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SUMMARY OBJECTIVE: Seborrheic dermatitis is a common papulosquamous skin disease with unknown pathogenesis. The aim of our study was to determine the serum level of 25-hydroxy vitamin D in patients with seborrheic dermatitis SD. METHODS: A total of 53 patients and 60 healthy controls were included in the study. Serum vitamin D, calcium, phosphorus, and parathormone levels were measured in the patient and control groups, and a comparison was made between the two groups regarding these parameters. RESULTS: Severe vitamin D deficiency was more frequent among patients with seborrheic dermatitisSD compared to controls (52.8 vs. 25.8%, p=0.003). In patients with severe vitamin D deficiency, seborrheic dermatitis SD was detected more frequently at an early age (p=0048) and in women (p=0.015). No correlation was found between the seborrheic dermatitis skin involvement site and vitamin D level. CONCLUSION: The fact that vitamin D levels decreased in patients with seborrheic dermatitis SD and patients with severe vitamin D deficiency develop seborrheic dermatitis SD earlier suggests that the low levels of vitamin D are related to seborrheic dermatitis.

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SUMMARY OBJECTIVE: The objective of this study was to examine the effects of orlistat use on metabolic control and weight loss in diabetic and nondiabetic patients. METHODS: A total of 119 patients with body mass index≥40 kg/m2 and receiving orlistat therapy, who applied to the Endocrinology polyclinic between January 2016 and October 2019, were included. The patients’ weight changes and biochemical values (i.e., fasting glucose, HbA1c, ALT, creatinine, and lipid parameters) were evaluated at the drug beginning and the last polyclinic control. The patients were divided into groups, whether they had diabetes or used metformin, and compared. RESULTS: The mean age of the 119 patients in the study was 45.3±11.5 years. A total of 94.1% of the patients were females and 5.9% were males. A total of 38.7% of the patients had diabetes and 29.4% had prediabetes. When the patients were compared to whether they had diabetes or used metformin, there was a statistically significant difference between the groups according to weight loss. The mean weight change of patients without diabetes and receiving metformin and orlistat was statistically significantly higher than that of patients with diabetes and receiving metformin and orlistat. DISCUSSION: It was determined that the weight loss effect of orlistat in obesity was seen in all groups, but this effect decreased in the diabetic group.

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SUMMARY OBJECTIVE: Fibromyalgia is one of the most important problems, especially for women. Studies point to disorders in the sexual functions of fibromyalgia patients that reduce their quality of life. The aim of this study was to investigate sexual dysfunction and its relationship with disease severity and depression in women with fibromyalgia. METHODS: This study included 98 female patients diagnosed with fibromyalgia and 54 healthy women. The Female Sexual Function Index was used to assess sexual dysfunction. Fibromyalgia disease severity was measured with the Fibromyalgia Impact Questionnaire. Hamilton Depression Scale was filled in to evaluate the depression status of the patients. RESULTS: According to the female sexual function index data, female sexual dysfunction was found in 78 (79.6%) patients with fibromyalgia and only in 12 (22.2%) controls. When the female sexual function index scores of fibromyalgia patients with and without depression were compared, patients with additional depression had lower female sexual function index scores, and this difference was statistically significant (p=0.002). In the correlation analysis, the female sexual function index score showed a significant negative correlation with the hamilton depression scale (rho=-0.235, p=0.020) and fibromyalgia impact questionnaire (rho=-0.215, p=0.033) scores. CONCLUSION: This study highlights the high prevalence of sexual dysfunction in female fibromyalgia patients and the significant correlation between sexual dysfunction and both disease severity and depression.

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SUMMARY OBJECTIVE: The aim of our study was to compare the traditional radial artery, distal radial artery, and transfemoral artery, which are vascular access sites for coronary angiography, in terms of pain level using the visual analog scale. METHODS: Between April 2021 and May 2022, consecutive patients from three centers were included in our study. A total of 540 patients, 180 from each of the traditional radial artery, distal radial artery , and transfemoral artery groups, were included. The visual analog scale was applied to the patients as soon as they were taken to bed. RESULTS: When the visual analog scale was compared between the groups, it was found to be significantly different (transfemoral artery: 2.7±1.6, traditional radial artery: 3.9±1.9, and distal radial artery: 4.9±2.1, respectively, p<0.001). When the patients were classified as mild, moderate, and severe based on the visual analog scale score, a significant difference was found between the groups in terms of body mass index, process time, access time, and number of punctures (p<0.001). Based on the receiver operating characteristic analysis, body mass index>29.8 kg/m2 predicted severe pain with 72.5% sensitivity and 73.2% specificity [(area under the curve: 0.770, 95%CI: 0.724–0.815, p<0.0001)]. CONCLUSION: In our study, we found that the femoral approach caused less access site pain and a high body mass index predicts severe pain.

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SUMMARY OBJECTIVE: The aim of the study was to research the video-based digital platforms that orthopedic specialists in Turkey use as an educational resource in their surgical preparations that they have not seen or done before, the frequency of their use of these platforms, and their trust in these platforms, with a survey study. METHODS: The importance of video-based digital platforms in surgical preparations that surgeons have not seen or done before was measured using the data obtained from 181 orthopedic specialists using a survey prepared on an Internet-based server (docs.google.com). RESULTS: Orthopedists used video-based digital platforms with a ratio of 38.7% among the educational resources in their surgical preparations that they have not seen or done before. There was no significant difference between the specialists with a surgical experience of 1–10 years and more than 10 years of experience in terms of using video-based digital platforms in surgical preparation (p>0.05). A total of 81.2% of the participants used only video-based digital platforms in the preparation of a surgical procedure they have never seen before. The most frequently used digital platform was YouTube, and 62% of the participants considered these platforms reliable. CONCLUSION: Orthopedic specialists in Turkey primarily and frequently use video-based digital platforms as a training resource in their preparations for surgery that they have not seen or done before. The establishment or support of platforms with evidence-based content with references from official orthopedic institutions and organizations can increase the trust of orthopedic specialists in these platforms.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the opinions of female academicians about oocyte freezing. METHODS: This qualitative study included 12 single academic women who had not yet entered menopause, did not have children, and were continuing their doctoral education in Istanbul, Turkey, between August and September 2022. Data were collected with semi-structured interviews and evaluated by content analysis. RESULTS: Three main themes were “Difficulty of fertility in academics,” “Advantages of oocyte freezing,” and “Concerns about oocyte freezing.” Participants mostly had positive attitudes about the advantages of oocyte cryopreservation, but they had concerns about pregnancies obtained with frozen oocytes. CONCLUSION: The academic women attributed fertility as an obstacle to their career and experienced anxiety about fertility. They were aware of the advantages of oocyte cryopreservation; however, they defined the pregnancy with oocyte freezing as artificial.

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SUMMARY OBJECTIVE: Sclerostin is a protein produced by osteocytes, kidneys, and vascular cells and has many effects on kidney and vascular structures. Soluble TNF-related weak inducer of apoptosis is a proinflammatory cytokine that may cause glomerular and tubular injury and increase sclerostin expression. This study aimed to investigate serum sclerostin and soluble TNF-related weak inducer of apoptosis levels in patients with glomerulonephritis and the effects they may be associated with. METHODS: This cross-sectional study included 93 patients, 63 of whom were glomerulonephritis and 30 were healthy controls. Serum sclerostin, soluble TNF-related weak inducer of apoptosis, and 24-h urinary protein excretion were measured, and pulse wave velocity was calculated for arterial stiffness. RESULTS: Serum sclerostin and soluble TNF-related weak inducer of apoptosis were higher in glomerulonephritis patients than in the control group, and serum sclerostin and soluble TNF-related weak inducer of apoptosis levels were correlated with both proteinuria and pulse wave velocity. In addition, in the regression analysis, serum sclerostin and soluble TNF-related weak inducer of apoptosis levels were found to be independent predictors of proteinuria in patients with glomerulonephritis. CONCLUSION: This is the first study to show that serum sclerostin and soluble TNF-related weak inducer of apoptosis are elevated in glomerulonephritis patients, and these two markers correlate with arterial stiffness and proteinuria in these patients. Considering the effects of sclerostin and soluble TNF-related weak inducer of apoptosis in patients with glomerulonephritis, we think these mechanisms will be the target of both diagnosis and new therapies.

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SUMMARY OBJECTIVE: This study was carried out to investigate the differentiation of mucinous borderline ovarian tumor from mucinous ovarian carcinoma using magnetic resonance imaging. METHODS: We evaluated 77 women patients who underwent abdominal magnetic resonance imaging due to pelvic mass. magnetic resonance imaging was reviewed by an experienced radiologist. A total of 70 women patients were included in the study. The magnetic resonance imaging features were retrospectively evaluated and compared between the two pathologies. RESULTS: There was no difference between the two groups in terms of maximum tumor size. Age at diagnosis was 56.29±11.92 in the mucinous ovarian carcinoma group and 44.74±13.60 in the mucinous borderline ovarian tumor group (p<0.05). A significant difference was found between the two groups, and it was observed that mucinous borderline ovarian tumors appeared in the younger age group compared to mucinous ovarian carcinomas. Presence of ascites, peritoneal dissemination, lymphadenopathy, and mural nodules was found significantly more frequently in mucinous ovarian carcinomas than in mucinous borderline ovarian tumors. Honeycomb appearance was found more frequently in mucinous borderline ovarian tumor patients than in mucinous ovarian carcinoma patients. CONCLUSION: magnetic resonance imaging findings of these two pathologies overlapped considerably. Compared with mucinous borderline ovarian tumors, mucinous ovarian carcinomas frequently had mural nodules larger than 5 mm, larger tumor size, peritoneal dissemination, and abnormal ascites.

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SUMMARY OBJECTIVE: The aim of this study was to examine the impact of symptom-based screening on the prevalence and outcomes of neonatal coronavirus disease 2019 in pregnant women admitted for delivery. METHODS: A retrospective observational study was conducted from June to August 2020 at Gonzaga Mota of Messejana Hospital, Fortaleza, CE, Brazil. All pregnant women were screened for coronavirus disease 2019 based on symptoms. Reverse transcription-polymerase chain reaction or immunology assays for severe acute respiratory syndrome coronavirus 2 were performed when a patient reported a symptom. All newborns of symptomatic patients were submitted for Reverse transcription-polymerase chain reaction. Newborns were divided into groups according to the Reverse transcription-polymerase chain reaction results to identify the relationship between maternal symptoms and neonatal coronavirus disease 2019. RESULTS: A total of 55 (55/1,026, 5.4%) and 50 (50/1,026, 4.8%) pregnant women reported symptoms and had a positive confirmatory test, respectively. The most common symptom of coronavirus disease 2019 among the pregnant women with positive confirmatory test was cough (n=23, 46%). Seven newborns (7/50, 14%) of symptomatic mothers had positive Reverse transcription-polymerase chain reaction. Upon birth, no newborn had serious complications. CONCLUSION: Universal screening of pregnant women admitted for delivery can reduce the perinatal transmission of coronavirus disease 2019. Symptom-based screening can be an alternative for regions with a low prevalence of the disease where a better allocation of financial resources is necessary.

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SUMMARY OBJECTIVE: In our study, it was aimed to compare the power of trauma scores (Glasgow Coma Score, Revised Trauma Score, Abbreviated Injury Scale, Injury Severity Score, and Trauma Score-Injury Severity Score) in order to predict mortality in patients with geriatric trauma and to determine the predictive values of these scores in mortality. METHODS: Demographic data, clinical features, etiological causes, laboratory results, and trauma scores of the patients were statistically analyzed. SPSS 20 for Windows was used for this evaluation. RESULTS: It was determined that as the Glasgow Coma Score value of the patients increased, the Abbreviated Injury Scale and Injury Severity Score scores decreased and the Trauma Score-Injury Severity Score score increased. Abbreviated Injury Scale and Injury Severity Score values increased and Revised Trauma Score and Trauma Score-Injury Severity Score values decreased as the lactate levels of the patients increased. It was determined that the Abbreviated Injury Scale and Injury Severity Score scores of the patients hospitalized in the intensive care unit were significantly higher, while their Trauma Score-Injury Severity Score scores were lower. CONCLUSION: Glasgow Coma Score, Revised Trauma Score, Trauma Score-Injury Severity Score, Abbreviated Injury Scale, and Injury Severity Score scores and blood lactate levels are important parameters that can be used in the emergency department for the early detection of high-risk patients in geriatric trauma and the evaluation of the prognosis of geriatric trauma patients.

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SUMMARY OBJECTIVE: The aim of this study was to assess the effect of lymphovascular space invasion on recurrence and disease-free survival in patients with low-risk endometrial cancer. METHODS: The study included patients with stage 1A, grade 1–2 endometrioid endometrial cancer who underwent a total hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Independent prognostic predictors of endometrial cancer recurrence were assessed using the Cox regression model. Binary logistic regression analysis was used to identify the predictors of distant recurrence. Kaplan-Meier analysis was used to describe survival curves, and the log-rank test was used to compare the differences in survival curves. RESULTS: A total of 189 patients met the inclusion criteria, of whom 24 (12.7%) had lymphovascular space invasion. The median follow-up time was 60 (3–137) months. Distant recurrence was present in 11 of 22 patients who developed recurrence. Kaplan-Meier survival analysis showed that the 5-year disease-free survival rates of patients with lymphovascular space invasion(+) and lymphovascular space invasion(-) were 62.5 and 91.9%, respectively, which were significantly lower (p<0.001). In multivariate Cox regression analysis, the presence of lymphovascular space invasion (p<0.001) and age ≥60 years (p=0.017) remained as prognostic factors for reduced disease-free survival. In binary logistic regression analysis, only lymphovascular space invasion (adjusted OR=13, 95%CI=1.456–116.092, p=0.022) was a prognostic factor for distant recurrence. CONCLUSION: lymphovascular space invasion is a prognostic risk factor for recurrence and distant metastasis and also a predictor of poorer disease-free survival outcomes in low-risk endometrial cancer.

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SUMMARY OBJECTIVE: Our goal was to contrast the prognoses of patients with endometrial cancer who had adenomyosis against those that did not. METHODS: All patients who had received surgical staging for hysterectomy-based endometrial cancer had their medical data retrospectively examined. The analysis covered 397 patients, who were split into two groups depending on the presence of adenomyosis. Comparisons were made between patients covering type of surgery, histopathology, endometrial cancer stage, lymphovascular space invasion, presence of biochemical or histochemical markers, adjuvant therapy, presence of adenomyosis in the myometrial wall, and outcomes in terms of overall survival and disease-free survival. RESULTS: There is no statistically significant difference in the 5-year disease-free survival or overall survival rates between endometrial cancer patients with and without adenomyosis. This is based on comparisons of tumor stage, tumor diameter, histological type and grade of tumor, myometrial invasion, lymphovascular space invasion, and biochemical markers that affect the course of the disease. The median follow-up times were 61 months for the adenomyosis-positive group and 56 months for the group without adenomyosis. CONCLUSION: Coexisting adenomyosis in endometrial cancer has no bearing on survival rates and is not a prognostic factor.

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SUMMARY OBJECTIVE: Coronavirus disease 2019 emerges as a disease caused by severe acute respiratory syndrome coronavirus 2. It is a systemic disease associated with vascular inflammation and endothelial damage. In this study, we aimed to investigate whether vascular endothelial growth factor gene insertion/deletion polymorphism is associated with coronavirus disease 2019 in the Turkish population. METHODS: The study included 179 participants (79 patients with coronavirus disease 2019 and 100 controls). DNA isolation was made from peripheral blood, and then the polymerase chain reaction analysis was performed. RESULTS: When we analyze vascular endothelial growth factor gene insertion/deletion polymorphism in the study group, we found that the DD genotype and D allele were found to be statistically significantly different when compared to coronavirus disease 2019 patients with high vitamin D value (p=0.005 for DD genotype and p=0.006 for D allele) in the control group. In this high-level control group, when we analyze II+ID genotype versus DD, a statistically significant difference was also detected (p=0.007). CONCLUSION: As a result of the study, we found that DD genotype and D allele were associated with vitamin D level in Turkish patients with coronavirus disease 2019.

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SUMMARY OBJECTIVE: Disease-related skeletal muscle loss is highly prevalent among patients with Crohn’s disease. Low skeletal muscle mass lead to disability and interventions to prevent skeletal mass loss as an effective strategy to prevent disability. The aim of this article was to identify the factor associated with skeletal muscle loss of Crohn’s disease and seek for management target for the prevention of sarcopenia-related disability. METHODS: Patients with Crohn’s disease were divided into low and normal skeletal muscle mass groups based on L3 skeletal muscle index using abdominal CT scans. The clinical and laboratory parameters and colonoscopy were compared between the two groups. Univariate and multivariate regression logistic models were built to identify the prognostic markers of Crohn’s disease-associated muscle loss. RESULTS: A total of 191 Crohn’s disease patients were enrolled in this study, of whom 116 (60.73%) were detected to have low L3 skeletal muscle index, including 71 (68.26%) males. The multivariate logistic regression analysis showed that age (OR: 1.031, 95%CI: 1.006–1.057), female gender (OR: 2.939, 95%CI: 1.386–6.233), disease duration (OR: 0.988, 95%CI: 0.980–0.996), endoscopic disease activity (simple endoscopic score for Crohn’s disease) (OR: 0.923, 95%CI: 0.855–0.996), serum albumin (OR: 1.079, 95%CI: 1.009–1.154), and serum creatinine (OR: 1.037, 95%CI: 1.011–1.063) were associated with L3 skeletal muscle index among Crohn’s disease patients. CONCLUSION: The gender, age, and duration of disease were uncontrollable factors associated with muscle loss of Crohn’s disease. The treatment target of mucosal healing and improved nutritional status may be beneficial for maintaining muscle mass among Crohn’s disease patients.

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SUMMARY OBJECTIVE: The aim of this study was to perform a cross-cultural adaptation of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding for use in a Brazilian-Portuguese context. METHODS: The cross-cultural adaptation process involved the translation from original English into Brazilian Portuguese by two qualified and independent translators. Both translations were synthesized into a single version that was back-translated into English. An expert committee was created to assess linguistic equivalences, formulating a pre-final version that was tested on ten nursing women attending a maternity hospital. To assess its psychometric properties, a cross-sectional study was carried out. The population consisted of 99 nursing women from a reference maternity hospital in southern Brazil. The scale’s stability and internal consistency were measured through Cronbach’s alpha. The Pearson’s correlation coefficient and the intraclass correlation coefficient between two applications were assessed to ascertain the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br scale’s reliability. The construct validity was evaluated through exploratory factorial analysis. RESULTS: The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br showed a general Cronbach’s alpha of 0.849. The test-retest analysis showed a Pearson’s correlation coefficient of 0.483 and intraclass correlation coefficient of 0.645. The exploratory factorial analysis showed two domains among the nine items of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br: the functional domain, including six items, and the cognitive domain, including three items, explaining 59.77% of the variance. CONCLUSION: The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br was considered adequate for the cultural context and reliable and valid for Brazilian nursing women.

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SUMMARY OBJECTIVE: Atherosclerosis is a disease of the arteries that is not practically observed in veins. There are a lot of proposed mechanisms underlying this phenomenon. We aimed to compare the lipoprotein and total cholesterol levels in aortic and venous blood samples. METHODS: A total of 125 patients ≥18 years of age were included in the study. After overnight fasting, we drew blood from the proximal ascending aorta and brachial vein. Serum lipid profiles were compared between these samples. RESULTS: Out of 125 patients, 45 (36%) were females, and 80 (64%) were males. The mean age of the patients was 62 years (24–85 years). Notably, 39 (31%) patients were using statin treatment. Coronary angiography showed that 103 (82%) patients had coronary artery disease. Mean arterial total cholesterol (low-density lipoprotein), high-density lipoprotein, and triglyceride levels were significantly lower than mean venous total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels (187.3±45.3 mg/dL vs. 204.5±52.6 mg/dL, p<0.001; 116.7±41.5 mg/dL vs. 128±45 mg/dL, p<0.001; 40.8±12.9 mg/dL vs. 45.3±13.3 mg/dL, p<0.001; and 142.8±81.5 vs. 161.5±100.3 mg/dL, p<0.001, respectively). CONCLUSION: Aortic lipoprotein and total cholesterol levels are significantly lower than venous lipoprotein and total cholesterol levels in patients presenting to the hospital for coronary angiography.

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SUMMARY OBJECTIVE: Pectus excavatum is the most prevalently encountered deformity of the thoracic wall. It can be accompanied by congenital anomalies. METHODS: The cardiac findings of 36 children who were diagnosed at the Thoracic surgery outpatient clinic of our university between 10 February 2021 and 1 October 2021 and 57 healthy children in a similar age group were analyzed. RESULTS: We determined that the pectus excavatum patients in our study had a higher risk of having mitral insufficiency, mitral valve prolapse, tricuspid valve prolapse, cardiac malposition, and congenital heart disease. CONCLUSION: Our study showed that the prevalence of cardiac pathologies was higher in pediatric pectus excavatum patients than in healthy children in the control group. Thus, we recommend clinicians to refer pediatric pectus excavatum patients to pediatric cardiology outpatient clinics for the early diagnosis of potential cardiac pathologies.

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SUMMARY OBJECTIVE: Therapeutic exercises are well documented for the treatment of osteoarthritis; there is less evidence on what the effect of closed kinetic chain exercises is for knee osteoarthritis. The aim of this study was to investigate the effects of open kinetic chain exercises and closed kinetic chain exercises on pain, muscle strength, functional status, and quality of life in patients with knee osteoarthritis. METHODS: The study included a total of 60 patients with primary unilateral knee osteoarthritis grade I and II. The patients were categorized into three groups as open kinetic chain exercises (n=20), closed kinetic chain exercises (n=20), and control group (n=20). The outcome measures, including pain, isokinetic muscle strength, functional status, and quality of life, were collected at baseline and at the end of 6 and 12 weeks. RESULTS: Closed kinetic chain exercises and open kinetic chain exercises had significant improvement in pain, muscle strength, WOMAC, and SF-36 scores after the treatment and at their 6th and 12th week follow-ups compared to their baseline values and compared to the control group (p<0.05). CONCLUSION: The changes in all outcome measures were similar between closed kinetic chain exercises and open kinetic chain exercises (p>0.05). Closed kinetic chain exercises and open kinetic chain exercises were similar for knee osteoarthritis grade I and II. Closed kinetic chain exercises could be safely added to the exercise programs of patients with low-grade knee osteoarthritis.

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SUMMARY OBJECTIVE: In our study, we aimed to investigate whether systemic inflammatory indices could be an indicator of mortality in very low birth weight (<1,500 g) preterm infants. METHODS: Very low birth weight preterm infants were included in our study, and patient data were recorded retrospectively. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, pan-immune-inflammation value, and systemic inflammation response index were calculated and recorded. The survivors and infants who died were compared for systemic inflammatory indices. RESULTS: A total of 1,243 very low birth weight infants were included in the study. Of the patients, 1,034 survived and 209 died. Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, pan-immune-inflammation value, systemic immune-inflammation index, and systemic inflammation response index were found to be statistically significantly lower in the mortality group than those in the survivor group (p=0.039, p=0.001, p<0.001, p<0.001, p<0.001, and p=0.002, respectively). According to the receiver operating curve analysis, systemic immune-inflammation index with the highest area under the curve (0.844) was found to be the most effective systemic inflammatory indices in predicting mortality with a cutoff level of ≤28.87 (p=0.0001). Multiple regression analysis showed that a lower level of systemic immune-inflammation index (≤28.87) was independently associated with mortality (OR: 1.677, 95%CI 1.061–2.685, p=0.001). CONCLUSION: We have shown that low systemic immune-inflammation index value in very low birth weight preterm infants may be a novel systemic inflammatory index that can be used to predict mortality.

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SUMMARY OBJECTIVE: Our study aimed to evaluate the correlation of cardiac troponin T levels with comorbidities and in-hospital outcomes in patients with coronavirus disease-2019 in Brazil. METHODS: Data from a cohort of 3,596 patients who were admitted with suspected coronavirus disease-2019 in a Brazilian tertiary center, between March and August 2020, were reviewed. A total of 2,441 (68%) patients had cardiac troponin T determined in the first 72 h of admission and were stratified into two groups: elevated cardiac troponin T (cardiac troponin T >0.014 ng/mL) and normal cardiac troponin T. Associations between troponin, comorbidities, biomarkers, and outcomes were assessed. Regression models were built to assess the association of several variables with in-hospital mortality. RESULTS: A total of 2,441 patients were embraced, of which 924 (38%) had normal cardiac troponin T and 1,517 (62%) had elevated cardiac troponin T. Patients with elevated cardiac troponin T were older and had more comorbidities, such as cardiovascular disease, hypertension, diabetes, arrhythmia, renal dysfunction, liver disease, stroke, cancer, and dementia. Patients with abnormal cardiac troponin T also had more altered laboratory parameters on admission (i.e., leukocytes, C-reactive protein, D-dimer, and B-type natriuretic peptide), as well as more need for intensive care unit, vasoactive drugs, mechanical ventilation, dialysis, and blood transfusion. All-cause mortality was markedly higher among patients with increased cardiac troponin T (42 vs. 16%, P<0.001). Multiple regression analysis demonstrated that in-hospital mortality was not independently associated with troponin elevation. CONCLUSION: This study showed that cardiac troponin T elevation at admission was common and associated with several comorbidities, biomarkers, and clinical outcomes in patients hospitalized with coronavirus disease-2019, but it was not an independent marker of in-hospital mortality.

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SUMMARY OBJECTIVE: The expression of cytotoxic T lymphocyte-associated antigen 4, E-cadherin, and CD44 in the area of tumor budding was investigated in breast carcinomas in our study. METHODS: Tumor budding was counted at the invasive margins in 179 breast carcinomas. To understand the microenvironment of tumor budding, we examined the expression status of the immune checkpoint molecules such as cytotoxic T lymphocyte-associated antigen 4, E-cadherin, and CD44. RESULTS: Tumors were separated into low (≤5) and high tumor budding groups (>5) based on the median budding number. Lymphovascular, perineural invasion, and the number of metastatic lymph nodes were significantly higher in high-grade budding tumors (p=0.001, p<0.001, and p=0.019, respectively). Tumor-infiltrating lymphocytes were significantly higher in tumors without tumor buddings (p<0.001). When the number of budding increases by one unit, overall survival decreases by 1.07 times (p=0.013). Also, it increases the risk of progression by 1.06 times (p=0.048). In high tumor budding groups, the cytotoxic T lymphocyte-associated antigen 4 staining percentage of lymphocytes was significantly higher (p=0.026). With each increase in the number of buds, an increase in the percentage of cytotoxic T lymphocyte-associated antigen 4 staining was seen in lymphocytes in the microenvironment of TB (p=0.034). CONCLUSION: Tumor budding could predict poor prognosis in breast carcinomas, and anti-cytotoxic T lymphocyte-associated antigen 4 immunotherapies may be beneficial in patients with high tumor budding tumors.

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SUMMARY OBJECTIVE: Gastrointestinal bleeding is an important part of gastrointestinal emergencies. This study aimed to examine the association between ABO blood groups and mortality in patients who were admitted to the emergency department and diagnosed with upper gastrointestinal bleeding. METHODS: The patients with upper gastrointestinal bleeding in the emergency department of a tertiary hospital in Turkey and the data of healthy blood donors were studied. The data of these patients were analyzed, and it was determined that the primary outcome was in-hospital mortality. RESULTS: The study was completed with 274 patients and 274 control group. The mean age of these patients was 65.1±18.2 years, and 64.2% of patients were males. It was found that the in-hospital mortality rate of patients with O blood group (16.2%) was statistically significantly higher than non-O blood group (7.5%) (p:0.032). CONCLUSION: The study concluded that the mortality rate of gastrointestinal bleeding patients with O blood group was higher compared to patients with other blood groups. Physicians can use ABO blood groups to predict mortality risk in gastrointestinal bleeding.

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SUMMARY OBJECTIVE: This study aimed to assess adverse maternal and perinatal outcomes in parturients undergoing labor analgesia. METHODS: This was a retrospective cohort study in parturients who underwent labor analgesia. Parturients were categorized into three groups: Group 1 (n=83)—analgesia performed with cervical dilatation ≤4.0 cm; Group 2 (n=82)—analgesia performed with cervical dilatation between 5.0 and 8.0 cm; and Group 3 (n=83)—analgesia performed with cervical dilatation ≥9.0 cm. RESULTS: Analgesia in parturients with cervical dilatation ≥9.0 cm showed a higher prevalence and a 3.86-fold increase (OR 3.86; 95%CI 1.50–9.87; p=0.009) in the risk of forceps delivery. Analgesia in parturients with cervical dilatation ≤4.0 cm showed a higher prevalence and a 3.31-fold increase (OR 3.31; 95%CI 1.62–6.77; p=0.0016) in the risk of cesarean section. Analgesia in parturients with cervical dilatation ≥9.0 cm was associated with a higher prevalence of fetal bradycardia (20.7%), a need for neonatal oxygen therapy (6.1%), and a need for admission to a neonatal intensive care unit (4.9%). Analgesia in parturients with cervical dilatation ≤4 cm was associated with a higher prevalence of Apgar score <7 at 1st minute (44.6%). CONCLUSION: Performing labor analgesia in parturients with cervical dilatation ≤4.0 or ≥9.0 cm was associated with a higher prevalence of adverse maternal and perinatal outcomes.