Non-anastomotic biliary strictures (NAS) represent one of the most challenging complications after living donor liver transplantation (LDLT) and are associated with heterogeneous outcomes following endoscopic retrograde cholangiopancreatography (ERCP). While ERCP is widely accepted as first-line therapy, the impact of stricture localization on endoscopic treatment success remains insufficiently defined. This study aimed to determine whether stricture location, as defined by the Buis classification, predicts ERCP outcomes in patients with NAS after LDLT. In this retrospective single-center study, LDLT recipients who underwent ERCP for post-transplant biliary strictures between January 2020 and January 2025 were evaluated. Among 124 patients with post-transplant biliary strictures, 44 patients (35.5%) with NAS constituted the study cohort and were analyzed separately from patients with anastomotic strictures (n=80). Pre-procedural magnetic resonance cholangiopancreatography was used to classify NAS according to the Buis classification. ERCP technical success, clinical success, recurrence, complications, and the need for percutaneous or surgical interventions were assessed and compared according to Buis-defined stricture locations. Overall ERCP success rates were significantly lower in patients with NAS compared with anastomotic strictures (63.6% vs. 88.7%, p<0.001). Within the NAS cohort, ERCP success varied markedly according to stricture location. Technical success rates were highest in Buis type 1 strictures (94.4%) and progressively declined in type 2 (74.0%), type 3 (40.0%), and type 4 lesions (33.3%) (p<0.001). Strictures involving intrahepatic regions, particularly C and D zones, were associated with significantly lower sustained clinical success and a higher need for adjunctive percutaneous interventions. Percutaneous guidewire-assisted access or biliary drainage was required in 61.3% of patients with intrahepatic involvement compared with 18.2% in extrahepatic-limited disease (p=0.002). Repeat ERCP sessions were more frequent in complex NAS patterns (median 5 vs. 2 sessions, p=0.004). Post-ERCP cholangitis occurred more commonly in NAS patients with multifocal intrahepatic disease (31.8%), whereas rates of pancreatitis (6.8%), bleeding (4.5%), and perforation (0%) remained low and comparable across locations. Sustained clinical success without recurrence was highest in extrahepatic-limited strictures (81.8%) and lowest in diffuse intrahepatic disease (22.2%). Stricture location is a major determinant of ERCP success in non-anastomotic biliary strictures after LDLT. Buis classification–based pre-procedural assessment provides valuable prognostic information and may guide individualized treatment strategy selection. Early consideration of percutaneous approaches in intrahepatic NAS may improve clinical outcomes, reduce repeated ERCP sessions, and minimize procedure-related complications.
The study aimed to evaluate the quality, clinical reliability, and guideline concordance of physician-level educational responses generated by artificial intelligence (AI) in diabetic foot ulcer management. A blinded, comparative analysis was conducted using three widely used large language models—ChatGPT, Gemini, and Claude—which were assessed across twelve standardized clinical questions covering prevention, diagnosis and classification, and treatment. All questions were developed based on an established clinical guideline (International Working Group on the Diabetic Foot, IWGDF). Responses were independently evaluated by six expert raters using predefined criteria, including clinical depth, technical accuracy, decision-making utility, overall quality, and the presence of potentially harmful or misleading information. Guideline concordance was assessed using structured checklists derived from established recommendations. Significant differences were observed among the evaluated models across all domains. Gemini consistently demonstrated higher performance in clinical depth, technical accuracy, decision-making utility, and overall quality, while also showing greater alignment with guideline-based recommendations. ChatGPT and Claude demonstrated comparatively lower scores and a higher tendency to produce responses containing potentially misleading information. Inter-rater reliability analysis indicated moderate to good agreement among evaluators. These findings suggest that, although artificial intelligence systems show considerable potential in generating clinically relevant information, their performance remains variable and may not consistently meet the standards required for high-risk clinical decision-making. Careful evaluation and validation are therefore essential before integrating such systems into routine clinical practice.
Vitiligo is a chronic depigmenting skin disorder that may adversely affect patients' psychosocial well-being because of its visible clinical manifestations. Anxiety and depression have been frequently investigated in patients with vitiligo; however, findings remain inconsistent across different populations. This study aimed to compare anxiety and depression levels between patients with vitiligo and healthy controls. This cross-sectional case–control study included 81 participants comprising 38 patients with vitiligo and 43 age-matched healthy controls. Sociodemographic data were collected using a structured questionnaire. Anxiety and depression were assessed using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Normality was evaluated using the Shapiro–Wilk test. Since continuous variables were not normally distributed, between-group comparisons were performed using the Mann–Whitney U test, while categorical variables were compared using the chi-square test. Statistical significance was defined as p < 0.05. The mean age was 30.05 ± 8.85 years in the vitiligo group and 28.70 ± 7.67 years in the control group (p = 0.528). Female participants accounted for 73.7% of the vitiligo group and 58.1% of the control group (p = 0.217). Median anxiety and depression scores were comparable between groups. Mean anxiety scores were 13.32 ± 10.81 in the vitiligo group and 14.12 ± 11.54 in controls (p = 0.642). Mean depression scores were 13.82 ± 9.55 and 12.00 ± 11.32, respectively (p = 0.149). No statistically significant differences were detected between groups for any psychological outcome. Patients with vitiligo demonstrated anxiety and depression scores comparable to those of healthy controls. Although depression scores were numerically higher in the vitiligo group, the difference was not statistically significant. Larger multicenter studies incorporating disease severity and lesion localization are warranted to further clarify the psychological burden associated with vitiligo.
This study aims to assess the severity of depressive and anxiety symptoms among medical residents in a university hospital and identify the factors associated with these symptoms. We expected depression and anxiety symptoms to be associated with working conditions, workplace relationships, and social functioning. This cross-sectional study included 283 medical residents at a university hospital who participated on a voluntary basis. Data were collected using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and a structured sociodemographic data form designed by the researchers. Significantly higher BDI and BAI scores were associated with female gender (p<0.001) and current use of psychiatric medication (p=0.029 and p=0.027, respectively). Key stressors identified included seeing more than 30 patients per day, finding the number of shifts excessive, and perceived inability to participate in social activities. Furthermore, negative workplace experiences -including exposure to threats, lack of peer support, poor relationships with superiors, and feeling unappreciated- were strongly correlated with increased psychological distress. Other contributing factors were overall workplace dissatisfaction, the desire to specialize in a different field, inadequate physical conditions, and a bleak professional outlook for one’s branch. Suicidal ideation during residency was specifically linked to higher depressive symptom severity (p<0.001). Lower professional experience and lower period of residency showed a significant negative correlation with anxiety scores (r=-0.177, p=0.003 and r=-0.146, p=0.014, respectively). In the adjusted regression models, female gender, fewer years of professional experience, current psychiatric medication use, and limited participation in social activities remained independently associated with higher BDI and BAI scores. These results suggest that severity of depressive and anxiety symptoms among resident physicians are closely related to modifiable occupational and environmental factors. Targeted interventions to improve these conditions are essential to support the mental well-being of physicians in training.
Ustekinumab is an effective biological agent for the treatment of ulcerative colitis (UC); however, real-world data on treatment persistence and factors affecting drug survival in biologic-experienced patients remain limited. This retrospective cohort study aimed to evaluate ustekinumab treatment persistence and identify factors associated with treatment discontinuation in UC patients treated between January 2021 and December 2025. Treatment persistence was defined as the time from treatment initiation to discontinuation and was analyzed using the Kaplan–Meier method. A total of 42 biologic-experienced UC patients were included. The 12-month and 24-month treatment persistence rates were 90.5% and 85.7%, respectively, and 14.3% of patients discontinued treatment during follow-up. Surgical history was significantly associated with higher treatment discontinuation rates (p=0.026), and patients with prior surgery had significantly lower treatment persistence (log-rank p<0.001). Female sex was also associated with lower treatment persistence (log-rank p=0.045). Other clinical variables, including smoking status, disease extent, prior biologic exposure, and extraintestinal manifestations, were not significantly associated with treatment persistence. In conclusion, ustekinumab demonstrates high treatment persistence in biologic-experienced UC patients in real-world practice, and surgical history and female sex may be associated with lower treatment persistence. Larger prospective studies are needed to confirm these findings.
Duloxetine (DX) is used in the treatment of depression, anxiety and diabetic neuropathic pain. However, It also has side effects such as muscle pain, stiffness and cramps. Therefore, this study aimed to investigate the possible effects of duloxetine on contractile parameters of rat uterine smooth muscle in vitro. Sixteen adult female rats were randomly assigned into control (n=8) and DX (n=8) groups. Following ketamine-xylazine anesthesia, rats were sacrificed by cervical dislocation, and uterine tissues were isolated and transferred into Krebs-Henseleit solution. Longitudinal uterine strips (20×3 mm) were mounted in an isolated organ bath (IOB) system. After the equilibration period, DX was administered cumulatively at concentrations of 1.5, 15, 30, and 60 μM, while the control group received equivalent volumes of vehicle. Contractions were also induced with 10⁻⁷ M oxytocin (OXT). Vehicle applications did not produce significant differences between groups overall (p>0.05); however, the highest volume (V4) significantly reduced contraction frequency compared to baseline (p=0.0282). DX (1.5–60 μM) caused a dose-dependent and highly significant inhibition in contraction force, AUC and contraction frequency during spontaneous uterine contractions (p<0.0001). This inhibitory effect was especially prominent at 60 μM, where contraction frequency decreased to 28.45±8.63%. Similarly, DX significantly and dose-dependently inhibited all parameters of OXT-induced contractions (p<0.0001). Partial recovery was observed after the washout period, and no significant differences were detected between groups indicated by the same letter (p>0.05). DX causes a dose-dependent reduction and inhibition in both spontaneous and OXT-induced uterine smooth muscle contractions.
This correspondence discusses the study by Öztop et al. regarding the diagnostic utility of SUVmax in focal FDG-avid thyroid incidentalomas. While the authors identify a significant correlation between metabolic activity and malignancy, the moderate diagnostic performance of SUVmax (AUC: 0.748) suggests limitations as a standalone tool. Furthermore, the reported lack of association between ultrasonographic (US) features and malignancy may be attributed to a constrained sample size. In our larger cohort study, both individual US characteristics and structured risk stratification systems (e.g., EU-TIRADS) demonstrated superior diagnostic accuracy (AUC: 0.901). These findings emphasize that integrating metabolic parameters with standardized morphological assessments provides a more robust framework for clinical decision-making in thyroid incidentalomas.
Candidozyma auris (formerly Candida auris) is an emerging multidrug-resistant fungal pathogen associated with healthcare-associated infections and high mortality. This study evaluated the clinical characteristics, antifungal susceptibility profiles, and risk factors for candidemia and mortality in patients with C. auris isolation. This retrospective cohort study included patients with at least one clinical specimen positive for C. auris between May 2023 and June 2025. Patients were classified as having colonization or infection based on clinical and microbiological criteria. Trend analysis evaluated changes across colonization, non-bloodstream infection, and candidemia, and risk factors for candidemia and mortality were assessed using Firth penalized logistic regression. Forty-nine patients were included (median age, 67 years), of whom 63.3% were in the intensive care unit at the time of isolation. Colonization and infection were identified in 55.1% and 44.9% of patients, respectively, with candidemia being the most common presentation (68.2% of infections). The frequencies of intensive care unit stay, central venous catheter use, and total parenteral nutrition increased significantly from colonization to candidemia (p for trend <0.05). In multivariable analysis, intensive care unit stay (aOR 4.2, p=0.03) and total parenteral nutrition (aOR 6.9, p=0.04) were independently associated with candidemia. All isolates were resistant to fluconazole, echinocandins showed high in vitro activity, and amphotericin B MICs were ≥2 μg/mL in 64.3% of isolates. Overall, in-hospital mortality was 46.9%. Charlson Comorbidity Index, total parenteral nutrition, and clinically significant infection were independently associated with in-hospital mortality.
We read with interest the study by Öztürk et al. evaluating the performance of ultrasound risk stratification systems in focal FDG-avid thyroid incidentalomas. While TIRADS-based systems have shown high diagnostic performance, the SUVmax cut-off value and negative predictive value reported in their study closely align with our findings. This suggests that SUVmax offers consistent and complementary metabolic risk information across different centers. We believe that SUVmax and ultrasound-based risk stratification systems should not be seen as competing tools but rather as mutually supportive elements of a comprehensive clinical decision-making strategy.
Valproik asit ensefalopatisi, ensefalopati etiyolojisinde nadir bir tablo olup VA tedavisi sırasında gelişen bilinç değişikliği, kognitif yavaşlama, fokal nörolojik defisitler ve epileptik hastada paradoksal nöbet artışı ile karakterizedir. Hiperamonyemik(en sık), non-hiperamonyemik ve hepatotoksisite ilişkili olabilir. Serum valproat düzeyleri yüksek veya terapötik aralıkta olabilir. EEG’de zemin aktivitesinde diffüz yavaşlama ve trifazik dalgalar yardımcıdır. Vakamızda, valproat kullanan ve belirgin metabolik veya hepatik predispozan faktörleri olmaksızın nöbet artışı ve ensefalopati geliştiren bir şizofreni hastası yer almaktadır. Serum valproik asit düzeyleri terapötik aralıkta olmasına rağmen, EEG'de zemin aktivitesinde diffüz yavaşlama ile birlikte ağır ensefalopati saptanmış ve yüksek serum amonyak düzeyleri ile tanıya gidilmiştir. Semptomlar valproat kesilmesi ve L-karnitin tedavisi düzelmiştir. Psikiatrik hasta grubunda bulguların ensefalopati ile ayırt edilmesi gerekliliği ve erken tanı tedavi ile geri dönüşümlü olması kritiktir.
This study evaluated the mechanisms, clinical characteristics, and outcomes of ocular injuries associated with carbonated mineral water bottles. Twenty patients presenting with bottle-related ocular trauma at a tertiary referral center were retrospectively reviewed. Demographic features, injury mechanisms, ocular findings, management strategies, and visual outcomes were analyzed. The mean age was 37.2 ± 17.4 years, and most patients were male (75%). Injuries were predominantly caused by high-velocity bottle cap impact during opening (80%), whereas the remaining cases resulted from bottle explosion after impact (20%). Bottle cap injuries were consistently associated with closed-globe trauma, while bottle explosions caused open-globe trauma in most cases. The left eye was more commonly affected (65%), particularly in bottle cap–related trauma. At presentation, 55% of eyes had a best-corrected visual acuity of ≥20/40, increasing to 65% at final follow-up. Hyphema and traumatic cataract were the most frequent anterior segment findings, whereas commotio retinae was the most common posterior segment pathology. Most patients were managed conservatively with medical treatment, while a smaller proportion required retinal laser or surgical intervention. Although visual outcomes were generally favorable, severe injuries could occur, especially following the bottle explosion. Carbonated mineral water bottle–related ocular trauma represents an under recognized yet preventable cause of eye injury, and increased public awareness together with simple safety precautions may help reduce these avoidable accidents.
The aim of this study was to investigate the relationship between migraine characteristics, sleep quality, and insomnia severity using a hierarchical approach. A total of 50 patients diagnosed with migraine according to ICHD-3 criteria were prospectively evaluated using the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Headache Impact Test (HIT-6), and Beck Depression and Anxiety Inventories. The cohort exhibited a significant sleep burden, with 70% of participants classified as poor sleepers and 68% reporting morning headaches. Hierarchical linear regression analysis was performed in two steps; Model 1, including pain intensity (VAS) and disability (HIT-6), explained 22% of the variance in insomnia (R2=0.22, p=0,003). The addition of depressive and anxiety symptoms in Model 2 significantly increased the explained variance to 54% (ΔR²=0.32, p<0.001). Notably, in the final model, headache-related clinical parameters lost their significance, while depressive symptoms emerged as the strongest independent predictor of insomnia severity. Chronic migraineurs showed significantly higher insomnia and depression scores compared to episodic patients. These findings suggest that the relationship between migraine and sleep disturbances is predominantly driven by comorbid affective distress rather than pain characteristics alone. In conclusion, a multidisciplinary approach integrating psychological screening and mood stabilization is essential for effectively managing insomnia in the migraine population.
Cavum septum pellucidum (CSP), cavum vergae (CV), cavum veli interpositi (CVI), and interthalamic adhesion (IA) are midline developmental variants and their associations with psychiatric disorders are unclear. Our study aimed to compare the prevalence of these four structures and the dimensional features of CSP in bipolar disorder (BD), major depression (MD), and obsessive-compulsive disorder (OCD) with healthy controls (HC) under a single MRI protocol. A total of 454 adults with 1.5T brain MRI were examined retrospectively. CSP length ≤6 mm was classified as “small,” >6 mm as “large”; the presence of CV, CVI, and IA was evaluated by two blinded radiologists. When all participants (patients and healthy controls) were considered together, CSP prevalence was 61.5%. “Large” CSP was observed only in clinical groups (BD 23.8%; MD 38.1%; OCD 38.1%). CVI was found in 37.4% of OCD and 29.9% of MD patients, showing a significant increase compared to 10.5% in HC (p
Frailty has emerged as a critical determinant of outcomes among older adults presenting to the emergency department (ED). However, limited evidence exists regarding the comparative prognostic performance of commonly used frailty screening tools. This study aimed to evaluate and compare the predictive accuracy of the Edmonton Frailty Scale (EFS), Identification of Seniors at Risk (ISAR), and PRISMA-7 for short-term mortality in the ED setting. This prospective observational study included patients aged ≥65 years admitted to a tertiary ED between January and July 2022. Frailty was assessed at admission using EFS, ISAR, and PRISMA-7. The primary outcome was 30-day all-cause mortality. Group comparisons were performed with Mann–Whitney U and chi-square tests. Prognostic accuracy was evaluated using receiver operating characteristic (ROC) curves, and optimal cut-offs were defined with the Youden Index. Among 103 patients (mean age 73.9±7.2 years), 16 (15.5%) died within 30 days. Non-survivors had higher frailty scores on all tools (EFS 11 vs. 7; ISAR 4 vs. 3; PRISMA-7 5 vs. 3; all p≤0.001). AUC values were 0.811 for EFS, 0.765 for ISAR, and 0.754 for PRISMA-7. At a cut-off of >7, EFS showed 100% sensitivity, while ISAR and PRISMA-7 provided a more balanced sensitivity–specificity profile. Frailty screening with EFS, ISAR, or PRISMA-7 yields valuable prognostic information in older ED patients. EFS offers maximal sensitivity, whereas ISAR and PRISMA-7 achieve greater balance, supporting complementary use in practice.
Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure in the absence of secondary causes and is most commonly associated with headache and visual disturbances. The aim of this study was to investigate the demographic and clinical characteristics, headache phenotypes, associated symptoms, and neuroimaging findings of patients with IIH. This retrospective observational study included 80 patients diagnosed with IIH between 2020 and 2025. Clinical information including headache characteristics, associated symptoms, cerebrospinal fluid opening pressure, and magnetic resonance imaging (MRI) findings was obtained from medical records. Migraine-like headache was defined by using the International Classification of Headache Disorders, 3rd edition (ICHD-3). The majority of patients were women (78.8%), and the median age at diagnosis was 38 years. Headache was the most frequent presenting symptom (87.5%), followed by transient visual obscurations (70.0%) and pulsatile tinnitus (46.3%). Migraine-like headache was identified in 37.1% of patients with headache. Typical MRI findings of IIH—including empty or partially empty sella, perioptic subarachnoid space distension, optic nerve tortuosity, and transverse sinus stenosis—were observed at varying frequencies. Acetazolamide was prescribed to all patients, while topiramate was used in approximately one-third; surgical interventions were required in a minority of cases. The findings of this study underscore the heterogeneous clinical presentation of IIH, with substantial overlap between IIH-related and migraine-like headache phenotypes. Recognition of these clinical features, together with supportive neuroimaging findings, may facilitate earlier diagnosis and reduce misclassification with primary headache disorders.
The differential diagnosis between pleural epithelioid mesothelioma and peripheral lung adenocarcinoma remains a significant diagnostic challenge for pathologists. This study aimed to evaluate the diagnostic efficacy of a multi-antibody immunohistochemical (IHC) panel comprising Napsin A, Caveolin-1, Type III Collagen, and Tenascin-X. While Napsin A and Caveolin-1 are established markers, the diagnostic utility of Tenascin-X and Type III Collagen remains less explored in the current literature. A retrospective IHC analysis was performed on 70 paraffin-embedded tissue blocks, comprising 35 lung adenocarcinomas and 35 epithelioid mesotheliomas, diagnosed between 2005 and 2014. The expression patterns of Napsin A, Caveolin-1, Type III Collagen, and Tenascin-X were evaluated and compared between the two groups. Napsin A showed high sensitivity for adenocarcinoma (94.3%) with minimal expression in mesothelioma (2.9%). Conversely, Caveolin-1 and Tenascin-X emerged as strong markers for mesothelioma, with positivity rates of 97.2% and 88.6%, respectively (p < 0.001). Although Type III Collagen was exclusively expressed in mesothelioma (17.1%) and absent in all adenocarcinoma cases, its low sensitivity limits its standalone utility. Significant statistical differences were observed between the two tumor types for all markers evaluated. Our findings suggest that a panel including Napsin A, Caveolin-1, and Tenascin-X significantly aids in the differential diagnosis of lung adenocarcinoma and epithelioid mesothelioma. While Tenascin-X provides valuable supplementary data, the clinical application of Type III Collagen is constrained by its low sensitivity. Integrating these markers into diagnostic protocols can enhance diagnostic accuracy, though further validation in larger cohorts is recommended.
To evaluate perioperative antibiotic prophylaxis (PAP) practices and factors associated with prolonged postoperative antibiotic use among urologists and general surgeons in Türkiye. This cross-sectional questionnaire-based study was conducted among actively practicing urologists and general surgeons in Türkiye between April-May 2026. The survey evaluated demographic characteristics, PAP preferences, postoperative antibiotic use patterns, institutional protocol adherence, and factors associated with prolonged prophylaxis. Prolonged postoperative antibiotic use was defined as antibiotic continuation beyond 24 hours. Comparisons between specialties were performed, and logistic regression analysis was used to identify independent predictors of prolonged antibiotic use. A total of 102 surgeons participated in the study, including 52 urologists and 50 general surgeons. First-generation cephalosporins were the most commonly preferred prophylactic antibiotics (49%). Although 66.7% of participants reported preferring a single-dose PAP strategy, 45.1% continued postoperative antibiotics beyond 24 hours in actual clinical practice, and 19.6% prescribed oral antibiotics at discharge. Fear of infection (43.1%), institutional habits (19.6%), and medicolegal concerns (17.6%) were the leading perceived reasons for prolonged antibiotic use. Urologists more frequently preferred third-generation cephalosporins, prolonged postoperative antibiotic use, and discharge oral antibiotics (all p
Diabetic nephropathy (DN) is a major microvascular complication requiring early markers for risk stratification. We investigated the clinical utility of the uric acid (UA) to high density lipoprotein cholesterol (HDL-C) ratio (UHR) as a practical proinflammatory-prooxidative marker for DN. In this retrospective cross-sectional study, records of 934 patients with diabetes mellitus (DM) were analyzed. UHR was calculated as [UA/HDL] x 100. DN was defined based on the albumin-to-creatinine ratio (ACR) and/or estimated glomerular filtration rate (eGFR) criteria. Patients were evaluated according to the presence of nephropathy, stage of nephropathy, and albuminuria categories. ROC analysis was performed for UHR, UA and HDL-C. Factors associated with DN were evaluated using logistic regression analysis. UHR was significantly higher in patients with DN compared to those without DN (p
The most common skin cancer, basal cell carcinoma (BCC), has the most common subtypes: adenoid, nodular, and superficial. The androgen receptor (AR) gene, thought to have a potential oncogenic role, is a member of the steroid hormone receptor family and is localized on the X chromosome. Our study aimed to evaluate androgen expression in nodular, superficial, and adenoid BCC subtypes. This study included 60 cases diagnosed with adenoid, nodular, and superficial BCC subtypes at the Department of Pathology at Balıkesir University. AR immunohistochemical expression was evaluated by light microscopy using staining ratios. Positive cells were assigned to one of four groups based on their staining ratios: Group 1: (0-4%), Group 2: (5-29%), Group 3: (30-59%), and Group 4: (60-100%). A significant difference was found between the BCC subtypes in terms of AR expression (%) distribution, and this difference was highly statistically significant (p
Acromegaly is a chronic disease that can cause somatic disfigurement and hormonal changes. The aim of this study was to examine depression and anxiety levels, body image and sexual dysfunctions in patients with acromegaly and to compare them with those of controls. 52 patients with acromegaly who were being followed up at the Endocrinology Outpatient Clinic and 51 non-acromegalic individuals were included. The participants were evaluated cross-sectionally once and evaluated with the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Body Image Scale (BIS) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). The GRISS total, infrequency, dissatisfaction, impotence and premature ejaculation subdimension scores of the acromegaly patients were found to be significantly higher than those of the controls. Sexual dysfunctions were associated with older age, female sex, unemployment, menopausal status, and the presence of concomitant diabetes mellitus. No meaningful differences were detected in depression or anxiety scores between patients and controls. Body image was significantly more impaired in patients with acromegaly and was associated with higher depression and anxiety scores. There was no difference between scale scores according to disease activity. Although inverse correlations were observed between GRISS total scores and IGF-1 and free T4 levels in univariate analyses, IGF-1 was not independently associated with sexual dysfunction after adjustment for relevant clinical covariates. In conclusion, considering that patients with acromegaly are a risky group in terms of mental disorders and sexual dysfunctions, we recommend that patients should be routinely questioned in terms of psychopathology and sexual functions during their follow-up.
