Eurasian Journal of Medicine最新文献

Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of global morbidity and mortality. The current study provides a systematic review of the use of artificial intelligence (AI) technologies applied to the prediction and management of ASCVD. Traditional risk assessment approaches have their restrictions, leading to a growing preference for AI and machine learning techniques in risk assessment. First, this study tackles the complex pathophysiology of ASCVD and the problems associated with the current diagnosis, followed by an in-depth analysis of the wide variety of AI models that can be applied to electronic health records, medical imaging data, and other biomarkers. Special attention will be paid toward the potential of natural language processing models like bidirectional encoder representations from transformers in predicting risk from textual clinical data, and the overwhelming success of convolutional neural networks such as residual neural network and visual geometry group in plaque-based analysis through imaging modalities. Although the research results show that these models have a lot to offer in the clinical world, the authors also describe some serious disadvantages: data bias, interpretability of the model, and computational needs. It highlights, in particular, the need for multicenter validation studies as well as developing explainable AI techniques. Overall, AI-based approaches may pave the way for a new paradigm in ASCVD management. Nevertheless, deploying these technologies in everyday clinical practice will require overcoming technical, ethical, and regulatory challenges. As such, interdisciplinary collaboration and thorough clinical validation studies are essential for fulfilling the promise of these novel strategies to enhance patient outcomes. Cite this article as: Şakiroğlu F, Çolak C, Çolak MC. Pre-trained artificial intelligence models in the prediction and classification of atherosclerotic cardiovascular disease. Eurasian J Med. 2025, 57(3), 0937, doi:10.5152/eurasianjmed.2025.25937.

Background: This study aimed to evaluate the complication rates in femoral neck fractures treated with dynamic hip screw (DHS), with a focus on associations with age, gender, and fracture classification. Additionally, the impact of reduction quality on clinical outcomes was assessed.

Methods: A total of 172 patients aged 21-65 years were retrospectively reviewed. Fractures were classified according to the AO and Powell angle classification systems. Reduction quality was assessed using the Garden index. Complication rates were analyzed based on reduction method, age group, gender, and fracture type.

Results: A total of 172 patients were included. The overall complication rate was 7.5% (n=13), with nonunion (n=7), avascular necrosis (n=4), and implant failure (n=2) being the primary complications. Although complication and nonunion rates were higher in females, the differences were not statistically significant (P > .05). Similarly, no significant differences were observed between age groups (P > .05). However, unstable fractures (AO type B3) and high-angle fractures (Powell group 3) were significantly associated with increased complication rates (P < .05). Anatomical reduction significantly reduced complication rates compared to poor reduction (P < .01).

Conclusion: Fracture type and reduction quality were the most important factors influencing complications. In particular, unstable and high-angle fractures were associated with increased risk, and the quality of reduction had a direct impact on treatment success. Age and gender did not show a significant effect on complication rates. The DHS stands out as both a biomechanically and economically effective treatment choice.

Objective: High-risk human papillomavirus (HPV), particularly HPV-16, is a major driver of carcinogenesis. Despite advances in understanding HPV-mediated oncogenesis, the role of microRNA (miRNA) interactome networks in HPV-16-driven tumorigenesis remains unclear. Using an integrative bioinformatic approach, this study identified key miRNAs, target genes, and transcription factors (TFs) involved in HPV-16-associated cancers. Methods: Human papillomavirus-16-associated miRNAs were retrieved from viRBase. microRNAs and their interactors were analyzed using The Cancer Genome Atlas and Genotype-tissue Expression datasets to investigate the expression patterns and potential roles in carcinogenesis. microRNA-messenger RNA (mRNA) interactions, TFs enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, and GO terms analyses uncovered molecular networks disrupted by HPV-16. Receiver operating characteristic curve (ROC) and Kaplan-Meier analyses assessed the clinical significance of dysregulated miRNAs. Results: Eight miRNAs (hsa-miR-16-5p, hsa-miR-24-3p, hsa-miR-34a-5p, hsa-miR-100-5p, hsa-miR-125b-5p, hsa-miR-203a-3p, hsa-miR-205-5p, and hsa-miR-331-3p) were significantly dysregulated in HPV-16 infection and enriched in key KEGG pathways, highlighting involvement in cellular processes and regulatory mechanisms. Among these, hsa-miR-100-5p, hsa-miR-125b-5p, and hsa-miR-331-3p were the most significant in HPV-16-driven cancer types, with hsa-miR-125b-5p emerging as a key prognostic regulator. MAP3K13 and NR1H4 were identified as critical gene and TF candidates in HPV-16 carcinogenesis. Conclusion: This study provides novel insights into miRNA interactome networks in HPV-16-driven carcinogenesis, identifying biomarkers and therapeutic targets. Integrating translational bioinformatic insights with experimental validation paves the way for developing targeted diagnostic and therapeutic strategies and unravelling complex host-virus interactions, ultimately enhancing the management of HPV-associated cancers.

Background: Among the 1 017 290 people surveyed, the prevalence of pneumonia was 2.5% in the 55-64 age group, 3.0% in the 65-74 age group, and 2.9% in those aged 75 years and older. This indicates an increase in pneumonia prevalence from 1.8% to 2% in Indonesia. This study aimed to compare the length of treatment and comorbidities in older and adult patients with community-acquired pneumonia at Jakarta Sukapura Islamic Hospital and Jakarta Pondok Kopi Islamic Hospital between September 2022 and September 2024. Methods: This was a comparative study with a cross-sectional design, and secondary data from 244 patient samples were used. Results: Among adult patients, 101 had a length of treatment of ≤5 days, whereas 17 had a length of treatment of >5 days. Among older patients, 67 had a length of treatment of ≤5 days, whereas 59 had a length of treatment of >5 days. Comorbidities were absent in 69 adult and 45 older patients. A total of 49 adult patients and 81 older patients had comorbidities. Conclusion: Older patients with community-acquired pneumonia had a longer treatment duration and more comorbidities than adult patients with bacterial community-acquired pneumonia.

Background: This study aims to examine the relationship between dark triad personality traits and autism spectrum traits, exploring their impact on social skills, communication, imagination, and empathy. By doing so, it seeks to contribute to psychological assessment and intervention strategies in these areas. Methods: The study was conducted with a community sample of adults aged 18 and above. Participants were invited through online platforms to complete an anonymous survey. The survey included a sociodemographic form, the short dark triad scale, and the autism spectrum quotient. Inclusion criteria required participants to be at least 18 years old, have sufficient proficiency in Turkish, and not have any known mental or developmental disabilities that could affect their ability to complete the survey. Exclusion criteria included undergoing psychiatric treatment during the study. Prior to participation, informed consent was obtained from all participants, and voluntary participation was emphasized. Results: The findings revealed a significant negative correlation between autism spectrum traits and Machiavellianism (r=-0.247, P=.001). This suggests that individuals with communication difficulties tend to struggle with manipulative or strategic social behaviors. Regarding the relationship between autism traits and narcissism, results indicated that higher autism-related imagination scores were associated with lower narcissism levels (r=-0.237, P=.002). Individuals with fewer autism traits were observed to have a stronger sense of self-worth. This finding suggests that the construction of an exaggerated self-image, a core component of narcissism, may be negatively influenced by deficits in imagination. On the other hand, no significant relationship was found between psychopathy and autism subdimensions. This indicates that the core features of psychopathy, such as emotional detachment and impulsivity, do not directly align with the structured and repetitive behaviors associated with autism. Conclusion: This study provides important insights into the impact of autism traits and dark triad characteristics on social functioning. Future research should further investigate the cognitive and emotional foundations of these traits using larger and more diverse samples.

Background: The aim is to create a new classification according to the contact and effect of dermatochalasis on the eyelashes and to examine the effect of blepharoplasty surgery on the visual field (VF) in these stages. Methods: Demographic characteristics of cases that were staged as dermatochalasis (group 1) (stage 1), (group 2) (stage 2), and (group 3) (stage 3) between February 2025 and April 2025 were examined, and changes in the VF before and after blepharoplasty were evaluated. Stage 1 was accepted as dermatochalasis only; stage 2 as dermatochalasis with eyelash contact but no eyelash inversion; and stage 3 as dermatochalasis creating inversion in the eyelashes. The Humphrey 30-2 test was applied in the VF. Mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), and upper half VF sensitivity were evaluated. Those with refractive error and additional eye diseases were not included in the study. Results: A total of 60 cases were examined, 20 in each group. The mean age of the cases was 42.7 ± 14.9 (28-75). Forty of the cases were female and 20 were male. The mean age was higher in group 3, and there was a statistically significant difference (P < 0.05). The changes in the VF in group 1 and group 2 were not statistically significant preoperatively and in the first month postoperatively (P > 0.05). In group 3, MD was -2.88 ± 1.20 (-3.63-2.10) dB, VFI was 97.45 ± 1.61 (89-92) dB, upper half VF sensitivity was 22.21 ± 1.54 (17-18.40) dB, and PSD was 2.19 ± 0.87 (1.2-2.02) dB at postoperative first month. The changes in group 3 were statistically significant preoperatively and in the first month postoperatively (P < 0.05). Conclusion: Dermatochalasis staging can predict the effect of dermatochalasis on the VF. This new dermatochalasis classification can be used in cases of equipment shortage. Visual field defects due to dermatochalasis can be corrected with blepharoplasty surgery.

Background: Early diagnosis is one of the most critical factors influencing the prognosis of lung cancer. This study aims to investigate radiological diagnostic delays and their underlying causes in lung cancer. Methods: The previous radiological images of newly diagnosed lung cancer patients were retrospectively reviewed by a multidisciplinary team consisting of 2 chest physicians and 1 radiologist. Radiological abnormalities were identified, and potential factors contributing to delayed diagnosis were analyzed. Results: Among 100 patients, 76 had prior thoracic imaging. In 22 of these, lesions had been previously identified and patients informed about the potential risk of malignancy, but further evaluation was declined. Retrospective review revealed unrecognized radiological abnormalities in 30 patients-12 on chest X-rays and 18 on computed tomography (CT) scans. In 7 cases, the lesions had been documented in the CT reports. Lesions located in peri-hilar, tracheobronchial, and paravertebral regions, as well as those originating from areas of lung sequelae, were among the most common factors associated with later diagnosis. Diagnostic delays were more common in cases of adenocarcinoma. Conclusion: A considerable proportion of lung cancer cases might have been detected earlier. Increased awareness of specific radiological features and careful co-evaluation of both imaging reports and the images themselves may enhance earlier detection in lung cancer.

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.