INTRODUCTION: Increasing cultural diversity in healthcare requires nurses to provide culturally sensitive care. Intercultural sensitivity is a key component of holistic nursing care. This study aimed to determine the intercultural sensitivity levels of final-year nursing students in surgical clinical rotation and to identify the associated factors.
METHODS: This descriptive and cross-sectional study was conducted with 124 final-year nursing students during the 2024 spring semester. Data were collected between May 15 and June 18, 2024 using the Individual Identification Form and the Intercultural Sensitivity Scale.
RESULTS: Students who had taken the transcultural nursing course demonstrated higher levels of intercultural sensitivity. In addition, students who spoke a second language and had experience working with international nurses or caring for foreign patients had significantly higher scores in the interaction confidence and interaction enjoyment subdimensions (p<0.05).
DISCUSSION AND CONCLUSION: Transcultural nursing education and intercultural experiences contribute to improving students’ intercultural sensitivity. Strengthening culturally focused content in nursing curricula and increasing opportunities for intercultural interaction are recommended.

INTRODUCTION: Pilonidal sinus disease (PSD) is a chronic condition predominantly affecting young adults, with various surgical and minimally invasive techniques described in the literature. However, the optimal management remains controversial.
METHODS: We retrospectively reviewed 198 patients treated for PSD between 2012 and 2024. Demographic data, presenting symptoms, number of sinuses, surgical technique, and recurrence during follow-up were recorded. Recurrence-based univariate comparisons were performed, and multivariable logistic regression was used to identify independent predictors of recurrence.
RESULTS: The mean age was 27.6 ± 9.8 years, and 83.3% of patients were male. Discharge was the most common presenting symptom (76.8%), and 23.2% presented with an abscess. After a median follow-up of approximately 12 months, recurrence occurred in 10 patients (5.1%). In univariate analysis, abscess at presentation and surgical technique group (p=0.040) were associated with recurrence. In multivariable logistic regression, abscess at presentation was the strongest independent predictor of recurrence. A higher number of sinus openings also increased recurrence risk (aOR 1.73 per sinus, 95% CI 1.07–2.78, p=0.024). Compared with simple excision, minimally invasive procedures were associated with higher odds of recurrence (aOR 35.47, 95% CI 2.24–560.54, p=0.011), whereas flap-based procedures showed a non-significant trend toward higher recurrence.
DISCUSSION AND CONCLUSION: Overall recurrence was low in this cohort. Presence of an abscess at admission and increasing sinus number independently predicted recurrence. Minimally invasive approaches showed higher recurrence compared with simple excision in our series, suggesting that technique selection should be individualized according to disease severity and presentation. Prospective studies are needed to better define the optimal strategy for PSD.

INTRODUCTION: The internet is a major source of health-related information for the public; however, the quality and reliability of online medical content vary widely. Spinal and epidural anesthesia are commonly used neuraxial techniques and are frequently associated with patient anxiety and misconceptions. This study aimed to evaluate the quality and reliability of Turkish-language internet information on spinal and epidural anesthesia using the Journal of the American Medical Association (JAMA) Benchmark criteria and the DISCERN instrument.
METHODS: This cross-sectional descriptive study analyzed publicly accessible Turkish-language websites retrieved via a systematic Google search using predefined terms. The first 50 results for each term were screened. Eligible websites (n = 120) were independently assessed by two anesthesiologists using the JAMA Benchmark criteria and the DISCERN instrument. Websites were categorized by content provider; analyses included between-group comparisons and correlation analysis.
RESULTS: A total of 120 websites were included. According to DISCERN, 50.8% were rated poor/very poor, whereas 23.4% achieved good/excellent quality. Academic institutions and government/official health websites had significantly higher JAMA and DISCERN scores than private hospitals, news websites, and other health portals (p<0.001). JAMA scores correlated positively with DISCERN scores (r = 0.68, p < 0.001).
DISCUSSION AND CONCLUSION: Turkish-language online information on spinal and epidural anesthesia is generally of low to moderate quality and varies across website categories. This may increase patient anxiety and complicate the informed consent process, highlighting the need for improved regulation and physician-led online health communication.

INTRODUCTION: The utility of botulinum toxin A in the treatment of obesity is debatable. The purpose of this study was to look at the effects of botulinum toxin injections into rat stomachs on body weight, insulin, glucagon, ghrelin, and leptin levels, along with oxidative stress markers.
METHODS: Three groups of 35 female Wistar Albino rats were created: botox group (n = 15), control group (n = 15), and sham group (n = 5). All rats were given cafeteria food (CAF) for 70 days. The botox group received 20 international units (IU) of botulinum toxin after 70 days of feeding, 2.5 IU to each of the eight locations in the stomach. The control group received 20 IU of saline in the same way. The sham group only underwent laparotomy. All rats continued the CAF after surgery, and their weights were monitored every 3 days. The rats were killed on the 51st day, and their blood and white and brown adipose tissue samples were collected.
RESULTS: In a diet-induced obesity rat model, botulinum toxin injection into the stomach did not affect weight reduction (*p> 0.05). However, the levels of insulin, glucagon and ghrelin secretion decreased and that of leptin remained unaffected. Botulinum toxin increased catalase expression (*p<0.05) but had no effect on other oxidative stress markers examined (*p> 0.05).
DISCUSSION AND CONCLUSION: Botulinum toxin administration had no impact on weight reduction in this animal model (*p> 0.05), although it did decrease insulin, glucagon and ghrelin production, but had no effect on leptin levels.

INTRODUCTION: Neonatal tachyarrhythmias are rare but clinically significant and may rapidly lead to hemodynamic compromise. Early recognition and appropriate management are essential to prevent serious complications. This study aimed to evaluate the clinical characteristics, treatment strategies, and early follow-up outcomes of neonates diagnosed with tachyarrhythmia at a referral center.
METHODS: This retrospective study included neonates (0–28 days) diagnosed with tachyarrhythmia at a tertiary referral center. Demographic, clinical, electrocardiographic, echocardiographic, treatment, and follow-up data were analyzed. Tachyarrhythmias were classified based on ECG and/or 24-hour Holter recordings. Treatment strategies were evaluated according to hemodynamic status, and recurrence was assessed during follow-up.
RESULTS: A total of 21 neonates (11 females, 10 males) were included. Narrow-QRS tachyarrhythmia was observed in 85.7% of cases. Supraventricular tachycardia (SVT), predominantly reflecting an atrioventricular re-entry mechanism, was the most common diagnosis (71.4%), followed by atrial flutter (23.8%) and atrial tachycardia (4.8%). Intravenous adenosine restored sinus rhythm in 66.7% of cases, whereas 33.3% required additional antiarrhythmic therapy and/or synchronized cardioversion. Propranolol monotherapy was the most frequently used maintenance therapy (52.4%). During a median follow-up of 11 months (range: 1–30 months), recurrence occurred in four cases (19.0%), all diagnosed with supraventricular tachycardia.
DISCUSSION AND CONCLUSION: In conclusion, supraventricular tachycardia, predominantly reflecting an atrioventricular re-entry mechanism, was the most common neonatal tachyarrhythmia in this single-center study. Although adenosine was effective as first-line therapy in most cases, some patients required additional antiarrhythmic therapy and/or cardioversion. Propranolol was the most commonly used maintenance therapy. Close follow-up during the first year of life is important for early detection of recurrences.

INTRODUCTION: Acute biliary pancreatitis (ABP) and acute cholangitis can present with overlapping clinical features due to shared etiologic mechanisms. This study aimed to evaluate the clinical validity and potential overdiagnosis effect of the Tokyo 2018 Guideline (TG18) acute cholangitis criteria in patients diagnosed with ABP.
METHODS: A total of 115 adult patients hospitalized with a diagnosis of ABP were retrospectively analyzed. According to the TG18 criteria, the patients were split into three groups: no cholangitis (n=14), probable cholangitis (n=60), and definite cholangitis (n=41). The groups were compared with regard to demographic data, laboratory measurements, imaging results (CT, MRCP, ERCP), clinical scores (SIRS, BISAP, APACHE), and therapeutic outcomes.
RESULTS: In the definite cholangitis group, age, frequency of jaundice, total and direct bilirubin at admission, CRP, and WBC levels were significantly higher, while lipase levels were significantly lower relative to other groups. SIRS, BISAP, and APACHE scores were proportional to cholangitis severity. Cholangitis, common bile duct dilation, and choledocholithiasis were significantly more common in the definite cholangitis group, and this group received ERCP intervention at a significantly higher frequency (78.05%) compared to the other groups. Notably, 87.83% of ABP patients were classified as suspected or definite cholangitis according to TG18 criteria.
DISCUSSION AND CONCLUSION: TG18 criteria provide a high rate of cholangitis diagnosis in ABP patients, which may cause overdiagnosis. Cholestasis and inflammatory findings in the natural course of ABP can meet TG18 criteria, which may lead to unnecessary antibiotic use and misguide early ERCP decisions.

INTRODUCTION: This study aimed to evaluate the clinical, histopathological, and HPV type distribution characteristics of patients who underwent LEEP or conization for cervical preinvasive lesions.
METHODS: A total of 156 patients who underwent excisional procedures (LEEP or conization) due to cervical preinvasive lesions between 2015 and 2025 at Ankara Training and Research Hospital were retrospectively included. Data were obtained from patient files and electronic records. Histopathology results and HPV typing data were analyzed.
RESULTS: The mean age of the patients was 44±10.2 years. The most common indication for excisional procedures was HSIL (66%), followed by cytology-biopsy discordance (18.6%) and carcinoma in situ (9.6%). HPV type 16 was the most frequently detected type (25.6%), while HPV status was unknown in 50.6% of the patients. LEEP was performed in 38.5% and conization in 61.5% of cases. The rate of ≥HSIL in final pathology was 53.3% in the LEEP group and 70.8% in the conization group. The overall rate of benign or low-grade lesions was 35.9%.
DISCUSSION AND CONCLUSION: LEEP and conization are effective procedures for the diagnosis and treatment of cervical preinvasive lesions. The predominance of HPV 16 highlights the importance of HPV-based screening strategies. The higher rate of ≥HSIL detected in the conization group suggests that conization may be particularly useful in patients with a higher suspicion of advanced cervical lesions.

INTRODUCTION: This study aimed to evaluate the clinicopathological characteristics and clinical outcomes of patients with GISTs and to describe risk stratification patterns according to the modified NIH classification in a real-world cohort.
METHODS: This retrospective study included 44 patients with histopathologically confirmed GIST who underwent surgical treatment at a tertiary center between 2012 and 2024. Demographic data, tumor characteristics (localization, size, mitotic activity, and Ki-67 index), treatment modalities, and follow-up outcomes were analyzed. Risk stratification was performed using the modified NIH criteria. Survival outcomes were assessed descriptively.

RESULTS: The mean age was 58.7 ± 11.8 years, and 65.9% of patients were male. The stomach was the most common tumor site (68.2%). The median tumor size was 5.8 cm, and spindle cell morphology was predominant (75%). Tumor necrosis was present in 31.8% of cases. The median Ki-67 index was 3%, and the median mitotic count was 5 per 5 mm². According to the modified NIH classification, 38.6% of patients were high risk. The overall survival rate was 86.4%. No significant associations were found between survival and tumor size, Ki-67 index, or mitotic count (all p>0.05).


DISCUSSION AND CONCLUSION: This study provides real-world clinicopathological data from a single-center cohort of surgically treated GISTs with generally favorable clinical outcomes and highlights the need for larger multicenter studies to better define prognostic determinants.

INTRODUCTION: The aim of this study was to evaluate the relationship between the spot urine protein concentration and 24-hour urinary protein results in pregnant women diagnosed with preeclampsia.
METHODS: This retrospective descriptive study included pregnant women diagnosed with preeclampsia between April 2023 and November 2024 at Kocaeli City Hospital. A total of 59 pregnant women were included. Patients were divided into severe and non-severe preeclampsia groups. Demographic characteristics, laboratory parameters, spot urine protein concentration and 24-hour urinary protein results were evaluated. Statistical analyses were performed using Chi-square, independent samples t-test, Mann–Whitney U test, Pearson, and Spearman correlation analyses. A p value of <0.05 was considered statistically significant.
RESULTS: The mean age of the patients was 30.9±5.39 years. The mean gestational week was significantly lower in the severe preeclampsia group compared to the non-severe preeclampsia group (33.18±3.43 vs 36.47±2.09 weeks, respectively; p<0.001). No significant differences were found between the groups in terms of age, gravidity, parity, spot urine protein concentration, 24-hour urinary protein excretion, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine levels, platelet counts, and duration of hospitalization.
No significant correlation was found between spot urine protein positivity and 24-hour urinary protein positivity (Spearman's ρ = −0.078, p = 0.559). Likewise, subgroup analyses demonstrated no significant correlations in patients with severe preeclampsia (Spearman's ρ = −0.142, p = 0.390) or non-severe preeclampsia (Spearman's ρ = 0.055, p = 0.824).


DISCUSSION AND CONCLUSION: Spot urine protein concentration was not significantly associated with 24-hour urinary protein measurements in this study. Although it cannot replace 24-hour urine protein assessment, its rapid availability may make it a useful adjunct in the clinical evaluation of women with suspected preeclampsia.

INTRODUCTION: This study aimed to identify admission, procedural, and laboratory parameters associated with in-hospital mortality and post-procedural radiological intracranial hemorrhage in patients treated with endovascular thrombectomy for large-vessel occlusion stroke.
METHODS: Medical records of 348 adults who underwent thrombectomy between 1 January 2023 and 1 January 2026 were reviewed. Large-vessel occlusion was verified by cranial computed tomography angiography. The evaluated outcomes were in-hospital mortality and any radiologically detected post-procedural intracranial hemorrhage; symptomatic and asymptomatic hemorrhages were not evaluated separately. Candidate variables were evaluated for their associations with the outcomes
RESULTS: In-hospital mortality was observed in 126 patients (36.2%), while post-procedural radiological ICH was detected in 130 patients (37.4%). In the mortality model, admission NIHSS score, post-procedural radiological ICH, glucose, and urea were independently associated with in-hospital death. In the radiological ICH model, admission NIHSS score, longer symptom onset-to-arterial puncture time, intravenous thrombolysis, and hypertension remained independently associated with hemorrhage. NIHSS score provided the strongest discrimination for mortality. For radiological ICH, hs-cTnT had the highest univariable AUC, although it did not remain independently associated after multivariable adjustment.
DISCUSSION AND CONCLUSION: In patients undergoing thrombectomy for large-vessel occlusion stroke, early adverse outcomes were mainly related to neurological severity, hemorrhagic complication, metabolic stress, vascular risk profile, and treatment delay. These findings may assist early risk evaluation, but they should be confirmed in external cohorts.

INTRODUCTION: Pancreatic neuroendocrine tumors (pNETs) are uncommon neoplasms with heterogeneous biological behavior. We aimed to describe the clinicopathological features of a single-center pNET cohort and to identify factors associated with overall survival (OS).
METHODS: We retrospectively reviewed 40 patients with histologically confirmed pNET. Tumors were graded according to the WHO 2022 classification. OS was calculated from diagnosis to death or last follow-up. Survival was estimated with the Kaplan–Meier method and compared with the log-rank test; prognostic factors were assessed with univariate and multivariable Cox proportional-hazards regression.
RESULTS: Median age was 60 years (IQR 50–68) with an equal sex distribution. Tumors were grade G1 in 30.0%, G2 in 45.0% and G3 in 25.0%; median Ki-67 was 8%. At diagnosis, 52.5% had distant metastasis and 47.5% were inoperable. Over a median follow-up of 65.6 months, 18 patients (45.0%) died. Median OS was 87.4 months (95% CI 34.1–not reached), with 1-, 3- and 5-year OS of 92.5%, 67.0% and 52.2%, respectively. Median OS differed markedly by grade (G1 not reached, G2 130.2 months, G3 16.9 months; p<0.001), with the separation driven by G3 disease (G1 vs G2, p=0.31). In univariate analysis, WHO grade G3, Ki-67 >20%, inoperable disease and nodal positivity were associated with worse OS. In multivariable analysis, WHO grade G3 remained the only independent predictor of mortality (HR 8.46, 95% CI 2.35–30.46; p=0.001).
DISCUSSION AND CONCLUSION: In this pNET cohort, tumor proliferation reflected by WHO 2022 grade was the dominant independent determinant of survival, outweighing anatomical and treatment-related variables.Proliferation-based grading remains central to risk stratification in pNET.

INTRODUCTION: Ischemic stroke remains a leading cause of morbidity and mortality worldwide. Both genetic and environmental risk factors contribute to its pathogenesis. Mitochondrial dysfunction, previously associated with neurodegenerative diseases, has also been implicated in the pathogenesis of stroke. This study aimed to investigate the correlation between mitochondrial DNA (mtDNA) copy number alteration with ischemic stroke, thereby evaluating the potential of mtDNA as a biomarker.
METHODS: DNA was isolated from peripheral blood, and mtDNA copy number was determined using quantitative PCR (qPCR). Statistical analyses were conducted using SPSS and R with the FactoMineR and factoextra packages for PCA analysis. A total of 67 patients with acute ischemic stroke and 24 healthy controls were included in the study.
RESULTS: mtDNA copy number was found to be decreased 1.35-fold in stroke patients in comparison to the control group (p = 0.0328). Patients in the stroke group were significantly older, and the prevalence of hypertension, diabetes mellitus and coronary artery disease was also significantly higher (p < 0.01 for all). PCA showed correlation patterns among variables suggesting that decreased mtDNA copy number may be associated with metabolic and inflammatory alterations.
DISCUSSION AND CONCLUSION: These findings suggest that reduced mitochondrial DNA copy number may indicated mitochondrial dysfunction and may represent a candidate biomarker for ischemic stroke, pending confirmation in adjusted and longitudinal studies.

INTRODUCTION: This study aimed to evaluate the clinical profile and demographic characteristics of children younger than two years with atopic dermatitis and to determine disease severity using the SCORAD and Objective SCORAD indices
METHODS: This retrospective cross-sectional study included 115 children aged 0–24 months diagnosed with atopic dermatitis between 2016 and 2018. Demographic and clinical data were retrospectively collected from medical records. Disease severity was assessed using the SCORAD and Objective SCORAD indices. Continuous variables were summarized as mean ± SD or median (IQR) according to data distribution.
RESULTS: A total of 115 children were included in the study, of whom 69.9% were male. The median age at symptom onset was 2 months (IQR: 1–4), whereas the median age at presentation was 7 months (IQR: 5–10). The mean SCORAD and Objective SCORAD scores were 36.51 ± 14.36 and 27.60 ± 9.95, respectively. Based on the SCORAD classification, most patients (65.2%) had moderate disease severity. Infants younger than 6 months exhibited significantly more frequent facial involvement than older children (89.1% vs. 67.3%, p = 0.004), while no significant difference in SCORAD scores was observed between the age groups (p = 0.118).
DISCUSSION AND CONCLUSION: Most children younger than two years with atopic dermatitis had moderate disease severity. More frequent facial involvement in infants younger than six months, together with the limited reliability of caregiver-reported symptoms, supports the use of Objective SCORAD as a practical tool for assessing disease severity during infancy.

Background: Autoamputated torsioned ovarian cysts are rare and may pose diagnostic challenges owing to their similarity to intestinal duplication cysts. We present a newborn case with an abdominal cystic lesion detected on prenatal and postnatal imaging, initially interpreted as an intestinal duplication cyst on MRI, but diagnosed intraoperatively and histopathologically as an autoamputated torsioned ovarian cyst.

Case Presentation: A cystic lesion was detected in the right adnexal region (38×35 mm) and a hemorrhagic cystic mass in the left adnexa (43×45 mm) at 32 weeks of gestation. Postnatal MRI revealed an 11-cm cystic lesion filling the right lower quadrant, reported as a duplication cyst. Exploratory laparotomy on the third postnatal day revealed an autoamputated cystic mass together with left ovarian torsion

Conclusion: Autoamputated torsioned ovarian cysts are rare lesions that can be confused with intestinal duplication cysts. A definitive diagnosis requires surgical exploration and histopathological evaluation. In neonates with intraabdominal cystic lesions, this entity should be considered in the differential diagnosis of cystic lesions.