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SUMMARY OBJECTIVE: The aim of this study was to investigate the relationship between serum iron and the severity of hypertriglyceridemic acute pancreatitis. METHODS: A total of 209 patients with newly diagnosed and treated hypertriglyceridemic acute pancreatitis admitted to our hospital from January 2021 to June 2024 were selected as the research subjects. The modified computed tomography severity index score was calculated to evaluate the severity of hypertriglyceridemic acute pancreatitis. According to the score values, they were divided into the mild group and the moderate-to-severe group. Another 60 healthy individuals during the same period were selected as the control group. The general clinical data of all enrolled subjects, as well as blood routine, high-sensitivity C-reactive protein, liver function, kidney function, random blood glucose, serum iron, serum calcium, serum triglyceride levels, modified computed tomography severity index scores, and abdominal computed tomography results, were collected. The differences in baseline data among the three groups were compared, and the correlations between different variables and modified computed tomography severity index scores were analyzed. Multiple linear regression analysis was used to further clarify the relationship between serum iron and modified computed tomography severity index scores. RESULTS: Among the baseline data comparisons among the three groups, except for hypertension, the differences in the remaining variables among the groups were statistically significant (p<0.05). Correlation analysis showed that blood routine, C-reactive protein, serum triglyceride, and random blood glucose levels were positively correlated with modified computed tomography severity index scores (r=0.601, r=0.492, r=0.604, r=0.432, all p<0.05), while serum iron was negatively correlated with modified computed tomography severity index scores (r=-0.475, p<0.05). The results of multiple linear regression analysis showed that in Model 1 and Model 2, serum iron was an independent influencing factor for modified computed tomography severity index scores (B=-0.084, B=-0.076, both p<0.05). In Model 3, after further adjusting for all remaining variables, serum iron was still an independent influencing factor for modified computed tomography severity index scores (B=-0.039, p<0.05), and the D-W value was the best, at 1.765. CONCLUSION: There is a certain negative correlation between serum iron and the severity of hypertriglyceridemic acute pancreatitis. That is, the lower the serum iron level, the higher the modified computed tomography severity index score, and the more severe the hypertriglyceridemic acute pancreatitis may be.

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SUMMARY OBJECTIVE: The aim of this study was to look at the effects of muscular energy technique method and aromatherapy on pain levels and neck disability in office workers with nonspecific neck pain. METHODS: This study involved 45 women diagnosed with nonspecific neck pain. Participants were randomized into three groups: aromatherapy (n=15), muscle energy technique (n=15), and control (n=15). Outcome measures included Visual Analog Scale for pain, Neck Disability Index, and Pittsburgh Sleep Quality Index. All measurements were conducted before and after the study. RESULTS: Neck pain, disability, and sleep quality improved in both the aromatherapy and muscle energy technique groups (p<0.001), with no significant between-group difference. In addition, both aromatherapy and muscle energy technique were significantly better at improving neck pain and sleep quality, and reducing neck disability when compared to the control group (p<0.017). CONCLUSION: This study provides evidence that both aromatherapy and muscle energy technique are safe and practical treatments, which are efficacious in the reduction of pain, disability, and sleep quality in nonspecific neck pain.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate whether laparoscopic adrenalectomy can be safely performed by senior residents (4 years and above) with the guidance of senior surgeons. METHODS: Patients who underwent unilateral laparoscopic transabdominal adrenalectomy between January 2012 and December 2023 were enrolled. Patients were divided into two groups. Patients’ demographic, clinical, and surgical data were recorded and analyzed. RESULTS: A total of 106 patients were enrolled in the study. Twenty of the patients were male, and 86 were female. The mean age was 51.8 (±standard deviation±12.1). In group 1, there were 83 patients (78.3%) who were operated on by a senior surgeon, and in group 2, there were 23 patients (21.7%) who were operated on by a senior resident. There was no significant difference between the two groups in terms of age, gender, and American Anesthesia Society score. A statistically significant difference was detected between the two groups in terms of mass diameter (p=0.042). In multivariate analysis, being operated on by a senior surgeon was not a risk factor for either postoperative complications or conversion to open surgery. CONCLUSION: In conclusion, laparoscopic adrenalectomy can be safely performed by senior residents under the supervision of senior surgeons.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate optic nerve sheath diameter using ultrasonography in patients with clinical and radiological suspicion of elevated intracranial pressure in the intensive care unit. Elevated intracranial pressure is a critical condition resulting from various intracranial pathologies and constitutes a major cause of morbidity and mortality. METHODS: Several invasive and noninvasive methods are available for detecting elevated intracranial pressure. Although invasive methods are regarded as the gold standard, they are associated with certain disadvantages. Ultrasonographic measurement of optic nerve sheath diameter, a noninvasive technique, has gained prominence owing to its repeatability, bedside applicability, and cost-effectiveness. From June to December 2023, 50 patients with suspected elevated intracranial pressure based on cranial computed tomography findings and clinical presentation, along with 36 healthy volunteers, were included in the study. RESULTS: Optic nerve sheath diameter was significantly greater in patients (right 6.13±0.50 mm, left 6.13±0.51 mm) compared with controls (right 4.23±0.22 mm, left 4.23±0.21 mm; p<0.001). Moreover, optic nerve sheath diameter was significantly correlated with mortality, as well as with Glasgow Coma Scale, Full Outline of UnResponsiveness, Acute Physiology and Chronic Health Evaluation II, and Sequential Organ Failure Assessment scores. Patients with computed tomography findings such as brain edema and midline shift also exhibited significantly elevated optic nerve sheath diameter values. CONCLUSION: Ultrasonographic measurement of optic nerve sheath diameter represents a reliable adjunctive modality for identifying patients with radiological signs of elevated intracranial pressure and for prognostic assessment in the intensive care unit. Nevertheless, the lack of invasive intracranial pressure monitoring as the gold standard constitutes a major limitation, and validation against direct intracranial pressure measurements is warranted in future studies. This technique may be particularly useful in hemodynamically unstable patients who cannot be safely transferred for computed tomography imaging.

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SUMMARY OBJECTIVE: The aim of this study was to prospectively assess the effects of labiaplasty on female sexual function, genital self-image, body dysmorphic symptoms, self-esteem, and life satisfaction, and to examine the sociodemographic and motivational profiles of women undergoing the procedure. METHODS: A prospective single-center study was conducted between October 2024 and March 2025 on heterosexual, sexually active women undergoing labiaplasty. Women completed the Female Sexual Function Index, Female Genital Self-Image Scale, Rosenberg Self-Esteem Scale, Yale-Brown Obsessive Compulsive Scale modified for Body Dysmorphic Disorder, and Satisfaction With Life Scale before surgery and 3 months postoperatively. RESULTS: The study included 42 women with a mean age of 39.7±9.2 years. Postoperative assessments revealed significant improvements in genital self-image (p<0.001, Cohen's d=0.66), sexual function (p<0.001, d=0.67), and body dysmorphic symptoms (p=0.016, adjusted p=0.048, d=0.39). No significant changes were observed in self-esteem (p=0.857) or life satisfaction (p=0.071). A majority (69.0%) reported that others, predominantly family members, were the primary decision-makers in their relationships. Motivations included boosting self-confidence (22.0%), feeling "normal" (18.3%), and increasing sexual pleasure (11.9%), with participants endorsing multiple reasons (mean: 3.2±1.4). Most women had considered surgery for more than 1 year (73.9%). CONCLUSION: Labiaplasty significantly improves genital-specific outcomes but does not alter global psychological measures. The high prevalence of external influence on surgical decision-making highlights the need for comprehensive psychosocial assessment and patient-centered counseling prior to female genital cosmetic surgery.

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SUMMARY OBJECTIVE: The aim of this study was to determine the quality, reliability, and readability of the responses provided by artificial intelligence chatbots about idiopathic pulmonary fibrosis. METHODS: The clinically relevant questions about idiopathic pulmonary fibrosis diagnosis, treatment, prognosis, and lifestyle management were submitted to four widely used artificial intelligence chatbots, including ChatGPT, Perplexity, Gemini, and Copilot. Responses were assessed by five clinicians based on readability, understandability, quality, and content reliability using standardized tools. RESULTS: The overall readability of chatbot-generated responses was low, corresponding to high educational requirements. Understandability ranged from moderate to good, whereas actionability remained moderate. Gemini produced the most readable and understandable outputs. Journal of the American Medical Association and Likert scores indicated limited source transparency but good guideline concordance. DISCERN analysis for the treatment question showed significant variation (p=0.003), with Perplexity achieving the highest total score. CONCLUSION: Although artificial intelligence chatbots offer rapid and accessible information, their readability and source reliability remain limited. These findings highlight the necessity of expert supervision and further model improvement before artificial intelligence chatbots can be safely integrated into patient education.

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SUMMARY OBJECTIVE: The aim of this study was to investigate knowledge and health beliefs regarding osteoporosis in individuals with myasthenia gravis. METHODS: This cross-sectional study included 40 individuals with myasthenia gravis and 40 healthy controls, who were selected among individuals accompanying patients at outpatient clinics and hospital support staff. Participants completed the Revised Osteoporosis Knowledge Test and the Osteoporosis Health Belief Scale. For individuals with myasthenia gravis, additional data were collected, including disease duration, current use of prednisolone, and clinical classification. RESULTS: In the myasthenia gravis group, the mean total Revised Osteoporosis Knowledge Test score was 16.6±2.3, and the mean total Osteoporosis Health Belief Scale score was 146.4±6.1, with no statistically significant difference compared with the controls (p>0.05). The myasthenia gravis group had significantly higher "barriers to exercise" scores compared with controls (p<0.001). Only 37.5% of individuals with myasthenia gravis perceived themselves to be at risk of developing osteoporosis. In the patient group, educational level showed a strong positive correlation with both total Revised Osteoporosis Knowledge Test (r=0.756, p<0.001) and total Osteoporosis Health Belief Scale (r=0.313, p=0.005) scores, whereas disease duration showed no significant correlation. There was also no significant difference in total Revised Osteoporosis Knowledge Test and Osteoporosis Health Belief Scale scores between patients currently receiving prednisolone and those not receiving it (p>0.05). CONCLUSION: This study indicates that individuals with myasthenia gravis have inadequate knowledge and low perception of osteoporosis risk. To enhance early identification and prevent osteoporosis-related complications, implementing targeted educational and preventive strategies is essential in this vulnerable population.

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SUMMARY OBJECTIVE: The aim of this study was to estimate the prevalence and factors associated with depression among Brazilian women based on the 2023 Vigitel National Survey. METHODS: This descriptive and analytical study utilized data from the Vigitel National Survey conducted by the Brazilian Ministry of Health. The sample included 13,558 women aged 18 years and older. Researchers analyzed depression prevalence, defined as a dichotomous outcome, alongside sociodemographic variables (age, education level, marital status, skin color, homeownership) and other factors such as health insurance coverage, physical activity, alcohol consumption, smoking, and body mass index. The study team performed descriptive and analytical statistics and tested associations using Pearson's chi-square test with a significance level of p<0.05. RESULTS: They found a depression prevalence of 17.5% (95%CI 16.8–18.1). Higher prevalence was observed among older women, those with up to 7 years of education, and those who reported being separated or divorced. White women showed the highest prevalence of depression. Additionally, physical inactivity, daily tobacco use, and a body mass index below 18 were associated with an increased occurrence of depression. CONCLUSION: Older women, those with lower education levels, separated women, physically inactive individuals, and smokers exhibited higher depression prevalence. These findings highlight the need for targeted care strategies and interventions addressing associated risk factors.

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SUMMARY OBJECTIVE: Labor pain management is a fundamental aspect of obstetric care. Pharmacological methods such as epidural and spinal analgesia are widely preferred in this process, but scientific productivity and trends regarding these approaches have not been sufficiently analyzed. The aim of this study was to provide a bibliometric assessment of the scientific profile in the field of pharmacological obstetric pain management by examining the literature published between 2000 and 2025. METHODS: Web of Science Core Collection database was searched with the keywords "labour pain management," "childbirth pain," "labour analgesia," "obstetric analgesia," "epidural analgesia," "spinal anaesthesia," "pharmacological analgesia," and "pharmacological pain management." The distribution of publications by years, contributions by countries and institutions, collaboration networks, most cited studies, and journal distribution were analyzed. RESULTS: A total of 1,606 publications were analyzed. Scientific productivity in the field of epidural and spinal analgesia has increased significantly, especially after 2019. The vast majority of publications are based in the USA, the UK, and China. The most cited publications focus on the efficacy, safety, and complications of pharmacological methods. Collaboration maps indicate a multidisciplinary and international research network. CONCLUSION: Pharmacological labor pain management literature reflects the current trends that guide clinical obstetric practice. When developing guidelines for the use of these methods in midwifery and obstetrics, qualitative aspects as well as the quantitative increase in the literature should be taken into account. Our study sheds light on the research gaps in this field and the research areas that can be focused on for the future.

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SUMMARY BACKGROUND: Juvenile idiopathic arthritis is the most common chronic rheumatic disease of childhood, with a significant genetic component. Polymorphisms in proinflammatory cytokine genes are potential contributors to disease susceptibility. The aim of this study was to investigate the association between tumor necrosis factor-alpha (TNF-α)-308G>A (rs1800629), interleukin-1 beta (IL-1β)-511C>T (rs16944), and interleukin-6 (IL-6)-174G>C (rs1800795) variants and juvenile idiopathic arthritis in a Turkish cohort. METHODS: A case–control study was conducted involving 57 juvenile idiopathic arthritis patients and 50 age- and sex-matched healthy controls. Genotyping was performed using polymerase chain reaction–restriction fragment length polymorphism. Genotype and allele distributions were compared between groups, and associations with clinical parameters (erythrocyte sedimentation rate, C-reactive protein, disease subtype) were assessed. RESULTS: A significant association was found between the IL-1β-511C>T polymorphism and juvenile idiopathic arthritis. The CC genotype was significantly more frequent in patients compared to controls (24.6 vs. 2.0%; p=0.004), and the C allele demonstrated a trend toward association (p=0.051). In contrast, no significant differences were observed in the genotype or allele frequencies of the TNF-α-308G>A or IL-6-174G>C variants between patients and controls. Furthermore, none of the studied polymorphisms were associated with erythrocyte sedimentation rate, C-reactive protein levels, or specific disease subtypes. CONCLUSION: This study identifies the IL-1β-511C>T polymorphism as a significant risk factor for juvenile idiopathic arthritis in the Turkish population, underscoring the role of the IL-1 pathway in disease pathogenesis. These findings contribute to the understanding of the ethnic-specific genetic architecture of juvenile idiopathic arthritis and suggest IL-1β as a potential candidate for further functional and pharmacogenetic studies.

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SUMMARY OBJECTIVE: The aim of this study was to compare the accuracy, scientific quality, and clarity of responses generated by GPT-4o and Gemini to frequently asked patient questions related to carotid artery disease and carotid endarterectomy. METHODS: In total, 40 unique carotid endarterectomy-related questions were compiled from online sources and clinical experience. Each was entered into separate new sessions with GPT-4o and Gemini 2.5 Flash in Turkish, and responses were collected without modification. Notably, four blinded cardiovascular surgeons independently rated each answer (1–5 Likert scale) in three domains: Accuracy, Scientific Quality, and Clarity. Mean response lengths and domain scores were compared using appropriate paired tests. RESULTS: GPT-4o produced longer responses than Gemini (258.1±101.6 vs. 193.2±43.7 words; p<0.001). Overall, GPT-4o had higher Accuracy scores (4.33±0.39 vs. 4.16±0.33; p=0.04), with no significant differences in Scientific Quality or Clarity (p=0.377 and p=0.154, respectively). In rater-level analyses, Gemini scored higher in Clarity for one rater, whereas GPT-4o was superior in Accuracy and Scientific Quality for another. Overall mean scores were comparable (4.17±0.36 vs. 4.13±0.31; p=0.636). Physician referral was recommended in 62.5% of GPT-4o and 52.5% of Gemini (p=0.366). CONCLUSION: Both GPT-4o and Gemini provided "good"-quality responses to carotid endarterectomy patient questions, with GPT-4o showing a modest accuracy advantage, with no difference in other domains. Explicit disclaimers on both platforms underscore their supportive, not definitive, role in patient education. Physicians should remain the primary source for individualized decisions, and AI-generated information should always be verified.

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SUMMARY OBJECTIVE: In recent years, cesarean section rates have been increasing worldwide. Identifying changes in birth preferences during pregnancy is crucial for reducing cesarean section rates. AIM: The aim of this study was to determine the Turkish validity and reliability of the Theory-Based Intention for cesarean section scale, originally developed by Naghibi et al. METHODS: This methodological study was conducted with 300 pregnant women. Data were collected using the Introductory Information Form and the Theory-Based Intention for cesarean section scale. Analyses were performed using IBM SPSS 25.0 and AMOS 22.0. Language validity was evaluated through translation from the original Persian into Turkish as well as from English into Turkish. Content validity was calculated with nine experts using the Davis technique, and a pilot test was conducted with 30 pregnant women. Construct validity was assessed through Exploratory Factor Analysis and Confirmatory Factor Analysis. Internal consistency was examined with Cronbach's Alpha coefficient and test–retest reliability. RESULTS: Exploratory Factor Analysis revealed a five-factor structure with 24 items for the scale. According to Confirmatory Factor Analysis, the model fit indices indicated a good model fit. The Cronbach's Alpha coefficient of the scale was 0.76. The item–total correlations and test–retest reliability of the scale were found to be high. CONCLUSION: The Theory-Based Intention for cesarean section scale is a valid and reliable measurement tool for use among Turkish pregnant women.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the levels of nuclear factor erythroid 2 related factor 2, tumor necrosis factor alpha, interleukin-40, and endorepellin in patients undergoing coronary artery bypass grafting and explore their potential diagnostic roles. METHODS: The study involved 43 coronary artery disease patients undergoing coronary artery bypass grafting and 43 age- and sex-matched healthy controls. Plasma levels of nuclear factor erythroid 2 related factor 2, tumor necrosis factor alpha, interleukin-40, and endorepellin were quantified by enzyme-linked immunosorbent assay. Statistical analyses were conducted using SPSS v25.0, with significance set at p<0.05. RESULTS: Nuclear factor erythroid 2 related factor 2 levels were significantly reduced, while tumor necrosis factor alpha and interleukin-40 were elevated in coronary artery disease patients (p<0.001, p=0.003, p=0.001). Endorepellin levels did not differ significantly (p=0.120). Nuclear factor erythroid 2 related factor 2 correlated inversely with tumor necrosis factor alpha and interleukin-40; tumor necrosis factor alpha and interleukin-40 showed a positive correlation. Regression identified nuclear factor erythroid 2 related factor 2 as a tumor necrosis factor alpha predictor. Principal component analysis distinguished patients from controls based on biomarker profiles. These findings reflect enhanced inflammation and impaired antioxidant defense in coronary artery disease. Interleukin-40 may serve as a novel inflammatory biomarker; endorepellin's unchanged levels suggest localized vascular effects. CONCLUSION: Nuclear factor erythroid 2 related factor 2, tumor necrosis factor alpha, and interleukin-40 emerged as significant biomarkers reflecting the inflammatory and oxidative stress mechanisms associated with coronary artery disease. Interleukin-40 and endorepellin may offer new insights into disease mechanisms and warrant further research.

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SUMMARY OBJECTIVE: The aim of this study was to enhance the early diagnosis of cervical cancer by utilizing both scanning atomic force microscopy and scanning electron microscopy images. Until now, these two imaging modalities have not been combined for this purpose. Relying on a single imaging technique may reduce diagnostic reliability. Therefore, a multimodal approach was developed to provide more accurate and consistent results. METHODS: A total of 540 scanning electron microscopy and 540 atomic force microscopy cell images were obtained from the Faculty of Nanotechnology and Scanning Electron Laboratories. The discrete wavelet transform method was applied to extract ideal feature regions from the images. At least three divergence-based classifiers, triangle divergence, Jensen–Shannon divergence, and Hellinger divergence, were employed to identify cervical cancer–related patterns. To improve classification reliability, feature likelihoods were calculated using exponential graph regulation. Feature weights were determined and incorporated into a combined classification function. Based on this, scanning electron microscopy and atomic force microscopy cells were categorized into six groups: normal scanning electron microscopy, normal atomic force microscopy, benign scanning electron microscopy, benign atomic force microscopy, and malignant scanning electron microscopy, malignant atomic force microscopy. RESULTS: The classifiers demonstrated interrelated performance, with triangle divergence achieving superior accuracy compared to Jensen–Shannon divergence and Hellinger divergence. The weighted feature approach improved diagnostic precision. The proposed method successfully predicted the likelihood of cervical cancer by combining scanning electron microscopy and atomic force microscopy data. CONCLUSION: The findings indicate that the triangle divergence-based multimodal classification outperforms single-modality approaches. The combined scanning electron microscopy and atomic force microscopy method using triangle divergence achieved a classification accuracy of 95.9%, demonstrating the effectiveness of this integrated approach for early cervical cancer detection.

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SUMMARY OBJECTIVE: The aim of this study was to determine the frequency of UGT1A1 and DPYD polymorphisms among Brazilian patients with gastrointestinal cancer. METHODS: UGT1A1 and DPYD polymorphisms were selected due to their importance in the metabolism of fluoropyrimidines and irinotecan, and the existence of available clinical guidelines for dosing recommendations based on genetic testing. Polymorphism rs3918290, rs67376798, rs56038477, rs55886062, rs115232898, and rs887829 were investigated in 100 patients. Allelic discrimination was performed using the TaqMan Assay. Minor allele frequencies were calculated, and metabolic phenotypes were inferred based on the Clinical Pharmacogenetics Implementation Consortium and the Dutch Pharmacogenetics Working Group guidelines. RESULTS: For DPYD, rs56038477 (n=100) showed a minor allele frequency of 1.50% (CI 0.51–4.32), rs115232898 (n=49) had a minor allele frequency of 1.02% (CI 0.18–5.56), and rs3918290 (n=100) had a minor allele frequency of 0.50% (CI 0.09–2.78). No variants were observed in rs67376798 (n=100) or rs55886062 (n=44). A total of 4% of patients received a Clinical Pharmacogenetics Implementation Consortium DPYD activity score (AS) of less than 2.0, with 3% of 1.5 AS and 1% of 0.5 AS. For UGT1A1, rs887829 (n=100) revealed a minor allele frequency of 37.5% (CI 31.09–44.39) and 16% of patients with Dutch Pharmacogenetics Working Group poor metabolizer phenotype. CONCLUSION: The presence of DPYD and UGT1A1 variants is considerable among Brazilian gastrointestinal cancer patients, reinforcing the promising use of pre-therapeutic genetic tests for irinotecan and fluoropyrimidines to avoid severe toxicities related to treatment. Genetic panels for these variants must be continuously updated and adapted for population-specific characteristics.

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SUMMARY OBJECTIVE: Approximately 5–10% of the cases with colorectal cancers have a hereditary cancer syndrome. MUTYH is a DNA base excision repair gene, and its mutation can induce the development of polyposis and colorectal cancer. Additionally, MUTYH repair gene may interact with the DNA mismatch repair system. The aim of this study was to investigate the clinicopathological features of colorectal cancer cases carrying germline MUTYH mutations. METHODS: Among patients genetically tested using large hereditary cancer panels, data of those carrying germline MUTYH mutations were retrieved from the archive files. Then, the patients who had colorectal cancer were included in the study. RESULTS: Ten male and three female colorectal cancer patients with pathogenic (n=10) and variant of uncertain significance MUTYH mutations (n=3) were included in the study. While seven cases had homozygous MUTYH mutations, six patients carried heterozygous MUTYH mutations. The patients had c.800C>T p.P267L (n=4), c.1353_1355delGGA p.E452del (n=4), c.1087C>T p.Q363 (n=1), c.631G>A p.V211I (n=1), c.180A>G p.R60R (n=1), c.509G>A p.G170E (n=1) and c.650G>A p.R217H (n=1) mutations. The ascending colon was the most common site of involvement. Six cases with homozygous and one case with double heterozygous mutations had polyposis. Cases with homozygous (n=1) and heterozygous (n=1) MUTYH mutations were found to be MSH2-deficient. In both MSH2-deficient cases, the tumors were located in the ascending colon, and the case with a homozygous mutation had >100 polyps. CONCLUSION: Given that the MUTYH mutation is rarely seen in cases of colorectal cancers, we believe that our findings may contribute to identifying potential clinical and therapeutic implications for individuals with this mutation.

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SUMMARY OBJECTIVE: The aim of the study was to determine the association between low muscle mass and abnormal fluid distribution with in-hospital mortality in patients with acute heart failure. METHODS: In a prospective cohort study at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran in Mexico City, patients with acute heart failure who underwent thoracic or abdominal computed tomography within 72 h before or after admission between September 2017 and July 2024 were included. The exclusion criteria were an illegible computed tomography scan, an incorrect bioimpedance analysis lecture, the presence of cancer, COVID-19, chronic kidney disease with renal replacement therapy, or dismissal of a diagnosis of acute heart failure. Bioelectrical impedance analysis was performed within the first 24 h of hospitalization to measure phase angle and impedance ratio for evaluating hydration status. The skeletal muscle area was measured using a single axial slide at L3 for abdominal computed tomography and the T4 level for thoracic computed tomography. RESULTS: This study included 134 patients, with an overall hospital survival rate of 83.6%. The mortality group had a lower abdominal skeletal muscle area (86.5 vs. 111 cm2, p=0.024), smaller pectoral skeletal muscle area (18.9 vs. 26 cm2, p=0.005), lower phase angle (3 vs. 3.9, p=0.010), increased impedance ratio (0.89 vs. 0.86, p=0.002), greater prevalence of reduced pectoral muscle mass (40.9 vs. 12.5%, p<0.001), and abnormal fluid distribution according to impedance ratio (86.4 vs. 57.1%, p=0.016). In survival analyses, the interaction effect of pectoral skeletal muscle area and increased impedance ratio had the lowest survival probability (log-rank test, p<0.001). CONCLUSION: Low skeletal muscle mass and abnormal fluid distribution are associated with in-hospital mortality in patients with acute heart failure.

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SUMMARY OBJECTIVE: The aim of this study was to determine the relationship between satisfaction with prenatal care and labor satisfaction and perception of labor. METHODS: The cross-sectional and correlational study was conducted in the obstetrics ward of a public hospital. The population of the study consisted of women who gave birth in this hospital, while the sample consisted of 200 women. The data were collected face-to- face using the "Personal Information Form, Prenatal Care Satisfaction Scale, Birth Satisfaction Scale, and Mother's Perception of Childbirth Scale." RESULTS: It was found that 56% of the mothers who participated in the study received prenatal care from a midwife/nurse, 60.3% received prenatal care at a Family Health Center, and the mean total scores of the mothers were 71.69±9.67, 73.66±5.48, and 102.56±5.26 on the Prenatal Care Satisfaction Scale, Mother's Perception of Childbirth Scale, and Birth Satisfaction Scale, respectively. In addition, a positive and significant correlation was found between the mean scores of the women on the Prenatal Care Satisfaction Scale and the mean scores on the Mother's Perception of Childbirth Scale and Birth Satisfaction Scale. CONCLUSION: In the study, it was concluded that as women's prenatal care satisfaction levels increased, their birth satisfaction and positive birth perception also increased.

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SUMMARY OBJECTIVE: The use of social media is rapidly expanding worldwide. In parallel with the development of digital pathology, the use of digital social media platforms in the field of pathology has also increased. However, as with many other groups, pathologists still have some concerns about using social media. The aim of this study was to investigate the frequency and purposes of social media use among pathologists in their professional and personal lives. METHODS: This study was conducted using an online survey designed via Google Forms and distributed among pathologists. The questionnaire collected data on participant demographics, the frequency and purposes of social media use, and its application in pathology education and practice. RESULTS: A total of 124 pathologists participated in the study. All participants reported using social media in their daily lives. Among them, 101 (81.5%) indicated that they also used social media for pathology-related purposes. The platform considered most useful for pathology practice was X (formerly Twitter) (35.6%). Additionally, 98% of participants believed that social media could be beneficial for pathology education. CONCLUSION: Despite potential sampling bias, our study indicates that among digitally connected pathologists in Turkey, social media, particularly X, is widely adopted as a valuable tool for professional education and practice.

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SUMMARY OBJECTIVE: The aim of this study was to investigate the effect of capsule invasion on recurrence and survival in breast cancer patients with axillary lymph node metastases. METHODS: This retrospective study included 135 breast cancer patients with axillary lymph node involvement who underwent surgery between 2009 and 2018. The relationships between capsule invasion and various clinicopathological factors—including demographic parameters, tumor stage, surgical technique, histological type, number of involved lymph nodes, tumor size, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67 index—were analyzed using chi-square, Kaplan-Meier, and Fisher's exact tests. Additionally, multivariate Cox regression analysis was performed to assess the independent prognostic value of capsule invasion for recurrence. A p<0.05 was considered statistically significant. RESULTS: Capsular invasion was observed in 64 of 135 patients (47.4%). Recurrence occurred in six patients with capsule invasion compared to only one patient without capsule invasion. Multivariate Cox regression analysis, controlling for positive lymph node count, tumor size, grade, and receptor status, confirmed that capsule invasion was an independent predictor of recurrence [HR 3.45, 95%CI 1.12–10.65, p=0.032]. No significant association was found between tumor size and capsule invasion (p>0.05). During follow-up, 20 patients died (9 with and 11 without capsule invasion), with no significant difference in 5-year survival or mean survival time between groups (p=0.972, Kaplan-Meier analysis). Grading of capsular invasion showed a significant correlation with recurrence (p=0.026). DISCUSSION: Although lymph node capsule invasion in breast cancer with axillary lymph node involvement does not significantly impact overall survival, it independently and significantly elevates the risk of recurrence, as demonstrated by multivariate analysis.

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SUMMARY OBJECTIVE: The aim of this study was to determine the effect of a targeted mobilization program applied after cesarean surgery on postoperative recovery outcomes. METHODS: A randomized controlled trial was conducted with 64 women undergoing elective cesarean section at a training and research hospital in Central Anatolia, Turkey. Participants were randomly assigned to an experimental group (n=32) or a control group (n=32). All women received routine care, while the experimental group additionally received structured mobilization training beginning 6 h postoperatively and continuing for 48 h. Data were collected using the Preliminary Assessment Form, Personal Information Form, Gastrointestinal Function Form, Abdominal Distension Diagnosis Form, Walking Schedule Form, Visual Analog Scale, and Latch, Audible swallowing, Type of nipple, Comfort, and Hold Breastfeeding Diagnosis and Assessment Scale. RESULTS: Women in the experimental group demonstrated significantly faster gastrointestinal recovery, with shorter times to first gas expulsion and first defecation. Abdominal distension scores at 12, 24, and 48 h postoperatively were consistently lower in the experimental group. Pain scores were also significantly reduced at 24 and 48 h. In addition, the experimental group showed a shorter milk let-down time and higher Latch, Audible swallowing, Type of nipple, Comfort, and Hold breastfeeding scores, indicating better early breastfeeding performance. These differences represent clinically meaningful improvements across multiple recovery indicators. CONCLUSION: The targeted mobilization program applied after cesarean surgery enhanced overall postoperative recovery by accelerating bowel function, reducing abdominal distension and pain, and improving breastfeeding outcomes. These findings support the integration of structured mobilization strategies into routine post-cesarean care.

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SUMMARY OBJECTIVE: The aim of this study was to determine the effects of transdermal melatonin patches on sleep quality in patients undergoing urological surgery. METHODS: This study is a randomized controlled trial. Fifty-seven patients hospitalized in the urology department of a university hospital in Istanbul were included. Patients were randomly assigned to two groups (melatonin and control). Patients in the melatonin group received transdermal melatonin containing 7 mg of melatonin at 11:00 PM in a quiet, darkened room the night before surgery. RESULTS: According to the results of this study, Richards-Campbell Sleep Scale sleep-quality scores increased significantly in the melatonin group (p<0.001). The control group showed lower sleep-quality scores. In addition, a statistically significant decrease was observed between the visual analog scale well-being scores before and after the application in the melatonin group (p<0.001). CONCLUSION: In this study, our results showed that melatonin patches improved sleep quality and psychological well-being in patients undergoing urological surgery.

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SUMMARY OBJECTIVE: Patients with polycystic ovary syndrome face an increased risk of developing metabolic syndrome. Identifying biomarkers that can detect metabolic syndrome in polycystic ovary syndrome is essential, as it may enable physicians to implement preventive strategies aimed at reducing the risk of metabolic complications. The aim of this study was to assess angiopoietin-like protein-3 levels in polycystic ovary syndrome and to investigate the potential of angiopoietin-like protein-3 for discriminating metabolic syndrome in polycystic ovary syndrome. METHODS: A total of 50 women with polycystic ovary syndrome and 45 controls were included in this prospective study. Then, polycystic ovary syndrome patients were categorized into two subgroups: metabolic syndrome-positive (n=15) and metabolic syndrome-negative polycystic ovary syndrome (n=35). Age, parity, body mass index, blood pressure, waist circumference, Ferriman-Gallwey scores, hormone and lipid profiles, glucose, insulin, C-reactive protein, procalcitonin, and angiopoietin-like protein-3 levels were compared between groups. RESULTS: The median angiopoietin-like protein-3 level was significantly higher in polycystic ovary syndrome as compared to controls [41.19 (15.28–69.56) vs. 29.11 (9.85–66.25) ng/mL, p<0.001]. Similarly, angiopoietin-like protein-3 levels were higher in metabolic syndrome-positive polycystic ovary syndrome patients compared to those without metabolic syndrome (p=0.010). Angiopoietin-like protein-3 >32.5 ng/mL yielded a sensitivity of 76% and a specificity of 66.7% for predicting polycystic ovary syndrome (p<0.001, AUC=0.751), while angiopoietin-like protein-3 >44.54 ng/mL provided 68.8% sensitivity and 79.4% specificity for predicting metabolic syndrome in polycystic ovary syndrome (p=0.002, AUC=0.759). No correlation was detected between angiopoietin-like protein-3 and systolic blood pressure, body mass index, waist circumference, glucose, homeostatic model assessment insulin resistance, lipids, and inflammatory markers in polycystic ovary syndrome patients with metabolic syndrome. CONCLUSION: Angiopoietin-like protein-3 could discriminate metabolic syndrome in polycystic ovary syndrome patients. However, given that the correlation analysis did not find any association between Angiopoietin-like protein-3 and any etiopathogenesis-related characteristic, we think that further research is necessary to determine how it accomplishes this.

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SUMMARY OBJECTIVE: Preterm premature rupture of membranes is a pregnancy complication in which infection and inflammation play an important role. Soluble urokinase plasminogen activator receptor has been described as a biomarker of infectious and inflammatory diseases. The aim of this study was to evaluate maternal serum soluble urokinase plasminogen activator receptor levels in pregnant women with preterm premature rupture of membranes and to determine the predictive value in neonatal outcomes. METHODS: In this prospective case-control study, complete blood count parameters, serum C-reactive protein, and soluble urokinase plasminogen activator receptor levels of 40 pregnant women with preterm premature rupture of membranes and 40 randomly selected healthy pregnant women between 22 and 34 weeks’ gestation were recorded. Neutrophil-to-lymphocyte ratio, systemic inflammation response index, and systemic immune-inflammation index were calculated. Receiver operating characteristic analysis assessed the predictive value of maternal serum soluble urokinase plasminogen activator receptor levels for neonatal intensive care unit admission. RESULTS: Maternal serum soluble urokinase plasminogen activator receptor levels, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index scores were significantly higher in the preterm premature rupture of membranes group than in controls (p<0.05). The soluble urokinase plasminogen activator receptor value in receiver operating characteristic analysis identified 4.33 ng/mL (62% sensitivity, 64% specificity) and 3.65 ng/mL (72% sensitivity, 73% specificity) for neonatal intensive care unit admission and adverse perinatal outcomes in the preterm premature rupture of membranes group (p<0.05). CONCLUSION: Soluble urokinase plasminogen activator receptor may be used as an ancillary marker in the prediction of neonatal intensive care unit admission and adverse perinatal outcome in preterm premature rupture of membranes cases, along with clinical findings.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of a pretrained Vision Transformer model on nailfold capillaroscopy images, comparing its performance to that of expert rheumatologists. METHODS: We retrospectively analyzed 104 anonymized images (23 normal, 81 pathological) from publicly available datasets. The pretrained Vision Transformer model was applied without fine-tuning. Two rheumatologists independently assessed the same image set. Accuracy and interrater agreement were calculated. RESULTS: The AI model produced 0% clinical applicability, failing to generate meaningful classifications. In contrast, the consensus of two rheumatologists achieved the highest diagnostic performance, with 94.2% accuracy and a Cohen’s Kappa of 0.827. Individual rheumatologist evaluations yielded comparatively lower accuracy and agreement. CONCLUSION: We retrospectively analyzed X anonymized images (XX normal, XX pathological) from publicly available datasets. The pretrained Vision Transformer model was applied without fine-tuning. Two rheumatologists independently assessed the same image set. Accuracy and interrater agreement were calculated.

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SUMMARY OBJECTIVE: Polycystic ovary syndrome may impair bone metabolism. The aim of this study was to assess serum type-1 collagen N-terminal procollagen and beta-C terminal telopeptide levels in non-obese women with polycystic ovary syndrome. METHODS: This cross-sectional study comprised 174 patients, 18–35 years old. Among the patients with menstrual irregularity, 82 were diagnosed with polycystic ovary syndrome according to the Rotterdam criteria and 92 were in the control group. Women with obesity (BMI>30 kg/m2) were excluded. Hormonal and metabolic parameters, 25-hydroxy vitamin D, procollagen-1 N-terminal peptide, and beta-C terminal telopeptide levels were measured. RESULTS: Demographics and most biochemical parameters were comparable between groups. Polycystic ovary syndrome patients had significantly lower 25-hydroxy vitamin D (80.12±68.00 vs. 117.08±73.92 ng/mL, p=0.010), procollagen-1 N-terminal peptide (597.36±501.49 vs. 863.47±509.01 ng/mL, p=0.013), and beta-C terminal telopeptide (572.88±585.94 vs. 929.91±641.38 ng/L, p=0.004) levels compared with controls. CONCLUSION: Non-obese women with polycystic ovary syndrome show significantly reduced bone formation and resorption markers, suggesting adverse effects on bone turnover. These findings suggest a low-turnover bone state in non-obese polycystic ovary syndrome women.