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Background: Anatomy is a crucial part of medical education, and there have been attempts to improve this field by utilizing various methods. With the advancement of technology, three-dimensional (3D) materials have gained popularity and become a matter of debate about their effectiveness compared to two-dimensional (2D) sources. This research aims to analyze the effectiveness of 3D PDFs compared to 2D atlases., Methods: This study is a randomized controlled trial involving 87 Year-1 and Year-2 medical students at Gazi University Faculty of Medicine, Turkey. The study was conducted in two steps. In Step-1, students were randomized to watch lecture videos on liver anatomy and male genitalia anatomy supplemented with either a 3D PDF (intervention group) or 2D atlas (control group) images. Following the video lectures, a test (immediate test) was administered. In Step-2, the same test (delayed test) was administered 10 days after the immediate test. The test scores were compared between the intervention and control groups. In addition to the descriptive analyses, Chi-square and Mann-Whitney U tests were performed., Results: In the immediate test, while there was no significant difference between the groups for the liver test (p > 0.05), 3D PDF group's scores (Median = 24.50) was significantly higher than the 2D atlas group's in the genitalia test (Median = 21.00), (p = 0.017). The effect size (Cohen's d) was 0.57. In the delayed test, there was no significant difference between the groups in the liver and genitalia tests (p > 0.05). However, the effect size in the immediate genitalia test was 0.40. Year-1 students' immediate test of genitalia performances were significantly higher in the 3D PDF group (Median = 24.00) than the 2D atlas group (Median = 19.00), (p = 0.016). The effect size was 0.76. Also, Year-1 students' 3D PDF group (Median = 20.50) presented with significantly higher performance than the 2D atlas group (Median = 12.00), (p = 0.044) in the delayed test of genitalia, with the 0.63 effect size., Conclusion: 3D PDF is more effective than 2D atlases in teaching anatomy, especially to initial learners. It is particularly useful for teaching complex anatomical structures, such as male genitalia, compared to the liver. Hence, it may be a valuable tool for medical teachers to utilize during lectures., (© 2023. The Author(s).)

Objective: This study aimed to analyze the clinical causes, resuscitation interventions, and outcomes of pediatric cardiopulmonary arrest to identify key predictors of survival and neurological prognosis. Design: A retrospective observational cohort study was conducted to evaluate pediatric cardiopulmonary arrest cases and their clinical outcomes. Subjects/Patients: A total of 150 pediatric patients aged 0 to 18 years who experienced cardiopulmonary arrest at a tertiary hospital were included in the study. Patients were categorized based on whether the arrest occurred in-hospital or out-of-hospital. Methods: Patient data, including demographics, causes of cardiopulmonary arrest, resuscitation interventions, and clinical outcomes, were collected from hospital records between September 1, 2019, and August 31, 2024. Statistical analyses were performed to assess the association between key variables and survival outcomes. Results: The return of spontaneous circulation was significantly higher in in-hospital cases compared to out-of-hospital cases. Early resuscitation was strongly associated with improved survival outcomes. Mortality rates were highest during early morning hours. The most common causes of cardiopulmonary arrest were cardiac, respiratory, and systemic diseases. Conclusion: Timely resuscitation and the location of cardiopulmonary arrest significantly impact survival and neurological outcomes in pediatric patients. The findings emphasize the importance of rapid intervention and structured emergency protocols to improve clinical outcomes in pediatric resuscitation.

Abstract Management of melanoma has changed significantly with the discovery of targeted therapies and immune checkpoint inhibitors (ICI). Our aim in the study is to determine which treatment alternatives, specifically dabrafenib plus trametinib and ICIs, are effective in adjuvant therapy and which treatment is effective as first-line metastatic therapy. This retrospective, multicenter study included 120 patients diagnosed with stage IIIB-IIID melanoma receiving both adjuvant and first-line metastatic treatment between 2007 and 2023. Data on clinicopathologic characteristics, treatment regimens and outcomes were collected. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were analyzed. Patients treated with dabrafenib plus trametinib as adjuvant therapy had the longest relapse-free survival (RFS) (median: 8.3 months), followed by those treated with interferon (4.1 months) and nivolumab (1.9 months) (p = 0.002). Metastatically, the highest ORR was observed in patients treated with dabrafenib plus trametinib (54.5%), followed by ICI (52.0%) and chemotherapy (33.3%). Similarly, DCR was superior for dabrafenib plus trametinib (86.3%) compared to ICI (70.8%) and chemotherapy (66.6%). Median PFS was 9.7 months (95% CI 7.2–12.2 months) in the whole group. This was 14.3 months (95% CI 9.6–19.0 months) with ICI, 10.3 months (95% CI 4.2–16.4 months) with BRAF/MEK inhibitors and 6.3 months (95% CI 4.7–7.9 months) with chemotherapy, which was statistically significant (p 6 months, ORR are all independent factors for OS prognosis. In our study, dabrafenib plus trametinib combination was more effective in adjuvant treatment of melanoma, while immunotherapy was more effective in metastatic first-line treatment.

OBJECTIVE: Tobacco use is an important risk factor for more than 20 types of cancer, especially cardiovascular and respiratory diseases, and many other health problems. Cigarettes are one of the most commonly used tobacco products in the world, and they can cause both physical and mental addiction. Adolescence is known to be the highest-risk period in terms of addiction among all age groups. As a result, smoke-free campus practices have become even more important in universities. This study investigates the prevalence of smoking among Pamukkale Medical School students and their views and behaviors regarding smoke-free campus practices. MATERIAL AND METHODS: This cross-sectional study was conducted with 548 medical students at Pamukkale Universıty Faculty of Medicine during the academic year 2021-2022, between April 1-29, 2022. A face-to-face interview was conducted. Students’ smoking status and their views about a smoke-free campus were assessed. In the questionnaire, the independent variables were socio-demographic characteristics, duration of staying in a smoke-free environment, smoking status in the place of residence, areas where smoking is most common, Fagerström nicotine dependence level, knowledge about smoke-free campus applications and campuses with the smokefree application. The Statistical Package for the Social Sciences version 21.0 package program was used to analyze the data. Descriptive statistics are presented with numbers and percentages for categorical variables, while the arithmetic mean and standard deviation are used for continuous variables. The chi-square test was used to compare categorical variables,and the Kolmogorov-Smirnov analysis was used to test the compatibility of data to normal distribution. RESULTS: The student smoking rate increased significantly as the number of semesters increased (P = .021). The smoking rate of male students was higher than that of female students (P = .001). The smoking rate of students living with their family or relatives was lower (P = .020). Smokers (14.7%) were more likely to have heard about the introduction of smoke-free zones on campus than nonsmokers (11%) (P = .280). 81.4% of students affirmed the statement, “The number of smoke-free rooms should be increased,” and 84.3% responded, “I support the existence of smoke-free spaces.” Nonsmoking students (90.8%) are more likely to agree that smoke-free spaces should be increased than those who smoke (57.7%) (P < .001). Among the students, 17.6% of nonsmokers and 37.8% of smokers find the information about smoke-free spaces sufficient (P < .001). The rate of those who consider smoke-free space inspections to be sufficient is lower for nonsmoking students than for nonsmokers (P = .017). Nonsmokers (89.5%) support the existence of smoke-free spaces to a higher degree than smokers (71.2%) (P < .001). CONCLUSION: One-third of Pamukkale University Faculty of Medicine students smoke, and smoking rates are higher among men and those who do not live with family or relatives. All participants strongly support the existence of smoke-free zones (84.3%), while a proportion of tobacco users (31.4%) support the implementation of a smoke-free campus. Student opinions of the smoke-free zones and the smoke-free campus application are more positive among nonsmokers than smokers.

Objectives:To analyze the effect of macular choroidal thickness (MCT) and peripapillary choroidal thickness (PPCT) on the classification of obese and healthy children by comparing the performance of the random forest (RF), support vector machine (SVM), and multilayer perceptrons (MLP) algorithms.Materials and Methods:Fifty-nine obese children and 35 healthy children aged 6 to 15 years were studied in this prospective comparative study using optical coherence tomography. MCT and PPCT were measured at distances of 500 μm, 1,000 μm, and 1,500 μm from the fovea and optic disc. Three different feature selection algorithms were used to determine the most prominent features of all extracted features. The classification efficiency of the extracted features was analyzed using the RF, SVM, and MLP algorithms, demonstrating their efficacy for distinguishing obese from healthy children. The precision and reliability of measurements were assessed using kappa analysis.Results:The correlation feature selection algorithm produced the most successful classification results among the different feature selection methods. The most prominent features for distinguishing the obese and healthy groups from each other were PPCT temporal 500 μm, PPCT temporal 1,500 μm, PPCT nasal 1,500 μm, PPCT inferior 1,500 μm, and subfoveal MCT. The classification rates for the RF, SVM, and MLP algorithms were 98.6%, 96.8%, and 89%, respectively.Conclusion:Obesity has an effect on the choroidal thicknesses of children, particularly in the subfoveal region and the outer semi-circle at 1,500 μm from the optic disc head. Both the RF and SVM algorithms are effective and accurate at classifying obese and healthy children.

INTRODUCTION: Breast cancer is the most common cancer and major cause of cancer death in women worldwide. The importance of usage positron emission tomography (PET)/computed tomography (CT) in oncology is increasing. In our study, we planned to investigate the relationship between 18 F-fluoro-2-deoxy-D-glucose (18 F-FDG) uptake and characteristics of the tumor. METHODS: The medical records of 414 patients who applied to our oncology clinic with the diagnosis of breast cancer and underwent PET/CT were analyzed retrospectively. Patients with breast cancer aged between 18-90 years were included in the study. Patients with secondary malignancy, mentally unstable, younger than 18 years of age and older than 90 years of age were excluded from the study. FDG uptake was investigated according to molecular subtypes, tumor sizes, body mass index and proliferation indices. RESULTS: The mean age of 414 patients included in the study was 48.8 years. The vast majority of patients had invasive ductal carcinoma. While 86 patients were in the metastatic stage at the time of diagnosis, 327 patients had local or locally advanced disease. In the study, there was a correlation between the increase in Ki-67 and the increase in FDG uptake and it was statistically significant (p

Introduction:This study aimed to evaluate patients who presented with eyelid tumour and to evaluate the masses pathologically.Methods:Between March 1, 2016- April 1, 2019, 2019, age, gender, eyelid side, pathological evaluation results and surgical margin status of the patients who presented to our clinic with eyelid mass were evaluated.Results:During the study period, 212 patients with a mean age of 55±16 years (range, 15-85 years) who underwent surgery because of an eyelid mass were included in the study. Among these patients, 78 (37.8%), 74 (35.9%) and 54 (26.2%) underwent surgery of the right, left and both eyelids, respectively, whereas 55 (26.9%), 128 (62.7%) and 21 (10.2%) underwent surgery of the lower, upper and both lower and upper eyelids, respectively. A total of 376 eyelid mass surgeries were performed. Among these masses, 371 (98.6%) were benign and 5 (1.3%) were malignant. Regarding pathological types of benign masses, 71 (19.1%) were seborrheic keratosis, 70 (18.8%) were squamous papilloma, 53 (14.21%) were fibroepithelial polyps, 52 (14.2%) were xanthelasma, 35 (9%) were intradermal nevus, 22 (5.9%) were epidermoid cyst, 14 (3.8%) were verruca vulgaris and 51 (13.7%) were different types of tumours. Five patients were diagnosed with malignant eyelid tumours; three of them had basal cell carcinoma, one had squamous cell carcinoma and one had malignant melanoma.Conclusion:Although eyelid tumours are mostly benign tumours, malignant tumours may be present in some cases. Pathological evaluation of valve masses obtained surgically is important to determine the prognosis of patients.

Objective: The present study was an investigation of the relationship between fragmented QRS (fQRS) and left ventricular apical thrombus (LVAT) in patients presenting with first acute anterior myocardial infarction (MI). Methods: Consecutive 148 patients (mean age: 60.1+-10.1 years; male: 75.6%) with first acute anterior MI who underwent primary percutaneous coronary intervention (PCI) were included. Study population was divided into 2 groups based on presence of LVAT. fQRS was defined as presence of various RSR' patterns, which included additional R wave or notching of R wave or S wave, and presence of more than 1 R in 2 contiguous leads corresponding to major coronary artery territory on 12-lead electrocardiogram. Patients with bundle branch block were excluded from the study. Results: Of these, 32 (21.6%) had LVAT. Patients with LVAT had higher prevalence of fQRS (53.1% vs. 22.4%; p0.05 for all). Presence of fQRS was independent predictor of LVAT (odds ratio [OR], 2.795; 95% confidence interval [CI], 1.058–7.396) in multivariable logistic regression analysis. Conclusion: Presence of fQRS in leads V4-V6 is independently associated with LVAT in patients presenting with first acute anterior MI.

We report a 68-year-old man who presented with heart failure and atrial fibrillation (AF) with rapid ventricular response and wide QRS complexes. Tachycardiainduced cardiomyopathy (TIC) due to persistent AF developing on the basis of Wolff-Parkinson-White (WPW) syndrome was considered. Signs and symptoms of heart failure improved with restoration of sinus rhythm. This case suggested that persistent AF in a patient with WPW syndrome is one of the rare causes of TIC.

Objectives: The aim of this study was to assess the relationship between mean platelet volume (MPV) and the presence and extent of coronary artery disease (CAD) in patients who underwent coronary angiography for stable chest pain. Study design: A total of 540 patients (350 male, 190 female; mean age: 59.6+-11.4 years) were consecutively included in the study. The patients were divided into four groups according to the presence and extent of their CAD as follows: Group 1 - patients with no significant CAD, group 2 - one vessel disease, group 3 - two vessel diseases, and group 4 - three vessel disease. Also, the Gensini score of each coronary angiogram was calculated. Results: There were 159 patients in group 1, 169 in group 2, 110 in group 3, and 102 in group 4. As expected, we found significant differences among the groups regarding mean age and other coronary risk factors including gender, hypertension, diabetes mellitus, hyperlipidemia, smoking, and family history of ischemic heart disease. However, there were no significant differences among the groups regarding platelet counts and MPV values (8.5+-0.1 fl, 8.5+-1.2 fl, 8.6+-0.9 fl and 8.6+-0.9 fl, MPV values of groups 1-4, respectively). Although the Gensini score was found to be significantly correlated with age, plasma uric acid level, white blood cell count, hemoglobin level, fasting blood glucose, and high density lipoprotein level, no significant association was detected between MPV and Gensini score values. Conclusion: This study is one of the largest studies assessing the relationship between MPV and the extent of coronary atherosclerosis in patients with stable CAD to date. However, we found no association between MPV and the presence and extent of coronary atherosclerosis.

Although acquired diaphragmatic rupture is often associated with trauma, rarely it may be spontaneous (atraumatic). Spontaneous diaphragmatic rupture is one of the rarest thoracoabdominal emergencies, and is harder to detect in patients without visceral damage. Diagnosis may be delayed by several months or even years. A sceptical approach, combined with thorough physical examination and the correct interpretation of the chest X-ray, are very important in diagnosis. In this report we present a patient who was admitted to the emergency department with stomach pain, nausea, vomiting and hiccups lasting for 3 days, and was diagnosed with spontaneous diaphragmatic rupture. The patient was treated with thoracotomy, and the defect was repaired primarily.