Amaç: Endoskopik retrograd kolanjiyopankreatografi (ERCP) uygulanan hastalarda işlem öncesi ekokardiyografi zamanlaması ile hastanede olumsuz sonuçlar arasındaki ilişkiyi değerlendirmek.Gereç ve Yöntemler: Bu retrospektif kohort çalışmasında, 2015 ile 2024 yılları arasında ERCP uygulanan 40-70 yaş arası hastalar dahil edildi. Demografik özellikler, eşlik eden hastalıklar, kardiyoloji konsültasyonu, hastaneye yatıştan transtorasik ekokardiyografiye (TTE) kadar geçen süre, yatıştan ERCP’ye kadar geçen süre ve TTE’den ERCP’ye kadar geçen süre kaydedildi. Birincil sonuç, hastanede ölüm, yoğun bakım ünitesine yatış, intravenöz inotropik destek ihtiyacı veya hemodiyaliz olarak tanımlanan birleşik bir son noktaydı.Sonuçlar: Toplam 224 hasta dahil edildi. Gruplar arasında yaş, cinsiyet, hipertansiyon, diyabet mellitus veya koroner arter hastalığı açısından anlamlı farklılıklar yoktu (tüm p > 0,05). Kombine sonlanım noktalarına sahip hastalarda malignite, olmayanlara göre daha sık görüldü (%27,3’e karşı %11,4, p = 0,035). Hastaneye yatıştan TTE’ye kadar geçen süre gruplar arasında anlamlı farklılık göstermezken, hastaneye yatıştan ERCP’ye kadar geçen süre kombine sonlanım noktalarına sahip hastalarda daha uzundu (5,0’a karşı 3,0 gün, p = 0,020). TTE-ERCP kategorilerinin dağılımı da anlamlı farklılık gösterdi (p = 0,007) ve TTE’den sonra %5 günlük gecikme, kombine sonlanım noktalarına sahip hastalarda daha sık görüldü (%22,7’ye karşı %6,4). Kardiyoloji konsültasyonu, kombine sonlanım noktası grubunda daha yaygındı (%63,6’ya karşı %40,6, p = 0,038). Birleşik sonlanım noktalarına sahip hastalarda ayrıca akut böbrek yetmezliği, pankreatit, başarısız ERCP, yoğun bakım ünitesine yatış, inotropik destek, hemodiyaliz ve hastane içi ölüm oranları da anlamlı derecede daha yüksekti (tüm p < 0,05).Sonuç: Daha uzun ERCP zamanlaması, özellikle TTE ve ERCP arasındaki uzun aralık, ERCP uygulanan hastalarda hastane içi olumsuz sonuçlarla ilişkiliydi.
Aim: To evaluate the diagnostic performance of preoperative computed tomography (CT) using a short-axis diameter threshold of ≥10 mm for predicting lymph node metastasis (LNM) in patients with endometrial cancer.Material and Methods: This retrospective single-center study included 408 patients with endometrial cancer who underwent primary surgical treatment with sentinel lymph node (SLN) mapping and/or systematic lymphadenectomy. Preoperative contrast-enhanced CT scans were reviewed, and lymph nodes with a short-axis diameter ≥10 mm were considered positive. Pathological LNM was defined as metastatic involvement in SLN and/or lymphadenectomy specimens. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and odds ratios (ORs) were calculated.Results: Pathological LNM was identified in 36 patients (8.8%). CT detected lymph node enlargement (≥10 mm) in 39 patients. The sensitivity and specificity of CT for detecting LNM were 50.0% and 94.4%, respectively. PPV was 46.2%, NPV was 95.1%, and overall diagnostic accuracy was 90.5%. CT positivity was significantly associated with pathological LNM (OR 16.7, 95% CI: 8.1–34.3, p < 0.001). However, 18 patients with LNM (50%) had no radiologically enlarged lymph nodes on CT. In multivariable analysis, CT positivity remained independently associated with LNM after adjustment for LVSI and histological type (adjusted OR: 2.83, 95% CI: 1.10–7.29, p = 0.031).Conclusion: Preoperative CT using a ≥10 mm short-axis criterion demonstrates high specificity and negative predictive value but limited sensitivity for detecting lymph node metastasis in endometrial cancer. While CT positivity markedly increases the likelihood of nodal metastasis, a negative CT does not reliably exclude microscopic disease. Therefore, surgical nodal assessment strategies should not rely solely on CT findings.
Aim: Colistin is frequently used for the treatment of multidrug-resistant gram-negative infections in intensive care units; however, nephrotoxicity remains a major limitation of its clinical use. The incidence and risk factors of colistin-associated renal toxicity vary across studies, particularly in critically ill populations. This study aimed to evaluate the incidence of renal toxicity and associated risk factors in intensive care unit patients receiving intravenous colistin therapy.Material and Methods: This retrospective observational cohort study included 59 critically ill patients who received intravenous colistin therapy between 2013 and 2015. Nephrotoxicity was defined according to the Acute Kidney Injury Network criteria. Clinical and laboratory data were analyzed. Variables associated with nephrotoxicity were assessed using appropriate statistical tests, and multivariate analysis was performed to identify independent predictors.Results: Nephrotoxicity developed in 67.8% of patients. Older age, coronary artery disease and higher baseline blood urea nitrogen were associated with toxicity in unadjusted analyses. After adjustment, only elevated baseline blood urea nitrogen remained independently associated with nephrotoxicity. Renal impairment most commonly occurred within the first week of therapy, and 8.5% of patients required renal replacement therapy. Colistin dose was not independently associated with nephrotoxicity.Conclusion: Colistin-associated nephrotoxicity was common and typically developed early in critically ill patients. Reduced baseline renal functional reserve, particularly reflected by elevated blood urea nitrogen levels, appears to increase susceptibility to toxicity. Close renal monitoring and early risk assessment are essential during colistin therapy.Keywords: colistin, nephrotoxicity, intensive care, risk factors, acute kidney injury
Background: Systemic inflammation and nutritional status are key determinants of prognosis in metastatic clear-cell renal carcinoma (mccRCC). Composite indices such as the Systemic Immune–Inflammation Index (SII) and the Modified Glasgow Prognostic Score (mGPS) have demonstrated prognostic relevance across cancers, but real-world data in mccRCC remain limited. Methods: This retrospective, single-center cohort included patients with histologically confirmed mccRCC who received first-line tyrosine kinase inhibitor (TKI) monotherapy (sunitinib, pazopanib, or cabozantinib) between November 2022 and November 2024 at Etlik City Hospital (Ankara, Türkiye). Associations between inflammatory–nutritional indices (SII, mGPS) and progression-free survival (PFS) were evaluated using Kaplan–Meier and multivariable logistic regression analyses. Results: A total of 55 patients met eligibility criteria and were included in the analysis. The median age was 62 years (IQR 52–71), and 67% were male. Median PFS was 13.24 months (95% CI 7.75–19.12), while median OS was not reached. High SII (≥ 870) was independently associated with shorter PFS in multivariable analysis (OR 5.05; 95% CI 1.14–15.77; p = 0.039). mGPS (1–2) was significantly associated with inferior PFS in Kaplan–Meier analysis (HR 3.43; 95% CI 1.42–8.30; p = 0.006; log-rank p = 0.001), but lost significance in multivariable modeling. Metformin use (OR 0.12; 95% CI 0.02–0.93; p = 0.044), sunitinib therapy (OR 0.07; 95% CI 0.006–0.74; p = 0.027), and favorable/intermediate IMDC risk group (OR 0.17; 95% CI 0.06–0.96; p = 0.047) were independently associated with a lower progression risk. Patients treated with cabozantinib (n = 15) showed a numerically longer median PFS (18.6 months; 95% CI 13.8–23.3) compared with sunitinib (n = 25, 12.2 months; 95% CI 5.5–19.0) and pazopanib (n = 15, 12.1 months; 95% CI 6.7–17.5), although this difference was not statistically significant (log-rank p = 0.152). Conclusion: In this real-world cohort of patients with mccRCC treated with first-line TKI, host-related inflammatory and nutritional status were closely associated with progression-free survival. Additionally, patients classified within the favorable IMDC risk group exhibited a significantly lower risk of progression, highlighting the importance of integrating clinical risk stratification with systemic inflammatory and nutritional markers. Incorporating such easily measurable biomarkers and clinical risk scores into existing prognostic models may enhance individualized risk assessment and therapeutic decision-making. Future prospective, multicenter, randomized controlled, and artificial intelligence–assisted studies are warranted to validate these findings and refine precision oncology approaches in this population.
Amaç: Uzak doku hasarının patogenezinde birçok farklı mekanizma vardır ve reaktif oksijen türlerinin oluşumu en sık gözlenen mekanizmadır. Bu nedenle, bu çalışmada, deneysel olarak indüklenen karaciğer iskemi reperfüzyonu (I/R) tarafından indüklenen uzak doku (kalp, böbrek ve akciğer) hasarı üzerinde kurkuminin koruyucu rolünü araştırdık. Materyal ve Metod: Çalışmada 24 Wistar-Albino sıçan kullanıldı. Üç grup (n=8) Sham, I/R ve Kurkumin'den oluşuyordu. Üç grup (n=8) Sham, I/R ve Curcumin'den oluşmuştur. Sıçanlar orta hat kesisi ile açılmış ve karaciğere giden hepatik portal ven ve hepatik arter bulldog klemp ile kapatılmıştır. I/R grubu 45 dakika iskemiye ve ardından 45 dakika reperfüzyona tabi tutulmuştur. Tedavi grubuna 100 mg/kg dozunda kurkumin intraperitoneal olarak verildi. Deneyden sonra sıçanlar biyokimyasal inceleme için öldürüldü. Karaciğer, kalp, böbrek ve akciğer doku örneklerinde indirgenmiş glutatyon (GSH) ve 8-izoprostagladinF2α (8-isoPGF2α) düzeyleri ölçülerek uzak doku hasarı, oksidatif stres hasarı ve kurkuminin koruyucu etkileri belirlendi. Bulgular: Karaciğer, kalp, böbrek ve akciğer dokularındaki GSH düzeyleri kurkumin grubunda anlamlı olarak daha yüksek, 8-isoPGF2α düzeyleri ise anlamlı olarak daha düşüktü (p
Amaç: Pankreatikobilier sistem adenokarsinomları, agresif biyolojik davranışları ve yüksek metastaz potansiyeli ile prognozu kötü tümörlerdir. Bu çalışmada metastatik veya inoperabl pankreas ve bilier sistem adenokarsinomu tanılı hastalarda ikinci basamak kemoterapilerin tedavi yanıtları ve sağkalım üzerine olan etkileri ile yan etki profillerinin değerlendirilmesi amaçlanmıştır. Metod: Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Medikal Onkoloji polikliniğinde 2010–2019 yılları arasında takip edilen, en az iki basamak kemoterapi almış ve dosya bilgilerine ulaşılan 74 hasta retrospektif olarak incelendi. Demografik özellikler, Eastern Cooperative Oncology Group performans skoru (ECOG-PS), operabilite, metastaz bölgeleri, serum CA 19-9 düzeyleri ile birinci ve ikinci basamak tedaviler kayıt altına alındı. Genel sağkalım (GS), progresyonsuz sağkalım (PS), tedavi yanıt oranları ve toksisite profilleri değerlendirildi. Bulgular: Tanı anında ECOG-PS durumu 0 ve operabl kabul edilen hastaların GS süreleri istatistiksel olarak anlamlı derecede daha uzundu. Tanı anındaki CA 19-9 düzeyleri ile GS arasında istatistiksel anlamlı bir ilişki saptanmadı. İkinci basamakta Kapesitabin + oksaliplatin (XELOX) kolunda GS süresinin, 5-fluorourasil + irinotekan + oksaliplatin (FOLFIRINOX) ve gemsitabin kombinasyon kollarına kıyasla daha kısa olduğu gözlemlendi. Ancak; tedavi kolları arasında PS ve yanıt oranları açısından anlamlı fark izlenmedi. Toksisite değerlendirmesinde grade 2 lökopeni ve grade 3 nötropeni oranlarının FOLFIRINOX ve gemsitabin kombinasyonlarında, XELOX’a göre istatistiksel olarak anlamlı derecede daha yüksek olduğu saptandı. Sonuç: Metastatik veya inoperabl pankreatikobilier sistem kanserlerinde ikinci basamak kemoterapi seçenekleri ile GS arasında farklılıklar saptanmış olmakla birlikte, PS ve yanıt oranları açısından belirgin bir fark tespit edilmemiştir. FOLFIRINOX ve gemsitabin kombinasyonları, hematolojik toksisite açısından daha riskli bulunmuştur. Bu tedavilerin etkinlik ve toksisite farklılıklarının değerlendirilmesinde daha geniş hasta serilerinin dahil olduğu çok merkezli çalışmalara ihtiyaç olduğunu düşünmekteyiz.
Objectives: BRCA1-mutated ovarian cancer is characterized by impaired DNA double-strand break repair and homologous recombination deficiency, leading to distinct tumor biology and therapeutic responses. Competing endogenous RNA networks have emerged as important regulatory mechanisms in cancer progression. This study aimed to investigate the functional and clinical significance of the HOTAIR–miR34a–CCND1 axis in BRCA1-mutated ovarian cancer. Methods: Transcriptomic and clinical data of high-grade serous ovarian cancer patients were obtained from the TCGA-OV cohort via the GDC portal. Differential gene expression analysis was performed using edgeR, while pathway enrichment analysis was conducted with clusterProfiler and KEGG. Survival analyses were evaluated using Kaplan–Meier curves. Results: The HOTAIR–miR34a–CCND1 axis displayed distinct expression profiles in BRCA1-mutated ovarian cancer tissues compared to wild-type cases. Kaplan–Meier survival analysis revealed no statistically significant differences in overall survival based on the expression levels of these genes (p > 0.05). However, KEGG pathway enrichment analysis demonstrated that these genes are involved in cancer-associated microRNA pathways, suggesting their potential role in tumor progression despite the lack of direct survival association. Conclusion: The HOTAIR–miR-34a–CCND1 axis may represent a potential prognostic biomarker and therapeutic target in BRCA1-mutated ovarian cancer, supporting the development of novel strategies such as HOTAIR inhibition, miR-34a replacement, or combination with PARP and CDK4/6 inhibitors.
Introduction: Vitamin B12 deficiency may influence cardiac autonomic function and ventricular repolarization. The frontal QRS-T angle is a novel and useful electrocardiographic parameter that reflects the relationship between ventricular depolarisation and repolarisation. The aim of this study was to evaluate the association between serum vitamin B12 levels and the frontal QRS-T angle in asymptomatic individuals. Method: The current retrospective study comprised 92 adults who underwent a standard 12-lead ECG and serum vitamin B12 testing on the same day. Participants were divided into two groups according to their vitamin B12 levels (Group 1 was defined as abnormal having a level of less than 300 pg/mL, while Group 2 was defined as normal having a level of 300 pg/mL or more). The patient's clinical characteristics, laboratory findings and ECG parameters were recorded. The frontal QRS-T angle was calculated automatically using the QRS and T axes provided by the ECG device. Results: The average age of participants was 46.1 (±12.2) years, and 51.9% of participants were female (p < 0.001). Individuals with low vitamin B12 concentrations exhibited a wider frontal QRS-T angle. It was determined that vitamin B12 level is an independent predictive factor for the frontal QRS-T angle. Conclusion: The frontal QRS-T angle may serve as a useful parameter for evaluating electrical changes and susceptibility to ventricular arrhythmias in individuals with vitamin B12 deficiency.
Aims: Dysregulated coagulation and fibrinolysis are central to sepsis pathobiology. This study evaluated the prognostic value of the D-dimer/fibrinogen ratio (DFR) for in-hospital mortality in patients with sepsis. Methods: We analyzed 130 consecutive sepsis patients. The Sepsis-3 criteria were used to establish the diagnosis of sepsis. Demographic and clinical variables, APACHE II, SOFA, D-dimer, fibrinogen, and DFR were recorded at admission. The association between DFR and in-hospital mortality was assessed using multivariable models alongside APACHE II and SOFA. Discrimination was examined with ROC analysis. Results: Non-survivors had higher APACHE II scores, SOFA scores, and DFR than survivors. In multivariable analysis, increasing APACHE II, SOFA, and DFR were each independent predictors of in-hospital mortality. DFR showed high sensitivity and specificity for mortality on ROC analysis. Demographic features did not correlate with survival. Conclusion: DFR is a practical and informative biomarker that independently predicts in-hospital mortality in sepsis, complementing established severity scores. To our knowledge, this is among the first studies to evaluate DFR specifically in septic patients. Our findings suggest that DFR may provide additional value for early risk stratification, but external validation in larger, multicenter cohorts is warranted before its routine implementation.
Abstract Background: Deep vein thrombosis (DVT) is a major cause of morbidity and mortality. Proximal DVT carries a higher risk of pulmonary embolism (PE), but the distinct inflammatory profiles of proximal and distal DVT remain unclear. Objectives: This study aims to compare the distribution of next-generation systemic inflammatory indices (SII, SIRI, AISI, NLR, PLR, MLR) and conventional biomarkers (CRP, D-dimer) and to evaluate the diagnostic and prognostic value of these parameters in predicting PE. Additionally, the effects of demographic and etiological differences between groups on the systemic inflammatory response were analyzed; the findings were validated using logistic regression models and ROC curve metrics to identify independent predictive markers. Methods: In this retrospective case-control study, 750 patients (2019–2025) with suspected lower extremity DVT were classified into proximal DVT (n=250), distal DVT (n=250), and Doppler-negative control group (n=250). Inflammatory indices [SII, SIRI, AISI, NLR, PLR, MLR], conventional biomarkers (CRP, D-dimer), and biochemical parameters were evaluated. Group differences were tested using ANOVA/Kruskal–Wallis, while logistic regression and ROC analyses identified predictors of proximal DVT and PE. Results: Patients with proximal DVT had significantly higher inflammatory indices, CRP, and D-dimer values compared to those with distal DVT and controls (all p
Aim: Alzheimer's disease (AD) is a neurodegenerative disease characterized by beta-amyloid and tau accumulation, leading to memory loss and impairment in daily life. It is more common in women. Considering this difference, the current research explored the hereditary predisposition through examining estradiol (E2) levels and the rs2228480 and rs2295190 polymorphisms in the ESR1 gene in women with AD. Material and Methods: The study included 66 women diagnosed with AD and 62 women without any disease. E2 levels were measured in plasma samples from the participants using the electrochemiluminescence immunoassay (ECLIA) method. Genotyping of the rs2228480 and rs2295190 polymorphisms in ESR1 was performed in DNA samples isolated from whole blood using RT-PCR and TaqMan hydrolysis probes. Results: For the rs2228480 polymorphism, patients with the GA and AA genotypes were found to have an increased risk in women with AD compared to those with the GG genotype (OR = 3.1; 95% CI: 1.33–6.82; p = 0.007). However, no significant difference was found in the genotype distribution of the rs2228480 polymorphism between female AD patients and controls. Furthermore, no difference was observed between the study groups in terms of E2. Conclusion: We believe that there is a significant association between the ESR1 rs2228480 polymorphism and AD; therefore, this polymorphism may play a role in increasing the risk of developing AD. However, comprehensive studies with larger cohorts of women are needed to obtain more definitive data.
Aims: Nasal septal deviation (NSD) patterns are typically described by shape, but the anatomical distribution in septorhinoplasty patients—and its relation to symptoms—is not well established. This study aimed to (i) determine the frequency and anatomical levels (high, central, base, caudal) of SD and its morphological subtypes, and (ii) compare findings between symptomatic and asymptomatic patients Methods: We retrospectively analyzed 378 consecutive septorhinoplasty cases using standardized rhinoscopic/endoscopic data. NSD was classified by localization (high, central, base, caudal), presence of crest/spur, and new hierarchical morphology: Type I (localized), Type II (septal tilt), Type III [C-shape; Anteroposterior (AP) / Cephalocaudal (CC); ±crest/spur], Type IV (S-shape; AP/CC; ±crest/spur). Result: Central SD was most common (81.2%), followed by caudal (61.1%), high (48.9%), and base (40.7%). Caudal deviation (74.3% vs 53.0%, P
Aim: The most effective management approach for non–small cell lung cancer (NSCLC) patients presenting with mediastinal (N2) lymph node involvement has not yet been clearly established. This study compared clinical outcomes between neoadjuvant chemotherapy followed by surgical resection (NACTx-Surgery) and definitive concurrent chemoradiation (CRT) in patients with N2 disease.Methods: In this retrospective cohort analysis, we evaluated 61 individuals diagnosed with N2 stage NSCLC who received treatment at two high level tertiary care institutions. Thirty one patients received NACTx-surgery, and 30 patients received definitive CRT. Overall survival (OS), event free survival (EFS), and prognostic factors were compared using Kaplan-Meier analysis and Cox proportional hazards modeling.Results: The NACTx-surgery group achieved significantly superior median OS (37.9 months vs. 26.8 months; p=0.031) compared with the CRT group. EFS showed a trend toward improvement with NACTx-surgery (median 21.4 months vs. 13.9 months; p=0.052). TNM stage emerged as an independent predictor of EFS in multivariable analysis (HR 0.48; p=0.03). Recurrence occurred in 54.8% of NACTx-surgery patients and 70.0% of CRT patients.Conclusions: For appropriately selected patients with resectable N2 NSCLC, multimodal NACTx-surgery approaches achieved superior survival outcomes compared with definitive CRT. These findings support aggressive pursuit of resectability assessment and multimodal therapeutic planning. Future prospective randomized trials comparing contemporary NACTx-surgery with modern CRT plus consolidation immunotherapy are needed.
Objective: The prognostic efficiencies of GRIm and HCC-GRIm scores in HCC have been determined in previous studies. However, there is no study evaluating them according to etiological subtypes in the literature yet. The aim of this study was to investigate the prognostic efficacy of GRIm (Gustave Roussy immune score) and HCC-GRIm score in HCC etiological subgroups. Methodology: The study was conducted on patients aged 18 years and older with unresectable/metastatic hepatocellular cancer (HCC) diagnosed between 2017 and 2023. GRIm and HCC-GRIm scores was calculated. The prognostic efficiencies of these scores were evaluated. Results: Sixty-seven (54%) of the patients had low GRIm scores, while 68(54.8%) had low HCC-GRIm scores. Median overall survival (OS) was 17.2 months in patients with low-viral GRIm scores, while median OS was 2.1 months in patients with high-viral GRIm scores. Median OS was 12.6 months in patients with low-nonviral GRIm scores. Median OS was 3.3 months in patients with high-nonviral GRIm scores (HR: 2.4(%95 CI 1.3-4.7) p
Aim: Emerging evidence suggests that rosacea may be associated with sleep disorders, alongside multiple systemic comorbidities. We aimed to evaluate sleep quality and obstructive sleep apnea risk in rosacea and their relationships with dermatology-specific quality of life. Material and Methods: In this cross-sectional case-control study, adults with rosacea (n=130) and controls (n=114) completed the Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire (BQ), and, for patients, the Dermatology Life Quality Index (DLQI). Analyses used non-parametric tests, chi-square, Spearman correlations, and backward logistic regression. Results: Rosacea participants had higher global PSQI scores than controls (mean 6.21±3.42 vs 4.87±2.70; p=0.002) and more often met the poor-sleep threshold (PSQI>5: 63.1% vs 46.5%). BQ-defined high OSA risk did not differ significantly (30.8% vs 25.4%; p=0.356). Among patients, mean DLQI was 6.86±6.06; poor sleepers reported greater impairment (7.69±6.23 vs 5.47±5.56; p=0.021). In multivariable modeling, higher BMI (adjusted OR 1.078; p=0.006) and higher PSQI (OR 1.143; p=0.004) independently predicted rosacea status. PSQI and BQ did not differ by clinical subtype or severity. Conclusion: In this study, rosacea was associated with poorer subjective sleep without a parallel increase in questionnaire-defined OSA risk versus controls. Within rosacea, worse sleep related to higher dermatologic quality-of-life burden. Sleep health and metabolic risk appear actionable in rosacea care; incorporating brief sleep assessment, weight optimization, and selective OSA screening may support holistic management.
Objective: The aim of this study was to evaluate the relationship between the triglyceride glucose (TyG) index, a practical biomarker of insulin resistance, and the electrocardiographic indicators of ventricular repolarisation, namely the Tp–e interval, Tp–e/QT, and Tp–e/QTc ratios. Materials and Methods: This retrospective cross-sectional study was conducted at the Department of Cardiology, Faculty of Medicine, Karamanoğlu Mehmetbey University, between 1 January 2024 and 31 September 2025. The demographic, laboratory, and electrocardiographic data of 200 adult individuals who met the inclusion criteria were retrieved from the electronic record system. The TyG index was calculated from fasting glucose and triglyceride levels, and patients were divided into four quartiles (Q1–Q4) according to their TyG values. Tp–e, Tp–e/QT, and Tp–e/QTc measurements were performed by two independent observers from digital ECG recordings. Intergroup differences were evaluated using the ANOVA test, and relationships were assessed using correlation and multivariate regression analyses. Results: The mean age of participants was 51.5 ± 18.8 years, and 51% were male. With an increase in the TyG index, the Tp–e duration (r = 0.558, p < 0.001), Tp–e/QT ratio (r = 0.374, p < 0.001), and Tp–e/QTc ratio (r = 0.422, p < 0.001) significantly increased. In multivariate regression analysis, the TyG index remained an independent predictor of the Tp–e interval (β = 0.38, p < 0.001). According to ROC analysis, a TyG cutoff value > 8.70 predicted the presence of prolonged Tp–e with 77% sensitivity and 72% specificity (AUC = 0.78, p < 0.001). Conclusion: This study is the first to demonstrate an independent association between the TyG index and the Tp–e interval, Tp–e/QT, and Tp–e/QTc ratios. These findings suggest that metabolic stress may contribute to cardiac electrical instability by increasing the heterogeneity of ventricular repolarisation. The TyG index, as an easily calculable parameter, may be a potential biomarker for early detection of subclinical arrhythmic risk.
Aim: We aimed to compare the number and endocrine reasons of consultations between non-surgical departments (NSDs) and surgical departments (SDs). Material and Methods: Adult inpatient endocrine consultations during working hours for 7 consecutive months in our center were retrospectively reviewed. Patients who were discharged before consultation, consulted by the coronavirus disease 2019 (COVID-19) service, or referred for consultation for thyroid ultrasound, biopsy, and prescription were excluded. The patients' age and gender, the consultation department (NSDs and SDs), the endocrine issue for consultation, and preoperative or other consultations were recorded. If the consultation recommends a new medication, discontinuation of a medication, or a change in medication dosage, or provides advice on the preoperative management of endocrine diseases, such as suggesting a glucose-insulin infusion protocol, the consultation was considered improvement management (IM). If the consulted physician did not make a new diagnosis or prescribe a new therapy other than to support the present plan, it was accepted as no improvement management (NIM). Results: A total of 361 consultations were received, but data from 46 were excluded. The remaining 315 consultations and 214 patients were analysed. The rates of consultations that NIM were significantly higher in NSDs in all endocrine issues except bone and calcium metabolism. The department with the highest consultations was dermatology. The most consulted endocrine issue was diabetes in both NSDs and SDs, the second one was thyroid in NSDs and pituitary in SDs. The mean glycated hemoglobin (HbA1c) of consultations that NIM and the mean thyroid stimulating hormone (TSH) level of patients with repeated consultations were significantly low and high, respectively. Conclusion: Since the incidence of endocrine diseases is expected to increase in the future, training to be conducted according to the related endocrine issue, especially for consultations from the NSDs, could reduce NIM consultation rates.
Aim: Lung cancer is the leading cause of cancer-related mortality worldwide. Spread through air spaces (STAS) refers to tumor cells found within air spaces surrounding the main tumor mass and has been associated with poor prognosis. This study aimed to investigate the relationship between STAS positivity and clinical as well as pathological variables in operated non-small cell lung cancer (NSCLC) patients followed at our center. Material and Methods: Patients diagnosed with NSCLC who underwent surgery between January 2018 and May 2022 at our institution were retrospectively analyzed. The relationship between clinical and pathological variables and STAS was investigated. Survival analyses were performed using the Kaplan-Meier method. Results: A total of 85 cases were evaluated within the scope of the study. STAS positivity was observed in 64.7% (n=55) of patients. Low-grade tumors were less common in the STAS positive group (p = 0.006). Regarding lymph node involvement, the frequency of N2 disease was significantly higher in STAS positive patients compared to STAS negatives (p = 0.003). The presence of lymphovascular invasion (LVI) was also significantly higher in the STAS positive group (p = 0.011). Although disease-free survival (DFS) and overall survival (OS) were numerically higher in the STAS negative group, the difference was not statistically significant. Conclusion: In this study, a significant association was found between STAS positivity and N2 disease, grade, and LVI in patients diagnosed with NSCLC. Although survival times were found to be lower in STAS positive patients compared to the STAS negative group, this difference did not reach statistical significance.
Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disease in which inflammation and nutritional status jointly influence disease severity and prognosis. This study aimed to evaluate the relationships between nutritional–inflammatory indices—C-reactive protein–Albumin–Lymphocyte (CALLY) index, Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score, and Geriatric Nutritional Risk Index (GNRI)—and disease activity in patients with RA. Materials and Methods: Clinical and laboratory data of 199 RA patients who presented to the Rheumatology Outpatient Clinic between January 2024 and July 2025 were retrospectively analyzed. Disease activity was assessed using DAS28-CRP, CDAI, and SDAI scores. PNI, CONUT, CALLY, and GNRI values (for patients aged ≥60 years) were calculated, and their correlations with disease activity and nutritional parameters were examined. Results: The study included 199 patients with a mean age of 53.4 ± 14.5 years, of whom 72.9% were female. The CALLY and PNI indices showed strong negative correlations with disease activity indicators, including DAS28-CRP and SDAI scores. The CONUT score was not significantly associated with disease activity. In the geriatric subgroup (≥60 years), correlations between all indices and disease activity were stronger, and GNRI was found to be negatively associated with both malnutrition risk and inflammatory activity. Conclusion: The CALLY and PNI indices are reliable and practical laboratory markers that comprehensively reflect inflammatory burden and nutritional status in RA. GNRI appears clinically useful for assessing malnutrition and inflammation-related frailty, particularly in older patients. Integrating nutritional–inflammatory indices into routine clinical evaluation may enhance comprehensive monitoring of disease activity and support comprehensive patient management.
Amaç: Serviks kanseri taraması, kadın hastalıkları polikliniklerinde rutin olarak uygulanan bir işlemdir. Her ne kadar smear testi jinekologlar açısından basit bir işlem olsa da, hastalar bu süreçte anksiyete yaşayabilmektedir. Bu çalışmanın amacı, smear testi öncesinde ve sırasında uygulanan müzik müdahalesinin hastaların işlem sırasındaki ve sonrasındaki ağrı ve anksiyete düzeylerine olan tamamlayıcı etkisini değerlendirmektir. Gereç ve Yöntemler: Bu randomize kontrollü çalışmaya, smear testi yapılacak olan ve Türkçe konuşan, 30 yaş üzeri 160 kadın dahil edilmiştir. Katılımcılar rastgele müzik ve kontrol grubu olmak üzere ikiye ayrılmıştır. İşlem sırasında, hasta ve hekim arasındaki iletişimi korumak amacıyla hoparlör sistemi aracılığıyla müzik çalınmış ya da müzik çalınmamıştır. Anksiyete ve ağrı düzeyleri, işlem öncesi ve sonrası Devlet-Sürekli Kaygı Envanteri (STAI) ve Görsel Analog Skala (VAS) ile değerlendirilmiştir. Bulgular: Çalışmaya toplam 160 hasta dahil edilmiştir; 80’i müzik grubunda, 80’i kontrol grubundadır. Müzik grubundaki ortalama STAI skoru 36 (SD = 13) iken, kontrol grubunda 41 (SD = 17) olarak saptanmıştır (p = 0,042). STAI skorlarına göre, kontrol grubundaki 28 hastada (%35) yüksek düzeyde anksiyete saptanırken, müzik grubunda bu sayı yalnızca 15 (%19) olarak bulunmuştur. Benzer şekilde, işlem sonrası yapılan değerlendirmede müzik grubunda VAS skorları anlamlı derecede daha düşüktür (4,3’e karşı 2,7, p = 0,001). Sonuç: Çalışmamız, jinekolojik muayene ve smear testi sırasında uygulanan müzik terapisinin anksiyete ve ağrıyı azaltabileceğini göstermektedir. İnvaziv olmayan bu yöntem, zararlı bir etkisi bulunmayan, düşük riskli, maliyeti düşük ve uygulanması kolay tamamlayıcı bir müdahale olarak değerlendirilebilir.
