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SUMMARY OBJECTIVE: Teriflunomide is an oral medication approved for the treatment of patients with multiple sclerosis. The primary effect of teriflunomide is to reduce de novo pyrimidine synthesis by inhibiting mitochondrial dihydroorotate dehydrogenase, thereby causing cell-cycle arrest. We aimed to investigate the occurrence of peripheral neuropathy, a rare side effect of teriflunomide, in patients receiving teriflunomide. METHODS: Multiple sclerosis patients receiving teriflunomide (n=42) or other disease modifying therapies (n=18) and healthy controls (n=25) were enrolled in this cross-sectional study between January 2020 and 2021. The mean duration of teriflunomide treatment was 26 months (ranging from 6 to 54 months). All participants underwent neurological examination and nerve conduction studies of tibial, peroneal, sural, superficial peroneal, median, and ulnar nerves by using surface recording bar and bipolar stimulating electrodes. RESULTS: The mean superficial peroneal nerve distal latency and conduction velocity were significantly slower, and the mean superficial peroneal nerve action potential amplitude was lower in patients using teriflunomide (2.50 ms, p<0.001; 47.35 m/s, p=0.030; and 11.05 μV, p<0.001, respectively). The mean peroneal motor nerve distal latency was significantly longer and amplitude was lower in teriflunomide patients (3.68 ms, p<0.001, and 5.25 mV, p=0.009, respectively). During the study period, treatment switching to another disease-modifying therapy was planned in 10 patients, and all neuropathic complaints were reversed after switching. CONCLUSION: Teriflunomide has the potential to cause peripheral neuropathy. The awareness of peripheral neuropathy, questioning the symptoms, and if suspected, evaluation with electromyography and switching the therapy in patients under teriflunomide treatment are crucial.

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SUMMARY OBJECTIVE: Acute appendicitis is one of the most common surgical causes of an acute abdomen among patients admitted to the emergency room due to abdominal pain. The clinical diagnosis of acute appendicitis is usually difficult and is made by evaluating the clinical, laboratory, and radiological findings together. The aim of this study was to investigate the diagnostic potential of signal peptide-CUB-EGF-like domain-containing protein 1 as a biomarker for acute appendicitis. METHODS: A total of 67 adult patients without any comorbidities who presented to the emergency department with abdominal pain and were clinically diagnosed with acute appendicitis were included in the case group. The patients included in the study were classified into the negative appendectomy group and the acute appendicitis group according to their histopathological final diagnosis. In addition, 48 healthy volunteers without comorbidities were included in the control group. Signal peptide-CUB-EGF-like domain-containing protein 1 levels of patients and the control group were measured. RESULTS: According to postoperative histopathological examinations of the patients, 7 (10.4%) patients were diagnosed with negative appendectomy, and 60 (89.6%) patients were diagnosed with acute appendicitis. Signal peptide-CUB-EGF-like domain-containing protein 1 levels were higher in the patients with acute appendicitis than in negative appendectomy patients (p=0.012). Signal peptide-CUB-EGF-like domain-containing protein 1 levels were also higher in the case group compared to the control group (p=0.001). CONCLUSION: The admission signal peptide-CUB-EGF-like domain-containing protein 1 level was significantly higher in adults with acute appendicitis. The SCUBE1 level is a novel but promising biomarker that aids in the diagnosis of acute appendicitis.

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SUMMARY OBJECTIVE: The aim of this study was to examine the isokinetic knee strength, H/Q ratio (%), and bone mineral density values between amputees (n=14; amputee soccer players) and healthy football players (n=14; non-amputee soccer players). METHODS: A total of 28 amputee soccer players and non-amputee soccer players participated in the study. An isokinetic dynamometer was used to determine the knee flexion/extension forces of the dominant legs of the athletes at 60, 180, and 240°/s. Bone mineral density scans were performed using dual-energy X-ray absorptiometry. RESULTS: H/Q ratio and 60º/s flexion and 180 and 240º/s flexion/extension strength (p<0.05) were found to be high (180º/s, p=0.03; 240º/s, p=0.048) in the non-amputee soccer player group. Accordingly, the bone mineral density values of the lumbar vertebra, femoral neck, proximal metaphysis of the femur (p<0.01), tibia/fibula proximal metaphysis, and tibia/fibula distal metaphysis (p<0.05) were found to be high. A correlation was observed between the 60º/s knee extension strength and tibia/fibula diaphyseal bone mineral density (p=0.025; r=0.594) and tibia/fibula distal metaphysis bone mineral density (p=0.017; r=0.623) values in the amputee soccer players group. The Z-scores of the amputee soccer players and non-amputee soccer players were in the expected range according to age (>-2). CONCLUSION: The bone mineral density, H/Q ratio, and all measured angular velocities of isokinetic strength were high in non-amputee soccer players. This finding made us think that lower extremity amputation may also be associated with losing strength. However, it was observed that the relationship between strength and bone mineral density in amputee athletes might vary according to different angular velocities. It is recommended that isokinetic strength measurement can be evaluated together with bone mineral density in athletes.

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SUMMARY OBJECTIVE: This descriptive cross-sectional study aimed to determine the effect of pregnancy symptoms on the sexual quality of life. METHODS: This study included 150 pregnant women who visited the obstetrics and gynecology outpatient clinic of the hospital between October 1, 2019, and April 1, 2020, and met the inclusion criteria. Data were collected using the Personal and Obstetric Information form, Sexual Quality of Life-Female scale, and Pregnancy Symptom Inventory. RESULTS: The mean age of the participants was 27.7±5.2 years. As per the collected data, 39.3% of the participants had university- or higher-level education and 21.3% had an income-generating job. A weak negative correlation was found between the scores of Sexual Quality of Life-Female and frequency of pregnancy symptoms and limitation in daily activities (p=0.016 and p=0.020, respectively), whereas a strong positive correlation was found between frequency of pregnancy symptoms and limitation in daily activities. Regression analysis showed that as Sexual Quality of Life-Female scores decreased, frequency of pregnancy symptoms and limitation in daily activities scores increased (p<0.001). CONCLUSION: Our study showed that, as the frequency of symptoms experienced during pregnancy and their impact on daily life increase, the sexual quality of life decreases. We recommend providing education and counseling services to women and their partners about pregnancy symptoms and its impact on sexual life during pregnancy and implementing effective measures to eliminate the negative effects of these symptoms on the sexual quality of life.

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SUMMARY OBJECTIVE: Inflammatory bowel diseases may have extra intestinal manifestations such as those affecting the skin. This study aimed to study skin manifestations in a cohort of Brazilian patients with inflammatory bowel diseases. METHODS: Epidemiological and clinical data were obtained through a cross-sectional study of 70 inflammatory bowel diseases patients and a control group comprising 50 healthy individuals. All patients were subjected to dermatological examination and photography of skin lesions. RESULTS: Out of the 70 inflammatory bowel diseases patients, 50 had ulcerative colitis and 20 had Crohn’s disease. Skin lesions occurred in 95.7% of the inflammatory bowel diseases patients and in 88% of individuals in the control group (p=0.001). Alopecia (p<0.0001), xerosis (p=0.03), striae (p=0.02), and acne (p=0.04) were more common in inflammatory bowel diseases patients than in the control group. Alopecia was more frequent in females (p=0.01) than in males. Two male patients, one with ulcerative colitis and the other with Crohn’s disease, had pyoderma gangrenosum. Erythema nodosum was not observed in both groups. CONCLUSION: There was a high prevalence of skin lesions in the Brazilian inflammatory bowel diseases patients. Additionally, alopecia, xerosis, striae, and acne were more common in patients with inflammatory bowel diseases than in those in the control group.

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SUMMARY OBJECTIVE: This study aimed to assess the sociodemographic and clinical profile of women deprived of their liberty and to identify the prevalence of sexually transmitted diseases and human papillomavirus through self-sampling samples. METHODS: This is an epidemiological, cross-sectional, observational, and descriptive study of the prevalence and correlation of the diagnosis of human papillomavirus infection in 268 encarcered women in Amazonas submitted to self-sampling from June 2019 to September 2020 using the genotyping analysis. Patients with positive and inconclusive results were evaluated by commercialized PCR to detect pathogens causing sexually transmitted diseases. The sample size used was based on a convenience sample. RESULTS: In 268 women, human papillomavirus DNA was detected in 87 (32.5%) of them. Sexually transmitted diseases were detected in 30 (34.48%) of the 87 women with a positive or inconclusive result for human papillomavirus. Women with more than three pregnancies had a higher risk of human papillomavirus detection (p=0.004). CONCLUSION: The prevalence of human papillomavirus and other sexually transmitted diseases in encarcered women in Amazonas is 32.5 and 34.48%, respectively. Most women were single (60.4%) and reported having had more than 15 partners (90.8%).

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SUMMARY OBJECTIVE: This study was planned to examine the factors affecting the decision-making styles of pregnant women in the coronavirus disease 2019 epidemic, their choice of birth environment, and their decision to start breastfeeding. METHODS: The study was conducted in a cross-sectional descriptive type. The study was conducted with 631 pregnant women who voluntarily participated between January 2020 and April 2021 and met the sample selection criteria. Women aged 18–45 years who had healthy singleton pregnancies were included. Pregnant women with signs or symptoms of coronavirus disease 2019 or suspected or diagnosed with birth were excluded from the study. The data were collected by the questionnaire method through the links shared with the pregnant women. Data Collection Form, Questionnaire for Birth and Breastfeeding in the coronavirus disease 2019 Period, and Melbourne Decision-Making Styles Scale-II were used as data collection tools. RESULTS: The mean age of the pregnant women was found to be 28.56±6.36 years. Approximately 50.71% of the participants reported that they preferred normal vaginal delivery. It was reported that 56.1% of the pregnant women had a say in the decision-making process of the delivery method. It has been determined that there is a significant difference between the education status, employment status, pregnancy planning, family type, and the person who has a say in deciding the mode of delivery (p<0.05). The results of the analysis of worrying about starting breastfeeding according to the decision-making styles of the pregnant women in the sample group are examined. The difference between the scores of avoidant and procrastinating decision-making style, which is the sub-dimensions of the scale, and worrying about starting breastfeeding is statistically significant (p<0.029 and p<0.029, respectively). CONCLUSION: The research findings show that situations such as epidemics affect the decisions of pregnant women, and breastfeeding situations and decision-making styles affect each other. For this reason, education programs and guides including guidance services and support systems should be published and pregnant women should be guided correctly.

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SUMMARY OBJECTIVE: The objective of this study was to investigate the protectiveness of resveratrol on cisplatin-induced damage to the ovary using experimental models. METHODS: A total of 30 female Wistar-Albino rats constituted the research material. The rats were categorized into three groups: Group 1 was administered one milliliter of 0.9% NaCl solution, Group 2 was administered 7.5 mg/kg cisplatin, and Group 3 was administered 7.5 mg/kg cisplatin and 10 mg/kg resveratrol. Ovaries were extirpated in all groups and subjected to biochemical and histopathological tests. Cisplatin-induced damage to ovarian tissue was graded and scored as the total histopathological findings score. The ovarian function was assessed using immunohistochemical staining for c-kit expression. Rats’ malondialdehyde, catalase, and superoxide dismutase levels were determined. RESULTS: The histopathological finding score was significantly higher in Group 2 than in other groups (p<0.05). The superoxide dismutase and catalase levels were significantly higher in Group 3 than in Group 2 (p<0.001 for both cases). The malondialdehyde level was significantly higher in Group 2 than in Group 3 (p<0.001). CONCLUSION: The study findings demonstrated that resveratrol reduced ovarian injury and enhanced biochemical parameters following cisplatin-induced ovary damage in experimental models.

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SUMMARY OBJECTIVE: This study aimed to evaluate the quality of life of patients with endometriosis before and after surgical treatment. METHODS: An observational, longitudinal, and prospective study was conducted with 102 women with pelvic pain and endometriosis that was unimproved by clinical treatment and indicated for surgical treatment. The patients’ quality of life was assessed using the 30-item Endometriosis Health Profile (EHP-30) questionnaire before and 3 and 6 months after surgery. The statistical tests were analyzed using the Statistical Package for Social Sciences version 17.0, and the Friedman test was used. RESULTS: There was a reduction in EHP-30 scores 3 and 6 months after surgery compared to before surgery, as well as 6 months after surgery compared to 3 months after surgery, in the central questionnaire (PART 1) and in Sections A, B, C, E, and F (p<0.0001). For Section D, there was a reduction in scores 6 months after surgery compared to before surgery (p<0.0001). CONCLUSION: Surgical treatment of endometriosis improves quality of life in several areas assessed by the EHP-30 questionnaire.

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SUMMARY OBJECTIVE: This study aimed to determine the computed tomography findings associated with very recent catastrophic 2023 Turkey-Syria earthquake-related injuries and their anatomotopographic distribution in the adult population. METHODS: The incorporated computed tomography scans of 768 adult cases who had been admitted to the hospital and had undergone computed tomography imaging after these tragic disasters had been examined on the Teleradiology Reporting System of the Turkish Ministry of Health. To this end, the injuries were classified into six categories: head, thoracic, spinal, pelvic, extremity, and abdominal injury, with three age groups (18–34, 35–64, and ³65 years) and four different imaging intervals (<24, 24–48, 49–72, and >72 h). RESULTS: This study incorporated 316 (41.1%) cases on the first day, 57 (7.5%) on the second day, 219 (28.5%) on the third day, and 176 (22.9%) on the fourth day after the earthquake or later. Of the 768 cases, 109 (14.2%) had a head injury, 100 (13.0%) had a thoracic injury, 99 (12.9%) had a spinal injury, 51 (6.6%) had a pelvic injury, 41 (5.4%) had an extremity injury, and 11 (1.4%) had an abdominal injury. CONCLUSION: In these regrettable earthquake disasters, we determined a high ratio of head injuries, which was closely followed by thoracic and spinal injuries, in our preliminary outcomes for the pediatric population, Part I. The frequency of abdominal injuries was low among individuals who experienced the earthquake. Last but not least, we have noticed a higher likelihood of spinal injury in individuals older than 65 years in the studied population.

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SUMMARY OBJECTIVE: This study aimed to analyze its predictive role in incipient postoperative atrial fibrillation by constructing an inflammatory prognostic index based on hematological and biochemical parameters in patients undergoing elective isolated coronary artery surgery accompanied by cardiopulmonary bypass. METHODS: The data of 343 patients who underwent coronary bypass surgery between May 2021 and July 2022 were evaluated. Multivariate logistic regression and recipient study characteristic curve analyses were studied by comparing the patients’ hematological indices and basic clinical features between the two groups. RESULTS: Logistic regression analysis showed that age (p<0.001), hypertension (p=0.01), and inflammatory prognostic index (p<0.001) were independent predictors of new-onset postoperative atrial fibrillation. To predict the development of postoperative atrial fibrillation, a cutoff value of 0.25 (77.8% sensitivity and 69.3% specificity) was determined for inflammatory prognostic index in the receiver-operating characteristic curve analysis (area under curve=0.798, 95% confidence interval 0.752–0.840). CONCLUSION: Inflammatory prognostic index can be a noninvasive, easily available marker for predicting new-onset atrial fibrillation after coronary artery bypass surgery.

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SUMMARY OBJECTIVE: This study aimed to investigate prenatal education and its relationship with anxiety and stress in pregnant women. METHODS: This research was carried out between July 1, 2022, and December 1, 2023, at Giresun Gynecology and Pediatrics Training and Research Hospital. Women aged >18 years at >20 weeks of pregnancy were included. Patients were randomized into two groups, and one group received a 4 week training on meditation, breathing exercises, and pregnancy-related health issues. A questionnaire was applied to both groups to analyze sociodemographic characteristics, pregnancy, birth, medical history, the Pregnancy Stress Rating Scale, and the State Trait Anxiety Inventory. RESULT: The groups were similar in terms of age, educational status, anthropometric characteristics, occupation, economic status, and gestational week. There was no difference between the trained and nontrained groups in terms of the Pregnancy Stress Rating Scale score and the State Trait Anxiety Inventory-state score. The State Trait Anxiety Inventory-trait was significantly lower in the trained group (p=0.033). There were weak positive correlations between Pregnancy Stress Rating Scale score and medication use and between State Trait Anxiety Inventory-state score and age. A negative correlation was found between the State Trait Anxiety Inventory-state score and working status, showing that employed women had lower anxiety scores irrespective of training. Another weak positive correlation was found between the State Trait Anxiety Inventory-trait score and the presence of comorbidities. CONCLUSION: State Trait Anxiety Inventory-trait anxiety was lower in pregnant women who received training on prenatal meditation, exercise, and pregnancy health; however, State Trait Anxiety Inventory-state and Pregnancy Stress Rating Scale scores were similar in the two groups. Unemployed pregnant women and those with chronic diseases appear to need closer follow-up to reduce anxiety levels.

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SUMMARY INTRODUCTION: Patients hospitalized for treatment may be exposed to healthcare-associated infections, and these infections can affect patients seriously. OBJECTIVE: This research was conducted to determine what hospitalized patients know and what they want to know about healthcare-associated infections. METHODS: This is a full-text original research article. The study was conducted between July and September 2022 with inpatients in all clinics of Kocaeli University Hospital in Turkey. A total of 310 patients participated in this cross-sectional study. The questions were asked by the researcher and the answers were recorded. RESULTS: Almost all (92.8%) the patients who stated that they knew what healthcare-associated infection was evaluated their knowledge as insufficient. Patients with higher educational levels have more information (p=0.000) about healthcare-associated infections. Young (p=0.000) and highly educated patients (p=0.000) stated that the infection rate of the hospital would affect the choice of hospital. CONCLUSION: Patients want to learn about healthcare-associated infections, but most do not know about them. Patients should be informed about healthcare-associated infections during hospitalization planning and hospitalization.

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SUMMARY OBJECTIVE: Hepatitis B virus is a global threat that can lead to liver cirrhosis and hepatocellular carcinoma. For the treatment of chronic hepatitis B virus, polymorphisms might be an option for gene treatments. This study aimed to investigate the effects of IL-17, TNF-α, IL-10, IFN-γ, and IL-18 gene polymorphisms on hepatitis B virus infection in the Turkish population. METHODS: The genotypes and allele distribution of 75 patients exposed to hepatitis B virus and 50 healthy control individuals were analyzed. The real-time polymerase chain reaction method was used for identification. RESULTS: A correlation was observed between susceptibility to hepatitis B virus infection and IL-17 Exon 3/3'UTR (rs1974226) C, IL-17 Exon 3 (rs763780) A, IL-18 (-607) (rs1946518) A alleles, and IL-17 Exon 3 (rs763780) AA genotype (p=0.006, p=0.009, p=0.025, and p=0.008, respectively). Furthermore, IL-18 (-137) (rs187238) TT genotype and TNF-α-308 (rs1800629) G and A alleles, were associated with protection against hepatitis B virus infection (p=0.0351 and p=0.032, respectively). CONCLUSION: This study demonstrated that TNF-α (-308), IL-17 (Exon 3/3’ UTR), IL-17 (Exon 3), and IL-18 (-607) polymorphisms are associated with hepatitis B virus infection. Therefore, these may serve as potential therapeutic targets for chronic viral hepatitis in the Turkish population.

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SUMMARY OBJECTIVE: This study aimed to investigate the expression levels of sirtuin 2 and sirtuin 7 in the placenta accreta spectrum to reveal their role in its pathogenesis. METHODS: A total of 30 placenta accreta spectrum, 20 placenta previa, and 30 controls were experienced. The sirtuin 2 and sirtuin 7 expression levels in the placentas of these groups were determined by Western blot. sirtuin 2 and sirtuin 7 serum levels in the maternal and fetal cord blood were examined by enzyme-linked immunosorbent assay. RESULTS: It was found that sirtuin 7 in placenta accreta spectrum was significantly lower in the placenta compared to the control and placenta previa groups (p<0.05). However, a significant difference was not observed between the sirtuin 2 and sirtuin 7 levels in the maternal and fetal cord serum samples of those three groups (p>0.05). CONCLUSION: Sirtuin 7 may play an important role in the formation of placenta accreta spectrum. The effect of decreased expression of sirtuin 7 might be tissue-dependent in the placenta accreta spectrum and needs to be investigated further.

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SUMMARY OBJECTIVE: Folliculogenesis is a complex process involving various ovarian paracrine factors. During folliculogenesis, vitamin D3 and progesterone are significant for the proper development of follicles. This study aimed to investigate the effects of vitamin D3 and selective progesterone receptor modulator ulipristal acetate on ovarian paracrine factors. METHODS: In the study, 18 female Wistar-albino rats were randomly divided into three groups: control group (saline administration, n=6), vitamin D3 group (300 ng/day vitamin D3 oral administration, n=6), and UPA group (3 mg/kg/day ulipristal acetate oral administration, n=6). Ovarian tissue was analyzed by histochemistry and immunohistochemistry. For quantification of immunohistochemistry, the mean intensities of growth differentiation factor 9, bone morphogenetic protein 15, and forkhead box O3a expressions were measured by Image J and MATLAB. Blood samples were collected for the analysis of serum anti-Müllerian hormone levels by ELISA. RESULTS: Atretic follicles and hemorrhagic cystic structures were observed in the UPA group. After immunohistochemistry via folliculogenesis assessment markers, growth differentiation factor 9, bone morphogenetic protein 15, and cytoplasmic forkhead box O3a expressions decreased in the UPA group (p<0.05). Anti-Müllerian hormone level did not differ significantly between the experimental groups (p>0.05). CONCLUSION: Ulipristal acetate negatively affects folliculogenesis via ovarian paracrine factors. The recommended dietary vitamin D3 supplementation in healthy cases did not cause a significant change.

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SUMMARY OBJECTIVE: This study was carried out to evaluate the injuries in pediatric earthquake victims due to the 2023 Turkey-Syria earthquakes with computed tomography and determine the anatomotopographic distribution of injuries. METHODS: The material of this retrospective study consisted of the computed tomography findings of 257 pediatric cases injured in the 2023 Turkey-Syria earthquakes, and those were divided into subgroups based on their age group, i.e., 0–4, 5–9, 10–14, and 15–18 years, and the type of injury, i.e., head, maxillofacial, thoracic, abdominal, pelvic, and spinal injuries. RESULTS: Earthquake-related injuries had been detected in 102 (39.6%) patients. Of the 29 patients with multiple injuries, 17, 10, and 2 had injuries in two, three, and four topographic regions, respectively. The most common injury was a head injury, which was detected in 48 (18.7%) cases, followed by thoracic injury, spinal injury, pelvic fracture, abdominal injury, and maxillofacial fracture, which were detected in 40 (15.6%), 22 (8.5%), 19 (7.4%), 10 (3.9%), and 6 (2.3%) patients, respectively. The cranial bone fractures and intracranial injuries were significantly more frequent in the 0–4 years age group compared with other age groups (p=0.028 and p=0.024, respectively). The rib fractures with spinal and pleural injuries were significantly more common in the 15–18 years age group compared with others (p=0.016, p=0.004, and p=0.002, respectively). CONCLUSION: The head injury was the most common earthquake-related injury in pediatric cases. Herein, it was more common in younger children compared with other age groups, whereas rib, spine, and pleural injuries were more common in older children.

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SUMMARY OBJECTIVE: This study aimed to investigate the sex-specific association between hyperuricemia and the risk of hypertension and whether obesity mediates this association. METHODS: This study included 31,395 (47.0% women) adults without hypertension, cardiovascular disease, or cancer at baseline who completed at least one follow-up annual examination between 2009 and 2016. Cox regression models were performed to calculate hazard ratios and 95% confidence intervals. Mediation analysis was conducted to estimate the effect of body mass index on the association between hyperuricemia and hypertension. RESULTS: During a median 2.9-year follow-up, hyperuricemia was significantly associated with a higher risk of hypertension (HR 1.15, 95%CI 1.07-1.24 for all participants; HR 1.12, 95%CI 1.03-1.22 for men; and HR 1.23, 95%CI 1.02-1.48 for women) after adjustment for potential confounders. Additional adjustment for body mass index attenuated this association (HR 1.09, 95%CI 1.08-1.10 for all participants; HR 1.07; 95%CI 0.98-1.16 for men; HR 1.18; 95%CI 0.96-1.44 for women). Mediation analysis showed that BMI partially mediated the relationship between hyperuricemia and incident hypertension (indirect effect HR 1.09, 95%CI 1.08-1.10; direct effect: HR 1.08, 95%CI 1.02-1.15). The percentage of the mediation effect was 53.2% (95%CI 37.9-84.5). CONCLUSION: Hyperuricemia is associated with a risk of hypertension in both sexes, and BMI partially mediates hyperuricemia-related incident hypertension.

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SUMMARY OBJECTIVE: Sepsis and septic shock are clinical conditions with high mortality and an ever-increasing prevalence, and early diagnosis is of great importance in treating these diseases. Increase in serum Galectin-3 protein in septic patients is associated with increased inflammation, which in turn is associated with mortality. This study aimed to investigate the diagnostic importance of serum Galectin-3 levels and its relationship with in-hospital mortality in sepsis and septic shock patients. METHODS: This prospective cohort study included 44 sepsis and 44 septic shock patients. Sequential Organ Failure Assessment score and Acute Physiology and Chronic Health Evaluation 2 score were calculated. In addition, routine clinical and laboratory parameters along with serum Galectin-3 were evaluated. RESULTS: Serum Galectin-3 levels were significantly higher in the septic shock group [4.1 (0.1-10.2) vs. 6.0 (0.1-11.3) ng/mL, respectively; p=0.01]. Moreover, patients with a Galectin-3 level <6.94 ng/mL were associated with longer survival [31.4 vs. 23.1 days; hazards ratio, 1.85; 1.03-3.34, p=0.03]. More importantly, the need for mechanical ventilation, the duration of mechanical ventilation, and serum Galectin-3 levels were independent prognostic factors and predicted poor in-hospital survival in both sepsis and septic shock patients. CONCLUSION: These findings suggest that Galectin-3 levels are higher in septic shock patients and predict mortality. In addition, high serum Galectin-3 levels, together with mechanical ventilation requirement and mechanical ventilation duration, are closely associated with poor in-hospital survival. Therefore, Galectin-3 may be a valuable diagnostic and prognostic biomarker in these patients.

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SUMMARY OBJECTIVE: This study was conducted to determine the effect of postnatal breastfeeding education given to women who had normal vaginal and cesarean delivery on breastfeeding self-efficacy and breastfeeding success. METHODS: This is a pretest-posttest randomized controlled quasi-experimental study. This study included 76 women (38 intervention group and 38 control group) who gave birth in a women’s and children’s diseases training and research hospital.ClinicalTrials.gov Identifier: NCT 05666817. The data were collected by means of the introductory information form, breastfeeding knowledge level diagnosis form, LATCH scale, and postnatal self-efficacy scale. In the evaluation of the data, independent group t-tests and dependent group t-tests were used. RESULTS: Research findings indicate that the women’s breastfeeding knowledge level, LATCH scale, and postnatal breastfeeding self-efficacy scale scores were statistically higher than the control group in the post-test (p<0.05). CONCLUSION: It was found by the researchers that postnatal breastfeeding education is effective in increasing the level of breastfeeding knowledge, breastfeeding success, and breastfeeding self-efficacy.

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SUMMARY OBJECTIVE: This study aimed to explore the relationship between skeletal patterns and the frequency of sella turcica bridging in a sample of young Turkish adults in order to provide a better understanding of the relationship between craniofacial morphology and sella turcica abnormalities. METHODS: A total of 90 individuals aged between 18 and 25 years were examined in this study. The individuals were classified according to their skeletal pattern, specifically Class I, Class II, and Class III. Each group consisted of 15 males and 15 females. The length, depth, and anteroposterior diameter of sella turcica were calculated. The shape and bridging of sella turcica were estimated using lateral cephalometric images. All data were correlated and statistically analyzed according to skeletal patterns, genders, and age. RESULTS: The mean length, depth, and anteroposterior diameter of sella turcica were 7.02±2.13, 7.56±1.38, and 10.54±1.3 mm in Classes I-III, respectively. There was no significant difference between the dimensions of sella turcica according to gender and age (p˃0.05). The length of sella turcica was larger in Class III, and the depth of sella turcica was larger in Class II individuals (p<0.05). A total of 44.4% of the individuals had normal sella turcica, while the remaining 56.6% had other types of sella turcica. It was determined that 31.1% of the individuals have no calcification, 62.2% had partial calcification, and 6.7% had total calcification. CONCLUSION: The normal dimensions, shape, and bridging of the sella turcica can be used by the orthodontist for diagnosis, treatment planning, and evaluation of various pathological conditions associated with the sella turcica.

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SUMMARY OBJECTIVE: There are studies showing clinical and laboratory differences between elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis. Temporomandibular joint involvement in rheumatoid arthritis is not rare. In this study, we aimed to examine the temporomandibular joint involvement and magnetic resonance imaging findings in elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis patients. METHODS: A total of 87 rheumatoid arthritis patients were investigated retrospectively. The onset ≥60 years was considered elderly-onset rheumatoid arthritis. Erosion, flattening, and resorption of the condyle, narrowing of the joint space, joint effusion, synovial hypertrophy, and synovitis were interpreted as temporomandibular joint involvement with magnetic resonance imaging. Patients’ age, gender, rheumatoid factor, and anti-cyclic citrullinated peptide positivity, extra-articular findings, medical treatment, and disease activity score were noted. RESULTS: A total of 15 (17.2%) patients had elderly-onset rheumatoid arthritis. Temporomandibular joint involvement was detected in 67 (77%) patients; 9 (60%) of them were in the elderly-onset rheumatoid arthritis group (n=15) and 58 (80.6%) of them were in the young-onset rheumatoid arthritis group (n=72). Patients with temporomandibular joint involvement were significantly higher than those without temporomandibular joint involvement in both the elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis groups (p<0.001). No significant difference was found between elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis for the temporomandibular joint involvement (p=0.100). In the young-onset rheumatoid arthritis group, rheumatoid factor positivity and anti-cyclic citrullinated peptide positivity were more frequent in the patients with temporomandibular joint involvement (p=0.011, p=0.024). A comparison of the elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis patients showed no significant difference in the magnetic resonance imaging findings except for the resorption of the condyle. CONCLUSION: According to our findings, elderly-onset rheumatoid arthritis is not much different from young-onset rheumatoid arthritis in terms of temporomandibular joint involvement, magnetic resonance imaging findings, and clinical and laboratory features.

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SUMMARY OBJECTIVE: This study was conducted to determine the relationship between self-care agency and sleepiness in chronic hemodialysis patients. METHODS: The study was conducted with 75 patients with chronic renal failure in the hemodialysis unit of a training and research hospital in our country. In the descriptive study, the data were collected through a face-to-face questionnaire. The IBM SPSS Statistics 22.0 program was used to evaluate the data. RESULTS: It was determined that there was no significant relationship between self-care agency and sleepiness total scores in chronic hemodialysis patients (p>0.05) and a significant relationship between sleepiness and drug use compliance and mental status in female patients and between diet compliance and sleepiness in patients younger than 52 years of age (p<0.05). CONCLUSION: As a result, it was observed that there was no relationship between self-care agency and sleepiness in chronic hemodialysis patients. We think that working with a larger sample group can lead to clearer results.

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SUMMARY OBJECTIVE: In this study, we investigated the relationship between age, creatinine, and left ventricular ejection fraction risk score and the severity of coronary lesions detected by applying fractional flow reserve in the patient group presenting with chronic coronary syndrome. Also, we presented long-term follow-up results in patients whose age, creatinine, and left ventricular ejection fraction score was evaluated by the fractional flow reserve procedure. METHODS: This study was planned retrospectively and in two centers. For this purpose, 114 patients who met the study criteria and who underwent elective fractional flow reserve between January 2014 and January 2019 were included in the study. Age, creatinine, and left ventricular ejection fraction was calculated as age/left ventricular ejection fraction +1 (if estimated glomerular filtration rate<30 mL/min). RESULTS: They were divided into two groups according to the cutoff value of the age, creatinine, and left ventricular ejection fraction score. A total of 76 patients had an age, creatinine, and left ventricular ejection fraction score of ≤1.17 (Group I) and 38 patients had an age, creatinine, and left ventricular ejection fraction score of >1.17 (Group II). The number of patients with severe lesions in fractional flow reserve was significantly higher in Group II compared with Group I (60.5 vs. 32.9%, p=0.005). According to the Kaplan-Meier analysis, a significant increase was observed in major adverse cardiac events and mortality during the follow-up period in the group with a high-risk score (Log Rank: 15.01, p<0.001 and Log Rank: 8.51, p=0.004, respectively). CONCLUSION: In light of the data we obtained from our study, we found a correlation between the severity of the lesion detected in fractional flow reserve and the age, creatinine, and left ventricular ejection fraction scores. In addition, we found that patients with high age, creatinine, and left ventricular ejection fraction scores had higher mortality and major adverse cardiac events rates during follow-up.

Resumo em Inglês:

SUMMARY OBJECTIVE: The aim of this study was to investigate the correlation of fibrosis stages in cases of chronic hepatitis by comparing shear wave elastography and diffusion-weighted magnetic resonance imaging. METHODS: A total of 46 chronic hepatitis patients with an age range of 20-50 years were classified into three groups based on their fibrosis stages. Comparison group 1: the presence of fibrosis (S0 and S1≤); comparison group 2: the presence of significant fibrosis (≤S2 and S3≤); and comparison group 3: the presence of cirrhosis (≤S4 and S6). Shear wave velocities were measured by acoustic radiation force impulse elastography. Diffusion-weighted magnetic resonance imaging was performed on a 3.0 Tesla MRI device. RESULTS: In comparison group 1 (S0 and S1≤), the area under the curve, sensitivity, and specificity of acoustic radiation force impulse values were 0.784, 87, and 60%, respectively, while these values were 0.718, 80, and 66%, respectively, for apparent diffusion coefficient . In comparison group 2 (≤S2 and S3≤), the area under the curve, sensitivity, and specificity of acoustic radiation force impulse values were 0.917, 80, and 86%, respectively, and the apparent diffusion coefficient values were 0.778, 90, and 66%, respectively. In comparison group 3, the area under the curve, sensitivity, and specificity of acoustic radiation force impulse values were 0.977, 100, and 95%, respectively. There was no statistically significant difference between the apparent diffusion coefficient values of the cases in the three groups (p=0.132). CONCLUSION: Noninvasive methods are gaining importance day by day for staging hepatic fibrosis. Acoustic radiation force impulse elastography was evaluated as a more reliable examination than diffusion-weighted magnetic resonance imaging in revealing the presence of fibrosis, determining significant fibrosis, and diagnosing cirrhosis.