INTRODUCTION: This study aims to examine cognitive and neuropsychiatric differences between dementia patients who retain versus those who lose the ability to use the telephone. Given the limited research available on this topic, the findings hold particular importance, as telephone use is crucial for dementia patients’ access to information and communication.
METHODS: The retrospective study included patients with Alzheimer’s (AD), Lewy Body (LBD), Frontotemporal (FTD), and Vascular Dementia (VD) who had been followed for at least one year. Activities of daily living were assessed using the Barthel Index, and telephone use was directly questioned. Dementia stages were evaluated with the Clinical Dementia Rating (CDR) scale, and cognitive status with the Mini-Mental State Examination (MMSE). Findings were compared between groups with and without telephone-use ability.
RESULTS: 204 patients were included (124 AD, 21 FTD, 35 VD, 24 LBD). Those who lost the ability to use the phone had lower Barthel Index scores. Except for LBD, patients who lost phone use ability had higher MMSE scores. In AD patients, the loss of phone ability corresponded with lower MMSE scores. Positive factors for phone use included younger age, male gender, longer education, and shorter disease duration.
DISCUSSION AND CONCLUSION: Developing accessible programs for early-stage dementia patients and planning appropriate interventions for advanced cases could be beneficial. Larger-scale studies are needed to confirm these findings and further explore influencing factors.

INTRODUCTION: To evaluate the predictive role of platelet indices, inflammatory markers, and the Systemic Immune-Inflammation Index (SII) in determining the need for erythrocyte suspension (ES) transfusion in patients undergoing total abdominal hysterectomy.
METHODS: This retrospective matched case-control study analyzed 176 patients who underwent total abdominal hysterectomy for benign indications between August 2020 and September 2022. Patients were categorized into transfusion and non-transfusion groups, matched 1: 1 based on age and body mass index (BMI). Data collection included demographic, clinical, surgical characteristics, and laboratory markers. Receiver operating characteristic (ROC) analysis identified predictive cutoffs for preoperative hemoglobin (HB) and SII. Multivariate logistic regression was used to identify independent predictors of transfusion.
RESULTS: The transfusion group exhibited significantly lower preoperative HB levels (10.50 ± 1.15 g/dL vs. 12.25 ± 1.30 g/dL, p<0.001) and higher SII values (721.62 vs. 619.97, p = 0.043). Preoperative HB (odds ratio [OR] = 0.302, p < 0.001) and SII (OR = 1.001, p = 0.006) were identified as independent predictors of ES transfusion. ROC analysis revealed that preoperative HB ≤ 11.15 g/dL demonstrated a sensitivity of 73.9% and specificity of 77.3% (p<0.001), while SII ≥ 670.62 showed a sensitivity and specificity of 56.8% (p=0.043).
DISCUSSION AND CONCLUSION: Preoperative HB and SII emerge as reliable predictors for ES transfusion in patients undergoing total abdominal hysterectomy. Integrating these markers into routine preoperative assessments could significantly enhance perioperative blood management. Further validation in diverse patient populations and clinical settings is essential to confirm their utility and optimize surgical outcomes.

INTRODUCTION: Pancreatic cancer is a low-incidence yet fatal malignancy. This study was carried out to investigate the prevalence of malnutrition, frailty, and cachexia, which are frequently encountered in unresectable (locally advanced or metastatic) pancreatic cancer patients, and their effects on overall survival (OS).
METHODS: The sample of this prospective, observational, non-interventional and single-center study consisted of 65 adult patients with newly diagnosed unresectable pancreatic cancer. The patients' malnutrition, frailty, and cachexia scores were calculated and recorded at the time of diagnosis. Mini Nutritional Assessment-Short Form (MNA-SF) was used to assess malnutrition; Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale was used to assess frailty; weight loss rates in the last 6 months were used to assess cachexia.
RESULTS: The median age of the sample was 65 (range, 35-84) years. The prevalence of malnutrition, frailty, and cachexia in patients at the time of diagnosis was 47.7%, 63.1% and 58.5%, respectively. The multivariate analysis conducted to identify the risk factors for OS revealed that the presence of malnutrition (p<0.001), frailty (p=0.02), and hypoalbuminemia (p<0.001), at the time of diagnosis were associated with shorter OS, whereas cachexia was not.
DISCUSSION AND CONCLUSION: Our findings indicated that the presence of malnutrition, frailty, and hypoalbuminemia at the time of diagnosis were associated with shorter OS in patients with unresectable pancreatic cancer. These risk factors, especially when present together, may worsen the overall health of pancreatic cancer patients.

INTRODUCTION: Endocervical curettage (ECC) is a diagnostic method commonly performed as an outpatient procedure but often associated with pain and discomfort. This prospective randomized observational study aimed to evaluate the quality of histological specimens obtained using Novak curette, endocervical brush, and Pipelle, as well as the pain levels experienced during these procedures.
METHODS: Between April 2018 and August 2018, patients undergoing ECC at our hospital were included in the study. Novak curette, endocervical brush, and Pipelle were used as sampling instruments. Patients rated their pain levels during the procedures using a visual analog scale (VAS). Histological material was scored by a pathologist for tissue adequacy. The correlation between the quality of histological specimens and the surgical instruments used was analyzed.
RESULTS: The study included patients with a mean age of 41.9 ± 8.78 years, mean parity of 2.7 ± 1.23, mean BMI of 30.9 ± 3.11, and a smoking prevalence of 22%. The mean pathological examination scores were as follows: Novak curette, 3 ± 1.31; endocervical brush, 1.6 ± 1.14; and Pipelle, 1.6 ± 1.13. The mean VAS pain scores were 3.7 ± 1.21 for Novak curette, 3.1 ± 1.18 for endocervical brush, and 3.0 ± 1.02 for Pipelle.
DISCUSSION AND CONCLUSION: Among the instruments evaluated, the Novak curette caused the highest levels of pain, while pain levels associated with the endocervical brush and Pipelle were comparable. These findings suggest that while the Novak curette may provide high-quality samples, alternative methods such as Pipelle and endocervical brush offer comparable diagnostic value with potentially improved patient comfort.

INTRODUCTION: In our study, we aimed to evaluate the Code Blue (CB) call system implemented in our hospital, to determine our cardiopulmonary resuscitation (CPR) success rate, problems, deficiencies and mistakes in CB implementation.
METHODS: A retrospective review of CB notifications and hospital records was conducted for patients over 18 who received CB outside the ICU, emergency department, and operating theatre between 2013 and 2021. If cardiopulmonary arrest (CPA) was absent when the team arrived at the CB location, it was defined as a false code blue (FCB). Patient age, gender, CB unit and time, CB team response time, FCB reason, whether CPR was initiated, CPR response, and ICU prognosis were recorded.
RESULTS: 389 (37%) of the 1051 calls given a CB were FCB notifications, the most common reason for FCB notifications is hypoxia findings in the patient (36%). Among the patients who underwent CPR, 62.3% were male and 37.6% were female and the median age was 67 years (IQR: 59-77). The average arrival time of the CB team is 2.77±1.59 minutes. The highest number of CB notifications were received from internal medicine services (22%). 53.7% of CB notifications were made during off-hours. The most common comorbidity in patients with CPA is malignancy (31.4%). In 244 of 662 (36.9%) patients with CPA, CPR was not started until the CB team arrived. Of the 662 patients who underwent CPR, 284 (%42.9) patients died.
DISCUSSION AND CONCLUSION: Since the FCB rate was 37%, we believe training aligned with updated resuscitation guidelines will reduce it and enhance healthcare professionals' awareness.

INTRODUCTION: Reliable and cost-effective prognostic markers for predicting mortality in geriatric intensive care patients are limited. The present study evaluated the role of the Serum Albumin-Creatinine Ratio (sACR) in predicting mortality.
METHODS: This retrospective cohort study was conducted in *************** ICU between May 01, 2023 and May 01, 2024. After exclusion criteria, 485 geriatric patients aged 65 years and over were included. Demographic data, comorbidities, reasons for ICU admission, disease severity scores, and laboratory parameters were collected. sACR was calculated from the ratio of serum albumin (g/dL) and creatinine (mg/dL). Mortality risk factors were examined with Multivariate Logistic Regression, and the prognostic performance of sACR was examined with In Receiver Operating Characteristic (ROC) analysis.
RESULTS: A total of 59.4% (n=288) of the patients were classified as survivors and 40.6% (n=197) as non-survivors. Congestive heart disease, malignancy, chronic kidney disease, sepsis, acute kidney injury and need for invasive mechanical ventilation were higher in non-survivors (p<0.05). In multivariate analysis, sACR was found to be an independent predictor of mortality (OR: 0.843, 95% CI: 0.749-0.950, p=0.005). The ROC analysis, sensitivity was 74.7%, specificity was 60.4% and AUC was 0.719 (p<0.001) at a cut-off value of 2.50 for sACR.
DISCUSSION AND CONCLUSION: The sACR is an independent prognostic marker for predicting 30-day mortality in geriatric ICU patients. The present study contributes to the literature by being the first study to evaluate sACR in this population. Low sACR is associated with mortality risk and can be employed in clinical practice for risk stratification and treatment planning.

INTRODUCTION: The relationship between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (non-HDL-C/HDL-C ratio, NHHR) and stent thrombosis (ST) in the setting of ST-elevation myocardial infarction (STEMI) has been understudied. We aimed to evaluate the prognostic value of NHHR in patients presenting with STEMI due to ST.
METHODS: This retrospective study included 168 patients who underwent primary PCI for ST-related STEMI between January 2020 and April 2024. The primary outcome was 1-year all-cause mortality. Patients were stratified according to NHHR: <3 or ≥3.
RESULTS: During 1-year follow-up, 35 patients (20.8%) died. Compared with survivors, non-survivors were older (64 vs. 58 years, p = 0.049), more often female (48.6% vs. 30.1%, p = 0.040), and had higher rates of hypercholesterolemia, heart failure, and Killip class ≥2 (all p < 0.05). They also had lower LVEF (41% vs. 45%, p = 0.009), and higher admission levels of creatinine, CRP, and glucose. HDL-C and hemoglobin were significantly lower in non-survivors. An NHHR ≥3 was more frequent in the mortality group (71.4% vs. 51.1%, p = 0.032), and associated with higher 1-year mortality (26.8% vs. 13.3%, p = 0.032). In multivariate Cox regression, NHHR ≥3 remained an independent predictor of 1-year mortality (HR = 2.751; 95% CI, 1.048–7.221; p = 0.040).
DISCUSSION AND CONCLUSION: Among patients presenting with STEMI due to ST, an elevated non-HDL-C/HDL-C ratio was independently associated with increased 1-year all-cause mortality. NHHR may serve as a simple, accessible biomarker for risk stratification in this high-risk population.

INTRODUCTION: Vaginal infections are often associated with disruption of the normal vaginal microbiota, with bacterial pathogens being the most common causative agents. This study aimed to identify the microorganisms isolated from vaginal discharge samples of patients presenting with vaginal complaints and to evaluate their antimicrobial susceptibility profiles.
METHODS: This retrospective study included 266 patients who presented to the Obstetrics and Gynecology outpatient clinics or inpatient services of XXX Training and Research Hospital with complaints of vaginal discharge and had positive vaginal culture results. Microorganism identification was performed using Gram staining, conventional biochemical methods, and the VITEK-2 system. Antimicrobial susceptibility testing was conducted according to standard laboratory protocols.
RESULTS: Among the isolated microorganisms, 49.3% were Gram-positive bacteria, 48.1% were Gram-negative bacteria, and 2.6% were identified as Candida species. The most frequently isolated pathogens were Escherichia coli (E. coli) (35.7%), coagulase-negative staphylococci (19.9%), Streptococcus agalactiae (14.6%), Staphylococcus aureus (9.3%), and Klebsiella spp. (9.3%). E. coli showed the highest susceptibility to colistin, meropenem, and imipenem, while Gram-positive isolates exhibited the greatest sensitivity to linezolid, tigecycline, and vancomycin.
DISCUSSION AND CONCLUSION: E. coli was identified as the most common pathogen associated with vaginal discharge. Understanding the antimicrobial susceptibility profiles of these isolates is essential for guiding appropriate treatment strategies and preventing recurrent infections and potential complications.

Percutaneous closure of atrial septal defects (ASD) is an increasingly utilized method for selected patients, offering advantages such as shorter recovery times and lower complication rates compared to surgery. Despite being considered as a rather safe treatment method, it may rarely lead to life-threatening complications such as cardiac erosion. We report a case of a 38-year-old male who presented with symptoms of intravascular hemolysis two months after percutaneous ASD closure. Despite initial suspicion of urinary bleeding due to hematuria, further evaluation revealed a fistula between the non-coronary sinus and the left atrium, caused by device-related aortic erosion. Surgical removal of the closure device and successful repair of the fistula with autologous pericardial patches resolved the symptoms. This case underscores the importance of considering structural complications, including aorto-atrial fistula, in patients with unexplained hemolysis following percutaneous ASD closure.