Erva Eser

Background: To evaluate longitudinal radiographic outcomes, exploratory radiographic response, and planned versus unplanned revision burden after magnetically controlled growing rod treatment in patients with early-onset scoliosis. Methods: We retrospectively reviewed 55 patients with early-onset scoliosis treated with magnetically controlled growing rods at a single center. Complete year-3 radiographic measurements were available for 40 patients; therefore, year-3 estimates were conditional on imaging availability. Cobb angle, T1–S1 length, and apical vertebral translation (AVT) were assessed preoperatively and at postoperative years 1, 2, and 3. Longitudinal changes were evaluated using generalized estimating equations. Exploratory radiographic responder endpoints included ≥20° Cobb correction, ≥30% Cobb correction, and a ≥30 mm preoperative-to-year-3 T1–S1 length difference. Freedom from unplanned revision and composite endpoints were also evaluated. The radiographic thresholds were pragmatic and were not validated measures of clinically important improvement. Results: The cohort included 33 female and 22 male patients, with a mean age at surgery of 8.10 ± 1.86 years. Neuromuscular and congenital scoliosis accounted for 41.8% and 40.0% of cases, respectively, and dual-rod constructs were used in 83.6%. At year 3, mean Cobb angle was 40.15° ± 19.03°, mean radiographic T1–S1 length was 383.02 ± 54.42 mm, and mean AVT was 32.80 ± 23.56 mm among 40 patients with complete measurements. GEE models showed significant reductions in Cobb angle and AVT and increases in T1–S1 length at each postoperative year (all p < 0.001). At year 3, ≥20° Cobb correction, ≥30% Cobb correction, and ≥30 mm preoperative-to-year-3 T1–S1 length difference were achieved in 50.0%, 55.0%, and 67.5% of patients, respectively; 35.0% achieved both radiographic thresholds and 25.0% achieved both thresholds with no recorded unplanned revision. Patient-level fields recorded any complication in 20.0%, unplanned revision in 16.4%, internal revision classification in 43.6%, and definitive fusion in 16.4%; these fields were not treated as mutually exclusive. Conclusions: MCGR treatment was associated with longitudinal radiographic improvement among patients with available measurements. The preoperative-to-year-3 T1–S1 difference includes the effect of index surgery and should not be interpreted as biological spinal growth alone. These findings suggest that MCGR success should be assessed not only by curve correction, but also by measured spinal-length gain and revision burden.

Background: Adjuvant radiotherapy (RT) after gross-total resection of World Health Organization (WHO) grade 2 meningioma remains an individualized decision in the absence of definitive randomized evidence. We aimed to identify the clinical, radiological, and pathological factors associated with observed adjuvant RT allocation after Simpson grade I resection and to evaluate the discriminatory performance of proliferative biomarkers in real-world multidisciplinary practice. Methods: This single-center, retrospective cohort included 65 patients, of whom 56 undergoing Simpson grade I resection constituted the primary analytic cohort. Associations with observed RT allocation were evaluated using Firth-penalized logistic regression. Ki-67 and mitotic-index discrimination was summarized using receiver operating characteristic (ROC) analysis, and Ki-67 threshold stability was assessed in 5000 bootstrap resamples. Brain invasion was evaluated in a documented-case sensitivity analysis. Results: Adjuvant RT was administered to 24 of 56 patients (42.9%). In models adjusted for age, sex, neutrophil-to-lymphocyte ratio, and tumor size, each 5-percentage-point increase in Ki-67 was associated with higher odds of RT allocation (OR 7.10, 95% CI 2.20–22.94; p = 0.001), as was each increase of 5 mitoses per 10 high-power fields in mitotic index (OR 5.81, 95% CI 2.01–16.75; p = 0.001). Ki-67 showed greater apparent discrimination than mitotic index (area under the curve [AUC] 0.925 vs. 0.801; DeLong p = 0.008). The apparent Youden-optimal Ki-67 threshold was 14%, but thresholds of 12%, 14%, and 15% were selected in 33.4%, 41.9%, and 23.1% of bootstrap samples. Among 44 patients with documented brain-invasion status, Ki-67 remained associated with RT allocation after adjustment for brain invasion (OR 4.53, 95% CI 1.77–11.63; p = 0.002). Conclusions: Ki-67 and mitotic index were associated with observed RT allocation, but both markers were already available to the tumor board. These findings describe institutional treatment-allocation patterns and do not establish RT benefit or validate a Ki-67 threshold for recommending treatment.

Aim: Brain metastases (BM) are an increasing oncological challenge due to improved systemic cancer survival. Surgical resection is essential for symptom control and diagnosis; however, survival outcomes remain heterogeneous. The objective of the current investigation was to evaluate the clinical and surgical determinants that impact overall survival (OS) outcomes in a cohort of patients undergoing resection for BM.Material and Methods: A total of 158 adult cases treated surgically for intracranial metastases from January 2018 to December 2024 were systematically analyzed through a retrospective institutional review. Demographic, clinical, radiological, and surgical variables were analyzed. OS was the primary endpoint. The Kaplan-Meier method was utilized for survival estimation, while the influence of various covariates on prognosis was examined through Cox proportional hazards modeling. The Tarone-Ware test was used to assess early survival differences. Results: Our analysis revealed a median survival time of 6.0 months. Initial univariable screening showed that survival was significantly linked to factors such as patient age, gender, adjuvant therapies, and KPS measured at different perioperative stages. In the revised multivariable analysis, postoperative KPS (HR: 0.974, 95% CI: 0.962-0.986, p

Objective: The objective was to evaluate longitudinal changes in health-related quality of life (HRQoL) following surgical resection of brain metastases and investigate the prognostic value of the Graded Prognostic Assessment (GPA) score in predicting HRQoL improvement. Methods: This prospective observational study included 42 consecutive adult patients undergoing microsurgical resection for histopathologically confirmed brain metastases. HRQoL was assessed using the EuroQol Five-Dimension Five-Level questionnaire (EQ-5D-5L) questionnaire and EuroQol Visual Analogue Scale (EQ-VAS) preoperatively and at 1 and 6 months postoperatively. Patients were stratified according to their preoperative GPA scores, and longitudinal changes in HRQoL were analyzed using non-parametric statistical methods. Results: Mean EQ-VAS scores exhibited a significant postoperative increase from 38.3 ± 19.3 at baseline to 77.6 ± 19.3 at one month and 75.7 ± 16.7 at six months (p < 0.001). Significant improvements were observed across all five EQ-5D-5L dimensions (all p < 0.001). Patients with favorable GPA scores (3.0–4.0) demonstrated greater improvements in EQ-VAS than those in lower GPA categories at one month (p = 0.035) and six months (p = 0.013). Higher baseline GPA scores were positively correlated with HRQoL improvement at both follow-up time points (ρ = 0.51 and ρ = 0.50, respectively; both p < 0.001). Changes in clinician-rated Karnofsky Performance Status (KPS) did not differ significantly across GPA categories (p = 0.731). Conclusions: Surgical resection of brain metastases significantly improves patient-reported HRQoL. The GPA score is a significant predictor of postoperative HRQoL gain, whereas traditional clinician-rated scales like KPS may lack the sensitivity to capture these patient-centered improvements. However, the findings regarding GPA subgroups should be considered exploratory due to the limited number of patients in certain tiers.

Objective: This study is a bibliometric analysis of scientific publications reporting the beneficial effects of gut microbiota modulation by probiotics and/or prebiotics on colorectal cancer. Methods: This study adhered to the PRISMA guidelines and focused on English peer-reviewed research articles published between 2020 and 2025, as indexed in Google Scholar and PubMed. Search terms included “Colorectal Cancer”, “Colon Cancer”, “Colorectal Carcinoma”, “Colon Carcinoma” and “Gut Microbiota”. A total of 116 studies were selected and manually reviewed, taking into account the inclusion and exclusion criteria. Results: The bibliometric analysis of 37 studies revealed that China leads research efforts, primarily focusing on prebiotics (70.3%), such as dietary fibres, while probiotic-focused studies are limited (24.3%) due to practical challenges. Although the combined use of prebiotics and probiotics (2.7%) is theoretically beneficial, their practical application remains complicated. The trend in the literature aligns with a growing interest in traditional medicine and functional foods, but annual publication rates have declined, with only three papers from 2025 (30.8%). Despite recognising microbial diversity, the number of probiotic-based studies is low, with Clostridium butyricum being the most prevalent species. Conclusion: Overall, this analysis underscores the critical role of gut microbiota in CRC treatment and the potential of natural compounds, while highlighting the need for further research. Further research is essential to deepen our understanding of gut microbiota dynamics and optimise therapeutic approaches for patients with CRC.

At kazaları hem biniciler hem de hayvanlar açısından ciddi yaralanma ve komplikasyon riskleri taşımaktadır. Binicilerde en sık kafa travması, omurga ve ekstremite yaralanmaları görülürken; atlarda kanama, tendon ve iskelet sistemi lezyonları ile davranışsal bozukluklar ön plana çıkmaktadır. Literatürde binicilik kazalarının büyük çoğunluğunun düşme kaynaklı olduğu ve koruyucu ekipman kullanımının mortaliteyi belirgin şekilde azalttığı bildirilmektedir. Etkin ilk yardım uygulamaları, yaşamın korunması, yaralanmaların ilerlemesinin engellenmesi ve profesyonel tedavi sürecine uygun koşulların sağlanması açısından kritik öneme sahiptir. Bu kapsamda, ortam güvenliğinin sağlanması, hemorajilerin ve kırıkların kontrolü, şok belirtilerinin izlenmesi ve hızlı veteriner veya tıbbi destek sağlanması temel ilkeler olarak öne çıkmaktadır. Ayrıca hem at hem de biniciye yönelik donanımları içeren standart bir ilk yardım çantasının hazır bulundurulması, acil durumlara etkin yanıt verilmesini kolaylaştırmaktadır. Bu bölüm, at kazaları ve ilk yardım süreçlerine ilişkin güncel bilgileri, istatistiksel verileri ve uygulamalı yaklaşımları disiplinler arası bir çerçevede değerlendirmekte; hayvan refahı ve insan güvenliği açısından koruyucu önlemlerin önemini vurgulamaktadır.