Eurasian Journal of Medicine最新文献

Background: Chronic and night pain are common challenges in the geriatric population, often complicating pain management. This study aimed to evaluate sleep quality, night pain frequency, and associated factors in regional degenerative pain among elderly patients to identify individuals at risk for night pain early.

Methods: A total of 130 geriatric patients diagnosed with degenerative osteoarthritis and experiencing regional chronic pain were included. Demographic data, sleep quality, and bone mineral density were assessed. Patients were grouped based on the presence of night pain, and comparisons were made accordingly.

Results: Night pain was reported by 95 patients (73%), and 76 participants (58%) had poor sleep quality. Those with night pain showed significantly worse sleep quality (P < .001). No significant differences were found between groups in terms of pain location, gender, or number of chronic conditions (P = .41, P = .368, P = .206). However, night pain was significantly more common among participants with low education levels or illiteracy (P = .006). Resistance to simple analgesics was also higher in the night pain group (P = .009). Bone mineral density values did not significantly differ between groups (P = .785, P = .398, P = .232).

Conclusion: Early identification of geriatric patients at risk for night pain is essential for optimal pain management. Poor sleep quality, inadequate response to analgesics, and lower education levels were significantly associated with night pain. Proactive follow-up and individualized treatment approaches may improve outcomes in this vulnerable population.   Cite this article as: Ay BK, Yıldır CZ. Investigation of night pain in geriatric regional degenerative pain and associated conditions. Eurasian J Med. 2026, 58(1), 1085, doi: 10.5152/eurasianjmed.2026.251085.

The emergence of therapeutic resistance remains the primary challenge to achieving durable responses in cancer treatment, thereby limiting the long-term e"cacy of several chemotherapies and targeted agents. Resistance may develop through diverse and often overlapping mechanisms. Conventional approaches to overcome resistance, such as dose escalation or combination regimens, are frequently constrained by systemic toxicity and adaptive tumor evolution. Moreover, many central drivers of resistance, including transcription factors and non-enzymatic regulatory proteins, remain inaccessible to therapeutics. Small interfering RNAs (siRNAs) o#er a fundamentally distinct and pathway-centric approach to overcoming drug resistance by enabling sequence-specific degradation of resistance-associated messenger RNAs. By acting upstream of protein synthesis, siRNA therapeutics can directly suppress both druggable and traditionally undruggable targets, including e$ux transporters, anti-apoptotic regulators, DNA repair enzymes, epigenetic modifiers, epithelial-mesenchymal transition transcription factors, and key oncogenic drivers such as KRAS and MYC. Advances in chemical modification and delivery platforms have significantly improved siRNA stability, specificity, and pharmacokinetic durability, enabling sustained gene silencing in vivo. The current review examines the molecular principles of siRNA-induced gene silencing and evaluates the current siRNA-based strategies targeting key mechanisms of chemotherapy resistance. Preclinical and translational studies demonstrating the reversal of multidrug resistance, restoration of apoptotic sensitivity, disruption of DNA repair-mediated tolerance, and suppression of adaptive oncogenic signaling are highlighted. In addition, the emerging clinical trials that validate siRNA-based approaches in cancer treatment are summerized. Cite this article as: Bardaweel SK, Hajjo R, Sabbah DA, Qasem DA. Small interfering RNA strategies to overcome drug resistance in cancer: pathway targeting and translational advances. Eurasian J Med. 2026, 58(1), 1350, doi:10.5152/eurasianjmed.2026.251350.

Background: Hip fractures are a major consequence of osteoporosis. While dual-energy X-ray absorptiometry (DXA) is the gold standard for bone mineral density (BMD), radiographic indices may complement DXA. The canal-to-bone ratio (CBR)-the intramedullary canal diameter divided by the outer cortical diameter on plain radiographs-may reflect bone quality. We examined the relationship between CBR and BMD and whether CBR independently predicts hip T- and Z-scores.

Methods: The study retrospectively analyzed 90 patients with femoral radiographs and DXA. Canal-tobone ratio was measured 7 cm distal to the lesser trochanter. Lumbar and hip T-/Z-scores were recorded. Associations were tested with Pearson/Spearman correlations and linear regression; multivariable models adjusted for age.

Results: Canal-to-bone ratio correlated negatively with hip BMD (T-score r = -0.63, P = .005; Z-score r = -0.65, P = .004), but not with lumbar scores (P > .20). Each 0.1 increment in CBR was associated with a 0.67-unit decrease in hip T-score and a 0.59-unit decrease in hip Z-score. After adjusting for age, CBR remained an independent predictor of hip T-score (β = -6.09, P = .012, R2 = 0.44) and hip Z-score (β = -5.59, P = .009, R2 = 0.43).

Conclusion: Canal-to-bone ratio shows a strong, independent association with hip BMD. As a simple metric obtainable from routine radiographs, CBR may serve as a surrogate marker of hip bone quality and fracture risk, particularly in settings with limited DXA access.   Cite this article as: Kaya S. Canal-to-bone ratio as an independent predictor of hip bone mineral density scores: A retrospective analysis. Eurasian J Med. 2026, 58(1), 1164, doi: 10.5152/eurasianjmed.2026.251164.

Background: The fear of malpractice is a significant factor influencing physicians' decision-making processes in modern medical practice. This can cause defensive medicine, which involves behaviors such as requesting unnecessary tests and imaging, avoiding high-risk patients, and applying cautious but sometimes medically unnecessary treatments. The aim of this study is to evaluate the effect of surgical and internal medicine residents' fear of malpractice on defensive medicine attitudes, while examining the mediating role of working hours on this relationship.

Methods: This study is a cross-sectional investigation designed to examine the impact of surgical and internal medicine residents' fear of malpractice on defensive medical practices. The Fear of Malpractice Scale and the Defensive Medical Practices Attitude Scales were used to collect data. Years of residency, working hours, and opinions on the subject were also included during data collection.

Results: The findings revealed a statistically significant and strong positive correlation between fear of malpractice and defensive medical practices. The total score on the Malpractice Fear Scale showed a strong positive correlation with the total score on the Defensive Medicine Practices Attitude Scale. However, work variables such as average weekly working hours and length of residency do not play a mediating role in the relationship between fear of malpractice and defensive medical practices.

Conclusion: This study supports the notion that fear of malpractice is a central factor influencing physicians' decision-making processes and increases positive defensive behaviors, such as requesting unnecessary tests, and negative defensive behaviors, such as avoiding high-risk patients.   Cite this article as: Kasali K, Kahramanlar AA, Yılmaz MA, .zg.dek HB, Şenocak E. The mediating role of working hours in the effect of surgical and internal medicine residents' fear of malpractice on defensive medical practices. Eurasian J Med. 2026, 58(1), 1279, doi:10.5152/eurasianjmed.2026.251279.

Background: Adhesive capsulitis involves capsular fibrosis and restricted shoulder movements, particularly external rotation and abduction. Magnetic resonance imaging (MRI) enables assessment of capsular and ligamentous thickening. The relationship between capsular thickness, range of motion (ROM), and rotator cuff and biceps tendon pathologies remains unclear. This study aimed to investigate the relationship between the coracohumeral ligament and inferior glenohumeral capsule thickness, shoulder range of motion, and MRI-detected edema patterns in patients with adhesive capsulitis.

Methods: This prospective study included 100 adhesive capsulitis patients who underwent shoulder MRI between July 2024 and July 2025. Coracohumeral ligament (CHL) and inferior glenohumeral capsule (IGHC) thicknesses were measured, and rotator cuff and biceps tendon pathologies graded. Shoulder ROM in external rotation (ER) and abduction was measured using a goniometer. Analyses included correlation tests, multiple linear regression, and Kruskal-Wallis tests.

Results: The mean patient age was 57.7 ± 11.9 years, with 66% women. CHL thickness strongly negatively correlated with ER ROM (r = -0.82, P < .001), while IGHC thickness strongly negatively correlated with abduction ROM (r = -0.79, P < .001). Regression analysis showed that CHL thickness independently predicted ER limitation, and IGHC thickness predicted abduction limitation. Rotator cuff and biceps tendon pathologies were common but not independently associated with ROM.

Conclusion: Coracohumeral ligament and IGHC thickening are key determinants of restricted shoulder mobility in adhesive capsulitis. Magnetic resonance imaging assessment of these structures provides reliable diagnostic markers and can guide treatment, while concomitant rotator cuff and biceps pathologies have a limited impact on ROM restriction. Cite this article as: Soğukpınar Karaağaç S, Yeşilmen N. Quantitative MRI evaluation of coracohumeral ligament and inferior glenohumeral capsule thickening in adhesive capsulitis: correlation with range of motion and edema patterns. Eurasian J Med. 2026; 58(1): 1185. doi: 10.5152/eurasianjmed.2026.251185.

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.