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Soft tissue recurrence in giant cell tumor of bone: Risk factors and radiological and histopathological features

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

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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 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

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“What are we measuring?” reconsidering the biological identity and clinical interpretation of malaria-derived particles

Cytometry B Clin Cytom. 2026 Jan 24. doi: 10.1002/cytob.70011. Online ahead of print.

NO ABSTRACT

PMID:41578811 | DOI:10.1002/cytob.70011

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The relationship between preoperative relative second metatarsal length and postoperative transfer metatarsalgia following hallux valgus surgery

Acta Orthop Traumatol Turc. 2025 Dec 31;59(6):387-393. doi: 10.5152/j.aott.2025.25512.

ABSTRACT

OBJECTIVE: This study aimed to investigate the potential association between transfer metatarsalgia, a complication that may arise post operatively following hallux valgus surgery, and the preoperative relative second metatarsal length measured on weight-bearing radio graphs. Additionally, it was sought to evaluate the predictive value of this radiographic parameter.

METHODS: A total of 126 patients who underwent primary hallux valgus surgery between January 2022 and December 2023 and had a minimum follow-up of 12 months were retrospectively reviewed. Patients were categorized into 2 groups based on the presence or absence of transfer metatarsalgia during the postoperative follow-up. Relative second metatarsal length was measured as the primary radiographic variable using preoperative weight-bearing anteroposterior foot radiographs. In addition, the hallux valgus angle (HVA) and the intermetatarsal angle (IMA) were evaluated preoperatively. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS Hallux MTP-IP) score at the 12-month follow-up. Demographic and surgical variables, such as age, sex, surgical technique, and implant type, were also recorded. Group comparisons were performed, and multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to identify variables predictive of transfer metatarsalgia.

RESULTS: Patients who developed transfer metatarsalgia had significantly higher preoperative relative second metatarsal length values (P < .001). Among the variables included in the multivariate logistic regression model, only relative second metatarsal length was found to be a statistically significant predictor of transfer metatarsalgia (odds ratio: 5.176; 95% CI: 2.813-9.493). Receiver operating characteristic curve analysis identified a threshold value of 2.15 mm, which was adopted as 2 mm for clinical applicability, with an area under the curve of 0.832, sensitivity of 79.4%, and specificity of 78.2%. In contrast, other parameters such as age, sex, surgical technique, implant type, preoperative HVA, IMA, and postoperative AOFAS Hallux MTP-IP scores were not significantly associated with the development of transfer metatarsalgia.

CONCLUSION: Relative second metatarsal length was found to be significantly associated with the development of postoperative transfer metatarsalgia, and ROC analysis identified 2 mm as a clinically applicable cutoff value. Preoperative measurement of relative second metatarsal length can help identify patients at higher risk of this complication, allowing for improved patient counseling and more informed surgical planning. Cite this article as: Karagoz B, Bayrak HC, Dincer DE. The relationship between preoperative relative second metatarsal length and postoperative transfer metatarsalgia following hallux valgus surgery. Acta Orthop Traumatol Turc., 2025;59(6):387-393.

PMID:41578810 | DOI:10.5152/j.aott.2025.25512

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Cemented versus cementless hemiarthroplasty in end-stage chronic kidney disease: A retrospective comparative study of femoral neck fracture outcomes

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

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Association Between Mean Platelet Volume and Other Inflammatory Markers in Patients with Influenza A (H1N1)

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

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Optical Coherence Tomography Angiography-Based Evaluation of Foveal Avascular Zone and Macular Vessel Density in Prediabetic Patients

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.

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Evaluation of Testicular Volume in Children Aged 6-36 Months with Cryptorchidism: A Retrospective Ultrasonographic Study

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

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Hip and knee arthroplasty in solid organ transplant patients: Results from a Turkish government-based health registry

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

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Fibrosis-4 Score and Postoperative Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease

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