Objective: Laparoscopic techniques have emerged as the preferred approach over traditional open surgery for the treatment of adrenal gland disorders. Right laparoscopic adrenalectomy (RLA) typically requires liver retraction for exposure, and various retractors can be used for this purpose. While studies have been conducted on liver injury during liver retraction in upper abdominal surgeries, no research has specifically addressed liver damage during laparoscopic adrenalectomy (LA). This study aims to evaluate the impact of two retractors used for liver retraction during RLA on liver function test results (LFTs) and their clinical significance.
Methods: This retrospective study included 87 LA patients who underwent surgery for adrenal gland pathology at our institution between 01/01/2010 and 04/30/2024. The patients were divided into two groups: RLA (n=42) and left LA (LLA) (n=45). The RLA patients were further categorized into two subgroups based on the retractor used: 5-blade retractor (FB) (n=22) and full ring retractor (GF) (n=20). Clinicopathological findings, operative outcomes, and laboratory test results were compared across groups.
Results: Postoperative levels of aspartate aminotransferase (AST), alanine aminotransferase, and alkaline phosphatase were significantly higher in the RLA groups (FB and GF) compared to the LLA group (p<0.001, p<0.001, p=0.001, respectively). Although no statistically significant difference was observed between groups, the median length of stay (LOS) was slightly shorter in the FB group (2 (2-3), p=0.058). There were no significant differences between FB and GF groups in terms of operation time, LFTs, complications, or mortality. Correlation analysis showed a statistically significant positive correlation between postoperative AST levels and lesion size (rho=0.31, p=0.045). Additionally, patients with functional adrenal pathologies had a significantly longer hospital stay compared to those with nonfunctional pathologies (2 (2-2.25) vs. 3 (2-3.5), p<0.001).
Conclusion: In RLA procedures, the LFT values were higher compared to LLA procedures. The effects of FB and GF retractors on surgical outcomes and LFT values were similar, indicating both retractors can be safely used during RLA surgeries. While no clinical impact was detected, caution is advised regarding potential liver injury during RLA procedures.

Introduction: Inflammatory bowel diseases (IBD) are lifelong conditions that exhibit periods of remission and exacerbation. In addition to gastrointestinal manifestations, they can also cause growth retardation and disorders of puberty in children [1]. The objective of this study was to evaluate the effects of the disease and the treatment regimens on growth and puberty in children and adolescents with IBD.
Materials and Methods: A retrospective screening of patients aged 2 to 18 years with a minimum of six months of follow-up due to inflammatory bowel disease (IBD) between January 2016 and April 2022 was conducted. The growth parameters were compared between disease groups, gender groups, disease activity and level of inflammation groups, and treatment regimen groups. The effects of treatment protocols on growth were evaluated by comparing the data before and after treatment, and the pubertal status of patients was evaluated by comparing them with healthy children.
Results: A total of 58 patients were evaluated, comprising 29 individuals with Crohn's Disease (CD) and 29 with ulcerative colitis (UC). The growth and pubertal development of patients at the time of diagnosis did not differ based on gender or the specific disease type. A negative deviation from the target height was observed to be more prevalent in patients with Crohn's disease. Following treatment, patients exhibited a significant improvement in weight and BMI SDS, although no significant change in height SDS was observed. In comparison to healthy Turkish children, the patients exhibited a delayed pubertal progression, despite the normal onset of puberty.
Conclusion: Children and adolescents with IBD exhibited no significant adverse effects on linear growth at diagnosis or during the follow-up period, regardless of the primary disease and the treatment protocols. This was likely due to their timely diagnosis and successful treatment. It is important to monitor puberty, as it may progress more slowly or even cease in these patients compared to healthy children.(NCI-2024-2-6/R1)

Objectives: This study examines how demographic factors and disease conditions affect B-cell depletion and regeneration after Rituximab (RTX) infusion in pediatric patients with rheumatic conditions.
Methods: We retrospectively reviewed 27 patients approved by the Institutional Review Board, all of whom received at least one RTX infusion, analyzing 99 lymphocyte subunits. Inclusion: patients under 18 at their first RTX infusion, diagnosed with pediatric rheumatologist-confirmed autoimmune diseases. B-cell depletion was defined as a CD19 positive B Cells (CD19+) count below 10 cells/μL, assessed at 6- and 12-months post-RTX infusion. Complete regeneration was defined as CD19+ ≥170 cells/μL using adolescent norms.
Results: Most patients had connective tissue disorders (CTD); Systemic Lupus Erythematosus, Sjögren's Disease, Systemic Sclerosis; n=17; 63%), followed by vasculitis (n=5; 18.5%), juvenile dermatomyositis (n=4; 14.8%), and miscellaneous conditions (n=1; 3.7%). Among patients with CTD, 4 out of 12 (33%) had B-cell depletion at 6 months. At 12 months, 3 out of 6 (50%) achieved CD19+ counts ≥10 cells/μL, while 5 out of 6 (83%) did not reach normal levels of CD19+ (≥170 cells/μL). No significant correlation existed between immunosuppressants (mycophenolate mofetil, methotrexate, azathioprine, cyclosporine, cyclophosphamide) and CD19+≥10 cells/μL at 6 or 12 months. However, hydroxychloroquine significantly differed for persistent depletion at 12 months.
Conclusion: This study demonstrates that demographic factors and disease conditions influence B-cell depletion and regeneration in pediatric patients treated with RTX for rheumatic conditions. The findings highlight the variability in response to RTX and suggest that factors such as hydroxychloroquine use may impact long-term B-cell levels.(NCI-2025-3-8/R1)

Objective: Biofeedback electromyography (EMG) involves the transmission of pelvic and abdominal muscle activity to the patient via visual and sometimes auditory feedback, with the ultimate goal of learning to contract and relax the pelvic muscles at the appropriate times through real-time analysis and feedback. To determine the optimal number of biofeedback therapy sessions required for a therapeutic response in the treatment functional voiding dysfunction.
Methods: The retrospective data of 779 patients who underwent biofeedback therapy at a tertiary pediatric hospital between 2017 and 2023 were analyzed. The study included patients referred for urinary symptoms and uroflow/EMG findings who did not respond to standard urotherapy and behavioral therapy and completed at least 8 biofeedback sessions. During treatment, methods such as EMG biofeedback, pelvic muscle training, and keeping symptom diaries were utilized. Statistical analyses were performed using the Mann-Whitney U test and Chi-square test.
Results: Of the patients, 62.4% were female, 37.6% were male, and the mean age was 9.05±3.05 years. The most common urinary symptoms were daytime urinary incontinence (59.4%) and nocturnal enuresis (54%). The average number of sessions required for a therapeutic response was 6±1.3. Female patients showed an earlier response to treatment compared to males (p<0.01). Younger patients demonstrated faster recovery and better response to therapy (p<0.05). Patients who did not respond to therapy had a higher mean age and required more sessions (p<0.05). The higher mean number of sessions in non-responders compared to responders was found to be statistically significant (p=0.001; p<0.05)

Conclusýon: Biofeedback is an effective and non-invasive treatment method for children with functional voiding dysfunction. Most patients show symptomatic improvement within 1.5–2 months (2-8 sessions - average 6). Male patients may require longer treatment durations, while younger children respond better to therapy. Future studies focusing on factors influencing biofeedback success may contribute to optimizing this treatment.

Objective: A combination of local anesthetic treatments provides better pain alleviation than periprostatic nerve block (PPNB) alone during a prostate biopsy procedure. The primary objective of this study was to compare Visual Analog Scale (VAS) pain levels during transrectal ultrasound (TRUS)- guided prostate biopsy whilst the use of prilocaine-lidocaine cream, diclofenac suppository, or PPNB only in a prospective, randomized study.
Methods: This study included 162 patients who had TRUS-guided prostate biopsies performed at the XXX Center within a 6 month period, from April to October 2017. Three groups of patients were randomly assigned: group 1 underwent PPNB plus prilocaine-lidocaine cream, group 2 received diclofenac suppository along with PPNB, and group 3 underwent PPNB alone. The VAS was used to measure the degree of pain: VAS 1 was used to record the pain at the time the ultrasound probe was inserted, VAS 2 was used to document the pain during PPNB, and VAS 3 was used to record the pain during needle biopsy. Following the biopsy, any complications or negative consequences were recorded.
Results: Mean age or serum prostate specific antigen (PSA) levels were similar between the three groups. The VAS 1, VAS 2, and VAS 3 pain scores showed statistically significant difference among the three groups (p=0.001). Between groups 1 and 2, there was a statistically significant difference in VAS 1 pain scores (p=0.01). There was no statistically difference in VAS 2 and VAS 3 pain scores between the groups 1 and 2 (p=0.08 and p=0.23, respectively). Patients between the groups 3 and other groups had significantly difference in VAS pain scores (p<0.05).
Conclusion: In this study, we highlight that when applied as an adjuvant to PPNB, either 5% prilocaine-lidocaine cream or a 100 mg diclofenac suppository reduced pain levels relative to PPNB alone. When compared to a 100 mg diclofenac suppository, prilocaine-lidocaine cream significantly reduces pain during the insertion and manipulation of the ultrasound probe.(NCI-2024-4-6)

Objective: Acute Scrotum (AS) is defined as pain associated with swelling and redness of the scrotum. This study investigates the hemogram and C-Reactive Protein (CRP) values obtained from patients diagnosed with AS, based on the hypothesis that blood parameters can be used as biomarkers in the diagnosis of Testicular Torsion (TT). The aim was to evaluate the predictability of these parameters in diagnosing AS in both pediatric and adult age groups.
Methods: Demographic data and blood parameters including Hemoglobin (Hb), Platelet (PLT), CRP, and White Blood Cell (WBC) levels of patients who presented to our Emergency Department with the diagnosis of AS (TT, epididymitis, varicocele) and received medical and surgical treatment were analyzed. The importance of these parameters in diagnosis was assessed.
Results: A total of 26 patients were included in the study. The mean age of the cases was 15.8 ± 3.6 years. 20 of the patients (76.9%) were in the pediatric age group, while 6 (23.1%) were in the adult age group. 93.1% (27) of the cases were unilateral, while 6.9% (2) had bilateral acute scrotum symptoms. The highest incidence of cases occurred in spring with 9 cases (31%), followed by winter and summer with 7 cases each (24.1%), and autumn with 6 cases (20.7%). Significant differences in age, platelet, and hemoglobin levels were observed between the pediatric and adult age groups.
Conclusion: In conclusion, this study highlights significant age-related differences in the diagnosis and treatment of AS. The higher requirement for surgical intervention in pediatric patients further emphasizes the importance of early diagnosis and timely intervention. However, further studies with larger sample sizes are needed to validate these findings and better understand the etiological differences. Additionally, a more specific analysis of blood parameters in subgroups (such as epididymitis, orchitis, TT) under the term "acute scrotum" may contribute to the literature.

Objective: Febrile neutropenia is a critical condition in patients with malignancy, requiring oral and/or parenteral antibiotic treatment; and a significant cause of mortality and morbidity. It is well known that nutritional status is excessively impaired in these patients due to underlying disease itself along with the chemotherapeutics used. In this study we investigated nutritional status and general characteristics of patients admitted to our internal medicine clinic with febrile neutropenia.
Methods: Thirty patients who were followed up in the internal medicine service were included in the study. For the analysis of the data of the patients, height, weight, body mass index (BMI), weight loss in the last three months, albümin and total iron binding capacity values were recorded. Hand grip strength, mid-upper arm and mid-calf circumference measurements were obtained for the assessment of muscle strength; Mini Nutritional Assessment (MNA) and Nutrition Risk Screening 2002 (NRS 2002) scores were calculated at admission and discharge to evaluate nutritional status. Multinational Association of Supportive Care in Cancer (MASCC) score was used to identify risk and manage treatment.
Results: We included thirty patients (mean age 58,27± 16.52 years, 53% females). Of 30, six patients had lung cancer, four patients had myelodysplastic syndrome, three patients had stomach cancer, two patients had gastrointestinal system lymphoma, two patients had colon cancer, two patients had breast cancer, two patients had Non-Hodgkin`s lymphoma.
Conclusion: Majority of the patients, admitted to our internal medicine clinic, with febrile neutropenia were found to be malnourished; regardless of their risk classifications. Nutritional assessment scores of the majority were in the low-risk group. In conclusion, patients hospitalized with febrile neutropenia had poor nutritional status.(NCI-2024-2-13/R1)

Objective: TFE3 rearranged carcinomas constitute 5% of malignant tumors of the kidney in adults. TFE3 immunohistochemistry plays a crucial role in the diagnosis. TFE3 positivity in the appropriate histological context supports the diagnosis of Xp11 translocation renal cell carcinomas. However, there isn’t any standardized approach to performing and interpreting immunohistochemical staining.
Methods: A total of 51 renal cell carcinomas are included in the study. In this study, we compared the expression profiles of two different anti-TFE3 antibody clones (MRQ37, Cell Marque, and IHC627, GeneAbTM) on renal cell carcinoma samples that have conflicting morphologies and assessed the overall performance of these clones to identify TFE3 rearranged carcinomas.
Results: There was a statistically significant difference in terms of immunohistochemical staining with TFE3-MRQ37 clone between TFE3 rearranged renal cell carcinomas and other subtypes, while no significant difference was found in staining with TFE3-IHC672. 47% of cases were stained with the TFE3-IHC672 clone and 9.8 % of cases were stained with the TFE3-MRQ37 clone at different staining intensities and proportions.
Conclusion: The TFE3-MRQ37 clone is easier to interpret because of the absence of background staining and is more reliable in identifying TFE3 rearranged renal cell carcinomas. However, because of various sensitivity and specificity rates, and immunoreactivity in many subtypes of renal cell carcinomas, there is a need for a standardized approach for TFE3 immunohistochemistry for diagnostic use in TFE3-tRCCs.(NCI-2024-4-2/R1)

Objective: We aimed to evaluate the feasibility of a mini-laparoscopic surgical approach versus standard laparoscopy.
Methods: 75 patients with endometrial cancer treated by mini-laparoscopic (n=25) or conventional laparoscopic surgery (n=50) at a tertiary-care university-based teaching hospital and academic affiliated private hospital were included.
Results: There was no significant difference between the mini-laparoscopy and the conventional laparoscopy group regarding surgical procedures. The mean operation time and the median estimated blood loss were similar (p=0.671 and p=0.158, respectively). No difference was found in terms of the number of lymph nodes removed. No intraoperative complications were observed in both groups. Return to daily routine and the rate of additional analgesia requirement were similar in the groups. The mean duration of hospitalization was 3.6±1.2 days in the mini-laparoscopy group and 4.9±3.6 days in the conventional laparoscopy group (p=0.025).
Conclusion: We demonstrated that mini-laparoscopic staging could be a competent technique performed regardless of harm by talented surgeons using state-of-the-art instruments. Mini-laparoscopic surgery appears to be a further possibility to minimize surgical trauma by reducing the size of the ports without decreasing the extent and effectiveness of the procedures. (NCI-2024-1-17/R1)

Objective: In this study, the possible role of dardarin and spexin in the protective effect of hydroxytyrosol (HT) against corn syrup-induced renal injury in rats was investigated.
Method: Rats were categorized into four groups (n=6) as control, HT, corn syrup, and corn syrup+HT. Over 6 weeks, rats were administered water infused with 30% corn syrup, 4 ml/kg/day solution containing HT was administered, both independently and in conjunction with corn syrup, throughout the 6 weeks. The molecular parameters of dardarin and spexin in the renal tissue were assessed through histopathological examination. Biochemical parameters were also examined with the ELISA Method.
Result: In this study, it was observed that the dardarin and spexin levels increased in the control group as a result of the administration of corn syrup. After HT treatment, it was observed that the dardarin and spexin levels decreased. The increase in glucose, amylase, and lipase levels because of corn syrup consumption decreased with hydroxytyrosol consumption. The increase in erythrocyte extravasation, exudate accumulation, and fibrosis in kidney tissue observed as a result of corn syrup decreased as a result of HT administration.
Conclusion: It is thought that the protective effect of HT against damage to the renal due to corn syrup consumption may be mediated by dardarin and spexin.

Ado-trastuzumab emtansine (T-DM1) is a key treatment for HER2-positive metastatic breast cancer (HER2+ MBC), yet the influence of progression sites and therapy lines on outcomes remains unclear.To assess the relationship between progression sites and the line of T-DM1 therapy with survival outcomes in HER2+ MBC.

Objective: Congenital myasthenic syndromes (CMS) represent a group of genetically heterogenous disorders characterized by defective signal transmission at the neuromuscular junction. Although global prevalence of CMS remains uncertain, regional studies have reported varying prevalence rates. This study aimed to define the incidence and prevalence of CMS in Turkiye utilizing data from the national electronic health registry. Additionally, the rate of pyridostigmine prescriptions among patients with CMS was assessed.
Methods: The study was a retrospective national cohort study, and patients with at least three G70.2 ICD-10 code entries between between 1 January 2015 and 22 May 2024 were included. While calculating incidence and prevalence rates official census data from the Turkish Statistical Institute were used.
Results: A total of 406 patients were included in the study, with females comprising 48.8% of the cohort. The mean age at diagnosis was 20.59±21.65 years (median: 12.00, min-max: 0-86). Among the cohort, 58.6% were diagnosed before the age of 18, and 12.3% before the age of one. Pyridostigmine was prescribed at least once to 68.2% of the patients. The annual incidence of CMS ranged from 0.28 to 0.59 per million between 2016 and 2023. In 2023, the incidence and prevalence rates of CMS were calculated as 0.63 and 4.49 per million, respectively.
Conclusion: This study represents the first comprehensive nationwide epidemiological analysis of CMS in Turkiye utilizing national electronic health registry. The study enhances the understanding of the epidemiological landscape of CMS in the country by reporting the current incidence, prevalence, and pyridostigmine prescription rates and underscores the significance of this rare but impactful neuromuscular disorder.

Purpose: Parvovirus B19 is a very common infection, especially in school-age children, with its rapid spread. In the present study, Parvovirus B19 infection was detected in frequently ill nursery children. The present study aimed to determine the seroprevalence value, to determine whether there is an active infection and to determine to what extent it affects the relevant immune system parameters, to determine whether the obtained data will contribute to the epidemiology of childhood Parvovirus B19 infections in our country and also, to determine whether it is a reason for children to become ill frequently.
Method: Parvovirus B19 DNA test results of 112 children aged 2-6 years who were grouped as frequently ill and infrequently ill and who went to nursery and kindergarten were examined quantitatively with the Real-Time PCR Method. Parvovirus B19 IgG and Parvovirus B19 IgM antibody presence was investigated with the ELISA Method. Flow Lymphocyte subgroups were analyzed with the Cytometry Method.
Results: Among the 112 patients who were included in the study, 105 (93.7%) Parvovirus B19 DNA results were negative and 7 (6.3%) were positive. Parvovirus B19 IgG test results were negative in 108 (96.4%) patients and positive in 4 (3.6%). When the Parvovirus B19 IgM results were evaluated, 109 (97.3%) were determined as negative and 3 (2.7%) positive.
Natural Killer Cells (NK) from patients with positive Parvovirus B19 DNA, Parvovirus B19 IgG, and IgM were detected outside the normal limit value ranges in CD25, CD19, HLA DR, CD3, CD45RO, and CD8 values.
Conclusion: No significant relationships were detected between frequent illness and Parvovirus B19 infection, the infection did not significantly affect the immunodeficiency parameters, and although it is already known that Parvovirus B19 infection peaks every 3-4 years, the study did not coincide with this period of Parvovirus B19 infection.(NCI-2024-12-10)

Objective: Chronic spontaneous urticaria is characterized by recurrent hives and/or angioedema that persists for more than six weeks, with unknown triggers. This study aimed to gather and analyze real-world data from adult patients diagnosed with chronic spontaneous urticaria who were receiving omalizumab treatment.
Methods: This retrospective observational study included adults who received omalizumab between September 2022 and February 2024.
Results: A total of 64 patients were included in the study, with a mean age of 44.3 years. Among them, 40 (62.5%) were female, and 24 (37.5%) were male. The mean duration of urticaria diagnosis was 46.6 months, with a mean omalizumab use of 23.6 months. Prior to omalizumab treatment, second-generation antihistamines (sgAHs) were the most commonly used treatment at the highest dose (60.9%) and oral steroid combination therapy (31.3%). All patients received omalizumab 300 mg once every four weeks from the start of treatment and continued using antihistamines. No significant correlation was observed between the antihistamine dosage and treatment response (p=0.06). An observed interval extension and/or dose increase was noted in 23.4% of the patients. The mean Urticaria Control Test (UCT) score, weekly Urticaria Activity Score (UAS7), and Dermatology Life Quality Index (DLQI) scores significantly improved from the first visit before omalizumab treatment to the last visit after treatment (all p<0.001). Of the patients, 98.4% responded moderately to treatment, 26.6% responded thoroughly, and 46.9% responded well. Only three patients (3.1%) experienced myalgia as a side effect of omalizumab therapy, with no severe adverse events reported.
Conclusion: Combination therapy with antihistamine and omalizumab is a reliable and beneficial therapy for managing chronic spontaneous urticaria.

Objective: The aim of this study is to radiologically compare area and volume changes in the costoclavicular region with the unaffected side in patients treated nonoperatively after unilateral midshaft clavicle fracture and to evaluate functional outcomes.
Methods: This study included 16 patients (14 males, 2 females) with midshaft clavicle fractures who were admitted between 2017-2018 and union was achieved with conservative methods. Magnetic resonance imaging (MRI) of the shoulder including the costoclavicular region was performed after union. Area and volume calculations of the fractured and unaffected costoclavicular region of the patients were performed on the standard MR sections under the guidance of a specialist radiologist. The Short Version of Disabilities of the Arm, Shoulder and Hand (QDASH) score was used for functional assessment. Range of motion was measured on the affected and unaffected sides at the last follow-up visit.
Results: The mean age of the patients was 30.4 ± 20.8 years (5-69) and the mean follow-up was 8.3 ± 1.3 (6-10) months. The mean shortening was 14.3 mm ± 8.2 (3-29). The area measurements of the costoclavicular region were divided into 3 levels in axillary section: acromioclavicular joint, mid 1/3 of the clavicle, and sternoclavicular joint level. The median area measurements were 1115 (364-3675) mm2, 1495 (365-4199) mm2, and 1201 (197-3812) mm2 on the unaffected side and 895.5 (351-3670) mm2, 1098.5 (340-3191) mm2, and 1037.5 (166-3237) mm2 on the fractured side, respectively (p=0.905, p=0.491, p=0.888). In volume measurements, the median volumes of the unaffected side and the fractured side were 34.3 (10.7-69.7) mm3 and 28.9 (8.1-60.9) mm3, respectively (p=0.268). No significant difference was found in the statistical analysis of area and volume measurements. At the end of the follow-up period, the QDASH score and functional outcome of the patients were good.
Conclusion: Conservative treatment of midshaft clavicle fractures did not result in significant area and volume changes in the costoclavicular region. The inability to clinically demonstrate the theoretical expectation of decreased area and volume on the fractured site suggests that other biomechanical factors are involved in the healing process of the human body.(NCI-2024-3-13)

Objectives: Dual-phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has demonstrated superiority over conventional imaging methods in various clinical conditions. However, its efficacy in detecting metastases from colorectal cancer is uncertain. We aim to reveal whether dual-phase FDG-PET/CT can be superior in detecting metastases compared to the standard PET-CT study in patients with an established diagnosis of colorectal cancer.
Methods: This is a single-center, retrospective case-control study involving 35 patients with colorectal cancer who underwent whole-body FDG PET-CT imaging. Late-phase FDG-PET-CT images were obtained 1-2 hours after the standard technique, emphasizing the identification of new lesions or clarified lesions.
Results: Among the 35 patients evaluated, 5 (14.3%) exhibited new cancer lesions, while 6 (17.1%) demonstrated more evident cancer regions at late-phase FDG-PET-CT. New lesions or more evident cancer regions with the dual-phase technique were described within the liver, in regional lymph nodes, and in peritumoral regions.
Conclusions: The study findings suggest that dual-phase FDG-PET-CT can reveal new and more evident metastatic lesions in a subset of colorectal cancer patients. This technique, precious in identifying liver metastases and lymph nodes, enhances the accuracy of colorectal cancer diagnosis and staging.(NCI-2024-1-14/R1)

Objective: Tracheal intubation out-of-operation theatre has a higher risk than intubation inside the theatre, and studies on this topic are sparse. Safety interventions during tracheal intubation can reduce adverse events. This study aims to assess current practices, compliance with tracheal intubation bundle guidelines, and the incidence of adverse events during out-of-operating-theatre intubations in our hospital.
Methods: A prospective observational study was conducted over a 6-month period on all tracheal intubations occurring outside the operating theatre. Data were collected through discussions with the anaesthesia duty team and review of hospital records, using a standardized proforma based on intubation bundle guidelines and adverse events. The variables were summarized using counts and percentages.
Results: Thirty-two patients required out-of-operating-theatre tracheal intubation, with the most common indication being respiratory failure in 13 (40.6%) cases. Airway assessment was performed in 21 (65.6%) cases, and nil per oral status was confirmed in 26 (81.3%) cases. Role planning by the team leader occurred in 27 (84.4%) cases. Fluid loading was administered in 24 (75%) cases, Ryle’s tube aspiration in 29 (90.6%) cases, and pre-oxygenation in 30 (93.8%) cases. Rapid sequence induction was used in 26 (81.3%) cases, with first-attempt endotracheal tube placement in 22 (68.8%) cases, aided by a stylet in 21 (65.6%) cases. Capnography was not used in 29 (90.6%) cases to confirm intubation. Alternative airway securing methods (supraglottic airway) were present in 29 (90.6%) cases. Overall, 13 patients (40.6%) experienced adverse events during tracheal intubation.
Conclusion: Adverse airway events can be decreased by adhering to the intubation bundle, and staff training should be provided for effective implementation of guidelines. The use of a stylet as an intubation aid helps achieve successful first-attempt intubation and should be incorporated into the bundle. Capnography should be routinely used to confirm endotracheal tube placement.(NCI-2024-1-25/R1)

Objective: Metformin, which is commonly recommended drug for managing type II diabetes, has been reported to have anti-cancer properties and may improve the prognosis of some malignancies. Epidemiology studies have shown improved survival in cancer patients using metformin. However, the mechanism behind this phenomenon remains incompletely understood. In our study, Our objective was to investigate how metformin influences the proliferation and apoptosis of hepatocellular carcinoma cells induced with steatosis via palmitic acid and oleic acid.
Methods: We established an in vitro cellular model of non-alcoholic fatty liver disease by inducing lipid accumulation in HepG2 cells through the use of oleic acid and palmitic acid. Oil Red O staining was conducted to observe the distribution of intracellular lipid droplets. Cell proliferation were detected using the BrdU cell proliferation detection kit. Protein expressions were detected by western blot method techniques.
Results: We found that metformin reduced cell proliferation in palmitic acid and oleic acid-induced HepG2 cells compared to the control group. Moreover, our western blot data show that metformin treatment changes apoptosis.
Conclusion: Our results show that metformin inhibits cell viability of steatosis HepG2 cells. These findings may be preliminary for new studies in steatosis HepG2 cells and may provide new therapeutic targets or treatment strategies against hepatocellular carcinoma.

Aim: In this study, we aimed to examine the thirty-year effectiveness and trend of research on refugee mental health.
Methods: A bibliometric analysis methodology was used. Web of Science (WOS) database was used to obtain the necessary data. In particular, a review and analysis encompassed the quantity of publications featuring articles on refugee mental health, the most prolific countries and institutions, the highly cited articles, citation patterns, international collaboration, and the relevant journals. The study's timeframe was defined from 1992 to 2022.
Results: The number of documents obtained is 3912. The majority of the documents obtained were in the field of psychiatry. The quantity of publications and citations experienced a notable upsurge, particularly following the year 2016. The United States emerged as the leading country in terms of both the highest number of publications and citations on this subject. The institutions with the highest publication rates are, in order, the University of New South Wales in Australia, the University of Melbourne in Australia, and McGill University in Canada. This bibliometric study shows that publications on refugee mental health have been observed since 1992 and are gaining momentum, especially after 2016. In addition to the terms "refugees" and " mental health," the keywords "depression," " Post-traumatic stress disorder (PTSD)," and "children" were most commonly used.
Conclusion: Refugee communities also appear to have similar mental illnesses and experiences regardless of where and when they settled in the world. Research collaboration and networks should be encouraged to prioritize research in refugee mental health.(NCI-2024-1-17/R1)

Heavy metals exposure might be linked to rheumatic diseases and has been studied in a few articles. The aim of this article is to review the studies that evaluated metal toxicity in rheumatological diseases. A systematic search of PubMed, Embase, and Scielo databases was performed, looking for articles on toxic metals and rheumatic diseases published between 1966 and March 2023. A total of 31 studies (1,559 RA and 4,308 patients with other rheumatic diseases) were included. Most patients were females, ranging from 4 to 62 years old. Although most studies showed higher concentrations of toxic metals in rheumatic diseases, a few showed a positive association with disease activity or severity of the conditions. This systematic review reveals the presence of toxic metals in patients with rheumatic disease. Screening for toxic metals may be elucidative in selected cases. NCI-2024-1-16/R1