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 systematically evaluate the prevalence, correlates, and mental health outcomes of behavioural addictions—including Internet Gaming Disorder (IGD), Internet Addiction (IA), Social Media Addiction (SMA), and Work Addiction (WA)—among healthcare professionals (HCPs) and medical students.Methods: A systematic search of PubMed, Web of Science, Scopus, and PsycINFO was conducted from January 2017 to September 2025 following PRISMA 2020 guidelines. Only observational studies reporting prevalence, risk factors, or outcomes of behavioural addictions in healthcare professionals or medical students were included. Data extraction covered study characteristics, assessment instruments, prevalence estimates, and associated psychological or occupational outcomes. Risk of bias was assessed using the Joanna Briggs Institute Prevalence Checklist. Random-effects meta-analyses were performed, with subgroup analyses based on profession, addiction type, and geographic region.Results: A total of 27 cross-sectional studies involving approximately 23,000 participants from 12 countries were included. Pooled prevalence estimates were high across all addiction types: IGD (2.1–20.0%), IA (11.1–75.5%), SMA (55.2–68.8%), and WA (23.7–70.7%). IGD and IA were more common among medical students, SMA among nurses, and WA among physicians—particularly emergency doctors. Behavioural addictions were consistently associated with depression, anxiety, insomnia, burnout, reduced academic performance, and work–family conflict. Risk of bias was generally low to moderate, while heterogeneity was explained by differences in measurement tools, cut-offs, and cultural factors.Conclusions: Behavioural addictions are highly prevalent among healthcare professionals and trainees, often exceeding rates observed in the general population. Given their strong associations with mental health problems and occupational impairment, standardized diagnostic tools, targeted interventions, and institution-level policies are urgently needed to mitigate their impact on workforce well-being and patient safety.
Objective: Remnant liver tissue is essential for the surgery of primary liver tumors, metastasectomy, or donor hepatectomy. We aimed to determine whether an effective supportive treatment can improve the safety of donors with insufficient remnants and expand the donor pool in countries where LDLT is performed intensively. Therefore, our study investigated the effects of various substance extracts on the regenerative capacity of residual liver tissue following hepatectomy.Methods: Rats of equal age and approximately equal weight were grouped into 6 groups: Sham, Genabilic acid, Silymarin+curcumin, Ganoderma lucidum, Mixture containing group B vitamins, amino acids, l-carnitine, and sugars, and Phenoxy-2-methyl-2-propionic acid. Subjects' mTOR, insulin, nesfatin, and leptin levels were checked. PCNA was performed for regeneration control, and immunohistochemistry for Ki-67, mTOR, VEGF, FGF, HGF, and Calpain-10 was performed on the liver.Results: In comparisons between the Sham group and the other groups, there were significant differences for insulin in group 4 (p=0.041) and for nesfatin in group 3 (p<0.001). The other markers were similar. PCNA, Ki-67, mTOR, and Calpain-10 differed significantly across all groups (p < 0.001). It was also significantly different with respect to VEGF, FGF, and HGF compared with the other groups, except for group 4.Conclusions: It was determined that the silymarin-curcumin was more successful in suppressing hunger hormones. Since liver regeneration with fibrosis is undesirable, although Ganoderma lucidum is thought not to affect FGF levels, it may promote healthier regenerative tissue; however, this has not been demonstrated by immunostaining.
Objective: Sugammadex has been widely studied in pregnant women undergoing cesarean section. However, the use of sugammadex for non-obstetric surgery in pregnant women has not been clearly defined. We aimed to evaluate the effects of sugammadex on the mother and fetus in pregnant women undergoing non-obstetric surgery.Methods: Pregnant women who underwent non-obstetric surgery between January 2017 and December 2022 under general anesthesia and received sugammadex were included in this retrospective cohort study. Postoperative maternal and fetal complications, delivery method, and neonatal outcomes were analyzed.Results: In total, 26 patients were included in the study. The mean age was 28.46±5.99, and the mean gestational age at the time of operation was 17.29 ± 7.31. The mean anesthesia duration was 69.46 ± 20.85 minutes. The mean delivery week was 38.23 ± 2.66 weeks. The cesarean delivery rate was 61 %. No abortion or preterm delivery occurred within two weeks after sugammadex usage. The mean neonatal weight was 2940 ± 799 grams, and height was 48.75 ± 3,97 cm. No teratogenic effect was observed.Conclusions: In this small retrospective cohort, no serious maternal or fetal complications that may be associated with sugammadex have been observed within two weeks of administration. Larger multicenter controlled studies are needed to prove the safety of sugammadex in early pregnancy.
Objective: Lung cancer remains one of the leading causes of cancer-related mortality worldwide, and the emergence of resistance to existing therapies together with severe adverse effects necessitates the investigation of novel therapeutic agents. In this study, the effects of bee venom (BV) derived from Apis mellifera anatoliaca on the non-small cell lung cancer cell line A549 were evaluated with respect to cell viability and cell migration.Methods and Results: Cell viability was assessed using the MTT assay following treatment with BV at concentrations of 8, 16, and 32 ng/mL. At the sixth hour, statistically significant differences were detected among the experimental groups (p < 0.0001). While no significant difference was observed between the control group and the 8 ng/mL group (p = 0.83), treatment with 16 and 32 ng/mL BV resulted in a significant decrease in cell viability (p < 0.0001 for both). Time-course analyses performed using lower concentrations (0.5–12 ng/mL) revealed no statistically significant differences at the 6th, 18th, or 48th hours (p > 0.05); however, a limited but significant difference was observed at the 24th hour (p = 0.02). According to two-way repeated-measures ANOVA, BV concentration did not exert a significant main effect on cell viability (F(7,16) = 0.53; p = 0.80), whereas the time factor showed a strong and significant effect (F(3,41,54,52) = 146.3; p < 0.0001). Cell migration was evaluated using a wound-healing assay, which revealed a dose-dependent biphasic effect. Migration increased at lower concentrations (4 ng/mL: 91.31 ± 1.76%; 8 ng/mL: 85.83 ± 4.17%) compared with the control group (70.26 ± 7.96%), whereas higher concentrations significantly suppressed migration (12 ng/mL: 58.16 ± 6.42%; 32 ng/mL: 54.53 ± 8.05%; p < 0.05).Conclusions: These findings indicate that BV modulates cell migration in A549 cells without inducing pronounced cytotoxicity and may exhibit potential antimetastatic properties at higher concentrations.
Objective: The aims of this study were to determine the prevalence of anxiety disorder in patients with primary hyperaldosteronism (PA), to compare it with patients diagnosed with essential hypertension (EHT) after exclusion of secondary causes, and to evaluate the association between treatment modalities for PA and changes in the course of anxiety disorder.Methods: A total of 133 patients were included in this retrospective study, comprising 90 patients with PA and 43 patients with EHT. Among patients with PA, 39 received surgical treatment and 51 received medical therapy. The PA and EHT groups were compared with respect to demographic, clinical, and laboratory characteristics. Within the PA group, the relationship between treatment modality and changes in anxiety disorder management during follow-up was also analyzed.Results: The prevalence of anxiety disorder was significantly higher in the PA group compared with the EHT group (27.8% vs. 9.3%, p = 0.029). Patients with PA were younger and more frequently male. Serum aldosterone levels and the aldosterone-to-renin ratio were significantly higher, whereas renin and potassium levels were significantly lower in the PA group (all p < 0.05). Among patients with PA, no significant differences were observed in most clinical and laboratory parameters between those with and without anxiety disorder. Discontinuation of anxiety disorder treatment was observed more frequently in patients who underwent surgical treatment compared with those receiving medical therapy.Conclusions: These findings suggest that anxiety disorder accompanying hypertension may be more frequently observed in patients with PA and that there may be an association between treatment modality and psychiatric outcomes.
Objective: Sarcopenia is increasingly recognized as a marker of frailty and a predictor of adverse outcomes in surgical oncology. However, its role in patients undergoing radical prostatectomy (RP) for localized prostate cancer (PCa) remains unclear.Methods: We retrospectively analyzed 165 men who underwent RP between 2015 and 2025 at a single institution. Sarcopenia was assessed using preoperative CT-derived skeletal muscle index (SMI). Perioperative complications, pathological outcomes, urinary continence, erectile function, biochemical recurrence (BCR), and all-cause mortality (ACM) were com-pared between sarcopenic and non-sarcopenic patients. Statistical analyses included the Mann–Whitney U test, chi-square test, Kaplan–Meier analysis with the log-rank test, and Cox proportional hazards regression.Results: Of the cohort, 75 patients (45.5%) were sarcopenic. These patients were older (median age 69 vs. 66 years, p=0.005) and had higher comorbidity scores (CCI ≥5: 56.0% vs. 32.2%, p=0.002). Major complications (Clavien-Dindo ≥3) occurred more frequently in the sarcopenic group (10.7% vs. 1.1%, p=0.007), although no perioperative mortality was observed. Continence status at 12 months was comparable between the groups (p=0.373). IIEF-5 scores were lower in sarcopenic patients at 12 months (median, 10 vs. 12; p=0.021); however, baseline IIEF-5 scores also differed significantly between the groups. During a median follow-up of 37 months, 65 patients developed BCR and 11 died (7 sarcopenic). Cumulative incidence of biochemical recurrence was 44% at the median follow-up. Although sarcopenic patients showed a higher recurrence trend (≈65% vs. 37%), no statistically significant difference was observed (p=0.267). In Cox Regression analysis, sarcopenia did not appear to significantly predict BCR (HR 0.75, 95% CI 0.45–1.24, p=0.272).Conclusions: Preoperative sarcopenia may be associated with increased major perioperative complications and impaired erectile function following RP. However, it was not significantly associated with BCR in this cohort. Sarcopenia may primarily serve as an indicator of surgical vulnerability rather than oncological prognosis.
Objective: This study aimed to compare quality of life, depression levels, and sexual function among women with natural, surgical, and premature menopause.Methods: This cross-sectional observational study was conducted between July and October 2018 at the Department of Obstetrics and Gynecology, Sakarya Training and Research Hospital. A total of 315 women were included and categorized according to menopausal type as natural (n = 164), surgical (n = 100), or premature menopause (n = 51). Data were collected using the Menopause-Specific Quality of Life Questionnaire (MENQOL), the Beck Depression Inventory, and the Female Sexual Function Index (FSFI).Results: The mean age of the participants was 50.09 ± 6.26 years. Depression was identified in 23.8% of the women, with no statistically significant difference observed among menopause groups. Although no significant differences were found in total MENQOL scores, vasomotor symptom scores were significantly higher in the surgical menopause group compared with the natural and premature menopause groups (p < 0.05). Total FSFI scores were significantly higher in the premature menopause group than in the other groups, whereas no significant difference was observed between the natural and surgical menopause groups. FSFI subdomain scores for desire and pain did not differ significantly among the three groups (p > 0.05).Conclusions: Differences in quality of life, depression levels, and sexual function were observed across menopausal types, reflecting the influence of menopausal etiology and timing. These findings highlight the need for individualized approaches to improve quality of life, sexual health, and psychological well-being in menopausal women.
Objective: The aim of this study is to investigate the differences between acute cerebrovascular disease (CVD) with COVID-19 and acute cerebrovascular disease (CVD) without COVID-19.Methods: This was a single-center, retrospective study. Using the database of the University of Health Sciences Kanuni Sultan Süleyman Training and Research Hospital, In this study was analyzed 84 cases of CVD with COVID-19 and 56 cases of CVD without COVID-19. Statistical comparisons were performed using the Mann–Whitney U test and Pearson Chi-Square test.Results: There were no significant differences between the two groups in terms of age, gender, or comorbidities (p > 0.05). The rates of large vessel occlusion, ischemic stroke, single lesion, anterior circulation lesion, and left hemisphere lesions were high in both groups. But there were no significant differences between the two groups. However, hemorrhagic stroke, multiple territory involvement, and mortality rates were significantly higher in the CVD with COVID-19 group compared to the CVD-only group (p < 0.05).Urea, BUN, AST, CK, CRP, direct bilirubin, ferritin, neutrophil count and percentage, immunoglobulin percentage, INR, PTsec, immunoglobulin, and troponin T levels were significantly higher (p < 0.05) in the CVD with COVID-19 group. Meanwhile, GFR, Cl, Ca, albumin, RBC, lymphocyte count and percentage, monocyte percentage, basophil count and percentage, and PT% were significantly lower (p < 0.05) in the CVD with COVID-19 group.Conclusions: The findings indicate that COVID-19 may contribute to more severe neurovascular complications and is associated with increased mortality rates.
Objective: Primary hyperparathyroidism (PHPT) has been linked to adverse cardiovascular (CV) remodeling and atherosclerosis. We assessed subclinical CV disease in PHPT using carotid intima-media thickness (CIMT), and serum adrenomedullin (ADM) and pentraxin‑3 (PTX3) concentrations, and explored early changes after parathyroidectomy.Methods: In this case–control study, adults with PHPT (n=40) and healthy controls (n=23) underwent clinical assessment, laboratory testing, and high‑resolution carotid ultrasound. A subset of PHPT patients who had surgery (n=22) were reassessed 3 months post‑parathyroidectomy. Serum ADM and PTX3 were measured by ELISA. Group differences and pre/post comparisons used parametric or non‑parametric tests as appropriate; correlations used Spearman’s rho. Significance was set at p<0.05.Results: Compared with controls, the PHPT group had higher CIMT and PTX3 and lower ADM (p=0.009, p=0.029 and p<0.001, respectively). Post‑parathyroidectomy, ADM increased significantly versus preoperative values (p=0.004), whereas CIMT and PTX3 showed no significant short‑term change (p=0.632 and p=0.547, respectively). Changes in ADM didn’t correlate with CIMT or biochemical variables.Conclusions: PHPT was associated with alterations in CIMT, ADM, and PTX3, suggesting a potential increase in subclinical CV risk. ADM increased 3 months after surgery, while CIMT and PTX3 were unchanged at this early time point. These markers may have potential utility in the assessment of subclinical CV alterations in PHPT; however, their predictive value requires confirmation in larger, adequately powered studies.
Objective: In this study, we aimed to evaluate the potential roles of various biomarkers (serum total thiol, urinary neutrophil gelatinase-associated lipocalin (NGAL) tumor necrosis factor- α (TNF-α), transforming growth factor β (TGF-β) and Vanin-1) in disease staging, determining surgical indications, and postoperative follow-up in pediatric patients diagnosed with congenital ureteropelvic junction obstruction (UPJO).Methods: A prospective study included 64 pediatric patients diagnosed with UPJO between 2019 and 2022. Patients were grouped according to the Society of Fetal Urology (SFU) staging system and treatment plan. Biomarker levels were measured using the ELISA method from serum and urine samples. Preoperative and 6-month postoperative biomarker levels were compared in patients who underwent surgery.Results: Serum total thiol levels were found to be significantly higher in the SFU Grade 4 and surgical groups (p=0.023 and p=0.0339). Urinary NGAL levels also showed a significant increase in the surgical group and patients with advanced stage disease (p=0.0017 and p=0.007). TNF-α and TGF-β levels did not show significant differences between groups. Vanin-1 levels significantly increased after surgery (p=0.008), and the AUC value in ROC analysis was found to be 0.864 (cut-off: 1.15; 100% specificity, 66.7% sensitivity).Conclusions: Serum total thiol and urinary NGAL levels stand out as biomarkers associated with disease severity and surgical necessity, while Vanin-1 may be a potential follow-up tool for assessing the postoperative recovery process. It is considered that these biomarkers should be evaluated as non-invasive tools that can support clinical decisions in diagnosis, treatment, and follow-up processes.
Objective: Malignant melanoma (MM) is an aggressive cancer responsible for 80% of deaths caused by skin cancers. Despite the increase in the incidence of MM in our country, existing studies are limited in number and mostly focus on cutaneous melanomas. The aim of this study is to evaluate the epidemiological and clinicopathological characteristics and survival data of MM patients diagnosed at our clinic and to contribute to the literature.Methods: A total of 157 malignant melanoma cases were retrospectively examined in terms of gender, age, tumor location, histological subtype, lymph node involvement, Clark and Breslow stages, mitotic count, presence of satellite lesions, ulceration, regression, tumour lymphocytic response, metastasis sites, treatment methods applied, and survival.Results: The majority of cases were found to be at an advanced stage and had high tumour thickness. Most histological and clinical parameters showed predominantly high-risk features. Metastasis distribution and overall survival analyses supported the poor prognosis associated with late presentation.Conclusions: In Türkiye, data suggest the incidence of MM is increasing but available studies are limited in number. In this study, we indicate that MM cases in our region are frequently diagnosed at an advanced stage This situation reveals that the society needs to be more aware of malignant melanoma, risk factors and prevention methods. We aimed to describe the epidemiologic, clinicopathologic, and survival characteristics of patients diagnosed with MM and to contribute these data to the literature.
