SUMMARY OBJECTIVE: Calorie restriction and exercise are commonly used first interventions to prevent the progression of prediabetes and alleviate the symptoms of type 2 diabetes. Our study was designed to determine the effect of the energy deficit caused by long-term (12-week) calorie restriction and exercise programs on appetite responses in obese individuals with prediabetes and type 2 diabetes. METHODS: Calorie restriction and exercise programs appropriate for age, gender, and work environment were applied to 22 individuals with prediabetes and 22 with type 2 diabetes participating in the study for a period of 12 weeks. Ghrelin, glucagon-like peptide-1, and peptide tyrosine tyrosine values of samples taken before and after treatment were determined by the enzyme-linked ιmmunosorbent assay method. RESULTS: Appetite hormone levels did not change after calorie restriction and exercise in the prediabetes group (p>0.05). In the diabetes group, calorie restriction and exercise significantly increased ghrelin and peptide tyrosine tyrosine concentrations (p<0.005). Additionally, when all patients were evaluated together, ghrelin, glucagon-like peptide-1 and peptide tyrosine tyrosine levels differed significantly after the intervention (p<0.005). CONCLUSION: The energy deficit created by long-term calorie restriction and exercise did not modulate the appetite hormones in prediabetic and obese individuals. However, increased ghrelin and peptide tyrosine tyrosine levels in individuals with diabetes support that the same treatment program is an effective method to regulate appetite hormones.

SUMMARY OBJECTIVE: Coronary artery bypass graft surgery is one of the most frequently performed surgeries worldwide. Coronary artery bypass graft surgery induces an inflammatory response. Interleukin-8 is a pro-inflammatory cytokine that plays a role in the pathogenesis of cardiovascular diseases. C1q/TNF-related protein-12 is implicated in mitigating inflammation and cardiomyocyte damage. This study aimed to compare interleukin-8 and C1q/TNF-related protein-12 levels before and 45 days after coronary artery bypass graft surgery. METHODS: A total of 43 patients who underwent coronary artery bypass graft surgery were studied. Serum concentrations of interleukin-8 and C1q/TNF-related protein-12 were evaluated using the enzyme-linked immunosorbent assay method before and 45 days after the surgery. RESULTS: No significant differences were observed in interleukin-8 levels between pre- and post-coronary artery bypass graft surgery (p=0.077). However, serum levels of C1q/TNF-related protein-12 were found to be lower 45 days after coronary artery bypass graft surgery compared to pre-surgery levels (p<0.001). Moreover, changes in C1q/TNF-related protein-12 were not associated with diabetes, hypertension, and body mass index (p>0.05), but C1q/TNF-related protein-12 alterations were found to be associated with opium addiction. CONCLUSION: These findings suggest that the evaluation of C1q/TNF-related protein-12 can be beneficial for the late assessment of post-coronary artery bypass graft surgery inflammation. The reduction of C1q/TNF-related protein-12 levels might indicate increased levels of inflammation after surgery at this time point, which requires the assessment of further inflammatory factors to confirm this finding.

SUMMARY OBJECTIVE: This study aims to examine whether the presence of mutation exists in the vitamin D-connector protein gene rs7041 variant of the pancreatitis table for patients diagnosed with coronavirus disease 2019. METHODS: A total of 113 patients with normal pancreatic enzyme levels diagnosed with coronavirus disease 2019 and 120 patients with both coronavirus disease 2019 diagnosis and high pancreatic enzyme levels were included in the study. The rs7041 genotyping of the 11th single nucleotide variation in the vitamin D-connector protein gene was determined by polymerase chain reaction and restriction fragment length polymorphism methods. RESULTS: In the patient group with coronavirus disease 2019 diagnosis and high pancreatic enzyme levels, the vitamin D-connector protein gene rs7041 variance GG genotype ratio was determined to be higher than the normal coronavirus disease 2019 patients. As a result of comparisons between the two groups, the difference between the genotype ratios in the relationship was determined to be statistically significant (p=0.004). CONCLUSION: Coronavirus disease 2019 patients were determined that the rs7041 halves in the vitamin D-connector protein gene could be prone to pancreatitis formation. Different populations and work with more patient groups are needed to verify the results of the study.

SUMMARY OBJECTIVE: The aim of this study was to investigate the effect of music-supported acceptance and commitment therapy on perceived stress and pain levels in cancer patients. METHODS: A total of 79 cancer patients participated in this controlled, pre-test/post-test quasi-experimental study (experimental group: n=29; control group: n=50). The intervention group received eight sessions of acceptance and commitment therapy with music, while the control group received standard care. Data were collected using the Perceived Stress Scale and the West Haven-Yale Multidimensional Pain Inventory. RESULTS: The post-test Perceived Stress Scale scores of the experimental group were statistically significantly lower compared to the control group (26.17±3.52 vs. 28.88±5.73, p<0.05), indicating a reduction in perceived stress. Additionally, there was a statistically significant difference in pain severity scores between the groups (9.62±2.33 in the experimental group vs. 8.06±3.14 in the control group, p<0.05). The effect size for stress reduction was moderate (Cohen's d=-0.54). CONCLUSION: This study revealed that a music-supported acceptance and commitment therapy reduced perceived stress, pain severity, and pain interference in cancer patients. Nurses should actively involve non-pharmacological methods in pain and stress management planning in collaboration with patients and their families. They should create a therapeutic environment and take necessary measures to enable patients to benefit from non-pharmacological interventions.

SUMMARY OBJECTIVE: Several studies have been conducted to determine handgrip strength cutoffs that can identify people living with frailty. However, the handgrip strength cutoff value, which can detect individuals living with frailty based on the Clinical Frailty Scale, has not been determined before. The aim of this study was to investigate the capacity of handgrip strength to detect individuals living with frailty by using Clinical Frailty Scale as a reference scale. METHODS: This retrospective study was carried out by including patients who applied to the geriatric outpatient clinic of a university hospital. A comprehensive geriatric assessment was performed on all patients. Level 4 and above were considered as living with frailty according to Clinical Frailty Scale. Receiver operating characteristic curve analysis was performed to determine the handgrip strength cutoff values for predicting individuals living with frailty. RESULTS: The median age of 742 patients included in this study was 72.0 years (25p-75p: 68.0-77.0), of which 59.3% (n=440) were female and 49.3% (n=366) were living with frailty. The median Clinical Frailty Scale level was 3.0 (25p-75p: 3.0-4.0). According to the results of binary logistic regression analysis, age, sex, and handgrip strength displayed a statistically significant relationship with frailty (p<0001, p=0.001, and p<0.001, respectively). As a result of the receiver operating characteristic analysis performed to determine the handgrip strength cutoff values that predict frailty, cutoff values of 16 kg for females and 26.7 kg for males were identified. The area under the curve values for females and males were 0.679 (p<0.001) and 0.790 (p<0.001), respectively. CONCLUSION: Handgrip strength can be used alone as a predictor to identify individuals living with frailty.

SUMMARY OBJECTIVE: Isthmocele or cesarean scar defect is a pouch-like defect in the myometrium at the isthmic level that is thought that it might occur as a result of the insufficient healing process of the uterine incision after cesarean section. It is important not to underestimate isthmocele and its preventive measures since it might cause serious gynecologic and obstetric complications. However, the best suturing technique suitable for the prevention of isthmocele formation is yet to be identified. The aim of this study was to compare the effects of three different uterine closure techniques applied during cesarean section on isthmocele formation. METHODS: In this prospective study, a total of 120 term (>37 weeks) pregnant women with no history of cesarean section and scheduled for primary cesarean section were randomized preoperatively to three different uterotomy closure techniques (baseball, single-locked, and single-unlocked groups). RESULTS: In a total of 43 patients, postoperative third-month sonography revealed isthmocele as an anechoic triangular area with ≥1 mm depth at the scar site. Compared with the single-locked and single-unlocked groups, isthmocele development was significantly lower in the baseball-type closure group (47.5% in the single-locked, 46.2% in the single-unlocked, and 15.4% in the baseball-type closure group). The group with the highest residual myometrial thickness, that is, 5.7 mm, was again the patients who underwent baseball sutures. CONCLUSION: Uterotomy closure with baseball-type suturing seems to be an advantageous method as compared to the traditional techniques in terms of preserving the residual myometrial thickness and preventing isthmocele formation.

SUMMARY OBJECTIVE: Bone mineral density is affected by many gene regions. Osteoporosis is a disease that occurs due to decreased bone mineral density and has a polygenetic multifactorial pathogenesis. The aim of this study was to examine the effect of gene variants in eight gene regions related to bone mineral density in patients diagnosed with osteopenia or osteoporosis. METHODS: A total of 60 patients diagnosed with osteoporosis, 50 patients diagnosed with osteopenia, and 40 healthy volunteers (control group) were included in the study. Collagen type I alpha 1 1997G/T, estrogen receptor α PvuII, estrogen receptor α XbaI, vitamin D receptor BsmI, lactase gene, osteoprotegerin G209A, osteoprotegerin T245G, and interleukin-6 G174C gene variants were analyzed. RESULTS: No important difference was found in the distribution of collagen type I alpha 1 1997G/T, estrogen receptor α PvuII, estrogen receptor α XbaI, vitamin D receptor BsmI, lactase gene T13910C, osteoprotegerin T245G, and interleukin-6 G174C gene variants between groups. A significant difference was detected between the distribution of osteoprotegerin G209A gene variants in the patient groups and the distribution of osteoprotegerin G209A gene variants in the control group. On the other hand, no important difference was detected in the distribution of osteoprotegerin G209A gene variants between patient groups. CONCLUSION: The osteoprotegerin G209A gene variant may be associated with the risk of osteopenia and osteoporosis in the Turkish population. Other gene variants analyzed that affect bone mineral density were not associated with the risk of osteopenia and osteoporosis.

SUMMARY OBJECTIVE: The aim of this study was to calculate a useful cut-off point of the 18F-fluorodeoxyglucose positron emission tomography/computed tomography SUVMax value to decide on a computed tomography-guided percutaneous transthoracic needle biopsy for solitary pulmonary nodules of sizes between 11 and 20 mm. METHODS: Between January 2015 and April 2020, patients with solitary pulmonary nodules who underwent computed tomography-guided percutaneous transthoracic needle biopsy were retrospectively reviewed, and those with solitary pulmonary nodules of 11–20 mm in diameter, who had undergone an 18F-fluorodeoxyglucose positron emission tomography/computed tomography examination before computed tomography-guided percutaneous transthoracic needle biopsy, were included in the study. A total of 76 patients who met the inclusion criteria were evaluated. RESULTS: There was no distinguishing finding on the computed tomography examination (p>0.05). The SUVMax values of the malignant solid solitary pulmonary nodules were higher than the benign solitary pulmonary nodules (p<0.05). CONCLUSION: The benign and malignant solid solitary pulmonary nodules between 11 and 20 mm have similar computed tomography features. 18F-fluorodeoxyglucose positron emission tomography/computed tomography is a useful imaging technique for distinguishing benign and malignant solitary pulmonary nodules. Notably, 4.85 SUVMax value can be used to decide on a computed tomography-guided percutaneous transthoracic needle biopsy procedure in solid solitary pulmonary nodules between 11 and 20 mm with excellent sensitivity and moderate specificity rates.

SUMMARY OBJECTIVE: This study evaluated head posture in patients with temporomandibular joint disorders and explored the effects of postural changes on clinical parameters. METHODS: In total, 81 individuals diagnosed with temporomandibular joint disorders participated in this cross-sectional prospective study. Demographics, pain status, head posture, and jaw movement data were collected. Head posture was assessed using the Posture Screen Mobile application. RESULTS: Results indicated moderate negative correlations between pain and mouth opening (rho=-0.437, p<0.001) and maximum mouth opening (rho=-0.427, p<0.001). Anterior translation showed weak positive correlations with mouth opening and maximum mouth opening, while right lateral translation exhibited a weak positive correlation with pain (rho=0.264, p=0.017). Posterior angulation showed weak significant correlations with pain, mouth opening, and maximum mouth opening. CONCLUSION: These findings suggest that head posture has a significant influence on temporomandibular joint disorder symptoms. Treatment strategies addressing postural abnormalities may help alleviate symptoms and enhance the quality of life in temporomandibular joint disorder patients.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the role of systemic inflammation response index, systemic immune-inflammation index, platelet/hemoglobin ratio, and other defined low-grade inflammatory indices in predicting preeclampsia. METHODS: The presented retrospective case-control study was conducted on 304 patients diagnosed with preeclampsia and 240 low-risk pregnant women who gave birth between 2019 and 2021 in Ankara Bilkent City Hospital, a tertiary center. Patient information was obtained from the hospital database. Patients diagnosed with preeclampsia, along with possible predictive indices in the first trimester, were evaluated to predict the development of preeclampsia. The indices were neutrophil/lymphocyte ratio, AST/platelet ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, platelet/hemoglobin ratio, creatinine/platelet ratio, systemic immune-inflammation index (neutrophil×platelet/lymphocyte), and systemic inflammation response index (neutrophil×monocyte/lymphocyte). These indices were calculated from the first-trimester routine blood test results and compared between preeclampsia and control groups. The indices were also evaluated for the predictive value regarding the severity and onset time of the disease. RESULTS: In the first trimester, hemoglobin counts were lower in the preeclampsia group, whereas creatinine and monocyte counts were higher. The platelet/hemoglobin count ratio was significantly higher in the preeclampsia group, with a p-value of 0.025. According to receiver operating characteristic analyses, a platelet/hemoglobin count ratio of 21.41 was identified as the optimal cut-off value for the disease prediction. CONCLUSION: Systemic inflammation response index and platelet/hemoglobin ratio were evaluated along with the other indices to predict preeclampsia. The platelet/hemoglobin ratio was found to be higher in the preeclampsia group in the first trimester, making it a promising index for preeclampsia prediction.

SUMMARY OBJECTIVE: The aim of this study was to investigate the effects of sexually transmitted disease education provided via Instagram on university students’ knowledge and attitudes about sexually transmitted diseases. METHODS: This pretest-posttest control group experimental study was conducted on 69 participants (Instagram group: 30, control group: 39). Participants in the Instagram group followed the @sexualinfectmarmara Instagram account prepared by the researchers. Five modules about sexually transmitted diseases prepared by the researchers were shared on this account. RESULTS: When the pre-training STD scores of the Instagram and control groups were compared with the analysis of covariance (ANCOVA) analysis, it was found that the scores of the Instagram group were statistically significantly higher than those of the control group. No significant difference was found between the sexually transmitted disease scores. After the training, the participants in the Instagram group responded significantly more with disagreement to the statement "sexually transmitted disease patients are easily recognized in society." CONCLUSION: Instagram can be a new and alternative educational tool for increasing the sexually transmitted disease knowledge and attitude levels of university students.

SUMMARY OBJECTIVE: In women who are believed to have ovarian cancer but have a poor performance status or have advanced disease thought to be beyond the scope of primary cytoreductive surgery, neoadjuvant chemotherapy can be administered with acid cytology and/or tru-cut biopsy referral. The aim of this study was to determine the accuracy, adequacy, safety, and reliability of these minimally invasive interventional procedures. METHODS: This is a retrospective analysis of 63 patients with a suspicion of ovarian cancer who reported to Bezmialem University Hospital between 2014 and 2021, underwent ultrasound-guided acid cytology and tru-cut biopsy, and also had postoperative final pathology results. RESULTS: On comparing acid cytology and tru-cut biopsy at the same time with the postoperative final pathology results, it was seen that the positive predictive value was 100% in all groups. It was revealed that the sensitivity of acid cytology was 64%, the specificity was 100%, the negative predictive value was 12%, and the accuracy of the test was 65%. The sensitivity of the tru-cut biopsy was 91%, the specificity was 100%, the negative predictive value was 42%, and the accuracy of the test was 92%. In the case of both procedures, the sensitivity was calculated as 93% and the accuracy of the test was calculated as 93%. There were no false-positive cytology and biopsy results. CONCLUSION: Due to its high reliability and accuracy, the combined application of these minimally invasive methods has the potential to routinely replace more invasive methods for adequate tumor sampling, such as diagnostic laparoscopy or exploratory laparotomy.

SUMMARY OBJECTIVE: Myocardial perfusion scintigraphy is a common non-invasive method for assessing ischemic burden, though artifacts can affect accuracy. Speckle-tracking strain echocardiography improves left ventricular function assessment, and global longitudinal strain correlates well with coronary artery disease. The aim of this study was to compare myocardial perfusion scintigraphy with global longitudinal strain in stable angina pectoris patients. METHODS: A total of 133 suspected coronary artery disease patients who underwent myocardial perfusion scintigraphy and coronary angiography were prospectively enrolled and classified as myocardial perfusion scintigraphy true positives or false positives based on coronary angiography results. Global longitudinal strain values for the epicardium, endocardium, and myocardium (avg) were calculated. RESULTS: Ischemic percentages of myocardial perfusion scintigraphy>12% and mid-wall global longitudinal strain<-18.4% correlated with true positive coronary angiography results. Left ventricular ejection fraction/global longitudinal strain mid ratio positively correlated with coronary artery disease presence and severity. Higher ischemic percentages of myocardial perfusion scintigraphy showed a negative correlation (r: −0.2606, p: 0.002) with global longitudinal strain, indicating a greater likelihood of coronary artery disease (OR 0.25, 95%CI 0.08–0.73, p: 0.012). Female sex was linked to fewer true positive myocardial perfusion scintigraphy results. CONCLUSION: The GLS value of the Left Ventricle obtained by two-dimentional strain echocardiography offers sensitivity and specificity similar to myocardial perfusion scintigraphy in the detection of coronary artery disease.. An elevated left ventricular ejection fraction/global longitudinal strain ratio is a significant predictor of the presence and severity of coronary artery disease.

SUMMARY OBJECTIVE: The aim of this study was to investigate independent risk factors for diversion colitis induced by the surgical interruption of fecal flow in the non-functional colon. METHODS: We performed a retrospective study with 163 patients who underwent low anterior resections and created prophylactic ileostomies for rectal cancer between January 2014 and June 2023 at the Department of General Surgery, Air Force Medical University Tangdu Hospital. Colonoscopy results of the non-functional region of the distal colon and clinical variables were collected, including age, sex, body mass index, pathological tumor node metastasis staging, ileostomy method, diversion time, receiving radiotherapy or chemotherapy or not, suffering from preoperative inflammatory bowel disease or postoperative anastomotic leakage or not. Diagnosis of diversion colitis based on the results of the patients’ colonoscopy results. Univariate analysis and multivariate analysis of diversion colitis-related risk factors were performed subsequently. RESULTS: The morbidity of diversion colitis is 53.4% (87/163) in our study. Multivariate analysis showed that risk factors for diversion colitis included single-lumen prophylactic ileostomy (63.2 vs. 30.3%, OR 4.481, 95%CI 1.897–10.584, p<0.001), diversion time ≥90 days (79.3 vs. 40.8%, OR 4.474, 95%CI 1.849–10.826, p<0.001), inflammatory bowel disease (17.2 vs. 3.9%, OR 7.491, 95%CI 1.839–30.507, p=0.005), radiotherapy (58.6 vs. 42.1%, OR 0.515, 95%CI 0.196–1.352, p=0.178). CONCLUSION: These findings suggest that single-lumen prophylactic ileostomy, diversion time, and inflammatory bowel disease are independent risk factors for diversion colitis.