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In this study, we aimed to evaluate the accuracy of fetal weight prediction, to investigate the validity of sonographic fetal anthropometric parameters in a Turkish population and to assess the most commonly used sonographic formulas for estimation of fetal birth weight. Our retrospective, cross-sectional study included 126 singleton deliveries between June 2010 and January 2011, at the Department of Obstetrics and Gynecology of the GATA Haydarpaşa Training Hospital. Ultrasonography measurement results were applied to nine different fetal weight estimation formulas. Mean error, mean absolute error, mean percentage error and mean absolute percentage error rates were calculated. Under- or overestimation rates and correlation coefficients were also calculated. Fetal biparietal diameter (BPD) and abdominal circumference (AC) were significantly correlated with the actual birth weight and the power analysis for both parameters was calculated as 81%. The highest correlation coefficients in our general population were those of the F1 (Hadlock 1) and F2 (Hadlock 2) models. The highest mean percentage error was detected on F8 (Merz 2) model. Fetal weight estimation modalities were observed to give the best results in a weight range of 3,000 and 3,500 g. Regression formulae used in our population, in general, tended to underestimate, however Hadlock 1 and 2 formulations provided the most accurate results. The Hadlock 1 formula estimated the closest to the actual birth weight in fetuses expected to be born under 3,000 g or over 3,500 g. [ABSTRACT FROM AUTHOR]

Empirical research frequently involves regression analysis with binary categorical variables, which are traditionally handled through dummy explanatory variables. This paper argues that separate category-wise models may provide a more logical and comprehensive tool for analysing data with binary categories. Exploring different aspects of both methods, we contrast the two with a Monte Carlo simulation and an empirical example to provide a practical insight. [ABSTRACT FROM PUBLISHER]

Purpose: Hip fractures in elderly individuals are associated with high mortality rates, even with advanced treatment options. Identifying factors correlated with mortality could guide potential preventive strategies. Elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, as well as the AST/ALT ratio (AAR), have been associated with mortality in various diseases, but their association with hip fracture mortality remains underexplored. This study investigates the correlation between AST, ALT, AAR, and routine laboratory parameters with 1-year mortality in elderly patients undergoing partial hip arthroplasty for femoral neck fractures., Methods: This retrospective cohort study analyzed data from 179 elderly patients (≥60 years) who underwent partial hip replacement for femoral neck fracture between January 2019 and December 2021., Results: Of the 179 patients, 29.6% died within one year of surgery. The deceased patients were older, predominantly male, and had higher rates of postoperative complications and transfusions. Univariate analysis identified age, sex, blood type, comorbidities, postoperative complications, transfusions, and laboratory parameters (including AAR, creatinine, and lymphocyte count) as associated with mortality. Multivariate analysis further highlighted advanced age, male sex, blood group A, postoperative transfusions, elevated creatinine levels, and high AAR (>2.1) as independent predictors of mortality., Conclusion: Our findings suggest that preoperative AAR may serve as an independent predictor of mortality in elderly patients undergoing hip fracture surgery, highlighting its potential utility in preoperative risk stratification., Competing Interests: Declarations. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki. This research has been approved by the Mersin Üniversitesi Rektörlüğü Klinik Araştırmalar Etik Kurulu (Mersin University Clinical Research Ethics Committee) (Decision date and no: 01/11/2023, 21/740). Informed consent was obtained from all individual participants included in the study as part of a routine process in our hospital for scientific research purposes. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Inborn errors of immunity (IEI) disorders, formerly primary immune deficiency diseases, are a heterogeneous group of disorders with variable hereditary transitions, clinical manifestations, complications and varying disease severity. Many of the clinical symptoms, signs and complications in IEI patients can be attributed to inflammatory and immune dysregulatory processes due to loss of microbial diversity (dysbiosis). For example, in common variable immunodeficiency patients, the diversity of bacteria, but not fungi, in the gut microbiota has been found to be reduced and significantly altered. Again, this was associated with a more severe disease phenotype. Compromise of the STAT3/Th17 pathway in hyper-IgE syndrome may lead to dysbiosis of the oral microbiota in these patients, causing Candida albicans to switch from commensal to pathogenic. Modification of the microbiota can be used as a therapeutic approach in patients with IEI. Prebiotics, probiotics, postbiotics and fecal microbiota transplantation can be used to restore the balance of the gut microbiota and reduce pathogenicity in IEI patients. Clinical trials are currently underway to understand the impact of this dysbiosis on the phenotype of IEI diseases and its role in their treatment., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Although guidelines strongly recommend low levels of low-density lipoprotein cholesterol (LDL-C) in patients with acute coronary syndrome (ACS), these goals are not achieved in many patients. We present expert recommendations for the in-hospital and post-discharge management of lipid-lowering therapy in ACS patients in Türkiye. A group of expert cardiologists comprising members of the Turkish Society of Cardiology and leading lipidologists who have all worked in national cardiology lipid working groups for at least 4 years, considered the optimal approach to lipid management in ACS patients in Türkiye, taking into account Turkish healthcare infrastructure and issues from real-world practice. Novel standardized algorithms covering the first year after an ACS event were developed. The main elements of the proposed approach are summarized. The in-hospital strategy includes lipid profile assessments and commencement of statin therapy, including appropriate measures for patients with possible familial hypercholesterolemia or with a history of recurrent cardiovascular events. The role of a specially-trained nurse, use of a patient follow-up card, and the provision of patient information and referrals to affiliated healthcare professionals, are covered. The post-discharge strategy covers follow-up visits to monitor the patient's progress and recommends timepoints at which modifications to treatment (based on LDL-C levels) should be made. A country-specific approach to lipid management in ACS patients in Türkiye is proposed. Further work is needed to determine the best way to implement the strategy, and to validate the recommendations and their application in daily practice.

Objective: The aim of our study was to evaluate the effect of anatomical measurements consisting of volar tilt, radial length, radial inclination, and ulnar variance obtained from X-ray radiography in predicting deformity in patients with rheumatoid arthritis and the power of these measurements in predicting rheumatoid arthritis in patients with nonspecific wrist pain., Methods: A total of 98 rheumatoid arthritis and 40 control patients presenting with nonspecific wrist pain were cross-sectionally evaluated by X-ray radiography. Rheumatoid arthritis patients were divided into subgroups with and without deformity. Volar tilt, radial length, radial inclination, and ulnar variance measurements were performed., Results: When the anatomical measurements of rheumatoid arthritis patients with and without wrist deformity were compared with the control group, volar tilt and radial length were significantly lower in rheumatoid arthritis patients with and without wrist deformity than in the control group. There was no difference between rheumatoid arthritis groups with and without deformity., Conclusions: Low volar tilt and radial length may be an early X-ray radiographic finding of rheumatoid arthritis and may provide additional diagnostic data in patients presenting with nonspecific wrist pain, especially for seronegative rheumatoid arthritis where diagnosis is difficult.

Introduction Tracheal intubation is a high-risk airway management protocol frequently applied in patients with critical illnesses. Numerous parameters have been suggested to predict mortality in these patients. Blood gas analysis, electrolyte levels, enzyme activities, and other biochemical measurements provide insights into a patient's metabolic status and organ functions. Accordingly, it is considered that these parameters have a significant potential for predicting the clinical outcomes of intubated patients. The study aimed to investigate the role of biochemical parameters in determining the 24-hour mortality risk of patients intubated in the emergency department and understand the potential significance of these parameters in predicting the clinical prognosis of these patients. Methods The present study was conducted on 1,236 patients who were intubated within a 1.5-year period at the Emergency Medicine Clinic of a tertiary Education and Research Hospital. Lactate, hemoglobin (Hgb), platelets (PLT), pH, HCO 3 , K, urea, creatinine, high-sensitivity troponin I (HS troponin I), and serum sodium levels were recorded for each patient in a data form. The 24-hour mortality rates were then analyzed based on these test results and comorbidities in the patients, and the data were recorded. Results The study included 702 patients after reviewing 1,236 cases. The median/mean values of HCO 3 , PLT, and pH were significantly higher in survivors compared to those who did not survive within 24 hours. Conversely, the median/mean values of lactate, creatinine, potassium, and HS troponin I were significantly higher in the patients who lost their lives within 24 hours than in the survivors. Epilepsy status, HCO 3 , lactate, potassium, and PLT values were statistically significant in the multivariate model in predicting 24-hour mortality. Conclusion The results of this study indicate that specific laboratory values, particularly blood gas analysis, play a significant role in predicting mortality among patients who present to the emergency department and undergo rapid sequence intubation. Patient prognosis can be predicted using these parameters, and treatment can be planned accordingly. Future multicenter prospective studies using standardized patient-specific intubation could provide further evidence for using the parameters in question in predicting mortality., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Prof. Dr. Cemil Taşcıoğlu City Hospital Clinical Research Ethics Committee issued approval 350. The documents related to the application file given above have been examined and found appropriate, taking into account the justification, purpose, approach and methods of the research/study, and it has been decided by the majority of the ethics committee members who attended the meeting that there is no ethical or scientific harm in conducting the research/study in the centers specified in the application file. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Koca et al.)

Introduction: Treatment of de novo vesicoureteral reflux (VUR) into the transplanted kidney constitutes a clinical challenge. Herein, we present our data on patients who underwent endoscopic subureteric injection for the treatment of VUR following renal transplantation (RT) in our center., Methods: The patients who underwent endoscopic subureteric injection for VUR into the transplanted kidney after RT in our department between 2008 and 2023 were reviewed retrospectively. Indication for subureteric injection, age, gender, laterality, number of injections, amount of material used, renal failure etiology, auxiliary procedures, and treatment success were noted. All interventions were performed by pediatric urologists who also perform RT., Results: During a median followup of 27.5 (4-160) months, 22 patients (17 women, 77.2%) and 23 transplanted ureters (13 right, eight left, one bilateral) were treated with subureteric injections. In all patients, the indications for subureteric injection were recurrent febrile urinary tract infection (UTI), and the grades of VUR varied between I and IV. Patients received a median of 1.65 cc (0.7-2.7) dextranomer-hyaluronic acid copolymer. In total, 10 RTs (eight from living donors, two from cadaveric donors) were performed in another center, whereas 13 RTs were carried out in our center (eight from cadaveric donors and five from living donors). Among the patients who were transplanted in our center, the rate of subureteric injections due to de novo symptomatic VUR after RT was 2.2% (13/593 patients). After subureteric injections, five patients required a second injection due to the recurrence of VUR. Ureteroureterostomy (to the native ureter) was performed in two patients who had further UTIs after the second endoscopic treatment. Eventually, 19/21 patients (90.4%) benefited clinically from the endoscopic treatment and none of the patients underwent re-do ureteroneocystostomy. It is noteworthy that the etiology of renal failure was VUR nephropathy in seven (31.8%) patients., Conclusions: Subureteric injection provides a high clinical success for the treatment of de novo VUR after RT.

Pharmaceutical companies claim that they need high drug prices to generate sufficient profits to invest in innovation. While this claim can be valid in principle, it is contradicted by the extent to which "Big Pharma" companies in the United States (US) distribute profits to shareholders in the form of cash dividends and stock buybacks. For 2013-2022, the 14 US-based pharmaceutical companies in the S&P 500 Index paid out 54% of net income as dividends and another 51% as buybacks. Incentivizing senior corporate executives to allocate resources in this financialized manner is, as we document, their stock-based compensation. In effect, these companies use high stock prices to boost stock yields at the expense of investing in innovation and compensating workers and taxpayers who make value-creating contributions to the corporation. Given the prominence of US-based pharmaceutical corporations in Canada, we explain how their financialization results in high Canadian drug prices and underinvestment in pharmaceutical research and development in Canada., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: This study aims to compare vastus lateralis and ventrogluteal site utilizations concerning pain and fear in intramuscular injection in children between 4 and 6 years of age., Methods: A randomized trial design was utilized in this study. Groups were randomly assigned as ventrogluteal (n=43) and vastus lateralis (n=40). Children in both groups were compared before, during, and after the procedure using the Children's Fear Scale and the Wong-Baker Faces Pain Rating Scale. Crying time was measured using a stopwatch during the procedure., Results: While the mean Children's Fear Scale total scores of the children in the ventrogluteal group were similar before the procedure, the mean Children's Fear Scale total scores during and after the procedure were significantly lower than the children in the vastus lateralis group. Wong-Baker Faces Pain Rating Scale mean scores were significantly lower in the ventrogluteal group. The mean crying time of the children in the ventrogluteal group was significantly lesser than those in the vastus lateralis group (p=0.000)., Conclusion: The results of the study showed that the choice of the ventrogluteal site in intramuscular injection in children between 4 and 6 years of age was effective in reducing pain, fear, and crying time.

This study was aimed to identify the most frequently observed pathogens in uncomplicated urinary tract infections from outpatient urinary isolates obtained across seven different geographical regions in Türkiye and to determine whether the antibiotic resistance rates of these pathogens differ significantly between these regions. The study included patients aged 18 to 65 years who were diagnosed with uncomplicated urinary tract infections and had positive urine cultures from March 2021 to August 2022, across 37 different centers in Türkiye. The participating centers were selected based on their use of the disk diffusion method, in line with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines, to ensure standardization of urine culture data. A total of 1850 patients who met the inclusion criteria were included in the study. The analysis of the distribution of antibiotic resistance rates in Escherichia coli isolates revealed statistically significant differences in resistance to ampicillin, fosfomycin and nitrofurantoin across different regions (p< 0.05, p< 0.05, p< 0.05, respectively). The Southeastern Anatolia region was identified as having the highest resistance rates to fosfomycin and trimethoprim-sulfamethoxazole (27.4% and 35.3%, respectively). Additionally, the region with the highest nitrofurantoin resistance was determined as the Eastern Anatolia Region with a rate of 35.7% and the region with the highest ciprofloxacin resistance was determined as the Central Anatolia Region with a rate of 51%. Our study demonstrated that antibiotic resistance in the treatment of uncomplicated urinary tract infections varies by geographical region. We believe this comprehensive, national prospective study will provide valuable insights for clinicians planning empirical treatment for uncomplicated urinary tract infections.

Vitamin D is a steroid hormone that is naturally produced in the body or obtained through dietary sources, primarily under the influence of UVB radiation. This essential nutrient has a vital role in numerous physiological processes, encompassing immune function, cell growth, differentiation, insulin regulation, and cardiovascular well-being, along with its pivotal role in sustaining the delicate equilibrium of calcium and phosphate concentrations in the body. Moreover, vitamin D reinforces mucosal defense and bolsters the immune system through immunomodulation, making it a critical component of overall health. Numerous studies have unveiled the profound connection between vitamin D and the predisposition to respiratory tract infections, including well-known viruses such as influenza and the novel severe acute respiratory syndrome coronavirus 2. Vitamin D deficiency has been consistently linked to increased severity of coronavirus disease 2019 (COVID-19) and a heightened risk of mortality among afflicted individuals. Retrospective observational studies have further substantiated these findings, indicating that levels of vitamin D are linked with both the occurrence and severity of COVID-19 cases. Vitamin D has its influence on viral infections through a multitude of mechanisms, such as promoting the release of antimicrobial peptides and fine-tuning the responses of the immune system. Additionally, vitamin D is intertwined with the intricate network of the renin-angiotensin system, suggesting a potential impact on the development of complications related to COVID-19. While further clinical trials and extensive research are warranted, the existing body of evidence strongly hints at the possible use of vitamin D as a valuable tool in the prophylaxis and management of COVID-19 and other viral infectious diseases., Competing Interests: Conflict-of-interest statement: All authors have no conflicts of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Competing Interests: The authors declare no conflicts of interest.

Objectives: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes., Materials and Methods: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes., Results: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge., Conclusion: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields., Competing Interests: None declared., (Copyright: © 2024 Turkish Journal of Emergency Medicine.)

Mast cells are a subtype of white blood cells and are involved in the immune system. These cells contain many chemical substances called mediators, which are involved in the allergic response. The fact that mast cells play a role in many events that require urgent intervention, especially anaphylaxis, has led to a more detailed study of these cells. The diseases also caused by dysfunctions of mast cells have been examined in many circumstances. For instance, mast cell activation syndrome is known as an augmented number of cells due to decreased cell death, resulting in clinical symptoms affecting many systems. The main common symptoms include flushing, hypotension, urticaria, angioedema, headache, vomiting and diarrhea. Although the underlying mechanism is not yet clearly known, we aim to review the literature in a broad perspective and bring together the existing knowledge in the light of the literature due to the diversity of its involvement in the body and the fact that it is a little known syndrome., Competing Interests: Conflict-of-interest statement: The authors whose names are listed above, certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)