OBJECTIVE: In our study, our aim was to compare the clinical outcomes of utilizing a 6-stranded hamstring autograft (HAG) lacking tibial attachment site separation in Anterior Cruciate Ligament Reconstruction (ACLR), an approach previously unreported in literature, with alternative methodologies.
METHODS: A total of 85 patients admitted to our Orthopedics and Traumatology clinic between April 2019 and July 2022 with Anterior Cruciate Ligament (ACL) rupture, who underwent surgical treatment, were retrospectively analyzed. ACLR was initiated using HAG in all patients. The surgical procedure was determined based on the length of the HAG used during ACLR. In all cases, femoral fixation was performed with an adjustable loop endobutton. 3 methods were applied to all patients. These are: repair with a 6-strand hamstring tendon graft without severing the tibial insertion (new method), repair with 4-strand hamstring tendon graft without severing the tibial insertion and repair with 4-strand hamstring tendon graft without protecting the tibial insertion. Preoperative and postoperative International Knee Documentation Committee (IKDC) subjective evaluation score, Lysholm score and Tegner activity score were used in the evaluation of the patients. Comparisons between groups were made according to these scores.
RESULTS: 78 patients were included in the study. There were 31 patients in Group 1, 23 in Group 2 and 24 in Group 3. The mean age of the patients was 29 (19–40) in Group 1, 32 (16–49) in Group 2 and 31 (18–54) in Group 3. In the comparison of the groups, there was a significant increase in tendon thickness in Group 1 (p<0.001) and a significant decrease in the rate of re-rupture as a complication (p<0.05). There was no statistically significant difference between the groups in terms of age, side of surgery, follow-up period, and length of hospital stay. There was statistical significance between Group 1 and Group 2 in terms of tendon diameter (p<0.05) and re-rupture (p<0.05). In the comparison of Group 2 and Group 3, there was statistical significance between Group 2 and Group 3 in terms of tendon thickness and length of hospital stay (p<0.05), while no significant difference was found in terms of re-rupture (p>0.05).
CONCLUSION: ACLR with 6-strand tendon graft with preservation of the HAG insertion is not a method described in the literature. As a result of our study, it was concluded that the functional results of this newly described method are as good as other methods and have lower re-rupture rates.

OBJECTIVE: The purpose of this study is to analyze the situation of Methicillin-Resistant Staphylococcus aureus (MRSA) in TRNC by examining the prevalence of Community-acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA)/Hospital-acquired Methicillin-Resistant Staphylococcus aureus (HA-MRSA) cases, the acceleration of CA-MRSA/HA-MRSA patients from past to present, the impact of pandemic, gender and age on MRSA cases.
METHODS: In order to analyze the trend of MRSA cases and the effects of selected parameters on MRSA cases, statistical tests are employed to the obtained data including ANOVA test, regression analysis tests and Post-hoc Tukey test.
RESULTS: Incidence rate of MRSA carriage in the community has increased over the years to 45.6%. p-value of the relationship between community-acquired MRSA cases and hospital-acquired MRSA cases is less than 0.05. The results also revealed that the p-value of both the relationship between COVID-19 and MRSA cases and the relationship between 50+ age and MRSA cases are significant. On the other hand, p-value of the relationship between gender and MRSA cases is found to be greater than 0.05.
CONCLUSION: It is concluded that MRSA carriage in the community has increased over the years and CA-MRSA and HA-MR-SA cases are related since p<0.05. Moreover, it’s revealed that there is an effect of COVID-19 pandemic and 50+ age (66% of the cases) on MRSA cases because of p<0.05 while the gender is not an effect for MRSA cases in the country, since p-value for gender comparison is greater than 0.05.

OBJECTIVE: Pseudomonas aeruginosa is considered one of the leading pathogens responsible for community- and health-care-associated infections.
P. aeruginosa infections are difficult to treat due to antibiotic resistance, various virulence factors, and the capacity to build biofilms, which provide resistance to drugs and immune cells. Antibiotics used to treat biofilm-associated infections over an extended period resulted in the establishment of resistance strains. In this study, we comparatively investigated the efficacy of natural compounds (Furanone-C30 [F], Ellagic-acid C11 [EA], Tobramycin [TOB], Ciprofloxacin [CIP], and Meropenem [MEM]) and antibiotics in inhibiting and eradicating P. aeruginosa biofilm.
METHODS: The Minimum Biofilm Inhibition Concentrations (MBIC) and Minimum Biofilm Eradication Concentrations (MBEC) were determined using a micro broth dilution technique, and their effects on the biofilm were evaluated by crystal violet staining and cell viability tests (MTT).
RESULTS: F significantly suppressed P. aeruginosa biofilm formation in a dose-dependent way, with 100% inhibition at 512 and 256 g/mL and 92% inhibition at 128 µg/mL. F also eradicated 92.9% of the biofilm at 512 µg/mL and 90% at 256 µg/mL. EA provided 41.6% biofilm inhibition and 33.1% biofilm eradication at 512 µg/mL.
CONCLUSION: Our findings indicate that the natural compounds displayed a dose-dependent effect on P. aeruginosa biofilm, with F being found to be more effective than EA. In conclusion, this study suggests that furanone may hold promise as a natural alternative for the treatment of P. aeruginosa biofilm and highlights the need for further research to support this hypothesis.

OBJECTIVE: Screening for latent tuberculosis (LTB) is necessary, especially for people living with human immunodeficiency virus (HIV) and people receiving anti-TNF therapy. Although there is no microbiological test accepted as the gold standard, interferon-gamma release assays (IGRAs) are suggested to be used by World Health Organization. We aimed to analyze QuantiFERON®-TB Gold Plus test results in different patient groups with high reactivation risk.
METHODS: Patients admitted to Marmara University Pendik Training and Research Hospital Microbiology Laboratory between August 2016 - March 2020 have been analyzed retrospectively. Patient demographic data was obtained from the records of the laboratory information management system. Blood samples have been studied as recommended by the manufacturer (QuantiFERON®-TB Gold Plus, QIAGEN, Germany).
RESULTS: We evaluated samples from 1506 patients, of whom with a chronic inflammatory disease (CID) in 1223 patients and HIV positivity among 283 patients. Mean age was 38.29±12.66 for HIV patients and 41.57±14.45 for chronic inflammatory disease patients. QFT test was positive in 319 (21.2%) of 1506 patients in total and in 43 (15.2%) of HIV patients and in 276 (22.6%) of CID patients. Indeterminate results were obtained in 1.7% (n=26) of the samples. Among patients with CID highest rate of QFT test positivity was detected among patients with psoriasis (27.8%), followed by patients with rheumatoid arthritis (21.8%) and ankylosing spondylitis (19.8%). Active tuberculosis was not developed in any of QFT-GIT-positive CID patients followed up in our hospital for the 4 years period.
CONCLUSION: QuantiFERON®-TB Gold Plus test requires a short-term and one-time contact with the patient and it seems to be a suitable option for screening of patients who have a high risk of tuberculosis.

OBJECTIVE: Urinary tract infections (UTIs) are among the most common bacterial infections. The misuse of antibiotics is one of the factors contributing to the global increase in antimicrobial resistance (AMR), making the management of UTIs more challenging. Our study aims to evaluate the causative agents of UTIs and the factors influencing resistance, as well as to identify antibiotics that can be used in the outpatient treatment of patients diagnosed with UTIs.
METHODS: This retrospective study was conducted by collecting urine sample results between 2015–2023. The culture results of the urine samples and the results of the antibiotic sensitivity tests of the Enterobacteriaceae isolates were analyzed. Antimicrobial susceptibilities of the isolates were defined using the VITEK®2 Compact system (bioMérieux, Marcyl’Etoile, France) and PheonixTM (Becton-Dickinson, NJ, USA). All sensitivity statuses were determined according to EUCAST standards. Data analysis was conducted using SPSS software version 23.
RESULTS: 1842 culture results were included. 71.5% of the included samples were from women, and the average age of the cases was 63±18. The most commonly grown agent in urine cultures is Escherichia coli. The resistance profile of the Enterobacteriaceae to antibacterial agents was examined, and it was found that the highest resistance rates were against ampicillin (77.92%), cefazolin (52.36%), ciprofloxacin (49.5%), and trimethoprim/sulfamethoxazole (45.5%), while the lowest resistance rates were against meropenem (4.9%), amikacin (7.6%), fosfomycin (11.4%), and nitrofurantoin (11.6%). Comparing resistance rates before and after 2019, a significant increase in resistance to amikacin and nitrofurantoin was observed (p≤0.001). It was found that resistance rates were higher in urine samples from male cases.
CONCLUSION: Our study revealed that patients should be carefully evaluated in terms of the necessity of culture requests and patients should be informed about culture requests due to the high rate of non-growth and contamination in urine culture results. The high rates of antimicrobial resistance were detected, and the outpatient treatment options of UTI patients are narrowing which can increase hospital admission rates. Our study is important because it shows that nitrofurantoin and fosfomycin can be included in the outpatient and empirical treatment of UTI patients.

OBJECTIVE: Lung cancer is one of the most prevalent malignancies worldwide, with 80–85% of cases diagnosed as non-small cell lung cancer (NSCLC). The majority of NSCLC patients present with advanced disease, contributing to high mortality and limited treatment options. Angiogenesis, a crucial process in cancer progression, is largely regulated by growth factors and cytokines. Vascular Endothelial Growth Factor (VEGF) is a key regulator of angiogenesis. Asymmetric Dimethyl Arginine (ADMA) inhibits endothelial nitric oxide synthase (eNOS), leading to reduced nitric oxide (NO) release and subsequent endothelial dysfunction. The aim of this study is to investigate the serum levels of ADMA, NO, VEGF and several tumor markers including Carcinoembryonic Antigen (CEA), Cancer Antigen 125 (CA 125), Neuron Specific Enolase (NSE), Lactate dehydrogenase (LDH) and Cyfra 21-1 in NSCLC patients to assess their potential role in early diagnosis, tumor invasion, and staging of the disease.
METHODS: Our study consisted of 56 newly diagnosed NSCLC patients and 32 controls with similar demographic characteristics. Patients with chronic diseases and inflammatory disorders were excluded. Statistical analysis was conducted using R Statistical Software.
RESULTS: In our study, compared to the control group, the serum VEGF, NO, ADMA, CA 125, CEA, Cyfra 21-1 and NSE levels were significantly higher in NSCLC group (p=0.001, p=0.013, p=0.041, p<0.001, p<0.001, p<0.001 and p=0.001, respectively). In the diagnosis of NSCLC, Cyfra 21-1 exhibited the highest diagnostic efficacy with a 71% sensitivity and 94% specificity. The combination of VEGF, CA125, and Cyfra 21-1 showed a 73% sensitivity and 100% specificity, while the combination of CA125, CEA, and Cyfra 21-1 achieved an 85% sensitivity and 91% specificity.
CONCLUSION: Our study revealed that the serum concentrations of VEGF, NO, ADMA, CA125, Cyfra 21-1, CEA, and NSE were significantly elevated in patients with NSCLC compared to the control group, and that levels of Cyfra 21-1, LDH, and NSE increased with advancing TNM stage. The combination of markers distinguished NSCLC with high sensitivity and specificity. Further studies involving larger populations, including those with benign lung diseases, are needed to validate and expand upon our findings.

OBJECTIVE: To investigate the effects of methylenetetrahydrofolate reductase (MTHFR) gene C677T/A1298C polymorphisms on serum homocysteine levels and hypertension.
METHODS: Venous blood samples were collected in EDTA tubes from patients and controls (80 hypertensive patients and 67 healthy controls) and genomic DNA was isolated. The polymorphisms of MTHFR C677T and A1298C were identified using the polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP) technique. The enzyme-linked immunosorbent assay (ELISA) method was used to determine serum homocysteine levels. ANOVA, Student’s t-test, chi-square test and logistic regression analysis tests used in the evaluation of statistical analysis between patient and control groups
were performed with SPSS 21.0 program.
RESULTS: A statistically significant difference was observed between the patient group, which were hypertension-diagnosed patients, and control group for C677T polymorphism (p<0.001), but not for the A1298C polymorphism (p=0.058). When serum homocysteine levels were compared between the patient and control groups, no significant difference was observed (p=0.065). A significant difference was observed between C677T allele frequency (TT + CT versus CC) and homocysteine levels in both groups (p=0.027), whereas no significant difference was observed between A1298C allele frequency (CC + AC versus AA) and homocysteine levels (p=0.996).
CONCLUSION: The MTHFR C677T polymorphism is more common in hypertensive patients. T allele frequencies (CT and TT genotypes) and TT genotypes might increase the risk of hypertension and homocysteine levels. Although the A1298C C allele frequency (AC and CC genotypes) might increase the risk of hypertension, CC genotype distributions and homocysteine levels show no statistical significance on hypertension. C677T polymorphism is associated with hypertension thus it may be used as a potential biomarker.

OBJECTIVE: In this retrospective study, we aimed to investigate the etiology, success, and complication rate of percutaneous nephrostomy (PCN) in patients with non-dilated renal collecting system (NCT) using saline and diuretic agents.
METHODS: PCN was performed on 62 kidneys from 35 patients with NCT. Prior to the procedure, a combination of saline and furosemide infusion was administered. Several parameters were evaluated, including pre- and post-procedure levels of creatinine and blood urea nitrogen, fluoroscopy time, total air kerma (TAK), dose area product (DAP), puncture number, success rate, and complication rate.
RESULTS: Fistula was the most common etiology and was detected in 29 out of 62 kidneys. The other most common cause was ureteral injury, detected in 21 out of 62 kidneys. The success rate of our procedures was 96.7%, and the rate of minor complications was 1.7%. Transient macroscopic hematuria was one of the minor complications observed in one patient. No major complications were observed. During each procedure, the average number of needle passes was 1.44±0.5 (range: 1–3). The average duration of the complete procedure was 13.17±6.46 minutes (range: 8–31 minutes). The mean fluoroscopy time was 2.37 minutes (range: 0.8–11.6 minutes). In terms of radiation exposure, the mean DAP was 166.94±148.5 μGy·m² (range: 3.93–666.59 μGy·m²) with a median of 127.04 μGy·m², and the cumulative dose (TAK) was 72.43 mGy (range: 12–342 mGy) with a median of 42.05 mGy, respectively.
CONCLUSION: Diuretic infusion in saline is a safe and beneficial method for PCN in NCT. With its low complication rate and high success rate, PCN provides rapid treatment for various etiologies with the potential to address conditions such as fistula, ureteral injury, and urosepsis in the collecting system, which may otherwise have devastating consequences.

OBJECTIVE: This study aims to explore the predictive performance of machine learning-based radiomic features extracted from T2-weighted magnetic resonance imaging (MRI) in differentiating between women with polycystic ovary syndrome (PCOS) and healthy counterparts.
METHODS: The study included patients diagnosed with PCOS who had undergone pelvic MRI in the endocrine department between 2014 and 2022, along with an age-matched control group. The ovaries were manually segmented from T2-weighted images using the 3D Slicer software. Both first- and second-order features, including wavelet filters, were extracted from the images. Utilizing the Python 2.3 programming language and the Pycaret library, various machine learning algorithms were employed to identify highly correlated features. The optimal model was selected from the 15 algorithms assessed.
RESULTS: The study involved a total of 202 ovaries from 101 patients with PCOS (mean age 23±4 years) and 78 ovaries from the control group comprising 40 individuals (mean age 24±5 years). In the training set, the machine learning models displayed accuracy and area under the curve (AUC) values ranging from 72% to 83% and 0.50 to 0.81%, respectively. Notably, the Light Gradient Boosting Machine (LightGBM) model emerged as the most effective model among the various machine learning algorithms, exhibiting an AUC of 0.81 and an accuracy of 83%. When evaluated on the test set, the AUC, accuracy, recall, precision and F1 values of the LightGBM model were 0.80, 82%, 91%, 86%, 88%, respectively.
CONCLUSION: Machine learning-based T2-weighted MRI radiomics seems viable in differentiating between individuals with and without PCOS.

OBJECTIVE: Acne vulgaris is a chronic and common disease among adolescents. The effects of acne vulgaris on the caregiver’s quality of life and its relationship to patient’s quality of life have been seldom studied. This study aims to investigate impact of adolescent acne vulgaris on the patients’ and their caregivers’ quality of life and to evaluate the relationship between these two variables.
METHODS: Acne vulgaris patients aged between 10 and 18 years and their caregivers were included in this prospective study. CDLQI (Children Dermatologic Quality of Life Index) and DFIS (Dermatological Family Impact Scale) questionnaires were used to assess the impact of acne vulgaris on the quality of life of patients and caregivers. SPSS version 21 was used for the statistical analysis; Spearman correlation test and Mann Whitney U test were used.
RESULTS: This study has shown a significant correlation between DFIS and CDLQI, between severity of acne and CDLQI, and between the previous use of systemic antibiotics and DFIS. There is no relationship of age, sex, disease duration, number of siblings, amount of money spent and previous treatment modalities to CDLQI. There is no relationship between age, sex, acne severity, disease duration, number of children and amount of money spent on DFIS.
CONCLUSION: Acne vulgaris not only has an impact on the patient’s quality of life but also on the caregiver’s quality of life, which in turn affects the patient’s quality of life.

OBJECTIVE: Flexible bronchoscopy (FB) is an important tool for evaluating pediatric patients with respiratory issues. This study aims to investigate the clinical features of children who underwent FB.
METHODS: The study included 191 children who underwent FB between April 1, 2021 and December 31, 2022. Demographic and clinical data were retrospectively reviewed.
RESULTS: One hundred ninety-one children (45% girl) were enrolled to study. Median age was 25 months (min 1, max 214 months) and median duration of complaints was 4 (min 1, max 80) months. Among the patients, 61.7% of them had a chronic disease. The main indications were stridor (17.6%) and extubation failure (13.5%). Rate of patients in the ICU during FB was 27.5% and 15.5% of them were intubated. Airway secretions in the lower respiratory tract and isolated laryngomalacia were the most common abnormal FB results (30.1% and 9.8% respectively). The most common abnormal FB findings were in children with extubation failure (92.3%). Forty percent of patients with chronic cough had abnormal FB findings. Bronchoalveolar lavage (BAL) sampling was performed in 61.6% (n=119) of patients and Haemophilus influenzae was the most common pathogen in these patients (n=40).
CONCLUSION: FB is a valuable tool for investigating airway pathology and BAL sampling in children with respiratory problems.

OBJECTIVE: Preseptal cellulitis is an infection of the palpebrae and the periorbital superficial tissue and is more common in children than adults. This study aims to evaluate the demographic and clinical characteristics of children hospitalized for preseptal cellulitis and the factors affecting these characteristics.
METHODS: In this retrospective, single-center study, 101 children hospitalized for preseptal cellulitis between March 2019 and March 2022 were included. The patients were divided into 2 groups as under five years old and over five years old.
RESULTS: 56 patients (55.4%) were male and the median age was 56 (24–89) months. All patients had eye swelling. Periorbital erythema was seen in 81 (80.1%), conjunctivitis in 39 (38.6%), eye discharge in 30 (29.7%) patients. The most common treatment was ampicillin-sulbactam+clindamycin (77.2%). Mean treatment duration was 8.42±2.89 days, clinical improvement was 5.01±2.20 days. Patients with leukocytosis had longer duration of treatment compared to patients without leukocytosis (9.3±3.1 vs. 7.8±2.5 days, p=0.009). While the lymphocyte level was higher in patients under 5 years of age compared to patients over 5 years of age (p<0.001); neutrophil (p<0.001), hemoglobin (p=0.002) and NLR (p<0.001) levels were low. The duration of clinical improvement was short in patients under 5 years of age (4.4±1.6 vs. 5.6±2.5 days, p=0.005).
CONCLUSION: The most common finding in patients with preseptal cellulitis was swelling in the eye. The presence of leukocytosis in patients may be used to predict the duration of treatment. Age was an important factor in predicting the duration of clinical improvement in patients.

OBJECTIVE: Cardiovascular disease (CVD) is the most common cause of death in chronic kidney disease (CKD) patients. The prevalence of CVD is significantly increased in CKD patients, and the frequency of CVD increases as the CKD stage worsens. Although atherosclerosis is more common in CKD patients, the lipid profile may change as the CKD stage changes. Many mechanisms cause this. Also, mortality is more common in patients with advanced CKD. In this study, we aim to emphasize the incidence of cardiovascular diseases and dyslipidemia in patients with CKD at different stages and the effect of these variable conditions on patient mortality.
METHODS: Patients who applied to the internal medicine outpatient clinic and were diagnosed with chronic kidney disease were examined. Mortality and complications were followed up for one year. A total of 1323 patients with a diagnosis of CKD between stages 3a-5 were included in the study. The relationships between kidney functions and lipid profiles, biochemical values, and prognosis of the patients were evaluated.
RESULTS: Non-survivors had lower glomerular filtration rate (GFR) and higher C-reactive protein (CRP) levels. High-density lipoprotein (HDL), low-density lipoprotein (LDL), and albumin values decreased, and CRP increased as the disease stage progressed. More survivors had CKD and hyperlipidemia than non-survivors. It was observed that the stage remained the same in patients with hyperlipidemia at a higher rate. In contrast, the stage worsened or remained at stage 5 more in patients with cardiovascular disease or diabetes mellitus. Declining CKD stage and increasing CRP were influential risk factors that affect mortality.
CONCLUSION: It is essential to closely monitor the changes in laboratory parameters at baseline and follow-up in CKD patients to predict or prevent comorbidities, mortality, and deterioration in patients’ renal functions.

OBJECTIVE: The aim of this study is to determine the frequency and clinical features of diagnosed rheumatological disease in patients who have no previous history of rheumatic disease and are consulted to the rheumatology clinic from other departments to investigate the etiology of early-onset ischemic stroke.
METHODS: Patients aged 18-65, who had not previously been diagnosed with rheumatic disease, had ischemic stroke for the first time, and were consulted to rheumatology clinic to investigate the etiology of the disease, were retrospectively included in the study. Demographics, clinic laboratory, imaging data and the final diagnosis of the patients were obtained from hospital records.
RESULTS: A total of 115 patients who had their first ischemic stroke were identified in the study. 70 of them were detected to have young ischemic stroke. Of these patients, 1 was diagnosed with lupus with secondary antiphospholipid syndrome (APS) and Sjögren’s syndrome 1 with lupus and secondary APS, 2 with primary APS, 1 with lupus, 1 with primary Sjögren’s syndrome and 1 with granulomatous with polyangiitis.
CONCLUSION: Determining the correct etiological diagnosis of ischemic stroke, especially in young adults, is important in terms of preventing recurrent ischemic attacks. It is important to raise awareness of clinicians in terms of rheumatic diseases and to refer patients to the rheumatology department if deemed necessary.

OBJECTIVE: Medical students try to cope with challenging emotional experiences caused by stress factors specific to medical education during their education. In this process, students’ cognitive emotion regulation (CER) strategies and psychological resilience (PR) act as protective mechanisms to alleviate the impact of challenging emotions. Therefore, it is important for medical students to use adaptive emotion regulation strategies and demonstrate psychological resilience in the face of challenging emotional experiences. This study aimed to reveal the effects of CER strategies and PR on the emotional well-being (EWB) of medical students and the mediating effect of PR in the relationship between CER strategies and EWB.
METHODS: In this study, Structural Equation Modeling (SEM) was used to determine the mediating effect of PR in the relationship between CER strategies and EWB. The sample of the study consisted of 210 students who were randomly selected from the 1st and 4th year medical students and volunteered to participate in the study. Cognitive Emotion Regulation Scale, Psychological Resilience Scale and Emotional Well-Being Scale, which are the data collection tools of the study, were administered to the participants face-to-face by the researchers. Descriptive statistics and correlations were analyzed with SPSS 26. The SEM was analyzed with Jamovi 2.3.19 SEM module and R 4.1.1 Iavaan package.
RESULTS: 54.8% (n=115) of the participants were 1st-grade and 45.2% (n=95) were 4th-grade students; 54.8% were male and 45.2% were female. The results of SEM analysis showed that the relationship between adaptive CER strategies in the two sub-scales (refocusing on plan; β=0.088, p=0.011 and positive reappraisal; β=0.175, p<0.001) and EWB was found to be mediated by the commitment sub-scale of PR.
CONCLUSION: This study showed that the relationship between positive reappraisal and refocusing on a plan, which are adaptive CER strategies, and EWB was mediated by PR-commitment. These results indicate that CER and PR stand out as concepts that support students’ EWB in medical education.

OBJECTIVE: To assess the health status and functional impairments in patients with axial spondyloarthritis (axSpA) using the Assessment of SpondyloArthritis International Society Health Index (ASAS-HI) and Environmental Factors (ASAS-EF) Index, and to evaluate the correlation of these indices with established clinical parameters.
METHODS: This cross-sectional study included 91 patients diagnosed with axSpA at the Rheumatology Department between November 2017 and July 2018. Participants were evaluated using ASAS-HI, ASAS-EF, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, and Health Assessment Questionnaire (HAQ). Descriptive statistics and correlation analyses were performed to examine relationships between these indices and various clinical and demographic variables.
RESULTS: The study found that 49.5% of patients had a BASDAI score >4, indicating high disease activity. The mean ASAS-HI score was 6.8, reflecting moderate to severe functional impairment in the study population. Significant positive correlations were observed between ASAS-HI and BASFI, BASDAI, spinal pain, and HAQ scores (p<0.05). However, no significant correlations were found between ASAS-HI and ASQoL, disease duration, CRP, or ESR. ASAS-EF was also positively correlated with BASFI, BASDAI, spinal pain, and HAQ scores.
CONCLUSION: The ASAS-HI and ASAS-EF indices effectively evaluate health status and functional impairments in patients with axSpA. The significant correlations with established clinical parameters highlight the indices’ utility in capturing the multifaceted impact of axSpA, emphasizing the importance of comprehensive disease assessment in guiding targeted interventions.

OBJECTIVE: Many patients visit the emergency department with headaches. The most crucial point in patient management is detecting secondary headaches. Accurate history, detailed physical examination, and appropriate neuroimaging are essential for diagnosis. This study aimed to examine the compatibility of neuroimaging findings with the symptoms of patients presenting to the emergency department with non-traumatic headaches.
METHODS: The data regarding the reasons for application, demographic information, accompanying symptoms, and neuroimaging results of patients who visited the green area of Goztepe Prof. Dr. Suleyman Yalcin City Hospital Emergency Medicine Clinic with headache complaints from June 2022 to June 2023 were analyzed.
RESULTS: The study included 4,908 individuals, with 38.33% identifying as male and 61.67% as female. The mean age was 42.34±19.13 years. Additionally, 75.28% of participants experienced issues beyond headaches, while 78.71% had no prior medical diagnoses. High blood pressure was the most reported condition, affecting 6.66% of those studied. Among the patients, 23.68% were advised to undergo a non-contrast CT scan, and 96.78% did not require further imaging.
Thirty-two individuals (0.65%) were found to have underlying conditions that could lead to secondary headaches. Among these, 27 cases (84.37%) showed no additional symptoms (p=0.0001). A total of 99.61% of individuals were discharged from the emergency room. The age distribution did not correlate with the identified pathologies responsible for secondary headaches (p=0.058).
CONCLUSION: Our neuroimaging rates exceeded those found in the literature. Women were more likely to visit the emergency department for headaches. Three out of five patients experienced additional symptoms, predominantly hypertension. Approximately four out of five patients had no previous diagnosis. CT scanning was considered the gold standard for diagnosis. The occurrence of secondary headaches and associated symptoms was low. There was no correlation between increasing age and secondary headaches.

OBJECTIVE: An experience regarding full-thickness rectal biopsies (FTRB) indications and results is presented.
METHODS: The records of patients who underwent FTRB between January 2010 and January 2022 were retrospectively reviewed.
RESULTS: 107 patients were included. There were 66 men (61.6%) and 41 women (38.3%). The median age at biopsy was 15 (1–196) months. FTRB was performed in 81 patients who were unable to pass meconium in the first 48 hours or had intractable constipation. A stoma was performed in 26 patients before the rectal biopsy. Contrast colon radiography was conducted in 61 patients and/or anorectal manometry in 32 patients. Of the biopsies, 74 were full-thickness while 33 were not. Biopsies were repeated in 12 patients. Of the 49 (45%) patients with aganglionic specimens, data about nerve hypertrophy was reported in 37. Among these, 33 had nerve hypertrophy and 4 did not. A definitive surgery was performed in 44 of the 49 patients diagnosed with Hirschsprung disease (HD). Complications were observed in 7 (6.5%) of the patients.
CONCLUSION: HD was histopathologically diagnosed. Biopsies that are not full-thickness can be of value when using immunohistochemistry stains.

OBJECTIVE: Idiopathic urethritis (IU) is among the causes of macroscopic hematuria in children and primarily affects males aged between 5 and 15 years. Common symptoms include dysuria and hematuria. The etiology remains incompletely understood. Untreated IU may progress to urethral stricture in the long term. Conventional treatments like prolonged antibiotic therapy and nonsteroidal anti-inflammatory drugs have limited success. Recent studies suggest favorable outcomes with associated dysfunctional elimination syndrome treatment or steroid instillation. This study aims to present a 13-year retrospective analysis of patients diagnosed with IU via cystourethroscopy, assess long-term outcomes with or without steroid injection and explore the relationship between IU and voiding dysfunction.
METHODS: Patients who underwent cystoscopy due to unexplained hematuria and/or dysuria between 2010 and 2023 were retrospectively screened. Patients diagnosed with IU were included and those who underwent steroid instillation (Group S) or received no steroid treatment (Group NS) evaluated separately. Available uroflowmetry (UFM) results were assessed.
RESULTS: Thirty male patients were diagnosed with IU, with a mean age of 11.1 (2–17) years and mean symptom duration of 9.3 (0.1–36.5) months. Steroid instillation was performed in 21 patients (Group S), yielding a 57% recovery rate. In Group NS, symptoms resolved without treatment in 66% of patients. UFM results showed obstructive patterns in patients with urethral strictures.
CONCLUSION: Cystourethroscopy allows for accurate diagnosis of IU and targeted intervention. In our series, the promising steroid instillation therapy did not significantly alter long-term symptom-free survival compared to observation alone. Further research is warranted to elucidate IU’s pathogenesis and establish standardized treatment approaches.

(NCI-2023-8-12)