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SUMMARY OBJECTIVE: In daily practice, 18F-fluorodeoxyglucose positron emission tomography/computed tomography plays a crucial role in the clinical follow-up to evaluate treatment response and detect recurrence in patients with elevated serum tumor markers. In this research, we aimed to elucidate whether there was a correlation between markers and semiquantitative-metabolic parameters. METHODS: In this study, 66 patients who applied to our institution with a histopathological diagnosis of colorectal carcinoma and had two consecutive 18F-fluorodeoxyglucose positron emission tomography/computed tomography scans for diagnosis or response to treatment were enrolled. The obtained images were evaluated based on response evaluation criteria in solid tumors and positron emission tomography response criteria in solid tumors criteria. The patients were divided into two groups: regression patient group (n=45) and progression patient group (n=21). RESULTS: There was a high positive correlation between whole body-total lesion glycolysis and serum tumor marker (r=0.618, p=0.000), a moderate positive correlation between SUVmax (standardized uptake value) and primary tumor-total lesion glycolysis and serum tumor marker (r=0.497, p=0.001; r=0.511, p=0.000), and a weak positive correlation between SUVmean and whole body-metabolic tumor volume and serum tumor marker (r=0.435, p=0.003) in patients achieving regression. There was a moderate positive correlation between whole body-total lesion glycolysis and tumor marker in the progression group (r=0.596, p=0.004) and a weak positive correlation between SUVmax, SUVmean, total lesion glycolysis, whole body-metabolic tumor volume, and tumor marker in the progression group (r=0.343, p=0.128; r=0.299, p=0.188; r=0.279, p=0.220; r=0.374, p=0.095). CONCLUSION: We concluded that 18F-fluorodeoxyglucose positron emission tomography/computed tomography will provide beneficial outcomes in evaluating treatment response and detecting recurrent disease in patients with colorectal carcinoma. In this context, the whole body-total lesion glycolysis value is the most sensitive parameter that can be an alternative to SUVmax in predicting treatment response.

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SUMMARY OBJECTIVE: The aim of the study was to investigate the relationship between pregnancy happiness and prenatal attachment, as well as postpartum maternal functioning. METHODS: The study was conducted between December 2022 and January 2024 and involved 312 women. Data were collected using the Oxford Happiness Scale Short Form, Prenatal Attachment Inventory, and Barkin Maternity Function Scale. The Oxford Happiness Scale Short Form was administered during the second trimester of pregnancy, the Prenatal Attachment Inventory during the third trimester, and the Barkin Maternity Function Scale at 6–10 weeks postpartum. RESULTS: The study found that prenatal attachment mediates the effect of pregnancy happiness on maternal functioning. Additionally, it was observed that both pregnancy happiness and prenatal attachment have a direct impact on maternal functioning. CONCLUSION: This study clarifies the mechanism linking pregnancy happiness and maternal functioning. The findings suggest that increasing levels of pregnancy happiness and prenatal attachment may improve positive attitudes and ensure high maternal functioning.

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SUMMARY OBJECTIVE: Median arcuate ligament syndrome is a rare pathology where the median arcuate ligament causes compression on the celiac trunk. Different techniques are utilized in the treatment of median arcuate ligament syndrome, and studies on a standard laparoscopic technique are limited. The aim of this study is to evaluate the surgical and clinical outcomes of patients who underwent laparoscopic "antegrade" release of median arcuate ligament in a single tertiary center. METHODS: This retrospective study includes nine adolescents/young adults who underwent laparoscopy for median arcuate ligament syndrome between 2016 and 2024. All laparoscopic procedures were performed with an antegrade approach. The patients’ demographic data, symptoms, radiologic imaging methods, operative technique, and postoperative outcomes were recorded. RESULTS: There were seven female and two male patients in our series. The median age at diagnosis was 17 (range: 15–26) years. The most common symptoms were postprandial abdominal pain (n=9), nausea and vomiting (n=8), and weight loss (n=7). Doppler ultrasonography and/or computed tomography angiography (n=9, 100%) were performed in all patients as preoperative diagnostic imaging. The mean operation time was 92 (range: 60–110) min. The mean oral intake time was 1.2 (range: 1–3) days. The mean hospitalization time was 3 (range: 2–5) days. There was no conversion to laparotomy. One patient had a recurrence during follow-up and underwent a secondary intervention. The mean follow-up time was 62.6 (3–88) months. CONCLUSION: Laparoscopic median arcuate ligament release with an antegrade approach is safe and feasible to perform and adequate in terms of symptom relief and celiac artery compression release in both adolescent and young adult groups.

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SUMMARY OBJECTIVE: Juvenile idiopathic arthritis is the most common chronic rheumatic disease of autoimmune origin in childhood. While altered DNA methylation has been associated with adult autoimmune rheumatic diseases, studies on juvenile idiopathic arthritis remain limited. This study evaluated levels of 5-methylcytosine and 5-hydroxymethylcytosine, important epigenetic biomarkers, in juvenile idiopathic arthritis and its subtypes. METHODS: This single-center cross-sectional study included patients diagnosed with juvenile idiopathic arthritis aged 1 month to 18 years. Children with systemic or autoimmune diseases and comorbidities were excluded. The study comprised 58 juvenile idiopathic arthritis patients and 35 age-gender-matched healthy controls presenting with non-rheumatological complaints. Demographic and clinical characteristics, including juvenile idiopathic arthritis subtypes, were recorded. The 5-methylcytosine and 5-hydroxymethylcytosine levels were assessed quantitatively using an enzyme-linked immunosorbent assay kit. The relationships between 5-methylcytosine and 5-hydroxymethylcytosine and juvenile idiopathic arthritis and its subtypes were evaluated statistically. RESULTS: The 5-hydroxymethylcytosine level was significantly higher, whereas the 5-methylcytosine and 5-methylcytosine/5-hydroxymethylcytosine ratios were significantly lower in the patient group than in the control group. No significant differences between different juvenile idiopathic arthritis subtypes and disease activity status were found in 5-hydroxymethylcytosine and 5-methylcytosine levels or 5-methylcytosine/5-hydroxymethylcytosine ratios (p>0.05). The 5-methylcytosine/5-hydroxymethylcytosine ratio, with an optimal cut-off value of ≤28.05, demonstrated a sensitivity of 70.69% and a specificity of 77.14% in distinguishing juvenile idiopathic arthritis patients from controls (p<0.001). CONCLUSION: 5-Hydroxymethylcytosine and 5-methylcytosine can be potential biomarkers for juvenile idiopathic arthritis and its subtypes, indicating their roles in juvenile idiopathic arthritis development regarding molecular mechanisms and novel therapeutic approaches.

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SUMMARY OBJECTIVE: Hepatitis C virus prevalence is higher in hemodialysis patients than in the general population. It is recommended that patients who are detected to be anti-hepatitis C virus seropositive should be dialyzed in separate machines. In patients requiring urgent hemodialysis treatment, anti-hepatitis C virus seropositivity may cause confusion and delay in dialysis sessions. METHODS: The aim of the study was to determine the most appropriate signal-to-cutoff value to predict hepatitis C virus viremia in hemodialysis patients and to evaluate the effect of genotype differences. A total of 12,280 anti-hepatitis C virus results from hemodialysis patients between 2021 and 2024 were examined. RESULTS: The mean age of 563 patients included in the study was 57 years, and 330 (58.6%) were male. Of the 563 patients, 68 (12.07%) were true hepatitis C virus patients. The mean age of hepatitis C virus-ribonucleic acid(+) patients was higher than that of the hepatitis C virus-ribonucleic acid(-) group (p<0.018). Anti-hepatitis C virus signal-to-cutoff value was >1 in all true hepatitis C virus patients. Hepatitis C virus-ribonucleic acid was accepted as the gold standard to determine the best threshold value in receiver operating characteristic curve analysis, and the most appropriate signal-to-cutoff value was found to be 2.23. Sensitivity was 98.5%, specificity was 87.1%, positive predictive value was 51.2%, and negative predictive value was 99.8%. 49 (85.96%) of the patients were identified as genotype(-1; the most common subtype was genotype-1b (n=43). CONCLUSION: Anti-hepatitis C virus negativity is a reliable result in hemodialysis patients. If anti-hepatitis C virus signal-to-cutoff ≥2.23 is detected, confirmation by direct hepatitis C virus-ribonucleic acid testing is recommended. In hemodialysis patients with anti-hepatitis C virus signal-to-cutoff values between 1 and 2.23, false positivity should be considered first, and confirmatory tests should be performed if anti-hepatitis C virus is reactive in a second sample.

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SUMMARY OBJECTIVE: The aim of this study was to compare the evolution of high-grade human papillomavirus-induced cervical lesions between human immunodeficiency virus-positive and human immunodeficiency virus-negative women. METHODS: Human immunodeficiency virus-positive and human immunodeficiency virus-negative women were enrolled in a retrospective cohort study after undergoing large-loop excision of the transformation zone between January 2008 and December 2017 as participants in the high-grade cervical lesion screening program. The evolution of human papillomavirus lesions induced in human immunodeficiency virus-infected women was evaluated in comparison with the general population. The following potentially confounding variables were examined: age at treatment and at the end of follow-up, histologic grade of treated intraepithelial disease, compromised margins, adequacy of colposcopy during follow-up, and recurrence of histopathologic diagnosis of high-grade squamous intraepithelial lesion. RESULTS: Of the 195 women, 51 were human immunodeficiency virus-positive (26.2%) and 144 were human immunodeficiency virus-negative (73.8%). Age of menarche (11.8±1.5) and sexarche (14.5±2.2) were earlier in human immunodeficiency virus-positive women (p=0.021 and 0.006, respectively). Parity (2.35±109) and number of pregnancies (2.86±1.47) were higher in human immunodeficiency virus-positive women (p=0.027 and 0.018, respectively). The prevalence of incomplete schooling was lower in human immunodeficiency virus-positive women (47.1 vs. 19.8%, p=0.002). Smoking was more common in human immunodeficiency virus-positive women (58.8 vs. 31.9%, p=0.001). Compromised surgical margins were found in 33.3% of human immunodeficiency virus-positive and 16.7% of human immunodeficiency virus-negative women (p<0.001). The risk of recurrence was 37.3% in human immunodeficiency virus-positive and 13.9% in human immunodeficiency virus-negative women (p<0.001). Cumulative survival over months was shortened in human immunodeficiency virus-positive women (p<0.001). CONCLUSION: human immunodeficiency virus-positive women in this cohort had a significantly higher risk of recurrence than human immunodeficiency virus-negative women in addition to shorter overall survival.

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SUMMARY OBJECTIVE: To describe the perinatal outcomes of monochorionic pregnancies complicated with twin-to-twin transfusion syndrome, laser photocoagulation of placental anastomoses was presented as an initial experience in a reference center in South Brazil. METHODS: Case series between October 2020 and March 2024, including monochorionic twin/triplet pregnancies complicated with twin-to-twin transfusion syndrome. This syndrome was classified according to Quintero's stage. The maternal and surgical characteristics, as well as the perinatal outcomes were assessed. RESULTS: Of the 17 pregnant women diagnosed with twin-to-twin transfusion syndrome, 11 (64.7%) were treated at our center, including 9 monochorionic-diamniotic, 1 dichorionic-triamniotic, and 1 monochorionic-diamniotic triplet. Of the 9 laser ablations of placental anastomoses included in the study, 8 (88.9%) had 2 or more live births, and 1 (11.1%) had no live births. The mean gestational age at surgery was 21.9 weeks. Regarding Quintero stage at the time of surgery, 2 were stage I, 3 were stage II, and 4 were stage IV. The interval between surgery and delivery was 10.8 weeks, with a mean gestational age at delivery of 32.7 weeks. The mean birth weight of the recipient was 1,845 g, and that of the donor was 1,667.8 g. CONCLUSION: Our initial experience with laser ablation of placental anastomoses in monochorionic pregnancies complicated by twin-to-twin transfusion syndrome showed good perinatal outcomes with lower complication rates.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the effect of a cherry seed pillow on pain and quality of life in fibromyalgia patients. METHODS: This study used a pretest-posttest, randomized, and controlled prospective research design. It was conducted between December 2023 and February 2024 in the physiotherapy clinic of a private hospital. A total of 72 adults with fibromyalgia were randomly assigned to the cherry seed (n=36) and control (n=36) groups. Both groups received conventional physiotherapy 5 days a week for 4 weeks. A cherry seed pillow (microwave-heated) was used in the cherry seed group. A hot pack was applied to the control group. The data were collected using a personal information form, Visual Analog Scale, and Fibromyalgia Impact Questionnaire. RESULTS: The change in the participants’ resting pain before and after the treatment decreased in both the treatment (p<0.001, d=0.86) and control (p<0.001, d=0.97) groups. The change in activity pain decreased in the intervention (p<0.001, d=0.79) and control (p<0.001, d=0.87) groups. Similarly, there was a decrease in night pain in the intervention (p<0.001, d=0.86) and control (p<0.001, d=0.89) groups. The change in Fibromyalgia Impact Questionnaire scores of the participants showed a decrease in the intervention (p<0.001, d=3.90) and control (p<0.001, 30.03, d=4.28) groups. CONCLUSION: Both groups showed a reduction in pain, likely due to the combined effect of heat and physiotherapy; however, the clinical improvement was more significant in the control group, suggesting that the cherry seed pillow was less effective.

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SUMMARY OBJECTIVE: Remnant cholesterol is an important component of triglyceride-rich lipoproteins and has emerged as an important potential biomarker for the assessment of cardiovascular risk. The aim of the study is to examine acute changes in remnant cholesterol levels pre- and post-angiography and evaluate their relationship with inflammatory markers. METHODS: A total of 183 patients who underwent coronary angiography were included in this retrospective study. Remnant cholesterol, low-density lipoprotein, high-density lipoprotein, creatine kinase-myocardial band, Troponin-T, C-reactive protein, and white blood cell levels were analyzed pre- and post-angiography. Correlation and regression analyses were used to evaluate the relationships between the data. RESULTS: Remnant cholesterol levels increased significantly post-angiography (p<0.05), while low-density lipoprotein showed no significant change (p=0.0588). C-reactive protein levels were significantly higher post-angiography than pre-angiography (p<0.05), which was considered as an indicator of procedure-related inflammatory response. Correlation analysis found a significant inverse relationship between baseline remnant cholesterol and post-angiography C-reactive protein (p<0.05). However, in a multivariable regression, C-reactive protein did not have a significant independent effect on remnant cholesterol levels (p>0.05). Baseline remnant cholesterol (pre-angiography) levels showed an inverse association with post-procedure troponin T (β=-0.014, p<0.05), whereas post-angiography remnant cholesterol demonstrated no significant correlation with troponin T (p>0.05). CONCLUSION: This study reveals significant post-angiography increases in remnant cholesterol, indicating acute metabolic and inflammatory changes. While these findings enhance understanding of remnant cholesterol dynamics during vascular interventions, the lack of long-term outcomes necessitates cautious interpretation. Future research should validate its prognostic value and therapeutic implications. Remnant cholesterol shows potential as a biomarker but requires further investigation before clinical implementation.

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SUMMARY OBJECTIVE: The aim of the study was to investigate the prevalence of insomnia in postmenopausal osteoporotic women. It also evaluated the relationship between insomnia, fatigue, and mood disorders. METHODS: This cross-sectional study was conducted with 200 postmenopausal osteoporotic women aged 50–75 years. Insomnia severity was assessed using the Insomnia Severity Index, while fatigue and mood disorders were measured using the Fatigue Severity Scale and the Hospital Anxiety and Depression Scale, respectively. The participants were divided into two groups based on the Insomnia Severity Index scores, using a cutoff of 15. We then analyzed the clinical characteristics of these two groups, focusing on the relationship between insomnia severity and factors such as fatigue, anxiety, depression, and bone mineral density. RESULTS: Among the participants, 20.5% were clinically diagnosed with insomnia (Insomnia Severity Index≥15). Sleep initiation difficulties were reported by 73.5%, sleep maintenance difficulties by 57.5%, and early awakening by 45%. Insomnia severity was significantly correlated with higher levels of fatigue (r=0.342, p<0.001), depression (r=0.297, p<0.001), and anxiety (r=0.323, p<0.001). There was no significant correlation between insomnia and bone mineral density or T-scores. CONCLUSION: Insomnia is common in postmenopausal osteoporotic women and is closely linked to higher fatigue, anxiety, and depression levels. Early detection and management of insomnia in this population are essential to reduce fall risk and prevent fractures.

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SUMMARY OBJECTIVE: The objective of the study was to evaluate perioperative and oncologic outcomes of laparoscopy without the use of uterine manipulators and laparotomy in high-grade and serous endometrial cancer. METHODS: Patients with grade III endometrioid adenocarcinoma and serous carcinoma between 2018 and 2022 were included in the study. Preoperative staging with positron emission tomography/computed tomography or thoracoabdominal computed tomography and pelvic magnetic resonance imaging was performed. All patients underwent staging surgery including hysterectomy, bilateral salpingo-oophorectomy, peritoneal washing, omentectomy, and pelvic and paraaortic lymphadenectomy up to the renal vein. No uterine manipulator was used for laparoscopic hysterectomy. Age, CA 125 level, body mass index, accompanying diseases, pathologic data including stage, lymphovascular invasion, number of pelvic and paraaortic lymph nodes, and surgical data including surgical time, surgical complications, and adjuvant therapies were collected from the hospital database retrospectively. RESULTS: Notably, 89 patients were included in the study: 34 underwent laparotomy and 55 underwent laparoscopy. Surgical times were similar between the groups. The mean pelvic lymph node count in the laparotomy and laparoscopy groups was 33 and 34, respectively. The mean paraaortic lymph node counts in the laparotomy and laparoscopy groups were 23 and 22, respectively. Red blood cell transfusion, hemorrhage, urinary tract infection, postoperative fever, bladder atony, bladder injury, and chylous leakage showed no significant differences between the groups. However, ileus, intestinal injury, and evisceration were significantly higher in the laparotomy group. Hospital stay was significantly longer in the laparotomy group compared with the laparoscopy group. Overall and recurrence-free survival were similar between the groups. CONCLUSION: Laparoscopic surgery, performed without manipulators, provides comparable oncologic outcomes to open surgery in the treatment of high-grade endometrial cancer, while also offering improved perioperative results.

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SUMMARY OBJECTIVE: The aim of this study was to investigate the effect of vaginal progesterone used to prevent spontaneous preterm birth in the development of gestational diabetes mellitus. METHODS: This is a cross-sectional study that investigated pregnant women aged 18–39 years. The study participants underwent a 2-h, 75-g oral glucose tolerance test at 24 and 28 weeks of gestation. A total of 3,066 patients met the inclusion criteria, and 418 were diagnosed with gestational diabetes mellitus based on at least one abnormal plasma glucose value during screening. The remaining 2,648 patients, who had normal plasma glucose levels, were classified as the control group. The two groups were compared based on various factors, including age, parity, pre-pregnancy body mass index, smoking status, gestational age, and use of vaginal progesterone. RESULTS: The use of vaginal progesterone was statistically significant at a higher rate in the gestational diabetes mellitus group compared to the control group (22.0 vs. 16.0%; p=0.002). The mean duration of vaginal progesterone use was 53.4±14.6 days (ranging from 28 to 90 days), and this duration was statistically significantly longer in the gestational diabetes mellitus group (59.9±14.8 vs. 52.0±14.2; p<0.001). CONCLUSION: The findings suggest that the use of vaginal progesterone may increase the risk of gestational diabetes mellitus, and the risk appears to rise with the duration of progesterone use. It is important to consider that patients on prolonged vaginal progesterone, particularly those started early in pregnancy, may be at increased risk of diabetes. Therefore, it may be advisable to repeat the oral glucose tolerance test performed at 24–28 weeks in the following weeks.

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SUMMARY OBJECTIVE: Diabetic retinopathy exhibits a higher risk of atherosclerotic cardiovascular disease-related complications. Proliferative diabetic retinopathy is the most serious complication of diabetic retinopathy and can lead to total visual loss. Given that inflammation plays a key role in diabetic retinopathy, using blood-derived indexes could be a feasible way to predict the proliferative diabetic retinopathy. The aim of this study was to assess the effectiveness of pan-immune-inflammation value in predicting proliferative diabetic retinopathy in type 2 diabetes mellitus patients and atherosclerotic cardiovascular disease. METHODS: This retrospective study included 234 patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease. The study population was classified into three groups according to severity of diabetic retinopathy: no-diabetic retinopathy, non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy groups. Complete blood counts were obtained, and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and pan-immune-inflammation value ([neutrophils×platelets×monocytes]÷lymphocytes) were calculated. A receiver operating characteristic curve was performed to analyze the ability of inflammatory markers for proliferative diabetic retinopathy. RESULTS: The mean age was 56.6±7.8 years, and there were 109 men and 125 women. The median (interquartile range) pan-immune-inflammation value levels in the no-diabetic retinopathy, non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy groups were 213 (137–325), 240 (157–297), and 375 (318–540), respectively (p<0.001). Multivariate analysis revealed that the pan-immune-inflammation value (OR 1.066; 95%CI 1.051–1.072; p=0.001), total cholesterol (OR 1.055; p=0.018), and hemoglobin (OR 0.145; p=0.036) were independent risk factors of proliferative diabetic retinopathy in patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease. CONCLUSION: Our study revealed a significant association between increased pan-immune-inflammation value levels and high proliferative diabetic retinopathy risk in type 2 diabetes mellitus patients and atherosclerotic cardiovascular disease.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the effect of prophylactic administration of parecoxib sodium on postoperative delirium in elderly orthopedic patients. METHODS: In this prospective, single-center, randomized, double-blind, placebo-controlled trial, a total of 166 elderly orthopedic patients were included. Patients were randomly divided into placebo group (Group A) and parecoxib sodium group (Group B) with normal saline and parecoxib sodium 40 mg given, respectively, before operation. Delirium was evaluated by the Confusion Assessment Method-Chinese Reversion. The main outcome was the incidence of delirium within 48 h after operation. The secondary outcomes were the average delirium and pain scores. The follow-up outcome was measured by the Activities of Daily Living scale after 2 months and 6 months. RESULTS: Finally, 53 of 166 patients developed postoperative delirium (31.9%), of which the incidence of Group B was significantly lower than that of Group A (42.2 vs. 21.7%, p=0.015). The average delirium scores of Group B were lower than those of Group A (p<0.05). However, the average pain scores only differed at 8 pm in the second day after surgery. There was no significant difference in Activities of Daily Living scale scores between the two groups at either 2 months (67.12±19.82 vs. 65.19±19.53, p=0.609) or 6 months (68.36±18.56 vs. 66.63±19.44, p=0.927). CONCLUSION: Preoperative prophylactic administration of parecoxib sodium significantly reduced the incidence of postoperative delirium in elderly orthopedic patients but did not improve long-term functional recovery.

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SUMMARY OBJECTIVE: The aim of this study was to examine the preventive behaviors of young adults regarding sexually transmitted infections and identify the factors influencing these behaviors. METHODS: This descriptive study was conducted between May and December 2024 with a sample of 385 young women aged 18–25. Data were collected using the Descriptive Information Form and Behavioral Scale for Protection from Sexually Transmitted Diseases. Statistical analysis was performed using SPSS 22.0. Data analysis was conducted using an independent groups t-test, analysis of variance, and posthoc analysis. RESULTS: The mean total score on the Behavioral Scale for Protection from Sexually Transmitted Diseases was 83.91±9.03 (min: 57; max: 105). Single participants had significantly higher total scores in the information and protection sub-dimension of the Behavioral Scale for Protection from Sexually Transmitted Diseases (p=0.021). Furthermore, those who have received sexual health education demonstrated significantly higher scores (p<0.001). Linear regression analysis indicated that receiving sexual health education accounted for 14% of the total variance. CONCLUSION: This study highlights the significant role of sexual health education in enhancing awareness and promoting preventive behaviors against sexually transmitted diseases among young adults.