Objectives: The reported incidence of multifocal breast cancer (MFBC) and multicentric breast cancer (MCBC) varies widely in the literature. This study aimed to compare the clinicopathological characteristics, treatment approaches, and survival outcomes between patients with MFBC/MCBC and those with unifocal breast cancer (UFBC).
Methods: Data from 666 female patients aged >18 years who were histopathologically diagnosed with breast cancer and followed up at the Department of General Surgery of a tertiary hospital between January 2018 and January 2025 were retrospectively reviewed. MF and MC were defined based on tumor localization within breast quadrants and the distance between foci. Clinical, pathological, and treatment-related parameters were compared between the groups.
Results: Of all patients, 83.5% (n=556) had UFBC and 16.5% (n=110) had MF/MCBC. The mean age was 54.89±12.17 years. Axillary lymph node positivity was significantly higher in the MF/MCBC group (p=0.022). Magnetic resonance imaging (MRI) identified MF/MCBC in 71% of cases, demonstrating greater sensitivity than mammography (MMG) and ultrasonography (USG). Mastectomy was performed in 85.4% of patients with MF/MCBC compared with 45% of those in the UFBC group. The rate of neoadjuvant chemotherapy was also significantly higher among patients with MF/MCBC (p=0.008). There were no significant differences between the groups regarding local recurrence, distant metastasis, or overall survival.
Conclusion: Patients with MF/MCBC exhibited higher rates of axillary involvement and more frequent use of neoadjuvant therapy. However, overall survival was comparable to that of patients with UFBC. A multidisciplinary approach remains essential for determining the optimal management strategy in this subgroup.

Objectives: The impact of preoperative predisposing factors on postoperative complications in patients undergoing pneumonectomy for non-small cell lung cancer (NSCLC) remains a critical issue. Understanding these factors may provide valuable insights into postoperative risks and complications. This study aimed to evaluate the influence of preoperative predisposing factors (comorbidities) on the development of postoperative complications in patients undergoing pneumonectomy for NSCLC. Using the age-adjusted Charlson Comorbidity Index (a-CCI), we sought to identify risk factors that potentially contribute to complications and investigate their impact on survival.
Methods: In this retrospective study, 236 patients who underwent pneumonectomy between February 2018 and February 2023 were analyzed. Demographic characteristics, comorbidities based on the a-CCI, surgical details, postoperative complications classified according to the Clavien–Dindo system, and survival outcomes were evaluated.
Result: Postoperative complications occurred in 44.1% of patients (n=104). The development of complications was significantly associated with right-sided pneumonectomy (p=0.018), prolonged operative time (p=0.002), and increased intraoperative blood loss (p<0.001). Although the a-CCI failed to predict postoperative complications, it demonstrated a significant association with survival outcomes. Patients with higher a-CCI scores had markedly reduced mean survival times (p=0.001).
Conclusion: In patients undergoing pneumonectomy for NSCLC, right-sided resections, prolonged operative duration, and exces-sive intraoperative blood loss increase the risk of postoperative complications. While the a-CCI is limited in predicting postoperative complications, it serves as a valuable prognostic indicator of survival. Assessing these factors may guide risk stratification and optimize perioperative management strategies in surgical candidates.

Objectives: To evaluate the impact of percutaneous nephrostomy (PN) on family burden, health-related quality of life (HRQoL), depressive symptoms, and pain, and to identify predictors of postoperative change.
Methods: In this prospective study, 119 patients undergoing PN for obstructive uropathy were assessed before and after PN using the Visual Analog Scale (VAS), Beck Depression Inventory (BDI), EQ-5D-3L sum score, and Family Reported Outcome Measure-16 (FROM-16). Pre- and post-procedure differences were analyzed using the Wilcoxon signed-rank test, and multivariable linear regression was used to identify predictors of change (p<0.05).
Results: The mean age was 61.7 years, and 64.7% of the patients were male. Malignancy was the most common etiology, followed by stone disease and benign strictures. All outcomes deteriorated after PN: FROM-16 increased from 7.39 to 15.87, EQ-5D-3L sum score from 7.45 to 13.71, BDI from 12.97 to 17.92, and VAS from 1.22 to 5.23 (all p<0.001). Malignancy, ureteral stricture, and infec-tion were associated with smaller increases in family burden. Spousal caregiving was associated with greater HRQoL deterioration (p=0.020), whereas infection predicted less worsening. Older age was associated with greater increases in BDI, while longer mar-riage duration and unemployment were associated with smaller BDI changes (p<0.05). Pain worsening was less pronounced in male patients and those with higher education levels (p<0.05).
Conclusion: Although PN relieves obstruction, it is associated with significant deterioration in psychosocial outcomes. Psychosocial screening and caregiver support should be integrated into PN care pathways to protect patient-centered outcomes.

Objectives: Proximal femoral growth disturbance (PFGD), resulting from conditions such as Legg–Calvé–Perthes disease and developmental dysplasia of the hip, causes femoral head deformity and trochanteric overgrowth. This study evaluates the effectiveness of distal trochanteric transfer (DTT) in anatomical restoration using objective radiological parameters.
Methods: Patients with unilateral PFGD who presented with pain, abductor muscle weakness, and Trendelenburg gait and subsequently underwent DTT were retrospectively included in this study. All patients had skeletal growth potential, confirmed by the presence of open growth plates. Patients who had standard anteroposterior pelvic radiographs and anteroposterior and lateral hip radiographs were included, as these imaging modalities were required to evaluate the articular trochanteric distance (ATD), central trochanteric distance (CTD), trochanteric offset (TO), and lever arm ratio (LAR).
Results: The study cohort consisted of 13 patients (11 females, 2 males). The mean age at surgery was 10.54±2.11 years, and the mean follow-up period was 7.62±5.25 years. The intraclass correlation coefficient (ICC) was significant for 9 of the 12 total measurements, with three parameters demonstrating statistically non-significant values. Preoperatively, the pathological hips showed a significantly reduced mean ATD of −2.00±8.57 mm compared with the normal hips (17.38±5.58 mm; p=0.001). Postoperative ATD significantly improved to 15.62±6.36 mm (p=0.001). Similarly, the significantly reduced preoperative TO (18.69±6.84 mm) was restored to 24.85±7.03 mm postoperatively (p=0.008). Furthermore, the postoperative LAR (2.83±0.48) was significantly higher than both the preoperative value (2.21±0.46; p=0.012) and the normal hip value (p=0.001). No significant difference was observed for CTD.
Conclusion: DTT effectively achieves trochanteric distalization and lateralization, leading to restoration of the abductor muscle mechanism. Our analysis confirms that both ATD and TO are reliable radiographic parameters, as demonstrated by their strong ICC values, for evaluating immediate anatomical results. However, CTD is age-dependent, and both CTD and LAR are inherently influenced by the underlying femoral head anatomy. Future studies are needed to correlate these anatomical improvements with long-term clinical outcomes.

Objectives: The effect of obesity on sepsis outcomes remains controversial. Several studies have described an “obesity paradox,” whereby a higher body mass index (BMI) correlates with improved survival in critically ill patients. This study aimed to investigate the relationship between BMI and 28-day mortality in adult patients with sepsis admitted to the intensive care unit (ICU).
Methods: We conducted a retrospective observational study including 83 adult patients diagnosed with sepsis according to the Sepsis-3 criteria who were admitted to the ICUs of Şişli Hamidiye Etfal Training and Research Hospital between June 2023 and June 2025. BMI was reported using World Health Organization categories and analyzed using three BMI groups based on the final cohort distribution. The primary endpoint was 28-day mortality. Multivariable logistic regression analysis was conducted with adjustment for age, sex, Sequential Organ Failure Assessment score, creatinine, and C-reactive protein.
Results: The median age was 75 years (interquartile range, 66–82), and 55% of the patients were male. Survivors had a higher BMI than non-survivors (27.3 vs. 24.9 kg/m²; p=0.004) and higher albumin levels (p=0.024). BMI was inversely associated with 28-day mortality in the multivariable analysis (odds ratio, 0.74 per 1 kg/m²; 95% confidence interval, 0.58–0.91; p=0.008).
Conclusion: Higher BMI was associated with lower 28-day mortality in septic ICU patients. Further prospective studies are needed to validate this relationship and explore the underlying potential mechanisms.

Objectives: Stroke is a significant disease associated with high mortality and morbidity rates, and carotid artery stenosis (CAS) is one of its most important causes. Although endovascular applications have increased in the treatment of CAS, carotid endarterectomy (CEA) surgery remains prominent. The systemic coagulation inflammation index (SCII) has emerged as an important marker indicating coagulation and inflammatory status. In this study, we aimed to investigate the effect of SCII values on worse outcomes during 30-day follow-up in patients who underwent CEA.
Methods: This retrospective study consecutively included patients who underwent carotid endarterectomy at our clinic between January 1, 2020, and June 1, 2025. Patients who did not develop worse outcomes within the first 30 days after surgery were assigned to Group 1, and those who did were assigned to Group 2. Worse outcomes in the study were defined as stroke, myocardial infarction, and death.
Results: A total of 594 patients underwent elective CEA surgery. The 546 patients in Group 1 and the 48 patients in Group 2 had median ages of 71 (44–88) and 69 (41–91) years, respectively (p=0.185). As a result of the multivariate analysis, the presence of coronary artery disease (OR: 1.690, 95% CI: 1.210–1.984, p=0.032) and high SCII values (OR: 1.780, 95% CI: 1.270–2.894, p<0.001) were determined as independent predictors of worse outcomes after CEA surgery.
Conclusion: Our results indicated that high SCII values were associated with worse outcomes within 30 days after CEA. In patients undergoing CEA, SCII values can be calculated preoperatively to identify at-risk patient groups; therefore, measures can be taken for patient management and follow-up in the postoperative period.

Objectives: Obesity is a key modifiable risk factor for cardiovascular disease (CVD), yet the most effective anthropometric index for identifying individuals at elevated cardiovascular risk (CVR) remains debated. Body fat (BF) and visceral fat (VF) measured by bioimpedance may provide greater discriminatory capacity than body mass index (BMI) or waist circumference (WC) when applied to validated CVR scales. To compare the predictive performance of BF and VF with BMI and WC for identifying elevated CVR according to Framingham vascular age, SCORE vascular age, and SCORE2 in a large occupational cohort.
Methods: This cross-sectional study included 8,590 Spanish workers (52.2% women) who were evaluated between 2021 and 2023 during routine occupational health assessments. Anthropometric measures included BMI and WC, while BF and VF were obtained through validated bioelectrical impedance analysis. Elevated CVR was defined according to the thresholds of each scale. Predictive capacity was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC) values with 95% confidence intervals (CIs).
Results: In women, VF showed the highest AUC for Framingham vascular age (0.828; 95% CI: 0.808–0.849) and SCORE vascular age (0.779; 95% CI: 0.755–0.804), whereas WC performed slightly better for SCORE2 (0.647; 95% CI: 0.629–0.666). BF achieved moderate accuracy across all scales (AUC: 0.640–0.794), while BMI consistently yielded the lowest values (AUC: 0.607–0.749). In men, BF had the highest AUC for Framingham vascular age (0.799; 95% CI: 0.775–0.823), VF was superior for SCORE vascular age (0.768; 95% CI: 0.749–0.787), and all indices showed lower discrimination for SCORE2 (AUC range: 0.611–0.624).
Conclusion: BF and VF measured by bioimpedance demonstrated higher predictive capacity for elevated CVR than BMI or WC in both sexes, although the best-performing index varied by scale and sex. These findings support the inclusion of direct adiposity measurements in occupational health screening to improve the early detection of cardiovascular risk.

Objectives: This study evaluated the factors predicting the effect of long-term intramuscular botulinum toxin-A (BTX-A) treatment on motor and gait functions in children with spastic cerebral palsy (CP).
Methods: Two hundred children diagnosed with CP were treated with BTX-A, with particular attention given to the lower limbs. The children were followed up for over two years. The severity of spasticity was evaluated using the Modified Ashworth Scale. The Gross Motor Function Classification System (GMFCS) and Observational Gait Scale (OGS) were used to assess changes in motor and gait function scores. Outcomes at the end of two years were compared with baseline values.
Results: After two years, the severity of spasticity and the GMFCS and OGS scores improved with BTX-A treatment. The most important factors predicting improvement in motor scores after treatment were young age, high baseline OGS scores, independent walking, baseline GMFCS scores, and hemiplegia. The determinant factors for improvement in gait scores were the number of injections and a high baseline GMFCS level.
Conclusion: The predictors of the efficacy of BTX-A treatment on gait and motor function were young age, independent ambulatory status, gross motor function level, high baseline gait scores, hemiplegic type of CP, and multiple BTX-A injections.

Objectives: Epilepsy is a chronic disease that can cause cognitive, psychological, and social problems due to recurrent seizures. Knowledge of the risk of seizure recurrence is crucial for patient treatment management. Therefore, we aimed to statistically evaluate the effects of stress, sleep deprivation, fasting/prolonged hunger, and excessive physical activity on seizure frequency, despite conflicting results in the literature.
Methods: This study prospectively analyzed data from 40 patients and a total of 60 seizures. The correlation between the proportional hazards assumption and survival rank was investigated using Schoenfeld residuals and correlation tests.
Results: This study found that stress, sleep deprivation, fasting/prolonged hunger, and excessive physical activity increased the risk of seizures. However, some additional, unidentified environmental or genetic factors were found to increase seizure risk by 2.7 times within the established model.
Conclusion: While our study found that stress, sleep deprivation, fasting/prolonged hunger, and excessive physical activity may increase seizure frequency, it was also determined that some additional, unidentified environmental or genetic factors affect seizure frequency. The limited sample size, heterogeneity of the patient population, and reliance on patients’ subjective assessments constitute the primary limitations of this study. Furthermore, objective scales or validated measurement tools for sleep depriva-tion, fasting, stress, and excessive physical activity were not used. Further studies with larger, more homogeneous groups and objective assessment methods are needed to validate these findings.

Objectives: Encephalitis is a potentially fatal inflammation of the brain parenchyma characterized by neurologic dysfunction. Although the etiology of most encephalitis cases cannot be determined, viruses are the most common known causative agents. In this study, pediatric patients diagnosed with encephalitis were evaluated in terms of etiology, clinical findings, laboratory and imaging results, treatment, and prognosis.
Methods: A total of 115 patients aged 1 month to 18 years who were diagnosed with encephalitis between January 2008 and December 2020 were retrospectively evaluated in the Pediatric Infection Clinic of our hospital.
Results: The study included 115 children, of whom 36% (n=41) were girls and 64% (n=74) were boys. The disease was most frequently observed in children younger than 5 years of age (48%). The most common symptoms at admission were fever (54.8%), convulsions (46%), and impaired consciousness (27%). The etiology was identified in 67% of the patients; viral agents were the most common cause (44%). Varicella zoster virus (VZV) was the most common etiologic agent (26.9%). Acyclovir treatment was initiated in 94% (n=108) of the patients. Sequelae developed in 6% (n=7) of the patients, and mortality occurred in 1.7% (n=2).
Conclusion: In the presence of suspected encephalitis, antiviral treatment should be initiated early, considering the mortality and morbidity associated with the disease, and then continued with treatment appropriate to the identified etiology. Studies investigating etiology will be useful in determining the prognosis of encephalitis cases.

Objectives: To characterize pathogen distribution and antibiograms in neonatal ventilator-associated pneumonia (VAP) and to examine clinical correlates of recurrent growth and colonization.
Methods: This was a single-center retrospective cohort study conducted between September 1, 2020, and September 1, 2025. Among 152 neonates with tracheal aspirate culture (TAC) growth, 61 met the VAP criteria; 48 with complete clinical and antibiogram data were analyzed. Recurrent growth was defined as a second positive TAC with a different species obtained at another time point, and colonization was defined as the same organism in ≥3 consecutive TACs. Demographics, inflammatory biomarkers, blood cultures, and EUCAST susceptibilities were recorded. Group comparisons were performed using the Mann–Whitney U test and Fisher’s exact test; temporal susceptibility trends were assessed using Spearman’s rho.
Results: Gram-negative organisms predominated. The most frequent first TAC isolates were Klebsiella pneumoniae (33.3%) and Escherichia coli (18.8%); K. pneumoniae also predominated among second isolates (45.0%). Blood cultures were positive in 33.3% of cases, with 37.5% TAC–blood species concordance. Compared with non-gram-negative cases, gram-negative infections had higher C-reactive protein levels (7.9 vs. 1.1 mg/L; p=0.029) and procalcitonin levels (3.13 vs. 0.22 ng/mL; p=0.045) but a lower neutrophil-to-lymphocyte ratio (0.93 vs. 2.37; p=0.017). NICU length of stay was longer in patients with gram-negative growth (63.0 [29.0–111.5] vs. 17.5 [10.25–45.75] days; p=0.023); the Hodges–Lehmann median difference was +39.5 days (95% CI +13.0 to +69.0), with a moderate effect size (Cliff’s δ=0.36). Recurrent growth occurred in 41.7% of cases and was associated with a longer intubation-to-growth interval (12.0 [5.0–15.75] vs. 4.5 [3.0–8.25] days; p=0.002) and colonization (p=0.002). Susceptibility to amikacin, colistin, and tigecycline was relatively preserved, whereas resistance to third- and fourth-generation cephalosporins, piperacillin–tazobactam, carbapenems, and fluoroquinolones was common. Overall susceptibility declined over the years (ρ=−0.95; p=0.001). In multivariable logistic regression, no variable independently predicted adverse prognosis.
Conclusion: In our tertiary NICU, neonatal VAP is predominantly caused by multidrug-resistant gram-negative organisms, particularly Klebsiella pneumoniae and Escherichia coli. These infections are associated with higher inflammatory markers and prolonged hospitalization. Recurrent growth, defined as the isolation of a different species at another time point, highlights the role of airway hygiene and adherence to ventilator bundle practices. Given the decreasing susceptibility trends, maintaining the efficacy of agents such as amikacin, colistin, and tigecycline through rational antibiotic use is crucial.

Objectives: Morganella morganii is an opportunistic Gram-negative pathogen increasingly associated with healthcare-associated infections and antimicrobial resistance. However, long-term epidemiological data from Türkiye remain scarce.
Methods: This retrospective study analyzed M. morganii isolates obtained between January 2015 and December 2024 at a 1500-bed tertiary care hospital. Demographic data, clinical specimen sources, and antimicrobial susceptibility results were retrieved from the laboratory database. Identification was performed using conventional methods and MALDI-TOF MS, while antimicrobial susceptibility was determined according to EUCAST guidelines. Linear regression analysis was applied to evaluate resistance trends over time.
Results: A total of 673 non-duplicate isolates were included, predominantly from urine (68.6%), followed by wound (19.2%), blood (4.7%), respiratory (3.6%), abscess (1.9%), and sterile body fluid (1.0%) specimens. The annual incidence ranged from 0.47% in 2015 to 1.9% in 2024, with a transient decline during 2020–2022, likely related to the COVID-19 pandemic. Male patients accounted for 63% of isolates, with a median age of 52 years. Meropenem and amikacin showed the highest overall activity (>98% susceptibility), while cefoxitin demonstrated the lowest efficacy (≈50%). Trend analysis revealed statistically significant increases in resistance to amikacin, imipenem, meropenem, ertapenem, ceftriaxone, ceftazidime, cefoxitin, cefepime, piperacillin–tazobactam, trimethoprim–sulfamethoxazole, and ciprofloxacin (all p<0.05), whereas gentamicin showed no significant change. Notably, carbapenem and aminoglycoside resistance increased markedly after 2022.
Conclusion: This study highlights the rising clinical importance of M. morganii, with increasing resistance across multiple antibiotic classes, including carbapenems. The findings underscore the need for continuous surveillance, prudent antimicrobial use, and further genomic studies to elucidate resistance mechanisms and guide effective therapy.

Objectives: The global rise of antimicrobial resistance underscores the urgent need for alternative therapeutic agents for common infections such as otitis externa. This study aimed to investigate and compare the in vitro antimicrobial activity of five Turkish honey types—thyme, pine, linden, sunflower, and lavender—against eight microorganisms commonly associated with otitis externa.
Methods: Honey samples were collected from certified Turkish beekeepers and analyzed for their physicochemical and biochemical properties. Antimicrobial activity was assessed using the broth microdilution method in line with CLSI guidelines. The tested microorganisms included Pseudomonas aeruginosa (ATCC and clinical isolate), Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus faecium, Candida albicans, and C. tropicalis. Minimum inhibitory concentrations (MICs) were determined to evaluate antibacterial efficacy.
Results: Thyme honey showed the broadest spectrum of antimicrobial activity (62.5%), with particularly low MICs against P. aeruginosa. Linden and lavender honey inhibited 50% of the tested organisms, with lavender honey being the most effective against S. aureus. Pine honey demonstrated moderate efficacy (25%), whereas sunflower honey showed minimal antimicrobial activity (12.5%). Notably, all honeys were ineffective against both Candida species at the tested concentrations. A strong correlation was observed between total phenolic content and antimicrobial effect, with thyme honey having the highest phenolic and antioxidant values.
Conclusion: Turkish honey, especially thyme honey, demonstrates promising antibacterial activity against otitis externa pathogens. These findings suggest potential for honey-based adjunctive therapies in managing bacterial ear infections, particularly amid rising antibiotic resistance. However, the lack of antifungal efficacy highlights limitations in fungal otitis cases.

Objectives: Opioid use has been associated with alterations in gut–brain axis signaling and intestinal barrier function. Zonulin, a key regulator of intestinal permeability, has been implicated in various neuropsychiatric and inflammatory conditions; however, its role in heroin addiction and remission remains poorly understood. This study aimed to investigate serum zonulin levels in patients with heroin addiction (HA) during active heroin use (AHU) and remission (R) and to compare these levels with those of healthy controls (C).
Methods: A total of 104 male participants were included: patients with AHU, patients in remission under buprenorphine/naloxone maintenance treatment, and C. Serum zonulin levels were measured using an enzyme-linked immunosorbent assay. Group comparisons and correlation analyses were performed, and receiver operating characteristic (ROC) analysis was used to evaluate the discriminatory value of zonulin.
Results: The scores of addiction diagnostic criteria, the severity of craving, and the total API score were significantly higher in the AHU group than in the R group. The difference between the groups was significant when the R, AHU, and C groups were compared for zonulin levels (p=0.02). This difference was due to zonulin levels being higher in the R group than in the C group. When the HA (R+AHU) and C groups were compared for zonulin levels, zonulin levels were significantly higher in the HA group than in the C group (p=0.00). In the ROC analysis, the highest area under the curve (AUC) values were obtained in the R-C group comparison and the HA-C group comparison (AUC=0.683 and AUC=0.650, respectively).
Conclusion: These findings suggest that increased intestinal permeability, as reflected by elevated serum zonulin levels, may persist during the remission phase of heroin addiction. However, given the cross-sectional design and the fact that remission was defined as a medication-stabilized state under buprenorphine treatment, these results should be interpreted cautiously. Longitudinal studies incorporating follow-up assessments and gut microbiota analyses are warranted to clarify the temporal dynamics and clinical significance of zonulin alterations in heroin addiction.

Objectives: The rapid global proliferation of TikTok has increased the need for culturally adapted measurement tools to assess problematic TikTok use. This study aimed to evaluate the psychometric properties of the Turkish version of the TikTok Addiction Scale (TTAS-TR) and examine its associations with social media addiction, perceived stress, and personality traits.
Methods: A cross-sectional online survey was administered to 508 Turkish TikTok users. Participants completed the TTAS-TR, the Bergen Social Media Addiction Scale (BSMAS), the Perceived Stress Scale (PSS-10), and the Big Five Personality Inventory (BFI-10). The factor structure of the scale was examined using confirmatory factor analysis. Internal consistency, test-retest reliability, concurrent validity, and incremental validity analyses were performed. Additionally, the predictive contribution of the TTAS-TR to perceived stress was evaluated using multivariate models beyond personality traits and social media use.
Results: The findings supported the theorized six-factor structure of the TTAS-TR—salience, mood modification, tolerance, with-drawal, conflict, and relapse—demonstrating high internal consistency and stable test-retest reliability coefficients. TTAS-TR scores were positively associated with social media addiction and perceived stress. Findings regarding personality traits were consistent with established patterns in the literature: higher neuroticism and lower conscientiousness, openness to experience, and extraversion were associated with higher TTAS-TR scores. In multivariable models, the TTAS-TR made an additional contribution to explaining perceived stress beyond personality traits and social media use, with the tolerance subdimension showing a particularly strong association with stress.
Conclusion: The TTAS-TR demonstrated strong factor validity, reliability, and concurrent and incremental validity in the Turkish sample. The scale appears to be a valid and reliable instrument for screening and research on problematic TikTok use. The tolerance dimension of TikTok use emerged as a prominent indicator associated with perceived stress.

Objectives: Sleep disturbances and fatigue are prevalent among dermatology patients. Owing to the growing evidence on the effects of light-based therapies on neuropsychiatric disorders, this study aimed to investigate how narrow-band ultraviolet B (NB-UVB) phototherapy influences sleep quality and fatigue.
Methods: In this prospective observational study, 30 patients receiving or scheduled to receive NB-UVB phototherapy were included. Phototherapy was administered 2–3 times per week with eye protection. Sleep quality, fatigue, and dermatology-specific quality of life were assessed using the Pittsburgh Sleep Quality Index (PSQI), Piper Fatigue Scale (PFS), and Dermatology Life Quality Index (DLQI), respectively. Measurements were performed at study entry and at the one-month follow-up.
Results: The mean age was 48.2±12.9 years, and 63.3% of the patients were male. The most common diagnoses were vitiligo (40%), mycosis fungoides (26.7%), and psoriasis vulgaris (13.3%). The median PSQI score decreased from 8 at baseline to 5 at the one-month follow-up (p<0.001). The median PFS score decreased from 3.88 to 2.38 (p=0.019). DLQI showed no significant change. Changes in PSQI and PFS were significantly correlated (r=0.435, p=0.016). Multiple regression analysis identified ΔPFS, total cumulative dose, and ΔDLQI as independent predictors of ΔPSQI.
Conclusion: NB-UVB phototherapy was associated with improvements in sleep quality and fatigue in dermatology patients over the course of treatment. These effects appear to be independent of changes in dermatology-specific quality of life and are likely mediated through neuroendocrine, circadian, and peripheral pathways. NB-UVB phototherapy may serve as an effective adjunctive treatment for sleep disturbances and fatigue in dermatology patients.

Cerebellar ataxia associated with metronidazole is rare. Sjögren’s syndrome (SS), a chronic autoimmune disease, can also rarely present with neurological symptoms such as cerebellar ataxia. In this report, we aimed to present a 40-year-old female patient diagnosed with SS who developed acute-onset speech disorder and imbalance. The patient’s complaints developed shortly, four days, after taking metronidazole for a vaginal infection. Her neurological examination revealed a broad-based gait, explosive speech, and bilateral dysmetria. Routine blood tests, nerve conduction studies, and cerebrospinal fluid analysis were normal. Brain magnetic resonance imaging showed hyperintensity in the dentate nuclei of the cerebellum, consistent with metronidazole-induced neurotoxicity. The patient’s symptoms rapidly improved after discontinuation of the drug, and the lesions had completely resolved on imaging one month later. Apart from neuropathy and cerebellar degeneration, which are the most common etiologies of ataxia in Sjögren’s syndrome, rare metronidazole-induced neurotoxicity was observed in our patient. Metronidazole-induced neurotoxicity may be a potentially reversible cause of cerebellar symptoms, and its recognition based on typical radiological features is important for drug withdrawal and complete recovery.

We report the case of a 30-year-old female patient with Crohn’s disease who was receiving infliximab and mesalazine therapy. She presented with left ear pain accompanied by bloody diarrhea and abdominal pain. Initial treatment with ciprofloxacin and aluminum acetate was ineffective, requiring hospitalization. She was treated with intravenous meropenem, clindamycin, and prednisolone, which led to symptom resolution after 12 days. However, 7 months later, the patient developed similar symptoms in the right ear without intestinal involvement. She was hospitalized and treated with intravenous antibiotics, followed by prednisolone treatment.

Tracheobronchomalacia is an expiratory collapse of the posterior wall of the trachea and at least one of the main bronchi. It may be idiopathic or may develop due to secondary causes. It results in a slowing of dynamic airflow and clinically presents with dyspnea, cough, and pneumonia. Although tracheal stents provide temporary relief in treatment, considering the problems encountered during the chronic phase, endobronchial therapy does not offer a long-term solution. Tracheobronchoplasty is a surgical treatment option. Examination of the few cases reported in the literature shows that, in centers with adequate video-assisted thoracoscopic surgery (VATS) experience, this procedure, which is frequently performed via right thoracotomy, can be effectively performed using minimally invasive techniques. A 66-year-old male patient presented with dyspnea. Severe tracheomalacia was detected, and tracheoplasty was performed using VATS. The present study aims to describe the first VATS tracheobronchoplasty procedure in Türkiye.

Neonatal pneumopericardium is a rare form of air leak syndrome associated with high morbidity and mortality. With advances in neonatal care, the incidence of pneumopericardium has decreased, as with other air leak syndromes; however, most cases occur in premature infants with a history of respiratory distress and mechanical ventilation. Pneumopericardium should be considered in the differential diagnosis of newborns experiencing sudden respiratory distress. Early diagnosis and appropriate treatment can significantly reduce mortality. This case report presents the management of isolated pneumopericardium using ultrasound-guided pericardiocentesis, which was detected after sudden clinical deterioration in a premature female infant born at 28 gestational weeks and followed up on mechanical ventilation. Recognition and prompt intervention by neonatal intensive care unit physicians significantly impact the patient’s prognosis.

PTeye is a near-infrared autofluorescence device used intraoperatively to identify parathyroid tissue, typically using thyroid tissue as a reference. In patients with prior total thyroidectomy, the absence of thyroid tissue limits its standard application. Although the use of alternative reference tissues with the PTeye device in thyroidectomized patients has been reported, such data remain limited. Our case differs in that skeletal muscle was used specifically for the detection of recurrent intramuscular parathyroid tissue and may serve as a meaningful reference point for future clinical applications. A patient underwent total thyroidectomy for multinodular goiter and excision of a left lower parathyroid adenoma for primary hyperparathyroidism. The left upper gland was devascularized and autotransplanted into the left sternocleidomastoid muscle. Sixteen years later, recurrent primary hyperparathyroidism developed, and imaging revealed a lesion at the autograft site. During revision surgery, PTeye was used with skeletal muscle as the autofluorescence reference. PTeye accurately identified parathyroid tissue using skeletal muscle as the reference. Successful excision was confirmed by a significant intraoperative parathyroid hormone decline from 125 pg/mL to 35 pg/mL and postoperative histopathology consistent with hyperplasia. This case suggests that PTeye may be effectively used with skeletal muscle as a reference tissue in patients lacking thyroid tissue.