Eurasian Journal of Medicine最新文献

Background: Although numerous studies have examined the relationship between learning styles and factors such as gender, academic performance, and participation, no research has been found that comprehensively investigates the interplay between learning styles, motivation (intrinsic and extrinsic), and academic performance across diverse educational activities. This study aims to explore the influence of different learning styles and motivations (intrinsic and extrinsic) on medical students' engagement and academic performance. Methods: Using a mixed-methods approach, the study combined quantitative data from 169 medical students with qualitative insights from focus groups and in-depth interviews with 27 participants. Quantitative data were analyzed using descriptive statistics and Chi-square tests, while qualitative data were thematically analyzed. Results: Findings revealed no significant direct relationship between learning styles and academic performance. However, intrinsic motivation was strongly associated with higher academic achievement. Female students showed a notable preference for visual and kinesthetic learning styles. Practical, hands-on educational activities, such as laboratory work and simulations, were linked to greater engagement, particularly for kinesthetic and visual learners. Students emphasized the importance of personalized feedback and diverse teaching methods in enhancing motivation. Conclusion: While learning styles alone do not predict academic performance, motivation, especially intrinsic motivation, plays a critical role in student achievement. The findings highlight the importance of using interactive and varied teaching methods that cater to different learning styles and foster motivation. Medical curricula should focus not only on accommodating diverse learning styles but also on strategies to enhance intrinsic motivation to improve academic outcomes.

Background: The aim of this study was to examine the Q angle in patients diagnosed with osteoporosis, osteopenia, and osteoarthritis and to compare the groups with each other. Methods: This study included 22 female patients diagnosed with osteoporosis, 22 female patients diagnosed with osteopenia, and 22 female patients diagnosed with osteoarthritis, aged 40-65 years. Q angle, pain, lower extremity muscle strength, foot posture, and pes planus were assessed using a goniometer, Visual Analog Scale (VAS), Medical Research Council (MRC) Scale, Foot Posture Index (FPI), and Navicular Drop Test (NDT), respectively. Results: There was a statistical difference in both right and left Q angle in osteoporosis compared to osteoarthritis (P=.009, P=.002, respectively). There was no statistically significant difference in both right and left Q angle between osteoporosis and osteopenia (P=.730, P=.491, respectively), and osteopenia and osteoarthritis (P=.022, P=.017, respectively). However, a statistically significant difference was found between osteoporosis and osteoarthritis in the right (P=.009) and left (P=.002) sides. In addition, a significant negative correlation was found between Q angle and FPI and NDT in all patients in this study (P < .01). Conclusion: Patients with osteoporosis were found to have a higher Q angle than osteoarthritis and osteopenia patients. In addition, foot posture and pes planus were found to be associated with the Q angle. Osteoporosis patients may have a tendency to valgum.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by challenges in social interaction, communication, and the presence of restricted interests and repetitive behaviors. The increasing prevalence of ASD underscores the importance of early diagnosis and individualized interventions. This study investigates the sociodemographic and clinical characteristics of children aged 0-6 years diagnosed with ASD at the Etlik City Multidisciplinary Child and Adolescent Mental Health Center (ÇÖZGEM) and explores their healthcare journey from developmental delays to formal diagnosis. Methods: The medical records of 174 children evaluated at ÇÖZGEM between May and November 2024 were reviewed. Of these, 100 children diagnosed with ASD, with a mean age of 40.86 ± 16.92 months, were included. Multidisciplinary evaluations were conducted by specialists, including a child psychiatrist, clinical psychologist, and speech therapist. Results: Of the children diagnosed, 83% were boys and 17% were girls. Parents typically identified developmental concerns, focusing on language and social skill delays, at a mean age of 23.1 ± 10.94 months. The mean age at diagnosis was 31.54 ± 12.11 months, with an average delay of 8.44 ± 8.76 months between initial concern and diagnosis. After referral to ÇÖZGEM, the average waiting time for the first appointment was 18.21 ± 10.25 days, with diagnosis completed within 36.85 ± 19.8 days. Conclusion: This study highlights the importance of multidisciplinary teams in ASD diagnosis and intervention. Insights from ÇÖZGEM emphasize the need for parental awareness and streamlined healthcare pathways. Further studies with larger samples are necessary to validate these findings.

Impulsivity and compulsivity are complex constructs that underpin a wide range of psychiatric disorders. While traditionally viewed as opposing dimensions, emerging evidence suggests they exist on an overlapping spectrum, influencing diagnosis and treatment. Impulsivity is characterized by poorly planned, premature responses aimed at achieving gratification, while compulsivity involves repetitive behaviors driven by anxiety relief. Both constructs share common neurobiological substrates, such as impaired response inhibition and urgency, but differ in their executive dysfunction patterns. Psychiatric disorders traditionally associated with impulsivity (e.g., attention-deficit hyperactivity disorder, bipolar disorder) and those aligned with compulsivity (e.g., obsessive-compulsive disorder, anorexia nervosa) often exhibit overlapping symptoms. Additionally, the same disorder may present varying levels of impulsivity and compulsivity across individuals and time points. The impulsivity-compulsivity spectrum offers a dimensional framework for understanding psychiatric disorders, emphasizing the need for individualized clinical approaches. This review aims to highlight the shared and distinct features, as well as the neurobiological pathways, associated with this spectrum, while underscoring the need for future research to refine dimensional models that enhance diagnostic accuracy and guide personalized interventions.

Background: In this study, the aim was to assess the association between procalcitonin levels and culture positivity in patients with acute renal failure (ARF) admitted to the intensive care unit due to Type 1 and Type 2 respiratory failure. Methods: About 128 patients with ARF were restrospectively included between January 2022 and December 2023. Based on admission culture results, patients were grouped as infection-positive (n=40) or infection negative (n=88). Laboratory parameters, particularly procalcitonin levels, were compared. Results: Platelet levels were significantly higher in patients with positive culture results (P=.03), while procalcitonin levels did not differ between groups (P=.33). Escherichia coli was the most frequently isolated microorganism (25%), with the urinary tract being the most common site of growth. In culture- positive patients, procalcitonin levels exhibited a stronger negative correlation with glomerular filtration rate (GFR) (R=-0.355, P= .02) and a positive correlation with creatinine (R=0.385, P= .01), highlighting the impact of renal function. Additionally, procalcitonin levels were positively correlated with C-reactive protein (CRP) (R=0.586, P < .001) and negatively correlated with serum sodium (R=-0.39, P=.01) in patients with culture growth. As a secondary observation, platelet levels were elevated in patients with positive cultures. Conclusion: Although procalcitonin is a recognized marker for infection and sepsis, its diagnostic reliability appears limited in critically ill patients with ARF due to its association with renal dysfunction. Additionally, defining infection based solely on culture positivity has inherent limitations, and further research including comprehensive clinical and laboratory parameters is warranted.

Background: Skin-related health problems constitute a considerable portion of the reasons for consulting a family physician. Therefore, family physicians play a key role as gatekeepers in evaluating the signs and symptoms of various skin diseases, triaging the patients, and deciding upon the necessity for referral. The aim was to investigate the most common dermatological diseases encountered by family physicians in the outpatient clinics and determine the diagnostic and remedial approach of family physicians to these skin diseases in Türkiye. Methods: An online questionnaire composed of 48 questions related to the demographic and educational information of the participants, the most frequently seen dermatoses in outpatient settings, and the management skills of the participants for various skin disorders, was created using Google Forms. Via instant messaging and e-mail, the survey was distributed among practitioner family physicians, family physician residents, and family medicine specialists who were actively employed in different healthcare facilities in Türkiye. The snowball sampling method was used to convey the survey. Results: The present questionnaire-based study was conducted between October 2024 and January 2025. A total number of 176 participants who were actively working in different healthcare facilities in Türkiye were included in the study. The median number of patients examined in a month was 1025 (range: 90-4000). The most commonly encountered cutaneous diseases were fungal infections of the hair, nail, skin, and mucous membranes (91.5%) followed by scabies (80.1%), acne vulgaris (72.2%), and herpes simplex infection (65.9%). Herpes simplex infections, fungal infections of the skin, hair, nails, mucosa, and scabies were the 3 leading skin diseases at which family physicians felt competent while administering treatment. Conclusion: The results of the current study point out that since family physicians deal with a relatively high rate of skin disorders in their daily practice, it is quite essential to reinforce their diagnostic and therapeutic proficiencies through intensified dermatology courses and rotations.

Background: This study aimed to evaluate cardiac involvement during active inflammation in 2 pathophysi- ologically different diseases, rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and the change in cardiac involvement with suppression of inflammation after effective treatment. Methods: The study involved 30 newly diagnosed, active RA and 31 active AS patients in need of biologi- cal treatment. The patients were evaluated by the same cardiologist using pulse wave Doppler and tissue Doppler echocardiography at the beginning of the study and after 3 months of treatment. Myocardial per- formance index (MPI) was obtained by dividing the sum of isovolumetric relaxation time and isovolumetric contraction time, calculated from the recorded Doppler tracing, by ejection time (ET) from the same tracing was calculated separately for both ventricles. Results: It was found that diastolic dysfunction was present at the time of diagnosis and did not improve after treatment, despite regression in inflammatory values and joint findings. In the pre-treatment period, MPI was found to be higher than the normal value range in both groups. The MPI was 0.5 ± 0.07 for RA patients and 0.51 ± 0.1 for AS patients. No significant difference was found between the 2 groups before treatment (P=.697). In the post-treatment evaluation, no significant difference was found in RA and AS patients compared to pretreatment. Conclusion: Inflammation-induced cardiac involvement may develop in both RA and AS patients, despite their different pathophysiologic pathways. Longer follow-up periods are necessary for the improvement of inflammation-induced diastolic dysfunction and MPI values compared to joint findings used in activation parameters.

Background: Prostate cancer is the most common malignancy in men, and androgen deprivation therapy (ADT) serves as the primary approach for managing advanced cases. Certain research has suggested the impact of androgens on the physiological homeostasis of the optic nerve. Our aim was to investigate the impact of surgical ADT on peripapillary retinal nerve fiber layer (RNFL) thickness in patients with advanced prostate cancer. Methods: The study comprised 30 patients who had undergone bilateral orchiectomy for advanced prostate cancer, with a total of 60 eyes included in the analysis. Each participant received a standard ophthalmological examination. Peripapillary RNFL thickness measurements were performed preoperatively and 12 months postoperatively using optical coherence tomography. Results: The mean age of the patients was 73.77 ± 8.8 years. At the 12th month following surgery, we observed that the mean average thickness of the right and left RNFL, as well as the thickness of the left nasal, left inferior, and right and left temporal quadrants, was significantly thinner compared to presurgical values (P< .05). However, when comparing pre- and postsurgical measurements, the RNFL thickness in the right and left superior quadrants, as well as the right nasal and right inferior quadrants, showed no statistically significant difference. Conclusion: In this study, a significant difference was observed between the preoperative and 12-months postoperative peripapillary RNFL thickness values in patients who underwent surgical ADT for advanced prostate cancer. Additional research using larger sample sizes is required to clinically examine the impact of ADT on optic nerve homeostasis.

The Decipher genomic classifier (GC) is a 22-gene expression test that refines risk stratification and informs treatment decisions in localized prostate cancer. Traditional clinicopathologic factors, including prostate-specific antigen levels and kinetics, Gleason score, histologic variants, and tumor stage, do not fully capture disease heterogeneity, leading to potential overtreatment or undertreatment. The Decipher GC has demonstrated clinical utility across risk groups, helping to distinguish candidates for active surveillance in low-risk prostate cancer, refine the need for androgen deprivation therapy in intermediate-risk disease, and guide treatment intensification in high-risk patients. In the post-radical prostatectomy setting, the GC aids in determining the need for early salvage radiation therapy and hormonal therapy. While retrospective studies support its prognostic value, limitations include heterogeneity in study designs and the lack of established predictive utility for treatment response. Ongoing prospective trials, such as NRG GU-009 and NRG GU-010, aim to validate further the Decipher GC's role in clinical decision-making and treatment personalization.

Background: Magnusiomyces capitatus (M. capitatus) and Magnusiomyces clavatus (M. clavatus) are rare cause of fungemia leading to high mortality rates, particularly in neutropenic patients with hematological malignancies. This research set out to explore the clinical characteristics of patients with hematological malignancies with M. capitatus and M. clavatus fungemia. Methods: Eight patients from whom Magnusiomyces spp. were isolated, from among patients hospitalized at the Atatürk University Hospital between October 2017 and November 2022, were enrolled in this retrospective observational study. The 8 patients' medical data were subjected to analysis. Results: Magnusiomyces capitatus emerged as the pathogen in 5 cases and M. clavatus in 3. The patients' median age was 35.5 years. The most common underlying hematological malignancy was acute leukemia. Neutrophil values of 500 cells/mm3 were detected in all patients during Magnusiomyces spp. isolation, with severe neutropenia at less than 100 cells/mm3 in 5. The mean duration of neutropenia prior to Magnusiomyces spp. isolation was 29 days. Breakthrough fungemia developed in 7 patients using echinocandins, fluconazole, and posaconazole. Liposomal amphotericin B and voriconazole were used for initial treatment. The general mortality rate was 37%. All isolates were resistant to echinocandins. Voriconazole possessed the lowest minimum inhibitory concentration value against all isolates. The survival rate was higher among young patients. Mortality was higher among patients followed up in the intensive care unit. Conclusion: Life-threatening Magnusiomyces spp. can spread among patients with long-term neutropenia under treatment for hematological malignancies. Awareness and prompt initiation of treatment can reduce the risk of mortality in invasive infections caused by Magnusiomyces spp.