The European Research Journal (EuRJ) is an international, independent, double-blind peer-reviewed, Open Access and online publishing journal, which aims to publish papers on all the related areas of basic and clinical medicine.
Global News Exposure and Perinatal Anxiety in Pregnant Women: A Cross-Sectional Study
Objective: This study aimed to investigate the relationship between global news exposure and perinatal anxiety levels among pregnant women. Methods: This cross-sectional analytical study included 180 pregnant women. Data were collected via an online questionnaire consisting of sociodemographic characteristics, global news consumption habits, and the Perinatal Anxiety Screening Scale (PASS). Correlations were assessed using Spearman analysis, and independent predictors were evaluated with multivariate linear regression. Results: A total of 169 participants were included in the final analysis. The mean PASS score was 34.2±15.8. Significant positive correlations were found between anxiety levels and daily news checking frequency (r=0.172, P=0.025), fear of missing news (r=0.154, P=0.046), repetitive checking behavior (r=0.262, P<0.001), post-exposure tension (r=0.236, P=0.002), and perceived impact of negative news on pregnancy (r=0.343, P<0.001). In multivariate analysis, repetitive checking behavior and perceived negative impact remained independent predictors. Conclusion: Global news exposure is significantly associated with perinatal anxiety. This relationship appears to be driven more by behavioral and cognitive responses to news rather than exposure duration.
Copyright (c) 2026 The European Research Journal https://creativecommons.org/licenses/by-nc-nd/4.0
Impact of Visual Awareness of Postoperative Appearance on Functional Recovery After High Tibial Osteotomy: A Retrospective Case-Control Study
Objective: This study aimed to evaluate the impact of visual awareness of preoperative and postoperative leg appearance on patient satisfaction and functional recovery after medial open-wedge high tibial osteotomy (MOWHTO) in patients with varus malalignment. We hypothesized that providing patients with visual feedback of their cosmetic improvement may enhance perceived functional outcomes and overall satisfaction. Methods: A retrospective case-control study was conducted including 57 patients who underwent MOWHTO for varus malalignment between 2019 and 2023. Patients were divided into two groups: Group 1 (n=24), who were shown preoperative and postoperative leg photographs, and Group 2 (n=33), who were not. Functional outcomes were assessed using the Short Form-36 (SF-36) physical and mental scores and Lysholm score. Radiological parameters and joint range of motion were also evaluated preoperatively and at final follow-up. Results: Both groups showed significant postoperative improvements in SF-36 and Lysholm scores (P<0.05). However, Group 1 demonstrated significantly higher postoperative SF-36 physical (P=0.001), SF-36 mental (P=0.001), and Lysholm scores (P=0.002) compared to Group 2. Although radiological parameters and joint range of motion improved significantly in both groups, there were no significant differences between groups. Conclusion: Visual presentation of preoperative and postoperative leg photographs may increase patient awareness of surgical changes and be associated with improved patient-reported outcomes and satisfaction following MOWHTO. Incorporating visual methods into patient education may present a simple approach to influencing postoperative perception.
Maternal Serum Netrin-1 Levels in Pregnancies Complicated by Gestational Diabetes Mellitus
Objective: Gestational diabetes mellitus (GDM) is associated with metabolic and vascular disturbances, yet its underlying biological mechanisms remain incompletely understood. Netrin-1, a multifunctional protein involved in angiogenesis, inflammation, and endothelial homeostasis, has been implicated in metabolic disorders; however, clinical data in GDM are limited. This study aimed to evaluate maternal netrin-1 levels in pregnancies complicated by GDM and to assess their associations with clinical parameters. Methods: This prospective case–control study included 45 pregnant women with GDM and 80 healthy pregnant controls between 24 and 28 weeks of gestation. Serum netrin-1 concentrations were measured using enzyme-linked immunosorbent assay. Clinical characteristics, glycemic parameters, and pregnancy outcomes were recorded. Receiver operating characteristic (ROC) analysis assessed the discriminatory performance of netrin-1 for GDM, and correlation and multivariable regression analyses identified associations after adjustment for selected covariates. Results: Serum netrin-1 levels were significantly lower in GDM group compared with controls (P<0.001). Netrin-1 concentrations showed significant inverse correlations with fasting plasma glucose (r=−0.446, P=0.002) and HbA1c (r=−0.623, P<0.001). ROC analysis identified an optimal cut-off value of 0.09 ng/mL for discriminating GDM, yielding a sensitivity of 68.9% and a high specificity of 98.8% (AUC=0.861), indicating good discriminative performance. In multivariable analysis adjusted for age, body mass index, and parity, log-transformed netrin-1 levels were associated with GDM (P<0.001). Conclusion: Maternal netrin-1 levels are significantly reduced in pregnancies complicated by GDM and are closely associated with glycemic dysregulation. Netrin-1 may reflect underlying metabolic and vascular alterations and could be considered as a complementary biomarker rather than a standalone diagnostic tool in GDM.
Beyond the Node Count: Metastatic Lymph Node Ratio as a Prognostic Marker in Locally Advanced Colorectal Cancer
Objective: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality, and staging based on the number of metastatic nodes may not fully reflect nodal tumor burden. The metastatic lymph node ratio (mLNR) has been proposed as a more informative prognostic marker, but its role in locally advanced CRC is unclear. This study aimed to evaluate the prognostic value of mLNR in patients with locally advanced (T3–T4), non-metastatic CRC and to identify an optimal cut-off for recurrence prediction. Methods: We retrospectively analysed 225 patients with T3–T4, non-metastatic CRC who underwent curative resection between 2015 and 2019. Disease-free survival (DFS) and overall survival (OS) were estimated using Kaplan–Meier analysis. Associations between mLNR, recurrence, stage and survival were examined with standard statistical tests. An optimal mLNR cut-off for recurrence was derived by receiver operating characteristic (ROC) analysis. Results: Patients with recurrence had significantly higher mLNR than recurrence-free patients. mLNR correlated inversely with DFS but not with OS. Higher mLNR was associated with T4 tumors and with higher AJCC stage. ROC analysis identified an mLNR cut-off of 0.1846 (area under the curve 0.643). Patients with mLNR ≥ 0.1846 had significantly shorter DFS and OS. A lymph node yield ≥12 was associated with longer DFS but not OS. Conclusion: mLNR is associated with recurrence, tumor stage and survival in locally advanced CRC, and a threshold around 0.18 may improve risk stratification beyond conventional node counts.
Early-Onset Rupture and Cardiac Embolization of an Implantable Venous Port Catheter: A Case Report of Pinch-Off Syndrome
Implantable venous access devices are indispensable for long-term treatment management in oncology patients; however they may lead to rare but serious mechanical complications. While ''Pinch-off syndrome'' is typically associated with chronic catheter wear occurring over several months, we present the case of a 46-year-old female patient who developed complete rupture and cardiac embolization only 12 days after implantation. The catheter ruptured during the first chemotherapy session, 7 days after placement, and became lodged between the right ventricle and the subclavian vein. The embolized distal fragment was successfully retrieved via the right brachial vein using a snare catheter.
Effect of Active Aspiration Drainage System Use on Postoperative Outcomes After Cardiac Surgery
Objective: Postoperative drainage systems are essential for maintaining hemodynamic stability and enabling early detection of complications after cardiac surgery. This study aimed to evaluate the impact of an active suction drainage system applying negative pressure on postoperative morbidity and mortality. Methods: This single-center retrospective study included 153 patients who underwent open-heart surgery between August 2023 and August 2024. Patients were divided into two groups based on the drainage method: active suction drainage (n=69) and conventional drainage (n=84). Postoperative drainage volume, cardiac tamponade, re-exploration for bleeding, mortality, and postoperative complications such as acute kidney injury and wound infection were evaluated. Univariate logistic regression analyses were performed to assess potential confounding factors. Results: Cardiopulmonary bypass time, aortic cross-clamp time, and total operative duration were significantly longer in the active suction group (P=0.007, P=0.009 and P=0.010, respectively), while local hemostatic agent use was higher in the conventional group (P<0.001). Despite these differences, postoperative drainage volume, re-exploration rates, incidence of cardiac tamponade, acute kidney injury, wound infection, and mortality were comparable between groups (all P>0.05). Length of hospital stay was significantly longer in the active suction group. Univariate regression analyses did not identify any independent predictors of re-exploration or cardiac tamponade (P>0.05 for all variables). Conclusion: Active suction drainage was not associated with significant differences in major postoperative outcomes compared with conventional drainage methods. Although operative variables differed between groups, these factors did not demonstrate an independent effect on clinical outcomes. A numerically higher incidence of cardiac tamponade in the active suction group did not reach statistical significance and should be interpreted cautiously. Further large-scale prospective studies are warranted.
Evaluation of Ozone Therapy Effectiveness by the Red Cell Distribution Width/Albumin Ratio
Objective: Ozone is an inorganic gas utilized for medical purposes. Ozone therapy has gained increasing popularity in recent years and is employed in the treatment of chronic diseases associated with inflammation. The red cell distribution width/albumin ratio (RAR) has recently emerged as an inflammatory marker. The aim of this study was to evaluate the efficacy of ozone therapy in patients with spinal pain and to investigate the effect of ozone therapy on inflammation through changes in the RAR value. Methods: This prospective pilot study was conducted in a pre- and post-treatment design on patients with spinal pain. In addition to demographic data, visual analog scale (VAS) scores and RAR values were recorded before and after ozone therapy. All patients underwent major ozone autohemotherapy. Data were analyzed using the SPSS software. Results: During the study period, 93 patients presented to the ozone therapy unit. After applying the exclusion criteria, 66 patients were included in the analysis. The mean pre-treatment VAS score was 6.74±1.53, while the mean post-treatment VAS score was 4.08±1.54 (P<0.05). The mean pre-treatment RAR value was 3.37±0.64, which decreased to 3.14±0.50 following ozone therapy (P<0.05). Conclusion: Our findings demonstrate that major ozone autohemotherapy is effective in alleviating spinal pain. Furthermore, the reduction in RAR values before and after treatment indicates that major ozone autohemotherapy exerts an anti-inflammatory effect.
The Contribution of Yâdigâr-i Ibn-i Sharif to Orthopedics Through Fifteenth-Century Medical Knowledge: Modern Interpretations of Traditional Therapeutic Practices and an Ethnopharmacological–Orthopedic Analysis
This study examines the fifth chapter of Yâdigâr, written by the 15th-century Ottoman physician Tabîb Ibn-i Sharif, within the context of contemporary orthopedics and traumatology. The chapter addresses therapeutic approaches for musculoskeletal conditions, including fractures, dislocations, and contusions. The historical practices described in the text were interpreted in light of current biomedical and ethnopharmacological knowledge, with particular emphasis on herbal formulations and nutritional recommendations. Several of these traditional approaches suggest conceptual parallels with modern scientific understanding, especially regarding anti-inflammatory, antimicrobial, and nutritional effects that may support tissue healing. However, certain practices, such as bloodletting, are inconsistent with current orthopedic principles. Overall, this analysis indicates that historical medical texts such as Yâdigâr may provide conceptual rather than directly clinical relevance, offering valuable insights for ethnopharmacological research and contributing to a broader understanding of the historical development of orthopedic knowledge.
Endometrioid Carcinoma Metastasis and Minute Pulmonary Meningothelial-Like Nodules in the Lung: A Case Report
Minute pulmonary meningothelial-like nodules (MPMN) are rare pulmonary lesions characterized by the proliferation of cells showing meningothelial differentiation and are most commonly detected incidentally. Their coexistence with pulmonary metastases is uncommon. We report a case of metastatic endometrioid carcinoma of the lung associated with incidentally identified MPMN. A 60-year-old woman with a history of endometrioid carcinoma presented with a soft tissue density lesion measuring 38×42 mm with ill-defined margins, causing mild narrowing of the right upper lobe bronchus on computed tomography. Surgical resection of the lung mass was performed. Intraoperative frozen section examination revealed a malignant epithelial neoplasm consistent with adenocarcinoma. On permanent sections, histopathological evaluation demonstrated an epithelial tumor composed of complex and cribriform glandular structures within a desmoplastic stroma, accompanied by loss of polarity and nuclear enlargement, consistent with metastatic endometrioid carcinoma. In the wedge resection specimen obtained after frozen section examination, multiple microscopic lesions were identified in the non-neoplastic lung parenchyma. These lesions consisted of bland cells with round to ovoid nuclei arranged in whorled patterns along the alveolar septa. Immunohistochemical analysis supported the diagnoses of metastatic endometrioid carcinoma and MPMN, respectively. Based on the histopathological, immunohistochemical, and clinical findings, the mass lesion was diagnosed as metastatic endometrioid carcinoma, while the incidental parenchymal lesions were diagnosed as MPMN. To our knowledge, coexistence of MPMN with metastatic endometrioid carcinoma is exceedingly rare and not well documented in the indexed English-language literature.
Minute Pulmonary Meningothelial-Like Nodules
Predictive Value of First Trimester APRI Score and FIB-4 Index for Gestational Diabetes Mellitus
Objective: Inflammation, liver injury, and subclinical fibrotic processes secondary to insulin resistance are thought to play an important role in gestational diabetes mellitus (GDM). This study aimed to evaluate the predictive value of the aspartate aminotransferase–platelet ratio index (APRI) and fibrosis-4 (FIB-4) index, which reflect inflammatory status and hepatic involvement, for the prediction of GDM. Methods: This retrospective study included 3,305 pregnant women who delivered at Department of Obstetrics and Gynecology, Bursa Yüksek İhtisas Training and Research Hospital between January 2020 and December 2024. Of these, 371 women were diagnosed with GDM, while 2,934 women with normal glucose tolerance constituted the control group. Oral glucose tolerance test results, APRI scores, and FIB-4 indices were compared between the groups. Results: The median APRI score and FIB-4 index were significantly higher in the GDM group than in the control group (P<0.001 and P=0.027, respectively). An APRI score >0.22 predicted GDM with a sensitivity of 61.46% and a specificity of 66.02% (AUC=0.667, P<0.001), whereas a first-trimester FIB-4 index >0.53 showed a sensitivity of 66.31% and a specificity of 41.0% (AUC=0.535, P=0.027). ROC analysis demonstrated that first-trimester APRI had significantly greater predictive ability for GDM than FIB-4 (P<0.001). Correlation analysis revealed no significant associations between APRI and clinical parameters, while the FIB-4 score showed weak positive correlations with age and parity. Conclusion: The present study suggests that both APRI score and FIB-4 index may serve as noninvasive biomarkers for the early prediction of GDM. Notably, the APRI score demonstrated superior predictive performance compared with FIB-4 index. Keywords: Gestational Diabetes Mellitus, APRI Score, FIB-4 Index, Inflammation, Oral Glucose Tolerance Test
Meeting Abstracts of the 6th Uludag Cardiology Summit, March 26-29, 2026, Bursa, Türkiye
OP-1. Prognostic Value of the HALP Score for Predicting Left Ventricular Remodeling in STEMI Patients Undergoing Primary PCI OP-2. Short Term Clinical Outcomes and Predictors of Selective Left Bundle Branch Pacing OP-3. Association Between Delayed QRS Transition Zone and Diabetes Mellitus OP-4. Vasospastic Angina: A Case of Coronary Spasm Confirmed by Ergonovine OP-5. Cardiac Effects of Chronic Pyrethroid Exposure OP-6. Effect of SGLT-2 Inhibitors on MPV in Heart Failure Patients OP-7. Evaluation of Subclinical Myocardial Dysfunction in Cirrhosis Using 4D Strain Analysis OP-8. The Role of the Intermountain Risk Score in Predicting Coronary Artery EctasiaOP-9. Association Between Uric Acid to Albumin Ratio and No-Reflow Phenomenon in Patients with NSTEMI OP-9. Association Between Uric Acid to Albumin Ratio and No-Reflow Phenomenon in Patients with NSTEMI OP-10. Coronary Vasospasm Presenting as ST-Elevation Myocardial Infarction: A Case Report OP-11. Management of a Stripped Stent within a Dissected Coronary Lesion OP-12. Prognostic Utility of the Pan-Immune-Inflammation Value (PIV) in Predicting No-Reflow Among Patients Undergoing Primary PCI for STEMI OP-13. VARC-3 Outcomes of Myval, Portico, and Evolut-R in TAVI OP-14. Colchicine Aiding Recurrent Pacemaker Pocket Inflammation Management: A Case Report OP-15. Colchicine Use After Coronary Artery Stenting: One-Year Follow-Up Results OP-16. Drug-Coated Balloon-Only Strategy for Chronic Total Occlusion: A Prospective, Two-Center Study of 48 Patients OP-17. The Role of Pharmacological Cocktails in Preventing Radial Spasm and Complications During Percutaneous Coronary Intervention (PCI): A Clinical Study OP-18. Drug-Coated Balloon-Only Strategy in a True LCx–OM Bifurcation Lesion (Medina 1.1.1): Case Report with 12-Month Follow-Up OP-19. The Utility of Atherogenic Index of Plasma in Predicting in-Hospital Ischemic Stroke in Patients Undergoing Carotid Artery Stenting OP-20. A Case of Long QT Syndrome Presenting with Ventricular Arrhythmia OP-21. Can We Predict Reperfusion in ST-Elevated Myocard Infaction? OP-22. The Effect of Volume Overload on Ventriculo-Arterial Coupling in Hemodialysis Patients OP-23. Minimal Symptoms, Maximum Risk: Hidden Type A Dissection Accompanying an 81 mm Ascending Aortic Aneurysm OP-24. Comparative Efficacy of Single- and Dual-Defibrillator Orthogonal Electrical Cardioversion in Persistent Atrial Fibrillation OP-25. Complete Atrioventricular Block and Postpartum Cardiomyopathy in a Patient With c-TGA: A Case of Right-Sided Cardiac Resynchronization Therapy OP-26. Predictive Value of Systemic Immune-Inflammation Index for INOCA OP-27. Transcatheter Closure of Mitral Paravalvular Leak Developing After Mechanical Mitral Valve Replacement: A Case Report OP-28. Acute Coronary Syndrome After Anaphylaxis: Kounis Syndrome Case OP-29. Cardiac Lymphoma: A Rare Case Report OP-30. The Clinical Significance of the Plasma Atherogenic Index in Predicting Total Occlusion in Patients with Non-ST Elevation Myocardial Infarction OP-31. Prognostic Nutritional Index and Frailty After Ischemic Stroke: Mid-Term Follow-Up Results OP-32. Diagnostic Challenge in Cardiac AL Amyloidosis: When Imaging Speaks Louder Than Serum Biomarkers OP-33. Nightmare in the Cath Lab: LMCA Dissection OP-34. Association of Preoperative Serum Magnesium Levels and Acute Kidney Injury Following Thromboembolectomy in Acute Limb Ischemia OP-35. Could the Systemic Coagulation Inflammation Index Be a Predictor of Worse Outcomes After Carotid Endarterectomy? OP-36. The Role of Exocrine Pancreatic Insufficiency in Predicting Concomitant Carotid Artery Disease in Diabetic Patients Scheduled to Undergo Coronary Artery Bypass Grafting OP-37. Relationship Between TASC II Lesion Severity and Carotid Artery Stenosis: A Cross-Sectional Analysis OP-38. Hyponatremic Seizure in a Middle-Aged Woman on Spironolactone–Hydrochlorothiazide OP-39. An Unexpected Cause of Angina: Successful Percutaneous Closure of an Internal Mammary Artery–Left Atrium Fistula OP-40. Predictors of Isolated Nocturnal Hypertension in Non-obese Non-diabetic Individuals OP-41. The Impact of Guideline-based Treatment on In-hospital Outcomes in Infective Endocarditis OP-42. The Effect of Unfractionated Heparin Administration Timing on Radial Artery Spasm and Occlusion in Radial Coronary Angiography OP-43. The Mediating Role of Heart Rate in the Relationship Between Smoking and Myocardial Performance Op-44. Avoiding Emergency Surgery with Imaging-Guided Thrombolysis in Mechanical Valve Thrombosis OP-45. Predictive Value of the Frontal QRS-T Angle for Coronary Thrombus Burden in Patients Presenting with Acute Myocardial Infarction OP-46. STEMI Caused by Thrombotic Subclavian Occlusion in LIMA Grafted Patient OP-47. Hemoptysis During Cardioverter-Defibrillator Implantation: A Rare Complication OP-48. Intra-Arterial Lidocaine for Resistant Radial Artery Spasm OP-49. Routine Clinical and Lipid Parameters Predict High-Grade Atrioventricular Block After Transcatheter Aortic Valve Implantation: A Pragmatic Single-Center Study OP-50. CONUT Score and Length of Hospital Stay in Acute Decompensated Heart Failure OP-51. Distinction Between Type 2 Myocardial Infarction and Myocardial Injury in Troponin Positivity: Retrospective Clinical Classification and 30-Day Prognosis OP-52. Myocardial Contraction Fraction as an Independent Predictor of Cardiovascular Mortality in Patients with Chronic Renal Failure OP-53. Surgical Stentectomy and Bypass in Coronary Full Metal Jacket OP-54. AF-Ablation Performed via Transeptal Passage Through Septal Occuder Device: A Case Report. OP-55. Acute Axillary Artery Occlusion Following Transradial Intervention: A Case Report OP-56. A Multidomain Risk Cluster for Predicting Contrast-Induced Nephropathy After Carotid Artery Stenting OP-57. An Overlooked Phenotype: Widespread Non-calcified Atherosclerosis Presenting with Vision Loss OP-58. Safety and Efficacy of Carotid Artery Stenting Without Routine Anticholinergic Pretreatment OP-59. The Dark Path of Infective Endocarditis: Prosthetic Valve Endocarditis Unveiled by Multimodality Imaging OP-60. The Cost of Pregnancy? Peripartum Cardiomyopathy Following IVF OP-61. Malignant RCA in the Shadow of Perimyocarditis Op-62. One Implantation, Two Challenges: Anatomical Difficulty and Post-Cardiac Injury Syndrome OP-63. Ozaki Procedure OP-64. Diagnostic Performance of Coronary CT Angiography Compared with Invasive Coronary Angiography and the Impact of Coronary Calcium Score: A Single-Center Real-World Study
Mutation-Associated P53 Immunohistochemical Patterns in Invasive Breast Carcinoma: Clinicopathological Correlations
Objective: TP53 mutations are the most common genetic changes in human malignancies. Recent studies suggest that specific p53 immunohistochemical staining patterns may reflect underlying TP53 mutations and have prognostic significance. This study aimed to evaluate the predictive and prognostic importance of p53 immunohistochemical staining patterns in invasive breast carcinoma. Methods: A total of 345 patients with invasive breast carcinoma were included in the present study. p53 immunohistochemistry was evaluated and categorized as wild-type, overexpression, null, cytoplasmic or equivocal. Clinicopathological variables were compared statistically. Results: Wild-type p53 staining was observed in 243 (70.4%) cases, whereas abnormal p53 staining were detected in 90 (26.1%) cases. Abnormal p53 expression were associated with a younger patient age (median 48 vs. 52 years, P=0.041), larger tumor size (29 vs. 22 mm, P<0.001), higher histological grade (P<0.001) and higher Ki-67 levels (P<0.001). Hormone receptor negativity was significantly more frequent in tumor with abnormal p53 staining (ER negativity: 63.3% vs. 9.1%; PR negativity: 65.6% vs. 21.0%; both P<0.001). HER2 positivity was also more prevalent in the abnormal p53 group (P<0.001). Triple-negative breast cancer was significantly more prevalent in tumor with abnormal p53 expression 43.3% vs. 6.6%, P<0.001. Additionally, lymph node metastasis was significantly more prevalent in the abnormal p53 group (75.6% vs. 56.8%, P=0.003). Conclusion: Abnormal p53 staining patterns are strongly associated with adverse clinicopathological features and aggressive molecular subtypes in invasive breast carcinoma. These results suggest that p53 staining patterns could be used as a practical surrogate marker to reflect tumor aggressiveness and provide prognostic information in routine pathological evaluations.
Long-Term Outcomes of Pediatric Intracardiac Masses: Clinical Course and Tumor Behavior in a Single-Center Experience
Objective: We aimed to evaluate the clinical characteristics, diagnostic pathways, echocardiographic and Holter findings, treatment strategies, and long-term outcomes of children with intracardiac masses, and to explore factors associated with tumor regression. Methods: This retrospective observational study included children with echocardiographically confirmed intracardiac masses followed at a tertiary pediatric cardiology center between January 2010 and January 2022. Demographic and clinical characteristics, tumor features, serial echocardiographic measurements, 24-hour Holter recordings, treatment strategies, and follow-up outcomes were analyzed. Results: A total of 20 patients were included. Rhabdomyoma was the most common tumor type (60%, n=12), followed by fibroma (30%, n=6). Most patients were asymptomatic or mildly symptomatic at presentation (90%, n=18). Clinically significant arrhythmias were observed in 15% (n=3), predominantly in patients with fibromas. Tumor size reduction was observed in 40% (n=8) of patients. All patients diagnosed during the fetal period (15%, n=3) exhibited tumor size reduction; all had rhabdomyomas. Everolimus was administered in 25% (n=5) of patients, with tumor size reduction observed in 80% (n=4) of treated cases; however, this was not statistically significant (P=0.253). Left ventricular systolic function remained preserved in all patients during follow-up. Conclusion: Pediatric intracardiac masses are predominantly benign but show heterogeneous clinical behavior. Tumor regression was more frequent in rhabdomyomas; however, this may reflect tumor type distribution. Arrhythmias were more frequent in fibromas, supporting rhythm surveillance. Everolimus may be considered in selected patients; however, findings should be interpreted with caution due to limited sample size and potential selection bias, and require confirmation in larger studies.
Stepwise Diagnostic Evaluation in Pediatric Epilepsy: Clinical and EEG Predictors of MRI Positivity and Diagnostic Reclassification
Objective: This study aimed to evaluate the predictive value of clinical and electroencephalographic (EEG) findings for identifying epileptogenic structural lesions on cranial magnetic resonance imaging (MRI) in pediatric epilepsy, and to assess the contribution of MRI to diagnostic reclassification. Methods: A total of 207 pediatric patients with a confirmed diagnosis of epilepsy were retrospectively analyzed. The diagnostic workflow was evaluated through a stepwise model integrating clinical assessment, EEG, and MRI. The primary endpoints comprised the MRI positivity rate, defined by the detection of epileptogenic structural lesions, and the diagnostic reclassification rate, defined as any modification in epilepsy type classification or etiological category following the incorporation of EEG and/or MRI findings. Independent predictors of MRI positivity were identified using multivariable logistic regression analysis. Results: Epileptogenic structural lesions were identified in 9.7% of patients. Despite a relatively modest MRI positivity rate, imaging significantly contributed to diagnostic refinement. Among cases with normal EEG findings, MRI revealed structural pathology in 12%. The overall diagnostic reclassification rate following the addition of MRI was 9.7%. In multivariable analysis, focal-onset seizures (OR=2.63), developmental delay (OR=2.91), abnormal neurological examination (OR=3.08), and focal epileptiform EEG activity (OR=2.47) emerged as independent predictors of MRI positivity (all P<0.05). Agreement between EEG and MRI lateralization was moderate (κ=0.60). Conclusion: In pediatric epilepsy, MRI may substantially contribute to etiological classification, particularly in the presence of high-risk clinical and electrophysiological features. These findings support the implementation of a risk-stratified, stepwise diagnostic approach to optimize clinical management.
Pediatric epilepsy; Magnetic resonance imaging; Electroencephalography
Outcomes of Single-Level and Multi-Level Thoracoscopic Sympathectomy in Primary Axillary Hyperhidrosis: A Multicenter Retrospective Analysis
Objective: Primary axillary hyperhidrosis is associated with substantial impairment in quality of life, and endoscopic thoracic sympathectomy (ETS) provides definitive treatment in refractory cases. However, the optimal level of sympathetic interruption remains controversial, and evidence directly comparing different surgical levels in axillary disease is limited. This study aimed to compare surgical outcomes among three sympathectomy levels in patients with primary axillary hyperhidrosis. Methods: This retrospective multicenter study included 83 patients who underwent bilateral clip-based thoracoscopic sympathectomy for primary axillary hyperhidrosis between 2009 and 2023. Patients were stratified into three groups: single-level R3 (n=24), single-level R4 (n=35), and multi-level R2–R4 (n=24). The primary outcome was compensatory hyperhidrosis. Secondary outcomes included complete remission, recurrence, postoperative complications, and patient satisfaction. Factors associated with outcomes were evaluated using univariate and multivariate logistic regression analyses. Results: Compensatory hyperhidrosis occurred in 83.3% of patients in the R2–R4 group, compared with 75.0% in the R3 group and 54.3% in the R4 group (P=0.045). Complete remission rates were comparable among groups (54.2%, 41.7%, and 34.3%, respectively; P=0.452). In multivariate analysis, R4 sympathectomy was associated with significantly lower odds ratio (OR) of compensatory hyperhidrosis compared with R2–R4 (OR: 0.25, 95% CI: 0.06–0.97; P=0.044). Recurrence rates did not differ significantly among groups (20.8%, 25.7%, and 12.5%, respectively; P=0.466). Recurrence was the only independent predictor of patient dissatisfaction (OR: 0.12, 95% CI: 0.03–0.44; P=0.001). Conclusion: Single-level R4 sympathectomy appears to provide a favorable balance between treatment efficacy and side-effect profile in primary axillary hyperhidrosis. Multi-level approaches were not associated with improved clinical outcomes but were linked to higher rates of compensatory hyperhidrosis. These findings should be interpreted with caution.
Analysis of Early Reoperation and Mortality Following Intertrochanteric Fracture Fixation in Elderly Patients: A Focus on Frailty, Bone Quality, and Technical Factors
Objectives: Intertrochanteric femur fractures in older adults carry high risks of early complications and mortality. This study aimed to identify independent predictors of early fixation failure and postoperative mortality by integrating patient-, fracture-, and technique-related factors. Methods: This single-center retrospective cohort included 150 patients aged ≥65 years who underwent surgical fixation with a Dynamic Hip Screw (DHS) or Proximal Femoral Nail Antirotation (PFN-A) for the AO Foundation/Orthopaedic Trauma Association (AO/OTA) 31-A intertrochanteric fractures. Evaluated variables included comorbidity burden assessed using the Charlson Comorbidity Index, bone quality assessed using the Singh Index, pre-fracture mobility assessed using the Functional Ambulation Scale, fracture pattern, and reduction–fixation quality. Results: Early reoperation occurred in 12.6% of patients, and 6-month mortality was 24%. Independent predictors of early reoperation included fracture instability (AO/OTA 31-A3; adjusted odds ratio [aOR]=1.41) and higher Charlson Comorbidity Index score (aOR=2.47). In contrast, better bone quality (higher Singh Index; aOR=0.16), superior reduction–fixation quality (aOR=0.12), and higher pre-fracture mobility (aOR=0.75) were protective against reoperation. Early mortality was independently associated with a higher Charlson Comorbidity Index score (aOR=1.74), poorer bone quality (aOR=0.42), and lower pre-fracture mobility (aOR=0.24). Implant type did not significantly influence either outcome. Conclusions: Early fixation failure is primarily influenced by fracture instability, osteoporosis severity, and fixation quality, whereas early mortality reflects comorbidity burden and frailty. Incorporating comorbidity burden, bone quality, and pre-fracture mobility into preoperative assessment may improve risk stratification and guide personalized perioperative management in elderly patients with intertrochanteric femur fractures.
Three Decades of SSRI/SNRI Withdrawal Research: A Bibliometric and Science-Mapping Study
Objectives: Selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are widely prescribed, and growing evidence highlights the clinical and methodological challenges of withdrawal during discontinuation. This study aimed to provide a comprehensive bibliometric map of SSRI/SNRI withdrawal research to clarify production patterns, citation structures, thematic evolution, and global collaboration. Methods: A comprehensive search of the Web of Science Core Collection (1995–2025) identified 652 original articles on SSRI/SNRI withdrawal, discontinuation, or tapering. Records were analyzed using the bibliometrix package in R for performance metrics, co-citation and keyword networks, and country–institution collaboration structures. Results: The corpus comprised 652 documents published in 308 journals, citing 18,957 references, with an annual growth rate of 7.79%. Articles received a mean of 41.6 citations. The Journal of Clinical Psychiatry (22 articles; h=20) and Journal of Clinical Psychopharmacology (18; h=14) were the most influential sources. Highly cited documents ranged from 270 to 730 citations, predominantly from Lancet, Pediatrics, The New England Journal of Medicine, and American Journal of Psychiatry. Keyword frequency was led by “depression” (n=172), “fluoxetine” (n=153), and “antidepressants” (n=152). The United States produced 240 articles (36.8%; 12,904 citations), forming the central hub of the collaboration network. Conclusions: SSRI/SNRI withdrawal research shows concentrated authorship, journal anchoring, and geographically centralized knowledge production, with emerging themes in tapering, pregnancy outcomes, and pharmacogenetics.
Selective Serotonin Reuptake Inhibitor (SSRI)
Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
Craniofacial Morphological Features in Childhood Age with Autism Spectrum Disorder
Objectives: Autism spectrum disorder often exhibits unusual craniofacial morphology, which may indicate underlying neurodevelopmental abnormalities in childhood. This study aimed to investigate the relationship between craniofacial anthropometric measurements, the severity of autism, and language development in children with autism spectrum disorder. Methods: This study included 66 children (50 boys, 16 girls) aged 6–10 years who were diagnosed with autism spectrum disorder. Three-dimensional facial scanning was performed after the removal of glasses, and anthropometric measurements were analyzed in relation to scores on the Gilliam Autism Rating Scale and the Turkish Communication Development Inventory. Results: A significant association was found between increased head circumference and higher autism severity (P=0.035), with larger head size correlating with decreased forehead height, may suggest greater symptom severity in boys. No significant associations were observed in girls. Craniofacial metrics showed no association with language development in either gender. Conclusions: Head circumference and forehead height have been identified as potential craniofacial indicators of autism severity in boys with autism spectrum disorder. These findings highlight the effectiveness of craniofacial phenotyping in clarifying the neurodevelopmental characteristics associated with autism. Future research, utilizing larger and more sex-balanced cohorts, is imperative to clarify these relationships and their potential diagnostic relevance.
Biologic Therapies for Type 2 Inflammatory Diseases: A Bibliometric Analysis of Publication Trends and Intellectual Structure
Objectives: To comprehensively analyze the scientific literature (2005–2025) on biologic agents for Type 2 inflammatory diseases, including Severe Asthma (SA), Atopic Dermatitis (AD), and chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to identify publication trends, thematic clusters, collaboration networks, and the field's intellectual foundation. Methods: A bibliometric analysis was performed using data from the Web of Science (WoS) Core Collection (retrieved October 27, 2025). VOSviewer software was used to analyze co-occurrence networks (based on Author Keywords) and map collaborations. Results: A total of 7,339 publications were analyzed. A significant acceleration in publishing occurred after 2017. The most productive countries were the USA (n=2,346), Italy (n=1,149), and the UK (n=936). Thematic analysis identified three distinct clusters: AD, SA, and CRSwNP. The intellectual foundation of the field is built upon highly cited phase 3 clinical trials (e.g., mepolizumab, dupilumab, benralizumab) published in top-tier journals (NEJM, The Lancet). Conclusions: The research landscape for Type 2 biologics has grown rapidly since 2017, driven by clinical validation in landmark trials. The field's focus is evolving from demonstrating clinical efficacy toward mechanism-based personalized medicine and biomarker identification.
Febrile Seizures: Clinical Factors Influencing the Length of Hospital Stay
Objectives: This study aimed to identify the clinical factors influencing the length of hospital stay (LOS) in children aged 0–60 months hospitalized with febrile seizures (FS), and to explore potential immunological and psychosocial modulators that may affect hospitalization decisions. Methods: A retrospective observational study was conducted at a tertiary hospital in Karabük, Türkiye, between September 2023 and September 2025. Medical records of patients diagnosed with FS (ICD-10 R56.0) were reviewed using the FONET and e-Nabız systems. Demographic and clinical variables - including age, sex, fever, seizure duration, type (simple/complex), recurrence, infection focus, and presence of seasonal allergic rhinitis (SAR) - were analyzed. Factors associated with LOS were evaluated using multivariable linear regression (P<0.05). Results: A total of 93 children (53.3% male, mean age: 24.6±13.7 months) were included. The mean LOS was 48.2±44.7 hours. Regression analysis showed that recurrence and SAR were associated with shorter LOS (P=0.062 and P=0.065, respectively), while seizure duration and prematurity had no significant effect. Bronchitis, otitis, and tonsillitis were linked to longer stays, whereas acute gastroenteritis and mild upper respiratory infections were linked to shorter ones. Family history was strongly associated with recurrence but not with LOS. Conclusions: Hospital stay in FS is influenced more by immunological and psychosocial dynamics than by traditional demographic factors. The presence of SAR may act as a modulatory condition reducing LOS, possibly through pre-activated immune regulation. Family experience appears to facilitate earlier discharge. Integrating these factors into clinical decision-making may improve resource use and standardize hospitalization criteria.
Biomechanical Determinants of Shooting Performance: The Role of Wrist and Elbow Joint Range of Motion in Male Basketball Players
Objectives: The aim of this study is to examine the relationship between wrist and elbow joint range of motion and shooting performance in young male basketball players. Methods: The research was conducted as a cross-sectional correlational study. The study sample consisted of 23 male basketball players residing in Diyarbakır, selected through purposive sampling. The wrist and elbow joint range of motion values, along with shooting performance scores of the athletes, were measured. Frequency analyses were performed, and after confirming the normality of the data distribution, Pearson correlation and multiple regression analyses were conducted. Results: According to the results, strong and significant positive correlations were observed between elbow flexion and pronation and shooting performance. In addition, elbow supination, as well as wrist flexion and extension, also showed statistically significant positive relationships with shooting performance. However, no significant relationship was found between shooting performance and radial deviation, ulnar deviation, or elbow extension. Conclusions: In conclusion, elbow joint range of motion appears to have a significant and determining effect on shooting performance in young male basketball players. In contrast, wrist mobility contributes to shooting performance to a more limited extent and therefore cannot be considered a direct determining parameter.
Effects of Localized Arm Fatigue, General Fatigue, and Elbow Bracing on Shooting Accuracy and Shoulder Proprioception: A Randomized Crossover Study
Objectives: This study aimed to comparatively investigate the effects of localized arm fatigue, general fatigue, and elbow brace use on proprioceptive accuracy and shooting accuracy in amateur female basketball players. Methods: Fifty-two amateur female basketball players (mean age: 23.08±2.02 years) participated in a randomized crossover study. Participants underwent three experimental conditions: localized arm fatigue, general fatigue, and brace application, each tested on separate days with a 48-hour washout period between sessions. Proprioceptive accuracy was assessed using the Joint Position Sense Error (in degrees), and shooting accuracy was evaluated based on shot success percentage. Fatigue perception was measured using the Borg Rating of Perceived Exertion Scale. Statistical analyses included Friedman and Wilcoxon signed-rank tests with Bonferroni correction for multiple comparisons. Results: Localized arm fatigue significantly decreased shooting accuracy (from 53.16% to 38.83%, P=0.014) and increased proprioceptive error (from 5.40° to 8.65°, P=0.003). General fatigue resulted in a moderate increase in proprioceptive error (from 4.05° to 5.35°, P=0.049) but did not significantly affect shooting accuracy (P=0.090). The use of an elbow brace improved proprioceptive accuracy (error reduction from 5.30° to 3.00°, P=0.035) and marginally enhanced shooting performance (increase from 48.33% to 54.83%, P=0.027). Strong negative correlations were found between proprioceptive degradation and shooting accuracy after localized fatigue (r= –0.787, P<0.001). Conclusions: Localized arm fatigue impairs proprioception and shooting accuracy more severely than general fatigue. Elbow bracing mitigates these impairments, suggesting its use as an intervention to maintain technical performance under fatigue in basketball athletes.
Chronobiology and Chronotherapy-Related Effects in Non-Traumatic Pain Presentations in the Emergency Department: A Retrospective Study
Objectives: Pain is one of the most frequent reasons for emergency department (ED) admissions, yet the chronobiological patterns of pain-related presentations remain insufficiently explored. This study aimed to retrospectively analyze the temporal and seasonal characteristics of non-traumatic pain-related ED visits, with a focus on daily and seasonal variations influenced by circadian rhythms. Methods: This retrospective, descriptive, cross-sectional study included adult patients (≥18 years) who presented to the Afyonkarahisar Health Sciences University Adult ED with non-traumatic pain between January 1, 2023, and December 31, 2023. Cases were identified based on ICD-10 codes for headache (R51, G43, G44), chest pain (R07.1–R07.4), abdominal pain (R10.0–R10.4), and musculoskeletal pain (M54, M79, M25). Demographic data, admission times, diagnostic procedures, treatment initiation, and hospitalization rates were analyzed. Statistical analyses utilized appropriate parametric and non-parametric tests, with significance set at P<0.05. Results: A total of 4524 patients were included (53.9% female; mean age 47.3±21.4 years). Chest pain was the most frequent diagnosis (40%), followed by headache (35.6%), musculoskeletal pain (19.6%), and abdominal pain (4.8%). ED visits peaked in the evening (mode: 21:09) and were least frequent after midnight. Headache admissions were significantly higher in autumn (30.7%), while chest pain was most common in winter (32%). Women more frequently presented with headache and abdominal pain, while men predominantly reported chest and musculoskeletal pain. Conclusions: Non-traumatic pain-related ED visits appeared to follow certain chronobiological patterns with observable sex-related differences. These preliminary findings may contribute to understanding temporal trends in pain-related ED utilization and could serve as a basis for future studies exploring the potential role of chronotherapy in pain management. Validation through larger, multicenter, and prospective studies is needed to strengthen and generalize these findings.
Impact of Comorbidities on Local Anesthetic Hypersensitivity: A Decade of Clinical Experience
Objectives: Clinicians widely utilize local anesthetic (LA) agents in pain management and surgical interventions. Nevertheless, drug hypersensitivity reaction (HR) to their use continue to raise considerable concern among both clinicians and patients. The present study aims to investigate the relationship between local anesthetic hypersensitivity reactions (LA-HRs) and comorbid conditions in patients referred to our clinic. Methods: Clinical data and test results of patients who were referred to our allergy clinic for evaluation of suspected LA-HR were retrospectively reviewed. Skin tests (ST) and subcutaneous provocation tests (SPT) were performed. Results: A total of 200 patients were included in the study. The most common reason for referral was a suspected LA-HR (80%), followed by a history of HR to other drugs with a need for LA use during upcoming procedures (20%). Among 160 patients with suspected LA- HR, only 5.6% demonstrated confirmed hypersensitivity by positive ST and SPT. Of the 40 patients with a history of HR to other drugs, only 2.5% tested positive for LA-HR. A history of comorbidity was present in 70% patients. Patients with suspected LA-HR had a significantly higher prevalence of comorbidities compared to those with HR to other drugs. However, none of the patients who tested positive had a history of comorbidity. Conclusions: Confirmed hypersensitivity risk among patients reporting LA-HR is very low. Although comorbidities were more common among patients reporting LA-HR, none of the patients with confirmed allergy had any comorbidities, underscoring the low confirmed hypersensitivity rate in this population.
Comparative Outcomes of Surgery and Chemoradiotherapy After Neoadjuvant Chemotherapy in Stage II–III Bladder Cancer
Objectives: Radical cystectomy following neoadjuvant chemotherapy is the standard treatment for Muscle-Invasive Bladder Cancer (MIBC). However, definitive chemoradiotherapy may represent a viable alternative in patients who are medically inoperable or decline surgery. This study aimed to compare the clinical outcomes of patients with stage II–III MIBC treated with neoadjuvant chemotherapy followed by either Radical cystectomy or CRT, the latter performed without maximal transurethral resection of bladder tumor (TURBT). Methods: This retrospective study included 63 patients with stage II–III MIBC treated between December 2014 and March 2025 at two tertiary referral centers in Türkiye. All patients received neoadjuvant chemotherapy (NAC) prior to either surgery (n=39) or Chemoradiotherapy (CRT) (n=24). Clinicopathological, laboratory, and survival data were analyzed. Overall Survival (OS) and Event-Free Survival (EFS) were assessed using the Kaplan–Meier method and compared with the log-rank test. Cox regression was used to identify independent prognostic factors. Results: The median age was 64 years, and 88.9% of patients were male. Comorbidities were more frequent in the CRT group (79.2% vs. 59%), though the difference was not statistically significant (P=0.099). Median OS was 46.5 months in the surgery group and 31.6 months in the CRT group (P=0.407), while median EFS was 30.1 and 21.0 months, respectively (P=0.375). Distant metastasis was the most common recurrence pattern (36.5%). Multivariate analysis identified comorbidity (Hazard ratio [HR] = 0.37, 95% CI: 0.17–0.80, P=0.012) and hemoglobin <12 g/dL (HR =0.53, 95% CI: 0.25–0.94, P=0.048) as independent predictors of poor survival. Conclusions: NAC followed by either surgery or CRT provides comparable long-term disease control in patients with stage II–III MIBC. Although RC remains the gold standard for operable patients, CRT offers an effective curative-intent option for those unfit for surgery—even in the absence of maximal TURBT. Comorbidity and anemia were significant adverse prognostic factors, emphasizing the importance of individualized treatment selection in this patient population.
Cancer Therapy (Excl. Chemotherapy and Radiation Therapy)
Therapeutic Effects of Alpha-Lipoic Acid on High-Dose Ibuprofen-Induced Renal Damage in Rats
Objectives: Nonsteroidal anti-inflammatory drugs, particularly ibuprofen, are commonly used worldwide and can cause nephrotoxicity through prostaglandin inhibition, oxidative stress, and inflammatory activation. This study aimed to investigate the histopathological, fibrotic, and oxidative effects of high-dose ibuprofen administration and to evaluate the therapeutic potential of alpha-lipoic acid) in reversing these changes. Methods: Twenty-eight male Wistar albino rats were randomly divided into four groups (n=7): Control, Alpha-lipoic acid (100 mg/kg), Ibuprofen (250 mg/kg), and Ibuprofen+Alpha-lipoic acid. Ibuprofen was administered orally for 21 days, while alpha-lipoic acid was given during the last 7 days. Histopathological changes were evaluated using Hematoxylin & Eosin, Masson’s Trichrome, and Periodic Acid–Schiff staining. Fibrotic and inflammatory markers (TGF-β1, α-SMA, TLR-4) were assessed immunohistochemically. Oxidative stress was evaluated by measuring malondialdehyde levels and superoxide dismutase activity. Results: Ibuprofen administration resulted in significant tubular degeneration, hydropic changes, necrosis, tubular dilatation, and hyperemia. Masson’s Trichrome staining showed a significant increase in collagen deposition, while Periodic Acid-Schiff staining revealed glomerular and tubular basement membrane thickening. Immunohistochemistry demonstrated marked upregulation of TGF-β1, α-SMA, and TLR-4 (P<0.001). Biochemically, malondialdehyde levels were significantly increased (P<0.01) and superoxide dismutase activity was markedly decreased (P<0.001) compared to controls. Alpha-lipoic acid treatment significantly ameliorated these changes, reducing fibrosis and inflammatory marker expression and restoring malondialdehyde and superoxide dismutase levels toward normal (P<0.05). Conclusions: Alpha-lipoic acid exerts renoprotective effects against ibuprofen-induced nephrotoxicity by reducing oxidative stress, modulating fibrotic pathways, and improving renal histoarchitecture, suggesting its potential as a therapeutic agent in drug-induced kidney injury.
Evaluation of Cardiac Functions and Rhythm in Pediatric Patients Diagnosed with Chronic Kidney Failure
Objectives: Chronic renal failure (CRF) represents a progressive and irreversible decline in renal function. Among individuals with end-stage renal disease (ESRD), cardiovascular disorders are recognized as the leading contributors to morbidity and mortality. The present study aimed to assess cardiac function in pediatric patients diagnosed with CRF. Methods: This cross-sectional study included 30 pediatric patients with CRF who were under follow-up between October 2018 and August 2019, along with 30 age- and sex-matched healthy controls. The CRF group was further divided into two subgroups according to dialysis status. For all participants, conventional 12-lead electrocardiography was performed, and indices associated with atrial (P-wave dispersion, Pd) and ventricular (QT dispersion, corrected QT dispersion, Tp–e, Tp–e/QT, Tp–e/QTc) arrhythmia risk were recorded. Each subject also underwent a detailed echocardiographic evaluation, including both conventional and tissue Doppler measurements. Results: Anthropometric characteristics and blood pressure values did not significantly differ between the patient and control groups. Apart from an increased mean corrected QT dispersion (QTcd), other electrocardiographic parameters were comparable between groups. Ejection fraction (EF) and fractional shortening (FS) values were lower in CRF patients compared with controls. LV mass index (LVMI) was significantly higher in the dialysis subgroup relative to the control group. Additionally, the myocardial performance index (Tei index) was markedly elevated in CRF patients (P<0.001). Conclusions: These findings underscore the need for comprehensive cardiac evaluation in children with CRF. Nonetheless, larger-scale studies are warranted to confirm and expand upon these observations.
The Effects of Nateglinide and Octreotide on the Uterus in Rats with Experimentally Developed Polycystic Ovary Syndrome: A Histopathological Study
Objectives: It was aimed to investigate the histopathological effects of Nateglinide (NG) and Octreotide (OC) on uterine morphology in rats with experimentally induced polycystic ovary syndrome (PCOS). Methods: Forty-two female Sprague-Dawley rats (10-12 weeks old, 340-360 g) were divided into six groups (n=7 per group) as Control, PCOS, PCOS+NG, NG only, PCOS+OC, OC only. PCOS was induced via daily oral administration of Letrozole (1 mg/kg) for 21 days. Treatment groups received NG (oral, 30 days) or OC (intraperitoneal, 0.1 mg/kg/day for 30 days). After the experiment, the uterus tissues of all rats were dissected and subjected to histopathological examinations after histological procedures. Results: Histopathological analysis revealed significant uterine damage in the PCOS group compared to other groups (P<0.01). In contrast, the Control, NG-only, and OC-only groups showed normal uterine architecture with intact epithelium, organized glands, and normal stromal structure and there were no significant differences between related groups (P>0.05). Treatment with NG or OC in PCOS rats led to improved epithelial and glandular morphology and reduced Mast cell density, no evidence of edema, and inflammation was found in the connective tissue of these treated groups, suggesting partial improvement of PCOS-induced uterine pathology (P<0.01). Conclusions: NG and OC treatments ameliorated PCOS-induced uterine histopathological changes, suggesting their potential to improve endometrial morphology. These findings may have implications for therapeutic strategies aimed at enhancing endometrial receptivity and highlighting the importance of addressing endometrial health in therapeutic strategies beyond ovarian treatment in PCOS patients.
Cardio-Hematology Crossroads: A Diffuse Large B-Cell Lymphoma Case Presenting with a Cardiac Mass
Cardiac involvement by diffuse large B-cell lymphoma (DLBCL) is a rare clinical entity that often presents with nonspecific symptoms, making early diagnosis particularly challenging. In this context, we report a case that highlights the diagnostic obstacles and the importance of early evaluation. A 58-year-old male presented with dyspnea, malaise, fingertip numbness, weight loss, and shoulder pain. Transthoracic echocardiography revealed a right atrial mass, prompting further assessment. Positron Emission Tomography-Computed Tomography demonstrated increased 18F-FDG (18F-fluorodeoxyglucose) uptake in multiple regions, including the cardiac musculature, raising suspicion for disseminated lymphoproliferative disease. The biopsy of the left superior cervical lymph node confirmed diffuse large B-cell lymphoma. The patient underwent six cycles of chemoimmunotherapy and achieved complete metabolic remission. This case underscores the need to consider lymphoid malignancies in the differential diagnosis of intracardiac masses and persistent cardiac symptoms without an obvious cause. Early use of multimodal imaging and prompt histopathological confirmation are critical for accurate diagnosis and appropriate treatment planning. Rapid initiation of immunochemotherapy may improve clinical outcomes and reduce the risk of severe cardiac complications.
Health Practices of Turkish Expectant Mothers
Objective: Health practices during pregnancy are important to support mother - child health and the safety of the delivery. Defining these health practices can help to support vulnerable groups at risk. This study aims to determine the health practices of Turkish expectant mothers and analyze related factors. Methods: A total of 350 pregnant women were reached in this cross-sectional study from a state hospital in Istanbul during their prenatal visits. Data were collected with a Personal Information Form and Health Practices in Pregnancy Questionnaire-II (HPQ-II). Results: Most (65.1%, n=228) were between 18-31 years, mean age 29.69±6.61 (18-45) years, with junior high school degree (55.7%, n=195), and housewives (90.3%, n=316). Nearly all (98.6%, n=345) followed routine examinations, were in the second trimester (51.7%, n=181), had planned pregnancy (86.6%, n=303), but had no pregnancy school attendance (96.6%, n=338). For most expectant women (55.7%, n=195), doctors were information resources. The average HPQ-II score was 108.76±5.36 (93-123). Analysis results emphasize a significant difference between education level, smoking behavior, stillbirth, and the HPQ-II score. Especially, elementary school graduate women, smokers, and those with stillbirth experience had a lower HPQ-ll score (P<0.05). Conclusion: Study results indicate the importance of improving the education level of women in mother and child health care and community health. Communities with higher levels of education will also contribute to better health practices. However, indicators like smoking behavior and previous history of stillbirth can also be considered important risk factors for lower health practices in pregnancy.