CC Attribution-NonCommercial-NoDerivatives 4.0
Efficacy of combined screening tests used in the first trimester in predicting adverse pregnancy outcomes
Aim: This study aims to evaluate the predictive efficacy of first-trimester screening test parameters, including free β-human chorionic gonadotropin (β-hCG), pregnancy-associated plasma protein-A (PAPP-A), and nuchal translucency (NT), in identifying adverse pregnancy outcomes such as gestational diabetes mellitus (GDM), fetal growth restriction (FGR), preeclampsia, preterm birth, and placenta accreta spectrum (PAS) or placenta previa (PP). Materials and Methods: A retrospective cohort analysis involved 776 pregnant women who underwent first-trimester screening tests between January 2023 and August 2024. Patients were categorized into two groups based on the presence or absence of pregnancy complications. Results: Pregnancy complications were identified in 36.6% of participants, with GDM, FGR, and preterm birth being the most common. PAPP-A levels were significantly reduced in pregnancies complicated by GDM (p=0.033), FGR (p=0.048), and preeclampsia (p=0.001). NT values were notably elevated in GDM cases (p=0.016). Free β-hCG levels were significantly higher in preterm birth (p=0.040) and PAS/PP cases (p=0.016). ROC analysis revealed notable predictive thresholds: PAPP-A <0.64 for preeclampsia (AUC=0.760, p=0.001) and β-hCG >1.01 for PAS/PP (AUC=0.814, p=0.016). Conclusion: First-trimester screening test parameters, particularly PAPP-A, NT, and β-hCG, exhibit potential in predicting adverse pregnancy outcomes. Reduced PAPP-A levels correlate with GDM, FGR, and preeclampsia, while elevated NT and β-hCG levels are associated with GDM and PAS/PP, respectively. Although these markers demonstrate promise, larger-scale prospective studies are needed to confirm their clinical utility and reliability in predicting pregnancy complications.
Copyright (c) 2025 Annals of Medical Research https://creativecommons.org/licenses/by-nc-nd/4.0
A resveratrol-loaded scaffold enhances tendon healing: Histological and biomechanical analysis in a rat Achilles tendon repair model
Aim: This study aims to evaluate the effects of Dermalix® (Dx), a resveratrol-loaded, bioabsorbable scaffold composed of collagen, laminin, and hyaluronic acid, on tendon healing and peritendinous adhesion formation following primary Achilles tendon repair in a rat model. Materials and Methods: A total of 28 female Wistar Albino rats underwent bilateral Achilles tendon injury and repair using the modified Kessler technique. The right legs were treated with local Dx application over the repair site, while the left legs served as untreated controls. Animals were randomly assigned to one of four groups (n = 7 per group). The groups were defined by the evaluation time point (3 or 6 weeks) and the type of analysis (histological or biomechanical). Assessments included macroscopic adhesion scoring, histological quantification (counts of fibroblasts, fibrocytes, and vessels), and biomechanical testing (maximum load to failure and elongation at rupture). Statistical comparisons were made using t-test, Mann-Whitney U, chi-square , ANOVA, or the Friedman test, as appropriate for the data. Results: Dx application significantly reduced severity of adhesion at both 3 and 6 weeks (p<0.01). Histological analyses revealed significantly lower fibroblast and fibrocyte counts with more organised collagen alignment in Dx-treated groups (p<0.05). Biomechanically, rupture force was significantly higher in Dx groups at both time points (p<0.01 and p=0.029), while no significant difference was found in elongation distance. The scaffold was resorbed by week 3, without inducing any foreign body reaction or systemic side effects. Conclusion: The local application of Dx enhanced tendon healing significantly and reduced peritendinous adhesions without compromising biomechanical strength. Its bioabsorbable composition and local antioxidant properties make Dx a promising supportive local treatment option in tendon repair surgery. This is particularly valid in cases with high adhesion risk.
Should videolaryngoscopy enter routine use? Unanticipated difficult airway: A five-year experience in a tertiary care hospital
Aim: An unanticipated difficult airway (UDA) can be very challenging for anesthesiologists in airway management and, if not managed appropriately, may lead to increased morbidity and even mortality in patients. Because patients with normal physical examination findings may also have a difficult airway, meticulous preparations are essential for every patient. Our study investigated the five-year outcomes of a tertiary care hospital in patients with UDA. Materials and Methods: We retrospectively reviewed the records of 143 patients with UDA who underwent surgery under general anesthesia between January 2020 and March 2025. We evaluated their airway management: preoperative physical examination findings, demographics, comorbidities, mask ventilation, laryngoscopic visualization, and tracheal intubation success. Results: We found that videolaryngoscopy (VL) improved glottic visualization compared to direct laryngoscopy (DL) in patients with UDA (p<0.001). VL reduced the risk of complications and accidental esophageal intubation compared to DL (p<0.001, p<0.001, respectively). We also found that 129 out of 133 patients (97%) who could not be intubated with DL were successfully intubated endotracheally using VL. Conclusion: VL improves glottic visualization, reduces the risk of complications, and increases the rate of successful intubation compared to DL in patients with UDA.
Evaluation of risk factors for morbidity and mortality in intensive care unit readmissions
Aim: Unplanned readmissions to the intensive care unit (ICU) are associated with poor clinical outcomes, prolonged hospital stays, and increased healthcare costs. Identifying the clinical and laboratory predictors of ICU readmission and its impact on in-hospital mortality remains critical for improving patient safety and optimizing utilization of the resources. This study aimed to investigate the factors associated with ICU readmission and evaluate its relationship with mortality in a tertiary-care hospital setting. Materials and Methods: In this retrospective cohort study, data of 1347 patients followed in Pulmonary ICU between 2016 and 2024 were retrospectively evaluated. Data of 153 patients (75 patients readmitted and 78 control cases selected randomly who were not readmitted during the same hospitalization) were analyzed. The two groups -those with and without ICU readmission- were compared in terms of demographic characteristics, clinical parameters, comorbidities, nutritional status, and laboratory findings. Logistic regression analysis was used to identify predictors of mortality. Results: Readmitted patients were older (p=0.001), had lower Glasgow Coma Scores (p <0.001), higher APACHE II scores (p <0.001), and longer ICU and hospital stays (p=0.002, p=0.006 respectively). They also required more vasopressors (p=0.004), mechanical ventilation (p=0.001), and sedation (p<0.001). Nosocomial infections were more frequent in this group (p <0.001). Univariate regression analysis revealed that ICU readmission, low serum albumin, nosocomial infections, use of vasopressors, and comorbidities such as dementia and cerebrovascular disease were significantly associated with mortality (p<0.05). In the Backward Wald model, albumin during hospitalization, nosocomial infection and APACHE II scores were independent risk factors for mortality (p<0.05). Conclusion: ICU readmission is strongly associated with adverse clinical outcomes and increased in-hospital mortality. Identifying high-risk patients based on clinical and laboratory parameters—such as low serum albumin levels, presence of nosocomial infections, use of vasopressors, and comorbidities like dementia/Alzhiemer’s disease—may facilitate early interventions and improve patient prognosis.
Role of loneliness in the relationship between chronic pain and analgesic use in the elderly
Aim: Loneliness is more frequently observed in older adults than in other age groups and is associated with adverse health outcomes. This study aimed to examine the relationship between loneliness, chronic pain, and analgesic use in the geriatric population. Materials and Methods: This cross-sectional study included 384 elderly subjects who presented to a family medicine outpatient clinic. The University of California, Los Angeles (UCLA) Loneliness Scale for the Elderly and the Geriatric Pain Measure were used to collect data on the variables. Results: The mean age of the 384 elderly participants included in the study was 74.91±7.12 years (range: 65–91). Of the participants, 52.9% were women and 11.7% were living alone. Higher frequencies of analgesic use were associated with higher pain and loneliness scores (p<0.001). A moderate, positive, and statistically significant correlation was found between pain and loneliness scores (r=0.478, p<0.001). In the multivariate linear regression analysis, each 1-point increase in the loneliness score led to a 1.72-point increase in the pain score. Female sex and chronic diseases were associated with 4.63- and 9.65-point increases in the pain score, respectively. Multinomial logistic regression analysis showed that, independent of age, sex, and pain score, each 1-point increase in the loneliness scale score was associated with a higher likelihood of using analgesics ≥15 times/month (OR=1.29), 8–14 (OR = 1.24), and 2–7 (OR = 1.22) times/month. Age and sex did not have any significant effect on monthly analgesic use. Conclusion: There is a positive relationship between loneliness, chronic pain, and frequent use of analgesics in the elderly subjects Psychosocial assessment and support in elderly patients may help reduce excessive analgesic consumption.
Impact of reflux, bruxism, age, and plaque index on anterior tooth wear: A cross-sectional clinical evaluation
Aim: This study aims to evaluate the effect of variables such as gastroesophageal reflux disease (GERD), bruxism, plaque index, and age on erosive wear occurring on the palatal surfaces of maxillary anterior teeth, and to objectively measure this wear using the Anterior Clinical Erosive Classification (ACEC). Materials and Methods: A total of 507 individuals were included. Participants completed self-report questionnaires regarding the presence, previous diagnosis, disease duration, and medication use. Bruxism was assessed through self-report and clinical examination. Erosive wear on maxillary anterior teeth palatal surfaces was measured using ACEC, and plaque accumulation using the Silness and Löe Plaque Index. Statistical analyses included independent sample t-tests and Spearman/Pearson correlation coefficients. Significance was set at p<0.05. Results: Reflux disease was detected in 20.9% of the participants in the study. ACEC scores of individuals reporting reflux symptoms were found to be significantly higher compared to healthy individuals (p<0.05). ACEC scores were also found to be significantly higher in individuals with bruxism than those of without bruxism. In contrast, the plaque index did not show a significant difference between the groups. Additionally, a significant and positive relationship was found between the duration of reflux and ACEC scores (r=0.281, p<0.01). ACEC scores were observed to be higher in individuals receiving reflux treatment compared to those not using medication. Conclusion: These findings indicate that reflux affects not only the gastrointestinal system but also oral and dental health and emphasize the importance of early diagnosis and intervention for dental erosion in individuals with reflux symptoms. Our study reveals the usability of the ACEC in large populations and sheds light on the multifactorial etiology of dental erosion. It also highlights the need to consider the potential abrasive effects of medications used in reflux treatment.
Anterior clinical erosive classification
The relationship between health literacy and digital healthy diet literacy and dietary habits of pregnant women in different trimesters
Aim: This study aimed to investigate the relationship between health literacy, digital healthy diet literacy, and dietary habits of pregnant women in different trimesters. Materials and Methods: This study included 189 pregnant women who had registered for routine prenatal care. The participants were interviewed about their demographic characteristics, general health, smoking and alcohol consumption, medical history, and general dietary habits. In addition, a questionnaire with the Health Literacy Scale and the Digital Healthy Diet Literacy Scale was completed. Results: A positive, weak, and statistically significant correlation was found between prepregnancy body mass index (BMI) and the Health Literacy Scale (p < 0.05). A positive, weak, and statistically significant relationship was found between health literacy and digital healthy eating literacy (r = 0.278; p = 0.007). Conclusion: As the health literacy of pregnant women improves, so does their digital healthy diet literacy. These results demonstrate the importance of promoting health literacy to support healthy dietary behaviors during pregnancy.
First-trimester screening markers in pregnancies complicated by cervical insufficiency: A comparative retrospective study
Aim: This retrospective study aimed to evaluate the relationship between first-trimester screening markers and cervical insufficiency, comparing biochemical parameters and pregnancy outcomes among women with cervical insufficiency, spontaneous preterm birth, and term pregnancies. Materials and Methods: A total of 248 singleton pregnancies were included and divided into three groups: control (term deliveries, n=121), cervical insufficiency with cerclage (n=60), and spontaneous preterm birth (n=67). First-trimester serum markers including pregnancy-associated plasma protein A (PAPP-A), free beta-human chorionic gonadotropin (β-hCG), nuchal translucency (NT), and alpha-fetoprotein (AFP) were analyzed. Obstetric and neonatal outcomes such as gestational age at delivery, birth weight, Apgar scores, and adverse neonatal outcomes were recorded. Results: No significant differences were observed in first-trimester PAPP-A, β-hCG, NT, and AFP levels between the cervical insufficiency and control groups. However, the spontaneous preterm birth group exhibited significantly lower PAPP-A and higher β-hCG levels compared to both other groups (p < 0.001). Gestational age at delivery, birth weight, Apgar scores, and adverse neonatal outcomes were significantly worse in both cervical insufficiency and spontaneous preterm birth groups compared to controls (p < 0.05). Conclusion: First-trimester biochemical markers have limited predictive value for cervical insufficiency but show significant alterations in spontaneous preterm birth. Cervical insufficiency appears to be a localized structural pathology not reflected by early systemic biochemical changes. Clinical management should prioritize second-trimester cervical length assessment and appropriate interventions over reliance on first-trimester serum markers. Further research is needed to identify specific biomarkers for early detection of cervical insufficiency.
Beta-human chorionic gonadotropin (β-hCG)
The relationship between lung involvement in rheumatoid arthritis and sarcopenia
Aim: This study investigated the effect of lung involvement in Rheumatoid Arthritis (RA) on sarcopenia. Materials and Methods: A retrospective analysis was conducted on patients with RA diagnosed between January 2020 and January 2024. Patients with non-contrast thoracic CT scans available in the hospital database were included. A control group consisting of individuals without any inflammatory diseases was also selected. Muscle area (MA) and muscle-to-aorta density (M/A density) ratio were compared between the RA and control groups, as well as between RA patients with and without pulmonary involvement. Results: A total of 187 individuals (156 women, 31 men) were included in the study, comprising 84 patients in the RA group and 103 in the control group. The M/A density ratio was significantly lower in the RA group (p<0.001). Among RA patients, 30 (36%) had pulmonary involvement. The M/A density ratio was significantly lower in RA patients with lung involvement compared to those without (p = 0.016). However, the muscle area showed no significant difference among the groups (p = 0.683). Conclusion: This study found that RA lung involvement may be associated with increased muscle adiposity. Prospective studies with large populations are needed to confirm this association.
Evaluation of patient-related factors and index treatment in recurrent ingrown toenail cases
Aim: This study aims to evaluate patient-related factors and previous treatments in patients with ingrown toenails that subsequently recurred. In this context, recommendations for clinical practice are proposed to contribute to the development of both effective treatment methods and preventive strategies. Materials and Methods: This retrospective study included 42 patients previously treated for ingrown toenails who developed recurrences due to various reasons. Patients with post-treatment complications (e.g., infection and bleeding), pain associated with the treatment, or dissatisfaction with the treatment were not considered as a recurrence and were excluded from the study. All patients gave informed consent for participation in the study. The demographic characteristics such as age and gender, patient-related factors that might affect recurrence (foot hygiene, footwear usage, nail trimming, additional deformities, trauma history, comorbidities), the clinics where the initial treatment was performed, and the initial treatment methods were recorded. Results: The mean age of the patients was 26.8 ± 10.1 years, with the youngest being 12.0 years and the oldest 49.0 years. Of the patients, 33.3% (n=14) were female, and 66.7% (n=28) were male. Comorbidities included diabetes mellitus in 21.4% (n=9), obesity in 31.0% (n=13), peripheral arterial disease in 7.1% (n=3), and hyperhidrosis in 16.7% (n=7). No predisposing factors were identified in 11.9% (n=5) of the 42 patients. An evaluation of initial treatment methods revealed that 40.5% (n=17) of the patients underwent Orthonyxia, 21.4% (n=9) underwent Chemical Partial Matricectomy, 21.4% (n=9) underwent Spicule Excision, and 16.7% (n=7) underwent Partial Matricectomy. Conclusion: Ingrown toenails are common in the general population and can significantly impair quality of life. When left untreated or improperly treated, they may result in unexpected and troublesome outcomes. Reducing risk factors and receiving appropriate treatment from an experienced clinician will help lower recurrence rates.
Determination of density ranges to be used in grading hepatosteatosis using computed tomography
Aim: To determine the density ranges to evaluate the degree of hepatosteatosis on computed tomography (CT) grades. Materials and Methods: Patients who were diagnosed with hepatosteatosis by ultrasonography and those who subsequently underwent tomography were included in the study. Measurements were made from each segment of the liver and the spleen in the CT images of the graded groups. Liver/spleen density ratios were compared. Results: In total 666 patients were included for evaluation in the present study. Liver/spleen density ratios for Grade 1, Grade 2, and Grade 3 were 0.94 ± 0.19, 0.70 ± 0.16, and 0.37 ± 0.13, respectively. There was a statistically significant difference in the Liver/spleen density ratios throughout all grades (p=.001). The cut-off value separating Grade 1 and Grade 2 was calculated as 0.77, and the cut-off value separating Grade 2 and Grade 3 was calculated as 0.47. Segment 1, which had the least fat accumulation, was significantly different from all the other segments. Conclusion: In the present study, it was determined that both contrast-enhanced and non-contrast-enhanced tomography can be used for the evaluation of hepatosteatosis. However, contrast-enhanced tomography has been found to distinguish Grade 1 from Grade 2 more effectively than unenhanced CT.
A novel benzamide derivative SY-15 inhibits multiple myeloma cell proliferation
Aim: Over the past two decades, the natural course of multiple myeloma (MM) has changed significantly, primarily due to the emergence of novel therapeutic agents targeting the bone marrow microenvironment (BMM). Despite these advancements, the underlying mechanisms of drug resistance remain largely unclear. In this study, the effects of a novel benzamide derivative, SY-15, on MM cell lines were investigated, and the findings suggest that this molecule could be a promising anticancer drug candidate, warranting further research. Materials and Methods: Multiple myeloma (MM) cell lines (MM1S, U266, H929, RPMI8226) were cultured, and the effects of various concentrations of a novel benzamide derivative on cell viability were evaluated using the MTT assay. Results: The anticancer activity of the SY-15 molecule was evaluated in multiple myeloma (MM) cell lines following 72 hours of treatment, and for comparison, in the L929 normal fibroblast cell line. A statistically significant difference in cell viability percentages was observed among the five cell lines (p<0.001). The median cell viability percentage was 93.6247 for the L929 cell line, 44.4110 for the MM1S cell line, 22.4655 for H929, 31.7180 for U266, and the lowest median value was recorded in the RPMI 8226 cell line at 13.0931. Notably, SY-15 did not exhibit significant cytotoxicity in L929 fibroblast cells. Conclusion: SY-15 has the potential to be an effective anticancer agent with high selectivity and low toxicity for the treatment of MM. It may offer a novel therapeutic option, particularly for patients who have developed resistance to other MM drugs.
Intersphincteric anal abscess, a rare cause of axial low back pain: A case report
A 60-year-old male patient presented with axial lower back pain. He had suffered from pain for one month. Within a week, the patient's pain had increased, and he experienced additional symptoms of fever, malaise, and weight loss. Lumbar MRI revealed an intersphincteric anal abscess extending to the level of the lower lumbar vertebrae. The patient was then referred to a general surgeon. After drainage of the abscess and administration of broad-spectrum antibiotics, the patient's pain resolved within one week. This case report describes a rare presentation of lower back pain, in which a normal physical examination led to an initial delay in considering an anal abscess. The diagnosis of an advanced intersphincteric abscess was ultimately established by a lumbar MRI, which had been ordered to investigate for possible malignant metastasis.
Functional neurological (conversion) symptoms mediate the effect of self-stigma in women seeking psychological help on their psychological well-being
Aim: This study aimed to examine the effect of self-stigma of seeking psychological help on psychological well-being in patients diagnosed with functional neurological symptom disorder (formerly conversion disorder) through conversion symptoms. Materials and Methods: In this cross-sectional study, the Self-Stigma of Seeking Psychological Help Scale (SSPHS), Psychological Well-Being Scale (PWBS), and Somatoform Dissociation Questionnaire (SDQ-20) were administered to the FNSD and HC groups. Results: The FNSD group consisting of 31 females (12 motor (M)-FNSD, 9 somatosensory (SS)-FNSD, and 10 mixed-FNSD) and the HC group consisting of 32 females were similar in terms of age (p = 0.350), education level (p = 0.386), marital status (p = 0.579), and working status (p = 0.136). Significant differences were observed between the FNSD and HC groups in terms of SSPHS (p<0.001), PWBS (p<0.001), and SDQ-20 (p<0.001). Significant differences were observed between the M-FNSD, SS-FNSD, and Mix-FNSD subgroups in terms of SDQ-20 (p = 0.034), SSPHS (p = 0.028), and PWBS (p = 0.015). The comparison that caused significant differences in terms of SDQ-20, SSPHS, and PWBS scores among the FNSD subgroups was between M-FNSD and Mix-FNSD. The mediating role of the FNSD symptom level (SDQ-20) in the relationship between SPH and PW was examined. The indirect effect of SPH on PW was determined as -0.436 (49.65%). The direct effect of SPH on PW was determined as -0.442 (50.35%). In the correlation analysis performed in the FNSD group, a significant relationship was found between SSPHS and SDQ-20 (r=0.921, p<0.001), between SSPHS and PWBS (r=-0.879, p<0.001), and between PWBS and SDQ-20 (r=-0.882, p<0.001). Conclusion: This study demonstrates that SPH increases and PW decreases in FNSD and that FNSD symptoms mediate the relationship between SPH and PW.
Functional neurological symptom disorder
Comparison of patients undergoing general anesthesia or ultrasonography-guided interscalene block in shoulder surgery in terms of postoperative analgesia: A retrospective study
Aim: We aimed to evaluate the pain scores with visual analog scale and compare opioid consumption in the early postoperative period in cases where single-shote interscalene brachial plexus block and general anesthesia or general anesthesia alone have been applied for arthroscopic shoulder surgery. Materials and Methods: Seventy-one patients, aged 18-65, who had undergone elective arthroscopic shoulder surgery were included in this study. Participants were allocated to one of two groups: the General Anesthesia (GA) group (n=36) or the Interscalene Block and General Anesthesia (ISBPB+GA) group (n=35). The severity of postoperative pain was evaluated using Visual Analog Scale (VAS) scores. Results: The VAS scores and analgesic requirements of patients in the ISBPB+GA group were significantly lower than GA group. Although the duration of operation was shorter in the ISBPB+GA group (87.37±17.65 min), it did not reach statistical significance (p˃0.05). Surgeon and patient satisfaction scores were higher in the ISBPB+GA group compared to patients who underwent GA alone. Conclusion: The cases that underwent ISBPB+GA had notably lower pain scores and decreased additional analgesic consumption in the postoperative period. We believe that this anesthesia technique provides a more comfortable recovery process in patients undergoing shoulder surgery and can be safely utilized by experienced anesthesiologists.
An increase in neuropathic complaints corresponds to the severity of central sensitization-related symptoms in women with fibromyalgia: A cross-sectional study
Aim: This study aimed to investigate the relationship between central sensitization (CS)-related symptoms and neuropathic complaints in female patients with fibromyalgia (FM). Materials and Methods: Demographic and clinical variables, including disease duration, current medication, severity of pain, and the FM survey questionnaire, were all recorded. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess the severity of the FM. Neuropathic complaints were investigated by the Self-Leeds Assessment of Neuropathic Symptoms and Sign (S-LANSS) and CS-related symptoms by the Central Sensitization Inventory (CSI), and patient data were compared according to the CSI severity levels. Patients with CSI scores that are at least moderate (CSI≥40) were considered to have central sensitization syndrome (CSS). Results: One hundred and forty female FM patients were included in the study. The mean (SD) S-LANSS score was calculated as 15.06 (5.61) for all patients. A total of 135 patients (96.4%) had CSS; the mean (SD) CSI-A score for all patients was 61.39 (13.03). Of them, 81.4% (n = 114) were in the very severe CSS group. There was an increase in pain intensity, FIQ, and S-LANSS scores in parallel with the severity of CS-related symptoms (p<0.001). CS-related symptoms and disease severity were shown to have significant effects on S-LANSS variation in hierarchical regression analysis (β:0.34, CI:0.08-0.26, p<0.001; β:0.25, CI:0.01-0.20, p=0.035, respectively). Conclusion: Neuropathic complaints become evident in tandem with the severity of CS-related symptoms in female FM patients. Clarifying its potential association to CS-related symptoms may help clinicians to understand neuropathic complaints in FM patients in more detail.
Examining the relationship between sustainability consciousness and physical activity in healthy young adults
Aim: Sustainability consciousness (SC) refers to the awareness and lived experience of sustainability phenomena, which includes personal insights and viewpoints. The objective of this study is to assess the correlation between SC and physical activity among young, healthy volunteers. Materials and Methods: We assessed sustainability consciousness (SC) using the Sustainability Consciousness Questionnaire (SCQ) and physical activity levels with the International Physical Activity Short Form (IPAQ-sf). Results: We included 235 participants in the study, with ages ranging from 18 to 33 years and an average BMI of 23.01. The study found no statistically significant association between overall physical activity levels (IPAQ-SF) and overall sustainability consciousness (SCQ) (p > .05). Furthermore, none of the IPAQ-SF sub-parameters showed a significant correlation with the SCQ's total scores for knowledge (r=-.014, p=.835), attitude (r=-.007, p=.912), or behavior (r=.070, p=.287). When examining the SCQ sub-parameters, we found no significant association between knowledge (economic) and attitude (environment) (r=-.040, p=.539), or between knowledge (economic) and behavior (social) (r=-.047, p=.472). However, all other SCQ sub-parameters showed significant intercorrelations (p<.001). Specifically, knowledge (social) and behavior (social) sub-parameters were not significantly related (r=.026, p=.689), but all other pairings within the SCQ sub-parameters were significantly correlated (p<.001). Conclusion: This study found no association between sustainability consciousness (SC) and physical activity in healthy young individuals. However, we did observe significant interrelationships among the knowledge, attitude, and behavior sub-parameters of the Sustainability Consciousness Questionnaire (SCQ), across economic, social, and environmental dimensions.
Investigation of the prognostic impact of proline-rich protein 11 (PRR11) transcription levels in early-stage bladder cancer
Aim: To investigate proline-rich protein 11 (PRR11) transcription levels and its prognostic effect in early-stage (non-metastatic) bladder cancer. Materials and Methods: Thirty-one patients diagnosed with early-stage (non-metastatic) bladder cancer were included in the study. Tumor tissues of the patients at the time of diagnosis were obtained from the pathology laboratory, PRR11 transcription levels were analyzed, and "median fold change" values ​​for PRR11 transcription levels were obtained. According to the median PRR11 transcription level determined from these values, the patients were divided into two groups (n = 16 and n = 15). The demographic and clinicopathological characteristics of the patients were examined, and the survival outcomes of the two groups were compared. Results: The determined median PRR11 transcription level was 1.386 (range: 0.135- 2.016). In the patient group with a median PRR11 transcription level ≤1.381 (n=16), median disease-free survival (mDFS) was 19 months (95% CI: 2.1-48.4 months); in the group with >1.381 (n=15), mDFS was 11 months (95% CI: 7.5-14.4 months). In the group with ≤1.381, median overall survival (mOS) was 27 months (95% CI: 4.1-58.3 months), and in the group with >1.381, mOS was 14 months (95% CI: 8.1-19.8 months). Conclusion: Our study revealed a negative correlation between PRR11 transcription level and survival outcomes in patients with early-stage bladder cancer. The PRR11 transcription level may be a prognostic marker in patients with early-stage bladder cancer. More comprehensive, prospective, and randomized controlled trials are needed.
Evaluation of clinical and demographic characteristics of elderly patients receiving inpatient treatment in a university hospital psychiatry clinic
Aim: In this study, we aimed to examine the sociodemographic and clinical characteristics of geriatric patients receiving inpatient treatment in the psychiatry clinic of a university hospital. Materials and Methods: This retrospective study was conducted by examining the medical records of patients aged 65 and over who received psychiatric treatment between January 1, 2018 and December 31, 2023. Data related to the patients were obtained from the electronic patient database of the hospital. Results: A total of 252 patients, consisting of 124 females and 128 males, were included in the study. The mean age of the patients was 70.67 ± 5.01 years, and the average length of hospital stay was 17.35 ± 12.18 days. The diagnoses were, respectively, anxiety disorder (46.8%), depression (25.0%), mood disorder (10.7%), psychotic disorders (8.3%), alcohol/substance dependence (2.0%), psychiatric disorders related to general medical conditions (4.8%), dementia (1.2%), and intellectual disability (0.4%). In total, 22.8% had received inpatient treatment more than once. The condition that most often caused repeated hospitalizations was anxiety disorder, and 39% of these patients had a coexisting chronic disease. Depression was the most common mental disorder accompanying anxiety (15.3%). Mild or higher dementia was detected in 24 of 64 patients who underwent Mini-Mental State Examination. While the rates of comorbid chronic diseases were high in patients with Yeşil Kart (s form of preliminary social security), the rate of female patients hospitalized due to psychotic disorders was higher than that of males Conclusion: Determining the frequency of psychiatric disorders in hospitalized elderly patients and knowing the characteristics that case repeated hospitalization will contribute to the planning and development of appropriate treatment strategies.
Efficacy of therapeutic plasma exchange in HELLP syndrome: A single-center experience
Aim: The objective of this study is to investigate the clinical efficacy of therapeutic plasma exchange in HELLP (Hemolysis, Elevated Liver Enzyme, Low Platelet) syndrome and its contribution to renal failure, which is an independent risk factor for maternal mortality. Materials and Methods: From 2019 to 2024, 20 patients diagnosed with HELLP syndrome who underwent therapeutic plasma exchange (TPE) were included. We evaluated the patients' pre- and post-procedure values to determine the efficacy of the procedure. Results: The median age of patients was 30 (19-38) years, and the median number of days of TPE was 6 days (3-14). There was a statistically significant increase in hemoglobin and platelet values and a statistically significant decrease in lactate dehydrogenase, total bilirubin, direct bilirubin, aspartate aminotransferase, alanine aminotransferase, urea, and creatinine values. The number of TPE sessions, length of stay in hospital, and the length of intensive care unit stay were significantly higher in hemodialysis patients. Conclusion: TPE is an effective treatment modality for both clinical improvement and prevention of permanent renal failure in patients with persistent postpartum hemolysis who are followed for HELLP syndrome.
The effect of music to sleep quality on liver transplanted patients
Aim: This study aimed to evaluate the effect of music listening on sleep quality in adult liver transplant recipients. Given the limited research in this specific patient population, the study contributes to the growing body of evidence supporting non-pharmacological strategies in postoperative nursing care. Materials and Methods: A quasi-experimental pre-test/post-test control group design was employed. A total of 88 patients were included, with 44 assigned to the experimental group and 44 to the control group. Sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ) before and after the intervention. The experimental group listened to 30 minutes of culturally familiar music each night for four consecutive days, while the control group received standard care only. Results: Baseline RCSQ scores indicated poor sleep quality in both groups. Following the intervention, the experimental group showed a statistically significant improvement in total RCSQ scores (from 24.0 to 50.0, p < 0.001). Subscale analysis revealed significant improvements in all five RCSQ dimensions—sleep depth, sleep latency, frequency of nighttime awakenings, wake time, and overall sleep quality (p < 0.001). In contrast, the control group showed no meaningful change except for a slight improvement in the frequency of awakenings subscale (p = 0.035). Conclusion: These findings suggest that music listening can significantly enhance sleep quality in liver transplant recipients. As a safe, inexpensive, and easy-to-apply method, music listening holds promise for integration into routine postoperative nursing care to promote patient comfort and recovery.
Analysis of intestinal parasitic infections seen in the Southeastern Anatolia Region tertiary hospital between 2019-2024
Aim: The objective of this study was to determine the prevalence of intestinal parasites over time among patients who presented with dyspeptic complaints and sought stool samples from a Turkish tertiary hospital, and to investigate the correlation between intestinal parasites and age and gender. Material and Methods: A retrospective study was conducted between 2019 and 2024 at Siirt Education and Research Hospital to determine the intestinal parasites (IP) trend. We assessed the association between IP and age and gender groupings, as well as the distribution of IP types by year. Stool samples were analyzed using the nativ-lugol technique under a direct light microscope. All data lacking sociodemographic characteristics and the year of stool examination were excluded from the study. Results: Data from 6291 patients were analyzed. In total, 56.9% of the patients were male. The presence of parasites in accord with the gender did not differ significantly (p=0.528). The prevalence of parasites was 5.7% in the 18–65 age group and 9.0% in the over-65 age group(p=0.006). The most common IP species were E. histolytica (48.3%), B. hominis (28.2%), and G. intestinalis (22.5%, n=84). The incidence of H. nana (1.1%, n=4) was very low. Conclusion: IP is a serious threat to health, particularly in developing countries. The prevalence of IP will decrease as our awareness increases together with efficient diagnosis, treatment, and prevention strategies.
In the article, “Doganay D. Punctoplasty surgery combined with 22-gauge intracath intubation in punctal stenosis: A practical, cost-effective, and efficient method.” Ann Med Res. 2025;32(4):169-172, published in the April 2025 issue (Vol. 32, Issue 4), the following correction has been made: The informed consent statement for Figure 1, which includes the publication of the patient's image and related clinical information, has been properly included at the end of the article under the "Informed Consent" section in the PDF version. You can access the updated article PDF file via this link: https://annalsmedres.org/index.php/aomr/article/view/4830
Coexistence of hypertension and antinuclear antibodies: High blood pressure as a potential risk factor for autoimmunity
Aim: Hypertension (HT) is characterized by endothelial damage, vascular wall stress, and inflammation, potentially fostering autoantibody production. The prevalence of antinuclear antibodies (ANAs), common autoantibodies associated with systemic autoimmune diseases, remains unclear in non-autoimmune conditions like HT. This study aimed to investigate the presence of ANAs (anti-dsDNA, anti-ENA, anti-Hep-2 nucleus) in HT patients and compare these findings with healthy individuals. Materials and Methods: This experimental case-control study included 32 hypertensive patients (7 men, 25 women; age 48.9 ± 6.6) and 32 age- and gender-matched healthy controls (7 men, 25 women; age 48.0 ± 5.2). HT status was self-reported based on prior diagnoses. ANAs, including anti-dsDNA, anti-ENA, and anti-Hep-2 nucleus antibodies, were measured using validated ELISA kits. Results: Body mass index (BMI) and ages were comparable between groups (p > .05). Median ANA index values and positivity rates (%) for hypertensive and healthy groups were: anti-dsDNA [1.25 (59.4%) vs. 0.8 (28.1%)], anti-ENA [0.92 (46.9%) vs. 0.64 (21.9%)], and anti-Hep-2 nucleus [0.93 (43.8%) vs. 0.84 (18.8%)]. All three ANA tests showed significantly higher ANA levels and positivity rates in the hypertensive group compared to controls (p < 0.05). Conclusion: Our findings indicate higher ANA levels and positivity rates in individuals with HT compared to healthy controls, suggesting a potential link between HT and autoantibody production. Further long-term prospective studies are needed to determine the clinical significance of this elevated ANA frequency and the potential role of these antibodies in the development of autoimmune diseases.
Blau syndrome: A case report with unusual symptoms and literature review
Blau syndrome (BS) is an autosomal dominant disease that is brought on by changes in the gene that codes for the NOD-like receptor (NLR) protein (NOD2). It is characterized by the trinity of granulomatous polyarthritis, rash, and uveitis One-third to one-half of BS patients were found to have atypical symptoms. This case report presents the clinical experience of a BS patient with unusual findings at a tertiary care center in Istanbul. A 7-year-old male patient admitted to the outpatient clinic with a complaint of abdominal pain. There were rash attacks with fever for 2 years. He has had abdominal pain that has been going on for years and was previously operated on due to intussusception. There were no hereditary familial diseases found in the patient's family history. In the superficial tissue ultrasonography, intussusception was observed in an intestinal segment. Pathological examination of segmental resection of ileum, cecum, and appendix showed that there were findings of acute appendicitis, peritonitis with surface fissuration, and ulcer. The skin biopsy showed noncaseating, granulomatous infiltration with epithelioid cells and lymphocytes. In the genetic test, the NOD2 c.1835C˃T heterozygous mutation was detected. Based on this, BS was diagnosed. The patient was started on adalimumab and additional colchicine treatment. This syndrome can mimic other systemic inflammatory diseases in the early stages. This case report shows that we need to consider the diagnosis of BS in more detail in cases who raise clinical suspicion.
Factors affecting mortality in cases of perinatal asphyxia treated with hypothermia; A 10-year experience: A retrospective cohort study
Aim: Birth asphyxia and intrapartum brain injury can cause death or irreversible brain damage. The only known treatment that improves prognosis is therapeutic hypothermia. Our goal was to assess the parameters associated with death in newborns receiving therapeutic hypothermia. Materials and Methods: This retrospective cohort study was conducted in a neonatal intensive care unit (NICU) and included neonates who underwent therapeutic hypothermia due to perinatal asphyxia over 10 years. Patients were categorized into survivors and nonsurvivors based on their in-hospital outcomes. Demographic characteristics, clinical parameters, laboratory findings, and complications were retrieved from the patients’ medical records. Prognostic factors were compared between groups using appropriate statistical methods, and multivariate logistic regression was performed to identify independent predictors of mortality. Results: A total of 114 newborns treated with therapeutic hypothermia were analyzed, of whom 11 (9.6%) died due to perinatal asphyxia (PA). Non-survivors had significantly lower gestational ages (37±2 vs. 38.4±1.6 weeks, p=0.042), lower 5-minute Apgar scores (5 [1–5] vs. 5.5 [4–7], p=0.048), and higher cesarean delivery rates (81.8% vs. 41.7%, p=0.011). Severe findings on aEEG and Sarnat Stage III were more common among nonsurvivors (p<0.001 for both). Non-survivors also exhibited significantly lower admission rectal temperatures [33.8°C (32–36) vs. 35.8°C (34.5–36), p=0.023], higher rates of thrombocytopenia (81.8% vs. 42.7%, p=0.013), acute renal failure (90.9% vs. 39.8%, p=0.001), and cranial ultrasound abnormalities (27.3% vs. 3.9%, p=0.019). In the multivariate logistic regression analysis, only a lower rectal temperature at admission remained an independent predictor of mortality (OR: 1.520, 95% CI: 1.061–2.178, p = 0.023). Conclusion: Factors such as lower Apgar scores, acute renal failure, and hypothermia severity on admission are strongly associated with mortality. The early identification and management of these risk factors are critical for improving outcomes in neonates treated with therapeutic hypothermia.
Effects of anti-TNF-α treatment on lipid profile in inflammatory bowel disease
Aim: Tumor necrosis factor-alpha (TNF-α) plays a significant role in the pathogenesis of inflammatory bowel disease (IBD) and is associated with atherosclerosis and dyslipidemia. Despite the established use of anti-TNF-α antagonists in the treatment of IBD, the impact of these drugs on lipid profiles remains unclear, with conflicting evidence in the literature. Our study aims to assess the effect of anti-TNF treatment on lipid profile in pateints with IBD. Materials and Methods: Lipid profiles, including total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, and the atherogenic index, were measured in 103 patients (66 patients with CD, 37 with UC) at baseline and at 12 and 24 weeks of TNF-α inhibitor treatment, and the results were compared between the groups. Results: No significant change in cholesterol levels was observed over the course of 24 weeks (p=0.349). However, a noteworthy increase in HDL levels was observed from baseline to 24 weeks (p=0.016). No significant alterations in LDL and triglyceride levels were noticed over 24 weeks. The atherogenic index demonstrated no significant changes over the treatment period (p=0.462). Conclusion: Anti-TNF-α therapy, either with infliximab or adalimumab, among patients with IBD does not lead to a considerable alteration in lipid profiles after 3 and 6 months of treatment, with the exception of a significant increase in HDL.
The relationship between sexual health literacy and sexual health attitudes in young adults
Aim: This paper investigated the relationship between sexual health literacy (SHL) of young adults and attitudes toward sexual health. Materials and Methods: This study was descriptive and correlational in design. The sample size included 281 young adults. Data were collected using a personal information form, the Sexual Health Literacy Scale (SHLS), and the Sexual Health Attitude Scale (SHAS). The data were analyzed using the independent-samples t-test, one-way analysis of variance (ANOVA), Welch ANOVA test, Pearson's correlation coefficients, and simple linear regression analysis. Results: Participants’ mean SHLS and SHAS scores were 59.60±10.86 and 149.68±12.43, respectively. Both SHLS and SHAS scores were significantly higher among women compared to men, and among those who had received sexual health education compared to those who had not (p<0.01). Participants with master's or higher degrees had higher mean SHLS score than other groups (p<0.01). When examining sources of sexual health information, participants who learned from healthcare professionals, books, and personal experiences scored higher on SHLS than those who did not (p<0.01). For SHAS, participants who gained knowledge from friends/acquaintances, siblings, and personal experiences had higher mean score than others (p<0.01). A positive correlation was found between total SHLS scores and both total SHAS score and all SHAS subscale scores (p<0.05). Additionally, SHLS “sexual attitude” subscale score was positively correlated with total SHAS score and all SHAS subscale scores (p<0.05). Similarly, SHLS “sexual knowledge” subscale score showed a positive correlation with total SHAS score and all SHAS subscale scores, except for the “gender roles” subscale (p<0.05). Finally, SHAS score explained 19% of the variance in SHLS score (β=0.433, p<0.001). Conclusion: Sexual health attitude, higher education, being a woman, and having received sexual health education are important determinants of SHL. Young adults with reliable sources of information on sexual health have high levels of SHL.
Comparison of fetal thyroid measurements between subclinical hypothyroidism and euthyroid pregnancies: A prospective observational study
Aim: To investigate the impact of maternal subclinical hypothyroidism (SCH) treated with levothyroxine on fetal thyroid dimensions during pregnancy. Materials and Methods: In this prospective observational study, 50 pregnant women with treated SCH and 52 euthyroid controls underwent ultrasonographic evaluation between 20 and 39 gestational weeks were recruited. Fetal thyroid circumference (FTC) and fetal thyroid area (FTA) were measured, and correlations with maternal TSH levels and levothyroxine dosage were analyzed. Results: No significant differences were found between the in fetal thyroid measurements in SCH and control groups before and after adjustment for gestational age. Correlation analyses revealed negligible associations between maternal thyroid function parameters and fetal thyroid size. Although the levothyroxine dose showed a weak negative trend with fetal thyroid measurements, the difference was not statistically significant. The amniotic fluid index (AFI) was significantly higher in the SCH group despite treatment. Conclusion: Adequately treated maternal SCH does not appear to affect fetal thyroid development. These findings support the importance of early diagnosis and levothyroxine therapy for normalizing maternal thyroid function and potentially protecting fetal outcomes.
Sonographic evaluation of diaphragm thickness in pediatric patients with steatotic liver disease
Aim: The most common liver disease in children is metabolic dysfunction-associated steatotic liver disease. We expect increased diaphragm thickness in pediatric patients with hepatosteatosis. We aimed to compare diaphragm thickness in children with hepatosteatosis with that in the control group and to discuss the results in light of the current literature. Materials and Methods: The study included 56 patients with metabolic dysfunction-associated steatotic liver disease and 78 healthy controls. The diaphragm measurement of the patient and control groups was performed from the anterior caudal part of the diaphragm at the end of expiration from the right and left sides. Results: Diaphragm thickness, BMI, weight, and height Z scores were significantly greater in the group with fatty liver. We found a significant positive correlation between the stages of fatty liver and anthropometric measurement Z score values ​​with diaphragm thickness. Conclusion: The current study found that diaphragm thickness was thicker in pediatric patients with hepatosteatosis than that in healthy individuals and was positively correlated with anthropometric measurements. However, further studies are needed to evaluate diaphragmatic muscle function.