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SUMMARY INTRODUCTION: The Ozaki procedure is an open-heart surgery technique used in aortic valve surgery. We investigated the effect of the Ozaki procedure on postoperative hematological and biochemical parameters as in other open-heart surgery applications. METHODS: A total of 42 patients between December 2020 and December 2022 who underwent the Ozaki procedure were analyzed retrospectively. Patients without any comorbid cardiac pathology were included in the study. Preoperative 3rd day, postoperative 6th hour, postoperative 24th hour, postoperative 7th day, and postoperative 30th day hematological and biochemical parameters of 42 patients with screening results were examined. RESULTS: Postoperative values were compared according to preoperative values. According to this, hematocrit and hemoglobin values were significantly lower at all times postoperatively. While white blood cells were found to be significantly higher until the postoperative 7th day, platelets were found to be significantly lower. The highest levels of creatine, blood urea, nitrogen, and aspartate aminotransferase were detected at the postoperative 24th hour, while the highest level for alanine aminotransferase was observed at the postoperative 7th day. CONCLUSION: As with all open-heart surgery methods, the Ozaki procedure may cause some changes in hematological and biochemical parameters in the postoperative period. So, this situation is the same as in other open-heart surgery methods.

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SUMMARY OBJECTIVE: Controlling Nutritional Status score was previously described and has been used in predicting short- and long-term outcomes in different patient populations. The aim of this study was to test the relationship between Controlling Nutritional Status score and in-hospital mortality in coronary care unit patients (MORCOR-TURK population). METHODS: In this multicenter and national study, all patients with an available Controlling Nutritional Status score were included in the analysis. The Controlling Nutritional Status score was calculated according to previously described criteria. To be able to understand the significance of the Controlling Nutritional Status score, we constructed two models. Model 1 included age, heart failure, chronic kidney disease, hypertension, diabetes mellitus, and coronary artery disease history. Model 2 included the Controlling Nutritional Status score and Model 1. We then statistically compared the performances of the two models. RESULTS: A total of 1,018 patients with known Controlling Nutritional Status scores were included in the analysis. Demographic characteristics are shown. In Model 1, the -2 log-likelihood ratio was 395.995, Nagelkerke R2 was 0.133, and area under the curve was 0.739 (95%CI 0.67–0.81). In the second model to which the Controlling Nutritional Status score is added (Model 2), the -2 log-likelihood ratio was 373.743, Nagelkerke R2 was 0.191, and area under the curve was 0.787 (95%CI 0.72–0.85). The area under the curve value of Model 2 was statistically higher than Model 1 (DeLong p-value: 0.01). A statistically significant correlation was found between death and Controlling Nutritional Status score in Model 2 [OR 1.347 (1.193–1.521), p<0.001]. CONCLUSIONS: Our study showed that the Controlling Nutritional Status score may be a significant predictor of in-hospital mortality in coronary care unit patients.

Abstract in English:

SUMMARY BACKGROUND: Inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis are influenced by environmental and immunological factors and may differ according to the patient’s sex. OBJECTIVE: The objective was to study the differences in the clinical profile of a Brazilian sample of inflammatory bowel disease patients according to sex. METHODS: Retrospective study with chart review of 158 inflammatory bowel disease patients (43 with Crohn’s disease and 115 with ulcerative colitis) from a single university hospital in southern Brazil. RESULTS: The Crohn’s disease sample showed a female/male ratio of 2.1, and the sample of ulcerative colitis showed a ratio of 1.5. The only significant difference found in the clinical profile was an increased constipation rate in female patients with ulcerative colitis. No other differences in epidemiological, symptom profile, or treatment could be detected. CONCLUSIONS: More females with inflammatory bowel diseases sought healthcare facilities compared to males. The only notable difference was a higher incidence of constipation symptoms among females; all other aspects were similar between the sexes.

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SUMMARY OBJECTIVE: This study aims to compare liver and spleen stiffness measurements using magnetic resonance elastography with T1 and T2 relaxation times in patients with chronic liver disease. METHODS: A total of 75 chronic liver disease patients and 25 healthy volunteers underwent MR. Patients with significant liver fat and iron accumulation were excluded. Student’s t-test was employed to compare magnetic resonance elastography and T1/T2 values. Pearson’s correlation test was used to assess the relationship between magnetic resonance elastography and T1/T2 values. RESULTS: Liver magnetic resonance elastography showed a significant moderate positive correlation with liver T1 mapping (r=0.51, p<0.001) and liver T2 mapping (r=0.30, p=0.009) in patients. Spleen magnetic resonance elastography exhibited a significant moderate positive correlation with spleen T2 mapping (r=0.37, p=0.001). However, there was no significant correlation between spleen magnetic resonance elastography and spleen T1 mapping in patients. Spleen magnetic resonance elastography was moderately positively correlated with liver magnetic resonance elastography (r=0.30, p=0.01), and spleen volume showed positive correlations with spleen magnetic resonance elastography, spleen T1 mapping, and spleen T2 mapping. Cut-off values for liver magnetic resonance elastography, liver T1 mapping, and liver T2 mapping in patient and control groups were 2.6 kPa (AUC=0.97), 619 ms (AUC=0.90), and 52.5 ms (AUC=0.62), respectively. CONCLUSION: Relaxation methods offer noninvasive imaging without additional equipment. Liver T1 mapping may serve as an alternative to magnetic resonance elastography for chronic liver patient follow-up, while spleen T1 mapping is not reliable.

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SUMMARY OBJECTIVE: The study aimed to evaluate the effects of musical-animated toys and audiobooks on the fear and pain in the tracheostomy care of children in the palliative care clinic. METHODS: The study design was a single-center, single-arm, crossover-controlled study. The sample consisted of 16 children who were 3–6 years old. Musical-animated toys and audiobooks were used to divert the children’s attention during tracheostomy care. The children whose control data were collected on the first day were shown musical-animated toys on the second day and listened to an audiobook a week later. The children were video-recorded during the interventions. RESULTS: The children who received musical-animated toy and audiobook interventions during and after tracheostomy care expressed less pain than those in the control group, and their fear levels were less during the care. CONCLUSION: Audiobook and musical-animated toy interventions were effective in reducing children’s procedure-related fear and pain during tracheostomy care in the pediatric palliative care clinic.

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SUMMARY OBJECTIVE: This study aimed to evaluate kinesiophobia levels in patients with osteoporosis compared to healthy controls and investigate the associations with pain, depression, anxiety, fear of falling, and quality of life. METHODS: The study involved 60 postmenopausal osteoporosis patients and 60 healthy controls aged 50 years and above. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia, while quality of life, psychological symptoms, and fear of falling were evaluated using the Quality of Life Questionnaire of the European Foundation for Osteoporosis, Hospital Anxiety and Depression Scale, and Tinetti Falls Efficacy Scale. RESULTS: Kinesiophobia levels were significantly higher in the osteoporosis group compared to controls (p<0.05). Positive correlations were observed between kinesiophobia and Falls Efficacy Scale (r=0.278, p=0.002), as well as with Quality of Life Questionnaire of the European Foundation for Osteoporosis physical function scores (r=0.185, p=0.043). No significant relationship was found between kinesiophobia and depression or anxiety scores. CONCLUSION: Kinesiophobia is notably higher in osteoporosis patients compared to healthy individuals, correlating with an increased fear of falling and reduced physical function. Early identification and management of kinesiophobia are essential to prevent reduced physical activity and associated risks, such as decreased bone mineral density and higher fracture risk.

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SUMMARY OBJECTIVE: The aim of this study was to investigate the relationship between pelvic obliquity and trunk control, spinal deformity, upper extremity functional performance, and motor function in patients with non-ambulatory Duchenne muscular dystrophy. METHODS: This cross-sectional study included 21 patients with Duchenne muscular dystrophy aged 8–18 years. In the study, participants’ upper extremity functional levels, pelvic obliquity degrees, spinal deformity, trunk control, upper extremity performance, and motor functions were evaluated using various tools such as the Brooke Upper Extremity Functional Scale, baseline scoliometer, spinal mouse, Trunk Control Measurement Scale, Upper Extremity Performance Scale, and Egen Klassifikation Scale Version 2, respectively. RESULTS: The study found a strong correlation between pelvic obliquity and frontal spine deformity (p<0.01), as well as moderate relationships between pelvic obliquity, motor function, wheelchair usage duration, and knee flexion contractures (p<0.05). CONCLUSION: The study found that pelvic obliquity may lead to spinal health deterioration and motor function limitations in non-ambulatory patients with Duchenne muscular dystrophy, especially those with lower extremity joint contractures and long-term wheelchair use.

Abstract in English:

SUMMARY OBJECTIVE: Acute appendicitis is the most common cause of acute abdomen. It is important to differentiate between complicated and uncomplicated appendicitis before surgery in the emergency department. Recently, immature granulocytes have become one of the biomarkers used as predictors of inflammation. The aim of this study was to determine whether immature granulocyte levels are a biomarker that can predict whether acute appendicitis is complicated or not in patients admitted to the emergency department. METHODS: Patients aged 18 years and older who presented to the emergency department between May 1, 2023, and April 30, 2024, and were diagnosed with appendicitis were included in the study. Patients with a histopathologic diagnosis of acute appendicitis were divided into two groups: acute simple appendicitis (n=149) and acute complicated appendicitis (n=103). Demographic characteristics, imaging results, and laboratory results were recorded. RESULTS: White blood cell, neutrophil count and percentage, lymphocyte count and percentage, immature granulocyte count and percentage, direct bilirubin, C-reactive protein, and procalcitonin values were found to be significantly higher in the complicated appendicitis group than in the uncomplicated group (p-values; 0.001, <0.001, <0.001, <0.001, 0.001, <0.001, <0.001, <0.001, <0.001, 0.016, <0.001, and 0.001, respectively). The immature granulocyte percentage was 92% specific for the diagnosis of complicated appendicitis at a cut-off value of 0.6. CONCLUSION: The immature granulocyte percentage may be useful as a predictive biomarker in the diagnosis of complicated acute appendicitis with a specificity of 92%. Additionally, the immature granulocyte percentage has a higher discrimination power than the immature granulocyte count, C-reactive protein, and procalcitonin.

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SUMMARY OBJECTIVE: The objective of this study was to describe the process of cross-cultural adaptation of the Breastfeeding Self-Efficacy Scale—Short Form among Fathers for use in Brazil. METHODS: This is a cross-cultural adaptation study that began with the translation from the original English into Portuguese, followed by back translation. A committee of experts evaluated the semantic, idiomatic, experiential, and conceptual equivalences. The pre-test of the Brazilian version of the Breastfeeding Self-Efficacy Scale—Short Form among Fathers was conducted with 10 fathers whose children were in the breastfeeding period. To assess the psychometric properties, a cross-sectional study was carried out involving 131 fathers with children in the breastfeeding phase. Factor analysis with principal component extraction and item response theory were used in data analysis. RESULTS: The Brazilian version of the Breastfeeding Self-Efficacy Scale—Short Form among Fathers presented an overall Cronbach α of 0.852. Very closely distributed factors explained 55.6% of the total variance in the principal component analysis. The item response theory showed that all questions have discriminatory characteristics. CONCLUSION: The cross-cultural adaptation process was carried out within validated international parameters and represents a potential instrument for promoting maternal and child health in Brazil.

Abstract in English:

SUMMARY OBJECTIVE: The aim of the study was to provide a golden opportunity to access sexual function in women who act as leaders in companies through the use of an instrument validated for this purpose (the Female Sexual Function Index). The number of women in leadership positions has been gradually increasing, which shows the need for women to prepare themselves to reorganize the different aspects of life, including social, family, and personal factors as well as sexuality. METHODS: This is a cross-sectional study involving female executives employed in private companies who answered the Female Sexual Function Index. A convenience sample was made up of 50 women in leadership positions who had been employed for at least 1 year and were aged between 35 and 50 years in childbearing age. RESULTS: The mean total Female Sexual Function Index score of the evaluated sample was 22.6+7.6, characterizing sexual dysfunction, and the domain that was less negatively impacted was pain. It was also observed that all Female Sexual Function Index domains were worse in women between 41 and 50 years old (p<0.05), except desire. CONCLUSION: The total Female Sexual Function Index score of female company leaders was below the cutoff point for adequate sexual function. According to the results of this study and the applied methodology, professional success may not be associated with the quality of sexual life.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the correlation between changes in the inferior vena cava collapsibility index and subclavian vein collapsibility index in patients undergoing passive leg raising tests in the intensive care unit, considering that respiratory changes affecting the inferior vena cava may similarly affect the subclavian vein. METHODS: This single-center observational study was conducted on patients aged between 18 and 85 years who underwent passive leg raising in the intensive care unit. When the patient was 45° above the bed, the inferior vena cava and subclavian vein were displayed using ultrasonography; subclavian vein collapsibility index and inferior vena cava collapsibility index values were calculated. After the initial values were recorded, passive leg raising was performed, and the initial measurements were repeated. The CI values measured after passive leg raising were subtracted from those calculated before passive leg raising to determine the changes (Δ) in inferior vena cava and subclavian vein collapsibility indices. RESULTS: The study was conducted with a total of 64 patients. The mean±standard deviation values for ΔIVC-CI% and ΔSCV-CI% variables were found as 8.97±8.89 and 10.31±10.81, respectively. There were no statistically significant differences in values of ΔIVC-CI% and ΔSCV-CI% (p=0.297). In the Bland-Altman plot, because there were only two values exceeding the +1.96 SD and -1.96 SD limits, it can be said that the agreement between ΔIVC-CI% and ΔSCV-CI% was adequate. CONCLUSION: ΔSCV-CI% values are compatible and correlated with ΔIVC-CI% values. Inferior vena cava and subclavian vein responded similarly to fluid changes during passive leg raising.

Abstract in English:

SUMMARY OBJECTIVE: Despite the availability of treatment and vaccines for chronic hepatitis B infection, it remains a public health problem. The use of nucleos(t)ide antiviral agents is effective in preventing complications such as cirrhosis and hepatocellular carcinoma, but despite the reduction, the risk persists. The objective of this study was to assess alterations in aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores and examine the effectiveness of risk estimates for HCC in chronic hepatitis B scores in predicting the risk of hepatocellular carcinoma among chronic hepatitis B patients undergoing prolonged antiviral treatment. METHODS: This is a retrospective 10-year follow-up study that included chronic hepatitis B patients who received antiviral treatment. The alterations in aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores were examined for the first, fifth, and tenth years. In addition, the expected long-term risk of hepatocellular carcinoma, if antiviral treatment was not initiated, was calculated using the risk estimates for HCC in chronic hepatitis B scores before treatment, and the incidence of hepatocellular carcinoma despite long-term antiviral treatment was compared with these values. RESULTS: The study included a total of 218 chronic hepatitis B patients. A noteworthy decline in aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores was noted across all fibrosis groups, irrespective of the initial degree of fibrosis, during the first year of antiviral treatment. Following the calculation using risk estimates for HCC in chronic hepatitis B scores, one case was observed compared to the expected 15.04 cases of hepatocellular carcinoma. CONCLUSION: We showed that both aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores significantly decreased until the fifth year of antiviral treatment, with a prominent decline occurring in the first year. This study demonstrates that the impact of antiviral treatment on fibrosis can be monitored using noninvasive fibrosis scores.

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SUMMARY OBJECTIVE: Pelvic organ prolapse affects women’s quality of life through symptoms such as vaginal laxity, urinary incontinence, defecation and sexual dysfunction, and pelvic pain. Given the challenges in managing recurrent cases, understanding risk factors and the effect of surgical choices on recurrence is vital for guiding clinical decisions. This study explores how uterine preservation influences postoperative recurrence and develops predictive models to aid in assessing recurrence risk. METHODS: A total of 87 patients diagnosed with pelvic organ prolapse who underwent laparoscopic sacral fixation were included. Patients were classified into two groups based on the occurrence of pelvic organ prolapse recurrence within 3 years post-surgery (recurrence: n=22; no recurrence: n=65). Follow-up over 3 years was recorded. Factors including age, body mass index, birth order, occupation, and uterus preservation during surgery were evaluated. The relationship between pelvic floor muscle strength and pelvic organ prolapse recurrence was also examined. Logistic regression analysis assessed the correlation between pelvic organ prolapse recurrence and levels of serum elastase inhibitor and osteopontin. RESULTS: In a follow-up of 87 patients with pelvic organ prolapse, 22 experienced recurrences within 3 years, marking a 25.29% recurrence rate. Multivariate analysis identified older age, higher parity, and sustained contraction of type II muscle fibers as independent risk factors for recurrence (all p<0.05). Lower systolic blood pressure in type I and II muscle fibers was associated with decreased serum elastase inhibitor and osteopontin levels, increasing pelvic organ prolapse recurrence risk. Logistic regression identified age, multiple deliveries, and low systolic pressure in type II muscle fibers as independent recurrence factors. The constructed nomogram risk prediction model, incorporating these factors, showed good discrimination ability with an area under the receiver operating characteristic curve of 0.891 (95%CI 0.871, 0.921), indicating accurate predictions and high net benefit. CONCLUSION: Factors such as age, birth order, uterine preservation, and pelvic floor muscle strength impact postoperative pelvic organ prolapse recurrence. Older age, a higher number of deliveries, and reduced systolic pressure of class II muscle fibers are independent risk factors for pelvic organ prolapse recurrence after surgery.

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SUMMARY OBJECTIVE: In addition to oxygen support, bronchodilator therapy constitutes the most essential treatment step in patients with chronic obstructive pulmonary disease. Our study aimed to compare the effectiveness of nebulizer treatments in patients who presented to the emergency department with acute exacerbation of chronic obstructive pulmonary disease. METHODS: Our study included 60 Group E chronic obstructive pulmonary disease patients admitted to the emergency department due to acute exacerbation of chronic obstructive pulmonary disease between June and September 2023 (NCT: 06178068). Patients were randomized as follows: Group 1: jet nebulizer treatment; Group 2: dry air nebulizer treatment; and Group 3: classic nebulizer treatment. RESULTS: While an increase in forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) levels was observed in Group 1 patients (in the order of p=0.009 and 0.007), a decrease in residual volume (RV) and total lung capacity (TLC) levels was observed (p=0.02 and 0.05, respectively). At the same time, an increase in FEV1 levels was observed in Group 2 and 3 patients (p=0.04 and 0.04, respectively). A decrease was observed in RV and TLC levels (p=0.02, 0.05, 0.02, and 0.04, respectively). When comparing the respiratory function test parameters at the beginning and on the fifth day of treatment, FEV1 and peak expiratory flow 25/75 (PEF25/75) levels were higher in Group 1 patients than in Group 2 and 3 patients (p=0.01 and 0.02, respectively). CONCLUSION: In chronic obstructive pulmonary disease patients, jet nebulizer treatment is more effective regarding bronchodilator activity than other nebulizer treatments. However, dry air nebulizer treatment may be preferred in chronic obstructive pulmonary disease patients because it is easily applicable and sterilizable.

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SUMMARY OBJECTIVE: Tumor necrosis factor alpha inhibitors are frequently used in the treatment of axial spondyloarthritis. While tumor necrosis factor alpha is associated with some malignancies, studies on its effects on thyroid functions and thyroid nodules are limited. This study aimed to assess the effect of tumor necrosis factor alpha inhibitors treatments on the evaluation of thyroid nodules and thyroid function tests in axial spondyloarthritis patients. METHODS: A total of 106 patients with axial spondyloarthritis, 48 receiving nonsteroidal antiinflammatory drugs and 58 receiving tumor necrosis factor alpha inhibitors, were included in the study. All cases were screened by ultrasound for the presence of nodules, European Thyroid Association – Thyroid Imaging Reporting and Data System classification category, thyroid volume, and thyroid function tests. RESULTS: The prevalence of patients with multiple nodules in the tumor necrosis factor alpha inhibitors treatment group was significantly higher compared to the nonsteroidal antiinflammatory drug group (68.2 vs. 38.1%, p=0.033). Furthermore, the prevalence of nodules measuring ≥1 cm in the tumor necrosis factor alpha inhibitors treatment group was higher compared to the only nonsteroidal antiinflammatory drug treatment group (56 vs. 19.05%, p=0.011). In the tumor necrosis factor alpha inhibitors treatment group, the proportion of patients with nodules requiring fine-needle aspiration cytology was higher compared to the nonsteroidal antiinflammatory drug group (34.5 vs. 16.7%, p=0.038). No significant difference was found between thyroid-stimulating hormone and free thyroxine values before and during treatment in both groups (p>0.005). CONCLUSION: The number of nodules requiring fine-needle aspiration cytology according to the European Thyroid Association – Thyroid Imaging Reporting and Data System classification seems higher in nonsteroidal antiinflammatory drugs users than Tumor necrosis factor-alpha inhibitor users. Therefore, it may be rational to examine the thyroid gland while administering Tumor necrosis factor-alpha inhibitor treatment in axial spondyloarthritis patients.

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SUMMARY OBJECTIVE: This study aimed to evaluate the prognostic significance of the cardiac electrophysiological balance index in predicting the recurrence of atrial fibrillation following radiofrequency ablation. METHODS: Patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation were enrolled from July 2021 to March 2023 and categorized into recurrence and non-recurrence groups based on postoperative atrial fibrillation recurrence during a 6- to 12-month follow-up. Clinical and electrocardiogram data at admission were collected, and cardiac electrophysiological balance index was calculated. Multivariate logistic regression analysis identified independent factors contributing to atrial fibrillation recurrence. Receiver operating characteristic curves assessed predictive values. RESULTS: Among 127 subjects, 36 experienced postoperative recurrence (22 paroxysmal atrial fibrillation, 10 atrial flutter, and 4 atrial tachycardia). Significant differences in hypersensitive C-reactive protein levels, QT, QRS, and cardiac electrophysiological balance index were observed between recurrent and non-recurrent groups. Multivariate analysis revealed cardiac electrophysiological balance index as an independent risk factor for recurrence (OR 1.766, 95%CI 1.415–2.204, p<0.001). Receiver operating characteristic curve analysis showed cardiac electrophysiological balance index’s predictive value with an area under the curve of 0.865 (95%CI 0.807–0.923, p<0.001), and a cutoff value of 4.3 demonstrated a sensitivity of 87.67% and a specificity of 71.23%. CONCLUSIONS: The cardiac electrophysiological balance index emerges as a non-invasive tool with substantial predictive value for estimating the likelihood of paroxysmal AF recurrence post-ablation.

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SUMMARY OBJECTIVE: This study was conducted as a randomized controlled trial to investigate the effect of breathing exercises on fatigue in patients diagnosed with tuberculosis. METHODS: The tuberculosis patients included in the study were divided into two groups: intervention (26) and control (28) by a program established after the power analysis. After the researcher informed the patients in the intervention group about breathing exercises, including diaphragmatic and pursed lip breathing, they were taught, and the first exercise was practiced. Then, the patients in this group did breathing exercises once a day in the morning, 3 days a week, for a total of 4 weeks, with the researcher using the online interview method. The data were collected using a questionnaire and the Piper Fatigue Scale. The total score of the Piper Fatigue Scale ranges from 0 to 10, and the higher the score, the higher the fatigue level. The Piper Fatigue Scale was repeated at the end of the fourth week in both groups. RESULTS: Patients in the intervention group (88.5%) and control group (85.7%) reported that they were tired after the diagnosis of tuberculosis. The Piper Fatigue Scale total mean score of the intervention group was 8.29±1.19 before the intervention and dropped to 6.83±1.02 at the fourth week (p<0.05), whereas the Piper Fatigue Scale total mean score of the control group was 7.88±1.09 before the intervention and 7.93±1.02 at the fourth week (p>0.05). CONCLUSION: Breathing exercises done by tuberculosis patients were found to lower their levels of fatigue. Accordingly, it is recommended to benefit from breathing exercises, which are effective, inexpensive, and easy to apply in the management of fatigue. Clinical Trial Registration Number: The study was registered with clinicaltrial.gov NCT05202431.

Abstract in English:

SUMMARY OBJECTIVE: The aim of this study was to determine the effects of interpersonal psychotherapy on anxiety and alexithymia in mothers in the postpartum period. METHODS: This randomized controlled experimental study with a pre-test and post-test design was conducted to determine the effects of interpersonal psychotherapy on anxiety and alexithymia in mothers during the postpartum period. Data were collected from postpartum mothers who presented to the pediatric outpatient clinic in a private hospital in Istanbul at the pre- and post-tests between August 2022 and January 2023. The study was conducted between June 10, 2022, and June 23, 2023. In the study, data were obtained with the "Personal Information Form," "Beck Anxiety Inventory," and "Toronto Alexithymia Scale." This randomized controlled experimental study with the pre- and post-test designs was conducted in a private hospital in Istanbul, a province located on both sides of the Bosporus Strait in northwest Turkey, with 14 postpartum mothers. Of them, seven were assigned to the experimental group and seven to the control group. The participants in the experimental group underwent interpersonal psychotherapy. The participants in the control group underwent no intervention. In the analysis of the data, while repeated measures analysis of variance was used to compare the scale scores, Fisher's least significant difference test was used for multiple comparisons of the group*time interaction. RESULTS: The mean scores obtained from the "Beck Anxiety Inventory" and "Toronto Alexithymia Scale" by the participants in the experimental group before the interpersonal psychotherapy were 19.71±4.11 and 55.43±9.05, respectively, and 8.86±3.02 and 41.00±7.44, respectively, after the intervention, indicating that they decreased statistically significantly (p<0.05). CONCLUSION: The results of the study indicated that interpersonal psychotherapy reduced anxiety and alexithymia levels in mothers in the postpartum period. Based on this result, it is recommended that interpersonal psychotherapy be utilized in clinical practice.

Abstract in English:

SUMMARY OBJECTIVE: High serum uric acid levels are associated with metabolic syndrome and diabetes mellitus. Several observational studies have shown the association between metabolic dysfunction-associated fatty liver disease and high serum uric acid. However, this association is controversial due to reverse causality. We aimed to investigate the relationship between the serum uric acid level and "aspartate aminotransferase-platelet ratio index score," which noninvasively shows the possible changes of metabolic dysfunction-associated fatty liver disease in the liver in patients diagnosed with type II diabetes mellitus. METHODS: This retrospective study was conducted with a total of 94 patients, 36 females and 58 males, who were hospitalized in the gastroenterohepatology outpatient clinic and diagnosed with hepatosteatosis and type II diabetes mellitus between January 2023 and January 2024. Laboratory tests, height, weight, body mass index, presence of fatty liver disease on ultrasound, and aspartate aminotransferase-platelet ratio index scores of the patients were examined. RESULTS: The mean serum uric acid level of the patients was 5.26±1.52 mg/dL, and the mean aspartate aminotransferase-platelet ratio index score was 0.26±0.13. The serum uric acid level was found to be associated with the hemoglobin A1c value (p=0.001; p<0.01). However, the aspartate aminotransferase-platelet ratio index scores of the patients did not show a statistically significant difference according to serum uric acid levels (p>0.05). CONCLUSION: No significant association was observed between serum uric acid and the noninvasive liver test aspartate aminotransferase-platelet ratio index score. Although a causal relationship between metabolic dysfunction-associated fatty liver disease and serum uric acid has been demonstrated in several studies, further research is needed to evaluate possible mechanisms in the liver.

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SUMMARY OBJECTIVE: The aim of this study was to compare the success and complication rates of retrograde intrarenal surgery for lower calyceal renal stones performed with novel tip-bendable suction ureteral access sheaths and standard ureteral access sheaths. METHODS: Between March 2023 and March 2024, a total of 88 patients underwent retrograde intrarenal surgery for lower renal calyceal stones smaller than 20 mm. Based on the access sheath used, patients were divided into two groups: Group 1 (n=43) included patients treated with novel tip-bendable suction ureteral access sheaths and Group 2 (n=45) included patients treated with standard ureteral access sheaths. The pre- and postoperative data of the two groups were compared. Complications were assessed by using the Modified Clavine Dindo system, and stone-free rate was assessed after 4 weeks by using non-contrast computed tomography. RESULTS: There was no significant difference between the groups regarding demographic data or preoperative laboratory results, and the median stone size was comparable in both groups. The stone-free rate did not show any significant difference between the two groups. However, the median residual stone size was substantially higher in the standard ureteral access sheaths group [4.25- (3.75–5) vs. 6- (5–7), p=0.01] and the surgical duration was less in the novel tip-bendable suction ureteral access sheaths group (p=0.032). CONCLUSION: Our current findings demonstrate that the use of a new tip-bendable suction-assisted access sheath during retrograde intrarenal surgery in the management of lower calyceal stones less than 2 cm may shorten the operative duration, limit the rate of complications, and end up with smaller residual stone fragments when compared with the use of standard ureteral access sheath.

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SUMMARY OBJECTIVE: In this study, we aimed to assess the effect of the BioFire FilmArray Blood Culture Identification 2 panel on agent identification and antimicrobial stewardship in patients with a critical state of sepsis secondary to bloodstream infection. METHODS: This study was designed as a prospective observational study. Patients who developed sepsis and septic shock secondary to bloodstream infection in the intensive care unit were included in the study. Concordance in both monomicrobial and polymicrobial results of Blood Culture Identification 2 panel and conventional blood culture, test result times, and antibiotherapy changes according to Blood Culture Identification 2 panel results were evaluated. RESULTS: In monomicrobial samples, sensitivity and specificity were 97.1% (95%CI 84.6–99.3) and 100% (95%CI 66.3–100), respectively, for gram-negative pathogens and 85.7% (95%CI 42.1–99.6) and 100% (95%CI 90.2–100), respectively, for gram-positive pathogens. In polymicrobial samples, Blood Culture Identification 2 panel results were 79% in concordance with conventional blood culture results. In this study, when the final turnaround time of the Blood Culture Identification 2 panel was compared with culture results, the Blood Culture Identification 2 panel was on average 1 day, 5 h, and 35 min faster than the culture (p<0.01). CONCLUSION: Blood Culture Identification 2 testing is a reliable tool for rapid pathogen and antimicrobial susceptibility detection in critically ill sepsis patients. The use of the Blood Culture Identification 2 panel in patients with sepsis and/or septic shock, where the transition to targeted antibiotherapy is critical, may improve patient outcomes.

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SUMMARY OBJECTIVE: Gastric cancer is the second most common cancer in the world, accounting for 650,000 deaths per year, and is observed in approximately 10% of the patients diagnosed. Extracellular matrix abnormalities have been documented in gastric cancer patients. The aim of our study was to understand the role of high levels of hyaluronan, an extracellular matrix glycosaminoglycan, and its mechanistic role in gastric cancer pathobiology. METHODS: Blood samples were collected from 82 gastric cancer patients and 41 healthy volunteers. Hyaluronan measurements were performed with the help of commercially purchased enzyme-linked immunosorbent assay kits. Gastric cancer (n=27) and healthy (n=29) tissue specimens were obtained after surgery and aliquoted for Western blot, immunofluorescence, and messenger RNA expression analysis. RESULTS: Increased hyaluronan levels were detected in the blood of cancer patients compared to controls [plasma hyaluronan levels mg/dL (mean±SD): gastric cancer (n=82) 549.80±155.68, and healthy control (n=41) 27.21±4.95 (p<0.044)]. In addition, intense hyaluronan binding protein staining was observed in gastric cancer tissues, while tumor necrosis factor-inducible gene 6 messenger RNA expression was found to be significantly increased in gastric cancer tissues compared to healthy controls [tumor necrosis factor-inducible gene 6 messenger RNA expression: gastric cancer (n=27) 7.09±1.94 and healthy control (n=29) 3.20±0.67 (p=0.048)] according to the immunofluorescence staining. CONCLUSION: The high hyaluronan levels in gastric cancer patients and the detection of increased messenger RNA levels of the tumor necrosis factor-inducible gene 6 enzyme in gastric cancer tissue, supporting a possible hyaluronan modification, suggest that this abnormality may have an important role in the formation of gastric cancer.

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SUMMARY OBJECTIVE: The aim of the study was to evaluate the effects of commonly used medications for epilepsy on thyroid function tests in children. METHODS: Epileptic children treated with valproic acid, levetiracetam, carbamazepine, and oxcarbazepine were retrospectively examined along with a healthy control group. Levels of free thyroxine 4 and thyroid-stimulating hormone were compared. RESULTS: In patients receiving valproic acid monotherapy, thyroid-stimulating hormone levels increased compared to both the control group and pre-treatment levels, while free thyroxine 4 levels remained unchanged. In those receiving carbamazepine or oxcarbazepine monotherapy, average free thyroxine 4 levels were found to be lower compared to the control group and pre-treatment levels, with no difference in thyroid-stimulating hormone levels. For patients receiving levetiracetam monotherapy, there was no difference in free thyroxine 4 and thyroid-stimulating hormone levels compared to the control group and pre-treatment levels. CONCLUSION: Despite significant changes in thyroid hormone levels with valproic acid, carbamazepine, and oxcarbazepine treatment, no significant clinical findings were observed. Additionally, no effect of levetiracetam on thyroid function tests was detected.

Abstract in English:

SUMMARY OBJECTIVE: The aim of this study was to evaluate the serum hCG level in the differential diagnosis between non-molar miscarriage and complete hydatidiform mole in<11 weeks gestation. METHODS: This was a retrospective collaborative cohort study. This study included women with gestational age<11 weeks, with ultrasound evidence of failed pregnancy and available serum hCG pre-uterine evacuation, divided into two groups: the non-molar miscarriage group and the complete hydatidiform mole group. Serum hCG levels were compared according to gestational age. Statistical analysis used a nonparametric test with a 5% significance level (p<0.05). RESULTS: In total, 416 patients were included, out of which 79 were included in the non-molar miscarriage group and 337 in the complete hydatidiform mole group. The calculated power of the sample was more than 80%. Data analysis showed that the 75th quartile of the median in the non-molar miscarriage group was always lower than the 25th quartile of the median in the complete hydatidiform mole group [9,721 mUI/mL/16,435 mUI/mL (6–7 weeks), 20,229 mUI/mL/64,911 mUI/mL (8–9 weeks), and 29,633 mUI/mL/126,278 mUI/mL (10–11 weeks), respectively; p<0.001]. CONCLUSION: Facing failed pregnancies, hCG>16,435 mUI/mL at 6–7 weeks, hCG>64,911 mUI/mL at 8–9 weeks, and hCG >126,278 mUI/mL at 10–11 weeks were most prevalent on complete hydatidiform mole diagnosis. On the contrary, hCG<30,000 mUI/mL at 10–11 weeks was most prevalent in non-molar miscarriage diagnosis.