The aim of this study was to investigate the prognostic values of neutrophil-to-lymphocyte ratio and red blood cell distribution width in diabetic foot ulcers treatment. A total of 250 adult patients who were treated in our clinic between 2007 and 2018 for diabetic foot ulcers were evaluated retrospectively. Diabetic foot ulcers were divided into 4 groups: major amputation, minor amputation, chronic wound, and complete healing. The mean age of our study groups was 60 years (range = 55-65 years). The mean follow-up period was 28 ± 4.3 months. Neutrophil-to-lymphocyte ratio and red blood cell distribution width cutoff values were determined as 4.3 and 12.1, respectively, for patients in complete recovery group (C sig. = .995 and .871, respectively; P < .05). Neutrophil-to-lymphocyte ratio and red blood cell distribution width cutoff values for patients in the major amputation group were 6.73 and 13.4 (C sig. = .864 and .951, respectively; P < .05), respectively. According to the χ² comparison of the groups, major amputation was seen in patients with neutrophil-to-lymphocyte ratio >6.3, and complete recovery was seen in patients with neutrophil-to-lymphocyte ratio 13.4, major amputation was found to be significant ( P < .05). According to these results, neutrophil-to-lymphocyte ratio and red blood cell distribution width are inexpensive and easy to access predictive parameters in the diagnosis and follow-up of diabetic foot ulcers.

Background/aim: Artificial intelligence (AI), particularly large language models (LLMs) such as ChatGPT and DeepSeek, is being increasingly applied in clinical care, research, and education. The aim of this review is to examine how these tools may transform the conduct of medical and biological research and to define their limitations. Materials and methods: A narrative synthesis of the literature was performed, encompassing studies published between 2020 and 2025. Peer-reviewed journals, systematic reviews, and high-impact original research articles were included to ensure an evidence-based overview. The principle applications, validation metrics, and clinical implications across orthopedics, oncology, cardiology, internal medicine, and the biological sciences were analyzed. Results: LLMs demonstrate strong potential in supporting physicians during clinical decision-making, enhancing patient education, and assisting researchers in their work. They are valuable for language-related tasks and for generating structured, clear, and comprehensible content. However, concerns persist regarding data privacy, algorithmic bias, factual accuracy, and excessive dependence on data-driven outputs. Responsible implementation requires safeguards such as human oversight, model transparency, and domain-specific training. Conclusion: AI tools such as ChatGPT, DeepSeek, and similar models are transforming the way healthcare is delivered and studied. Their current capabilities appear highly promising. However, clinicians, technical experts, and policymakers must collaborate to ensure the safe, equitable, effective, and ethical integration of these technologies into real-world healthcare workflows.

Background: Mortality after geriatric hip-fracture surgery remains substantial. This study evaluated whether preoperative GNRI, comorbidity burden, and CBC-derived inflammatory indices were associated with one-year and long-term mortality after PFN for pertrochanteric/intertrochanteric fractures. Methods: In this single-centre retrospective cohort study of prognostic risk markers, 248 PFN records were screened. After excluding six incomplete records and 25 patients aged <65 years, 217 older fracture/surgical episodes formed the time-to-event cohort; 194 were evaluable for binary one-year mortality. Living patients/episodes with <365 days of follow-up were censored in survival analyses. Logistic and Cox models were supported by Firth penalized logistic regression, calibration assessment, and internal validation. Results: Median age was 82 years, 65.0% were female, and 68.7% were ASA III–IV. Overall, 96/217 (44.2%) died during median follow-up of 570 days. Thirty-day, 90-day, and one-year evaluable mortality were 7.4%, 15.2%, and 27.3%. GNRI < 82 identified a small high-risk subgroup: 10/13 evaluable patients/episodes (76.9%) died within one year versus 43/181 (23.8%) with GNRI ≥ 82. GNRI < 82 remained associated with one-year mortality in adjusted logistic regression, although with a wide confidence interval due to sparse subgroup size (OR 6.43, 95% CI 1.50–27.55; p = 0.012), and in Firth penalized sensitivity analysis (OR 5.51, 95% CI 1.34–22.61; p = 0.018). In Cox analysis, age, ASA III–IV, available Charlson-domain comorbidity burden, and lower continuous GNRI were associated with long-term mortality, whereas adding GNRI < 82 and NLR did not materially improve cross-validated discrimination. Conclusions: GNRI < 82 identified a small subgroup with high observed mortality after PFN. Because the subgroup was sparse and biomarker addition did not materially improve internally validated discrimination, GNRI should be treated as an alerting clinical flag rather than a stand-alone basis for patient-level risk prediction. External validation is required.

Three-point index (TPI), which can be used in the follow-up of conservative treatment, is an important indicator and reveals objective results about the fracture redisplacement. The hypothesis of the current study was that an initial TPI value of 0.6–0.8 may also be dangerous as it has the potential to exceed over 0.8 before a sufficient consolidation occurs and a prompt revision of the cast may prevent an upcoming displacement. This prospective controlled study 84 patients between 4 and 16 years of age, with radius distal metaphyseal fractures with more than 30% displacement or more than 15° initial angulation, were included. All of the patients in the groups had no redisplacement at 5–7 days and had TPI between 0.6 and 0.8. The patients who had cast replacement and adjusted TPI below 0.6 were included Group 1. The patients who had no cast replacement were included in Group 2. Redisplacement was observed in 8 of 38 (21%) patients in the Group 1 and in 27 of 46 (58%) patients in the Group 2 (P value 0.001). Redisplacement with cast revision was 2.8 times less (P < 0.005). The first reduction quality, fracture obliquity, renewed TPI values were found to be statistically significant for the prediction of redisplacement (P < 0.005). We recommend that the follow-up of the TPI is an important predictive factor in the conservative treatment of pediatric metaphyseal radius fractures. TPI may be renewed for protection of the fracture reduction when calculated in the gray zone which is 0.6–0.08.

In all-inside anterior cruciate ligament (ACL) reconstruction, grafts with free tendon ends require bilateral suturing to suspensory fixation devices durin

Preoperative Surgical Fear, Anxiety, Depression, and Pain in Orthopedic Patients: A Cross-Sectional Comparison of Trauma and Elective Surgery - Forbes Journal of Medicine