Cerrahi Tıp Bilimleri Bölümü Koleksiyonu

The role of lipid-derived indices in patients with MASLD in Turkey: a nationwide, multicenter cross-sectional study

2026-06-26T14:13:58Z

The role of lipid-derived indices in patients with MASLD in Turkey: a nationwide, multicenter cross-sectional study Şahin, Cem; Solmaz, İhsan To investigate the role of lipid-derived indices-the monocyte-to-HDL cholesterol ratio (MHR), visceral adiposity index (VAI), atherogenic index of plasma (PAI), and cardiometabolic index (CMI)-in determining hepatic steatosis and fibrosis among patients with metabolic dysfunction-associated steatotic liver disease (MASLD) across Turkey. This nationwide, multicenter, retrospective cross-sectional study included 14,322 individuals from 44 internal medicine clinics in 31 provinces of Turkey. Anthropometric, clinical, and biochemical data were collected, and Participants were classified as MASLD (+) if ultrasonographic hepatic steatosis was present in the setting of >= 1 cardiometabolic risk factor according to current EASL-EASD-EASO guidelines; individuals without ultrasonographic steatosis were classified as MASLD (-). FIB-4 scores were calculated to assess the risk of advanced hepatic fibrosis. Cardiometabolic risk factors included obesity (BMI >= 25 kg/m & sup2; or increased waist circumference), type 2 diabetes mellitus, hypertension, impaired fasting glucose, and dyslipidemia as defined by international guidelines. The relationships between MHR, VAI, PAI, CMI, and MASLD presence and fibrosis severity were analyzed via nonparametric statistical tests. MASLD was detected in 10,836 participants (75.7%). The VAI, PAI, and CMI were significantly greater in the MASLD (+) group than in the MASLD (-) group (p < 0.001 for all), whereas the MHR was not significantly different (p = 0.453). Among MASLD (+) patients, 1,214 (11.2%) had high FIB-4 scores (>= 1.3; >= 2.0 if > 65 years) yet none of the lipid indices correlated significantly with FIB-4 levels. In multivariable logistic regression analysis restricted to MASLD-positive individuals, none of the lipid-derived indices were independently associated with high FIB-4 risk after adjustment for metabolic covariates. A weak negative correlation was observed only between FIB-4 score and the MHR (r=-0.030, p = 0.002). VAI, PAI, and CMI are significantly associated with hepatic steatosis in MASLD, suggesting their potential role as supportive, noninvasive markers in identifying individuals at increased risk of MASLD. However, these indices are not reliable predictors of advanced hepatic fibrosis risk based on FIB-4. The combination of these tools with other noninvasive fibrosis assessment tools may increase diagnostic accuracy in MASLD management.

Is the Prognostic Nutritional Index a Predictor of Urolithiasis?

2026-06-26T12:47:36Z

Is the Prognostic Nutritional Index a Predictor of Urolithiasis? Dereköylü, Engin; Çoşkun, Çağrı; Aydın, Uğur; Tarım, Kayhan Objective: Prognostic nutritional index (PNI) is a parameter that reflects nutritional status and inflammation. It is calculated from serum albumin and lymphocyte count. Our study investigated whether PNI has a predictive value in urolithiasis. Materials and Methods: Data of patients who applied to A & gbreve;r & imath; Training and Research Hospital with renal colic between January 2017 and December 2024 were retrospectively examined. Three hundred forty-eight patients were included in the stone group and 627 patients were included in the control group. Patients' age, gender, smoking, hypertension, and diabetes history, body mass index, hemoglobin level, glomerular filtration rate (GFR), blood urea nitrogen, uric acid levels, sodium, potassium, calcium, white blood cell count (WBC), neutrophil count, lymphocyte count, albumin, neutrophil/lymphocyte ratio (NLR), and PNI levels were compared. Results: No statistically significant difference existed between the demographic data and the patients' comorbidities. In the stone patients group and the control group, mean GFR was 88.04 [standard deviation (SD): 13.21], 93.90 (SD: 13.17); mean WBC was 8910 (SD: 1629), 8268 (SD: 1562); mean neutrophil count was 6040 (SD: 1416), 4933 (SD: 1283); mean lymphocyte count was 2070 (SD: 879), 2535 (SD: 944); mean NLR was 3.62 (SD: 2.1), 2.34 (SD: 1.41); PNI was 30.73 (SD: 6.85), 53.66 (SD: 6.94) (p<0.001, all). Conclusion: PNI value was lower in stone patients than in the control group. PNI may be a parameter predicting stone formation. Additionally, the predictive value can be strengthened with the NLR value.

Letter to the Editor Regarding "Comparative Analysis of Repeat Cranial Imaging in Mild Traumatic Brain Injury: Evaluating Risk Factors, Costs, and Radiation Exposure Between 2017 and 2023"

2026-06-24T07:36:14Z

Letter to the Editor Regarding "Comparative Analysis of Repeat Cranial Imaging in Mild Traumatic Brain Injury: Evaluating Risk Factors, Costs, and Radiation Exposure Between 2017 and 2023" Gölcük, Yalçın; Korkmaz, Olcay Letter to the Editor

Extraperitoneal versus transperitoneal approach in vNOTES sacrocolpopexy: a comparative pilot study

2026-06-23T12:03:12Z

Extraperitoneal versus transperitoneal approach in vNOTES sacrocolpopexy: a comparative pilot study Güngördük, Kemal; Biton, Emre; Şahin Uyar, Berican; Üstüntaş, Serkan BackgroundThis pilot study aimed to assess the feasibility, perioperative safety, and short-term outcomes of extraperitoneal versus transperitoneal vNOTES sacrocolpopexy.MethodsThirty-six patients with POP-Q stage III or higher who underwent simultaneous vNOTES hysterectomy, BSO, and sacrocolpopexy were retrospectively analyzed and categorized into extraperitoneal (Group A, n=14) and transperitoneal (Group B, n=22) groups. Anatomical success, quality of life, and recovery were evaluated using POP-Q, P-QOL, ICIQ-UI SF, QoR-15, and MESH-R scales.ResultsBaseline characteristics were comparable between groups. Six-month anatomical success rates were similar (extraperitoneal 90.8% vs. transperitoneal 91.6%). The most notable procedural difference was Trendelenburg positioning: Group A was maintained at 10 degrees-15 degrees throughout, whereas Group B required 25 degrees-30 degrees during the sacrocolpopexy phase. Numerical trends favoring the extraperitoneal approach were observed in operative time (99.6 vs. 110.4 min; p=0.185) and time to first stool (27.7 vs. 34.5 h; p=0.552), but neither reached statistical significance. No rectal injuries or intraabdominal abscesses occurred in either group.ConclusionsExtraperitoneal vNOTES sacrocolpopexy is feasible and safe, yielding anatomical outcomes equivalent to the transperitoneal approach at six months. Its most substantiated advantage is the reduced Trendelenburg angle, which may lower physiological burden in high-BMI patients. Remaining potential benefits require confirmation through larger prospective trials.