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SUMMARY OBJECTIVE: The aim of the study was to examine the effectiveness of adding indocyanine green fluorescence to the dual method, (Radioisotope+Isosulfanblue) for sentinel lymph node biopsy after neoadjuvant chemotherapy (on sentinel lymph nodes identification). METHODS: The 101 patients included in the study were randomized equally into each group. Dual method containing indocyanine green (group 1) or dual method alone (group 2) was used for sentinel lymph node mapping. RESULTS: The sentinel lymph node identification rate was 86.9% in the dual method group and 94.6% in the triple method group. The detection rates of two or more sentinel lymph nodes were 82.6% in the dual group and 89.2% in the triple group. There was no statistically significant difference between both the groups (p>0.05). CONCLUSION: Indocyanine green-based sentinel lymph node biopsy detection will bring a significant change in the management of patients in centers where there is no access to a nuclear medicine department. Nevertheless, multicenter studies with larger patient samples are needed to confirm our results.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the kinetics of immunoglobulin G and neutralizing antibody responses following vaccination with CoronaVac in healthcare professionals. METHODS: A cohort of 35 healthcare professionals was recruited, and blood samples were collected to assess immunoglobulin G detection and neutralizing antibodies against severe acute respiratory syndrome coronavirus 2. RESULTS: Immunoglobulin G seroconversion peaked at D30 (68.2%, 15/22), followed by stabilization at D48 and D90. Logistic regression confirmed a significant association between time post-vaccination and seroconversion (p=0.0043). Neutralizing antibody analysis showed a stable detection rate for Nab V1 (Wuhan and B.1.1.7) between D48 and D90 (p>0.9999), while Nab V2 (B.1.351 and P.1) remained consistently lower. Among immunoglobulin G-positive individuals, 92.3% (12/13) had neutralizing antibodies at D48, decreasing to 42.8% (6/14) at D90. CONCLUSION: CoronaVac effectively induces immunoglobulin G seroconversion, peaking at D30. However, neutralizing responses to emerging variants were lower, suggesting the need for booster doses to maintain immunity. These findings highlight the importance of monitoring vaccine-induced immunity over time.

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SUMMARY OBJECTIVE: The aim of this study was to compare central blood pressure, central pulse pressure, and parameters like augmentation index and pulse wave velocity, which are used to evaluate arterial stiffness using an oscillometric method called arteriography, among hypertensive patients with and without concomitant ascending aortic aneurysms. METHODS: This research was conducted as a single-center and prospective study. A total of 83 patients were included in this study, including 44 consecutive patients with hypertension diagnosed and an ascending aortic diameter of 40 mm or more detected by 2D transthoracic echocardiography, and 39 controls with hypertension diagnosed and a normal ascending aortic diameter. RESULTS: E/e’ ratio was found to be significantly higher in the aneurysm group (9.05±2.24 vs. 7.75±1.94, p<0.05). The difference between peripheral and central systolic blood pressures was found to be significantly lower in the aneurysm group compared to the control group (9.3±4.5 vs. 11.8±4.1, p<0.05, respectively). Among the examined arterial stiffness parameters, augmentation index values were significantly higher in the aneurysm group (27±8.7 vs. 22.7±9.6, p<0.05), while pulse wave velocity did not show a statistically significant difference between the groups (8.85±1.85 vs. 8.59±1.19, p>0.05, respectively). CONCLUSION: Our study suggests that a potential relationship between the development of ascending aortic aneurysm and elevated aortic stiffness in hypertensive patients.

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SUMMARY OBJECTIVE: Crimean-Congo hemorrhagic fever is a severe viral hemorrhagic disease transmitted by ticks and characterized by fever, malaise, and hemorrhages. This research was designed to measure serum neopterin concentrations in patients with Crimean-Congo hemorrhagic fever and to assess how these levels are associated with the disease's progression. METHODS: A total of 60 patients and 25 healthy controls, monitored at the Atatürk University Infectious Diseases Clinic from March 2009 to September 2010, were enrolled in the study. Serum neopterin concentrations were determined using an ELISA method, and statistical tests were conducted to explore their association with various clinical parameters. RESULTS: The results indicated a significant increase in serum neopterin levels in patients with Crimean-Congo hemorrhagic fever, and this rise was strongly linked to disease prognosis. Additionally, research has established that serum neopterin levels play a crucial role in determining patient outcomes, including survival and mortality. CONCLUSION: This study has demonstrated that neopterin levels can be used not only to track disease progression but also as a predictor of prognosis. Future research should delve deeper into the role of this biomarker in disease management.

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SUMMARY OBJECTIVE: Lung cancer is the leading cause of cancer-related mortality, with non-small cell lung cancer accounting for most cases. Surgery remains the primary treatment for early-stage non-small cell lung cancer, while advanced disease requires multimodal strategies. Immunotherapy, particularly immune checkpoint inhibitors targeting programmed cell death protein-1, programmed death-ligand 1, and cytotoxic T-lymphocyte-associated protein 4, has significantly improved survival and is increasingly incorporated into neoadjuvant and adjuvant settings. The aim of the study was to evaluate thoracic surgeons’ awareness, perceptions, and integration of immunotherapy in surgical practice. METHODS: A cross-sectional survey was conducted among 64 thoracic surgeons from 19 countries to assess their perspectives, challenges, and regional disparities in immunotherapy adoption. Statistical analyses examined associations between perceptions and variables such as specialty, experience, hospital type, and geographic region. RESULTS: Perceptions of immunotherapy did not differ significantly by specialty, experience, hospital type, or geographic location. However, significant associations were observed between years of experience and hospital type, as well as surgical specialty and geographic region. Key barriers included cost, lack of standardized guidelines, and challenges in multidisciplinary coordination. Surgeons in low- and middle-income countries reported greater difficulties in drug access and institutional infrastructure. The majority of participants (85%) expressed a need for further training, highlighting the importance of structured education programs and enhanced collaboration between surgical and medical oncology teams. CONCLUSION: While immunotherapy is widely accepted among thoracic surgeons, challenges related to education, accessibility, and implementation persist. Addressing these barriers through global initiatives, cost-effective policies, and multidisciplinary cooperation is essential for optimizing immunotherapy integration in thoracic surgery and improving outcomes for non-small cell lung cancer patients.

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SUMMARY OBJECTIVE: The aim of the study was to examine the impact of pelvic girdle pain on quality of life and depressive symptoms during pregnancy. METHODS: This descriptive, cross-sectional study involved 433 second- and third-trimester pregnant women who volunteered at two public hospitals in Central Anatolia, Turkey, between March 2024 and March 2025, excluding those with high-risk pregnancies. Data were collected using the Demographic Form, Pelvic Girdle Questionnaire, Short-Form Health Survey (SF-36), Beck Depression Inventory, and Visual Analog Scale. RESULTS: The mean age of women was 27.81±5.12. The findings revealed significant negative correlations between the Pelvic Girdle Questionnaire and SF-36 subscales, including physical function, physical and emotional role limitations, social functioning, general health and pain (p<0.05). Pelvic Girdle Questionnaire was positively correlated with depression, Visual Analog Scale, and gestational weeks (p<0.05). Moreover, 32.9% of the variance in Pelvic Girdle Questionnaire scores is explained by SF-36 subdimensions (physical function, role limitations, energy/vitality, mental health, and pain), number of births, and Visual Analog Scale. CONCLUSION: Pelvic girdle pain negatively affects physical and mental well-being, increases pain, and reduces quality of life in pregnancy. Its severity rises with gestational age and is linked to depressive symptoms.

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SUMMARY OBJECTIVE: The aim of the study was to evaluate the effects of epidural and spinal anesthesia techniques on neonatal cerebral oxygenation during cesarean surgery using near-infrared spectroscopy. METHODS: Pregnant women aged 18–35 years, classified as American Society of Anesthesiologists (ASA) II, scheduled for elective cesarean surgery at >37 weeks of gestation, and their newborns were included. Two groups, one to receive spinal anesthesia (Group S) and the other epidural anesthesia (Group E), were determined. Appearance Pulse Grimace Acitivity Respiration (APGAR) scores, heart rates, and SpO2 values of the newborns were recorded, and umbilical venous blood gas was collected. Near-infrared spectroscopy and rSO2 (regional cerebral oxygen saturation) change percentage were measured. RESULTS: A total of 80 patients were statistically analyzed, with 40 patients in Group S and 40 patients in Group E. Neonatal SpO2 values at 2.5 min were found to be significantly lower in Group S, while in blood gas parameters, PaO2 values were significantly lower in Group S. Near-infrared spectroscopy values at 2.5 and 5 min were significantly lower in Group S, and rSO2 change percentages were significantly lower at 2.5 min in Group S. Maternal hypotension was observed to be significantly higher in Group S (52.5%) than in Group E (22.5%). The amount of ephedrine administered until delivery was higher in Group S, but this difference was not statistically significant between the two groups. CONCLUSION: We found significantly lower near-infrared spectroscopy values at 2.5 and 5 min and rSO2 change percentage at 2.5 min in the spinal group. We believe that epidural anesthesia has minimally more positive effects on early neonatal cerebral oxygenation compared to spinal anesthesia.

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SUMMARY OBJECTIVE: The aim of the study was to evaluate the quality and readability of ChatGPT responses to frequently asked questions by individuals with posture disorder. Providing reliable and evidence-based information about posture disorders is vital for individuals to be correctly informed. METHODS: The 10 most frequently asked questions about posture disorder were selected by two researchers from a list created by ChatGPT. The questions were transmitted to ChatGPT 4.0, and the initial responses were recorded without further follow-up questions. The quality of the responses was then assessed by five independent experts (three physiotherapists, one physical therapy and rehabilitation specialist, and one orthopedics and traumatology specialist) with a four-grade evaluation system. Readability levels were analyzed with the Flesch-Kincaid Grade Level through WordCalc software. Statistical analysis was performed using Statistical Package for the Social Sciences v29.0, and intraclass correlation coefficients were used to measure inter-rater reliability. RESULTS: Following a thorough evaluation of the 10 responses received, six were rated as "Excellent responses requiring no explanation," while a further four were designated as "Satisfactory responses requiring minimal explanation." The median quality score of the responses was high, indicating good alignment with current evidence-based practice. The average readability level of the responses was determined to be 8.4. Inter-rater reliability was good, with an intraclass correlation coefficients value of 0.756. CONCLUSION: ChatGPT provides relatively coherent and generally readable answers to frequently asked questions about posture disorders, with most needing minimal explanation. While promising as a resource to meet the information needs of people with posture disorders, further improvements are needed to align it with personalized health needs.

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SUMMARY OBJECTIVE: In obesity, the fat storage in the body increases excessively and affects the whole metabolism. METHODS: Sixty-two obese patients were included in the study. The effect of weight loss, which was achieved with a 3-month diet/exercise program, on the following analytes was investigated; serum total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triacylglycerol, triglycerides (TAG), glucose, resistin, apelin, and a transcription factor sterol regulatory element binding protein-1c, and blood hemoglobin A1c. Basal (prediet/exercise) levels of analytes were taken as control values, and they were compared to the postdiet/exercise levels. RESULTS: After the 3-month diet/exercise program, apelin, hemoglobin A1c, and triacylglycerol, triglycerides levels decreased compared to basal levels, and those of sterol regulatory element binding protein-1c, glucose, and low-density lipoprotein-cholesterol increased. CONCLUSION: Considering the insulin-like effects of apelin, high levels of apelin in prediet/exercise phase can be interpreted as a kind of resistance to apelin, and the decreased postdiet/exercise apelin levels as a kind of normalization of it. The decrease in hemoglobin A1c and triacylglycerol, triglycerides levels following weight loss can be appreciated. High basal serum sterol regulatory element binding protein-1c levels suggest an increase in lipogenesis. The increases in glucose and low-density lipoprotein-cholesterol after diet/exercise program remain in a physiological range. However, we think that a longer diet/exercise follow-up in a larger population will further elaborate on the issue.

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SUMMARY OBJECTIVE: The aim of this study was to investigate maternal and paternal perceptions of breastfeeding self-efficacy in the postpartum period in Turkey between December 2023 and June 2024. METHODS: The present study was designed as a cross-sectional study. The sample consisted of 150 mothers and 150 fathers, making a total of 300 participants. Data were collected through face-to-face interviews using the "Descriptive Information Form for Mothers and Fathers," the "Breastfeeding Self-Efficacy Scale," and the "Paternal Breastfeeding Self-Efficacy Scale-Short Form." Data collection was carried out between December 2023 and June 2024. The obtained data were analyzed using the SPSS 25.0 statistical program, and a statistical significance level of p<0.05 was accepted. RESULTS: Mothers’ scores were higher than fathers’ scores (p<0.001). It was found that paternal breastfeeding self-efficacy significantly affected mothers’ breastfeeding self-efficacy (r=0.520, p<0.001). In the multiple regression analysis, monthly income, breastfeeding education, and the time of first breastfeeding were found to affect mothers’ breastfeeding self-efficacy (R2=0.099, p=0.02). Also found that employment status, breastfeeding experience, and planned pregnancy variables affected paternal breastfeeding self-efficacy (R2: 0.161, p<0.001). CONCLUSION: Empowering fathers about breastfeeding with in-service training and multidisciplinary approach is very important to increase breastfeeding rates. In addition, it is recommended that fathers should be handled together with pregnant women from the prenatal period, and counseling services should be provided to support the positive development of their perspective on breastfeeding.

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SUMMARY OBJECTIVE: This research sought to examine the relationship between toilet behaviors and recurrent urinary tract infections in women. METHODS: This descriptive correlational study was conducted with female patients with recurrent urinary tract infections who applied to the urology outpatient clinic of a city hospital in Istanbul between March 2023 and April 2024. Data were collected using the Patient Information Form and Toileting Behavior-Women's Elimination Behaviors Scale. RESULTS: The total mean score of the Toileting Behavior-Women's Elimination Behaviors Scale was found to be 49.79±9.98 in the patients. When the total mean scores of the Toileting Behavior-Women's Elimination Behaviors Scale were examined according to the individual characteristics of the patients, it was found that there was a statistical difference in the mean score of the Toileting Behavior-Women's Elimination Behaviors Scale according to marital status, education level, incontinence status, preferred toilet position inside, and outside the home (p<0.05) and that there was a statistical relationship between age and the mean score of the Toileting Behavior-Women's Elimination Behaviors Scale (p<0.05). CONCLUSION: Increasing age had a negative effect on early voiding and straining behaviors, and the presence of incontinence had a negative effect on early voiding and general toilet behavior in women with recurrent urinary tract infections.

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SUMMARY OBJECTIVE: Polycystic ovary syndrome is a common and important disease that affects ovarian functions in women of reproductive age. Disease—genetic variation associations between polymorphisms of the ADIPOQ gene rs1501299 and rs17300539, and polycystic ovary syndrome were studied in several populations previously and obtained divergent results; we have investigated this association in a case-control study for the first time in the studied population. METHODS: Forty-five polycystic ovary syndrome patients and 45 control participants were enrolled. Deoxyribonucleic acid of the participants was extracted from peripheral blood. Genotyping of subjects was made according to the real-time polymerase chain reaction method using custom primers. Allele and genotype frequencies, as well as clinical characteristics, were compared between the polycystic ovary syndrome and control groups using appropriate statistical methods. RESULTS: The mean testosterone level of the polycystic ovary syndrome group was significantly higher than the control group after multiple testing with Bonferroni correction (p<0.001). The mean progesterone level of the control group was significantly higher than the polycystic ovary syndrome group after multiple testing with Bonferroni correction (p<0.001). There were no significant differences between groups in terms of both allele and genotype frequencies (p>0.05). According to regression analysis, neither polymorphism had any effect on having polycystic ovary syndrome (p>0.05). CONCLUSION: For the first time in a sample from the studied ethnicity, we conclude that both rs1501299 and rs17300539 polymorphisms are not associated with polycystic ovary syndrome. Testosterone and progesterone levels were significantly affected by polymorphisms.

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SUMMARY OBJECTIVE: The aim of this study was to investigate polymorphisms in the proprotein convertase subtilisin/kexin type 9 gene and compare disease severity in familial hypercholesterolemia participants with and without these polymorphisms. METHODS: Fifty patients were included in this observational, cross-sectional study of primary data collection between June 2014 and June 2015 at Clinics Hospital of Ribeirão Preto Medical School/University of São Paulo Inclusion criteria for the study included individuals with an low-density lipoprotein cholesterol level ≥190 mg/dL, based on Dutch make early diagnosis prevent early death criteria for familial hypercholesterolemia. Patients with kidney disease, liver failure, a triglyceride level ≥300 mg/dL, or hypothyroidism were excluded. Gene analysis was performed using the high-resolution melting method. deoxyribonucleic acid samples with detected changes were sequenced to identify polymorphisms. Lipid profile, body mass index, history of cardiovascular events, gender, and statin use were compared between participants with and without polymorphisms. RESULTS: Of the 50 patients, 14 carried proprotein convertase subtilisin/kexin type 9 polymorphisms. Familial hypercholesterolemia was not associated with these polymorphisms in this cohort. As gene expression was not assessed, no conclusions can be drawn regarding functional effects. Six patients (four in the polymorphism group and two in the non-polymorphism group) reported cardiovascular events. The significantly higher occurrence of these events in the polymorphism group suggests a possible association between the presence of proprotein convertase subtilisin/kexin type 9 polymorphisms and an increased cardiovascular risk. CONCLUSION: Benign variants were identified in the proprotein convertase subtilisin/kexin type 9 gene, with no pathogenic alterations detected. Despite the significantly higher number of participants with a history of cardiovascular events in the polymorphism group, these data do not support a direct, causal association between these polymorphisms and an increased cardiovascular risk.

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SUMMARY OBJECTIVE: Artificial intelligence tools like Chat Generative Pretrained Transformer-4 are increasingly used in clinical decision-making, but their reliability for acute compartment syndrome remains understudied. The aim of the study was to evaluate Chat Generative Pretrained Transformer-4's accuracy, completeness, and quality in responding to acute compartment syndrome-related queries, addressing gaps in artificial intelligence-assisted medical information. METHODS: Chat Generative Pretrained Transformer-4 was given 60 questions (40 open-ended and 20 binary) that were taken from the American Academy of Orthopaedic Surgeons 2019 acute compartment syndrome guidelines. Responses were evaluated independently by two orthopedic specialists using the Quality Criteria for Consumer Health Information instrument (information quality), Flesch-Kincaid Reading Ease Score (readability), and Likert scales (accuracy and completeness). Inter-rater reliability (Cohen's kappa) was a statistical analysis. RESULTS: Chat Generative Pretrained Transformer-4 demonstrated high accuracy (95% for both question types) and completeness (mean scores: 5.92±0.8 [accuracy], 2.9±0.5 [completeness]). DISCERN scores were "excellent" (69–72), though source reliability was limited. Readability was "very difficult" (Flesch-Kincaid Reading Ease Score: 22.19), potentially hindering patient comprehension. CONCLUSION: Although Chat Generative Pretrained Transformer-4 is excellent at providing precise, high-quality acute compartment syndrome information, its complicated language and lack of credible sources make it difficult for wider adoption. To improve clinical utility and patient education, readability and transparency must be given top priority in future artificial intelligence developments.

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SUMMARY OBJECTIVE: The aim of the study was to investigate the relationship between echocardiographic parameters and clinical outcomes in acute ischemic stroke patients undergoing mechanical thrombectomy, aiming to identify predictors of poor prognosis despite successful recanalization. METHODS: This retrospective, single-center study included 320 acute ischemic stroke patients treated with mechanical thrombectomy for large vessel occlusion. Demographic, clinical, and echocardiographic data were collected. Univariable and multivariable logistic regression and receiver operating characteristic analyses were used. Futile recanalization was defined as achieving modified Thrombolysis in Cerebral Infarction 2b–3 with a poor functional outcome (mRS 3–6). RESULTS: Of the 320 patients, 176 (55%) were classified as favorable and 144 (45%) as futile recanalization. The futile group had a higher mean age (77.3±12.7 vs. 67.6±12.8; p<0.001), National Institutes of Health Stroke Scale score (median 17 vs. 14; p=0.007), and puncture-to-recanalization time (47.5 vs. 30 min; p=0.017), and lower Alberta Stroke Program Early Computed Tomography score (7.5 vs. 10; p<0.001). Echocardiographically, they had lower left ventricular ejection fraction (55 vs. 57.5%; p=0.036) and larger left ventricular end-diastolic diameter (4.8 vs. 4.5 cm; p=0.002). Multivariable analysis identified low Alberta Stroke Program Early Computed Tomography score (OR 0.192; p=0.002), high National Institutes of Health Stroke Scale (OR 1.212; p=0.029), and low left ventricular ejection fraction (OR 0.919; p=0.047) as independent predictors. Alberta Stroke Program Early Computed Tomography had the highest predictive value (area under the curve : 0.851), followed by left ventricular ejection fraction (area under the curve: 0.631), while National Institutes of Health Stroke Scale showed lower predictive power (area under the curve: 0.326). CONCLUSION: Poor outcomes after mechanical thrombectomy are associated with low Alberta Stroke Program Early Computed Tomography scores, high National Institutes of Health Stroke Scale, and reduced left ventricular ejection fraction. Echocardiographic evaluation, particularly of left ventricular ejection fraction, may aid in prognostication and treatment planning in acute ischemic stroke.

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SUMMARY OBJECTIVE: This study was conducted to determine the effect of genital self-image on sexual function and satisfaction in married women. METHODS: The study included 353 married women in Central Anatolia. Data were collected using the Descriptive Information Form, the Female Genital Self-Image Scale, the Female Sexual Function Index-6, and the Golombok-Rust Inventory of Sexual Satisfaction. RESULTS: The participants’ mean total scores were 20.36±4.03 on the Female Genital Self-Image Scale, 19.46±4.98 on the Female Sexual Function Index-6, and 55.84±16.79 on the Golombok-Rust Inventory of Sexual Satisfaction. The regression analysis indicated that Female Sexual Function Index-6, age, marriage duration, and total Golombok-Rust Inventory of Sexual Satisfaction scores collectively predicted Female Genital Self-Image Scale scores, accounting for 13.2% of variance and suggesting a modest yet meaningful effect. CONCLUSION: Approaches that enhance genital self-image support women's sexual health, and it is essential for healthcare professionals to provide quality care by taking these factors into consideration.

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SUMMARY OBJECTIVE: Cesarean scar pregnancy is a rare form of ectopic pregnancy in which the fertilized egg implants within the scar of a previous cesarean section. With the rising global cesarean delivery rate, the incidence of cesarean scar pregnancy has increased, posing serious risks such as massive hemorrhage and uterine rupture. To evaluate and compare the diagnostic and classification accuracy of transvaginal sonography and magnetic resonance imaging in the detection of cesarean scar pregnancy. METHODS: This retrospective study included 102 patients clinically suspected of cesarean scar pregnancy between January 2023 and May 2024. All patients underwent both transvaginal sonography and magnetic resonance imaging. Using final clinical and pathological diagnoses as the reference standard, the sensitivity, overall diagnostic accuracy, and classification accuracy of transvaginal sonography and magnetic resonance imaging were compared. RESULTS: Magnetic resonance imaging demonstrated significantly higher sensitivity, diagnostic accuracy, and classification accuracy than transvaginal sonography (p<0.05). Compared with transvaginal sonography, magnetic resonance imaging also showed superior detection rates for intrauterine hemorrhage, villous invasion of the myometrium, and invasion of the bladder and/or cervix, with statistically significant differences (p<0.05). CONCLUSION: Magnetic resonance imaging demonstrates superior diagnostic and classification accuracy compared to transvaginal sonography in evaluating cesarean scar pregnancy. As a valuable adjunct to ultrasound, magnetic resonance imaging facilitates more accurate diagnosis and individualized treatment planning, thereby reducing the risks of severe complications such as massive hemorrhage, hysterectomy, and maternal mortality in women of reproductive age.

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SUMMARY OBJECTIVE: The aim of this study was to examine the relationship between quality of life and self-confidence in women diagnosed with polycystic ovary syndrome, a chronic endocrine disorder that affects both physical and psychological well-being. METHODS: A cross-sectional study was conducted with women diagnosed with polycystic ovary syndrome. Data were collected using the Polycystic Ovary Syndrome Quality of Life-50 Scale (PCOSQ-50) and the Female Self-Confidence Scale. Descriptive statistics, correlation, and regression analyses were used to evaluate the association between quality of life and self-confidence levels. RESULTS: The findings indicated that sociodemographic and gynecologic characteristics did not significantly affect the quality of life or self-confidence levels of the participants. However, a significant positive correlation was observed between polycystic ovary syndrome-related quality of life and self-confidence (p>0.05). Women with lower quality of life scores reported significantly lower levels of self-confidence. Psychological distress, body image dissatisfaction, and infertility concerns were found to be key contributing factors to decreased self-confidence. CONCLUSION: Polycystic ovary syndrome negatively impacts women's psychological well-being and self-confidence, in addition to its physical symptoms. Integrating psychological support into polycystic ovary syndrome treatment may help to improve quality of life and promote emotional resilience. A multidisciplinary approach is essential for comprehensive care of women with polycystic ovary syndrome.

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SUMMARY OBJECTIVE: In today's world, with the prolongation of human life span, a significant part of women's lives is spent in the menopausal period. Factors that negatively affect the health and quality of life of women experiencing this process constitute an important problem in terms of women's health. The aim of this study was to determine the relationship between spousal support and quality of life among menopausal women. METHODS: The cross-sectional study was conducted with 300 women aged 45–65 years, who were in menopausal period and volunteered to participate in the study, registered in four family health centers located in eastern Türkye. The data were collected using the "Personal Information Form," "Menopause Spousal Support Questionnaire," and "Menopause-Specific Quality of Life Questionnaire." RESULTS: The mean total score of the women on the spousal support questionnaire was 116.39±17.88. In the subdimensions, the highest score belonged to valuing support (41.35±7.21) and the lowest score belonged to sexual intimacy support (21.52±3.91). Quality of life questionnaire subfield mean scores were as follows: vasomotor 5.43±3.24, psychosocial 10.83±5.23, physical 17.84±13.03, and sexual 2.02±3.16. Spousal support and quality of life levels differed significantly according to demographic characteristics (p<0.05). CONCLUSION: Increased support from husbands decreases menopause-related complaints and improves quality of life. On the other hand, smoking, irregular exercise, not receiving hormone therapy, and a lack of information increase complaints. The results show that spousal support and healthy living habits are determinants of quality of life during menopause.

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SUMMARY OBJECTIVE: Despite the longstanding clinical use of low-molecular-weight heparins and their well-characterized mechanisms of action, their effects on mitophagy pathways in acute myocardial ischemia remain incompletely delineated. The aim of this study was to investigate the enoxaparin effect on cardiomyocyte morphology and the immunopositivity of mitophagy-associated Parkin–LC3 proteins in a rat model of acute myocardial ischemia. METHODS: Female Wistar albino rats (median weight: 400 g, minimum: 375 g-maximum: 415 g) were divided into sham (n=7), control (n=7), and treatment (n=7) groups. The control group received subcutaneous 0.9% saline (0.2 mL/kg) twice daily for 28 days, followed by the induction of myocardial ischemia. The treatment group was administered subcutaneous enoxaparin sodium (1 mg/kg) twice daily for the same duration before undergoing myocardial ischemia. Myocardial ischemia was induced by occluding the proximal left anterior descending coronary artery using a 6-0 polypropylene suture for 10 min. Morphometric calculations of cardiomyocytes (cell length and diameter) were performed using light microscopy. Immunohistochemical analysis was performed using anti-Parkin and anti-LC3 antibodies, and immunopositive cells were counted. RESULTS: Statistically significant differences were found between the groups (p<0.001). Post-hoc analysis revealed significant differences between the control and treatment groups based on cell length, cell diameter, Parkin, and LC3 values (p<0.001, p=0.001, p<0.001, and p=0.001, respectively). CONCLUSION: This study demonstrated that enoxaparin preserved cardiomyocyte morphology and reduced the number of Parkin–LC3 immunopositive cells in a model of induced acute ischemic injury in rat myocardium.

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SUMMARY OBJECTIVE: The aim of this study was to explore the optimal method of induction of labor in women with gestational diabetes mellitus and its impact on delivery outcomes. METHODS: This retrospective cohort study was conducted among nulliparous women with gestational diabetes mellitus delivering at the First Affiliated Hospital of Fujian Medical University and the First People's Hospital of Yunnan Province from 2018 to 2023. Data were extracted from electronic medical records. RESULTS: A total of 600 patients who delivered met the inclusion criteria: the double-balloon group (Group B, n=198), the misoprostol vaginal insert group (Group M, n=200), and the Misoprostol combined with artificial membrane stripping group (Group MA, n=202). Group MA showed higher induction of labor success rates (93.5%) compared to Group M (86.0%) and Group B (81.5%, p=0.002). The time to labor onset was shortest in Group MA (32.5±6.5 h), followed by Group M (35.8±2.5 h) and Group B (45.8±4.5 h, p<0.001). Vaginal delivery time was also significantly shorter in Group MA (47.4±4.3 h) compared to Group M (49.1±7.4 h) and Group B (57.1±5.7 h, p<0.001). Chorioamnionitis rates were lower in Group MA (2.5%) and Group M (3.0%) compared to Group B (8.5%, p=0.007). No significant differences were observed between groups for cesarean rates, fetal distress, abnormal labor, or neonatal outcomes (p>0.05). CONCLUSION: The combination of misoprostol vaginal insert and artificial membrane stripping effectively enhances cervical ripening and improves vaginal delivery success in gestational diabetes mellitus patients, providing a promising strategy for labor induction.

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SUMMARY OBJECTIVE: The prognosis of metastatic breast cancer has improved with new targeted therapies like cyclin-dependent kinase 4/6 inhibitors. Renin-angiotensin system inhibitors, such as direct renin inhibitors, angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors are frequently used to manage hypertension and heart failure. However, recent research indicates that they may also provide potential benefits in cancer therapy. The combination of renin-angiotensin system inhibitors with cyclin-dependent kinase 4/6 inhibitors is an emerging area of interest in cancer research. Our hypotesis that, by inhibiting angiogenesis, renin-angiotensin system inhibitors may reduce tumor growth and improve the effectiveness of cyclin-dependent kinase 4/6 inhibitors by cutting off the supply of nutrients and oxygen to the tumor. METHODS: Metastatic breast cancer patients treated with cyclin-dependent kinase 4/6 inhibitors were enrolled and retrospectively divided according to angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use: angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (+) and angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (-). Progression-free survival and overall survival were defined as primary and secondary endpoints. The effect of categorized data on progression-free survival and overall survival was determined by Cox regression analyses. RESULTS: Estimated median progression-free survival (HR 0.61, 95%CI 0.34–0.94; p = 0.041) and overall survival (HR 0.71, 95%CI 0.49-0.79; p: 0.01) were statistically significantly longer in the angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (+) group than in the angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (-) group. CONCLUSION: Concomitant use of renin-angiotensin system inhibitors and cyclin-dependent kinase 4/6 inhibitors may have beneficial oncological effects in patients with breast cancer beyond their cardiovascular indications.

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SUMMARY OBJECTIVE: The aim of this study was to determine the association of unilateral multicystic dysplastic kidney in fetuses with genetic disorders, syndromic conditions, accompanying anatomical anomalies, and postnatal prognosis. METHODS: Cases diagnosed with multicystic dysplastic kidney and followed at the Perinatology Clinic of Samsun Ondokuz Mayıs University between January 2012 and June 2024 were retrospectively reviewed. Demographic, ultrasonographic, genetic, and postnatal outcomes were analyzed. RESULTS: Thirty-eight fetuses with multicystic dysplastic kidney were identified during intrauterine life. The diagnosis was made via antenatal ultrasonography in 97.2% of cases. Laterality was on the left side in 55.3% and on the right side in 44.7% of multicystic dysplastic kidney cases. The cohort consisted of 42.1% females and 57.9% males. Major extrarenal anomalies were present in 21.1% of fetuses with unilateral multicystic dysplastic kidney. Amniocentesis for karyotyping was performed in 23.7% of cases, all of which yielded normal karyotypes. Contralateral kidney anomalies were detected in 13.2% of cases, and ureterocele was observed in 15.8%. The most common postnatal anomalies were ureteropelvic junction obstruction and grade four-five vesicoureteral reflux. During a mean follow-up period of 7 years, no cases of hypertension or Wilms tumor were identified. CONCLUSION: Prenatal diagnosis of multicystic dysplastic kidney is crucial for early detection of potential contralateral kidney anomalies and predicting postnatal outcomes. In cases of isolated multicystic dysplastic kidney, the likelihood of karyotypic abnormalities, malignancies, or hypertension is very low, and the postnatal prognosis is favorable.

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SUMMARY OBJECTIVE: Human papillomavirus, the primary etiological agent of cervical cancer, is considered to be the most common sexually transmitted infection worldwide. The aim of this study was to determine the human papillomavirus literacy levels of midwifery students. METHODS: This cross-sectional and descriptive study included midwifery students enrolled in a university in Türkiye during the 2024–2025 academic year. Out of 327 students enrolled in the midwifery program, 284 voluntarily participated in the study. Data were collected online using a Personal Information Form and the Human Papillomavirus Literacy Scale. A significance level of p<0.05 was used in the data analysis. Ethics committee and institutional approvals were obtained before the study. RESULTS: The mean age of the students was 21.08±2.46, and 27.8% of them were in the first year. A majority (82.7%) reported having information about human papillomavirus, primarily obtained from school (79.6%), social media/TV (48.6%), and health institutions (27.5%). Most students (97.5%) knew human papillomavirus is contagious, and 96.1% recommended human papillomavirus screening to others. The mean total Human Papillomavirus Literacy Scale score was 90.85±15.60, on a scale ranging from 24 to 120. The subdimension scores were as follows: 45.28±8.13 for knowledge, 21.75±4.56 for screening, and 23.81±4.04 for analysis. CONCLUSION: The study found that midwifery students have a high level of human papillomavirus literacy. The majority reported acquiring their knowledge through school and media, highlighting the positive impact of formal education and media on human papillomavirus awareness. The findings emphasize the importance of integrating human papillomavirus education into the curriculum. Additionally, community-based education programs can be effective in reaching broader populations, increasing awareness, and promoting preventive health behaviors.

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SUMMARY OBJECTIVE: The aim of the study was to evaluate the cardiotoxic effects of pantoprazole in Wistar rats submitted to cardiac ischemia and reperfusion. METHODS: Cardiac ischemia and reperfusion was induced in rats through tourniquet of the left anterior descending coronary artery (10 min) followed by reperfusion (75 min). The incidences of ventricular arrhythmias, atrioventricular block, and lethality were evaluated by electrocardiogram analysis and compared between the control group (saline solution+cardiac ischemia and reperfusion) and the animals treated with pantoprazole 36 mg/kg (pantoprazole+cardiac ischemia and reperfusion), intravenously, immediately before cardiac ischemia (pantoprazole+cardiac ischemia and reperfusion) or before cardiac reperfusion (pantoprazole+cardiac reperfusion). RESULTS: There were no differences between the incidences of ventricular arrhythmias in the groups studied. Treatment with pantoprazole before cardiac ischemia and reperfusion increased the incidence of atrioventricular block and lethality and myocardial injuries compared to the saline solution+cardiac ischemia and reperfusion group, but treatment of animals with pantoprazole before cardiac reperfusion decreased these parameters and serum creatine kinase-MB levels. CONCLUSION: Our results indicate that when pantoprazole is administered before cardiac ischemia and reperfusion, it promotes cardiotoxicity; however, when administered before cardiac reperfusion, it promotes cardioprotection in Wistar rats.