Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence data in Türkiye is limited. We aimed to determine the nationwide prevalence of MASLD and advanced hepatic fibrosis risk in subjects with cardiometabolic risk factors (CMRF). Despite recent international consensus redefining fatty liver disease terminology, no nationwide MASLD study has been reported in Türkiye. Methods: This cross-sectional study included 14,371 adults with ≥1 CMRF from 44 centers across 31 cities. MASLD was diagnosed using liver ultrasonography plus cardiometabolic criteria. Advanced fibrosis risk was assessed by fibrosis-4 (FIB-4) score (≥1.3 for ≤65 years; ≥2.0 for >65 years). Logistic regression was used to identify independent predictors of high FIB-4. Results: A total of 61.4% of participants were women, the mean age was 51.3 ± 14.4 years, and the mean BMI was 31.4 ± 6.0 kg/m². MASLD prevalence was 75.7% (n = 10,873), rising with the number of CMRFs (56.5% with one factor vs. 83.4% with all). The prevalence of high FIB-4 scores was 12.0% overall, being lower in MASLD patients than non-MASLD patients (11.2% vs. 14.4%, p < 0.001). FIB-4 scores decreased with increasing BMI (28.1% underweight vs. 8.7% class III obesity). Male sex, T2DM, and hypertension independently predicted high FIB-4 scores, while smoking, higher BMI, and MASLD were inversely associated. Conclusions: Three-quarters of Turkish adults with CMRF have MASLD. Standard FIB-4 thresholds may underestimate fibrosis risk in obese and smoking populations, underscoring the need for adjusted cut-offs or alternative tools. This study is the first to provide nationwide MASLD prevalence data in Türkiye.

Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Neurotrophins such as nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) are crucial for neuronal maintenance and immune regulation. However, their dynamics during coronavirus disease 2019 (COVID-19) remain unclear. In this prospective study, 30 hospitalized patients with PCR-confirmed COVID-19 were evaluated longitudinally. Serum NGF, GDNF, and conventional inflammatory markers (CRP, ESR, fibrinogen, ferritin, D-dimer, LDH, hematological counts) were measured on Day 1, Day 4, and at discharge. A control group of 37 healthy individuals was included for cross-sectional comparison. Both NGF and GDNF levels were significantly lower in COVID-19 patients at admission compared with healthy individuals. NGF showed a modest early decline from Day 1 to Day 4, followed by partial recovery at discharge, whereas GDNF remained stable throughout hospitalization. Inflammatory markers demonstrated expected clinical trajectories: CRP, ESR, LDH, and fibrinogen decreased during recovery, while WBC, neutrophils, and platelets increased. Ferritin and D-dimer showed no meaningful temporal changes. NGF appears to reflect acute neuroimmune activation in COVID-19 and may serve as a dynamic biomarker of early inflammatory resolution. Conversely, GDNF remained persistently suppressed, suggesting a distinct role in chronic neuroimmune regulation. These findings highlight NGF and GDNF as potential targets for monitoring and modulating neuroimmune responses in COVID-19 and other inflammation-driven conditions.

THE EVALUATION OF HEALTH STATUS OF FAMILIAL MEDITERRANEAN FEVER PATIENTS WITH HOMOZYGOUS M694V MUTATION - Rheumatology Quarterly

Purpose: This study investigates the impact of digital transformation on healthcare accessibility among older adults in Turkey, with a focus on the digital divide.Methods: A cross-sectional study was conducted with 191 participants, categorized into two groups: older adults aged 65 and above, and younger adults aged 18 to 64. Data were collected through structured questionnaires addressing socioeconomic factors, technological usage, healthcare access, and dependency on caregivers for managing online appointment systems. Results: The key findings indicated that older adult participants reported lower income levels, limited smartphone and computer usage, and higher dependency on family members for scheduling appointments compared to younger participants. Even among highly educated older adults, digital engagement was significantly lower, highlighting the role of digital literacy over formal education in reducing technological barriers. Additionally, older adults with chronic conditions face compounded challenges in accessing healthcare services due to their increased dependency on caregivers.Conclusions: To address these challenges, recommendations include implementing digital literacy programs tailored to older adult populations, designing simplified user interfaces for online systems, and adopting hybrid models that integrate traditional and digital healthcare access methods. Policymakers are urged to prioritize digital inclusion initiatives to ensure equitable healthcare access across all age groups.

Background and objectives: In our study, we aimed to investigate the expression of vitamin D receptor and the relationship between clinical features, prognostic indicators, and expression of vitamin D receptor in Hodgkin lymphoma. Materials and Methods: Pathology records and medical files of patients with Hodgkin lymphoma were evaluated. Forty-two tissue samples were analyzed retrospectively. Vitamin D receptor staining was performed with immunohistochemistry. The patients were divided into low, medium, and intense staining subgroups. The demographic data, clinical and biochemical values of patients were reviewed retrospectively, and the relationship between clinical features, prognostic indicators, and vitamin D receptor expressions were examined. Results: VDR staining was positive in Reed-Sternberg cells of all Hodgkin lymphoma patients. The cases were divided into three groups according to VDR staining intensity as low, medium and intense staining and compared with known clinical prognostic parameters. Only the presence of symptom B was statistically significantly different. Gender, bone marrow involvement, extralymphatic involvement, mediastinal mass, bulky mass, mean leukocyte count, and treatment response were associated with vitamin D receptor staining intensity, but they were statistically insignificant. Conclusion: Our study is the second study showing VDR in tumor Hodgkin lymphoma tumor tissues and is meant to be the first to evaluate its association with clinical and biochemical prognostic laboratory tests. Vitamin D receptor staining in all Hodgkin lymphoma patients led to the conclusion that VDR can be used in the histopathological differential diagnosis of HL. More studies are needed to assess and demonstrate the relationship between prognostic and diagnostic indicators and vitamin D receptor intensity of immunohistochemically detected VDR in tumor tissues of Hodgkin lymphoma. Also, further studies with serum vitamin D levels and other histologic subtypes can provide more reliable results. Article visualizations: