategy for patients with AML.

PMID:41816747 | PMC:PMC12974292 | DOI:10.55730/1300-0144.6168

Turk J Med Sci. 2025 Nov 17;56(1):144-151. doi: 10.55730/1300-0144.6147. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: This study aimed to evaluate the impact of diabetic foot ulcers (DFUs) on retinal microvascular changes, specifically the radial peripapillary capillary (RPC) vessel density and retinal nerve fiber layer (RNFL) thickness in patients with mild-to-moderate nonproliferative diabetic retinopathy (NPDR).

MATERIALS AND METHODS: Ninety participants were enrolled and divided into three groups: 30 patients with DFUs and mild-to-moderate NPDR, 30 patients with NPDR but without DFUs, and 30 healthy controls. RPC density and RNFL thickness were evaluated using optical coherence tomography angiography (OCTA), a noninvasive imaging method. Comparisons between groups were made with statistical adjustments, including optic disc area.

RESULTS: Patients with DFUs exhibited significantly lower RPC vascular density across multiple quadrants than those without DFUs and healthy controls (p < 0.001). Furthermore, RNFL thickness was significantly increased in the DFU group, particularly in the inferior-hemi (p < 0.001) and temporal-inferior (p < 0.001) quadrants. The optic disc area was significantly larger in the DFU group (p = 0.017), which may have influenced the RNFL measurements.

CONCLUSION: The study underscores notable alterations in RPC density and RNFL thickness among patients with DFUs and mild-to-moderate NPDR. These alterations may reflect systemic microvascular impairment, potentially exacerbated by systemic inflammation, or changes suggestive of reactive gliosis, though further validation is needed. These findings underscore the need for early ophthalmological evaluation and a comprehensive approach to managing both peripheral and ocular diabetic complications. Future studies incorporating systemic inflammatory biomarkers and functional visual assessments are needed to explore the mechanisms underlying these retinal changes.

PMID:41816743 | PMC:PMC12974285 | DOI:10.55730/1300-0144.6147

Turk J Med Sci. 2025 Dec 21;56(1):23-31. doi: 10.55730/1300-0144.6134. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: Gout, the most prevalent form of inflammatory arthritis, has shown a global increase in prevalence; however, data from Türkiye remain scarce, inconsistent, and largely confined to western regions. This study aimed to estimate the prevalence of gout among adults in the Sincan district of Ankara, Türkiye, and to provide updated data from a previously understudied region.

MATERIALS AND METHODS: This cross-sectional, community-based study employed a multistage design. Adults aged ≥18 years who presented to selected family health centers in Sincan between February and June 2023 were screened using a structured questionnaire. Individuals with suspected gout underwent comprehensive clinical evaluation, including medical history, physical examination, and relevant laboratory testing, conducted by rheumatologists. Gout was classified according to the 2015 ACR/EULAR criteria, with a score of ≥8 required for classification.

RESULTS: Of the 517 individuals approached, 515 provided consent, and data from 513 participants were included in the final analysis. Screening identified 26 individuals with suspected gout, of whom 24 completed evaluation, resulting in the confirmation of seven gout cases (five men and two women). The overall estimated prevalence of gout was 1.36% (95% CI: 0.55%-2.81%). Prevalence was higher in men (2.18%; 95% CI: 0.71%-5.01%) than in women (0.70%; 95% CI: 0.09%-2.52%) although this difference was not statistically significant due to the small sample size, and prevalence increased with age.

CONCLUSION: These findings provide updated epidemiological data, indicating a higher prevalence than previously reported in western Türkiye, while remaining within the lower range of global estimates. These data underscore the need to enhance gout awareness and to develop effective management strategies within the Turkish population.

PMID:41816741 | PMC:PMC12974274 | DOI:10.55730/1300-0144.6134

Turk J Med Sci. 2026 Jan 19;56(1):218-228. doi: 10.55730/1300-0144.6155. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: Effective postoperative pain management after cesarean section is essential for maternal recovery. Poor pain control can lead to complications, including postpartum depression. This study aimed to compare the postoperative analgesic efficacy of erector spinae plane (ESP) and transversus abdominis plane (TAP) blocks following cesarean section, with a particular focus on their potential impact on postpartum depression.

MATERIALS AND METHODS: Sixty patients were randomly assigned to receive either an ESP block (Group E, n = 30) or a TAP block (Group T, n = 30) after cesarean section. Pain severity was assessed using a visual analog scale (VAS), and the need for rescue analgesics and patient satisfaction were recorded. Postpartum depression was evaluated using the Edinburgh Postpartum Depression Scale (EPDS) at 4-6 weeks postpartum.

RESULTS: There was no significant difference between the groups in analgesic duration (Group E: 15 h, Group T: 14 h, p = 0.314). Group E showed a significantly lower need for rescue analgesics (0 vs. 1, p = 0.049). The VAS score at the first hour was lower in Group E (2 vs. 3, p = 0.032), but no differences were observed at subsequent time points. Postpartum depression rates were not statistically significant.

CONCLUSION: With the ESP block, no significant difference was observed compared to the TAP block in terms of total analgesic duration, opioid consumption, postpartum depression, or patient satisfaction, except for the postoperative 1-h VAS pain score. This suggests that the ESP block does not provide clear superiority over the TAP block.

PMID:41816738 | PMC:PMC12974309 | DOI:10.55730/1300-0144.6155

Turk J Med Sci. 2025 Nov 17;56(1):32-37. doi: 10.55730/1300-0144.6135. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: To evaluate the association between the preoperative pan-immune inflammation value (PIV) and prognostic factors, including stage, lymph node involvement, and metastasis, in patients who underwent radical orchiectomy for germ cell testicular tumors.

MATERIALS AND METHODS: Data from 178 patients who underwent radical orchiectomy for testicular tumors between January 2014 and January 2024 were retrospectively reviewed. Preoperative serum tumor markers, hematologic parameters, and histopathological findings were recorded. Tumor staging was determined based on radiological imaging and serum tumor markers. The PIV was calculated using the formula: (monocyte count × neutrophil count × platelet count) / lymphocyte count. Optimal cut-off values for PIV were determined using ROC curve analysis. The association between the PIV score and clinicopathological variables was analyzed.

RESULTS: The mean age of the patients was 32.34 ± 9.62 years. The mean PIV score in patients with metastasis and retroperitoneal lymph node invasion (RPLNI) was significantly higher than in those without metastasis or RPLNI (p = 0.01 and p = 0.04, respectively). The PIV score increased progressively with higher tumor T, N, and M stages. Additionally, a statistically significant increase in PIV scores was observed among patients classified into higher International Germ Cell Cancer Collaborative Group risk groups (p = 0.01).

CONCLUSION: Higher PIV scores are significantly associated with tumor stage, lymph node involvement, and metastasis in patients with germ cell testicular tumors. The PIV score appears to be a useful and cost-effective preoperative marker for predicting advanced disease in testicular tumors at the time of diagnosis.

PMID:41816726 | PMC:PMC12974310 | DOI:10.55730/1300-0144.6135

Turk J Med Sci. 2025 Oct 13;56(1):265-273. doi: 10.55730/1300-0144.6160. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: This study aimed to evaluate the relationship between the impaction level and angulation of third molars and the incidence of caries in the adjacent second molars.

MATERIALS AND METHODS: A total of 690 panoramic radiographs obtained from patients at Ankara Yıldırım Beyazıt University between May 2022 and January 2024 were retrospectively analyzed. Third molars were classified based on their eruption status using the Pell and Gregory classification (levels A, B, and C), and angulation (mesioangular, distoangular, vertical, horizontal, and inverted). The presence of caries in adjacent second molars was assessed using the international caries detection and assessment system/international caries classification and management system. The association between third molar position and the presence of caries in second molars was statistically evaluated.

RESULTS: Among the 1164 third molars assessed, 52.9% were located in the mandible, and 75.2% were in a vertical position. Carious lesions were identified in 22.3% of third molars. Adjacent mandibular second molars had caries in 53.2% of cases, compared to 35.6% in the maxilla. According to the Pell and Gregory classification, class I, level A mandibular third molars were associated with the highest incidence of caries in adjacent second molars (159 out of 616). Furthermore, when only impacted teeth were considered, mesioangular impactions were associated with the highest prevalence of caries, observed in 41.1% of cases (51 out of 123).

CONCLUSION: The findings indicate that the position and angulation of third molars play an important role in the risk of caries development in adjacent second molars. In the mandible, level A third molars in vertical (65.2%) and mesioangular (41.1%) positions had the greatest risk for caries development in adjacent second molars, whereas in the maxilla, the highest risk was found in vertical (47.3%) and mesioangular (25.7%) impactions. These results underscore the importance of early clinical evaluation and the implementation of preventive strategies to minimize caries risk in second molars associated with impacted third molars.

PMID:41816725 | PMC:PMC12974290 | DOI:10.55730/1300-0144.6160

Turk J Med Sci. 2025 Aug 19;56(1):256-264. doi: 10.55730/1300-0144.6159. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: Healthcare workers (HCWs) face increased risks of COVID-19 infection due to occupational exposure. Understanding infection sources, risk factors, and workforce losses is crucial for mitigating these impacts in future pandemics. This study aimed to evaluate the risk factors, infection sources, and sickness absenteeism among HCWs diagnosed with SARS-CoV-2 infection, providing insights to enhance infection control strategies.

MATERIALS AND METHODS: The study included 2153 HCWs diagnosed with SARS-CoV-2 between March 2020 and February 2023 at a tertiary care hospital in Türkiye. Demographic, clinical, and professional characteristics, personal protective equipment (PPE) usage, infection sources, and vaccination data were analyzed. Statistical analyses were conducted using the R programming language.

RESULTS: Among infected HCWs, 68.5% were female, and nurses accounted for 39.4% of cases. PPE compliance was significantly higher in COVID-19-specific units compared to non-COVID-19 units (p < 0.001), yet inappropriate PPE use was observed in 10.5% of exposures. Infections were community-acquired in 35.4%, hospital-acquired from colleagues in 24.9%, and from patients in 7.2% of cases, while 32.5% of infections had unidentified sources. Vaccination data revealed that 73.7% of HCWs missed opportunities for timely vaccination, and nearly half of the vaccinated HCWs were not within the protective window at the time of infection. Sickness absenteeism totaled 23,454 days, exceeding expected workforce loss by 2891 days. Hospitalization occurred in 4.1% of cases, with one fatality.

CONCLUSION: The findings highlight the critical importance of comprehensive infection control measures, improved vaccination uptake, and robust workforce management to protect HCWs and sustain healthcare systems during pandemics.

PMID:41816722 | PMC:PMC12974273 | DOI:10.55730/1300-0144.6159

Turk J Med Sci. 2026 Jan 22;56(1):169-175. doi: 10.55730/1300-0144.6150. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: This study aimed to determine the prevalence of knee pain among healthcare workers in surgical units and to explore whether the use of knee panels during surgical hand scrubbing is associated with persistent knee pain.

MATERIALS AND METHODS: This single-center cross-sectional study was conducted between October 2023 and March 2025. A total of 400 physicians and nurses working in surgical and nonsurgical departments were included. Participants completed a structured and modified Nordic Musculoskeletal Questionnaire, as well as knee pain assessment tools, including a visual analog scale (VAS) and the Kujala score for anterior knee pain-related symptoms. Occupational exposure among surgical staff was additionally evaluated. Data were analyzed using IBM SPSS Statistics.

RESULTS: The prevalence of knee pain was 54.8% among surgical personnel and 39.5% among nonsurgical personnel. VAS scores were significantly higher in the surgical group, while there was no significant difference between groups in terms of Kujala scores. Knee panel use was common and more than half of the users reported discomfort during use; however, there was no statistically significant association between panel use and persistent knee pain. Regression analysis identified increasing age, longer duration of surgical experience, and employment in a surgical unit as factors independently associated with knee pain.

CONCLUSION: Employment in a surgical unit is associated with a higher prevalence of knee pain among healthcare workers. However, the use of knee panels during surgical hand scrubbing does not appear to be associated with persistent knee pain. Multicomponent ergonomic interventions should be implemented to prevent musculoskeletal disorders.

PMID:41816721 | PMC:PMC12974304 | DOI:10.55730/1300-0144.6150

Dialogues Health. 2026 Feb 26;8:100287. doi: 10.1016/j.dialog.2026.100287. eCollection 2026 Jun.

ABSTRACT

This study aimed to describe and categorize the eating practices and beliefs of trans women using a mixed-methods approach. Conducted in Cali, Colombia, the study included 33 trans women aged 18 years or older who voluntarily participated in August 2021. Food consumption and eating practices were assessed through structured questionnaires, and the data were analyzed using a Bayesian statistical approach and the Healthy Eating Practices Index (HEPI). In addition, discussion groups were conducted to explore participants’ experiences and food-related beliefs. The results showed that 55% of the trans women presented low levels of healthy eating practices, characterized by limited dietary diversity in recommended food groups and a higher frequency of consumption of less recommended foods. Being under 30 years of age, belonging to a middle socioeconomic level, having lower levels of education and income, living with a partner, and regularly having a salt shaker on the table were factors individually associated with a higher likelihood of unhealthy eating practices. The multiple inequalities faced by the transgender population generate structural barriers that shape food practices within the community as adaptive responses to their living conditions, perpetuating unfavorable dietary patterns. These findings highlight the need for primary health care strategies with a gender-sensitive and trans-affirmative approach, in which nutrition and food practices are addressed through the lens of the social determinants of health. Transforming hegemonic social imaginaries is essential for building inclusive health environments that respect and reflect human diversity.

PMID:41816685 | PMC:PMC12972529 | DOI:10.1016/j.dialog.2026.100287

Front Med (Lausanne). 2026 Feb 24;13:1744123. doi: 10.3389/fmed.2026.1744123. eCollection 2026.

ABSTRACT

INTRODUCTION: Program directors (PDs) play a crucial role in selecting candidates for the Saudi Board of Restorative Dentistry (SBRD) program. However, their views on selection and possible differences in opinions based on candidate characteristics remain unelucidated.

METHODS: This study surveyed restorative dentistry PDs in Saudi Arabia using a pre-validated questionnaire consisting of 30 questions grouped into seven domains to gather views on the selection process for the SBRD program. Responses from 30 participants were analyzed using means and standard deviations. We examined differences in PD variables, such as sex and years of experience using Student’s t-tests. Variations related to geographic location, years of experience as a PD, and hospital setup were assessed using analysis of variance.

RESULTS: The top preferences of the PDs were working as service residents, skill and reputation during electives, and dressing well for interviews. Electives abroad, multiple recommendation letters, and being on the dean’s honor list were less important. Interview was the most favored domain (4.04 ± 0.78), followed by service and electives (4.01 ± 0.47); recommendations were the least favored (3.41 ± 0.77). While differences existed among variables, they weren’t statistically significant, except for the interview domain (p = 0.015), where experienced PDs relied more on interviews compared to first-time PDs.

CONCLUSION: PDs showed diverse responses to all evaluated factors. Interviews and service/electives were most preferred. Service residencies, skills/reputation during electives, and being well dressed during interviews were favored for candidate selection. However, the results should be interpreted cautiously, given the potential limitations of statistical power associated with relatively small sample size.

PMID:41816683 | PMC:PMC12971420 | DOI:10.3389/fmed.2026.1744123