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OBJECTIVE: Late Fetal Growth Restriction (LFGR), a condition associated with perinatal and long-term neurodevelopmental problems, is caused by inadequate placental transfer of oxygen and nutrients to the fetus. This preliminary study evaluates the expression profiles and clinical significance of hypoxia-sensitive microRNA-210 (miR-210) and microRNA-185-5p (miR-185-5p) in placental and maternal circulation. The potential clinical implications of this research could significantly enhance the management of LFGR. STUDY DESIGN: In this prospective cohort study conducted at the Gynecology and Obstetrics Clinic of Trakya University Faculty of Medicine Hospital, miR-210 and miR-185-5p expression was evaluated in the placenta of healthy (n=30) and LFGR (n=30) cases. In healthy (n=15) and LFGR (n=15) cases, miRNA levels in maternal plasma were studied. We determined these two miRNAs using Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR) and statistically analyzed them with clinical data to determine robustness. We provided a comprehensive evaluation. RESULTS: Both the placenta and maternal plasma samples exhibited significant correlations with miR- 210 and miR-185-5p expression (r=0.615; r=0.771, p<0.01). The expression levels in both placenta and plasma were significantly higher in the LFGR group. Placental miR-210 demonstrated an AUC (0.908), sensitivity (93.3%), and specificity (96.7%), while plasma miR-210 showed AUC (0.738), sensitivity (86.7%), and specificity (66.7%). In contrast, placental miRNA 185-5p displayed a diagnostic performance with AUC (0.926), sensitivity (76.1%), and specificity (63.8%); plasma miRNA 185-5p exhibited an AUC (0.778), sensitivity (86.7%), and specificity (86.7%). However, placental miR-210 and miR-185-5p did not fully correlate with birth weight, placental weight, and fetal cerebroplacental Doppler ratio. CONCLUSION: Placental miRNA-210 showed superior diagnostic performance over placental miRNA 185-5p in LFGR pregnancies. However, it is crucial to emphasize that further studies are needed to validate these findings and correlate them with clinical data, underscoring the ongoing importance of research in this field. [ABSTRACT FROM AUTHOR]

Introduction: Insoles and exercise programs are the main treatment methods for pes planus patients. Insole using may prevent the formation of pain in daily activities as well as increasing the quality of walking. The aim of this study was to investigate insole usage time and the factors affecting this situation in patient with pes planus. Materials and Methods: 136 patients with pes planus who were prescribed an insole, included in the study. We invited patients to participate in a telephone survey. Patients´ demographics, insole usage time, reasons to quit and the quitting time were questioned. Insole usage rates and the demographic data of patients were compared. Results: Of the 136 patients included in the present study, 80 were women (59%) and 56 were male (31%). 86 of these patients used an insole six months and over, 15 of them used shorter than six months and 35 of them bought the insoles but they didn't use it (63%, 11% and 26% respectively ). The average age of patients who used insoles was 32.80±18.14 and who did not use insoles was 40.77±12.54 (p=0.04). 33.8 percent of women and 14.3 percent of men did not use insoles. This difference is statistically significant (p=0.04). We did not find any significant relationship between height, weight, body mass index values and usage of insoles (p>0:05). Conclusion: The use of insoles in treating patients with pes planus is widely accepted and may be affected by the demographics such as gender and age. Besides wearing comfort, female sex and older age should be considered that may affect the use of insoles.

Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights. [ABSTRACT FROM AUTHOR]

Purpose: The literature contains different information about the prognosis of invasive lobular carcinoma of breast cancer (BC). We aimed to address the inconsistency by comparatively examining the clinical features and prognosis of invasive lobular carcinoma patients in our university and to report our experience by dividing our patients into various subgroups. Patients and methods: Records of patients with BC admitted to Trakya University School of Medicine Department of Oncology between July 1999 and December 2021 were reviewed. The patients were divided into three groups (No-Special Type BC, Invasive Lobular Special Type BC, No-Lobular Special Type BC). Patient characteristics, treatment methods and oncological results are presented. Survival curves were generated using the Kaplan–Meier method. Statistical significance of survival among the selected variables was compared by using the log-rank test. Results: The patients in our study consisted of 2142 female and 15 male BC patients. There were 1814 patients with No-Special Type BC, 193 patients with Invasive Lobular Special Type BC, and 150 patients with No-Lobular Special Type BC. The duration of disease-free survival (DFS) was 226.5 months for the No-Special Type BC group, 216.7 months for the No-Lobular Special Type BC group, and 197.2 months for the Invasive Lobular Special Type BC group, whereas the duration of overall survival (OS) was 233.2 months for the No-Special Type BC group, 227.9 for the No-Lobular Special Type BC group, and 209.8 for the Invasive Lobular Special Type BC group. The duration of both DFS and OS was the lowest in the Invasive Lobular Special Type BC group. Multivariate factors that were significant risk factors for OS were Invasive Lobular Special Type BC histopathology (p =.045), T stage, N stage, stage, skin infiltration, positive surgical margins, high histological grade, and mitotic index. Modified radical mastectomy, chemotherapy, radiotherapy and use of tamoxifen and aromatase inhibitors for more than 5 years were significant protective factors for overall survival. Conclusion: The histopathological subgroup with the worst prognosis in our study was Invasive Lobular Special Type BC. Duration of DFS and OS were significantly shorter in Invasive Lobular Special Type BC than No-Lobular Special Type BC group. The classification of Invasive Lobular BC under the title of Special Type BC should be reconsidered and a more accurate treatment and follow-up process may be required. [ABSTRACT FROM AUTHOR]

Background : The principal aim of the present study was to determine whether Acinetobacter spp. pneumonia differs from hospital-acquired pneumonias (HAPs) caused by other agents with respect to therapeutic success and survival rate. METHODS : This study includes 140 adult patients diagnosed with HAPs caused by identified etiologic agents between March 2005 and February 2006. These patients were divided into two groups according to the agent responsible for their infection (Acinetobacter spp. [n = 63] or non-Acinetobacter spp. [n = 77]). The groups were compared in terms of risk factors, therapeutic success and six-week survival rates. Results : Previous antibiotic use and the risk of aspiration were independent factors responsible for the development of Acinetobacter spp. pneumonia. Hypoalbuminemia, steroid use and the use of a mechanical ventilator were determined to be mortality-associated independent risk factors for Acinetobacter spp. pneumonia. The clinical success rate at the end of therapy was 41.6% and, at the sixth week, the survival rate was 35% among patients in whom Acinetobacter spp. was the causative agent. Conversely, in the control group, these values were 43 and 32%, respectively ( P > 0.05). We found that the use of the appropriate antibiotics for the treatment of Acinetobacter spp. pneumonia was an important factor in survival ( P < 0.001). Conclusion : The outcomes of Acinetobacter spp. pneumonia do not differ from HAPs associated with non-Acinetobacter spp. in terms of therapeutic success and survival rates.

Purpose Lumbar puncture (LP) is one of the most common procedures performed in medicine. The aim of this prospective study is to determine the success rate of LP in lateral decubitus with 45-degree head-up tilt position, and compare it with traditional positions like sitting and lateral decubitus. Methods Three hundred and thirty patients between 25 and 85 years of age who had undergone abdominal, urologic, and lower limb extremities surgeries were enrolled and 300 patients were divided into three different groups. The LP was performed with a 25-G atraumatic needle, either in the standard sitting position (group S, n = 100), lateral decubitus, knee-chest position (group L, n = 100) or lateral decubitus, knee-chest position with a 45-degree head-up tilt (group M, n = 100). The free flow of clear cerebrospinal fluid (CSF) upon first attempt was considered to be evidence of a successful LP. Results Total LP success rate was significantly higher in group M (85 %) than in groups S and L (70 and 65 %, respectively) (p = 0.004). When the significance between the groups was evaluated according to age, the increase in the LP success rate was not significant for [less than or equal to]65 and >65 age groups. There were no differences among the three groups in terms of bloody CSF (p = 0.229) and the number of attempts before dural puncture (p = 0.052). Conclusions The lateral decubitus in knee-chest position with a 45-degree head-up tilt may be the preferred position for spinal anesthesia in young and elderly patients, due to the high success rate. Keywords Lumbar puncture * Spinal anesthesia * Technique * Patient position, Introduction Lumbar punctures (LP) are generally performed for spinal anesthesia, and also to diagnose neurological diseases with cerebrospinal fluid (CSF) examination. The sitting and lateral decubitus positions are commonly used [...]