Tag: nevin manimala

Eurasian J Med. 2026 Jun 12;58(4):1-5. doi: 10.5152/eurasianjmed.2026.261379.

ABSTRACT

BACKGROUND: Breast cancer in very elderly women presents unique clinical and imaging characteristics, and data regarding this age group remain limited. This study aimed to evaluate the imaging characteristics of breast cancer in patients aged 80 years and older together with clinical and pathological findings.

METHODS: A retrospective analysis was performed on 23 patients aged 80 years and older diagnosed with breast cancer at a single institution between January 2021 and January 2026. Clinical presentation, tumor size, histological grade, metastasis status, and imaging findings, including mammographic features and Breast Imaging Reporting and Data System (BI-RADS) categories, were evaluated. Associations between clinical presentation and tumor characteristics were statistically analyzed.

RESULTS: Of the patients, 30.4% were diagnosed during screening and 69.6% following diagnostic presentation. Tumor size was significantly larger in the diagnostic group than in the screening group (median: 24.5 mm vs. 14.5 mm; P < .001). Distant metastasis occurred only in diagnostically presenting patients (31.3%), while lymph node metastasis rates were similar between groups (P > .05). Grade 2 tumors were the most common (39.1%). The most frequent mammographic findings were masses with or without calcifications, most commonly irregular in shape, with spiculated margins and high density. BI-RADS 5 was the most frequent category (60.9%).

CONCLUSION: Breast cancer imaging features in women aged 80 years and older resemble those of the general population. Smaller tumor sizes and absence of distant metastasis in screen-detected cases suggest that screening may still support earlier detection in selected very elderly women. Cite this article as: Seyfettin A, Gültekin S, Kantarcı M. Imaging characteristics of breast cancer in women aged 80 years and older: A single-center experience. Eurasian J Med. 2026, 58(4), 1379, doi: 10.5152/ eurasianjmed.2026.261379.

PMID:42364220 | DOI:10.5152/eurasianjmed.2026.261379

Eurasian J Med. 2026 Apr 24;58(3):1-6. doi: 10.5152/eurasianjmed.2026.251290.

ABSTRACT

Our aim was to estimate the prevalence of non-thyroidal illness syndrome in individuals with chronic obstructive pulmonary disease (COPD). A systematic review and meta-analysis of studies indexed in Embase, ScienceDirect, PubMed, Virtual Health Library, Web of Science, and Cochrane Library from inception through December 31, 2023, was performed. The protocol was registered in PROSPERO (CRD42024492108). Pooled prevalence and 95% CIs were calculated using the DerSimonian-Laird random-effects model, and heterogeneity was assessed with the I2 statistic. Meta-regression analyses examined the influence of age, sex, and smoking status. Subgroup and sensitivity analyses were performed, and associations with arterial blood gas parameters (PaO₂, PaCO₂, and SaO₂) were evaluated using the inverse-variance method within a random-effects framework. Eleven studies including 1005 chronic obstructive pulmonary disease patients met the inclusion criteria. The overall pooled prevalence of non-thyroidal illness syndrome was 44.2% (95% CI, 30.0-58.4%) with high heterogeneity (I2, 96.1%). Non-thyroidal illness syndrome was more common during acute exacerbations (54.5%) than in stable disease (13.8%). Meta-regression analyses showed that age, sex, and smoking status did not significantly account for heterogeneity. Among arterial blood gas parameters, a modest but statistically significant reduction in SaO₂ was observed in patients with non-thyroidal illness syndrome compared with those without (-2.65%, 95% CI, -4.56 to -0.74). No significant differences were detected for PaO₂ or PaCO₂. As a conclusion, non-thyroidal illness syndrome is a common finding in patients with COPD, particularly during acute exacerbations, and is associated with reduced oxygen saturation. These findings highlight the importance of monitoring thyroid function and oxygenation in this population. Cite this article as: Vázquez PF, Diez-Manglano J. High prevalence of non-thyroidal illness syndrome in patients with chronic obstructive pulmonary disease: A systematic review and metaanalysis. Eurasian J Med. 2026, 58(3), 1290, doi: 10.5152/eurasianjmed.2026.251290.

PMID:42364217 | DOI:10.5152/eurasianjmed.2026.251290

Eurasian J Med. 2026 Apr 22;58(3):1-5. doi: 10.5152/eurasianjmed.2026.251291.

ABSTRACT

BACKGROUND: Melasma is an acquired disease with an unclear etiology. This study aimed to compare the hemoglobin, serum iron, iron-binding capacity, ferritin, zinc, vitamin B12, and vitamin D levels in patients with melasma to those in controls and to investigate a possible relationship between these parameters and melasma severity.

METHODS: One hundred consecutive patients with melasma and 50 healthy controls were included in this case-control observational study. Demographic features and disease duration were recorded. Melasma lesions were scored according to the melasma area severity index (MASI). Hemoglobin, serum iron, total iron binding capacity (TIBC), ferritin, vitamin D, vitamin B12, and zinc levels were compared between patients and controls. Possible correlations between these parameters and the MASI were also investigated.

RESULTS: In terms of laboratory data, there were statistically significant differences in hemoglobin, vitamin D, ferritin, and TIBC between melasma patients and the control group, but no statistically significant difference was observed in vitamin B12, zinc, and iron levels. A statistically significant positive correlation was found between the MASI score, age, melasma disease duration, and ferritin.

CONCLUSION: The study presented lower hemoglobin, vitamin D, and ferritin levels in patients with melasma than in controls and demonstrated a relationship between lower ferritin levels and melasma severity. Considerations of these deficiencies may contribute to the holistic approach to melasma. Cite this article as: Akal E, Melikoglu M. Relationship between hemoglobin, serum iron, iron-binding capacity, ferritin, zinc, vitamin B12, and vitamin D levels in patients with melasma and the severity of their condition. Eurasian J Med. 2026, 58(3), 1291, doi: 10.5152/eurasianjmed.2026.251291.

PMID:42364216 | DOI:10.5152/eurasianjmed.2026.251291

Urol Res Pract. 2026 Jun 11;52:1-8. doi: 10.5152/tud.2026.25137.

ABSTRACT

OBJECTIVE: To evaluate the clinical impact of a modified daytime double-J (DJ) stent removal model based on comfort-oriented medical care on patient pain, anxiety, procedural efficiency, and satisfaction.

METHODS: Between January 2024 and June 2025, 160 patients undergoing ureteroscopy or percutaneous nephrolithotomy requiring DJ stent removal were randomly assigned to a comfort group (n = 80) or a conventional group (n = 80). The comfort group received structured preoperative education, intravenous sedation combined with urethral local anesthesia, pressurized irrigation-assisted cystoscopic removal, and postoperative follow-up. The conventional group underwent traditional outpatient cystoscopic stent removal. Outcomes included Visual Analog Scale (VAS) pain scores, Self-Rating Anxiety Scale (SAS) scores, stent removal time, patient satisfaction, and postoperative complications.

RESULTS: The comfort group reported significantly lower 24-hour VAS pain scores than the conventional group (2.6 ± 0.9 vs. 5.5 ± 1.0, P < .001). Baseline SAS scores were significantly lower in the comfort group than in the conventional group (30.2 ± 5.7 vs. 46.2 ± 7.0, P < .001), and postoperative SAS scores were 28.4 ± 4.7 vs. 42.0 ± 6.8, both P < .001. Stent removal time was shorter in the comfort group (1.90 ± 0.35 minutes vs. 2.20 ± 0.50 minutes, P = .014). Satisfaction scores and satisfaction rates were higher in the comfort group (4.6 ± 0.5 vs. 3.6 ± 0.7, 96.2% vs. 70.0%, P < .01). The 24-hour postoperative complication rate was low and not statistically significant (2.5% vs. 2.5%, P > .05).

CONCLUSION: The comfort-oriented daytime stent removal model significantly reduces procedural pain and anxiety while improving patient satisfaction without increasing short-term complications. Cite this article as: Xu X, Wu S, Yu Q, Tang R. A randomized study of a comfort-oriented daytime double-J stent removal protocol: effects on pain, anxiety, and patient satisfaction. Urol Res Pract. 2026, 52, 0137, doi: 10.5152/tud.2026.25137.

PMID:42364215 | DOI:10.5152/tud.2026.25137

Florence Nightingale J Nurs. 2026 May 11;34:1-12. doi: 10.5152/FNJN.2026.25346.

ABSTRACT

AIM: The aim of this study was to determine the validity and reliability of the “Cardiac Self-Efficacy Questionnaire” in Turkish.

METHODS: This methodological research was conducted among 400 patients who were hospitalised at the Cardiology Clinic of Giresun University Training and Research Hospital between 25 March 2023 and 15 May 2024. The data were collected using the “Patient Introductory Form”, “Cardiac Self-Efficacy Questionnaire”, and “Chronic Diseases Self-Efficacy Scale”.

RESULTS: The scale demonstrated excellent content validity, with a content validity index of 1.00. Construct validity was examined using factor analytic techniques. “The Kaiser-Meyer-Olkin measure indicated adequate sampling adequacy 0.878, and Bartlett’s test of sphericity was statistically significant (p < .001), confirming the appropriateness of the correlation matrix for factor analysis.” Exploratory factor analysis supported a two-factor solution control of symptoms and maintenance of functionality which collectively explained 53.55% of the total variance. The results indicated that the model provided a goodto- acceptable fit to the data, as evidenced by the following fit indices: χ2/df = 2.172, Goodness of Fit Index = 0.91, Adjusted Goodness Fit Index = 0.87, Comparative Fit Index = 0.95, Incremental Fit Index = 0.95, Tucker-Lewis Index = 0.93, Normed Fit İndex = 0.91, and Root Mean Square Error of Approximation = 0.07. The reliability analysis indicated acceptable internal consistency, with Cronbach’s α values of 0.88 for the overall scale, 0.86 for the symptom control subscale, and 0.76 for the functionality maintenance subscale.

CONCLUSION: The Cardiac Self-Efficacy Questionnaire can be considered a valid and reliable instrument for assessing cardiac self-efficacy in the Turkish population. Cite this article as: Bayram, S., & G.k Uğur, H. (2026). Turkish validity and reliability study of the cardiac self-efficacy questionnaire. Florence Nightingale Journal of Nursing, 34, 0346, doi:10.5152/FNJN.2026.25346.

PMID:42364213 | DOI:10.5152/FNJN.2026.25346

Acta Orthop Traumatol Turc. 2026 Mar 12;60(2). doi: 10.5152/j.aott.2026.25585.

ABSTRACT

This study aimed to compare the clinical and functional outcomes of Kirschner wire (K-wire) fixation versus volar locking plate (VLP) fixation for intra-articular distal radius fractures (DRFs). It also aimed to identify key patient- and fracture-related factors that influence the choice of surgical technique and to evaluate the responsiveness of specific patient-reported outcome measures in assessing recovery. Methods: A total of 201 consecutive patients with Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association-classified DRFs (Type A: n = 51; B: n = 90; C: n = 60) treated surgically between 2005 and 2022 were analyzed. Treatment allocation was based on fracture complexity and surgeon preference, resulting in a distribution where K-wire (n = 63) was primarily used for partial articular fractures (72.4% of K-wire cases were Type B), while VLP (n = 138) was preferred for complete articular fractures (83.6% of plate cases were Type C). Functional outcomes were assessed using Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) (primary endpoint), Green-O’Brien, Gartland-Werley, and SF-12 at standardized intervals (6/12/24 months) during supervised physiotherapy. Results: Significant predictors of plate fixation included older age (58.1 ± 14.7 vs. 42.3 ± 12.1 years, P < .001), polytrauma (aOR: 2.4, 95% CI: 1.5-3.8), and complete articular fractures (83.6% Type C, P = .01). No statistically significant associations were found between injury type and fixation method (P = .20) or between complications and fixation method (4.8% vs. 2.2%, P = .41). Functional outcomes were comparable across all metrics, with no statistically significant differences observed: QuickDASH (34.9 ± 18.2 K-wire vs. 31.2 ± 16.8 plate, P = .146), Green-O’Brien (excellent-good: 76.2% vs. 82.6%, P = .552), Gartland-Werley (78.1% vs. 71.1% excellent-good, P = .591), and 12-Item Short Form Health Survey (SF-12) (100% vs. 99.3% good results, P = .32). Multivariable regression identified reduction quality (β = 0.81, P < .01), not implant type, as the primary outcome determinant. Conclusion: This study suggests that anatomical reduction quality-not fixation method-is the primary determinant of functional success in DRFs, with both K-wire and VLP achieving comparable outcomes (QuickDASH/Gartland-Werley P > .05). K-wires represent a cost-effective alternative for partial articular fractures (72.4% of cases), while plates were more frequently used in complex fractures and polytrauma cases (adjusted odds ratio [aOR] = 2.4). Early rehabilitation (median 4 days post-op) and condition-specific metrics (QuickDASH, Green-O’Brien) are critical for optimal recovery, whereas SF-12 proves less sensitive for wrist-specific assessment. These findings advocate for surgeon-tailored technique selection based on fracture pattern and emphasize the need for multicenter randomized controlled trials (RCTs) to evaluate long-term outcomes. Cite this article as: Yigit O, Kart H, Cat G, et al. Comparison of Kirschner wire versus volar locking plate fixation for distal radius fractures: clinical and functional outcomes. Acta Orthop Traumatol Turc. 2026; 60(2), 0585, doi: 10.5152/j.aott.2026.25585.

PMID:42364204 | DOI:10.5152/j.aott.2026.25585

Int J Clin Pharm. 2026 Jun 27. doi: 10.1007/s11096-026-02178-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Collaborative pharmacist prescribing in hospitals involves pharmacists, medical doctors, and patients working together to develop medicine plans that support shared decision-making and underpin pharmacist prescriptions. Shared decision-making is a process in which clinicians and patients make treatment decisions together, ensuring they reflect patient preferences and understanding. However, little is known about patient perspectives and experiences with collaborative pharmacist prescribing, particularly related to shared decision-making, in the inpatient hospital setting.

AIM: To examine patient perspectives and experiences of collaborative pharmacist prescribing in the hospital inpatient setting.

METHOD: A cross-sectional survey was conducted across four hospitals in South Australia. Eligible inpatients were aged ≥ 18 years and provided informed consent. The primary outcome was patient perspectives of collaborative pharmacist prescribing and experiences during medicine prescribing as an inpatient. Results were stratified by the type of prescribing model (collaborative pharmacist prescribing vs. medical prescribing) received by the patient during their admission. Free-text responses were thematically analysed using Braun and Clarke’s framework. Likert scale responses were summarised using descriptive statistics, and sub-group analysis compared categorical variables between groups.

RESULTS: Responses were received from 200 patients (100 who received collaborative pharmacist prescribing and 100 who received medical doctor prescribing). Overall, patients had a median age of 72 years and just over half were female. Qualitative analysis found that all respondents trust pharmacists’ expertise and ability to collaboratively prescribe. Patients in both groups perceived benefits of collaborative pharmacist prescribing including enhanced interprofessional communication, reductions in medication errors, and a better understanding of their medicines. These findings reinforced the quantitative results, with a higher proportion of patients who received collaborative pharmacist prescribing reporting feeling very or extremely involved in medicine decisions compared to patients who received medical prescribing (60% vs. 14%, p < 0.001).

CONCLUSION: Collaborative pharmacist prescribing enhances shared decision-making by actively involving patients in discussions about their medicines. It improves patients’ understanding of their medicines, which supports safer and more informed treatment decisions. These findings support wider adoption of collaborative pharmacist prescribing to improve patient-centered care in hospitals.

PMID:42364068 | DOI:10.1007/s11096-026-02178-0

J Endocrinol Invest. 2026 Jun 27. doi: 10.1007/s40618-026-02945-w. Online ahead of print.

ABSTRACT

BACKGROUND: The cardiovascular safety of testosterone replacement therapy (TRT) in older men with hypogonadism has been debated for over a decade, largely on the basis of underpowered trials and conflicting observational data. The TRAVERSE trial, published in 2023, provided the first adequately powered, placebo-controlled evidence on this question.

OBJECTIVES: This review synthesises current evidence on the cardiovascular safety of TRT in older men, with particular attention to the interpretation of TRAVERSE findings, the clinical significance of non-MACE safety signals, and the practical management of organic versus functional hypogonadism.

METHODS: A systematic search of PubMed/MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted through March 2026. Approximately 450 articles were identified; 64 met the inclusion criteria and were selected for review. Evidence was appraised according to study design, with RCTs and meta-analyses weighted above observational data.

RESULTS: TRAVERSE demonstrated non-inferiority of TRT versus placebo for major adverse cardiovascular events (MACE) in men with confirmed hypogonadism and elevated cardiovascular risk (HR 0.96, 95% CI 0.78-1.17) [5]. Non-MACE signals – including atrial fibrillation (3.1% vs. 2.4%), pulmonary embolism (2.0% vs. 1.5%), and acute kidney injury (2.3% vs. 1.5%) – were numerically higher in the TRT arm but did not reach statistical significance within the trial. In contrast, large observational cohorts consistently report statistically significant associations between TRT and AF and VTE. Erythrocytosis was the most reproducible adverse effect (17.0% vs. 3.3%, p < 0.001). Functional hypogonadism secondary to obesity or metabolic syndrome responds to lifestyle intervention and GLP-1/GIP agonists, with testosterone normalisation in 81.4% at 6 months and 89.5% at 24 months after bariatric surgery [45].

CONCLUSIONS: TRT does not increase MACE risk in men with confirmed organic hypogonadism when titrated to physiological levels. Non-MACE signals warrant vigilance rather than contraindication. Metabolic optimisation should precede TRT in functional hypogonadism. Individualised monitoring and careful patient selection remain essential.

PMID:42364061 | DOI:10.1007/s40618-026-02945-w

Langenbecks Arch Surg. 2026 Jun 27. doi: 10.1007/s00423-026-04118-y. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to explore survival outcomes and prognostic factors between intrahepatic and extrahepatic cholangiocarcinoma after surgical resection.

METHODS: Patients diagnosed with primary intrahepatic or extrahepatic cholangiocarcinoma between 2010 and 2018 who underwent cancer-directed surgery were identified from the SEER database. A 1:1 Propensity Score Matching was performed. Survival outcomes were analyzed via Kaplan-Meier curves and Log-rank tests. Multivariable Cox proportional hazards regression models and Fine-Gray competing risk models were constructed.

RESULTS: A total of 1,586 eligible patients were included. After matching, 478 patients (239 per group) were balanced. In the matched cohort, intrahepatic patients exhibited significantly superior Overall Survival (OS) compared to extrahepatic patients (median OS: 45 vs. 25 months; HR = 1.244, 95% CI: 1.001-1.545, P = 0.049). Conversely, a Fine-Gray competing risk analysis showed no significant difference in Cancer-Specific Survival (CSS) between the subtypes (SHR = 0.818, 95% CI: 0.641-1.043, P = 0.105). Independent risk factors for OS included advanced age, T3/T4 stage, N1/N2 stage, and tumor size ≥ 5 cm. Notably, the retrieval of 4 or more lymph nodes was associated with improved OS (HR = 0.630, 95% CI: 0.469-0.846, P = 0.002), though its association with CSS was not statistically significant in the competing risk model.

CONCLUSIONS: Results from this PSM analysis suggest that intrahepatic location is associated with better OS compared to extrahepatic disease, but cancer-specific survival is similar between the subtypes after accounting for competing risks. This divergence implies that survival differences might be driven by competing risks, potentially distinct long-term surgical morbidities, rather than intrinsic biological lethality. Furthermore, adequate lymphadenectomy (≥ 4 nodes) correlated with improved overall survival and staging accuracy, highlighting its potential role as a surgical quality metric for both subtypes.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42364046 | DOI:10.1007/s00423-026-04118-y

J Neurol. 2026 Jun 27;273(7):428. doi: 10.1007/s00415-026-13952-5.

ABSTRACT

OBJECTIVE: Social cognition, particularly emotion recognition, can be impaired in neurological disorders involving brain damage and neurocognitive deficits. However, it remains unclear whether distinctive profiles of social versus general cognitive impairments exist across neurological patient groups: moderate-severe traumatic brain injury (mod-sevTBI), acute ischaemic stroke (AIS), aneurysmal subarachnoid haemorrhage (aSAH), frontal low-grade glioma (LGG), advanced Parkinson’s disease (PD), and behavioural variant frontotemporal dementia (bvFTD).

METHODS: Data were obtained from scientific studies and clinical records in four Dutch research centres. Neuropsychological testing included emotion recognition [Eckman 60-Faces test (EFT): total score and subscores], memory [Dutch Rey Auditory Verbal Learning Test (DRAVLT): encoding and retrieval], information processing speed, and cognitive control (Trail Making Test A and B). Scores were transformed into Z-scores using normative data and compared across groups.

RESULTS: Included were 710 patients: 118 mod-sevTBI, 93 AIS, 121 aSAH, 100 LGG, 147 PD, 131 bvFTD. EFT-total was impaired in all groups (p < .001), with significant group differences (F(5,704) = 30.8, p < .001). Emotion recognition was the most severely affected domain in bvFTD, mod-sevTBI, AIS, and LGG. Only bvFTD and mod-sevTBI showed impairments in specific emotions, mainly sadness and fear. MANOVA showed overall group differences in general cognition (Wilks’ Lambda = .69, p < .001). Memory encoding was impaired in all groups, but retrieval in none. Information processing speed and cognitive control were impaired only in bvFTD, mod-sevTBI, AIS, and PD.

INTERPRETATION: Emotion recognition is significantly affected across six neurological patient groups, with distinct profiles relative to general cognition. These findings support tailored neuropsychological assessment in clinical practice.

PMID:42364036 | DOI:10.1007/s00415-026-13952-5