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Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal system, occurring in approximately 2% of the population. It is rare for MD to be symptomatic or complicated in adulthood. In this case report, we describe a patient who was admitted to the clinic with Meckel's diverticulitis, which had fistulized to the anterior abdominal wall, and was incidentally found to have an ileal inflammatory myofibroblastic tumor (IMT) on radiological imaging. A 46-year-old male patient presented to the emergency department with abdominal pain. Physical examination revealed localized guarding on the right side of the umbilicus. Blood tests showed elevated acute-phase reactants, including a white blood cell count of 13,800/µL, and C-reactive protein (CRP) level of 165 mg/L. Abdominal computed tomography demonstrated Meckel's diverticulitis fistulizing to the anterior abdominal wall and a polypoid structure in the ileum distal to the MD. The patient underwent emergency surgery, during which segmental ileal resection and ileocolic anastomosis were performed. On the fourth postoperative day, the patient developed an anastomotic leak. Relaparotomy, right hemicolectomy with end ileostomy, and mucous fistula creation were subsequently performed. Pathological examination of the resected ileum from the initial surgery revealed a benign IMT distal to the MD. The patient was discharged on the 40th postoperative day after developing a surgical site infection following the second surgery. The end ileostomy was closed six months later. In this case, it appears that the ileal IMT located distal to the MD may have caused intermittent intestinal obstruction, fecal stasis, and the development of Meckel's diverticulitis. Furthermore, a detailed examination of the patient's history, laboratory results, and radiologic tests may contribute to the detection of incidental pathologies and influence treatment choices.

Background: Colonoscopy difficulty and procedure time can vary between cases, posing challenges for daily scheduling in endoscopy units. In the literature, cecal intubation time (CIT) is commonly used to assess colonoscopy difficulty, yet there is debate regarding the factors influencing CIT. This prospective observational study aimed to evaluate the factors influencing CIT., Methods: In this single-center, prospective, observational study, 915 patients who underwent colonoscopy between July 2023 and April 2024 were evaluated. Failure to achieve cecal intubation due to poor bowel preparation and a history of colorectal surgery were considered as exclusion criteria. Patients with a CIT ≥ 11 min or those with technically failed cecal intubation were categorized into the prolonged CIT subgroup, while those with a CIT < 11 min were analyzed in the normal CIT subgroup. Patients were evaluated based on demographic characteristics, clinical parameters, and colonoscopy results., Results: A total of 902 patients included in the final analysis. The median age was 55 years and 55.4% of them were women. The cecal intubation rate was 97.5% (892 patients). The polyp, adenoma, and malignancy detection rate were 27.4, 20.7, and 1.9%, respectively. Median cecal intubation time (CIT) was 6 min (Interquartile range: 4-8). In multivariate analysis, body mass index ≤ 18.5, previous abdominal surgery, increased Wexner Constipation Score, and lesser endoscopist experience were associated with prolonged CIT., Conclusions: BMI, previous abdominal surgery, severity of constipation, and the experience of endoscopist may affect CIT. Considering these factors during daily planning in the endoscopy unit can lead to more efficient facility utilization., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: This study aimed to evaluate anti-cancer potential of a novel glutaminase (GLS) inhibitor IN-3 in prostate cancer cells., Methods: The cell viability upon IN-3 treatment was examined using crystal violet staining and IC 50 values were calculated for cancer cell lines PC-3 and LNCaP and normal fibroblasts CCD1072sk. The expression levels of GLS isoforms were determined by real-time polymerase chain reaction after IN-3 treatment. The metastatic prostate cancer dataset was downloaded from C-Bioportal and the expressions of GLS isoforms were analyzed., Results: The IC 50 values of IN-3 for LNCaP, PC-3 and CCD1072sk were 2.13, 6.14 and 15.39 μM respectively. The dose dependent effect of IN-3 was evident even in low concentration with 1 μM in LNCaP and 2 μM in PC-3 and these anti-proliferative effects of IN-3 were highly significant with p-values lower than 0.0001. The treatment of PC-3 cells with 10 μM IN-3 elevated the expression of kidney type GLS isoform of GLS1 but not GLS2. Comparison of metastatic and localized prostate cancer tissues showed that GLS1 was highly expressed not only in primary but also in metastatic prostate cancer tissues. GLS1 expression was significantly higher than GLS2 expression with p-values lower than 0.001., Conclusions: The GLS inhibitor IN-3 may be a potent anti-cancer agent in prostate cancer by demonstrating its differential effect between cancer and normal cells. Further studies are warranted to elucidate its drug potential in prostate cancer., Competing Interests: Conflict of Interest: The authors have no conflict of interest to declare., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of Istanbul Medeniyet University Faculty of Medicine.)

Background: The requirement for routine biopsy sampling in esophagogastroduodenoscopy (EGD) with normal endoscopic findings is a subject of debate. In this study, patients who had normal endoscopic findings in EGD and underwent biopsy sampling were retrospectively analyzed., Methods: This single-center retrospective cohort study included 671 patients who underwent EGD between 2021 and 2023 in the Sisli Hamidiye Etfal Training and Research Hospital Surgical Endoscopy Unit. All patients had normal endoscopic findings and a sampling biopsy was performed on all patients included. Patients were evaluated based on demographic and clinicopathologic findings. This study was registered to ClinicalTrials.gov (NCT06269380)., Results: Two hundred sixty patients (38.7%) have abnormal histopathologic findings. Helicobacter pylori positivity was detected in 200 (29.8%) patients. Intestinal metaplasia (IM) was present in 80 of 260 patients (30.8%). The frequency of IM was higher in older age groups and cases with mild gastritis ( P <0.001). The frequency and severity of gastritis were associated with increased H. pylori positivity and density ( P <0.001)., Conclusions: The biopsy sampling may contribute to the diagnosis and treatment process in cases where normal endoscopic findings are observed during EGD., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Fractures are an important symptom of physical violence that will negatively affect the woman's quality of life in the coming years. However, there is limited information in the literature about fractures in women exposed to domestic violence (DV). The aim of this study was to compare fracture development rates and age distributions in women exposed to DV and intimate partner violence (IPV), a component of DV, and women exposed to other physical violence (OV), to determine the incidence of DV cases with and without fractures, and to determine fracture locations in DV cases and to identify diagnostic lesions accompanying fractures., Methods: A retrospective review was made of patients injured as a result of IPV, other domestic violence (ODV) and OV. The data of cases with fracture were analyzed in terms of age groups of the victims and according to location and types of fractures., Results: Of the 854 female patients aged >18 years who were admitted to the hospital due to violence, 55.2% were exposed to DV. Most DV victims (87.9%) were assaulted by intimate partners. The incidence of fractures in IPV cases (7.2%), was nearly twice that of ODV and OV cases. The mean age of IPV cases with fractures (42.1 ± 12.1 years) was significantly higher than that of IPV cases without fractures (33.1 ± 11.8 years) (p < 0.05). Most IPV cases (61.8%) were aged <35 years. Most DV cases with fractures (75%) were aged <50 years. Facial/neck injuries (41.5%) and facial fractures (52.6%) were prominent in DV cases., Conclusion: The results of this study of the presence of facial fractures, especially in women aged <50 years, is an important finding that can alert doctors to potential cases of domestic violence., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Background/aim: Intestinal neomucosa formation is a technique defined for the treatment of short bowel syndrome. This study evaluates the effect of glutamine and omega-3 fatty acids on the growth of intestinal neomucosa on the colonic serosal surface has been evaluated., Materials and Methods: Thirty-two adult male Sprague-Dawley rats were randomly divided into 4 groups: sham, control, glutamine, and omega-3. Laparotomy was performed on all groups. For rats other than the sham group, a 1-cm full-thickness incision was made 4 cm proximal to the ileocecal valve, and colonic serosal surface was sutured as a serosal patch over these openings. By using the oral gavage technique, the glutamine group was ingested with 200 mg/kg/day of glutamine, and the omega-3 group was ingested with 100 mg/kg/day of omega-3 fatty acids. At the end of 14 days, the rats were euthanized, blood specimens were collected, and intestinal segments, including serosal patches, were excised., Results: Transforming growth factor-beta was significantly lower in the glutamine group compared to the control group. Similarly, fibroblast growth factor-2 was significantly lower in the glutamine group compared to the sham group. Intestinal neomucosa formation was observed in 100% of rats in the glutamine group. In the control and omega-3 groups, intestinal neomucosa formation was observed in 57.1% and 60% of rats, respectively. The inflammatory response, granulation tissue formation, and fibroblastic activity were more severe in the rats of the glutamine and omega-3 groups., Conclusion: The intestinal neomucosa formation is an experimental technique, and both glutamine and omega-3 fatty acids have the potential to positively affect inflammatory response, granulation tissue formation, and fibroblastic activity. Specifically, glutamine has a favorable effect on intestinal neomucosa formation., (© TÜBİTAK.)

Domain generalization (DG) approaches intend to extract domain invariant features that can lead to a more robust deep learning model. In this regard, style augmentation is a strong DG method taking advantage of instance-specific feature statistics containing informative style characteristics to synthetic novel domains. While it is one of the state-of-the-art methods, prior works on style augmentation have either disregarded the interdependence amongst distinct feature channels or have solely constrained style augmentation to linear interpolation. To address these research gaps, in this work, we introduce a novel augmentation approach, named Correlated Style Uncertainty (CSU), surpassing the limitations of linear interpolation in style statistic space and simultaneously preserving vital correlation information. Our method's efficacy is established through extensive experimentation on diverse cross-domain computer vision and medical imaging classification tasks: PACS, Office-Home, and Camelyon17 datasets, and the Duke-Market1501 instance retrieval task. The results showcase a remarkable improvement margin over existing state-of-the-art techniques. The source code is available https://github.com/freshman97/CSU.

Intraductal Papillary Mucinous Neoplasm (IPMN) cysts are pre-malignant pancreas lesions, and they can progress into pancreatic cancer. Therefore, detecting and stratifying their risk level is of ultimate importance for effective treatment planning and disease control. However, this is a highly challenging task because of the diverse and irregular shape, texture, and size of the IPMN cysts as well as the pancreas. In this study, we propose a novel computer-aided diagnosis pipeline for IPMN risk classification from multi-contrast MRI scans. Our proposed analysis framework includes an efficient volumetric self-adapting segmentation strategy for pancreas delineation, followed by a newly designed deep learning-based classification scheme with a radiomics-based predictive approach. We test our proposed decision-fusion model in multi-center data sets of 246 multi-contrast MRI scans and obtain superior performance to the state of the art (SOTA) in this field. Our ablation studies demonstrate the significance of both radiomics and deep learning modules for achieving the new SOTA performance compared to international guidelines and published studies (81.9% vs 61.3% in accuracy). Our findings have important implications for clinical decision-making. In a series of rigorous experiments on multi-center data sets (246 MRI scans from five centers), we achieved unprecedented performance (81.9% accuracy). The code is available upon publication.

Regeneration is a homeostatic process that involves the restoration of cells and body parts. Most of the molecular mechanisms and signalling pathways involved in wound healing, such as proliferation, have also been associated with cancer cell growth, suggesting that cancer is an over/unhealed wound. In this study, we examined differentially expressed genes in spinal cord samples from regenerative organisms (axolotl and zebrafish) and nonregenerative organisms (mouse and rat) compared to intact control spinal cord samples using publicly available transcriptomics data and bioinformatics analyses. Based on these gene signatures, we investigated 3 small compounds, namely cucurbitacin I, BMS-754807, and PHA-793887 as potential candidates for the treatment of cancer. The predicted target genes of the repositioned compounds were mainly enriched with the greatest number of genes in cancer pathways. The molecular docking results on the binding affinity between the repositioned compounds and their target genes are also reported. The repositioned 3 small compounds showed anticancer effect both in 2D and 3D cell cultures using the prostate cancer cell line as a model. We propose cucurbitacin I, BMS-754807, and PHA-793887 as potential anticancer drug candidates. Future studies on the mechanisms associated with the revealed gene signatures and anticancer effects of these three small compunds would allow scientists to develop therapeutic approaches to combat cancer. This research contributes to the evaluation of mechanisms and gene signatures that either limit or cause cancer, and to the development of new cancer therapies by establishing a link between regeneration and carcinogenesis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Gastric malignancies constitute the sixth most common cancer with regards to incidence and have the fifth most mortality rates. Extended lymph-node dissection is the surgical modality of choice while treating advanced stage gastric cancer. It is yet a topic of debate, whether or not the amount of positive lymph nodes after a pathological examination following the surgical intervention is of prognostic value. In this study, it is aimed to evaluate the prognostic significance of positive lymph nodes following the surgery. A total of 193 patients who underwent curative gastrectomy between January 2011 and December 2015 have been considered for a retrospective data collection. The cases with R1-R2 resections, palliative or emergent surgeries are excluded. Metastatic to total number of lymph nodes, corresponded a ratio which was analyzed in this survey and practiced as a predictive parameter of disease outcome. This survey includes 138 male (71.5%) and 55 female (28.5%) patients treated between 2011 and 2015 in our clinic. The survey follow-up duration of the cases range between 0, 2, and 72 months, corresponding an average of 23.24 ± 16.99 months. We calculated cutoff value of 0.09 with, sensitivity is 76.32% for positive to total number of lymph nodes ratio, whereas specivity applies for 64.10%, positive predictive value for 58% and negative predictive value for 80.6%. Positive lymph node ratio has a prognostic value in terms of predicting the prognosis of the patients with gastric adenocarcinoma following a curative gastrectomy. This might in long term contribute to the prognostic analysis of patients if integrated in the current staging system., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Our aim in this observational prospective study is to determine whether the prone position has an effect on intracranial pressure, by performing ultrasound-guided ONSD (Optic Nerve Sheath Diameter) measurements in patients with acute respiratory distress syndrome (ARDS) ventilated in the prone position., Methods: Patients hospitalized in the intensive care unit with a diagnosis of ARDS who were placed in the prone position for 24 h during their treatment were included in the study. Standardized sedation and neuromuscular blockade were applied to all patients in the prone position. Mechanical ventilation settings were standardized. Demographic data and patients' pCO 2 , pO 2 , PaO 2 /FiO 2 , SpO 2 , right and left ONSD data, and complications were recorded at certain times over 24 h., Results: The evaluation of 24-hour prone-position data of patients with ARDS showed no significant increase in ONSD. There was no significant difference in pCO 2 values either. PaO 2 /FiO 2 and pO 2 values demonstrated significant cumulative increases at all times. Post-prone SPO2 values at the 8th hour and later were significantly higher when compared to baseline (p < 0.001)., Conclusion: As a result of this study, it appears that the prone position does not increase intracranial pressure during the first 24 h and can be safely utilized, given the administration of appropriate sedation, neuromuscular blockade, and mechanical ventilation strategy. ONSD measurements may increase the safety of monitoring in patients ventilated in the prone position., (© 2023. The Author(s).)

Background and Objectives : Cardiopulmonary bypass (CPB) is an extracorporeal circuit that provides surgical access to an immobile and bloodless area, allowing for technical and procedural advances in cardiothoracic surgery. CBP can alter the integrity of the blood-brain barrier and cause changes in intracranial pressure (ICP) postoperatively. Optical nerve sheath diameter (ONSD) measurement is among the alternative non-invasive methods for ICP monitoring. In this study, we aimed to evaluate the optic nerve sheath diameter measurements under the guidance of ultrasonography for ICP changes during the extracorporeal circulation process. Materials and Methods : The study population included 21 patients over 18 years of age who required extracorporeal circulation. Demographic data of the patients, such as age, gender, comorbidity, American Society of Anesthesiologists (ASA) classification and reason for operation (coronary artery disease or mitral or aortic valve disease) were recorded. The ONSD was measured and evaluated before the extracorporeal circulation (first time) and at the 30th minute (second time), 60th minute (third time) and 90th minute (fourth time) of the extracorporeal circulation. Non-invasive ICP (ICP ONSD) values were calculated based on the ONSD values found. Results : The mean ONSD values measured before the extracorporeal circulation of the patients were found to be 4.13 mm (3.8-4.6) for the right eye and 4.36 mm (4.1-4.7) for the left eye. Calculated nICPONSD values of 11.0 mm Hg (1.0-21.0) for the right eye and 10.89 mm Hg (1.0-21.0) for the left eye were found. It was observed that there was a significant increase in the ONSD and nlCPONSD values recorded during the extracorporeal circulation of all patients compared to the baseline values ( p < 0.005). Conclusions : During extracorporeal circulation, ultrasound-guided ONSD measurement is an easy, inexpensive and low-complication method that can be performed at the bedside during the operation to monitor ICP changes.

Aim: The aim of this study was to investigate the effect of the largest metastatic lymph node (MLN) size on postoperative outcomes of patients with stage II-III gastric cancer (GC)., Methods: A total of 163 patients with stage II/III GC who underwent curative surgery were included in this single-center retrospective study. The lymph nodes were counted, each lymph node was analyzed for metastatic involvement by histopathological examination, and the diameter of the largest metastatic lymph node was recorded. The severity of postoperative complications was assessed by Clavien-Dindo classification system. Two groups of 163 patients were defined according to ROC analysis with cut-off value of histopathologically maximum MLN diameter. A comparative analysis of demographic and clinicopathological characteristics of the patients and their postoperative outcomes were performed., Results: The median hospital stay was significantly longer in patients with major complications compared to patients without major complications [18 days (IQR: 13-24) vs. 8 days (IQR: 7-11); ( p  < 0.001)]. The median MLN size was significantly larger in deceased patients compared to survived [1.3 cm (IQR: 0.8-1.6) vs. 0.9 cm (IQR: 0.6-1.2), respectively; ( p  < 0.001)]. The cut-off value of MLN size predicting mortality was found as 1.05 cm. MLN size ≥1.05 cm had nearly 3.5 times more negative impact on survival., Conclusions: The largest metastatic lymph node size had a significant association with survival outcomes. Particularly, MLN size over 1.05 cm was associated with worse survival outcomes. However, the largest MLN was not shown to have any effect on major complications. Further prospective and large-scale studies are required to draw more precise conclusions., Competing Interests: The reviewer EB declared a past co-authorship with the author SO to the handling editor., (© 2023 Omeroglu, Gulmez, Yazici, Demir, Guven, Capkinoglu, Uzun, Senger, Polat and Duman.)

Introduction: Despite significant advances in the management of patients with COVID-19, there is a need for markers to guide treatment and predict disease severity. In this study, we aimed to evaluate the relationship of the ferritin/albumin (FAR) ratio with disease mortality., Methodology: Acute Physiology and Chronic Health Assessment II scores and laboratory results of patients diagnosed with severe COVID-19 pneumonia were retrospectively analyzed. The patients were divided into two groups: survivors and non-survivors. Data for ferritin, albumin, and ferritin/albumin ratio among COVID-19 patients were analyzed and compared., Results: The mean age was higher in non-survivors (p = 0.778, p < 0.001, respectively). The ferritin/albumin ratio was significantly higher in the non-survival group (p < 0.05). Taking the cut-off value of the ferritin/albumin ratio of 128.71 in the ROC analysis, it predicted the critical clinical status of COVID-19 with 88.4% sensitivity and 88.4% specificity., Conclusions: ferritin/albumin ratio is a practical, inexpensive, and easily accessible test that can be used routinely. In our study, the ferritin/albumin ratio has been identified as a potential parameter in determining the mortality of critically ill COVID-19 patients treated in intensive care., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2023 Ozturk Taskin, Ayse Yilmaz, Veysel Garani Soylu, Ufuk Demir, Funda Catan Inan.)

Background and Objectives : This study aims to investigate whether erector spinae plane (ESP) block can be an alternative to general anesthesia as a primary anesthesia method in percutaneous balloon kyphoplasty surgery. In addition, postoperative intensive care needs were compared in terms of length of intensive care unit stay and length of hospital stay. Materials and Methods : Medical records of patients who underwent percutaneous balloon kyphoplasty operation at Kastamonu Training and Research Hospital between January 2020 and November 2022 were reviewed retrospectively. Among 70 patients who underwent percutaneous balloon kyphoplasty, 58 patients with ASA (American Association of Anesthesiologists) classification III or IV, who underwent general anesthesia as the anesthesia method or ESP block, were included in the study. The patients were divided into two groups according to the anesthesia method applied. Group GA: general anesthesia group ( n = 19) and Group ESP: ESP block group ( n = 39). Group data for age, gender, ASA classification, number of surgical levels, surgical urgency, duration of surgery, postoperative complications, need for intensive care, length of stay in the intensive care unit, and hospital stay were compared. Results : There was no statistically significant difference between Group GA and Group ESP in terms of age, gender, ASA classification, surgical urgency, number of surgical levels, duration of surgery, and postoperative complication data of the patients included in the study. Seven (36.6%) patients in Group GA and six (15.4%) patients in Group ESP needed intensive care, and there was no statistically significant difference between the groups ( p = 0.06). However, the need for intensive care was higher in Group GA. A statistically significant difference was found in Group GA and Group ESP, which was higher in Group GA for the length of stay in the intensive care unit ( p = 0.02) and length of hospitalization ( p = 0.04). Conclusions : ESP block may be an alternative method to general anesthesia as the primary anesthetic option for single or multilevel percutaneous balloon kyphoplasty surgery. With the ESP block, the length of stay in the intensive care unit and the length of stay in the hospital can be reduced, especially in high-risk patients.

Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in high mortality among patients in critical intensive care units. Hence, identifying mortality markers in the follow-up and treatment of these patients is essential. This study aimed to evaluate the relationships between mortality rates in patients with COVID-19 and the neutrophil/lymphocyte ratio (NLR), derived NLR (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic inflammation response index (SII), and systemic inflammatory response index (SIRI). Methodology In this study, we assessed 466 critically ill patients diagnosed with COVID-19 in the adult intensive care unit of Kastamonu Training and Research Hospital. Age, gender, and comorbidities were recorded at the time of admission along with NLR, dNLR, MLR, PLR, SII, and SIRI values from hemogram data. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and mortality rates over 28 days were recorded. Patients were divided into survival (n = 128) and non-survival (n = 338) groups according to 28-day mortality. Results A statistically significant difference was found between leukocyte, neutrophil, dNLR, APACHE II, and SIRI parameters between the surviving and non-surviving groups. A logistic regression analysis of independent variables of 28-day mortality identified significant associations between dNLR (p = 0.002) and APACHE II score (p < 0.001) and 28-day mortality. Conclusions Inflammatory biomarkers and APACHE II score appear to be good predictive values for mortality in COVID-19 infection. The dNLR value was more effective than other biomarkers in estimating mortality due to COVID-19. In our study, the cut-off value for dNLR was 3.64., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Yılmaz et al.)

The aims of this study were to compare the incidence of occupational accidents during one-year periods of the COVID-19 Pandemic and before the COVID-19 Pandemic, and to determine in which sectors occupational accidents occurred and what types of injuries were sustained in the population of Tokat, Turkey. A retrospective review was made of the records of Tokat State Hospital of patients injured in occupational accidents between 12.03.2019 and 11.03.2021. The patients injured in occupational accidents were classified according to age, gender, sector, accident type, trauma localization and type, time of the accident, and outcome of the injuries. Of 608 patients injured in occupational accidents, 384 (63.2%) were injured in the period before the pandemic and 224 (36.8%) were injured in the period during the pandemic ( p  < 0.001). Most work-related injuries occurred in the industry sector (n = 287; 47.2%; p  < 0.001). Occupational accidents increased in the service sector ( p  < 0.001), but decreased in other sectors. The increase in occupational accidents in the health sector ( p  < 0.001) and transportation sector ( p  < 0.05) within the service sector caused a general increase despite the decrease in other service sectors ( p  > 0.05). In current study, the increase in the number of injuries in the transportation sector due to the increase of motor courier accidents, in health sector, and in pandemic quarantines were remarkable. It was evaluated that this narrow-scoped study pioneered comprehensive studies on the measures that can be taken to prevent occupational accidents in such pandemics in the future.

Background and objectives : To investigate whether ultrasound (US)-guided femoral vein (FV) and inferior vena cava (IVC) measurements obtained before spinal anesthesia (SA) can be utilized to predict SA-induced hypotension (SAIH) and to identify risk factors associated with SAIH in patients undergoing non-obstetric surgery under SA. Methods : This was a prospective observational study conducted between November 2021 and April 2022. The study included 95 patients over the age of 18 with an American Society of Anesthesiologists (ASA) physical status score of 1 or 2. The maximum and minimum diameters of FV and IVC were measured under US guidance before SA initiation, and the collapsibility index values of FV and IVC were calculated. Patients with and without SAIH were compared. Results : SAIH was observed in 12 patients (12.6%). Patients with and without SAIH were similar in terms of age [58 (IQR: 19-70) vs. 48 (IQR: 21-71; p = 0.081) and sex (males comprised 63.9% of the SAIH and 75.0% of the non-SAIH groups) ( p = 0.533). According to univariate analysis, no significant relationship was found between SAIH and any of the FV or IVC measurements. Multiple logistic regression analysis revealed that having an ASA class of 2 was the only independent risk factor for SAIH development ( p = 0.014), after adjusting for age, sex, and all other relevant parameters. Conclusions : There is not enough evidence to accept the feasibility of utilizing US-guided FV or IVC measurements to screen for SAIH development in patients undergoing non-obstetric surgery under SA. For this, multicenter studies with more participants are needed.

Background: Although many studies have been conducted using the foramen magnum for sex estimation, recent findings have indicated that the discriminant and regression models obtained from the foramen magnum may not be reliable. Artificial Neural Networks, was used as a classification technique in sex estimation studies on some other bones, did not used in sex estimation studies on the foramen magnum until now. The aim of this study was sex estimation on an Eastern Turkish population sample using foramen magnum measurements, discriminant analyses and Artificial Neural Networks., Methodology: The study was performed on the CT images of a total of 720 cases, comprising 360 males and 360 females. For sex estimation, discriminant analysis and Artificial Neural Networks were used., Results: The accuracy rate was 86.7% with discriminant analysis and when sex estimation accuracy was determined according to cases with posterior probabilities above 95%, the accuracy ranged from 0% to 33.3%. With the use of the discriminant formulas of 2 other studies, obtained from different Turkish samples, sex could be determined at a rate of 84.6%. Some formulas were found to be unsuccessful in sex estimation. Sex estimation accuracy of 88.2% was achieved with Artificial Neural Networks., Conclusion: In this study, it was found that sex could be determined to some extent with discriminant formulas from other samples from the same population, although some formulas were unsuccessful. With the use of image processing techniques and machine learning algorithms, better results can be obtained in sex estimation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Purpose: To evaluate the efficacy of atropine penalization after non-response to patch therapy in amblyopic children and investigate the factors associated with treatment success., Patients and Methods: In this retrospective study, 26 children with amblyopia who were non-responders to patch therapy who were then switched to 1% atropine eye drops in the sound eye for a minimum follow-up of one year were included. All patients underwent detailed eye examinations, including optical coherence tomography and fundus autofluorescence (FAF) imaging. Response to treatment was defined as a two-line improvement in best-corrected visual acuity (BCVA) in the amblyopic eye, and patients were divided into two groups: the responder group and the non-responder group. Demographic and clinical parameters were compared between the two groups. The average central macular thickness and FAF were analyzed., Results: Sixteen of 26 patients (61.5%) showed treatment response. The mean age of the patients was 10.62 ± 3.42 (5-17) years. There was no difference between the groups in age, age at start of patch therapy, sex, follow-up period, refractive errors, type of amblyopia, reason for patch therapy non-response, or mean effective patching time per day. In the responder group, the LogMAR values of pretreatment BCVA, BCVA after optical correction, and BCVA after occlusion were significantly higher, but BCVA after atropine treatment showed no difference. FAF images of all patients were normal, and the mean central macular thickness did not significantly differ between the groups., Conclusions: Atropine penalization can improve BCVA in children with amblyopia who are non-responders to patch therapy. Atropine penalization may be more successful in children with poor BCVA at the start of atropine penalization in the amblyopic eye. The results of FAF imaging and mean central macular thickness were not associated with treatment outcomes.

Aim: This study aimed to evaluate the surgical procedures, outcomes, and prognostic factors in patients with ischemic heart disease who were operated on due to nonocclusive mesenteric ischemia (NOMI)., Material and Methods: This research contains all patients diagnosed with congestive heart failure and NOMI between January 2011 to January 2020. The patients who had angiography or CT that showed occlusion of more than 50% in any of the main branches of the mesenteric artery or patients who presented with symptoms in correlation with a total occlusion were excluded from the study. Patients who underwent coronary heart surgery but were not diagnosed with congestive heart failure and those with atrial fibrillation also were excluded from the study. Patients divided into two groups, according to a medical database., Results: A significant difference was found between the surviving and non-survivor groups in minutes, in terms of median time to segmenter intestinal resection (P = 0.042)., Conclusion: An early diagnosis and surgical segmental intestinal resection before peritonitis worsens can be the key to better prognosis for NOMI patients.

Accessory cardiac bronchus (ACB) is a rare congenital anomaly mainly located in the medial wall of the intermediate bronchus. This anomaly can present with dyspnea, recurrent infections, and hemoptysis. It usually has a blind ending, which may have an impact on airflow patterns and lobar distribution regardless of its diameter and depth. There have been very few cases with ACB. However, the airflow pattern and lobar distribution have not been well studied. In our case with ACB, the proportion of airflow in the right lung was higher than in the model without ACB, while mean airflow velocities were similar in both models. In this regard, quantitative lung ventilation scintigraphy could be better than the anatomical formula in predicting postoperative forced expiratory volume 1 in patients with accessory cardiac bronchus who will undergo lung resection.

The assessment of national suicide risks is considered critical in many countries for the establishment of suicide prevention initiatives aimed at considerably lowering suicide rates. The aim of this study is to identify at-risk suicide populations by reviewing the suicides in Turkey over a 25-year period. The Turkish Statistical Institute's suicide statistics for 1995-2019 in Turkey was retrospectively reviewed in current article. The data collected in the study was statistically analyzed using the MINITAB vn 14 software. Between 1995 and 2019, the total number of suicides in Turkey was 66,819, and suicide rates, especially in males, showed an increasing trend in this period. Males comprised 68.3% of the total cases, and most (27.2%) were aged 15-24 years. Suicides mostly occurred between May and July (27.7%), of individuals with a primary school level of education (51.7%) and who were married (6.0 per 100,000). Illness was most important risk factor for suicide (36.8%) and hanging (47.5%) was the leading suicide method in all age groups and in both genders. Despite the fact that Turkey's suicide rate is lower than many other countries, the growth in male suicide rates is concerning. Suicides are likely to become a severe problem in Turkey in the near future unless measures like education, psychiatric evaluations, the reactivation of psychological counseling service phone lines, and the establishment of youth counseling centers, as described in this paper, are taken., (© 2022 American Academy of Forensic Sciences.)

Colorectal cancer is one of the most common types of cancer in the world. The treatment options for colorectal carcinoma generally consist of surgery, radiotherapy and chemotherapy. The drug resistance to chemotherapy agents used in the current cancer treatment has brought about the finding of new drug molecules from some plant and aquatic species in the treatment approaches. Some species of aquatic biota create novel biomolecules as potential drugs for cancer and other diseases. Toluhydroquinone belongs to these groups of biomolecules and it shows anti-oxidative, anti-inflammatory and anti-angiogenic properties. In this study, we tested the cytotoxic and anti-angiogenic effects of Toluhydroquinone on Caco-2(Human colorectal carcinoma cell line) cells. It was observed that the amount of closure of the wound space, colony forming ability (in vitro cell survivability) and formation of tubule-like structures in matrigel decreased in comparison to the control group. As a result of this study, Toluhydroquinone has cytotoxic, anti-proliferative and anti-angiogenic properties on the Caco-2 cell line.

Sex estimation of skeletal remains is an important aspect of forensic anthropology. The clavicle is a bone with relatively high accuracy in sex determination. In this study, 7 clavicular parameters were obtained using the CT images and 3D reconstruction of 360 cases equally distributed as 180 males and 180 females. Sex determination was made using univariate, linear, and stepwise discriminant analyses, and multilayer perceptron neural networks. Maximum sex determination accuracy of 85.3% was achieved with univariate analysis, 89.4% with linear discriminant analysis, 90.0% with stepwise discriminant analysis, and 91.4% with multilayer perceptron neural networks. Significant changes were observed in the MLC, APMD-R and CDC parameters according to age, and these were determined to affect the accuracy of sex determination in different age groups. In forensic anthropological studies, more reliable results can be obtained by considering the confounding factors during sampling. Although high accuracy rates can be achieved with neural networks, the results should be approached with caution., (Copyright © 2022 Elsevier B.V. All rights reserved.)