Objective: In unilateral hydronephrosis (HN), differential renal function (DRF) derived from DMSA scintigraphy reflects split renal function; however, its reliability in dilated kidneys remains controversial. Normalized residual activity (NORA), obtained from MAG3 scintigraphy, is considered a robust indicator of renal drainage. This study aimed to compare NORA with classical and area-corrected DRF methods to determine which better reflects renal excretory function.Methods: A total of 63 patients with unilateral hydronephrosis who underwent both 99mTc-MAG3 and 99mTc-DMSA scintigraphy within one month were retrospectively analyzed. MAG3-derived parameters, including Tmax, T1/2, residual activity at 30 minutes (RA30), and NORA30, were calculated. Renogram patterns were classified into five categories according to diuretic response. DRF was measured using both classical and area-corrected methods based on DMSA scintigraphy. Correlations between drainage parameters, DRF measurements, hydronephrosis grade, and DMSA uptake were evaluated.Results: MAG3-derived drainage parameters (Tmax, T1/2, RA30, and NORA30) showed significant differences across renogram patterns and progressively worsened with increasing obstruction severity (all p < 0.001). Hydronephrosis grade correlated significantly with drainage parameters but not with any DRF measurement. Neither classical nor area-corrected DRF was associated with renogram patterns or hydronephrosis severity (all p > 0.05). Area-corrected DRF demonstrated the strongest correlation with visual DMSA uptake (r = −0.773, p < 0.001). Notably, several kidneys with supranormal classical DRF were reclassified as normal after area correction, and these discordant cases exhibited abnormal NORA30/RA30 values and obstructive renogram patterns.Conclusions: Although area correction improves DRF estimation in asymmetric hydronephrotic kidneys, DRF alone does not adequately reflect excretory function. Drainage parameters, particularly NORA and RA30, provide a more reliable assessment of renal impairment. Integrating NORA into routine evaluation may improve functional assessment and clinical decision-making in unilateral hydronephrosis.
Objective: To compare physician specialists and large language models in the differential diagnosis and plasma exchange decision making of standardized thrombotic microangiopathy case vignettes.Methods: This case vignette based comparative study included three standardized TMA scenarios representing atypical hemolytic uremic syndrome, malignant hypertension associated TMA, and acquired thrombotic thrombocytopenic purpura. Nine evaluators participated: two nephrologists, two hematologists, two internal medicine specialists, and three large language models (ChatGPT-5.2, Gemini Pro, and Microsoft Copilot). For each case, participants provided a most likely diagnosis, three differential diagnoses, supporting clinical reasoning, and a plasma exchange decision. Diagnostic accuracy, plasma exchange appropriateness, and critical management errors were analyzed descriptively and comparatively.Results: A total of 27 independent evaluations were analyzed. Overall Top-1 diagnostic accuracy was 51.9%. Accuracy varied by case, with the lowest performance observed in the aHUS scenario (22.2%) and the highest in malignant hypertension–associated TMA (77.8%). Physicians achieved a Top-1 accuracy of 50.0% (9/18), whereas LLMs demonstrated 55.6% accuracy (5/9). Plasma exchange decision accuracy was 63.0% overall, with overtreatment more common in non-TTP cases. Ten critical management errors (37.0%) were identified. Agreement for plasma exchange decisions demonstrated fair concordance (κ = 0.29).Conclusions: Substantial variability exists in both diagnostic classification and therapeutic decision-making in TMA scenarios. While LLMs demonstrated competitive diagnostic performance in selected cases, management variability persisted across evaluator groups. These findings highlight the diagnostic complexity of TMA and support the role of artificial intelligence as an adjunctive clinical decision-support tool rather than an autonomous decision-maker.
Objective: The main objective of this study is to identify clinical and pathological factors associated with recurrence in patients diagnosed with early-stage (stage I–II) endometrial cancer.Methods: A total of 98 patients diagnosed with stage I–II endometrial cancer who underwent surgical treatment at a single center between 2017 and 2021 were retrospectively analyzed. The patients’ clinical and pathological characteristics, the adjuvant therapies administered, and follow-up outcomes were evaluated. Factors associated with recurrence were assessed using univariate analyses.Results: The mean age of the patients was 59.8 years, and the mean tumor size was 3.58 cm. The mean follow-up period was 49.1 months. The recurrence rate was 8.2%. Five recurrences were identified as locoregional, and three as distant metastases. In univariate analyses, surgical type (p=0.015), adjuvant therapy (p=0.009), and histotype (endometrioid vs. non-endometrioid, p=0.016) were found to be associated with recurrence.Conclusions: The recurrence rate in early-stage endometrial cancer was found to be low, consistent with the literature, and it was determined that 5 of the recurrences were locoregional in nature, while the remaining 3 were distant metastases. Although surgical type, histological type, and adjuvant therapy were identified as factors associated with recurrence in univariate analyses, there is a need for a detailed examination of these factors through multicenter studies involving larger patient cohorts.
Objective: Residual instability may persist after isolated anterior cruciate ligament (ACL) reconstruction. Anterolateral ligament (ALL) augmentation has been suggested to enhance stability, though its clinical utility remains uncertain.Methods: This retrospective cohort study included 60 patients: 30 underwent isolated ACL reconstruction and 30 underwent combined ACL+ALL reconstruction. Outcomes included clinical stability, functional scores (IKDC, Lysholm), return-to-sport parameters, satisfaction, and complications with a mid-term follow-up of ≥12 months. The study was approved by the institutional non-interventional ethics committee.Results: Baseline demographic and perioperative characteristics were comparable between groups. Postoperatively, the ACL+ALL group showed lower pivot-shift positivity (7% vs. 27%, p=0.04), higher IKDC and Lysholm scores at 12 months (p<0.05), and shorter return-to-sport time (7.2 vs. 8.1 months, p=0.04). Patient satisfaction was higher (p=0.02), and the overall complication rate was significantly lower in the ACL+ALL group (10% vs. 33%, p=0.04).Conclusions: Combined ACL+ALL reconstruction yielded superior stability, functional recovery, and a more favorable complication profile compared with isolated ACL reconstruction. Given the retrospective design and limited sample size, results should be interpreted cautiously. Larger prospective trials are needed.
Objective: This report aims to present two atypical cases of autoimmune limbic encephalitis with distinct clinical manifestations and to emphasize the diagnostic challenges when neuroimaging findings are normal or non-specific.Methods: Comprehensive clinical, neurological, and psychiatric evaluations were performed. Diagnostic work-up included brain magnetic resonance imaging (MRI), electroencephalography (EEG), cerebrospinal fluid (CSF) analysis, and autoimmune antibody testing.Results: The first case was a 34-year-old male presenting with isolated executive dysfunction without psychosis, seizures, or movement disorders. MRI showed minimal nonspecific hyperintensities and EEG was normal. CSF analysis revealed mildly elevated protein and strongly positive anti-NMDAR antibodies. Significant cognitive improvement was observed after intravenous methylprednisolone followed by azathioprine. The second case was a 69-year-old male presenting with acute consciousness impairment due to non-convulsive status epilepticus. EEG demonstrated continuous 2–3 Hz spike-wave activity predominantly in the left hemisphere. CSF protein levels were elevated and GAD65 antibodies were positive. Clinical improvement was achieved after treatment with high-dose corticosteroids and intravenous immunoglobulin.Conclusions: Autoimmune encephalitis may present with heterogeneous and atypical clinical features, including isolated cognitive dysfunction or non-convulsive status epilepticus. Normal or nonspecific MRI findings do not exclude the diagnosis. Early recognition and timely immunotherapy are crucial to prevent irreversible neurological damage.
Objective: This study aimed to compare the effects of hydroxyethyl starch (6% HES 130/0.4) administered as preload or coload on the incidence of maternal hypotension and neonatal outcomes in elective cesarean sections performed under spinal anesthesia.Methods: This prospective, randomized trial included 162 parturients aged 18–45 years with American Society of Anesthesiologists physical status II and a gestational age greater than 36 weeks undergoing elective cesarean delivery under spinal anesthesia. Participants received 500 mL of HES either 30 minutes before spinal anesthesia (preload group) or at the onset of cerebrospinal fluid flow (coload group). Maternal hemodynamic parameters were monitored throughout the procedure. Umbilical cord blood gas analysis, Apgar scores at 1 and 5 minutes, and total ephedrine consumption were recorded.Results: The incidence of maternal hypotension was 51.1% in the preload group and 48.9% in the coload group, with no statistically significant difference between groups (p = 0.83). Systolic arterial pressure at the onset of hypotension was 86.41 ± 8.63 mmHg in the preload group and 82.20 ± 9.14 mmHg in the coload group (p = 0.19). Total ephedrine requirement and umbilical cord blood gas parameters were comparable between groups. While 1-minute Apgar scores were similar, the 5-minute Apgar score was significantly higher in the preload group (p = 0.01).Conclusions: Colloid preload and coload administration were associated with comparable effects on maternal hypotension, vasopressor requirements, and neonatal outcomes in cesarean deliveries performed under spinal anesthesia.
Objective: In recent years, targeted therapies and immune checkpoint inhibitors have provided significant gains in survival and quality of life compared to conventional chemotherapies. However, due to biomarker-based selectivity, high cost, and reimbursement restrictions, the concepts of “necessity” and “indication appropriateness” have become controversial from a medicolegal perspective. This study aimed to evaluate the clinical and forensic aspects of innovative cancer drug use by reviewing court case files.Methods: A total of 455 case files submitted between January 1, 2022 and May 31, 2025, were retrospectively analyzed. Demographic data, cancer type and stage, histological subtype, performance status, previous treatments, innovative drug active agents, licensing and indication status, therapeutic intent, and council and board decisions were recorded. Data were evaluated using descriptive statistics.Results: Of the cases, 53.6% were female and 46.4% male; the most common age group was ≥65 years. The most frequent malignancies were lung (35.2%) and breast (20.0%) cancers, and 69.5% of the patients were in stage IV disease. The most frequently used drugs were pembrolizumab (29.7%), nivolumab (16.0%), and atezolizumab (12.5%). Of all uses, 99.1% were licensed and 85.1% were indication-appropriate. Treatment intent was adjuvant in 48.6%, neoadjuvant in 10.1%, and post-progression in 41.1% of the cases. Multidisciplinary council decisions were documented in 47.3% of files, and the Forensic Board concluded that treatment use was “appropriate” in 97.6% of cases.Conclusions: The findings indicate that innovative cancer drugs in Türkiye are mostly used within licensed and guideline-concordant indications. However, the lack of biomarker data and multidisciplinary council documentation constitutes an important limitation in medicolegal evaluations. Addressing these deficiencies would make therapeutic decisions more defensible both clinically and legally.
Objective: This study investigates the potential discrepancy between post-void residual urine (PVR) measurements obtained immediately after uroflowmetry and those reflecting patients’ usual voiding patterns, aiming to evaluate the reliability of immediate post-test measurements.Methods: This prospective study included 110 men >45 years with lower urinary tract symptoms. PVR was measured by transabdominal ultrasonography immediately after uroflowmetry (PVR0), on day 1 (PVR1), and day 7 (PVR7). Patients were grouped by pre-void bladder volume: <300 mL, 300–500 mL, >500 mL. Uroflowmetric parameters, prostate volume, PSA, IPSS, BMI, and detrusor thickness were recorded.Results: The mean age was 60.32±6.93 years; mean prostate volume 44.84±20.44 mL. In the uroflowmetry test, the mean values for Qmax, Qave, and voided volume were detected as 15.83±7.00 mL/sec, 6.21±2.62 mL/sec, and 304.15±157.81 mL, respectively. The mean bladder volume was 408.30±191.53 mL. When stratified into three groups based on bladder volume (<300 mL, 300–500 mL, and >500 mL), 26.4% of the patients had a bladder volume <300 mL, 49.1% had 300–500 mL, and 24.5% had >500 mL. The mean PVR0, PVR1, and PVR7 were 104.12±108.51 mL, 33.74±82.54 mL, and 19.59±47.91 mL, respectively. A comparative analysis of PVR0, PVR1, and PVR7 revealed a statistically significant decreasing trend over time: PVR7 < PVR1 < PVR0 (PVR0 vs. PVR1, p < 0.001; PVR0 vs. PVR7, p < 0.001; PVR1 vs. PVR7, p = 0.003).Conclusions: Measuring PVR at a scheduled time after natural bladder filling may yield more accurate and clinically representative data, supporting more reliable treatment planning.
Objective: Degenerative osteoarthritis is one of the most important orthopedic disorders today. Many treatment methods have been developed for osteoarthritis in the knee joint. Excessive mechanical load on the cartilage in medial osteoarthritis of the knee causes both progression of degeneration and increased symptoms. On the other hand, the use of magnetic field in health is becoming increasingly common with the developing technology. This study aimed to investigate the use of magnetic power to reduce the mechanical load pressure on the knee joint.Methods: Two different models were created by setting up a joint model containing oppositely placed magnets. In the first model, magnets placed outside the joint were used, while in the second model, magnets placed inside the joint were used. The forces applied to the femur in increasing amounts and the loads transmitted from the femur to the tibia were recorded until joint contact was achieved.Results: At the moment of contact between the two joint surfaces, 58.45 newtons of load was transmitted in the extra-articular model, while 97.48 newtons of maximum load was transmitted in the intra-articular model.Conclusions: Part of the load on the knee joint surfaces was transferred from the femur to the tibia by magnetic force. It has been demonstrated that the mechanical load pressure on the joint surfaces can be experimentally reduced using this method.
Objective: This study aimed to investigate the prevalence of apathy in Parkinson’s Disease (PD) and explore its potential clinical correlates. Methods: Ninety-eight patients diagnosed with PD based on MDS clinical criteria and followed at the Movement Disorders Clinic of Sakarya University were included. Apathy was assessed using the Starkstein Apathy Scale. Clinical features including disease stage, motor subtype, prodromal symptoms, and daily total levodopa dosage were evaluated in relation to apathy status. Results: Apathy was detected in 59.2% of the participants. The apathy-positive group had significantly higher UPDRS III and H&Y scores (p<0.05), as well as longer disease duration and higher daily levodopa dosages. Although apathy was more frequent in advanced-stage patients and in the akinetic-rigid subtype, these differences did not reach statistical significance. Constipation and REM sleep behavior disorder were more commonly observed in the apathy group, though again without statistical significance. Conclusion: Apathy is a common and clinically relevant non-motor symptom in PD, particularly associated with greater motor impairment and longer disease duration. Our findings underline the need for increased awareness and further investigation into the pathophysiology and clinical management of apathy in PD.
Sistemik romatolojik hastalıklarda, hastaların enfeksiyonlara eğilimi artmıştır. Bu enfeksiyonlarla mücadelede en önemli araçlardan biri aşılamadır. Aşı konusuna çok vakit ayıramamak, aşılama şemalarının romatoloji uzman hekimlerine karışık gelmesi, aşı poliklinikleriyle yetersiz iletişim, aşının yetersiz immunizasyona neden olması ya da aşıya bağlı yan etkiler konusundaki çekinceler, gibi pek çok farklı nedenden ötürü aşılama erişkin romatoloji polikliniklerinde oldukça yetersiz kalmaktadır. Burada erişkin romatoloji hastalarının aşılanması konusunda klinik pratikte uygulanabilecek öneriler getirilecektir.
Objective: Malnutrition reshapes the hypothalamic–pituitary system through caloric deficiency and inflammatory mechanisms. Low albumin levels may be associated with low fT3, LH and IGF-1. This study aimed to clinically interpret the functional alterations of malnutrition on endocrine pathways.Methods: In this single-center study, medical records of 71 adult inpatients diagnosed with malnutrition according to GLIM criteria between 2018 and 2024 were retrospectively analyzed. Anthropometric parameters, biochemical markers, and pituitary hormones were classified based on laboratory reference ranges. Statistical analyses included the Shapiro–Wilk test for normality, the Mann–Whitney U test for group comparisons, Spearman’s correlation for associations, and multivariable logistic regression (significance level α=0.05). Ethical approval was obtained.Results: The mean age of the patients was 74.6±14.0 years. Low sT3 levels were observed in 90% of patients and low sT4 in 38% of patients, while TSH remained within normal limits in 70%. IGF-1 levels were reduced in 92% of patients, while GH levels remained within or slightly above normal ranges. In multivariable logistic regression, a one standard deviation increase in albumin decreased the likelihood of low sT3 and LH, whereas a one standard deviation increase in CRP was associated with low IGF-1. A decrease in pituitary volume (hypoplasia/atrophy) was detected in 3 of the 8 patients who underwent MRI.Conclusion: Malnutrition is characterized by adaptive endocrine responses. The consistent associations of the patterns with albumin and CRP support the prioritization of nutritional rehabilitation and inflammation control in treatment; hormone replacement should be administered only when clear clinical indications are present. These findings highlight the impact of nutritional rehabilitation and inflammation control on hormonal responses and provide a foundation for future volumetric studies.
Objective: Cannabis use disorder (CUD) is increasingly prevalent and often co-occurs with psychiatric and legal complications. While cross-sectional associations between CUD and mental illness are well-documented, longitudinal data on the clinical and forensic trajectories of affected individuals remain limited, particularly in real-world settings. Methods: This naturalistic follow-up study tracked 51 male patients diagnosed with CUD over a five-year period. Data were collected via structured telephone interviews and hospital records, assessing substance use patterns, psychiatric diagnoses, Alcohol and Substance Addiction Treatment Center (AMATEM) admissions, and legal outcomes. Psychiatric comorbidities were evaluated using medical records, and substance use severity was assessed using the Addiction Profile Index (API). Results: Over five years, 82.4% of participants continued substance use, with synthetic cannabinoids being the most frequently used substance (76.5%). More than half (64.7%) developed a psychiatric diagnosis, most commonly depression and anxiety. Synthetic cannabinoid use was significantly different in individuals with psychiatric comorbidity (p = .033). AMATEM admissions declined over time but remained higher in patients with psychiatric diagnoses (Year × Diagnosis interaction: F = 2.600, p = .037). Nearly half experienced judicial psychiatric evaluations, and 23.5% had a history of incarceration. Conclusion: CUD is associated with persistent substance use, high rates of psychiatric comorbidity, and substantial legal-system involvement. Synthetic cannabinoids appear to exacerbate psychiatric outcomes. Long-term, integrated interventions are needed to address dual-diagnosis and reduce forensic burden.
Amaç: Diyabet, çok sayıda komplikasyonu ile önemli bir halk sağlığı sorunudur. Bu çalışmada, diyabetik miyopatide E vitamininin olası koruyucu etkilerinin değerlendirilmesi amaçlanmıştır. Yöntem: Çalışmada 24 erkek Wistar albino sıçan kontrol, diyabet ve diyabet + E vitamini (DE) olmak üzere üç gruba ayrıldı. Diyabet, tek doz 45 mg/kg streptozotosin (STZ) enjeksiyonu ile oluşturuldu ve kan glukozu ≥250 mg/dL olan sıçanlar diyabetik kabul edildi. STZ uygulamasından 3 gün sonra kan glukoz düzeyleri ölçüldü. DE grubuna, diyabet oluşturulduktan sonra 3 hafta boyunca 250 mg/kg/gün oral E vitamini verildi. Kas fonksiyonları ters ekran testi ve in-situ kas kasılma analizi ile değerlendirildi. Bulgular: Çalışmanın başlangıcında gruplar arasında vücut ağırlığı ve kan glukoz düzeyleri açısından anlamlı fark yoktu. Deney sonunda, DE grubunda kontrol grubuna kıyasla vücut ağırlığında anlamlı azalma gözlendi (p=0.005). Diyabet grubunda kan glukoz düzeyleri kontrol grubuna göre anlamlı olarak artarken (p<0.001), E vitamini uygulanan grupta da yüksek seyretmeye devam etti (p<0.001). Ters ekran testinde diyabet grubunda kas dayanıklılığı azalırken (p<0.001), E vitamini uygulaması bu azalmayı anlamlı düzeyde iyileştirdi (p=0.001). Diyabet grubunda artan kas kasılma eşiği (p=0.002), E vitamini ile anlamlı şekilde azaldı (p=0.003). Tetani ölçümlerinde kontrol ve diyabet grupları arasında fark saptanmazken (p=0.072), E vitamini uygulaması diyabet grubuna kıyasla kas dayanıklılığını artırdı (p=0.026). Sonuç: Diyabetin kas gücü ve nöromüsküler iletim üzerinde olumsuz etkiler oluşturduğu, E vitamini tedavisinin ise bu bozulmaları kısmen düzelttiği görülmüştür. Bu bulgular, E vitamininin diyabete bağlı kas fonksiyon bozukluklarının önlenmesinde destekleyici olabileceğini düşündürmektedir.
Objective: We aimed to determine whether pre-detorsion rosmarinic acid (RA) mitigates oxidative and inflammatory damage in a rat torsion–detorsion (T/D)-induced I/R injury model.Methods: Thirty-two male rats were randomised (n=8/group) to sham, T/D, T/D + RA 40 mg/kg, or T/D + RA 80 mg/kg. T/D consisted of 2 h torsion followed by 2 h reperfusion. RA (i.p.) was administered 30 min before detorsion. Testis tissue was analysed for oxidative stress markers (MDA, MPO, OSI, TOS), antioxidant parameters (SOD, TAS), and inflammatory cytokines (TNF-α, IL-1β).Results: Compared with sham, T/D caused high MDA, MPO, TNF-α, TOS/OSI, IL-1β, and low SOD, TAS. RA significantly reversed these changes versus T/D, lowering oxidative and inflammatory markers and enhancing antioxidant defences. The high dose RA was equal or superior to low dose—with clearer gains for SOD, TAS, MPO, and cytokines—whereas TOS/OSI improvements were similar at both doses.Conclusion: RA attenuates oxidative and inflammatory injury in testicular T/D as a peri-detorsion adjunct.
Objective: This study aimed to compare retrograde intramedullary nailing (RIMN) and femoral locked plating (FLP) in the management of periprosthetic supracondylar femur fractures (PSFF) following total knee arthroplasty (TKA), focusing on fracture healing, blood loss, functional outcomes, and complication rates. Methods: Thirty-one patients surgically treated for PSFF between 2015 and 2021 were retrospectively analyzed. According to the fixation method, patients were divided into two groups: FLP (n=19) and RIMN (n=12). Group allocation was based on fracture pattern, distal fragment length, and prosthesis compatibility. Fractures were classified according to the Su system. Operative parameters, intraoperative blood loss, transfusion requirement, union time, complications, and functional outcomes (Knee Society Score, KSS) were evaluated. Statistical analysis was performed using SPSS 23.0, with a significance level of p<0.05. Results: No significant difference was found between groups in terms of demographics, fracture type, or complication rate (p>0.05). The RIMN group showed significantly lower intraoperative blood loss and transfusion requirements (p<0.001 and p=0.016, respectively). KSS and KSS-functional scores were significantly higher in the RIMN group (p=0.022 and p=0.028). There was no significant difference in union time between the two fixation methods. Conclusion: Both fixation methods are effective for PSFF treatment; however, RIMN provides advantages in terms of reduced blood loss, lower transfusion needs, and superior postoperative functional outcomes. Surgical method selection should be individualized according to bone quality, fracture morphology, and prosthesis compatibility.
Objective: Oxytocin plays a significant role in the regulation of carbohydrate and lipid metabolism and has been suggested to be associated with obesity and components of metabolic syndrome (MetS). This prospective study aimed to investigate the relationship between serum oxytocin levels and vitamin D status, body mass index (BMI), lipid profile, and various metabolic and biochemical parameters in the pediatric population. Methods: A total of 87 children, who presented for routine follow-up, were enrolled in this prospective study. Anthropometric measurements, serum oxytocin levels and comprehensive laboratory parameters were evaluated. Results: No statistically significant correlations were observed between oxytocin level and patient age, weight, height, body mass index (BMI), or their respective percentiles. Furthermore, oxytocin showed no significant associations with the evaluated laboratory parameters. Notably, a significant inverse correlation was detected between oxytocin and 25-hydroxyvitamin D (25OHD) concentrations, whereby oxytocin levels decreased as 25OHD levels increased (p = 0.001). Conclusions: This study demonstrated that, unlike findings reported in adult populations, oxytocin levels were not significantly associated with BMI, lipid profile, or other metabolic parameters in healthy children. Moreover, this is the first study to report that oxytocin levels are significantly elevated in children with vitamin D deficiency.
Objective: Becoming a mother involves a complex process of adjustment in biological, psychological, and social terms. This period is a special phase in which strong emotional bonds are formed and identity transformation takes place. The adjustment of primiparous becoming mother is particularly important in terms of mother-baby bonding and family relationships. The aim of this study was to establish the Turkish validity and reliability of the “Transition of Primiparous Becoming Mothers Scale” in first-time mothers. Methods: This metadological study was conducted with 218 women with first-time mothers experience who brought their 1-6-month-old infants to the pediatric outpatient clinic for routine check-ups between January 1 and December 31, 2024. In the adaptation stages of the scale, language validity, content validity, construct validity, discriminant validity and Cronbach's Alpha coefficient were used to determine the internal consistency of the scale. The significance level (p) was accepted as 0.05 in all statistical analyses. Results: The content validity index ranged between 0.87 and 1.00 for each item and was found to be 0.99 for the whole scale. The number of items of the scale, which initially had 30 items, was finalized as 29 according to the factor loadings. The Cronbach Alpha value calculated for the reliability of the scale was 0.870. Goodness of fit indices were also acceptable. Conclusions: The scale designed to assess the motherhood transition process of first-time mothers has been found to be a valid and reliable measurement tool for Turkish-speaking women. This scale can provide healthcare professionals with an important resource for evaluating primiparous women’s adaptation to motherhood and for planning appropriate interventions to support a healthy transition process.
Objective: Epilepsy is increasingly recognized as a condition associated with elevated cardiovascular risk, potentially influenced by both the disease itself and long-term antiseizure medication (ASM) use. Atherogenic lipid indices enable a more detailed evaluation of cardiovascular risk that may not be evident through conventional lipid measurements. Methods: In this retrospective analysis, 71 patients with epilepsy and 50 age- and sex-matched healthy individuals were recruited from the Neurology and Cardiology outpatient departments of Siirt Training and Research Hospital between January 1, 2024, and January 1, 2025. According to the criteria established by the International League Against Epilepsy (ILAE), patients were classified into two subgroups: drug-sensitive epilepsy (DSE, n=52) and drug-resistant epilepsy (DRE, n=19). Demographic, clinical, and biochemical data were collected. Atherogenic indices were calculated and compared across groups. The relationships between treatment duration and lipid-based risk indicators were examined using correlation analysis and multivariate linear regression, accounting for potential covariates. Results: Compared with healthy controls, the DRE group exhibited significantly lower high-density lipoprotein cholesterol (HDL-C) levels (p=0.030) and higher Castelli Risk Index II (CRI-II) values (p=0.01). In multivariate regression models, longer epilepsy duration and higher body mass index (BMI) were independently associated with increased CRI-II (p=0.023 and p=0.003, respectively) and Cholesterol Index (CHOLIndex) (p=0.026 and p=0.009, respectively). Conclusions: Epilepsy patients, particularly those with DRE or prolonged treatment duration, demonstrate unfavorable shifts in lipid-based cardiovascular risk markers.
Herpes zoster, a reactivation of the varicella-zoster virus (VZV), is uncommon during pregnancy but poses significant maternal and fetal risks, necessitating tailored anesthetic management. When neuraxial anesthesia is contraindicated due to lesions located near the insertion site, general anesthesia becomes a reasonable alternative. However, airway management is of paramount importance due to the risk of varicella pneumonia.This case report presents a 39-week pregnant patient with active herpes zoster lesions over the spinal access site who underwent cesarean section under general anesthesia. Airway management was achieved with the Tulip® GT#3 supraglottic airway device, providing a secure and effective alternative to endotracheal intubation. The device was successfully inserted on the first attempt, providing effective ventilation. Aspiration risk was minimized through gastric decompression with an orogastric tube.The postoperative course was uneventful for both mother and newborn. To the best of our knowledge, this is the first reported use of the Tulip Airway in an obstetric patient, highlighting its potential as a safe and effective alternative in appropriately selected cases.
