European Journal of Innovative Medical Research
The European Journal of Innovative Medical Research (EURJIMR) is an international, peer-reviewed, open-access journal dedicated to advancing the frontiers of medical science through innovation, technology, and translational research. The journal serves as a platform for clinicians, scientists, and healthcare professionals to share original studies, cutting-edge discoveries, and novel approaches that shape the future of medicine and healthcare delivery. Aims and Scope EURJIMR publishes high-quality research across the full spectrum of medicine, emphasizing originality, clinical relevance, and methodological rigor. The journal particularly welcomes manuscripts that integrate new technologies, data-driven methods, and interdisciplinary collaborations to address contemporary challenges in diagnosis, treatment, prevention, and healthcare management. Key areas of interest include, but are not limited to: Innovative surgical and medical techniques Artificial intelligence and digital health applications Molecular and translational medicine Clinical trials and outcome-based research Biomedical engineering and medical devices Regenerative medicine and tissue engineering Public health innovations and epidemiology Evidence-based healthcare policies and education Editorial Policy EURJIMR upholds the highest standards of editorial integrity and scientific transparency. All submissions undergo rigorous double-blind peer review conducted by experts in the relevant field. The journal adheres to the ethical principles outlined by the Committee on Publication Ethics (COPE) and follows the ICMJE recommendations for biomedical publications. Publication Model EURJIMR operates under an open-access model, ensuring that all published articles are freely available online without subscription barriers. Authors retain copyright under a Creative Commons license, promoting wide dissemination and reuse of published material for educational and research purposes. Mission Statement The mission of EURJIMR is to foster innovation in medicine by bridging the gap between scientific discovery and clinical practice. By encouraging interdisciplinary dialogue and global collaboration, the journal aims to contribute to a more effective, ethical, and equitable healthcare landscape worldwide. The European Journal of Innovative Medical Research is a registered Crossref member. All articles receive a unique DOI upon publication, enabling permanent citation, interoperability with global scholarly systems, and enhanced discoverability through structured metadata.
The relationship between pentraxin 3 levels and diabetic retinopathy in patients with type 2 diabetes
ABSTRACT Background: Diabetic retinopathy (DRP) is one of the most common microvascular complications of diabetes. Microvascular complications of diabetes, such as diabetic macular edema and proliferative DRP, are among the major causes of vision loss in the active working-age population. Pentraxin 3 (PTX3) is a protein that is rapidly released during local inflammatory processes in the body. Increased inflammation in diabetes damages the capillaries in the eye, thereby laying the groundwork for retinopathy. Materials and Methods: A total of 82 participants were included in the study. Twenty of these were healthy volunteers. Of the 62 diabetic patients, 41 had DRP and 21 did not. PTX 3 levels were compared between the groups with DRP, without DRP, and the healthy group. The patient group comprised 28 patients with non-proliferative DRP (NPDRP), 13 patients with proliferative DRP (PDRP) and 21 diabetic patients without DRP. The PTX 3 levels of the four groups were compared to assess the severity of DRP. PTX 3 levels in patient serum samples were determined using the ELISA method. Results: PTX3 levels did not show a statistically significant difference between the three study groups. It has been observed that PTX3 levels decrease as the severity of retinopathy increases in patients with diabetes; however, this decrease is not statistically significant. The reduction was not statistically significant, even when compared with the healthy control group. Conclusion: PTX3 levels did not increase in patients with DRP. Furthermore, PTX3 levels did not rise as the severity of DRP increased.
Copyright (c) 2026 Alpaslan Karabulut, Tayfun Şahin (Author) https://creativecommons.org/licenses/by-nc/4.0
Iliac Arterioenteric Fistula Presenting as Ileus: A Catastrophic Late Complication of Pelvic Surgery and Radiotherapy
Background: Arterioenteric fistulas are rare but life-threatening causes of gastrointestinal hemorrhage, most commonly occurring after aortic or aortoiliac reconstruction. Iliac artery–enteric fistulas without prior vascular surgery are exceptionally uncommon and may be difficult to recognize, particularly in a radiation-altered pelvis. Case Presentation: A 54-year-old male with prior low anterior resection and adjuvant chemoradiotherapy for rectal cancer presented with ileus-like symptoms two weeks after inguinal hernia repair. After initial improvement with conservative management, he developed sudden abdominal pain, hemodynamic collapse, and massive hematochezia. During colonoscopy, diffuse intraluminal hematoma and hemorrhagic content were observed throughout the lumen; however, no definite active bleeding source was identified. After the procedure, the patient developed hemodynamic instability, which progressed to hemodynamic collapse. Emergency laparotomy revealed massive hemorrhage from an arterial defect at the iliac bifurcation adherent to small bowel within a radiation-fibrotic pelvis, consistent with an iliac arterioenteric fistula/arterial erosion. Proximal vascular control and definitive repair were performed, along with extensive small-bowel resection and stoma formation. Conclusions: Iliac arterioenteric fistulas can occur without prior vascular reconstruction and may initially mimic ileus, even in the absence of herald bleeding. Non-localizing endoscopy should not exclude the diagnosis in patients with abrupt deterioration. While endovascular techniques aid stabilization, open surgical repair remains essential when bowel compromise or contamination is present.
Copyright (c) 2026 Orhan Aslan, Furkan Uğur (Author) https://creativecommons.org/licenses/by-nc/4.0
Temporal Lobe Brain Abscess Following Refractory Chronic Otitis Media Despite Repeated Antibiotic Therapy
Background: Brain abscess is a rare but potentially life-threatening intracranial infection. Despite advances in antimicrobial therapy and neuroimaging, otogenic brain abscesses remain clinically significant, particularly in patients with chronic otitis media and mastoiditis. Due to anatomical proximity, the temporal lobe is the most commonly affected region. Case Presentation: A 25-year-old male presented to the emergency department with a 40-day history of left ear pain, purulent otorrhea, high-grade fever, and deterioration of general condition. The patient had a long-standing history of chronic otitis media and multiple recent emergency and otolaryngology visits, during which repeated topical, oral, and parenteral antibiotic treatments were administered. Neurological examination revealed neck stiffness and mild alteration of consciousness. Brain computed tomography demonstrated a 40×30 mm mass lesion in the left temporal lobe with surrounding edema and erosion of the temporal bone, consistent with a brain abscess. Broad-spectrum intravenous antibiotics were initiated, and the patient underwent urgent neurosurgical drainage followed by mastoidectomy. Microbiological cultures showed no growth. The patient improved clinically and was discharged with oral antibiotic therapy. Conclusions: This case highlights that brain abscess may develop in patients with chronic otitis media and mastoiditis even in the absence of immunosuppression. In patients with refractory otologic infections and clinical deterioration, early neuroimaging and a multidisciplinary approach are essential for timely diagnosis and successful management.
Copyright (c) 2026 Can Berk İnan (Author) https://creativecommons.org/licenses/by-nc/4.0
Regional Versus General Anesthesia in Severe Aortic Stenosis: Revisiting Hemodynamic Assumptions
Severe aortic stenosis (AS) presents significant perioperative challenges due to fixed left ventricular outflow obstruction, impaired diastolic function, and dependence on adequate preload and systemic vascular resistance. Traditional anesthetic practice has favored general anesthesia (GA) over regional anesthesia (RA) because of concerns regarding sympathetic blockade and hemodynamic instability. However, emerging evidence suggests that carefully titrated regional techniques, particularly peripheral nerve blocks, may preserve cardiovascular stability by avoiding rapid vasodilation and tachycardia associated with induction and intubation. This article revisits the physiologic basis of anesthetic management in severe AS and argues against a binary approach to technique selection. Instead, it emphasizes individualized, physiology-driven strategies tailored to procedural type and patient condition, highlighting the need for prospective studies to refine evidence-based recommendations.
Copyright (c) 2026 Emine Özdemir, Ali Can Özdemir (Author) https://creativecommons.org/licenses/by-nc/4.0
Laparoscopic Management of a Ruptured Tubal Heterotopic Pregnancy After Spontaneous Conception
Background: Heterotopic pregnancy is a potentially life-threatening clinical condition that poses significant diagnostic challenges, particularly in spontaneous conceptions, due to its rarity and the masking effect of a concurrent intrauterine pregnancy. This case report aims to present the successful laparoscopic management of a ruptured tubal heterotopic pregnancy following spontaneous conception, with preservation of the intrauterine pregnancy. Case Presentation: We report a 27-year-old woman, gravida 2 para 1, presenting at 7 weeks of spontaneous gestation with lower abdominal pain. Initial ultrasonography confirmed a viable intrauterine pregnancy without free fluid in the pelvis or abdominal cavity. Rapid clinical deterioration with hemoglobin drop prompted further evaluation, and MRI revealed a coexisting ectopic gestational focus. Emergency laparoscopic salpingectomy was performed, removing a ruptured left ampullary ectopic pregnancy. The intrauterine pregnancy was preserved, and postoperative recovery was uneventful. Conclusions: This case highlights the importance of maintaining a high index of suspicion for heterotopic pregnancy in spontaneous conceptions, the potential utility of advanced imaging when ultrasonography is inconclusive, and the feasibility of laparoscopic management for maternal stabilization while preserving intrauterine pregnancy. Early diagnosis and timely surgical intervention are critical for favorable maternal and fetal outcomes.
Copyright (c) 2026 Seniye Burcu Torumtay Alıç, Tuğçe Doğan (Author) https://creativecommons.org/licenses/by-nc/4.0
Giant Rectocele Mimicking Cystocele in an Elderly Woman with Long-Term Manual Vaginal Splinting After Home Deliveries: A Case Report
Background: Large rectoceles are a recognized cause of obstructed defecation in multiparous women, yet markedly enlarged lesions that clinically resemble anterior compartment prolapse are uncommon. Misinterpretation as cystocele may delay definitive diagnosis and management, particularly in patients with limited access to specialized care. Case Presentation: A 71-year-old woman with a history of five unassisted home vaginal deliveries presented with a decade of obstructed defecation, incomplete evacuation, and chronic reliance on manual vaginal splinting. Initial gynecologic evaluation suggested cystocele; however, targeted pelvic examination and magnetic resonance imaging revealed an isolated grade III rectocele without accompanying cystocele or enterocele. She underwent native-tissue transvaginal rectocele repair with posterior colporrhaphy and perineoplasty. Recovery was uneventful, and at 6-month follow-up she remained fully asymptomatic, with complete resolution of splinting and no evidence of recurrence. Conclusion: This case highlights that giant rectoceles may mimic anterior compartment prolapse and remain untreated for years when healthcare access is limited. Accurate compartment-specific assessment supported by imaging is crucial for avoiding diagnostic error. Native-tissue transvaginal posterior colporrhaphy with perineoplasty offers an effective, mesh-free solution with excellent functional outcomes even in severe, long-standing rectocele.
Copyright (c) 2026 Mert Yiğit Akdoğan, Veysel Barış Turhan, Mahmut Arif Yüksek (Author) https://creativecommons.org/licenses/by-nc/4.0
Management of a Large Necrotic Abdominal Wall Ulcer Following Repeated Insulin Injections in a Patient with Diabetes Mellitus: A Case Report
Background: Large abdominal wall ulcers resulting from repeated insulin injections are exceptionally uncommon, with only isolated reports describing progressive soft-tissue necrosis arising from chronic injection-related microtrauma. Diabetic patients are particularly vulnerable to such complications due to underlying microangiopathy, impaired immunity, neuropathy, and diminished tissue resilience. This case is reported to highlight an unusual presentation of progressive abdominal wall necrosis in a long-standing insulin-dependent diabetic patient and to emphasize key principles of assessment and management. Case Presentation: A 69-year-old woman with long-standing type 2 diabetes mellitus presented with a progressively enlarging ulcer in the left upper abdominal quadrant, initially developing at a habitual insulin injection site. Examination revealed a large necrotic defect with extensive subcutaneous tissue loss but preserved fascial integrity. Laboratory evaluation showed hyperglycemia without systemic inflammatory response. Imaging and intraoperative assessment did not support necrotizing fasciitis. The patient underwent staged surgical debridement followed by negative pressure wound therapy to optimize the wound bed. Once robust granulation developed, definitive coverage was achieved with a split-thickness skin graft, resulting in complete graft take and uneventful recovery. Conclusions: This case underscores the potential for repeated insulin injections to precipitate extensive soft-tissue injury in diabetic patients, even in the absence of overt infection or necrotizing fasciitis. Early recognition, meticulous debridement, and timely initiation of negative pressure wound therapy are essential to preventing disease progression and enabling successful reconstruction. Clinicians should maintain a high index of suspicion for injection-site complications and reinforce preventive education on rotation techniques and site inspection in vulnerable patients.
Copyright (c) 2026 Fatih Şahin (Author) https://creativecommons.org/licenses/by-nc/4.0
Successful Conservative Management of Emphysematous Cholecystitis in a Non-Diabetic Elderly Patient with Multiple Comorbidities
Background: Emphysematous cholecystitis (EC) is a rare, fulminant variant of acute cholecystitis caused by gas-forming organisms in the setting of gallbladder ischemia and impaired mucosal defenses. It typically affects elderly diabetic men and carries a high mortality rate, particularly when associated with Clostridium perfringens. Although urgent cholecystectomy is considered the standard of care, emerging evidence suggests that early-stage EC may occasionally be managed non-operatively in carefully selected high-risk patients. Case Presentation: A 79-year-old non-diabetic male with coronary artery disease, prior cerebrovascular accident, acute kidney injury, and hyperlipidemia presented with right upper quadrant pain and nausea. Laboratory studies revealed leukocytosis, markedly elevated CRP, and impaired renal function. Contrast-enhanced CT demonstrated Type I emphysematous cholecystitis with intraluminal gas but no mural involvement, pericholecystic extension, gallstones, or perforation. Due to his high surgical risk, the patient was treated conservatively with IV piperacillin–tazobactam, fluid resuscitation, and close hemodynamic monitoring. On day two, he developed hypotension, oliguria, and rising inflammatory markers, prompting escalation to meropenem. Following antibiotic adjustment, he exhibited continuous clinical and biochemical improvement, with normalization of renal function and resolution of inflammatory markers. Repeat imaging confirmed complete resolution, and the patient was discharged on day ten in stable condition. Conclusion: This case demonstrates that early-stage emphysematous cholecystitis may be successfully managed with antibiotics alone in non-diabetic patients with significant vascular comorbidities when prompt diagnosis, close monitoring, and appropriate antimicrobial escalation are ensured. Early CT imaging and individualized, stage-based decision-making are essential to avoid progression to gangrene, perforation, or sepsis, particularly in high-risk patients and resource-limited environments.
Copyright (c) 2026 Cemalettin Yanık, Caner Çulha, Emre Boyun, Emre Acartürk (Author) https://creativecommons.org/licenses/by-nc/4.0
Endoscopic Vacuum Therapy in Boerhaave Syndrome: A Contemporary Narrative Review
Boerhaave syndrome remains a life-threatening condition due to rapid mediastinal contamination and sepsis, prompting growing interest in minimally invasive alternatives to surgery. Alongside surgery and endoscopic stenting, endoscopic vacuum therapy (EVT) has emerged over the past decade as an organ-preserving treatment option that combines defect closure with continuous internal drainage—an advantage over conventional stents, which often migrate and fail to control underlying contamination. This narrative review synthesizes current evidence on the role of EVT and hybrid vacuum–stent technologies in the management of spontaneous esophageal rupture. Across recent multicenter cohorts, observational studies, and case series, EVT demonstrates high defect closure rates (80–90%), particularly when applied early in contained perforations and in patients at increased operative risk. Comparative data suggest that, while stents provide effective luminal sealing, EVT offers a distinct advantage in controlling sepsis through active drainage, thereby reducing the need for adjunctive interventions in selected cases. Hybrid systems such as the VACStent further integrate luminal patency, sealing, and negative pressure, allowing nutritional intake while maintaining effective drainage. However, the available evidence remains heterogeneous and largely non-randomized, and EVT appears less effective in the presence of extensive contamination, large chronic cavities, or advanced sepsis. Current data support EVT as a central component of individualized, multimodal management strategies for Boerhaave syndrome, complementing rather than replacing surgical and stent-based approaches. Further prospective and comparative studies are required to refine patient selection and optimize treatment algorithms.
Copyright (c) 2026 Fatih Şahin, Kaan Canal, Mert Yiğit Akdoğan, Ertuğrul Gazi Alkurt (Author) https://creativecommons.org/licenses/by-nc/4.0
Azathioprine-Induced Severe Myelosupression Mimicking Disease Flare in Ulcerative Colitis: A Case Report
Background: Azathioprine is widely used as a steroid-sparing immunomodulator in the long-term management of ulcerative colitis; however, early-onset myelotoxicity remains one of its most serious and potentially life-threatening complications. The clinical presentation of azathioprine-induced marrow suppression frequently overlaps with symptoms of active ulcerative colitis, creating substantial diagnostic uncertainty. Early recognition is critical, particularly given the influence of pharmacogenetic susceptibility—most notably TPMT and NUDT15 variants—on the development of abrupt and profound cytopenias. Case Presentation: We report a 68-year-old man with ulcerative colitis who presented with progressive weakness, fatigue, and profuse bloody diarrhea one month after initiating azathioprine therapy. Initial laboratory testing revealed severe pancytopenia, prompting immediate discontinuation of the drug and initiation of supportive care. Despite withdrawal of azathioprine, cytopenias continued to worsen over the following 48–72 hours, reaching a nadir of 0.59×10³/µL WBC and 27×10³/µL platelets. Beginning on hospital day four, hematologic recovery became evident, with rapid normalization of cell counts by day six and complete clinical resolution at early outpatient follow-up. The temporal pattern of decline and subsequent brisk rebound strongly supported acute azathioprine-induced severe myelosuppression rather than an intrinsic hematologic disorder. The patient was transitioned to mesalamine maintenance therapy, and plans were made to initiate infliximab as a safer long-term immunomodulatory strategy. Conclusion: This case illustrates the diagnostic challenges posed by early azathioprine-induced marrow toxicity, particularly when symptoms mimic an ulcerative colitis flare. The predictable delayed nadir of cytopenias and rapid recovery following drug withdrawal underscore the importance of timely hematologic monitoring during the initial weeks of thiopurine therapy. Early identification enables prompt cessation of the offending agent and prevents progression to catastrophic complications. Given the severity of toxicity observed, thiopurines should not be reintroduced, and biologic agents represent a safer alternative for long-term disease control.
Copyright (c) 2026 Osman Nuri Koyun, Muharrem Özden, Hüseyin Köseoğlu (Author) https://creativecommons.org/licenses/by-nc/4.0
Comparative Analysis of Large Language Models in the Interpretation of Gynecologic Pathology Reports
This letter evaluates the performance of three large language models in explaining gynecologic pathology reports to patients. Using synthetic cases ranging from benign to malignant diagnoses, the author compares readability, emotional tone, and medical jargon density, highlighting clinically relevant differences in patient-centered communication styles.
Copyright (c) 2026 Aslı Karakaşlı (Author) https://creativecommons.org/licenses/by-nc/4.0
ChatGPT-4 Use During Diabetes Knowledge Testing and AI Readiness Characteristics in Nursing and Midwifery Students
Background: ChatGPT has gained attention for its role in accessing health information, supporting clinical decisions, and educating patients. Materials and Methods: This study aimed to evaluate nursing and midwifery students’ readiness for artificial intelligence (AI) and their diabetes knowledge using ChatGPT-4. A randomized controlled experimental design was used with 105 students (intervention=53, control=52) between April and June 2024. Data were collected using the Information Form, Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS), and the Diabetes Knowledge Scale for Adults (DKSA). Students in the intervention group used ChatGPT-4 to answer the DKSA, while those in the control group completed it independently without technology. Results: No significant difference was found between groups in MAIRS-MS scores. However, the intervention group had significantly higher DKSA total and sub-dimension scores for risk factors and symptoms (p=0.003; 0.000; 0.002). Conclusion: Using ChatGPT-4 significantly improved diabetes knowledge among nursing and midwifery students.
Copyright (c) 2026 Ayça Kale, Beyza Şahin, Sinem Özer, Nilay Bektaş Akpınar (Author) https://creativecommons.org/licenses/by-nc/4.0
Global Research Trends on Sleep Quality in Chronic Kidney Disease: A Comprehensive Bibliometric and SWOT Analysis
Background: Sleep disturbances are increasingly recognized as clinically significant complications across all stages of chronic kidney disease (CKD), yet the global research landscape remains heterogeneous and insufficiently mapped. This study provides a comprehensive bibliometric and SWOT analysis to evaluate worldwide research trends, thematic structures, and strategic gaps in the literature on sleep quality in CKD. Materials and Methods: A bibliometric search of the Web of Science Core Collection (1 January 2020–10 February 2023) identified 149 publications addressing sleep quality in CKD. VOSviewer was used to visualize keyword co-occurrence patterns, authorship and country collaboration networks, and thematic clusters. Temporal publication trends were assessed through linear regression. A SWOT framework was applied to contextualize strengths, weaknesses, opportunities, and threats within the research field. Results: Four major clusters were identified: hemodialysis–psychosocial burden, chronic renal failure–sleep quality, pre-dialysis sleep disorders, and estimated glomerular filtration rate–sleep disturbance. Hemodialysis-centered research formed the densest and most cited cluster, whereas early-stage CKD and objective sleep assessments (e.g., polysomnography, actigraphy) were notably underrepresented. Country-level mapping revealed substantial geographic variability, with China, the United States, and Türkiye leading in output, while Canada, Italy, and Sweden demonstrated high collaboration strength. Forecasting models showed a sustained upward trajectory in global publication volume through 2030. SWOT analysis highlighted a well-established but unevenly distributed research base, methodological variability, and clear opportunities for standardized, longitudinal, and mechanistic studies. Conclusion: Global research activity on sleep quality in CKD is expanding, yet critical gaps persist—particularly in early CKD populations, objective sleep measurement, and multinational collaboration. Addressing these limitations will be essential for developing robust evidence frameworks and improving clinical management of sleep disturbances across the CKD continuum.
Copyright (c) 2026 Duygu Tutan, Ibrahim Doğan, Barış Eser, Jan Ulfberg (Author) https://creativecommons.org/licenses/by-nc/4.0
Restoring Purpose to Medical Publishing: Why European Journal of Innovative Medical Research Exists
This editorial outlines the founding vision and editorial philosophy of the European Journal of Innovative Medical Research. It emphasizes ethical publishing, clinical relevance, transparency, and inclusivity, advocating for a scholarly ecosystem that prioritizes educational value and integrity over citation-driven metrics.
Copyright (c) 2026 Mehmet Berksun Tutan (Author) https://creativecommons.org/licenses/by-nc/4.0