Eurasian Journal of Medicine最新文献

The increasing antibiotic resistance of Helicobacter pylori (H. pylori) underscores the urgent need for alternative, nonantibiotic therapeutic strategies. This conceptual framework hypothesizes that Nitrosotalea devanaterra (N. devanaterra), an ammonia-oxidizing acidophile, could function as a biological competitor to H. pylori by reducing local ammonia availability, a critical factor for its survival and colonization in the gastric environment. To explore this hypothesis, a stepwise experimental framework is proposed. Initially, in vitro coculture models using gastric epithelial cells under microaerophilic conditions were employed to investigate potential interactions, metabolic competition, and impacts on H. pylori viability. Prospective in vivo validation could subsequently be performed using Mongolian gerbils, a model that closely mimics human gastric physiology, to assess the microbial load, histopathological changes, and host immune responses under controlled conditions. While direct empirical evidence for N. devanaterra survival and activity in the highly acidic gastric milieu is currently lacking, preliminary theoretical analysis suggests that ammonia competition could influence H. pylori persistence and pathogenesis. This hypothesis-driven approach emphasizes a microbiome-inspired strategy that does not rely on antibiotics, potentially reducing selective pressure for resistance. By introducing the concept of targeted nutrient competition as a therapeutic modality, this framework aims to stimulate further research into the feasibility of employing environmental acidophiles as modulators of pathogenicm bacteria in the stomach. The proposed strategy provides a foundation for future studies evaluating N. devanaterra or related ammonia-oxidizing microorganisms as innovative, nonantibiotic interventions against H. pylori infection.   Cite this article as: Warda M, Adıgüzel MC, Tekin S, Çelebi F, Abd El-Aty AM. Hypothesizing the biotherapeutic potential of Nitrosotalea devanaterra: targeting ammonia dependency to disrupt Helicobacter pylori survival strategies in gastritis. Eurasian J Med. 2026, 58(1), 1203, doi: 10.5152/eurasianjmed.2026.251203.

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.

Background: The physiopathology of eyelid aging (dermatochalasis) involves loss of collagen and elastin. However, few studies have assessed the relationship between anthropometric and body composition parameters and eyelid laxity. This study aimed to explore associations and sex differences between dermatochalasis and such parameters.

Methods: A case series study of 58 patients with dermatochalasis along with a comparison group of 32 normal patients matched by age (50-65 years) and sex was conducted in the ophthalmic clinic of a university hospital. The measures were body mass index, arm circumference (AC), waist circumference, calf circumference (CC), arm muscle circumference (AMC), skin folds, fat mass, grip strength, and change in weight in the previous 5 years.

Results: Men with a lower CC (P = .042), AC (P = .044), and AMC (P = .023) were more likely to have dermatochalasis. A linear regression model revealed that patients with mild and moderate/severe degrees of dermatochalasis tended to have lower AMC (-2.34 cm, P = .049) and (-2.80 cm, P = .047), respectively. In women, a tendency toward a greater AMC (P = .054) was found in those with dermatochalasis, and gains of 5.66 mm in the suprailiac skinfold (P = .030) and 1.89 cm in the AMC (P = .047) were found in those with mild dermatochalasis.

Conclusion: Adequate muscle reserve might protect men from eyelid aging, but the same tendency was not confirmed in women. This suggests the use of the diagnosis of dermatochalasis as a proxy variable for the assessment of nutritional disorders in older men.   Cite this article as: Correia e Silva TR, Cabral PC, Diniz AS, Arruda AM, Ferreira MF, Santos ACO. Eyelid laxity, anthropometric, and body composition parameters: sex-based differences. Eurasian J Med. 2026, 58(1), 1084, doi:10.5152/eurasianjmed.2026.251084.

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.

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.

Background: The aim of the study is to investigate whether long-term calorie restriction and physical activity have an effect on body weight and metabolism in obese individuals with different body mass indexes (BMIs).

Methods: Fifty-four obese women who were not receiving any obesity treatment were included in the study. Participants received 12 weeks of low-calorie diet and physical activity training appropriate to their age, gender, and BMI. Body weights were measured at the initial visit and after the intervention. Venous blood samples were collected twice: before and after the intervention. Baseline glucose, insulin, total cholesterol (TC), triglyceride (TG), HbA1c, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured using a Beckman Coulter AU 5800 clinical chemistry autoanalyzer. Hemoglobin A1c (HbA1c) levels were determined using boronate affinity and HPLC techniques using a Tirinity Biotech Premier 9210 autoanalyzer. Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the formula (fasting insulin [μU/mL] Å~ fasting glucose [mg/dL])/405).

Results: In the study, insulin and HOMA-IR levels increased significantly as the degree of obesity increased (P < .05). Obese individuals lost an average of 8.6% weight after the combined treatment, and when repeated measurement results were compared, insulin levels in all obese groups decreased significantly (P < .05). HbA1c levels decreased significantly only in moderately obese individuals after the treatment (P < .05). In the first group (those who lost between 5% and 9.9% of their weight), TG and insulin levels decreased while TC, LDL-C, and glucose levels increased (P < .05). In the second group (those who lost more than 10% of their weight), only insulin levels decreased (P < .05).

Conclusion: As obesity increased HOMA-IR levels an indicator of insulin resistance increased significantly. Participants lost an average of 8.6% of their weight and insulin levels decreased significantly after the intervention. Long-term lifestyle interventions produced relatively similar effects on metabolism across different obesity levels.   Cite this article as: Alyar G, Umudum FZ. Effects of long-term calorie restriction and physical activity on body weight and metabolism applied to different degrees of obesity. Eurasian J Med. 2026, 58(1),1020, doi: 10.5152/eurasianjmed.2026.251020.

Background: This study investigates the effect of pelvimetric measurements on intraoperative and postoperative outcomes in the open perineal radical prostatectomy procedure.

Methods: Distance of the ischial spines (ISD), angle of symphysis pubis (ASP), angle of symphysis pubisseminal vesicles (ASS), distance between the prostate apex and anus (DAA), distance between seminal vesicles and anus (DSA), distance of pelvic outlet (DPO) measurements were determined in multiparametric magnetic resonance imaging. The effects of these pelvimetric measurements on perioperative factors were analyzed.

Results: A total of 71 patients were included. Distance of the ischial spines was 9.0 Å} 0.82 mm, DPO 8.2 Å} 0.86 cm, DAA 4.8 Å} 1.2 cm, DSA 7.8 Å} 1.3 cm, ASP 63.7 Å} 7.2 degrees and ASS 44.9 Å} 6.5 degrees. It was found that a 1-cm increase in the ISD value resulted in a decrease of 9.19 minutes in the operation duration, a 1-cm increase in the DSA value caused an increase of 4.55 minutes in the operation duration, and a 1-cm increase in the ASS value caused a decrease of 0.76 minutes in the operation duration. A 1-cm increase in ASP resulted in 6.5 cm3 less blood loss and 1 unit increase in ASS resulted in 15.15 cm3 less blood loss. A 1-cm increase in ISD decreased anastomosis time by 1.7 minutes, whereas a 1-cm increase in DAA increased to 1.03 minutes. In the postoperative pathologic findings of the patients after radical prostatectomy, Gleason score 3 + 4 was the most common finding with 56.3%. Seminal vesicle invasion positivity was observed in 2 (2.8%) and extraprostatic invasion positivity in 18 (25.4%).

Conclusion: Six parameters were examined with pelvimetric measurements had particular effects on operation duration, blood loss, anastomosis time, and complication development.   Cite this article as: Arıkan Y, Danacıoğlu YO, Özcan A., et al. Relationship of pelvimetric diameters with peroperative outcomes, complications, and surgical success in patients undergoing perineal radical prostatectomy. Eurasian J Med. 2025, 57(4), 0877, doi:10.5152/eurasianjmed.2025.25877.

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.

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.