Background: Echinococcosis is a parasitic zoonosis that predominantly affects the liver and pulmonary system. Isolated involvement of skeletal muscle in the absence of visceral disease is exceptionally rare, accounting for approximately 1-3% of cases. Owing to nonspecific clinical manifestations and overlapping imaging characteristics, muscular hydatid cysts may be misinterpreted as neoplastic lesions or abscesses, thereby complicating the diagnostic process. Case Report: A 64-year-old woman presented with a painful mass in the posterior aspect of her thigh that had gradually increased in size. Magnetic resonance imaging revealed a well-circumscribed cystic lesion containing detached internal membranes, consistent with World Health Organization (WHO) stage 3a cystic echinococcosis (CE3a) and indicative of an active transitional hydatid cyst. Serological testing was strongly positive, and no evidence of hepatic or pulmonary involvement was detected. The patient was treated with albendazole therapy followed by a percutaneous puncture-aspiration-injection-reaspiration (PAIR) procedure, resulting in cyst regression without complications. Conclusion: In endemic regions, hydatid disease should be considered in the differential diagnosis of atypical soft-tissue masses, even in the absence of visceral organ involvement or a clear history of exposure.
Glioblastoma multiforme (GBM) is the most common and aggressive brain cancer in adults. It is also one of the most aggressive tumors of the central nervous system and is associated with the worst prognosis. Developing an effective treatment method is complicated by the disease: its resistance to treatment, a high recurrence rate, and genetic and histological heterogeneity. This review provides a detailed assessment of GBM diagnostic methods, molecular pathogenesis, histopathological features, and current treatment approaches. IDH mutations, together with molecular markers such as PTEN, EGFR, TP53, and MGMT promoter methylation, play a significant role in predicting the course of glioblastoma multiforme and determining treatment response. Personalized medicine and immunotherapies, together with routine treatments, represent noteworthy approaches to GBM treatment in the near future. Recent studies report that magnetic field-based interventions are a promising approach and that applications of low-frequency magnetic fields suppress glioma cell proliferation. Studies conducted with the OM-100 device have shown a significant reduction in tumor growth in both in vivo and in vitro models and have demonstrated synergistic effects when the device was combined with anti-PD-1 therapy. Furthermore, static magnetic fields have been reported to increase apoptosis, inhibit proliferation, and may offer a complementary treatment with low toxicity. These findings suggest that magnetic-field-based approaches offer an innovative strategy for GBM treatment.
Background: Schwannoma is a rare, slow-growing nerve sheath tumor that is infrequently reported in the anterior chest wall and requires thorough evaluation for accurate identification and appropriate treatment. Case Report: We describe a case of a 57-year-old woman with an incidentally discovered parasternal ancient schwannoma of the anterior chest wall during breast cancer screening. Contrast-enhanced computed tomography (CT) revealed a well-defined soft tissue mass located in the right third intercostal space. Surgical excision was performed via right anterior thoracotomy. Histopathological examination confirmed the diagnosis of ancient schwannoma. The patient experienced an eventful postoperative recovery, with no recurrence observed during two years of follow-up. Conclusion: Anterior chest wall schwannomas are rare incidental findings. Accurate imaging and complete surgical excision are essential for diagnosis and management, ensuring favorable outcomes and highlighting the importance of timely recognition of these uncommon tumors.
Objective:This study aimed to determine the effect of non-invasive hemoglobin (SpHb) measurement on blood transfusion decisions in patients undergoing hip surgery and to analyze the effect of these decisions on mortality. Materials and Methods:Fifty-two patients (ASA I-III, ≥60 years) undergoing hip surgery were randomized into the SpHb or conventional (CONV) group for transfusion management. Hemoglobin (Hb) levels were recorded before induction, at transfusion decision points, immediately after transfusion, and after recovery. Postoperative survival was monitored at 1 and 3 months. Results:The SpHb group maintained significantly higher Hb levels at the first transfusion decision point, after transfusion, and during recovery (p=0.001, p=0.012, p=0.001). Partial oxygen pressure (PaO2) was also higher in the SpHb group at the corresponding time points. The CONV group required significantly more blood transfusions (p=0.025) and had longer hospital stays (p=0.043). Although 3-month mortality was numerically lower in the SpHb group than in the CONV group (11.53% vs. 19.23%), no statistically significant difference was detected in this pilot-sized cohort (p>0.05). Conclusion:According to our findings, SpHb monitoring during hip surgery may be a useful tool for enabling earlier transfusion decisions, which could help prevent significant Hb declines. In our study cohort, this strategy was associated with a trend toward fewer transfusion requirements, shorter hospital stays, and better perioperative oxygenation.
A retrospective study was conducted to evaluate the need for perioperative autotransfusions and the amount of blood loss by comparing patients receiving different tranexamic acid (TXA) regimens following total joint replacement (TJR). A total of 1675 patients undergoing TJR were included: 76 did not receive TXA administration (group A); 77 received IV TXA (group B); 1510 received IV followed by IA administration of TXA (group C); and 12 received IA TXA administration alone (group D). Significant between-group differences were observed in intraoperative and postoperative blood loss (p<0.05). Blood autotransfusion and allogeneic transfusion rates were significantly higher in group D compared with the other treatment strategies (p<0.001) and with the control group of patients who did not receive TXA (p<0.05). IV combined with IA TXA administration represents the most effective way to prevent blood loss following TJA surgery. Conversely, isolated IA administration of TXA did not reduce the need for postoperative transfusions.
Objective:Inherited kidney diseases (IKDs) significantly contribute to chronic kidney disease (CKD), particularly in regions with high consanguinity rates. Despite the increasing availability of next-generation sequencing, evidence regarding its diagnostic and clinical effectiveness in adult populations remains limited. This study evaluated the diagnostic yield and clinical implications of genetic testing in adults with suspected IKD. Materials and Methods:A retrospective analysis of 63 adults who underwent genetic evaluation for unexplained or familial CKD was performed. Genetic testing used sequencing-based methods to identify and analyze genes relevant to the clinical phenotype. Clinical and demographic factors, diagnostic yield, genetic etiologies, and clinical utility were documented. Results:The genetic diagnostic yield in this predominantly female cohort, with a mean age of 37.2±14.9 years, was 54.0%. Autosomal recessive disorders were the most common inheritance pattern (61.8%). Alport spectrum disorders represented the primary etiology (67.6%), followed by ciliopathies/cystic diseases (14.7%). The diagnostic yield varied across clinical diagnostic groups, with Alport spectrum disorders showing the highest yield and other glomerulopathies showing the lowest yield (75.0% vs. 4.5%, p<0.001). Extrarenal manifestations were significantly associated with a positive genetic diagnosis (32.4% vs. 0.0%, p<0.001). Genetic findings confirmed the clinical diagnosis in 70.6% of positive cases, reclassified the diagnosis in 17.6%, and identified an alternative genetic diagnosis in 11.8%. Conclusion:Genetic testing demonstrated a high diagnostic yield and considerable clinical utility in Turkish adults with suspected IKD. These findings support the integration of genetic evaluation into routine nephrology practice, particularly for patients with syndromic features and a notable family history.
Objective:To evaluate the diagnostic accuracy and reliability of closed-source, multimodal large language models (LLMs)-ChatGPT-4o, ChatGPT-4.5, and Gemini 2.5 Pro-in detecting acute knee fractures on radiographs compared with an emergency medicine specialist and a radiologist. Materials and Methods:This retrospective study included 252 patients who underwent both knee radiography and CT between September 2023 and July 2025. Fracture status was determined by CT and reviewed by radiologists. Anteroposterior and lateral radiographs were independently assessed by an emergency medicine specialist, a radiologist, and three LLMs. Diagnostic performance was evaluated using sensitivity, specificity, predictive values, likelihood ratios, accuracy, and area under the curve (AUC). Reliability was assessed using Cohen's kappa and McNemar's tests. Results:According to CT findings, fractures were present in 23.08% (n=58) of patients. The LLMs demonstrated low sensitivity: ChatGPT-4o, 37.9%; ChatGPT-4.5, 13.8%; and Gemini 2.5 Pro, 10.3%, with moderate overall accuracy (72-77%). In contrast, the radiologist achieved 92.1% accuracy, with high sensitivity (77.6%) and specificity (96.4%), whereas the emergency medicine specialist showed 83.7% accuracy. AUC comparisons revealed significantly higher diagnostic performance for clinicians, particularly radiologists, than for all LLMs (p<0.05). Consistency analysis showed moderate agreement for ChatGPT-4o, slight agreement for ChatGPT-4.5, and substantial agreement for Gemini 2.5 Pro. Conclusion:Closed-source LLMs performed worse than clinicians in diagnosing acute knee fractures on radiographs, with a high risk of missed fractures. Although they may support triage by reliably identifying normal cases, they are not sufficient for standalone diagnostic use.
Objective: Accurate and timely diagnosis in emergency departments is crucial due to the high patient volume and time-sensitive nature of care. Intern doctors, who are nearing the completion of medical school, frequently work in emergency departments in many countries. However, after graduation, physicians are often expected to assume critical patient care responsibilities despite limited experience. Artificial intelligence models can quickly analyze patient data and generate diagnoses, thus assisting inexperienced physicians in enhancing diagnostic accuracy. This study aims to evaluate the diagnostic performance of ChatGPT-4 in emergency department case scenarios and compare its accuracy with that of intern doctors. Materials and Methods: This study involved intern doctors participating in the internship program during the 2024-2025 academic year. A total of 36 case-based questions, categorized by difficulty level, were administered to 155 interns and subsequently presented to artificial intelligence. Descriptive statistics were used to summarize the data, and a one-sample t-test was conducted to compare the diagnostic accuracy between intern doctors and ChatGPT. Statistical significance was set at p<0.05. Results: Intern doctors achieved an overall correct response rate of 58.3%, while ChatGPT achieved a rate of 97.2%. A statistically significant, moderate negative correlation was found between question difficulty and interns' performance (r=-0.684; p<0.001), indicating decreased accuracy as question difficulty increased. ChatGPT consistently demonstrated significantly higher performance across all difficulty levels. Conclusion: ChatGPT-4 may serve as a valuable diagnostic support tool in emergency departments, particularly for newly graduated physicians with limited clinical experience.
Objective:This study aimed to assess the demographic, clinical, histological classifications, and anterior segment optical coherence tomography (AS-OCT) features of conjunctival malignancies. The goal was to identify factors associated with tumor malignancy. Materials and Methods:This retrospective analysis included 37 patients with conjunctival tumors. Data collected comprised age, gender, tumor coloration, histological type, location, corneal involvement, subepithelial reflectivity of the lesion on AS-OCT, lesion homogeneity on AS-OCT, and the presence of intralesional cysts on AS-OCT. Statistical analysis was performed using chi-square and t-tests, with a significance level of α<0.05. The study protocol was approved by the Erciyes University Health Sciences Research Ethics Committee (Approval Number: 2025/365, Date: 09.07.2025). Results:Malignant tumors were identified in significantly older patients. No significant gender differences were found regarding malignancy. Amelanotic appearance was significantly more common in malignant tumors. The types of tumors identified included conjunctival nevus, conjunctival ocular surface squamous neoplasia (OSSN), conjunctival lymphoma, conjunctival melanoma, and conjunctival cyst. No significant relationship was found between tumor location and malignancy. Corneal involvement was significantly associated with malignancy. On AS-OCT, malignant tumors exhibited a hyporeflective subepithelial lesion with homogeneous internal reflectivity. Although benign tumors contained more intralesional cysts on AS-OCT, this finding was not statistically significant. Conclusion:Conjunctival tumors exhibit various characteristics. Advanced age, amelanotic pigmentation, corneal involvement, and a hyporeflective homogeneous lesion on AS-OCT are significant indicators of malignancy, highlighting the importance of detailed examination and increased vigilance.
Objective: In this single-center, tertiary-care coronary CT angiography (CCTA) series, we aimed to report the prevalence of coronary origin anomalies and describe the characteristics of their proximal course. Materials and Methods: This retrospective study included 3,181 consecutive CCTA examinations performed between January 1, 2020, and June 30, 2025. All scans were acquired using a 64-slice multidetector CT system (SOMATOM Definition AS+, Siemens Healthineers) with retrospective ECG gating. Two radiologists reviewed the studies, and examinations with suspected coronary origin anomalies were re-evaluated by consensus. Anomalies were classified according to the Angelini framework, and the proximal course was categorized as interarterial, retroaortic, transseptal/intraseptal, or prepulmonic. Results: Coronary artery origin anomalies were identified in 41 of 3,181 patients (1.29%). The largest subgroup was opposite-sinus origin (n=24, 0.76%), which included the right coronary artery (RCA) originating from the left sinus (n=12, 0.38%), the left circumflex artery (LCX) originating from the right coronary sinus (n=8, 0.26%), and the left main coronary artery (LMCA) originating from the right coronary sinus (n=4, 0.13%). An absent LMCA configuration-defined by separate left-sinus ostia for the left anterior descending artery (LAD) and LCX-was identified in 5 patients (0.16%). Single coronary artery anatomy was observed in 3 cases (0.09%), all of which had a common origin from the right coronary sinus. In one case (0.03%), the RCA arose from the noncoronary sinus. High take-off coronary artery origins were observed in 8 patients (0.26%). Regarding the course patterns, interarterial courses were observed in 20 patients, retroaortic courses in 10, and prepulmonic courses in 2. The interarterial LAD and LCX cases also demonstrated a transseptal/intraseptal segment. Conclusion: CCTA reliably delineates coronary ostial origin and proximal trajectory, supporting a comprehensive anatomic assessment of suspected congenital coronary variants.
Objective: Myeloid-derived suppressor cells (MDSCs) are immature myeloid progenitors, including monocytic and granulocytic subgroups (M-MDSCs and PMN-MDSCs).They exhibit immunoregulatory and immunosuppressive properties by limiting immune-mediated pathology and protecting the host from destructive inflammatory damage. Graft-versus-host disease (GVHD) comprises a series of immune-mediated inflammatory events in which donor-derived T cells target the tissues and organs of the transplant recipient. This study aims to evaluate the behavior of MDSCs during GVHD in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Materials and Methods: Fifteen patients who underwent allogeneic HSCT were included in the study. MDSCs and their subsets were identified and characterized by flow cytometry on days 0, 30, 60, and 90 post-engraftment. Results: The median frequency of monocytic MDSCs (M-MDSCs) on the first day of engraftment was significantly higher in patients without GVHD than in those who developed GVHD. Furthermore, the expansion of M-MDSCs occurred significantly earlier than that of the other MDSC subset. Conclusion: Monocytic MDSCs play a key regulatory role in limiting GVHD and may serve as potential therapeutic targets for GVHD prevention or treatment.
Objective:Epilepsy involves dysregulated inflammatory pathways and oxidative stress (OS). Nitric oxide (NO), an endogenous vasodilator, may exert neurotoxic effects under OS. D-limonene, a monoterpene with antioxidant and anti-inflammatory properties, can modulate these processes. This study addressed the neuroprotective effects of D-limonene by assessing its influence on NO levels in serum and brain tissue and its interaction with sodium valproate (VPA) in a penicillin-induced epilepsy model in rats. Materials and Methods:Thirty-five male Wistar albino rats (12-16 weeks, 200±50 g) were clustered into 5 groups (n=7): control (penicillin 500 IU, 2.5 µL, i.c.); D-limonene 50 mg/kg + penicillin 500 IU; D-limonene 100 mg/kg + penicillin 500 IU; VPA 300 mg/kg + penicillin 500 IU; and combination (D-limonene 100 mg/kg + VPA 300 mg/kg + penicillin 500 IU). Treatments were administered intraperitoneally. NO levels were determined using a commercial colorimetric assay kit. Data were analyzed using one-way ANOVA followed by Sidak's multiple comparisons test and are presented as mean±SD, with statistical significance set at p<0.05. Results:Serum NO peaked in the penicillin group (568.0±84.95 µmol/L) and decreased dose-dependently with D-limonene (490.5±86.12; 347.6±25.39 µmol/L). VPA further reduced NO (259.0±20.04 µmol/L), whereas the combination modestly increased it (390.6±74.95 µmol/L). Tissue NO showed a similar trend, with the lowest level observed with VPA (120.4±12.60 µmol/L) and partially restored by combination treatment (168.8±20.85 µmol/L). Conclusion:D-limonene reduced NO levels dose-dependently. VPA had a stronger inhibitory effect, whereas their combination attenuated this inhibition, suggesting that D-limonene may modulate NO metabolism and confer neuroprotection in experimental epilepsy.
Objective:Syphilis and human immunodeficiency virus (HIV) are sexually transmitted infections that share common risk factors and may facilitate each other's transmission. This study aimed to evaluate the frequency of syphilis coinfection among individuals living with HIV over a five-year period. Materials and Methods:In this retrospective study, anti-HIV, rapid plasma reagin (RPR), Treponema pallidum hemagglutination assay (TPHA), Treponema pallidum total immunoglobulin, and HIV confirmatory test results of individuals aged ≥18 years were evaluated between 2020 and 2024. Patients who had both HIV- and syphilis-related tests during the period of HIV positivity were included. Syphilis seropositivity was defined according to the institutional diagnostic algorithm based on the combination of treponemal and non-treponemal tests. Active infection was defined as concurrent positivity of treponemal and RPR tests, whereas isolated treponemal positivity was considered a past infection. Results:Among 200 individuals living with HIV, 162 underwent syphilis testing. Of these, 85.5% were male. Syphilis seropositivity was detected in 41 patients (25.3%), including 24 (14.8%) with active infection and 17 (10.5%) with past infection. No significant differences were observed based on age, sex, or year (p>0.05). During the same period, syphilis seropositivity among HIV-negative individuals was 0.96%. HIV positivity was strongly associated with syphilis seropositivity (OR: 34.8; 95% CI: 23.1-52.6; p<0.001). Conclusion:The high rate of syphilis seropositivity among HIV-positive individuals underscores the importance of routine screening at diagnosis and during follow-up.
Objective: This study aims to assess the impact of complications of the Fontan operation, such as protein-losing enteropathy and thrombosis, on patients' quality of life. We hypothesize that alterations in the diameter and flow of the inferior vena cava (IVC) and femoral vein (FV) are associated with these complications. The goal is to evaluate the influence of venous structural modifications on Fontan operation outcomes by analyzing Doppler time measurements of the IVC, FV, aorta (Ao), and femoral artery (FA). Materials and Methods: We retrospectively analyzed the recorded images of patients who had undergone Fontan palliation at least two years prior to presentation at our outpatient clinic between January 2022 and January 2023. Patients with chest pain but no cardiac pathology served as controls. Demographic and physical examination data were collected retrospectively. In patients with a normal single-ventricular ejection fraction, we measured the widest IVC diameter and Doppler values, the descending aortic diameter in systole, the widest FV diameter and Doppler values, and the femoral artery diameter in systole. Results: The study included 25 Fontan patients: 7 had an extracardiac Fontan, 4 had a fenestrated extracardiac Fontan, and 14 had an intra-extracardiac fenestrated Fontan. A significant difference (p=0.019) was found in the age at Fontan between patients with NYHA stages 1-2 and those with NYHA stages 3-4. A pathologic microalbumin/creatinine ratio (>15) was correlated with pre-Fontan pulmonary artery pressure >15 mmHg. The IVC/BSA (p=0.031) and FV/BSA ratios differed significantly between groups with and without complications, with lower ratios observed in the group with complications. Conclusion: Age at Fontan palliation is a risk factor for complications. High pre-Fontan pulmonary pressure is associated with microalbuminuria. IVC/BSA and FV/BSA are inversely associated with mid- to long-term complications following Fontan palliation.
Background: Glioblastoma is the most common malignancy of the central nervous system. Symptoms vary significantly depending on tumor location and size. Case Report: A 55-year-old man presented with mild memorydeficits,occasional eye twitching, and throat irritation for two months. Magnetic resonance imaging revealed a glioma centered in the piriform cortex, infiltrating the amygdala, hippocampus, bilateral fornices, mammillary bodies, anterior cingulate gyrus, and anterior commissure. Conclusion: Despite extensive involvement of the limbic system and the Papez circuit, the patient exhibited a remarkable paucity of symptoms and maintained his daily functioning.This discrepancy was elucidated by diffusion tensor imaging tractography, which demonstrated that the tumor primarily displaced, rather than destroyed, the adjacent white matter tracts.
Objective:Bitemporal alopecia may occur in association with various hair diseases. However, it has not yet been officially classified as a distinct type of alopecia. This study aimed to identify hair diseases that commonly accompany bitemporal hair loss and to evaluate the clinicodemographic characteristics of affected patients. Materials and Methods:This study included 86 patients aged ≥18 years with bitemporal alopecia. Clinicodemographic characteristics and concomitant hair diseases were recorded. The severity of bitemporal alopecia was classified into three categories: mild, moderate, and severe. Results:The mean age of the patients was 36.2±15.7 years. Of the participants, 58.1% were female and 41.9% were male. Most patients were in the 18-24 (29.1%) and 25-34 (25.6%) age groups. A positive hair pull test was observed in 45 patients. Bitemporal alopecia was classified as mild in 22 patients (25.6%), moderate in 40 patients (46.5%), and severe in 24 patients (27.9%). Hair diseases accompanying bitemporal alopecia included androgenetic alopecia (n=57, 66.3%), seborrheic dermatitis (n=38, 44.2%), telogen effluvium (n=29, 33.7%), traction alopecia (n=11, 12.8%), lichen planopilaris (n=5, 5.8%), alopecia areata (n=3, 3.5%), frontal fibrosing alopecia (n=2, 2.3%), and anagen effluvium (n=1, 1.2%). The most frequent coexisting conditions were androgenetic alopecia (25.6%), androgenetic alopecia with seborrheic dermatitis (25.6%), seborrheic dermatitis with telogen effluvium (9.3%), androgenetic alopecia with telogen effluvium (8.1%), seborrheic dermatitis with telogen effluvium and traction alopecia (5.8%), and other combinations. Conclusion:Bitemporal alopecia may serve as a potential predictive indicator for the diagnosis and follow-up of associated hair diseases.
Objective:Non-small cell lung cancer (NSCLC), the most prevalent type of lung cancer, remains the leading cause of cancer-related deaths worldwide. Late-stage diagnosis and resistance to conventional treatments highlight the need for further research into its molecular mechanisms. This study aimed to evaluate the anticancer effects of several benzoxazole derivatives (2-(4-tert-butylphenyl)-5-nitrobenzoxazole (1a), 2-(4-tert-butylphenyl)-6-nitrobenzoxazole (1b), 2-(2,3-dimethylphenyl)-5-nitrobenzoxazole (2a), and 2-(2,3-dimethylphenyl)-6-nitrobenzoxazole (2b)) on the viability of A549 cells. Materials and Methods:Cell viability was assessed using the MTT assay. We also performed a molecular docking study to investigate the interactions between the benzoxazole derivatives and caspase-3, a key executioner caspase involved in apoptosis. Results:The benzoxazole derivatives coded 1a, 1b, 2a, and 2b exhibited anticancer activity against A549 cells, with half-maximal inhibitory concentration (IC50) values of 17.41±0.16, 20.50±0.08, 32.17±0.08, and 31.13±0.07 µM, respectively. Among the tested benzoxazoles, 1a and 1b showed activity comparable to cisplatin (IC50=19.65±0.09 µM). According to the docking results, all compounds demonstrated satisfactory docking scores ranging from -4.339 to -5.202 kcal/mol. Conclusion:Our results demonstrate that the benzoxazole derivatives 1a and 1b exhibit significant anticancer effects by inhibiting lung cancer cell proliferation at low concentrations, similar to cisplatin. The structure-activity relationship suggests that substitution of a phenyl group at the 2-position of the benzoxazole ring with a tert-butyl group at the para position enhances anticancer activity against A549 cells. This preliminary study indicates that these benzoxazole derivatives have promising potential as cytotoxic agents for the treatment of NSCLC.
Objective:Obstructive sleep apnea syndrome (OSAS) is a common sleep-related breathing disorder frequently associated with cardiometabolic morbidity. In this retrospective study of 339 adults who underwent polysomnography (PSG) between January 2020 and December 2024, we investigated the relationship between routinely obtained clinical and anthropometric measures-body mass index (BMI), neck circumference (NC), waist circumference (WC), and the Epworth Sleepiness Scale (ESS)-and PSG-defined OSAS severity. Materials and Methods:Adults (≥18 years) who underwent overnight PSG and had complete clinical and anthropometric data were included. OSAS severity was defined using the apnea-hypopnea index (AHI): no OSA (<5 events/h), mild (5-14.9), moderate (15-29.9), and severe (≥30). Associations between AHI and clinical or anthropometric measures were assessed using Spearman's correlation analysis. Results:A total of 339 patients were included (mean age 46.1±12.0 years; 73.2% male; mean BMI 33.2±6.2 kg/m2). The median ESS score was 4 (interquartile range [IQR]: 2-9), and the median AHI was 10.1 (IQR: 6.3-32.2). AHI showed statistically significant but weak correlations with age (r=0.207), weight (r=0.136), NC (r=0.273), and WC (r=0.184), whereas the association with ESS was stronger (r=0.649; all p<0.05). No significant correlations were observed with height or BMI. Patients with moderate-to-severe OSAS had higher NC, WC, ESS scores, symptom burden, and cardiometabolic comorbidities compared to those with normal-to-mild OSAS. Conclusion:NC, WC, and ESS were associated with PSG-defined OSAS severity. However, correlations with age, weight, NC, and WC were weak in magnitude despite statistical significance, while BMI showed limited association. These routinely obtained measures may aid clinical assessment in sleep laboratory populations.
Objective: Mesenchymal stem cell (MSC)-derived microvesicles play a pivotal role in the regenerative cascade of wound healing. This study aimed to comparatively evaluate the therapeutic potential of microvesicles isolated from different MSC sources in the healing of diabetic cutaneous wounds. Materials and Methods: Forty Wistar albino rats were randomly assigned to four experimental groups (n=10 per group). Following the induction of diabetes and the creation of full-thickness circular dorsal skin defects, each group received a distinct treatment: Group 1 received saline (control), Group 2 received adipose-derived stem cell microvesicles (ADSC-MVs), Group 3 received umbilical cord-derived stem cell microvesicles (UCDSC-MVs), and Group 4 received bone marrow-derived stem cell microvesicles (BMDSC-MVs). Outcomes related to re-epithelialization, neovascularization, and collagen matrix formation were evaluated both macroscopically and histologically. Results: The microvesicle-treated groups demonstrated faster wound closure and improved collagen fiber alignment compared with the control group. Angiogenic activity was increased in all treatment groups, with the most pronounced effects observed in the UCDSC-MVs group. Notably, the UCDSC-MVs group exhibited a significantly greater epithelial tongue length than the control group on postoperative days 3 and 14 (p=0.008 and p<0.001, respectively). Conclusion: These findings indicate that UCDSC-MVs possess a superior capacity to promote re-epithelialization and may represent an effective cell-free therapeutic approach for diabetic wound repair.
Objective: The primary objective of this study was to investigate whether time to blood culture positivity (TTP) can reliably differentiate Candida species and to evaluate their antifungal susceptibility profiles to support more effective clinical decision-making. Materials and Methods: This retrospective study was conducted at Sivas Numune Hospital between January 1, 2022 and February 28, 2025. Adult patients (>18 years) with positive blood cultures for Candida species were included. Results: A total of 101 blood culture bottles from 70 patients were evaluated. C. albicans was the most common isolate (51.5%), followed by C. glabrata (21.5%). The shortest TTP was observed for C. tropicalis (19 hours), and the longest for C. glabrata (42 hours). When C. albicans and C. tropicalis were classified as early TTP species and C. glabrata and C. parapsilosis as late TTP species, the median TTP values were 21 and 35 hours, respectively. Receiver operating characteristic (ROC) analysis identified a TTP cut-off value of 28 hours as optimal for predicting the early TTP group (area under the curve: 0.751), indicating moderate discriminatory ability. Early TTP species were generally susceptible to fluconazole, whereas resistance was more frequent among late TTP species. Conclusion: Blood culture positivity times differ among Candida species. Early TTP species, such as C. albicans and C. tropicalis, were more likely to be fluconazole-susceptible, suggesting that fluconazole may be an appropriate option for empirical therapy in such infections.
