The guidelines for the management of thyroid nodules and differentiated thyroid cancer were first published by the American Thyroid Association in 1996 and subsequently updated in 2006, 2009, and 2015. In light of advances in technology and the accumulation of new scientific evidence, the guidelines were revised once again in 2025. The most notable change in the 2025 version is the exclusion of thyroid nodules, with the focus placed solely on differentiated thyroid cancer. This review aims to provide an overview of the major recommendation level changes introduced in the 2025 ATA guidelines compared with the previous version. This part specifically addresses the updates regarding the diagnosis and surgical management of differentiated thyroid cancer.

American Thyroid Association (ATA) guidelines for the management of thyroid nodules and differentiated thyroid cancer (DTC) were first published in 1996 and subsequently updated in 2006, 2009, and 2015. In 2025, the ATA released a revised version focus-ing exclusively on DTC and excluding thyroid nodules from its scope. In our previous review, we summarized the updates regard-ing preoperative evaluation, diagnosis, and surgical management of DTC. In this second part of the series, we aimed to compare the 2015 and 2025 ATA guidelines in terms of initial postoperative management. The main changes are evaluated at the level of recommendations, with a particular emphasis on recurrence risk stratification, postoperative risk-adapted surveillance, adjuvant radioactive iodine (RAI) use, postoperative imaging, and radiation safety. This review provides a comprehensive comparison of the 2015 and 2025 ATA guidelines, outlining the key changes in early postoperative management of DTC and highlighting their potential impact on individualized patient care.

American Thyroid Association (ATA) guidelines for the management of thyroid nodules and differentiated thyroid cancer (DTC) were first published in 1996 and updated in 2006, 2009, and 2015. In 2025, the ATA released a revised version that, for the first time, focuses exclusively on DTC. In our previous reviews, we summarized the updates on preoperative, diagnostic, surgical, and early postoperative management of DTC. In this third and final part, we compare the 2015 and 2025 ATA guidelines with respect to long-term follow-up, TSH suppression strategies, thyroglobulin monitoring, follow-up of low-risk patients. Diagnostic radioiodine whole-body scanning, FDG-PET/CT, dynamic risk stratification, and the management of recurrent or metastatic disease, including local therapies, radioiodine preparation and dosing, and systemic treatments were also highlighted in this part. Particular emphasis is placed on the expanded recommendations for kinase inhibitor therapy, sequencing of systemic agents, targeted therapies (NTRK, RET, ALK, BRAF), redifferentiation approaches, immunotherapy, and supportive care strategies addressing bone and brain metastases, financial toxicity and psychosocial needs. This review provides a comprehensive synthesis of these updates and discusses their implications for individualized long-term management of DTC.

Objectives: The aim of this retrospective study was to evaluate and compare cervical ultrasound findings, fine needle aspiration biopsy (FNAB) results and excisional biopsy results in the diagnosis of patients presenting with cervical lymphadenopathy and to reveal the most common causes.
Methods: A total of 137 patients who underwent cervical ultrasonography and FNAB before excision were included in the study. Demographic data, cervical ultrasonographic findings, FNAB pathology results and final pathology results after excisional biopsy were analysed.
Results: The pathological results indicated that reactive follicular hyperplasia was diagnosed in 33.6% (n=46) of the patients. A diagnosis of non-Hodgkin lymphoma (NHL) was made in 27.7% (n=38) of cases, while 13.1% (n=18) were diagnosed with Hodgkin lymphoma. Malignant pathology was diagnosed in 66 patients. In the FNAB results of patients diagnosed as malignant, 57 were interpreted as non-diagnostic and suspicious, while 9 were interpreted as benign. Of these, 8 had a pathological examination of lymph node excision that revealed non-Hodgkin lymphoma (NHL), and in one patient with a benign FNAB result, the result of lymph node excision was reported as malignant.
Conclusion: Especially in cervical lymphadenopathies in patients over 40 years of age, the possibility of malignancy increases significantly. In lymphoproliferative diseases and in cases accompanied by clinical suspicion, it would be rational to use the direct excisional biopsy option. Although prior fine needle aspiration biopsy may provide significant guidance in metastatic diseases, it should be kept in mind that false negative rates may increase in the diagnosis and staging of lymphoma.( SETB-2025-04-078)

Objectives: Despite the prevalence of saphenous vein graft (SVG) failure following coronary artery bypass graft (CABG) surgery, SVGs continue to be widely used. This study aimed to investigate the value of the CHA2DS2-VASc score, originally developed for predicting thromboembolic events in atrial fibrillation, in predicting SVG failure post-CABG.
Methods: This retrospective study analyzed data from 526 patients with a history of CABG who presented with non-ST-elevation myocardial infarction between January 2017 and April 2024. SVG failure was defined as exhibiting stenosis of 70% or greater, or complete occlusion. Preoperative CHA2DS2-VASc scores were calculated for each patient. Multivariable analysis was conducted to identify independent predictors of SVG failure.
Results: Among the 526 patients, 242 (46%) experienced SVG failure. Patients with SVG failure exhibited higher CHA2DS2-VASc scores. Multivariable analysis identified the CHA2DS2-VASc score (OR: 2.203, 95% CI: 1.672-2.902, p<0.001), time interval after CABG (OR: 1.167, 95% CI: 1.081-1.259, p<0.001), and number of SVGs (OR: 2.378, 95% CI: 1.745-3.241, p<0.001) as independent predictors of SVG failure. Of those parameters, the CHA2DS2-VASc score demonstrated a higher AUC value (AUC=0.796, AUC=0.724, AUC=0.641, respectively).
Conclusion: Pre-operative CHA2DS2-VASc score may be predictive of late SVG failure after CABG.(SETB-2024-12-198)

Objectives: This research evaluates the accuracy and reliability of ChatGPT’s responses to inquiries concerning coronary artery bypass graft (CABG) surgery.
Methods: Between December 1, 2024, and December 15, 2024, two sets of questions were used to assess ChatGPT’s performance: (1) a list of frequently asked questions (FAQs) sourced from official cardiovascular surgery websites, professional healthcare platforms, and social media, and (2) a list of scientific questions derived from the 2021 American Association for Thoracic Surgery (AATS) Guidelines for CABG in patients with ischemic cardiomyopathy and heart failure. Responses were evaluated using the modified DISCERN scoring system. To test reproducibility, each question was asked twice on separate computers within the same day. Two experienced cardiovascular surgeons independently scored the responses, and any disagreements were resolved through discussion.
Results: A total of 107 FAQs were assessed, of which 88 met the inclusion criteria. Based on the modified DISCERN scale, 71 responses (80.7%) received a score of 5, while 9 responses (10.2%) were rated as 4. The highest accuracy was observed in the preoperative preparation category, where all responses achieved a perfect score. Regarding scientific questions derived from the AATS Guidelines, 15 out of 20 (75.0%) were answered thoroughly and satisfactorily. The reproducibility rate was 92.0% for FAQs and 90.0% for guideline-based questions.
Conclusion: This study is the first to demonstrate that ChatGPT provides highly accurate and dependable responses regarding CABG surgery, particularly for frequently asked questions. Although performance declines slightly when addressing scientific questions based on guidelines, the reproducibility rate remains high. These findings indicate that AI-driven tools like ChatGPT could play a valuable role in patient education and enhancing public awareness about CABG surgery.

Objectives: To compare the outcomes of the patients with primary spontaneous pneumothorax (PSP) treated by immediate video-assisted thoracoscopic surgery (VATS) and chest tube placement in the first episode.
Methods: Fifty patients aged between 18 and 40 years with PSP were grouped regarding the treatment modalities as G1 (patients undergoing chest tube placement, n=25) and G2 (patients undergoing immediate VATS, n=25). VATS procedure consisted of apical blebectomy and partial pleurectomy. Early outcomes (chest tube and hospital duration, and in-hospital complications) and late outcomes (recurrence rate after 10 years) were compared.
Results: In G2, the mean duration of surgery was 40.3±14.5 min. No conversion to thoracotomy was required. The rate of complication was insignificantly higher in G1 (p>0.05). Prolonged air leak was significantly common in G1 (p=0.03). In G2, the duration of chest tube and hospital stay were significantly lower (p=0.03 and p=0.05, respectively). After a follow-up of 10 years, a significantly higher recurrence rate was recorded in G1 (p=0.02). Recurrence was insignificantly higher in smokers (p>0.05), and mostly detected in older patients (p=0.03).
Conclusion: Immediate VATS in the first episode of PSP is an effective treatment to prevent recurrence in patients with PSP. VATS is safe with a lower rate of morbidity, and lower durations of chest tube and hospital stay compared to chest tube treatment

Objectives: The role of bone grafting in the surgical treatment of displaced intra-articular calcaneal fractures (DIACFs) remains controversial. Although bone grafts are commonly used to restore joint congruity and support anatomical reduction, recent evidence favors minimally invasive approaches that may eliminate the need for routine grafting. This study aimed to evaluate the impact of bone graft use on radiological parameters and functional outcomes in Sanders Type II, III, and IV calcaneal fractures treated surgically.
Methods: This retrospective cohort study included 115 patients who underwent open reduction and internal fixation (ORIF) for DIACFs between 2016 and 2022. Fractures were classified using the Sanders classification and subgrouped as grafted (+) or non-grafted (–). Böhler and Gissane angles and calcaneal height were measured at four time points. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. Intergroup and intragroup comparisons were made using appropriate statistical methods.
Results: Of the 115 patients, 38 had Type II, 43 had Type III, and 34 had Type IV fractures. Demographics and follow-up durations were comparable across groups (p>0.05). Both grafted and non-grafted groups demonstrated significant postoperative improvements in radiological parameters (p<0.05), which gradually declined over time. No statistically significant intergroup differences were observed at any time point (p>0.05). AOFAS scores and superficial wound infection rates were also similar.
Conclusion: Bone grafting did not yield superior radiological or functional outcomes in Sanders Type II, III and IV DIACFs treated with ORIF. These findings support a selective approach to grafting, especially in cases with significant comminution or bone loss, and align with current trends favoring biologically friendly and minimally invasive techniques.(SETB-2025-04-092)

Objectives: Mechanical thrombectomy (MT) has revolutionized stroke care over the past decade. Thus, we aimed to assess whether presenting during off-hours affects workflow times, clinical outcomes, and mortality of patients with acute ischemic stroke (AIS) undergoing MT at our center and, if there is an impact, to identify areas for improvement in the treatment of acute stroke.
Methods: A total of 263 consecutive patients who underwent MT between January 2020 and April 2023 were included in the study. The patients were categorized into two groups: those who presented during on-hours (Group 1) and those who presented during off-hours (Group 2).
Results: Among the 263 patients enrolled in the study (131 men and 132 women; mean age: 69.49±12.22 years; age range: 25–95 years), 74 (28.14%) were admitted to the hospital during on-hours, and 189 (71.86%) were admitted during off-hours. Of these patients, 30 (40.54%) and 68 (35.98%) from Groups 1 and 2, respectively, had good outcomes in the third month. The groups showed similar demographics, treatment-related characteristics, and outcomes, with no significant differences detected. The only notable difference was that the percentage of Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) was notably greater in the off-hours group (p =0.044).
Conclusion: The results indicate that MT performed on patients presenting during off-hours yielded similar workflow times, successful recanalization, and clinical outcomes to MT performed on patients presenting during on-hours. (SETB-2025-03-064)

Objectives: The aim of this study is to evaluate whether the presence of other HPV genotypes in addition to HPV16 infection has a negative effect on pathological outcomes.
Methods: This retrospective study was conducted using data from patients followed up at the Gynaecological Oncology Clinic of Antalya Training and Research Hospital between 2017 and 2025. Patients who were HPV16-positive and also carried other genotypes in addition to HPV16 were included in the study. HPV genotyping was performed using the Hybrid Capture 2 and CLART Genomica systems.
Results: Of the total 2,700 HPV (Human Papillomavirus) -positive women, 524 were HPV16-positive only, while 358 were positive for HPV16 along with other genotypes. Histopathological results, including CIN 2/3, HSIL, and invasive cancer, did not show significant differences between the two groups (p>0.05). However, abnormal colposcopy findings were statistically more prevalent in the co-infection group (p=0.037). Cigarette smoking was associated with a 1.27-fold increased risk for co-infection (p=0.026).
Conclusion: The findings of this study indicate that HPV16 is the primary determinant in the development of high-grade cervical pathology, and the presence of other high-risk HPV types does not significantly worsen histopathological outcomes. The results support the importance of a risk-based approach in cervical cancer screening processes and emphasize the need to prioritise early diagnosis and preventive interventions in HPV16-positive individuals

Objectives: Inherited metabolic diseases (IMDs) arise due to deficiencies in enzymes involved in metabolic pathways or other dysfunctions within these pathways, leading to a deficiency of specific end products or the toxic accumulation of intermediate metabolites. These diseases may present at any age with varying clinical courses. With advances in treatment options and increased awareness, IMDs are increasingly being diagnosed and managed in adulthood. This study aims to understand the clinical features and diagnostic processes of patients diagnosed with IMDs during adulthood and to raise awareness regarding these conditions.
Methods: Medical records of adult patients diagnosed with IMDs between June 2022 and June 2024 were retrospectively reviewed. Patients were included if they were diagnosed with an IMD at or above the age of 18. Those diagnosed during childhood but transitioning to adulthood were excluded.
Results: Twenty patients, aged 19–72 years (11 males, 9 females), were diagnosed with IMDs. The mean age of symptom onset was 30 years (range: 15–70 years), and the mean age of diagnosis was 37 years (range: 18–72 years). Diagnoses included Fabry disease (n=10, 20%), familial hypobetalipoproteinemia (FHBL) (n=3, 15%), and alkaptonuria (AKU) (n=2, 10%). Other diagnoses included Gaucher disease, Niemann-Pick disease type B, glycogen storage disease type IIIa (GSD IIIa), glycogen storage disease type XV (GSD XV), and cerebrotendinous xanthomatosis (CTX). Sixty-five percent of patients were identified via family screening, while 35% were diagnosed based on clinical findings supported by biochemical tests. Misdiagnoses before definitive IMD diagnosis included osteoarthritis, psoriatic arthritis, renal failure, heart failure, proteinuria, interstitial lung disease, hepatosteatosis, and nephrolithiasis. Disease-specific treatments were initiated and follow-ups were conducted.
Conclusion: Chronic and mild phenotypes of certain IMDs may pose diagnostic challenges. Increased awareness among healthcare professionals and further studies focusing on differential diagnoses are critical to improving the detection and management of IMDs.

Objective: We analyses separate age groups for in-hospital COVID pediatric patients clinical symptoms, lab tests, and treatment efforts. We also wanted to see if having another illness or a patient’s nutritional condition could change the way the disease unfolds.
Method: Between July 2020 and September 2021, 90 pediatric patients (aged 1 month-18 years) with positive PCR and/or antibody tests who were hospitalised in our hospital were included in the study. Patients were classified according to age groups (0-2, 2-5, 5-12, >12 years), disease severity and presence of comorbidities. Demographic characteristics, clinical findings, laboratory parameters and radiological imaging were evaluated.
Results: The disease had a mild course in 73.3% of the patients with a mean age of 87 months. In the youngest age group (0-2 years), fever (53.3%) and respiratory distress (26.7%) were more common and hospital stay was longer (median 7 days). Comorbidity rate (47.4%) was significantly higher in the moderate to severe disease group (p<0.001). The rates of elevated CRP (54.5%) and pathological chest radiography (36.4%) were higher in obese children. Recovery time was significantly longer in comorbid patients (7.3±2.4 days).
Conclusion: Our study suggests that COVID-19 does not affect all children in the same way—it appears to vary notably with age. In our observations, younger children and those with existing health conditions seem to require a bit more care and close monitoring to ensure the best outcomes.

Objectives: Central precocious puberty (CPP) can present as either slowly progressing CPP (SP-CPP) or rapidly progressing CPP (RP-CPP). The speed of progression is critical in determining treatment decisions. This study aims to compare the clinical data between patients who received treatment and those who did not, and to identify factors that may influence the progression in cases of RP-CPP.
Methods: This single-center retrospective observational study includes 406 female patients aged 5-8 years who were followed for CPP at the pediatric endocrinology clinic between 2021 and 2023. The patients were categorized into two groups: those with SP-CPP who did not receive gonadotropin-releasing hormone agonist (GnRHa) treatment (n=252) and those with RP-CPP who did receive GnRHa treatment (n=154). Patients were analyzed according to clinical, laboratory, and radiological findings.
Results: The median age at onset of pubertal signs were 7.2 years (Range 5-8) for the SP-CPP group and 7 (5-8) years for the RP-CPP group (p=0.352). In univariate analysis, Tanner breast stage, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, peak LH levels, and bone age/chronological age ratios were significantly higher in the RP-CPP group. In multivariate logistic regression analysis, Tanner breast stage (p=0.001) and the bone age/chronological age ratio (p<0.001) were found to be a significant parameter, while other variables were not significant (p>0.05).
Conclusion: In this cohort, the bone age/chronological age ratio is a significant parameter for early detection of rapidly progressing precocious puberty cases. It is crucial to classify early puberty cases by evaluating clinical, laboratory, and radiological findings collectively and to make treatment decisions based on individual assessments.

Objectives: This study aimed to evaluate the therapeutic plasma exchange (TPE) procedures performed in our pediatric intensive care unit (PICU) and to review the relevant literature.
Methods: This retrospective study was conducted between 2020 and 2024. Forty-nine patients who received TPE at any point during their PICU stay were included. The groups were categorized as survivors and non-survivors.
Results: Of the 49 cases, 71.4% were male, with a median age of 54 months (range 20–135 months). A total of 274 TPE sessions were performed. The three most common indications for TPE were sepsis, trauma induced multiple organ dysfunction syndrome/disseminated intravascular coagulation, and neurological diseases. The non-survivor group had higher rates of chronic illness (p<0.001), pediatric risk of mortality score III, and pre- and post-procedure vasoactive inotropic scores (p=0.005, p<0.001, and p<0.001, respectively). The use of invasive mechanical ventilation and continuous renal replacement therapy (p=0.005, p<0.001, respectively), as well as TPE in cases with sepsis (p<0.001), were more frequent in non-survivors. The most common complication during the procedures was hypotension (9.9%).
Conclusions: Sepsis remains the most frequent indication for TPE in PICUs. Although the most common complication of TPE in our study was hypotension, there were no life-threatening complications, suggesting it is a safe treatment modality.

Objectives: Breastfeeding is accepted to be the optimum nutrition for term and preterm newborns. The objective of our study was to investigate the rates of exclusive breastfeeding (EBF) at discharge among infants less than 34 weeks of gestation (GWs), followed up in neonatal intensive care unit (NICU) and to analyze the factors influencing EBF practices at discharge and 6th months of age.
Methods: In this study, we retrospectively evaluated the medical records of neonates <34 GWs admitted to NICU within the first postnatal 24 hours of life between January 2022 and June 2023. The maternal and neonatal demographic data and the related medical and nutritional factors, morbidities were recorded. Data regarding the duration of exclusive breastfeeding, and the maintenance of breastfeeding were retrieved from the follow-up records of the high-risk newborn outpatient clinic post-discharge. The rate of breastfeeding at discharge and the factors influencing breastfeeding practices were analyzed.
Results: The study cohort comprised 114 neonates, of whom 44.8% were female and 55.2% were male. The mean gestational age was 29.8±2.6 weeks and the mean birth weight was 1365±474 grams. The exclusive breastfeeding rate was 57.8% at discharge and declined to 45.6% at six months. The mean duration of breastfeeding was 15.7±6.5 months. Maternal ethnicity and the language barrier were found to be statistically significantly associated with exclusive breastfeeding at discharge, respectively (p=0.04, p=0.05). Infants who were exclusively breastfed at six months had significantly higher gestational age and shorter duration of hospital stay, respectively (p=0.029, p=0.02). Exclusive breastfeeding at six months was statistically significantly associated with a reduced incidence of extrauterine growth retardation (EUGR) (p=0.04). Among exclusively breastfed infants at discharge, 96.9% (n=64) received breast milk as their first feed, significantly more than mixed-fed infants (p=0.005). Time to reach full enteral feeding was also statistically significantly shorter in the exclusively breastfed group (p=0.017). Infants with a shorter duration of feeding via orogastric/nasogastric tube had a significantly higher rate of exclusive breastfeeding at six months compared to the mixed-fed group (p=0.043).
Conclusion: To improve exclusive breastfeeding rates at discharge and six months postnatally, and to reduce the incidence of EUGR, feeding preterm infants with their mother’s own milk from birth should be actively promoted. In addition, comprehensive and consistent maternal support should be provided in the NICU to facilitate both the initiation and continuation of breastfeeding under all circumstances from birth. (SETB-2025-04-084)

Objectives: The aim of this study is to evaluate neurodevelopmental and cognitive outcomes in patients diagnosed with different types of hyperphenylalaninemia (HPA), identify the factors influencing these outcomes, and contribute to the debate regarding the thresold for initiating dietary treatment based on plasma phenylalanine (Phe) levels.
Methods: Patients with hyperphenylalaninemia (HPA) who were followed up and had developmental and/or cognitive evaluations at the Division of Pediatric Metabolism and Nutrition, Department of Pediatrics, between 1984 and 2018, were retrospectively assessed. The study included patients with mild (Phe: 360-600 μmol/L), moderate (Phe: 600-1200 μmol/L), or classic Phenylketonuria (PKU) (Phe ≥1200 μmol/L) treated with diet and/or tetrahydrobiopterin (BH4), along with untreated HPA patients (Phe: 240-360 μmol/L). This classification was based on plasma Phe levels measured at the time of diagnosis. Denver Developmental Screening Test (DDST), Stanford-Binet test, and Wechsler Intelligence Scale for Children (WISC-R) adapted for Turkish children were applied for developmental and cognitive evaluation. Intellectual disability or developmental delay (ID/DD) was defined as a full-scale intelligence quotient (IQ) <70 on the Stanford-Binet or WISC-R, or as delay in two or more developmental domains on the DDST, with children meeting any of these criteria classified as having ID/DD. The relationships between ID/DD, age at diagnosis, diagnostic methods, plasma Phe levels, and brain MRI findings were analyzed.
Results: A total of 342 patients were included in the study, comprising 182 (53.2%) females and 160 (46.8%) males. Of these, 53 (15.5%) had mild PKU, 97 (28.4%) had moderate PKU, 102 (29.8%) had classic PKU, and 90 (26.3%) were diagnosed with HPA. A significant association was found between ID/DD and both the age at diagnosis and diagnostic method in patients treated with diet and/or BH4 (p < 0.001 and p < 0.01, respectively). In patients with ID/DD, the median plasma Phe levels at the first, third, and last years of follow-up were significantly higher compared to patients without ID/DD (p < 0.024). White matter abnormalities observed on brain MRI were significantly associated with PKU severity, the presence of ID/DD, and the median plasma Phe levels in the last year of follow-up (p = 0.01, p < 0.001, and p < 0.001, respectively). Notably, 9 (10% ) of untreated HPA patients exhibited ID/DD, despite regular follow-up and the absence of known risk factors.
Conclusion: In addition to early diagnosis and treatment, lifelong adherence and regular follow-up are essential for achieving normal neurodevelopmental and cognitive outcomes in individuals with PKU. However, clinical management remains heterogeneous across centers. The presence of developmental delay in 10% of untreated HPA patients underscores the need to urgently re-evaluate current plasma Phe thresholds for treatment initiation and follow-up. (SETB-2025-12-209)

Objectives: Alopecia areata (AA) is a common, chronic autoimmune disease that causes non-cicatricial hair loss. Its relapsing and remitting nature leads to the search for new, effective treatment options. The study aimed to evaluate the therapeutic efficacy of intralesional platelet-rich plasma (PRP) and intralesional steroid (ILS) injections in patients with AA.
Methods: A retrospective chart review was carried out from 2020-2021. A total of 75 patients with AA were included in the study. Thirty-six patients were treated with intralesional PRP, and 39 patients were treated with ILS injections for three sessions. The patients were evaluated with a hair pull test and SALT scores at months 0, 3, and 6.
Results: Of 75 patients, the mean age of the PRP group was 34.33±10.61, and the mean age of the ILS group was 33.82±13.31 years. After three PRP or ILS therapy sessions, at 3. and 6. months, SALT 3 and SALT 6 scores were statistically significantly lower in the PRP group than in the ILS group (p=0.038, p<0.001, respectively). When the treatment response was evaluated at the end of the 6th month in the PRP group, there was no response in 2 (5.5%) patients, partial response in 1 (2.7%) patient, good response in 3 (8.4%) patients, and very good response in 30 (83.4%) patients. Only 2 (5.9%) patients had a clinical relapse in a 6-month period. Side effects were seen in 16 (44.4%) patients in the PRP group and 8 (20.5%) patients in the ILS group, and the frequency of side effects in the PRP group was statistically significantly higher than in the ILS group (p=0.026). However, the side effects of both groups were minor, such as itching, pain, burning, ecchymosis, and folliculitis.
Conclusion: PRP seems to be an effective and safe treatment option for limited patchy alopecia areata, but its superiority over ILS has not been fully demonstrated, making ILS still the first-line treatment.

Objectives: Family physicians (FPs) are directly responsible for the care of people with epilepsy. However, their education about epilepsy may be inadequate or lacking. The aim of this study was to assess the basic knowledge and self-efficacy levels regarding epilepsy among FPs and to identify their educational needs in managing epilepsy.
Methods: The sample for this pre-test-intervention-post-test study consisted of 60 FPs. FPs attended a four-hour training on epilepsy management. The effectiveness of the training was assessed with the Epilepsy Knowledge and Self-Efficacy (EKSE) scale before and after the training. In addition, a survey was conducted to determine the problems encountered in the follow-up of epilepsy patients and their training needs.
Results: 60 physicians participated in the study [37 males (61.7%), mean age 37.97±8.92 years and professional duration 80.48±70.59 months]. While the total EKSE score of FPs was 90.23 ± 10.97 before the training, it increased to 112.3±15.26 points after the training (p<0.001). After the training, significant score increases were observed in all subcomponents of the EKSE compared to before the training. After the training, there was a significant improvement in the physicians' ability to recognize diseases accompanying epilepsy, to have sufficient knowledge about antiseizure medications, and to follow up patients with epilepsy compared to before the training (p<0.001, p=0.001, and p=0.002, respectively).
Conclusion: This study demonstrated that FPs have need for education regarding epilepsy management and that the education provided has a positive impact. (SETB-2025-04-081)

Objective: This study aimed to identify the clinical factors independently associated with depressive symptoms in patients with multiple sclerosis (MS) and to evaluate the impact of depression on health-related quality of life (QoL).
Methods: In this prospective observational study, 90 patients with MS were evaluated. Age, sex, disease duration, MS subtype, and Expanded Disability Status Scale (EDSS) scores were recorded. The Fatigue Severity Scale (FSS), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale, and the EuroQol 5-Dimension 3-Level (EQ-5D-3L) questionnaire were administered. The presence of restless legs syndrome (RLS) was also recorded. Depression severity was measured using the Patient Health Questionnaire-9 (PHQ-9). First, univariable associations were examined, and relevant variables were subsequently entered into a multivariable linear regression model using backward elimination.
Results: Higher FSS, ISI, and EDSS scores were independently associated with higher PHQ-9 scores. FSS and ISI scores showed the strongest correlations with depression (ρ=+0.52 and +0.57; p<0.001). EDSS showed a modest association (ρ=+0.23, p=0.031). Age, sex, and disease duration were not significant predictors. S-LANSS scores, MS subtype, and RLS were significant in univariate analysis but excluded from the final model. Depression scores were significantly associated with higher EQ-5D-3L scores, indicating poorer QoL (p<0.001).
Conclusions: Fatigue and insomnia were the strongest independent predictors of depression in MS, surpassing traditional clinical indicators. Routine screening for these symptoms may facilitate earlier detection and treatment of depression and improve QoL in clinical practice.

Objectives: Environmental smoke exposure is a poorly understood issue and might be a potential source of long-term respiratory exposure to toxic pollutants. Both secondhand and thirdhand smoke (THS) exposure are important matters of public health. We aimed to document the knowledge about smoke exposure of vulnerable groups with respiratory diseases.
Methods: A total of 911 currently smoking patients admitted to the outpatient clinics between October 2023 - October 2024 enrolled in our study. Following a medical examination and pulmonary function assessment, individuals were asked to complete the BATHS questionnaire on thirdhand smoking exposure.
Results: Of the 911smoker participants who comprised our sample, 322 (35.3%) had COPD, 227 (24.9%) had asthma and 570 (62.5%) experienced moderate to severe secondhand exposure. Patients with COPD had the lowest BATHS total and persistence scores (3.61 ± 0.58 and 3.77 ± 0.69, respectively), while asthmatics had the lowest BATHS health scores (3.41 ± 0.46) (p<0.05). Total and subdimension scores were significantly higher among individuals aged 18-30, university graduates, employed in the workforce, and earning exceeds minimum wage (p<0.05). No gender difference was noted (p>0.05). BATHS total scores had significant negative correlation with secondhand smoke exposure and disease duration (p <0.05) whereas positively correlated with better pulmonary function values, attending a smoking cessation clinic, and living at home with children under sixteen (p<0.05).
Conclusions: This study identifies the knowledge gap about the detrimental effects of smoke exposure in patients with respiratory diseases. It underscores the importance of focusing initiatives to reduce both active and passive smoking through educational programs targeting active smokers at risk of lung illnesses.

Objectives: Gastrointestinal Kaposi sarcoma (GI-KS) is a rare vascular neoplasm associated with human herpesvirus 8 (HHV 8), most often emerging in immunosuppressed individuals. Its endoscopic appearance—ranging from nodular and polypoid lesions to ulcerations—can be subtle. In addition, histopathological features of KS may mimic benign inflammatory conditions or other mesenchymal tumors, delaying accurate diagnosis. This study aimed to evaluate the histopathological features of GI-KS and to clarify the neoplastic and non-neoplastic diagnostic challenges in a single-center cohort.
Methods: We retrospectively reviewed 13 GI-KS cases diagnosed between 2005 and 2025. Clinical data and endoscopic findings were retrieved from the hospital’s electronic medical records. Hematoxylin and eosin-stained sections, along with HHV-8 immunohistochemistry (IHC) slides, were retrospectively evaluated.
Results: Thirteen patients (11 male; mean age 47 ± 18 years) were identified, of whom 84.6% were immunosuppressed (eight HIV-positive, two renal transplant recipients, and one receiving corticosteroids). Cutaneous or extraintestinal KS lesions were present in 11 cases. Endoscopic evaluation revealed nodular lesions (30.8%), polypoid lesions (23.1%), snake-skin–like hemorrhagic areas (7.7%), infiltrative lesions (7.7%), erythematous elevated lesions (7.7%), or nonspecific erythematous changes (7.7%). Suspicion of KS was documented in only three endoscopy reports. Lesions were most commonly located in the stomach (76.9%), followed by the rectum (15.4%) and colon (7.7%). Histologically, slit-like vascular channels and erythrocyte extravasation were observed in 84.6% of cases, hemosiderin deposits in 53.8%, chronic inflammatory infiltrates including plasma cells in 76.9%, and foveolar epithelial hyperplasia in 70% of gastric cases. The histologic spectrum included diagnostic pitfalls such as chronic gastritis–like features in three cases, reactive gastropathy–like changes in one case, granulation tissue–like appearance in one case, and GIST/leiomyoma–like spindle cell morphology in one case.
Conclusions: The histologic features of GI-KS can mimic both neoplastic and inflammatory conditions. Therefore, histopathological evaluation should be conducted alongside clinical information, as GI-KS may present with subtle or nonspecific findings. Given the potential for life-threatening complications such as obstruction, bleeding, or perforation, accurate diagnosis and timely treatment are critically important. Routine application of HHV-8 IHC -even in cases with minimal suspicion- is essential for ensuring diagnostic accuracy, guiding appropriate management, and preventing serious outcomes.(SETB-2025-07-158)

With the increasing use of electronic toys, the number of cases involving battery ingestion has risen significantly in recent years. This case report presents a child who attended the emergency department with sudden chest pain and crying episodes. The electrocardiogram (ECG) revealed signs of myocardial ischemia in inferior leads, despite completely normal cardiac function. A chest X-ray detected a button battery lodged in the esophagus.
A 4-year-old boy presented to the emergency department with sudden, intense chest pain and crying while playing with his toys. An electrocardiogram showed prolonged corrected QT interval (cQT 0.56), marked ST depression, and negative T waves in leads DII, DIII and aVF. Echocardiography (ECHO) revealed normal cardiac function. Cardiac enzyme and biochemical tests returned normal results (troponin-I ≤ 3.2 ng/L, CK-MB 29.8 U/L). A disc-shaped battery was detected on chest radiography, and electrocardiographic findings completely normalized after the battery was removed endoscopically.
In the literature, rare adult cases of multiple cylindrical battery ingestion have been reported with ECG findings that mimic myocardial ischemia or infarction. Our case is notable as it presents a single disc battery lodged in the esophagus of a pediatric patient that mimicked an inferior myocardial infarction.