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SUMMARY OBJECTIVE: Postpartum depression significantly affects maternal mental health and family dynamics. Effective and safe treatments are crucial to enhance the quality of life for affected women. This study assesses the effectiveness and safety of combining sertraline with repetitive transcranial magnetic stimulation in treating postpartum depression. METHODS: We recruited 152 postpartum depression patients at West China Hospital between May 2020 and October 2023, dividing them into sertraline-only (n=61) and combined treatment (n=91) groups. We evaluated treatment outcomes after 8 weeks, comparing effectiveness, quality of life, neurotransmitter levels, and estrogen levels, while monitoring for adverse reactions. RESULTS: After 8 weeks, the combined treatment group exhibited a significantly higher effectiveness rate (95.6%) compared to the sertraline-only group (78.7%; p=0.001). Factors such as age, marital status, and treatment regimen significantly influenced treatment outcomes, with women under 30 and married women showing superior results. Post-treatment, both groups showed improvements in physical, psychological, social, and environmental aspects of life, with the combined group achieving notably higher scores. Improvements in neurotransmitter levels (5-hydroxytryptamine and plasma norepinephrine) and hormonal balances (luteinizing hormone, follicle-stimulating hormone, progesterone, and estradiol) were more substantial in the combined treatment group. Both groups had similar rates of adverse reactions, indicating that combining treatments did not significantly increase adverse events (11.0% in the combined group vs. 4.9% in the sertraline group; p=0.190). CONCLUSIONS: Combining sertraline with repetitive transcranial magnetic stimulation significantly enhances treatment effectiveness and improves neurotransmitter and hormone levels, contributing to better quality of life outcomes for postpartum depression patients without increasing adverse reactions.

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SUMMARY OBJECTIVE: The aim of this study was to compare the prognostic value of inflammatory indices, including the prognostic nutritional index, advanced lung cancer inflammation index, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, Glasgow Prognostic Score, and C-reactive protein/albumin ratio, in patients with metastatic non-small cell lung cancer and to determine whether any of the indices are correlated. METHODS: The demographic, clinicopathological, and laboratory data of 179 patients with metastatic non-small cell lung cancer who presented to our medical oncology clinic between 2014 and 2021 were retrospectively obtained from the hospital database system. RESULTS: Among the inflammatory indices, C-reactive protein/albumin ratio (p=0.002), advanced lung cancer inflammation index (p=0.04), and neutrophil/lymphocyte ratio (p=0.008) were associated with overall survival. Multivariate overall survival analysis showed that Eastern Cooperative Oncology Group Performance Status score (HR 1.37; 95%CI 1.06–1.77; p=0.016) and C-reactive protein/albumin ratio (HR 1.13; 95%CI 1.03–1.24; p=0.01) were independent prognostic factors associated with overall survival. Patients with a high and low C-reactive protein/albumin ratio differed statistically significantly in terms of gender, histopathological subtype, history of smoking, and metastatic site (p<0.05). Correlation analysis showed that C-reactive protein/albumin ratio was negatively correlated with advanced lung cancer inflammation index (r=-0.433, p<0.001) and positively correlated with the other four indices (neutrophil/lymphocyte ratio: r=0.368, p<0.001; platelet/lymphocyte ratio: r=0.321, p<0.001; Glasgow Prognostic Score: r=0.537, p<0.001; and prognostic nutritional index: r=0.223, p=0.003). CONCLUSION: Our findings show that among the investigated inflammatory indices, C-reactive protein/albumin ratio has the highest prognostic value in patients with metastatic non-small cell lung cancer.

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SUMMARY OBJECTIVE: The aim of this study was to determine the relationship between visceral fat thickness measurements obtained via computed tomography and clinical outcomes in order to predict the outcomes of oncology patients diagnosed with acute pulmonary embolism at the emergency department. METHODS: This study was conducted retrospectively by examining 75 cancer patients diagnosed with acute pulmonary embolism at the emergency department between 2019 and 2022. Visceral fat thickness was evaluated using the axial sections of computed tomography pulmonary angiography taken at the level of the first lumbar vertebra at the time of diagnosis. Clinical scores, hemodynamic status, laboratory and radiological parameters, length of hospital stay, and in-hospital and 90-day mortality were assessed. RESULTS: Notably, 20% of the patients included in the study were hemodynamically unstable at the time of presentation. In-hospital mortality occurred in 25% of the patients with breast cancer, while 90-day mortality was observed in 30% of those with lung cancer. The median visceral fat thickness obtained from computed tomography pulmonary angiography was 113 cm2. The patients’ visceral fat thickness values statistically significantly differed according to the presence of 90-day late-period mortality (p=0.025). CONCLUSION: Muscle and fat tissue areas obtained from imaging modalities used in the diagnosis of critical conditions, such as pulmonary embolism and cancer, have emerged as significant biomarkers for mortality in the literature. In light of our findings, we consider that visceral fat thickness can predict late-period mortality in oncological patients with pulmonary embolism.

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SUMMARY OBJECTIVE: The aim of this study is to develop the Early Period Mother–Infant Bonding Indicators Assessment Scale and to examine its validity and reliability. METHODS: This is a cross-sectional, methodological, correlational study. This study was carried out with 143 mothers in the Sakarya Training and Research Hospital Maternity Service between February and April of 2021. The content validity of the scale was assessed by consulting 11 experts. Exploratory and confirmatory factor analyses were performed, and the tool's internal consistency and construct validity were analyzed. RESULTS: For the mothers, the average age was 28.19±5.71. The Cronbach's alpha coefficient for the overall scale was 0.83, and the Cronbach's alpha values for the subscales were 0.85–0.80. The correlations between the physical and emotional intimacy and exploration and striving subdimensions with the whole scale were found to be highly positive and statistically significant (r=0.919, r=0.869, p<0.005). The exploratory factor analysis showed that the scale explained 55.59% of the total variance. The confirmatory factor analysis found that the physical and emotional intimacy and exploration and striving subdimension factor loads ranged from 0.53 to 0.75 and 0.59 to 0.77, respectively. CONCLUSION: The two-factor, 13-item Early Period Mother–Infant Bonding Indicators Assessment Scale was confirmed to have sufficient reliability and validity. With these measurement tools, mothers’ behaviors towards mother–infant bonding right after birth will be evaluated, and mothers will be directed to get support in the area of weakness.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the impact of a hip fracture multidisciplinary protocol in a Brazilian tertiary hospital, focusing on time to surgery, mortality, re-admission rates, and 6-month outcomes. METHODS: Conducted in a private hospital in Porto Alegre, Brazil, the protocol, initiated in October 2022 (group before protocol implementation [Group NP] and group after implementation [Group P]), involved a multidisciplinary team assessment within 24 h of admission, early ambulation, and discharge planning. Hospitalization data, including age, gender, comorbidities, length of stay, surgery timing, and mortality, were collected. Additionally, patient-reported outcome measures were evaluated 6 months post-discharge via phone, assessing disability (Oswestry Disability Index), pain level (back pain, Numeric Pain Rating Scale), and quality of life (general health, EQ5D-3L). RESULTS: The study included 213 hip fracture patients, with the majority (60.1%) undergoing surgery within 48 h of admission (Group NP: 51.3% vs. Group P: 64.7%, p<0.01). Six months later, patient-reported outcome measures favored Group P, showing a lower disability measured by the mean Oswestry Disability Index (22.0 vs. 28.0, p=0.02), reduced reported pain levels (back pain [3.0 vs. 3.9, p=0.04] and Numeric Pain Rating Scale median [3.5 vs. 4.5, p=0.04]), and a higher quality of life (health condition median [70.5 vs. 61.1, p=0.01] and EQ5D-3L median [0.72 vs. 0.65, p=0.02]). CONCLUSIONS: In the most recent period (2021–2023), long-term outcomes for hip fracture patients showed notable improvements, including reduced disability, more effective pain management, and enhanced quality of life, potentially reflecting the impact of protocol modifications.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the effectiveness of hysteroscopic myomectomy in the symptoms of women with uterine myomatosis. METHODS: This is a retrospective cohort study conducted on 119 women with uterine myomatosis who underwent hysteroscopic myomectomy in a tertiary hospital from 2018 to 2023. Women of reproductive age diagnosed with submucosal myoma who underwent hysteroscopic myomectomy were included, and women who did not have the data in their medical records necessary for completion were excluded. The sociodemographic and clinical variables of these women were evaluated. RESULTS: The average age of the women was 41.4±6.8 years. Among the fibroids, 37.0% were International Federation of Gynecology and Obstetrics (FIGO) 0 and 52.5% were FIGO 1. The average size of the fibroids was 2.7±1.4 cm. There were 10.0% of complications. After myomectomy, 67.2% of the women had improvement in symptoms, 66.1% opted for hormonal treatment, and 14.3% underwent hysterectomy. Ninety percent of the women who did not show improvement in symptoms had FIGO 1 and FIGO 2 fibroids (p=0.002), and 57% had a higher number of cesarean sections (p=0.038). In addition, 61% of these women required a new approach (p<0.001), and 93% opted for treatment after myomectomy (p<0.001). Factors associated with a greater chance of women's symptoms not improving were having more than two cesarean sections (hazard ratio [HR]=3.52, p=0.026), FIGO 1 fibroids (HR=5.75, p=0.003), and FIGO 2–3 fibroids (HR=8.25, p=0.030). CONCLUSION: Hysteroscopic myomectomy has a low complication rate, and having fibroids with a larger intramural component is the main factor responsible for myomectomy failure.

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SUMMARY OBJECTIVE: The aim of this study was to develop a scale to assess the self-efficacy of caregivers of individuals with serious mental illnesses and to determine its psychometric properties. METHODS: This study used a methodologic, cross-sectional, and descriptive design. A draft of a 26-item scale was developed based on interviews with caregivers and a literature review. The construct validity of the scale was tested by exploratory factor analysis. The reliability of the scale was tested. Caregivers of 348 individuals with serious mental illnesses participated in the study. RESULTS: The exploratory factor analysis produced a 20-item scale defined by three factors. Reliability coefficient values were adequate. CONCLUSION: The caregiver self-efficacy scale for caregivers of individuals with serious mental illnesses developed in this study is a valid and reliable instrument that can be used for measuring the self-efficacy of caregivers of individuals with serious mental illnesses.

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SUMMARY BACKGROUND: Subarachnoid hemorrhage secondary to a ruptured brain aneurysm should be promptly diagnosed. The angiographic study allows the diagnosis of vascular alterations that determine subarachnoid hemorrhage. The risk of rebleeding is highest in the first 24 h following the first bleeding. The prognosis of the surgical treatment of a brain aneurysm depends on many factors. OBJECTIVE: The aim of the present retrospective study was to determine which prognostic factors are related to the morbidity and mortality of the microsurgical treatment of different brain aneurysms. METHODS: A total sample of 371 patients with subarachnoid hemorrhage due to aneurysm bleeding treated by microsurgery from 2013 to 2022 were studied. The variables studied were patient characteristics (age, gender, smoking status, systemic arterial hypertension, and diabetes mellitus), the tomographic findings classified by the Fisher scale, the interval between stroke and surgery, and the clinical condition of patients at admission classified by the Hunt-Hess scale. The primary outcome was the occurrence of death, and the secondary outcomes were the length of hospital stay and the length of stay in the intensive care unit. RESULTS: The clinical presentation (characterized by the Hunt-Hess scale) at the time of admission of the patient was an important determining factor in the length of hospital stay and intensive care unit stay and the occurrence of death in these patients. Older age and occurrence of diabetes mellitus were also associated with the outcome of death. The surgical moment characterized by the time between stroke and surgery was inversely associated with the outcome of death. CONCLUSION: The timing for surgery has to be analyzed concerning the clinical presentation of the patient at the time of admission.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the risk of obstructive sleep apnea and sleep quality in adolescents with and without polycystic ovary syndrome. METHODS: A case–control study was conducted on 82 adolescent girls admitted to the pediatric endocrinology clinic of a training and research hospital in Turkey. Data were collected using the Participant Information Form, Stop and Stop-Bang Questionnaire, Cleveland Adolescent Sleepiness Questionnaire, Sleep Quality Scale, and Sleep Variables Questionnaire. RESULTS: It was determined that the mean Stop and Stop-Bang scores of adolescents in the healthy and polycystic ovary syndrome groups were similar and had a high level of obstructive sleep apnea risk. Daytime sleepiness levels were similar in both groups, but daytime sleepiness mean scores were a little higher in healthy adolescents. In addition, it was determined that the level of sleepiness at school and during transportation was statistically significant and high in the healthy group, and the sleep quality of all adolescents was moderately similar. CONCLUSION: Our data reveal the importance of a comprehensive assessment of sleep health, including obstructive sleep apnea, as well as duration, timing, and quality in adolescents when considering polycystic ovary syndrome. Healthcare professionals should consider the sleep health of all adolescents presenting to endocrine outpatient clinics.

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SUMMARY OBJECTIVE: The aim of this study was to develop and validate the Breast Cancer Myths Scale for women. METHODS: Confirmatory and exploratory factor analyses were used in this methodological study. The internal consistency was evaluated using the item–total correlation. RESULTS: The root mean square error of approximation was calculated as 0.072. The final scale version demonstrated excellent internal consistency (Cronbach's alpha=0.908). CONCLUSION: The Breast Cancer Myths Scale (single factor, 16 items) is a reliable and valid measure that can be used to evaluate breast cancer myths.

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SUMMARY OBJECTIVE: Cardiac implantable electronic devices are widely used today. Therefore, research is ongoing to provide better device implantation in technical terms. The aim of this study was to investigate the relationship between pre-procedural regional right ventricular strain and post-procedural endocardial R-wave amplitude in patients scheduled to receive an implantable cardiac defibrillator. METHODS: A total of 112 patients who underwent single-chamber implantable cardiac defibrillator implantation were included in the study. Right ventricular strain analysis was performed before the procedure, and the following parameters were recorded: four-chamber strain, free wall strain, septal strain, and apical strain. The relationship between R-wave amplitude, calculated after lead implantation in the apical region, and strain parameters was statistically analyzed. RESULTS: All strain parameters were statistically significantly better in the group with a high R-wave amplitude. Correlation analysis showed that a higher R-wave amplitude was associated with improved right ventricular four-chamber strain (p<0.001, correlation coefficient=0.436), right ventricular free wall strain (p<0.001, correlation coefficient=0.532), right ventricular septal strain (p<0.001, correlation coefficient=0.394), and right ventricular apical strain (p<0.001, correlation coefficient=0.814). In univariable regression analysis, all strain parameters were identified as dependent predictors; however, in multivariable regression analysis, only right ventricular apical strain (p<0.001) was found to be an independent predictor of high R-wave amplitude. CONCLUSION: Our study revealed a relationship between the right ventricular apical endocardial R-wave amplitude and all right ventricular strain parameters, especially right ventricular apical strain. We recommend that clinicians perform regional right ventricular strain analysis before implantable cardiac defibrillator implantation in cases where lead positioning is uncertain.

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SUMMARY OBJECTIVE: Temporomandibular disorders associated with myofascial pain syndrome cause pain and disability in daily life. The aim of this study was to investigate the effect of auricular vagus nerve stimulation on pain in women with myofascial pain syndrome-related temporomandibular disorder. METHODS: A total of 50 women with myofascial pain syndrome-related temporomandibular disorder aged between 18 and 35 years participated in this study. The vagus group (n=25) received auricular vagus nerve stimulation and manual therapy and exercise, and the control group (n=25) received only manual therapy and exercise twice a week for 3 months. The pressure pain threshold was used for the assessment. RESULTS: In the vagus group, pressure pain threshold on the masseter, temporalis, sternocleidomastoid, digastricus, trapezius, and levator scapula muscles increased statistically significantly after treatment compared to baseline (p<0.05). In the control group, pressure pain threshold on the masseter and levator scapula muscles increased (p<0.05), while no statistically significant difference was found in the pressure pain threshold on the temporalis, sternocleidomastoid, digastricus, and trapezius muscles (p>0.05). When both groups were compared, vagus group was found to be more effective than control group in increasing pressure pain threshold in the masseter, trapezius, and levator scapula muscles (p<0.05). CONCLUSION: Auricular vagus nerve stimulation was found to be effective in increasing pressure pain threshold in patients with myofascial pain syndrome-related temporomandibular disorder. The clinical trial registration number was NCT05500716.

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SUMMARY OBJECTIVE: The aim of this cross-sectional study was to identify genital hygiene behaviors and the influencing factors in a sample of women from the Turkish population. METHODS: Data collection was conducted through an online survey distributed via WhatsApp and social media groups (n=357). The data were collected using the "Genital Hygiene Behaviors Scale." Analyses were conducted using the Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation, and robust analysis of variance. RESULTS: The mean age of the women was 31.94±9.7 years; 66.1% were university graduates and 49.6% were married. The mean Genital Hygiene Behaviors Scale total score was 94.93±9.8. genital hygiene behaviors were found to be better among women who were older, who had a higher level of education, were employed, were married, who had received genital hygiene education, and who had a history of genital infections in the past year. Additionally, 38.7% of the women reported abnormal vaginal discharge, and those with abnormal discharge exhibited lower genital hygiene behavior scores. Women who practiced vaginal douching were found to exhibit less adequate genital hygiene behaviors. It was determined that the majority of women with a history of genital infections had not received genital hygiene education and obtained the lowest genital hygiene scores (p<0.05). CONCLUSION: The findings obtained in the present study indicate that women in socioeconomically disadvantaged groups require more education on this subject and that healthcare professionals should seize every opportunity to provide education.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the Turkish validity and reliability of the Neurorehabilitation Experience Questionnaire, which assesses the experiences of patients receiving neurorehabilitation. METHODS: Neurological patients receiving rehabilitation between October 2023 and August 2024 were included in the study. Reliability was assessed by calculating Cronbach's alpha for internal consistency and using the test–retest method to measure stability. Validity was assessed through construct and criterion validity with convergent validity tested with the Patient Care and Rehabilitation Perception Scale in Elderly Patients. RESULTS: The mean age of the participants was 54.88 years and BMI was 28.55. The test–retest reliability of the Neurorehabilitation Experience Questionnaire showed a strong positive correlation (r=0.932, p<0.001), demonstrating the stability of the scale. A moderate, significant correlation was found between Neurorehabilitation Experience Questionnaire and Perception of Patient Care and Rehabilitation in Older Patients Scale scores (r=0.440, p<0.001). Moreover, both the first and second assessments of the Neurorehabilitation Experience Questionnaire were positively correlated with the corresponding Perception of Patient Care and Rehabilitation in Older Patients Scale assessments, strengthening the convergent validity of the questionnaire. CONCLUSION: The Turkish version of the Neurorehabilitation Experience Questionnaire is a reliable and valid instrument for measuring neurorehabilitation experience in Turkish-speaking patients. The application of this questionnaire in clinical settings may improve patient-centered care by facilitating a better understanding of patient experiences and satisfaction in neurorehabilitation programs.

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SUMMARY OBJECTIVE: Exposure to extremely low-frequency electromagnetic fields can cause harmful or beneficial effects on living organisms. The aim of this study was to examine the potential effects of extremely low-frequency electromagnetic fields on respiratory physiology by investigating possible changes in respiratory function parameters during and after short-term extremely low-frequency electromagnetic field exposure. METHODS: Twenty Wistar albino rats were included in the study, and these rats were randomly divided into two groups: control and electromagnetic field. A noninvasive head-out plethysmography technique was used to accurately assess lung function in rats. Rats in the electromagnetic field group were exposed to electromagnetic field at a frequency of 50 Hz and a magnetic flux density of 0.3 mT for 2 min. Respiratory function parameters of both groups were recorded in three separate periods before, during and after electromagnetic field exposure. Respiratory rate, respiratory cycle duration, inspiration time, expiration time, tidal volume, minute volume, peak inspiratory flow, and peak expiratory flow were measured in these periods. RESULTS: There was no significant difference in the parameters measured before electromagnetic field exposure between the groups. During the electromagnetic field exposure period, the mean respiratory rate measured in the electromagnetic field group was lower compared to the control group data, while the mean respiratory cycle duration, inspiration time, and tidal volume measured in the electromagnetic field group were higher compared to the control group data. There was no significant difference in the parameters measured after electromagnetic field exposure between the groups. CONCLUSION: Short-term extremely low-frequency electromagnetic field exposure decreases respiratory rate and increases respiratory cycle duration, inspiration time, and tidal volume.

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SUMMARY OBJECTIVE: This study aimed to determine the relationship between pelvic organ prolapse distress, colorectal-anal distress, and urinary distress and sexual function in women with urinary incontinence. METHODS: This is a descriptive correlational study. The study was conducted in the urogynecology outpatient clinic of a training and research hospital in a province located in the central Anatolia region of Turkey. The study included 328 women with urinary incontinence. RESULTS: The women who participated in the study had urinary incontinence for 6.2 (SD 4.6) years. The mean total sexual function score of the women was 18.7 (SD 3.8), and they had poor sexual function. Pelvic organ prolapse distress, colorectal-anal distress, and urinary distress were significant associated factors negatively affecting the sexual function of the women (p<0.001). In addition, colorectal-anal distress was an important risk factor negatively affecting women's sexual function (p<0.001). CONCLUSION: Pelvic organ prolapse distress, colorectal-anal distress, and urinary distress negatively affect the sexual function of women with urinary incontinence.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the psychometric properties of the Eating Pathology Symptoms Inventory within the Brazilian context. Specifically, it assessed the scale's efficacy in measuring disordered eating behaviors, with an emphasis on binge eating, and investigated its relationship with food cravings. METHODS: This cross-sectional study utilized data from a non-probabilistic convenience sample of 1,374 Brazilians. Confirmatory factor analysis and multiple-group confirmatory factor analysis were employed to examine the factor structure and assess invariance across groups with and without binge-eating symptoms. Reliability was evaluated using Cronbach's alpha and McDonald's omega, while external validity was assessed through Pearson's correlations between Eating Pathology Symptoms Inventory and Food Cravings Questionnaire-Trait-reduced scores. Discriminant validity was analyzed using Welch's t-test. RESULTS: The confirmatory factor analysis supported the eight-factor model, demonstrating a good fit across the overall sample (Comparative Fit Index=0.936, root mean square error of approximation=0.057). Reliability analysis indicated high internal consistency, with Cronbach's alpha and McDonald's omega values ranging from 0.745 to 0.917. Multiple-group confirmatory factor analysis confirmed measurement invariance across groups with and without binge-eating symptoms. The Welch two-sample t-test showed significantly higher Eating Pathology Symptoms Inventory scores in the binge-eating group. Furthermore, Eating Pathology Symptoms Inventory subscales related to binge-eating behaviors exhibited strong correlations with food craving scores, supporting the scale's external validity. CONCLUSION: The Eating Pathology Symptoms Inventory demonstrates strong reliability and validity as a tool for assessing eating disorder symptoms in Brazil, with effectiveness in distinguishing binge-eating behaviors.