Aim: Despite advances in early detection and surgical de-escalation strategies in breast cancer, accurately predicting sentinel lymph node involvement (SLNI) among patients with T1 disease remains a clinical challenge, particularly in those with unfavorable histologic subtypes. In this context, this study aimed to examine clinical factors related to pathological SLNI among patients with T1 early-stage breast cancer (ESBC) and unfavorable histologic subtypes. Methods: This retrospective analysis included 128 patients with clinically node-negative T1 ESBC and unfavorable histology who underwent surgery between January 2010 and December 2020. Clinicopathological and preoperative laboratory parameters were analyzed. To identify the independent risk factors associated with SLNI, logistic regression analyses were performed. Results: Thirty-six (28.1%) patients were SLNI-positive, and 92 (71.9%) were SLNI-negative. In univariate analysis, the presence of lymph nodes with a thickened cortex on preoperative ultrasonography (p=0.016), lymphovascular invasion (LVI) (p=0.002), larger tumor size (p=0.002), and higher neutrophil levels (p=0.046) were significantly associated with SLNI positivity. SLNI-positive patients also demonstrated significantly lower serum albumin levels (p=0.002), while monocyte levels exhibited a tendency toward lower values (p=0.064). In multivariate analysis, serum albumin levels (p=0.015), neutrophil count (p=0.031), monocyte count (p=0.035), and LVI (p=0.040) remained independently associated with SLNI. Conclusion: Selected clinicopathological and inflammatory parameters were independently associated with SLNI in patients with T1 ESBC and unfavorable histology and may help identify patients at higher risk of nodal involvement.
Aim: Iron deficiency anemia remains a common global health problem, particularly affecting women owing to reproductive and nutritional factors. This study aims to assess the use of iron preparations, their side-effect profiles, and their impact on treatment adherence among women in T & uuml;rkiye. Methods: This study was designed as a cross-sectional analytical study between October 1 and November 30, 2023. A total of 270 female patients receiving iron replacement therapy for at least one month were included in the study. A structured 20-item questionnaire was used to collect data on demographic characteristics, iron preparations, side effects, and treatment adherence. Data were analyzed using descriptive statistics, chi-square tests, t-tests, and binary logistic regression to identify predictors of treatment discontinuation. Results: Nausea was the most frequently reported cause of medication discontinuation (84.0%) and of switching (73.4%). Iron (III) polymaltose complex was associated with the highest rates of side effects (55.6% reported dyspeptic complaints) and treatment discontinuation (88.9%). The tablet formulation substantially increased the risk of treatment discontinuation by approximately ninefold overall and by about 5.6 fold due to side effects. Each additional year of age increased the odds of discontinuation by 10.4% (odds ratio 1.104; 95% confidence interval 1.062-1.146; p<0.001). Non pregnant women experienced higher rates of side effects, treatment discontinuation (47.2% vs. 30.9%), and medication changes (38.9% vs. 25.3%) than pregnant women (p=0,007; p=0.018). Conclusion: These findings support the need for personalized treatment strategies that consider factors such as age, pregnancy status, and formulation type to improve adherence and minimize treatment discontinuation.
Aim: Endometrial hyperplasia, particularly when accompanied by atypia, is considered a well-established precursor of endometrial carcinoma. Yes-associated protein 1 (YAP1), a key effector of the Hippo signaling pathway, plays a crucial role in the regulation of cell proliferation, apoptosis, and tissue homeostasis and has been implicated in tumorigenesis. The present study aimed to investigate whether YAP1 protein expression in endometrial hyperplasia with and without atypia differs from that in normal endometrial tissue. Methods: This retrospective observational case-control study included 122 patients: 41 cases of endometrial hyperplasia with atypia, 41 cases of endometrial hyperplasia without atypia, and 40 controls with normal endometrial histology. Immunohistochemical analysis was performed on formalin-fixed, paraffin-embedded tissue sections using a YAP1 polyclonal antibody. Staining localization (nuclear and/or cytoplasmic), intensity, and distribution were evaluated semi-quantitatively. Statistical comparisons among the three groups were performed using parametric or nonparametric tests according to the distribution characteristics of the variables. Results: No statistically significant differences were observed among the study groups in terms of YAP1 staining localization, intensity, or distribution. Both nuclear and cytoplasmic expression patterns were comparable in endometrial hyperplasia with and without atypia and in control tissues. Conclusion: Yes-associated protein 1 protein expression did not differ significantly between precancerous endometrial lesions and normal endometrium. These findings suggest that YAP1 activation may represent a later molecular event in endometrial carcinogenesis rather than an early alteration during precursor stages. Further prospective studies integrating molecular and functional analyses are warranted to clarify the precise role of YAP1 in the progression from benign to malignant endometrial pathology.
Aim: Hospital security staff encounter specific occupational stressors, such as irregular work hours, exposure to violence, and crises, but research on their mental health remains limited. This study aimed to examine the association between psychological symptom severity and sleep quality, job satisfaction, work schedule, and psychiatric history among hospital security personnel. Methods: A cross-sectional study was performed with 115 hospital security personnel from May 1, 2025, to July 1, 2025. All security workers completed structured questionnaires. The assessment tools included the Minnesota Satisfaction Questionnaire, the Pittsburgh Sleep Quality Index, and the Symptom Checklist-90-Revised (SCL-90-R). Participants’ sociodemographic data were recorded. Spearman correlation analysis was used to examine associations between continuous variables. Multiple linear regression analysis was performed to determine variables that were independently associated with SCL-90-R scores. Results: Significant differences in psychological symptoms were not found across demographic groups, work schedules, or psychiatric history. Correlation analysis revealed a significant negative association between job satisfaction and psychological distress (r=-0.253, p=0.006). Multiple linear regression analysis demonstrated that job satisfaction was independently associated with SCL-90-R scores (B=-0.004, 95% confidence interval: -0.007 to -0.001, p=0.031), whereas sleep quality (p=0.310), age (p=0.299), gender (p=0.130), and work schedule (p=0.965) showed no statistically significant association. Sleep quality, age, gender, work schedule, and other variables showed no significant predictive value. Conclusion: Job satisfaction was the only variable independently associated with psychological well-being among hospital security personnel, independent of traditional occupational stressors such as shift work and sleep quality. These findings suggest that organizational interventions targeting job satisfaction may be associated with improved mental health outcomes in this population.
Aim: Considering that systemic inflammatory indicators may insufficiently represent localized gastric inflammation in juvenile populations, chronic Helicobacter pylori(H. pylori) infection is associated with persistent gastric inflammation, which may influence systemic inflammatory parameters in children. This study aimed to investigate whether the C-reactive protein/albumin ratio (CAR) was associated with the severity of histopathological gastritis and H. pyloricolonization density in H. pylori-positive children. Methods: This retrospective cross-sectional study included 121 children aged 1-18 years who underwent upper gastrointestinal endoscopy for dyspeptic symptoms and were diagnosed with H. pyloriinfection. Gastritis severity, activity, and H. pylori colonization density were graded according to the modified Sydney classification system. The association between the CAR and histopathological parameters was analyzed. Results: The study included 121 pediatric patients (mean age +/- standard deviation: 14.49 +/- 2.83 years), of whom 66% were female. No statistically significant association was observed between the CAR and chronic gastric inflammation grade, gastric inflammatory activity grade, or H. pylori colonization density grade (p=0.735, p=0.287, and p=0.318, respectively). Although the median CAR was higher in patients with severe H. pylori colonization than in those with mild or moderate colonization, this difference did not reach statistical significance (p=0.744). Conclusion: The findings indicate that the CAR is not associated with histopathological severity or colonization density of H. pylori in children and does not reflect the histopathological severity in pediatric H. pylori gastritis.
