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Giant cell ependymomas (GCE) are extremely rare tumors, with 24 cases described in the literature. Squash cytology is a rapid, reliable, simple technique for intraoperative consultation in neurosurgical practice. We describe a rare case of GCE arising at level of L4-L5 in a 66-year-old woman and discuss the cytologic/histologic features. Intraoperative smears were highly cellular with a prominent fibrillary background and exhibited papillary structures and sheets composed of highly atypical and bizarre cells. Some of the cells showed nuclear pseudoinclusions and rarely formed pseudorosette-like arrays. Intraoperative diagnosis was high grade glial tumor. On paraffin sections, besides extensive polymorphism, there were no microvascular proliferation, necrosis, and mitosis and the final diagnosis was WHO grade II GCE. GCE may be a diagnostic challenge on intraoperative smears, frozen, and paraffin sections. It must be kept in mind in the differential diagnosis of giant cell exhibiting benign and malignant tumors of brain.

Objectives: Parathyroid carcinoma (PC) is a rare parathyroid tumor compared to parathyroid adenoma (PA) and atypical parathyroid adenoma (APA). Recent studies have suggested parafibromin has a role in the differential diagnosis of parathyroid tumors. We sought to determine the role of parafibromin as well as galectin-3, Ki-67, and HBME-1 as diagnostic markers in the differential diagnosis of parathyroid tumors. Methods: A total of 92 cases diagnosed with PA, APA, or PC at Sifa University and Private Ege Pathology Laboratory between 2006–2012 were included in the study. Parafibromin (microarray), galectin-3, Ki-67, and HBME-1 were evaluated using immunohistochemistry in all parathyroid tumors. Results: Eighty-four cases were diagnosed with PA, six with APA, and two with PC. The study group consisted of 82 females and 10 males. Their mean age was 50.9 years, and the mean tumor diameter was 1.97 cm. Parafibromin was negative in the two PC cases but positive in all APA and PA cases. Positivity was observed with galectin-3 in 17 adenoma cases, three atypical adenomas, and two carcinoma cases. Positivity with HBME-1 was found in 26 PA cases and one PC case. Parafibromin and galectin-3 expression was significant between the three tumor groups but not for HBME-1 expression. Parafibromin expression increased in PA whereas galectin-3 expression decreased. A statistical significance was found between the three tumor groups according to the Ki-67 score (p=0.010). Additionally, the Ki-67 proliferation index was under 1% in PAs. Conclusion: The number of PCs in our series was small so our data mostly reflects the immunohistochemical characteristics of PAs. Parafibromin expression, galectin-3 negativity, and a Ki-67 proliferation index under 1% were estimated as beneficial in the differential diagnosis of difficult parathyroid tumors.

This paper aims to review the subtypes of childhood trauma and its effects on brain structures and function, especially the hippocampus and amygdala within the limbic system, in the context of clinical psychology. For this purpose, original articles published between 1996 and 2024 were systematically searched in major databases such as PubMed, PsycArticles, Web of Science, and Google Scholar using keywords such as early childhood trauma, psychological trauma, limbic system, hippocampus, amygdala, and neuroimaging. The articles were initially screened based on their titles, and those meeting the search criteria, including study population, investigated brain regions, and types of traumas, were further assessed for relevance. Ultimately, 136 articles were selected and discussed in this review. Trauma experiences in early life can have a significantly negative influence on a person's psychological health by causing neurodevelopmental impairments, especially in the limbic system. While it is understood that trauma influences how individuals think, behave, and feel, the results of neuroimaging studies reveal variations in the amygdala and hippocampus based on different trauma subtypes. These changes merit deeper investigation in future research to fully understand the reasons behind the diverse findings in existing literature.

Abstract Background Despite global efforts, HIV/AIDS remains a significant public health challenge, with Türkiye witnessing a consistent rise in annual diagnoses. Patient satisfaction with antiretroviral therapy (ART) is crucial for treatment adherence and effectiveness. This study examines treatment satisfaction levels among people living with HIV (PLWH) in Türkiye and identifies associated factors. Materials and methods A cross-sectional prospective cohort study was conducted at Tepecik Training and Research Hospital, Izmir, Türkiye, involving 238-PLWH receiving ART. Data were collected through face-to-face interviews using the HIV Treatment Satisfaction Questionnaire (HIVTSQ-12) and demographic/clinical forms. Confirmatory Factor Analysis and descriptive statistics were employed for data analysis. Results Participants exhibited high overall treatment satisfaction, with significant associations between satisfaction levels and socio-demographic/clinical factors. Individuals with lower education levels, no substance use, minimal alcohol consumption, and suppressed viral loads reported higher satisfaction scores. Conclusion This study highlights the potential for personalizing HIV treatment strategies based on socio-demographic and clinical factors. Findings emphasize the need to promote healthy lifestyles, enhance health literacy, and implement anti-addiction programs to improve treatment adherence and satisfaction among PLWH. Based on the findings, there is a need to develop strategies aimed at improving treatment satisfaction and outcomes in HIV management.

Amaç: Bu çalışma Üreme Özerkliği Ölçeğinin geçerlik ve güvenirliğinin sağlamak amacıyla yapılmıştır.Yöntemler: Metodolojik çalışma türü benimsenmiştir. Orijinal ölçek sahibinden izin alındıktan sonra dil ve kapsam geçerliği yapılan ölçek 18-60 yaş arası 386 kadın katılımcıya uygulanmıştır. Yapı geçerliği için açıklayıcı faktör analizi, doğrulayıcı faktör analizi yapılan çalışmanın güvenirlik analizleri yapılmıştır.Bulgular: Doğrulayıcı faktör analizi ki-kare/sd ‘ı mükemmel uyum (2,394); GFI değerinin, iyi uyum (0,943); AGFI değerinin, iyi uyum (0,916), RMSEA değerinin, iyi uyum (0,060); CFI değerinin, iyi uyum (0,946) gösterdiği bulunmuştur. Orijinal ölçekle benzer şekilde üç alt boyuttan oluşan ölçeğin Cronbach Alfa katsayısı “Karar Verme” alt ölçeği için ,650, “Baskıya Karşı Koyma” alt ölçeği için ,840, “İletişim” alt ölçeği için ,783 olarak hesaplanmıştır. Tüm ölçek toplam Cronbach Alfa iç tutarlık katsayısı değeri ise ,84 olarak ölçeğin geçerli ve güvenilir olduğu gösterilmiştir.Sonuç: Ölçeğin Türkiye de yaşayan kadınlarda geçerli ve güvenilir olduğu saptanmıştır.

OBJECTIVE: With the significant increase in the life expectancy of cystic fibrosis (CF) patients, many individuals now reach adulthood and develop specific coping strategies to maintain their physical and mental well-being. This study aims to evaluate coping styles and their relationship with mental health and Health-Related Quality of Life (H-RQoL) in adult CF patients. MATERIAL AND METHODS: Thirty adult CF patients completed the Hospital Anxiety and Depression Scale to assess anxiety and depression, the Cystic Fibrosis Questionnaire—Revised to evaluate quality of life, and the Brief Coping Orientation to Problems Experienced questionnaire to assess coping strategies. RESULTS: Twelve individuals (40%) met the diagnostic criteria for being at risk of experiencing anxiety and/or depression. Anxiety risk group exhibited lower life quality scores in the domains of vitality, emotional functioning, and role limitations (P = .027, P = .001, and P = .001, respectively). Patients reporting depressive symptoms had lower scores in emotional functioning and role limitations domains of quality of life (P = .005 and P = .018, respectively). Multivariate analysis indicated that depression and anxiety scores were significant predictors of emotional quality of life. In terms of coping strategies, “acceptance” was the most commonly preferred, while “substance use” was the least preferred strategy among all participants. Patients at risk of anxiety and/or depression often chose “avoidance” as their coping strategy. CONCLUSION: Anxiety and depressive symptoms are prevalent and associated with poorer H-RQoL in adult CF patients. These patients preferred to employ giving up strategy when dealing with the disease. Therefore, it is essential to screen adult CF patients for mental health risks and to work on improving their coping strategies.

Companies that aware of employees are the most important resource are developing employer branding practices that create a "best place to work” perception day by day. Today, social media platforms have become an important area for companies that want to increase the awareness of employer brands and reach large masses faster and more cost-effectively. This study aims to examine the practices of companies that reflect employer branding in the digital area. In the research, the accounts of 6 companies selected among the in Universum's research to determine the best employers in 2022 on Instagram, one of the most active platforms of social media, were examined; the posts were handled contextually and the practices reflecting the employer brand and the messages desired to be given were tried to be determined and the number of interactions were discussed. Content analysis method was used as the most appropriate method to determine the content of the companies' posts that reveal the employer brand and the practices discussed in these contents and to interpret the data obtained as a whole. Employee expectations identified in the "Employee Priorities and Preferences" research conducted by PwC in 2020, the employer brand dimensions (economic, interest-benefit, application, development, social-value, work-life balance and corporate social responsibility) identified within the scope of the research conducted by Berthon et al. in 2005 and Tanwar and Prasad in 2016 were analyzed and interpreted. In addition, when the posts are analyzed, it is seen that they can reach large audiences with likes, comments or views.

Introducción. El sistema de producción de cacao forma parte de la agricultura colombiana en las subregiones de Montes de María y La Mojana en el departamento de Sucre. En la literatura no hay evidencia de un estudio de caracterización y tipificación del sistema de producción. Objetivo. Analizar los aspectos socioeconómicos y tecnológicos del cultivo del cacao para la subregión de los Montes de María y La Mojana, y definir grupos homogéneos de productores que compartan las mismas características que sirvan de dominio de recomendación. Materiales y métodos. Se diseñaron y aplicaron encuestas a los agricultores de la región de Montes de María y La Mojana durante el año 2019. Se seleccionaron, por muestreo determinístico, veintidós agricultores. El análisis consistió en la tipificación de los agricultores por el método de distancias y agrupamiento jerárquico de Ward. Resultados. Se obtuvieron tres grupos de agricultores. El grupo GI con nivel tecnológico bajo, la escolaridad de los agricultores fue primaria incompleta, la producción presentó bajos rendimientos (420 kg ha-1). El Grupo GII agricultores con secundaria incompleta, rendimientos más altos que los del GI (491 kg ha-1), incorporaban prácticas como podas de formación y mantenimiento. El grupo GIII con mayor nivel de escolaridad, uso de opciones tecnológicas como mejores materiales de siembra y técnicas de manejo del cultivo, obtuvieron los rendimientos más altos entre todos los agricultores (550 kg ha-1). Conclusión. Las fincas tipificadas mostraron diferencias entre los grupos y se llegó a concluir que el grupo G3 fue el que obtuvo mayor rendimiento por hectárea, lo cual se atribuyó a la incorporación de nuevas tecnologías.

Objective: There is not enough data in the literature regarding Her-2 overexpression in uterine carcinosarcomas or its association with the prognosis. The aim of this study was to determine the Her-2 overexpression rate in uterine carcinosarcoma and to evaluate its relationship with the prognosis. Material and Method: Her-2 protein and gene status were evaluated by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), respectively, in hysterectomy specimens from 51 patients with uterine carcinosarcoma. Results: Her-2 protein expression in the epithelial component was negative in 42 patients (score 0 in 33 cases, score (+1) in 9 cases), score (+2) in 7 patients and score (+3) in 2 patients. None of the patients had Her-2 protein expression within the sarcomatous component of the tumors. Her-2 gene was not amplified in epithelial or mesenchymal tumor areas according to the FISH method. There was no difference between the Her-2 overexpression negative and positive groups in terms of disease-free survival (DFS) and overall survival (OS). Her-2 overexpression was significantly higher in tumors of patients diagnosed at 65 years or older (p=0.046). Conclusion: In our study, no relationship could be shown between Her-2 overexpression and prognosis in uterine carcinosarcoma. More comprehensive studies are needed to illustrate the relationship between Her-2 overexpression and carcinosarcoma prognosis.

One of the risk factors for pelvic insufficiency fractures is rheumatoid arthritis (RA). Unfortunately, the diagnosis of these fractures is difficult in these patients and their treatment is delayed. When a patient with RA comes a complaint of pain in the groin or lower back without a trauma, it should be considered that this may be an insufficiency fracture, and careful clinical assessment and appropriate imaging methods should be used. Insufficiency fractures are a rare complication of RA. In our case a 70-year old woman with RA presented with acute onset severe left groin pain. Computed tomographic scan of the left hip showed that there is probably an old fracture on the left anterior to the acetabular roof and superior-inferior pubic ramus. Fractures in the patient were treated conservatively. Early diagnosis followed by proper treatment may help improve the quality of life and prevent disability of these patients.

Tekstil işletmeleri hızlı değişen sektör dinamizminde ve artan rekabet ortamında hayatta kalabilmek için hem üretecekleri ürünlere doğru karar vermeli hem de üretimlerini gerçekleştirirken maliyet, hammadde temini, kapasite doluluk ve hata oranı kriterlerini optimum şartlarda sağlayabilmelidir. Bu çalışmada, Çok Kriterli Karar Verme (ÇKKV) yöntemlerinden MACBETH (Measuring Attractiveness by a Categorical Based Evaluation TecHnique) ve bulanık MARCOS (Measurement of Alternatives and Ranking according to the COmpromise Solution) yöntemleri birlikte kullanılarak bir tekstil işletmesi için üretilecek ideal ürün grubu belirlenmeye çalışılmıştır. Üretilecek ideal ürün grubu seçiminde dikkate alınan maliyet, hammadde temini, kapasite doluluk ve hata oranı kriterlerinin ağırlıklarının belirlenmesinde MACBETH yönteminden yararlanılmıştır. İşletmenin yoğun olarak en fazla ürettiği dört ürün grubu alternatifinin değerlendirilmesinde bulanık MARCOS yöntemi kullanılmış ve tekstil işletmesinde üretim parametrelerinin optimal şekilde yönetilebilmesi için en uygun ürün grubu belirlenmiştir.

Periduktal stromal hiperplazi (PDSH) iğsi stromal hücre proliferasyonu ile karakterize bifazik meme tümörleridir. Literatürde 15'ten az erişkin olgu bildirilmiştir. On dört yaşında kız olgu, 3 aydır sağ aksiller bölgede ele gelen şişlik nedeniyle başvurmuştur. Ultrasonografide her iki aksiller bölgede aksesuar meme dokusu ile uyumlu görünüm izlenmiştir. Sağ aksiller eksizyon materyalinin makroskopik incelemesinde 3x2x1 cm boyutlarda, kapsülsüz nodüler lipomatö görünümde kitle izlenmiştir. Kesit yüzünün yağ dokudan zengin ve ince fibrotik bantlar içerdiği dikkati çekmiştir. Histopatolojik değerlendirmede duktusların çevresinde yoğunlaşan iğsi hücreli stromal hücre proliferasyonu izlenmiştir. Olgumuzun postoperatif 14. ayında lokal nüks izlenmemiştir. PDSH sıklıkla ileri yaş kadınlarda gözlenen nadir lezyonlardır. Spesifik klinik ve radyolojik özellikleri yoktur. Genellikle eksizyon materyallerinde kesin tanı histopatolojik olarak verilebilmektedir. PDSH'ler filloid özellikler göstermezler. Periduktal alanlarda yoğunlaşan, düşük mitoz ve proliferasyon indeksi gösteren, belirgin atipi bulunmayan iğsi hücreli stromal proliferasyon izlenmektedir. Olgumuz beklenmeyen yaş grubu ve lokalizasyon açısından oldukça önemlidir. Aksiller kitle ile başvuran çocuklarda aksesuar meme dokusunun ayırıcı tanısı olarak PDSH akılda tutulmalıdır.

Objective: Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of GM cases, diagnostic clues for specific and idiopathic etiologies, the difficulties in evaluating trucut biopsies, and the results of different therapeutic approaches. Material and Method: We retrospectively analysed the clinical, radiological and morphological features of 114 GM cases diagnosed with fine needle aspiration, and trucut, incisional, and excisional biopsy. Results: The mean age was 35.8. Only eight cases were older than 45 years. Bilateral involvement was observed in 4 (3.5%) cases. The most common clinical symptoms were breast mass/abscesses, tenderness, and skin changes. Microbiological culture was positive in 4 cases for gram-positive bacteria. Only 3 cases showed a positive tuberculin/PCR test for tuberculosis. The major USG finding was a hypoechoic well-defined or ill-defined mass/abscess; MRI finding was heterogeneous non-mass contrast enhancement. Cases diagnosed with cytology (35 cases) did not have breast malignancy either in their history or clinical follow up period. Fine needle aspiration cytology materials revealed epitheloid granulomas mixed with neutrophils, lymphocytes accompanied by giant cells, and suppurative necrosis. Histopathological reevaluation of 65 trucut/incisional/ excisional biopsies revealed granuloma formation in 65 (100%), Langhans type giant cells in 59 (90.7%), microabscess formation in 41 (63%), caseous necrosis in 1 (1.5%), neutrophilic cysts in 30 (46.1%), eosinophilic infiltration in 48 (73.8%), interlobular inflammation in 14 (21.5%), fat necrosis in 5 (7.6%), ductal ectasia in 6 (9.2%), and lactational changes in 4 (6.1%) cases. Granulomas were lobulocentric in 58 cases, foreign body type/fat necrosis-related in 6 case, and periductular in 1 case. Cystic neutrophilic granulomatous mastitis was observed in one case. We also evaluated the histochemical stains of these 65 biopsies. Only one sample was positive for acido-resistant bacilli (ARB) by the EZN method and one sample was positive for gram-positive bacilli by gram stain. Conclusion: Small, superficial trucut biopsies may cause difficulties in determining the etiology and differential diagnosis of granulomatous mastitis. For optimal management and timing the appropriate therapy, the ideal biopsy procedure, special stains, and a multidisciplinary team consisting of the surgeon, pathologist, and radiologist are the most important issues.

Una revisión de la literatura evidencia que no está documentada la caracterización técnica y económica del sistema productivo de cacao en el departamento de Sucre, el objetivo de este trabajo fue caracterizar desde el punto de vista técnico y económico el sistema de producción estableciendo la relación entre los coeficientes técnicos de producción y los retornos económicos. La información se obtuvo de una encuesta estructurada aplicada a 23 agricultores, seleccionados mediante el método de muestreo determinístico. Los retornos económicos se calcularon con un patrón de costos de producción construido por el método del consenso. Los resultados permiten apreciar variables sociodemográficas para esta región donde el 77 % son del género masculino con un promedio de edad de 54 años y el 30.4 % del total alcanzaron estudios de bachillerato. El modelo productivo es de agricultura familiar, las técnicas de producción son sistemas agroforestales con algún grado de tecnificación como por ejemplo prácticas sostenibles de preparación del suelo y material de siembra certificado. La producción de un año en promedio genera ingresos por 4 320 000 COP que permiten recuperar los costos. La tasa interna de retorno es de 24 %, superior al costo de oportunidad del capital. Se concluye que los sistemas agroforestales con cacao contribuyen con la seguridad alimentaria y son sostenibles en el tiempo porque los ingresos son superiores a los costos, por cuanto el costo anual equivalente de 670 211 COP, es muy inferior a los ingresos generados por año, por tanto, es factible recuperar la inversión y generar ganancias.

Abstract The frequency of bacterial factors causing central nervous system infections has decreased as a result of the development of our national immunization program. In this study, it is aimed to obtain the data of our local surveillance by defining the viral etiology in cases diagnosed with meningoencephalitis for 1 year. Previously healhty 186 children, who applied with findings suggesting viral meningoencephalitis to 8 different tertiary health centers between August 2018 and August 2019, in Istanbul, were included. The cerebrospinal fluid (CSF) sample was evaluated by polymerase chain reaction. The M:F ratio was 1.24 in the patient group, whose age ranged from 1 to 216 months (mean 40.2 ± 48.7). Viral factor was detected in 26.8%. Enterovirus was the most common agent (24%) and followed by Adenovirus (22%) and HHV type 6 (22%). In the rest of the samples revealed HHV type 7 (10%), EBV (6%), CMV (6%), HSV type 1 (6%), Parvovirus (4%) and VZV (2%). The most common symptoms were fever (79%) and convulsions (45.7%). Antibiotherapy and antiviral therapy was started 48.6% and 4% respectively. Mortality and sequela rate resulted 0.53% and 3.7%, respectively. This highlights the importance of monitoring trends in encephalitis in Turkey with aview to improving pathogen diagnosis for encephalitis and rapidly identifying novel emerging encephalitis-causing pathogens that demand public health action especially in national immunisation programme.

Aim: This descriptive study was done to evaluate the perceptions of health beliefs and related factors of women attending a mammography unit for mammograms. Materials and Methods: It was carried out with 181 women admitted to a mammography unit of a university hospital. Data were measured using a questionnaire form. Results: Statistically significant differences were found between women's education (health motivation, Breast Self-Examination (BSE) benefits and barriers), BSE performance status (health motivation, BSE barriers and self-efficacy, mammography benefits and barriers) and family history of breast cancer (sensitivity, health motivation, BSE benefits) (p lt;0.05). As a result of the research findings, it was determined that 64.6% of women performed BSE. Conclusion: In accordance with these results, increasing the awareness training for breast cancer and the dissemination of screening may be suggested by taking into account the individual characteristics of women.