Background: Anthracycline-based chemotherapy is highly effective in breast cancer treatment but is limited by dose-dependent cardiotoxicity. Early identification of subclinical myocardial injury is crucial to prevent progression to irreversible dysfunction. Objectives: To evaluate whether a multimodal surveillance strategy integrating left ventricular global longitudinal strain (LVGLS), left atrial reservoir strain (LASr), and high-sensitivity troponin I (hs-TnI) can predict early anthracyclineinduced cardiotoxicity. Methods: This retrospective cohort study included 50 female breast cancer patients (mean age 49.3 ± 8.5 years) treated between January 2022 and December 2024. Echocardiography and biomarkers were assessed at baseline and 1 month after chemotherapy. Cardiotoxicity was defined as a > 10% reduction in LVEF to < 53%. Results: Cardiotoxicity occurred in 15 patients (30%). LVGLS, LASr, and hs-TnI significantly changed (all P < 0.001).Independent predictors were LVGLS (aOR 1.33), LASr (aOR 0.77), and hs-TnI (aOR 1.07). hs-TnI showed the highest discriminative ability (AUC 0.940). Conclusions LVGLS, LASr, and hs-TnI provide complementary information for early detection of cardiotoxicity.

Purpose: Real-world evidence comparing surgical techniques for symptomatic hemorrhoidal disease (HD) remains limited, despite the availability of multiple approaches. This study aimed to evaluate short-term, interim outcomes from a prospective, nationwide cohort study that compared the effectiveness of different operative techniques based on patient-reported outcome measures (PROMs) in patients with symptomatic HD. Methods: A prospective, nationwide cohort study was conducted at 20 tertiary care centers across Turkiye between July 2022 and July 2024. Adult patients aged 18 years or older with symptomatic HD (grades I–IV) who underwent surgery during this period were included. The choice of procedure was determined by the operating surgeon, and patients were categorized into excisional, fixative, and ablative groups according to the surgical approach used. The primary outcomes were changes in the Hemorrhoidal Disease Symptom Score, Short Health ScaleHD, visual analog scale for pain, and patient satisfaction, assessed from the preoperative period to postoperative day 7 and postoperative week 6. Results: The study included a total of 315 patients after excluding those who did not fulfil the inclusion criteria. Among them, 239 (78.9%) were male, with a mean age of 43.7±11.7 years. The distribution of patients across surgical groups was 207 (65.7%) in the excisional group, 30 (9.5%) in the fixative group, and 78 (24.8%) in the ablative group. All groups demonstrated significant improvements in PROM scores from preoperative to postoperative assessments. However, no statistically significant differences were observed between groups at any time point for PROM scores or for changes in PROM scores across consecutive evaluations (P≥0.05 for all comparisons). Urinary retention occurred more frequently, and hospital stays were longer in the fixative group (P=0.006 and P<0.001, respectively). The excisional group had a greater need for narcotic use and longer duration of use (P=0.003 and P<0.001, respectively). Conclusion This real-world cohort study shows that all 3 surgical approaches are effective for HD, providing comparable short-term symptomatic relief and patient satisfaction. These techniques appear equally valid treatment options, and the choice of procedure may best be individualized based on patient-specific characteristics and surgeon preference.Trial registration: ClinicalTrials.gov identifier: NCT05429060

Purpose: With a focus on dislocation rates, this study aims to compare the posterior or posterolateral approach (PLA) with the piriformis-sparing approach (PSA) in elderly patients undergoing cementless hemiarthroplasty for displaced femoral neck fractures. Materials and Methods: This retrospective study included 194 patients who met the eligibility criteria and underwent surgery using the PLA (n=140) or the PSA (n=54). Patient data were reviewed for age, sex, body mass index, postoperative dislocation rate, presence of neurological conditions or other comorbidities, surgical duration, length of hospital stay, follow-up period, infection rate, admission to the intensive care unit (ICU), and mortality rate. Results: In Group 1 (PLA), 12 out of 140 patients (8.6%) experienced dislocation within a postoperative period of 1 to 5 years. Dislocations occurred in three out of 54 patients (5.6%) in Group 2 (PSA). Although the difference was not statistically significant (P=0.565), a significant difference was observed between the groups in terms of mortality (P=0.015) and surgical duration (P=0.0001). Conclusion In terms of functional outcomes and postoperative pain management, the advantages of modified PLA have been highlighted in recent studies. Although no statistically significant difference was found in this study, a 3% lower dislocation rate was demonstrated by the PSA as compared to the PLA.

INTRODUCTIONRestless legs syndrome (RLS), also known as Willis-Ekbom disease, is characterised by abnormal sensations in the legs as well as dysaesthesia. Although the aetiology of RLS has not yet been determined, it may be associated with systemic inflammation. The neutrophil-to-lymphocyte ratio (NLR) is a new and simple marker indicating systemic inflammation. The present study aimed to investigate the relationship between systemic inflammation and RLS through the use of the NLR.

METHODSA total of 75 newly diagnosed patients with RLS and 56 healthy control subjects were included in the study. Baseline NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. The NLRs of the two groups were compared.

RESULTSThere were no significant differences in gender and age between the two groups. The NLR was 1.96 ± 0.66 in the patient group and 1.67 ± 0.68 in the control group (p = 0.005). Receiver operating characteristic analysis was performed to determine the cut-off value of NLR to predict RLS. The NLR was predictive at 1.58 with a 64% sensitivity and 50% specificity (95% confidence interval 0.55-0.74, area under curve 0.648 ± 0.05). The NLR was found to be statistically higher in patients with RLS and may be used to predict RLS.

CONCLUSIONThe aetiology of RLS remains undetermined. The present study showed that systemic inflammation may play a role in RLS. However, RLS could also be associated with systemic inflammatory diseases. This relationship is supported by high NLR values, which are related to chronic systemic inflammation.

Adult ; Case-Control Studies ; Female ; Humans ; Inflammation ; Leukocyte Count ; Lymphocyte Count ; Lymphocytes ; cytology ; Male ; Middle Aged ; Neutrophils ; cytology ; ROC Curve ; Restless Legs Syndrome ; blood ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the impact of treatment with oral trimetazidine (TMZ) applied before and after percutaneous coronary interventions (PCI) on short-term left ventricular functions and plasma brain natriuretic peptide (BNP) levels in patients with non-ST segment elevation myocardial infarction (NSTEMI) undergoing PCI. SUBJECTS AND METHODS: The study included 45 patients who were undergoing PCI with the diagnosis of NSTEMI. The patients were randomized into two groups. The first group (n=22) of the patients hospitalized with the diagnosis of NSTEMI was given conventional therapy plus 60 mg TMZ just prior to PCI. Treatment with TMZ was continued for one month after the procedure. TMZ treatment was not given to the second group (n=23). Echocardiography images were recorded and plasma BNP levels were measured just prior to the PCI and on the 1st and 30th days after PCI. RESULTS: The myocardial performance index (MPI) was greater in the second group (p=0.02). In the comparison of BNP levels, they significantly decreased in both of the groups during the 30-day follow-up period (29.0+/-8 and 50.6+/-33, p<0.01 respectively). However, decreasing of BNP levels was higher in the group administered with TMZ. The decrease of left ventriclular end-diastolic volume was observed in all groups at 30 days after intervention, but was higher in the group administered with TMZ (p=0.01). CONCLUSION: Trimetazidine treatment commencing prior to PCI and continued after PCI in patients with NSTEMI provides improvements in MPI, left ventricular end diastolic volume and a decrease in BNP levels.
Brain ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Natriuretic Peptide, Brain ; Percutaneous Coronary Intervention ; Plasma ; Stroke Volume ; Trimetazidine ; Ventricular Function, Left

No abstract available.
Aortic Valve Stenosis ; Coronary Stenosis ; Humans ; Hyperlipoproteinemia Type II

The superior cerebellar artery is the most consistent branch of the basilar artery and arises near the bifurcation of the basilar artery. A bilateral origin of the superior cerebellar arteries from the posterior cerebral arteries has been rarely reported in the literature. Reporting variations in brain vessels is important for neurosurgeons to safely and confidently treat pathologies in this region. We report on a specimen with a bilateral origin to the superior cerebellar artery from the posterior cerebral artery and discuss the embryogenesis of this rare variation.
Arteries ; Basilar Artery ; Brain ; Embryonic Development ; Female ; Posterior Cerebral Artery ; Pregnancy