INTRODUCTION: Huntington’s disease (HD), characterized by choreiform movements, psychiatric problems, and dementia, is an inherited progressive neurodegenerative disorder. While HD is typically perceived as a motor disorder, cognitive decline could manifest before the clinical symptoms. Cognitive impairments might appear as emotional instability, decreased vocabulary, or impaired executive functions. Herein, we aimed to evaluate the cognitive findings of our patients diagnosed with HD and the relationship with disease parameters.
METHODS: Our study included 15 patients and fifteen controls. To determine the clinical findings of the patients, the unified HD rating scale (UHDRS) was administered, and total motor score (TMS), independence scale scores, and functional capacity scores were calculated. To assess the cognitive status of individuals, the Montreal Cognitive Assessment Battery Turkish validated form (MOCA-TR), Stroop test Turkish validated form (Stroop test TBAG form), and Symbol Digit Modalities Test were conducted.
RESULTS: The MoCA-TR scores were significantly reduced in HD patients compared to controls (p<0.001). Among all patients, there was a notable elongation in completion time for the Stroop test TBAG form than controls (p<0.05). The MoCA-TR showed a robust negative correlation with the TMS while exhibiting a marked positive correlation with the independence scale score and functional capacity. Conversely, the MoCA-TR demonstrated a moderate negative correlation with the disease burden score (DBS) and a pronounced negative relationship with the progression rate (p<0.05). A strong opposing correlation was observed between cytosine-adenine-guanine (CAG) repeats and the age of disease onset, whereas a highly significant positive relationship emerged between CAG repeats and the DBS (p<0.05).
DISCUSSION AND CONCLUSION: We have demonstrated a strong correlation between patients’ cognitive scores and disease clinical findings. Patients’ cognitive scores have also been shown to impact disease burden and disease progression rate. The designation of cognitive impairment in the early stages could contribute to personalized disease-modifying treatment strategies.

INTRODUCTION: The purpose of this study was to analyze the relationship between foot pain, functional capability, and kinesiophobia among individuals diagnosed with calcaneal spurs.
METHODS: Patients with heel pain were evaluated clinically and radiologically at Bakýrköy Dr Sadi Konuk Training and Research Hospital Physical Medicine and Rehabilitation Clinic. Fifty patients diagnosed with calcaneal spurs and 50 healthy individuals were included. Demographic data were collected. The severity of pain was evaluated using the Visual Analog Scale (VAS), and foot functions were assessed with the Foot Function Index (FFI). Both groups were evaluated using the Tampa Scale for Kinesiophobia (TSK) and the Kinesiophobia Causes Scale (KCS) for kinesiophobia.
RESULTS: Total participants in the patient and healthy individual groups 90% were females (n = 45) and 10% were males (n=5). One of the demographic characteristics, body mass index, was found to be higher in the calcaneal spur group (p<0.05). However, there was no significant difference in TSK scores between the groups (p>0.05). There was a significant increase in the calcaneal spur patients compared to the healthy controls in the biological, psychological, and total scale scores, which are among the subscales of KCS (p=0.004, p=0.024, and p=0.003, respectively). In patients with calcaneal spurs, a strong positive relationship was found between VAS-activity and FFI-pain score (r=0.577, p≤0.001), VAS-activity and FFI-disability score (r=0.411, p=0.003), and a moderately positive correlation was found between activity limitation score (r=0.361, p=0.010) and FFI total score (r=0.512, p<0.001). Furthermore, a moderate and significant correlation was found between FFI-activity limitation scores and KCS-biological score (r=0.431, p=0.002) and KCS-total score (r=0.325, p=0.021).
DISCUSSION AND CONCLUSION: There were no significant differences in kinesiophobia levels between the TSK scores of patients and controls. A distinction was observed in the KCS scores. This highlights the need to address kinesiophobia in these patients. A comprehensive approach that includes biological, psychological, and rehabilitative techniques is essential for effectively treating calcaneal spur disease.

INTRODUCTION: The present study is intended to evaluate serum lipid levels in patients with spinal cord injury (SCI) and to investigate the factors affecting lipid levels.
METHODS: A total of 96 patients with SCI who were followed up in our Physical Medicine and Rehabilitation Clinic between 2018 and 2023 were included in this retrospective study. The American Spinal Injury Association Impairment Scale, Functional Ambulation Categories (FAC), SCI Spasticity Evaluation Tool and Spinal Cord Independence Measure, version III (SCIM III) assessments of the included patients were obtained from patient files and recorded. Serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglyceride (TG) levels, and TC/HDL-c ratios were evaluated.
RESULTS: Among the patients included, 41.7% had TC over 200 mg/dL, 32.3% had LDL-c over 130 mg/dL, 47.9% had HDL-c below 40 mg/dL, and 41.7% had a TC level above 150 mg/dL. In 29.2% of patients, the TC/HDL ratio was 4.5 or higher. 74 patients (77.1%) had an abnormality in at least one lipid profile. Male patients with SCI had lower HDL-c levels and higher TG levels and TC/HDL-c ratios than female SCI patients (p<0.05). There was a statistically significant correlation between TC and LDL-c and Body mass index (BMI) and FAC (p<0.05). HDL-c was significantly correlated with the duration of SCI, FAC, and SCIM III total score (p<0.05). There was a significant correlation between TG levels and BMI only (p<0.05). There was a statistically significant positive correlation between TC/HDL-c ratio and BMI and a negative correlation between the duration of SCI and SCIM III total score (p<0.05).
DISCUSSION AND CONCLUSION: Dyslipidemia was present in the majority of patients with SCI. Dyslipidemia rates were higher in the group of male patients. There was a correlation between lipid levels and BMI, SCI duration, independence levels, and ambulation degrees.

INTRODUCTION: The aim of this study is to reveal the diagnostic value of abdominal computed tomography (CT) in patients with suspected acute appendicitis according to their histopathological diagnosis and who were operated on after double contrast abdominal CT.
METHODS: The data of patients who were admitted to Bakirkoy Dr. Sadi Konuk Research and Training Hospital Emergency Medicine Clinic between March 01, 2009, and March 01, 2011, due to abdominal pain and were operated on with a clinical diagnosis of the acute appendicitis have been reviewed. The case group consisted of 111 patients who underwent preoperative double-contrast abdominal CT scans; the control group consisted of 50 randomly selected patients who were operated on without abdominal CT scans.
RESULTS: In this study, 57.1% of patients were male, 42.9% of patients were female, and the mean age of patients was 38.90±16.38 years. There was no significant difference between the groups in terms of gender, age, symptoms, body temperature, abdominal physical examination, white blood cells, complete urinalysis results, or Alvarado score (p>0.05). The diagnostic difference between ultrasonography (USG) and CT was found to be statistically significant in patients who were histopathologically diagnosed with appendicitis compared to those who did not. While the sensitivity of USG was 35.71%, specificity 85.71%, positive predictive value (PPV) 90%, and negative predictive value (NPV) 27.02%, the sensitivity of CT was 60.46%, specificity 92%, PPV 92.85%, and NPV 40.35% was found in the diagnosis of acute appendicitis.
DISCUSSION AND CONCLUSION: CT is one of the essential methods that can be used in the diagnosis of acute appendicitis in the emergency department and it can reduce unnecessary laparotomies. Acute appendicitis can be diagnosed by clinical examination and USG in the emergency department, but the value of CT was higher in patients who could not be diagnosed with acute appendicitis by USG.

INTRODUCTION: The COVID-19 pandemic caused a serious reduction both in blood donation and use of blood. The number of volunteer blood donors reduced to a great extent. Planning of blood transfusion services during a pandemic is essential to ensure appropriate management of blood reserve. The objective of this study was to define the transfusion needs of COVID-19 patients who needed to be hospitalized and to evaluate the impact on total hospital blood supply.
METHODS: This is a single-center retrospective observational study evaluating blood transfusion requirements over a 1-year period between March 11, 2020 and March 1, 2021 at the transfusion center. The clinical data were obtained from the hospital information management system records, and transfusion data were obtained from the laboratory information management system.
RESULTS: One hundred and eighty-one (44.5%) of 406 COVID-19 patients who were hospitalized needed blood transfusion. A total of 4106 (17.6%) units of blood were transfused to these individuals. The majority of blood products used were fresh frozen plasma (FFP). The number of transfusion of platelets (PLT) and erythrocyte suspensions (ES) were lower. The ES, PLT, and FFP transfusion rates in COVID-19 patients were found lower compared to patients who did not have COVID-19. The total number of transfusions of blood components was found significantly reduced compared to the same period in previous years. There was a 10.4% decrease in total blood component count, 15.4% decrease in ES, 40.2% decrease in PLT, and an 11% increase in FFP.
DISCUSSION AND CONCLUSION: While pandemics may reduce blood supply, our study showed that the rate of use of blood products was low in COVID-19 patients who were hospitalized. Studies examining patient factors may help to elucidate the mechanisms that affect the use of blood products in hospitalized COVID-19 populations to a greater extent.

INTRODUCTION: Since lung cancer is the most deadly cancer in the world, developments regarding immune control points and molecules affecting these points have increased. The positive effects of immunotherapy treatments affecting the PD-1/programmed death receptor ligand-1(PD-L1) immune checkpoint on prognosis have drawn attention to these immunocheckpoints. While immunotherapy studies developed for the PD-1 pathway continue rapidly, the aim of this study is to investigate whether PD-L1 level can be used as a prognostic marker in non-small-cell lung cancer independent of immunotherapy.
METHODS: 115 patients admitted to our center between January 01, 2016, and January 01, 2018 and diagnosed with non-small-cell lung cancer were retrospectively analyzed. The files of all patients were scanned in detail and their pathological data were confirmed. Demographic data of the patients included in the study, pathological diagnosis methods, treatment information about the disease, and past medical histories of the patients were recorded with reference to the hospital database.
RESULTS: The patients with PD-L1 <50% were considered the negative group (NG), and the group with a PD-L1 value of 50% or more was considered the positive group (PG). There were 27 patients in the NG and 11 patients in the PG. It was determined that 21 (67.8%) of 27 NG patients and 3 (21.3%) of 11 PG patients died. In total, 24 (73.2%) of 38 patients were found to have died. While the mean survival in the NG was 10.81 months, the mean survival in the PG was 28.54 months. Mean survival in the PG was statistically significant (p=0.046).
DISCUSSION AND CONCLUSION: PD-L1 expression was found to be a positive predictive value in Stage 4 non-small-cell lung cancer. Our study differs from other studies in that it excluded epidermal growth factor receptor, anaplastic lymphoma kinase, and ROS mutations. To determine the relationship of PD-L1 with prognosis more clearly, there is a need for randomized, prospective studies with larger patient groups that exclude target mutations and are independent of immunotherapy and targeted therapies.

INTRODUCTION: The number of patients diagnosed with ductal carcinoma in situ (DCIS) has increased in the past 20 years with the widespread use of mammography screening. This study aims to investigate which patients with DCIS should undergo sentinel lymph node biopsy (SLNB).
METHODS: Between 2008 and 2023, patients diagnosed with DCIS in the General Surgery Clinic were evaluated retrospectively. Age, clinical features, tumor nuclear grade, presence of comedonecrosis, tumor diameter, hormone receptor, presence of microinvasive components, axillary pathology, surgical interventions, locoregional recürrences, overall and disease-free survival information of the patients were evaluated.
RESULTS: Forty-eight patients with a mean age of 52.2+12.4 years (25–76) were included in the study. Mastectomy was performed in 16, breast-conserving surgery in 32, SLNB in 21, axillary dissection in three, and no axillary-directed intervention was performed in 24 patients. Pure DCIS was detected in 44 patients and microinvasive com-ponent was detected in four patients (8.3%). No metastasis was detected after axillary sampling. It was statistically significant that a higher proportion of patients who underwent axillary intervention were in the mastectomy group and had diffuse microcalcifications in their mammograms (p<0.001 and p=0.009). Patients were followed up for a mean of 82.5 months, and locoregional recurrence was detected in 3 (6.25%) patients. One of the recurrences was due to DCIS, and the others were due to invasive cancer. The tumor sizes in these cases were above the average tumor size in the study.
DISCUSSION AND CONCLUSION: Although the absence of axillary metastasis in our study is attributed to the low number of patients and small mean tumor size, routine SLNB might not be performed in patients with DCIS due to the low rate of axillary metastasis. SLNB may be preferred only in cases where mastectomy will be performed.

INTRODUCTION: This study was carried out to determine the male nurse perception of the patients.
METHODS: The study was carried out with 521 patients who applied to a training and research hospital and agreed to participate in the study. In the study, a sociodemographic characteristics questionnaire and a 3-point Likert-type proposition form consisting of 16 items were used, which was created by the researchers in line with the literature and to determine their views on the perception of male nurses.
RESULTS: About 30.7% of the cases were between the ages of 30 years and under, 63.1% were women, 27.3% were primary school graduates, and 33.4% were housewives. It was determined that the cases wanted to receive care from nurses of their own gender when they were hospitalized (p=0.001) and were embarrassed, hesitant, and surprised when they received care from a nurse who was not their same gender (p=0.001). It was determined that patients whose family members were health professionals could approve male nurses to work in every service in the hospital environment without discrimination and for their daughters to choose the nursing profession (p=0.028). It was determined that patients whose family members were not health-care professionals thought that men would not make a difference in the nursing profession (p=0.025).
DISCUSSION AND CONCLUSION: When the findings obtained from our study were evaluated, it was determined that the nursing profession was not gender specific, male nurses were accepted to work in all fields, but the patients wanted to receive care from their fellow nurses. In this context, public awareness should be raised that gender does not affect the quality of nursing care.

INTRODUCTION: Multiple sclerosis (MS) is a chronic neurodegenerative disease affecting young adults. While disease-modifying drugs (DMDs) help manage and decelerate disease progression, adherence to these treatments is a significant challenge. This study aimed to investigate the relationship between treatment adherence and different drug administration methods in MS patients in the context of neuropsychiatric evaluations.
METHODS: A prospective cohort study was conducted at the University Hospital of Neurology Clinic using the 2017 revised McDonald criteria for MS diagnosis. Demographic data, MS-related metrics, and DMDs were recorded. Participants were stratified based on their DMDs into oral, injectable, and infusion treatments. The MS Treatment Adherence Questionnaire, Beck Depression Inventory, and State-Trait Anxiety Inventory were administered.
RESULTS: Of the 89 patients, treatment adherence was 45%. There were significant differences in side effect scores between the non-adherent and adherent groups for both oral and injectable DMDs. The Beck Depression Inventory average score was 12.49±9.81, while the State-Trait Anxiety Inventory average scores for STAI1 and STAI2 were 38.95±10.41 and 47.89±10.66, respectively. Significant differences were observed in disease duration, the average expanded disability status scale score, and the average STAI score.
DISCUSSION AND CONCLUSION: Adherence rates varied with the method of drug administration, with oral treatments having 34.4% adherence and injectable treatments having 53.4%. Factors like perceived efficacy, depression, and anxiety influenced treatment adherence. No significant correlations were found between demographic factors like age, gender, or education and adherence rates. Treatment adherence is crucial in managing MS. This study highlights the role of drug administration methods and neuropsychiatric comorbidities in influencing adherence. A comprehensive assessment considering these factors is vital in choosing an appropriate DMD for MS patients.

INTRODUCTION: To prospectively evaluate the effect of coronavirus disease 2019 (COVID-19) on retinal thickness.
METHODS: Twenty-six cases of COVID-19 infection confirmed by real-time polymerase chain reaction constituted the study group. The thickness values of the macula, retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC) measured by optical coherence tomography before infection were compared with the thickness values at the 1st and 3rd months after the infection. The control group consisted of 13 cases that were determined not to have the disease by antibody testing. Only the right eyes in all cases were included in the study. For statistical analysis, repeated measures analysis of variance or the Friedman test were used to compare baseline, 1st, and 3rd-month data.
RESULTS: All cases in the COVID-19 group showed mild symptoms. No retinal pathology was observed in any of the cases with COVID-19. There was no difference in retinal thickness measurements at baseline, 1st, and 3rd months in the control group (p>0.05). There was no difference at baseline, 1st and 3rd-month RNFL and GCC thickness values in the COVID-19 group (p>0.05). The central macular thickness (MT) in the COVID-19 group was thicker at 1 and 3 months than before infection (p=0.03).
DISCUSSION AND CONCLUSION: Coronavirus infection affected the central MT in the first 3 months. RNFL and GCC thicknesses did not change after infection. However, a long-term follow-up of the cases may be required to observe the effects of the virus on retinal thickness.

Radiographic spondyloarthropathy, also known as ankylosing spondylitis, which is an important subgroup of spondyloarthritis, is a subgroup of diseases that we meet frequently in rheumatology practice. In untreated cases, the progression of the vertebrae to the shape of bamboo spine and the ankylosing of the sacroiliac joints causes the restriction of the movements of the patient and the more openness to traumas. With the use of biological treatments, the clinical scenario can usually be prevented. In this case report, it is aim reviews the literature by mentioning a case of paraplegia that developed after vertebral fracture in a case with AS whose follow-up and treatment were not regular.

The World Health Organization (WHO) acted with the project “Safe Surgical Saves Life” in 2008, and the surgical safety check list, which is considered the basis of safety practices in surgery, is presented to employees. It is the main intention to be able to perform patient safety professionally in the provision of safe surgeons involved in the project. Safe surgical practices will also contribute to ensuring patient satisfaction. The purpose of this project is to address the importance of practices that are named “safe surgical safety checklists” in our country and to introduce the list, considering its quality.