Category: Statistics

Acta Orthop Traumatol Turc. 2025 Oct 27;59(6):458-462. doi: 10.5152/j.aott.2025.25303.

ABSTRACT

OBJECTIVE: This study aimed to compare the functional outcomes and complications of cemented versus cementless femoral stem fixation in end-stage chronic kidney disease (CKD) patients with traumatic femoral neck fractures (FNF).

METHODS: This retrospective cohort study included 43 hips of 42 patients with end-stage chronic kidney disease (mean age 77.7 years; range, 55-89; 42.9% female) who underwent hemiarthroplasty for traumatic femoral neck fractures at a regional trauma center between 2010 and 2022. Patients were divided into two groups according to the fixation method: cemented hemiarthroplasty (n = 23) and cement less hemiarthroplasty (n = 20). Functional outcomes were assessed using the Harris Hip Score (HHS), and complications including throm boembolic events, surgical site infection, periprosthetic fracture, prosthesis dislocation, osteolysis, reoperation, and mortality were evaluated.

RESULTS: The mean follow-up duration was 45.1 months. At final follow-up, the mean HHS was significantly higher in the cementless group compared with the cemented group (72.1 vs. 68.3, P = .011). Osteolysis occurred more frequently in the cemented group (30.4% vs. 0%, P = .008). No statistically significant differences were observed between the groups regarding thromboembolic events (0% vs. 5.0%, P = .284), surgical site infection (4.3% vs. 10.0%, P = .473), periprosthetic fracture (4.3% vs. 0%, P = .351), prosthesis dislocation (8.7% vs. 5.0%, P = .639), reoperation rates (13.0% vs. 15.0%, P = .855), or overall mortality (69.6% vs. 60.0%, P = .517).

CONCLUSION: In end-stage CKD patients with traumatic FNFs, cementless hemiarthroplasty was associated with fewer cases of osteolysis and better functional outcomes compared with cemented fixation. These findings highlight the potential biomechanical advantage of cementless fixation in prolonging prosthesis survival and support its consideration as the preferred option in patients with end-stage CKD. Cite this article as: Abul MS, Yılmaz H, Sevim ÖF, Hekim Ö, Kayaalp ME, Eceviz E. Cemented versus cementless hemiarthroplasty in end-stage chronic kidney disease: A retrospective comparative study of femoral neck fracture outcomes. Acta Orthop Traumatol Turc., 2025;59(6):458-462.

PMID:41578806 | DOI:10.5152/j.aott.2025.25303

Eurasian J Med. 2025 Dec 1;57(4):1-5. doi: 10.5152/eurasianjmed.2025.25972.

ABSTRACT

BACKGROUND: Influenza is a viral infection affecting all age groups, with high transmissibility and the potential to cause epidemics and pandemics. Accurate and early prognosis prediction is essential for effective disease management and outbreak control. The objective of the present research was to assess the significance of mean platelet volume (MPV) and its relationship with inflammatory markers, particularly C-reactive protein (CRP), in predicting the prognosis of Influenza A (H1N1) infection.

METHODS: A retrospective analysis was conducted on 133 hospitalized patients who presented with respira tory symptoms and tested positive for H1N1 via nasopharyngeal swab. Data on MPV and CRP levels were collected at admission. The presence of comorbidities and clinical outcomes, including mortality, were also recorded. The relationship between MPV, CRP, and patient outcomes was statistically evaluated.

RESULTS: Comorbid conditions were found in 66.2% of the patients. Among the 31 patients who died (23.3%), 77.4% had comorbidities. Mortality was significantly higher in those with comorbidities (27.3%) than those without (15.5%). Compared with the healthy control group, patients exhibited a markedly lower MPV and higher CRP levels (both P < .005). Intensive care unit (ICU) patients had higher CRP levels than non-ICU patients (P < .005), but MPV did not differ significantly (P = .638). Higher CRP was associated with mortality (P < .005), whereas MPV showed no significant association (P = .086).

CONCLUSION: H1N1 infection has the potential to cause severe and fatal outcomes, particularly in elderly patients with comorbidities. Elevated CRP at admission may serve as a valuable prognostic marker. Although MPV may contribute diagnostically, its prognostic utility appears limited compared to CRP. Cite this article as: Tüzün Z, Saler T, Tüzün K, Çelik U, Avci BŞ. Association between mean platelet volume and other inflammatory markers in patients with influenza A (H1N1). Eurasian J Med. 2025, 57(4), 0972, doi:10.5152/eurasianjmed.2025.25972.

PMID:41578803 | DOI:10.5152/eurasianjmed.2025.25972

Eurasian J Med. 2026 Jan 10;58(1):1-5. doi: 10.5152/eurasianjmed.2026.261165..

ABSTRACT

BACKGROUND: To assess macular layer thickness, macular vessel density, and foveal avascular zone (FAZ) parameters in prediabetic patients compared with healthy normoglycemic controls using optical coherence tomography angiography (OCTA).

METHODS: Thirty prediabetic patients (group A; fasting plasma glucose 100-125 mg/dL, postprandial plasma glucose 140-199 mg/dL, glycated hemoglobin 5.7%-6.4%) and 30 age-matched normoglycemic subjects (group B) were included. The OCTA imaging was used to evaluate superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities, as well as FAZ area and perimeter. Participants with poor image quality, high refractive error, glaucoma, prior intraocular surgery, chorioretinal atrophy, or other ocular/systemic comorbidities were excluded.

RESULTS: The SCP and DCP perfusion densities (PDs) were lower in the prediabetic group, with significant reductions in the inferior and temporal quadrants of the DCP and the temporal quadrant of the SCP (P < .05). The FAZ area and perimeter were larger in the prediabetic group but not statistically significant (P > .05). Macular thickness was greater in all quadrants in group A, with significant thickening in the nasal and inferior quadrants (P < .05).

CONCLUSION: Prediabetic patients demonstrated early microvascular and structural changes, including reduced macular PD, increased macular thickness, and FAZ enlargement. These findings suggest subclinical retinal involvement in prediabetes, warranting larger longitudinal studies. Cite this article as: Utlu B, Utlu ES, Çinici E, Akgöz H, Bayrakçeken K, Kozan BD. Optical coherence tomography angiography-based evaluation of foveal avascular zone and macular vessel density in prediabetic patients. Eurasian J Med. 2026, 58 (1),1165, doi:10.5152/eurasianjmed.2026.261165.

PMID:41578802 | DOI:10.5152/eurasianjmed.2026.261165.

Eurasian J Med. 2025 Dec 17;57(4):1-5. doi: 10.5152/eurasianjmed.2025.251097.

ABSTRACT

BACKGROUND: Cryptorchidism, defined as the failure of the testes to descend into the scrotum, is a common condition in male children. The authors aimed to assess the testicular volume in children of different ages with cryptorchidism and to investigate its potential effects on testicular development.

METHODS: This retrospective study was approved by the institutional ethics committee. The study included 480 patients with abnormal scrotal ultrasonography findings and 67 control cases between January 2024 and January 2025. Testicular volume was calculated. Measurements were conducted by a pediatric radiologist with at least 10 years of experience.

RESULTS: The mean age of the enrolled male children was 21 months. A significant difference was observed between right testicular volumes (0.24 Å} 0.1) and left testicular volumes (0.27 Å} 0.13) in patients with right cryptorchidism (t = -4.568; P < .001). Similarly, there was a significant difference between right testicular volumes (0.26 Å} 0.12) and left testicular volumes (0.23 Å} 0.09) in patients with left-sided cryptorchidism (t = 4.661; P < .001). There were statistically significant differences in testicular volumes according to age groups in patients with cryptorchidism, hydrocele, and descended testis (F = 3.216; P = .013, F = 3.428; P = .013, F = 26.135; P < .001, respectively).

CONCLUSION: Testicular volumes in males under 3 years with cryptorchidism are significantly smaller than in healthy children. Cite this article as: Konukoğlu O, Kaya M, Cindemir E, Pirimoglu RB. Evaluation of testicular volume in children aged 6-36 months with cryptorchidism: a retrospective ultrasonographic study. Eurasian J Med. 2025, 57(4), 1097, doi: 10.5152/eurasianjmed.2025.251097.

PMID:41578799 | DOI:10.5152/eurasianjmed.2025.251097

Acta Orthop Traumatol Turc. 2025 Nov 7;59(6):452-457. doi: 10.5152/j.aott.2025.24054.

ABSTRACT

OBJECTIVE: This national database study of a large cohort aimed to investigate the mortality and complication rates of patients with a his tory of solid organ transplantation (SOT) who underwent total knee arthroplasty (TKA), total hip arthroplasty (THA), or hemiarthroplasty (HA). Additionally, this study aimed to identify predictive factors for medical and surgical complications as well as mortality in this patient population.

METHODS: This cohort study utilized data from the Turkish Ministry of Health to assess SOT patients undergoing TKA, THA, and HA. Propensity score matching was applied to create a comparable control group. Primary endpoints included medical and surgical complica tions within 90 days and mortality rates (in-hospital, at 1 month, 3 months, 1 year, and overall).

RESULTS: Kidney transplantation was the most common type of transplant (n = 666, 81.5%), followed by liver transplantation (n = 101, 12.4%). Revision rates were 4.5% in the SOT group and 3.9% in the control group (P = 0.472). SOT patients exhibited higher rates of medical complications, including chronic renal failure, pneumonia, electrolyte imbalances, urinary complications, and transfusion needs (P < 0.001). Mechanical complications were less frequent in the SOT group (2.57%) compared to the control group (3.7%), but prosthetic joint infection (PJI) rates were higher (2.57% vs. 1.4%, P = 0.035). Fracture history (HR: 4.82, 95% CI: 1.66-13.97, P = 0.004), chronic obstruc tive pulmonary disease (HR: 1.7, 95% CI: 1.17 2.46, P = 0.005), and age (HR: 1.034, 95% CI: 1.01-1.05, P < 0.001) were identified as indepen dent predictors of 90-day mortality. Patients undergoing HA experienced significantly higher mortality compared to TKA and THA (17.5%, 1.1%, and 1.7%, respectively; P < 0.001).

CONCLUSION: SOT patients undergoing joint arthroplasty have elevated risks of complications and mortality, particularly in the presence of fractures. Multidisciplinary management, perioperative optimization of modifiable comorbidities, and close monitoring may help mitigate these risks and improve patient outcomes. Cite this article as: Kürşat Yılmaz M, Serdar Hakyemez Ö, Birinci M, et al. Hip and knee arthroplasty in solid organ transplant patients: results from a Turkish government-based health registry. Acta Orthop Traumatol Turc., 2025;59(6):452-457.

PMID:41578796 | DOI:10.5152/j.aott.2025.24054

Turk J Gastroenterol. 2026 Jan 5;37(1):127-135. doi: 10.5152/tjg.2026.25693.

ABSTRACT

BACKGROUND/AIMS: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing globally. The Fibrosis-4 (FIB-4) score is a noninvasive biomarker used for assessing potential advanced fibrosis. The study aimed to evaluate the role of the FIB-4 score in predicting postoperative complications and mortality in patients undergoing surgery.

MATERIALS AND METHODS: This multicenter retrospective study included 11 072 patients who underwent surgery under general anesthesia. Demographic and clinical data-including age, gender, comorbidities, FIB-4 scores, American Society of Anesthesiologists classification, postoperative complications, and mortality-were analyzed.

RESULTS: A total of 1667 MASLD patients were included. Patients were classified based on FIB-4 scores: 70% (n = 1167) had FIB-4 <1.30, 25.1% (n = 418) had 1.30 < FIB-4 ≤ 2.67, and 4.9% (n = 82) had FIB-4 ≥ 2.67. Due to the limited number of patients with possible advanced fibrosis (FIB-4 ≥ 2.67), propensity score (PS) matching was performed. After PS matching, patients with a high FIB-4 score exhibited a significantly higher rate of postoperative complications (P < .001), and 12-month mortality was elevated (11%), although the difference was not statistically significant (P = .481).

CONCLUSION: A high FIB-4 score may serve as a predictive marker for postoperative complications in patients with MASLD undergoing surgery. Cite this article as: Eren F, Goktug MR, Ari D, et al. Fibrosis-4 score and postoperative outcomes in metabolic dysfunction-associated steatotic liver disease. Turk J Gastroenterol. 2026;37(1):127-135.

PMID:41578786 | DOI:10.5152/tjg.2026.25693

Acta Orthop Traumatol Turc. 2025 Nov 7;59(6):446-451. doi: 10.5152/j.aott.2025.24189.

ABSTRACT

OBJECTIVE: To prospectively evaluate the safety and effectiveness of arthroscopic acellular dermal matrix (ADM) augmentation of large rotator cuff tear repairs (RCR) in a comparative study.

METHODS: A prospective single-center series of 20 patients undergoing arthroscopic RCR. The patients were randomized to arthroscopic transosseous-equivalent rotator cuff patch augmentation repair with a decellularized dermis prepared in the tissue bank or a control group without augmentation. Preoperative and postoperative functional outcomes were assessed by The University of California- LosAngeles (UCLA) score. Magnetic resonance imaging (MRI) evaluation was obtained 1 year after surgery. All adverse events were recorded. Statistical analysis was performed in R 4.2 (Boston, USA), using non-parametric group tests for paired data to evaluate functional results. The mean age was 59 years in the ADM group and 56.7 years in the control group. The gender distribution was 60% male and 40% female in both groups.

RESULTS: Each group consisted of 10 patients, with no statistically significant differences observed in age, body mass index, or preoperative UCLA assessment. In the ADM augmentation group, 2 patients required reoperation due to re-tear before the end of the follow-up period.No statistically significant differences were found in functional outcome measures at any of the evaluation points. Final MRI identified 5 reruptures in the matrix group and 6 in the control group, showing no statistical difference between groups. No adverse events attribut able to the presence of the grafts were detected.

CONCLUSION: These findings suggest that ADM augmentation may yield outcomes comparable to standard care, in terms of UCLA scores and re-tear rates. No adverse events related to ADM were observed. Cite this article as: Sastre S, Pérez ML, Postnikov Y, et al. Prospective comparative study of arthroscopic rotator cuff repair with or without acellular dermal matrix augmentation: Clinical and radiological outcomes. Acta Orthop Traumatol Turc., 2025;59(6):446-451.

PMID:41578784 | DOI:10.5152/j.aott.2025.24189

Arch Rheumatol. 2025 Dec 1;40(4):492-498. doi: 10.5152/ArchRheumatol.2025.25088.

ABSTRACT

BACKGROUND/AIMS: Sarcopenia is known to worsen clinical outcomes in osteoarthritis, particularly in weight-bearing joints, yet its relationship with symptom burden in hand osteoarthritis has not been well established. This study explored the relationship between sarcopenia, hand pain, and functional status in patients with hand osteoarthritis.

MATERIALS AND METHODS: A retrospective analysis was conducted on 1139 patients aged ≥40 years with radiographically confirmed hand osteoarthritis. Sarcopenia was defined as the ratio of muscle mass to body mass index, measured via bioelectrical impedance analysis. Hand pain and function were assessed using the Australian/Canadian Osteoarthritis Hand Index, and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Sex-specific multivariable linear regression models were constructed, adjusting for demographic and lifestyle covariates.

RESULTS: In males, lower appendicular skeletal muscle mass/body mass index was significantly associated with higher DASH scores (estimate: -10.664, P = .006). A significant association with higher Australian/Canadian Osteoarthritis Hand Index scores was also observed (estimate: -26.236, P = .030). Lower upper-extremity muscle mass/body mass index was likewise associated with higher DASH scores in males (estimate: -41.074, P = .013). In females, none of the associations reached statistical significance.

CONCLUSION: These findings suggest that sarcopenia contributes to increased pain and disability in hand osteoarthritis, highlighting the clinical importance of preserving muscle mass in its management. Cite this article as: Lee H, Lee S-I, Cheon Y-H, et al. Association of sarcopenia with pain and disability in hand osteoarthritis: a retrospective, cross-sectional, single-center study. Arch Rheumatol. 2025;40(4):492-498.

PMID:41578777 | DOI:10.5152/ArchRheumatol.2025.25088

Crit Care. 2026 Jan 23. doi: 10.1186/s13054-026-05858-5. Online ahead of print.

ABSTRACT

BACKGROUND: Optimal pain and sedation management in intensive care unit (ICU) remains challenging. While opioids and benzodiazepines are widely used, their adverse effects highlight the need for alternative or adjunctive strategies. Ketamine, with its analgesic and opioid-sparing has been proposed as an adjuvant. However, current evidence regarding its efficacy in ICU patients, particularly within the surgical population, remains inconclusive. We evaluated whether continuous low-dose ketamine infusion in postoperative surgical ICU patients reduces opioid consumption and improves pain intensity, and whether it affects opioid-related adverse events and key ICU recovery outcomes.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing continuous postoperative ketamine infusion versus non-ketamine based infusion for analgesia & sedation in patients admitted to the surgical ICU. Literature searches were performed in PubMed, Cochrane Central, and ClinicalTrials.gov from inception until July 2025. The primary endpoints were cumulative opioid consumption in the first 24-48 h (standardized to IV morphine equivalents where applicable) and rest pain intensity at prespecified early postoperative timepoints. Secondary endpoints included PONV, psychotomimetic events (e.g., hallucinations), and ICU recovery outcomes (e.g., ICU length of stay and duration of mechanical ventilation) when reported. We performed random-effects meta-analyses and assessed certainty using GRADE.

RESULTS: Nine RCTs comprising 666 patients were included. Ketamine significantly reduced opioid consumption at 24 h in adults (mean difference [MD] – 5.77 mg morphine equivalents; 95% CI – 6.32 to – 5.23; p < 0.0001), although the reduction at 48 h and in pediatric subgroups was not statistically significant. Pain scores at 12, 24, and 48 h were comparable between the groups. Ketamine did not significantly shorten the mechanical ventilation time (MD – 0.84 h; 95% CI – 1.93 to 0.24) or ICU length of stay (MD – 0.97 h; 95% CI – 1.95 to 0.02). However, ketamine use was associated with a lower incidence of PONV (RR 0.59; 95% CI 0.36-0.98; p = 0.0399). Psychotomimetic adverse events were infrequent and not significantly increased. GRADE evidence was moderate for opioids in adults at 24 h and low to very low for the remaining outcomes.

CONCLUSIONS: In postoperative surgical ICU patients, continuous low-dose ketamine infusion provides modest opioid sparing and is associated with lower PONV, without clear improvements in pain scores or ICU recovery outcomes. Large-scale trials with different dosing protocols are needed to explore the optimal role of ketamine beyond analgesia and PONV reduction.

PMID:41578281 | DOI:10.1186/s13054-026-05858-5

BMC Public Health. 2026 Jan 23. doi: 10.1186/s12889-025-26157-8. Online ahead of print.

ABSTRACT

BACKGROUND: HIV has been reported a disproportionately increase among young students worldwide including China. Considering newly enrolled university students experienced living away from home, the absence of family control and the changes from a relatively closed environment to an open environment, HIV related knowledge, attitudes and practices (KAP) for this group may change after enrollment in universities. Thus, we aim to explore the changes of HIV related knowledge, attitudes and practices in newly enrolled students in universities.

METHOD: This prospective-based investigations were carried out among students when they enrolled in the university and 3 months after enrollment. All the newly enrolled students in the university were invited to participate in the investigation. HIV related knowledge was measured using the 8-item HIV Knowledge Questionnaire. Changes regarding HIV related knowledge, attitudes, sexual behaviors and social network self-efficacy were analyzed, and statistical differences were examined using Mcnemar and Wilcoxon signed-rank test.

RESULTS: Among the participants, 56.2% (431) were male students with 43.8% (336) were female students. The average HIV related knowledge score was 7.55 ± 0.73 at the enrolment and it increased to 7.64 ± 0.65 after 3 months of enrollment (p < 0.001). Regarding the HIV related attitudes, most items showed no significant difference between enrolment and after 3 months of enrolment (p > 0.05). However, more students thought they had traditional sexual beliefs after 3 months of enrollment compared with that at the enrollment (42.5% vs. 32.8%). Regarding the HIV related practice, the romantic love experiences increased from 23.2%(178/767) at enrollment to 30.0%(230/767) after 3 months of enrollment(p < 0.001), and the percentage of having sexual intercourse increased from 1.2%(9/767) to 2.0%(15/767) although it did not show significant difference with the P value of 0.07. In addition, condom using, sexual partner and internet dating did not show statistical difference between enrollment and after 3 months of enrollment (p > 0.05). The total score of social networking self-efficacy decreased from 80.31 to 79.25 from enrollment to 3 months after enrolment(p = 0.002) with decreased dimension of self-disclosure (p = 0.002) and self-control (p < 0.001).

CONCLUSION: This prospective study highlights that newly enrolled university students experienced an increase in HIV-related knowledge and a rise in romantic relationship within the first three months. However, this was not accompanied by a positive shift in attitudes or safer practices. This knowledge-behavior gap, coupled with declining social self-efficacy, highlights the urgent need for early, skills-based HIV interventions that go beyond mere knowledge dissemination to effectively address behavioral risks during this transitional period.

PMID:41578249 | DOI:10.1186/s12889-025-26157-8