INTRODUCTION: In patients admitted to burn intensive care units (ICUs), increase the need for blood transfusions. In parallel with prolonged ICU stays, the risk of bloodstream infections (BSIs) also increases. This study aims to examine the relationship between transfusion and BSIs and to promote the practice of restrictive transfusion.
METHODS: 158 patients with severe burns (≥20% total body surface area) were treated in the burn ICU of our hospital over five years. The hemoglobin (Hb) threshold for restrictive transfusion was defined as 7 g/dL, while for liberal transfusion it was set at 10 g/dL.
RESULTS: Of the 158 patients included in the study, 17.7% (n=28) were female. The mean age of the patients was 41±15 years. The average total body surface area (TBSA) burned was 42.7±17% (range: 20–92%). The causes of burns were flame in 79.2% (n=125), electricity in 10.1% (n=16), boiling water in 7% (n=11), hot oil and steam in one patient each (0.6%), and chemicals in 2.5% (n=4). A statistically significant relationship was found between the total number of transfusions and burn percentage, length of stay in the burn ICU, number of escharotomy procedures performed, final hemoglobin (Hb), white blood cell (WBC) count, and number of fresh frozen plasma (FFP) units (p<0.05). Restrictive transfusion was adopted in 72.5–86.8% of erythrocyte suspension (ES) transfusions. Among the BSIs, the most commonly isolated pathogens were coagulase-negative staphylococci (CNS) in 28.5% (n=45), A. baumannii in 19.6% (n=31), and P. aeruginosa in 12.7% (n=20). A statistically significant association was found between the number of transfusions and the presence of CNS and P. aeruginosa isolates (p<0.05), whereas no such association was found with A. baumannii (p>0.05). The rate of BSIs caused by Candida species was 4.5% (n=7).
DISCUSSION AND CONCLUSION: Were commend a restrictive transfusion strategy in burn ICU patientsto minimize transfusion-related reactions and BSI risk while ensuring optimal patient support.

INTRODUCTION: Gram-positive organisms are commonly identified in cultures, either as a result of true infection or contamination. This research focused on examining the correlation between commonly used laboratory indicators and clinical results.This study aimed to evaluate the relationship between clinical outcomes and routine laboratory markers, along with antibiotic choices, in pediatric patients with gram-positive culture results in the pediatric intensive care unit (PICU).
METHODS: A total of 179 PICU patients with gram-positive culture findings were retrospectively analyzed using hospital records from 2016 to 2019. Data collected included demographic information (age, sex), fever status, microbiological results, antibiotic therapy administered, laboratory values, and survival outcomes.
RESULTS: The patients had a median age of 33.00 months (IQR: 8.00–66.00). Of the cohort, 109 (60.89%) were male and 70 (39.11%) were female. Positive culture findings were documented in 90 patients (50.3%). Vancomycin was prescribed to 59 patients (33%), while 31 patients (17.3%) received teicoplanin. A total of 34 patients (18.9%) died during hospitalization. The identified microorganisms included Staphylococcus species (n=56, 31.3%), methicillin-resistant Staphylococcus epidermidis (MRSE) (n=81, 45.3%), Staphylococcus aureus (S.aureus) (n=22, 12.3%), Staphylococcus epidermidis (S.epidermidis) (n=15, 8.4%), and methicillin-resistant Staphylococcus aureus (MRSA) (n=5, 2.8%). White blood cell (WBC) and platelet (PLT) counts were significantly higher among survivors compared to non-survivors (p=0.001 and p<0.001, respectively). No statistically significant associations were found between mortality and categorical variables assessed (p>0.05).
DISCUSSION AND CONCLUSION: Gram-positive culture results are frequently encountered in pediatric intensive care units. By evaluating the clinical and laboratory parameters of the patient, it should be evaluated whether there is an infection or contamination, and infections should be treated.

INTRODUCTION: We aimed to determine the place of platelet indices [platelet (PLT), platelet crit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW)] in predicting the severity of hemorrhage and prognosis in non-variceal upper gastrointestinal system (GIS) bleeding.
METHODS: The study included 210 patients hospitalized due to non-variceal upper GIS bleeding. Full blood count values were recorded when the patients were admitted to hospital, on the 5th day and at discharge. The Rockall and Blatchford scores were calculated according to the clinical and endoscopic findings of patients and Forrest classification was made.
RESULTS: Blatchford and Rockall scores for patients whose hospitalization period is more than 5 days and who require transfusion was higher than the group without (p<0.001). When the groups with a hospital stay of more than 5 days and less than 5 days and the groups with and without transfusion were compared, no significant difference was found between PLT, PCT, MPV and PDW values (p>0.05). There was a very weak positive correlation between MPV at time of admission and MPV and PDW values at discharge with Blatchford score. There was a very weak positive correlation between MPV and PDW values at discharge with Rockall score. To predict the risk of admission of 5 days or more, forward selection logistic regression was performed and platelet indexes were not identified to be independent predictors.
DISCUSSION AND CONCLUSION: It was observed that platelet indices were not independent predictors in determining bleeding severity and prognosis in upper GIS hemorrhage, but MPV and PDW were very weakly related to scoring systems.

INTRODUCTION: The aim of this study was to evaluate the success rate of ectopic pregnancy cases treated with single-dose methotrexate in an advanced gynecology and obstetrics center over a 10-year period and the factors affecting the response to treatment.
METHODS: A total of 120 patients who were diagnosed with ectopic pregnancy and treated with single dose systemic methotrexate between January 2014 and December 2024 were retrospectively included in the study. Demographic data, clinical findings, baseline β-hCG levels, treatment responses, and rates of conversion to surgery if necessary were analyzed.
RESULTS: In the study, treatment success with a single dose of methotrexate was 78.3%. The rate of second dose methotrexate administration was 13.3% and the rate of surgical requirement was 8.3%. Baseline β-hCG level was found to be the most important factor affecting treatment success (p<0.001).
DISCUSSION AND CONCLUSION: Single-dose methotrexate treatment is an effective and safe treatment option in cases of ectopic pregnancy with appropriate criteria. Careful patient selection based on baseline β-hCG level and ectopic mass characteristics may increase treatment success and decrease the need for surgery.

INTRODUCTION: Fractures of the distal femoral physes usually occur after high energy trauma and they are serious injuries of pediatric population. This aim of this sudy is to examine distal femoral physeal fractures treated in a level I pediatric trauma center epidemiologically and to report the complications that occurred during follow-up.
METHODS: Patients, <18 years of age, admitted to the emergency department with distal femoral physeal fractures were included in the study. Demographic data, medical history, preoperative findings, injury mechanisms, postoperative outcomes, complications during follow-up period of the patients were noted. Salter-Harris classification was used to categorize the fractures.
RESULTS: In total, 21 patients, with a mean age of 12.3 years (range, 1-16 years), were included in the study. Male to female ratio was 2.5. 12 patients (57.2%) had Salter-Harris type 2 fractures and it was the most common type. 19 (90.5%) fractures were treated surgically with different fixation methods. Mean follow-up duration was 97 months (range, 72-133 months). Complications observed during follow-up were genu valgum (n=2, 9.5%), limb length discrepancy (n=2, 9.5%), reoperation (n=7, 33.3%) and joint stiffness (n=1, 4.8%).
DISCUSSION AND CONCLUSION: Distal femoral physeal injuries are injuries with a high rate of complications and these complications, like growth disturbance, may cause serious problems in adulthood. Although this injury is relatively uncommon, patients should be treated appropriately and followed regularly until skeletal maturity for possible late complications.

INTRODUCTION: Conscientious intelligence, unlike logical and emotional intelligence, can be defined as consulting one’s conscience in making decisions, determining what is good and what is bad, and consciously choosing what is right. This study aimed to determine the differences in conscientiousness among healthcare professionals based on sociodemographic characteristics.
METHODS: This study was designed as a descriptive, cross-sectional study. Data were obtained using the Personal Information Form and the Conscientious Intelligence Scale. The Personal Information Form consists of seven questions and 32 items regarding the demographic characteristics of employees. Developed by Aktý and colleagues in 2017, the scale consists of 32 items and 7 subfactors. The study was conducted at a private hospital in Istanbul. The study population consisted of 380 employees. A convenience sampling method was
used. An attempt was made to reach all employees using the complete enumeration method during sampling. The study was conducted by reaching 277 individuals who agreed to participate in the study. Data were collected using a survey method from employees who volunteered to participate in the study. Data were analyzed using statistical techniques in SPSS.
RESULTS: The Cronbach’s alpha value for the conscientious intelligence scale was found to be 0.87. This result demonstrates the reliability of the scale for the study. Of the participants, 84.1% were female, 63.9% were married, 35.5% had no children, 41.3% were between the ages of 26 and 34, 40.1% were high school graduates, 51.5% had less than 5 years of service experience, and 43% were midwives and nurses. The mean conscientious intelligence score was 121.28, and the standard deviation was 12.8.
DISCUSSION AND CONCLUSION: According to the research findings, the participants’ mean conscience intelligence scores were found to be high. It was concluded that the mean conscience intelligence scores of healthcare workers did not differ according to their socio-demographic characteristics, gender, and marital status. The mean conscience intelligence scores of healthcare workers varied according to their socio-demographic characteristics, such as number of children, age, educational status, length of service, and title.

INTRODUCTION: To investigate the association between electronic health literacy (eHealth literacy) and health-related quality of life in women with polycystic ovary syndrome (PCOS).
METHODS: A cross-sectional web-based survey was conducted among women with PCOS. Participants completed validated Turkish versions of the eHealth Literacy Scale (eHEALS) and the PCOS Quality of Life Questionnaire-50 (PCOSQ-50). Spearman’s correlation and multiple linear regression analyses were employed to assess associations between eHealth literacy and HRQoL, adjusting for covariates including age, BMI, education level, and marital status.
RESULTS: A total of 399 women participated in the study. The mean age was 28.5±6.5 years, and the mean body mass index (BMI) was 27.1±9.1 kg/m². A moderate positive correlation was observed between eHEALS scores and overall PCOSQ-50 scores (ρ=0.315, p<0.001). The strongest correlations were found with the emotional subdomain (ρ=0.326, p<0.001), followed by coping (ρ=0.239, p<0.001) and hirsutism (ρ=0.240, p<0.001). Regression analysis identified eHEALS as a significant positive predictor of quality of life (β=0.282, p<0.001).
Higher BMI was negatively associated (β=-0.353, p<0.001).
DISCUSSION AND CONCLUSION: Enhanced eHealth literacy is associated with improved quality of life in women with PCOS, particularly in emotional and coping domains. Targeted interventions to improve digital health literacy may optimize symptom management and psychosocial outcomes in this population.

INTRODUCTION: This study aims to analyze the clinical and demographic characteristics of patients with prolonged pediatric intensive care unit (PICU) stay, focusing on medical and social factors that prolong stay.
METHODS: To assess factors that prolong hospitalization, we reviewed medical records of patients hospitalized for at least 30 days in the PICU between January 1, 2017, and May 1, 2025.
RESULTS: A total of 328 patients with prolonged PICU stay were identified. The mean age was 4.3 years (range, 1 months to 17.8 years), and the mean length of PICU stay was 92 days (range 30-920 days). The most common condition at admission was respiratory failure (68.9%). The vast majority of patients (71.6%) had underlying chronic conditions, the most common being central nervous system diseases (30.2%) followed by chronic respiratory diseases (23%). Two hundred fourteen patients (65.2%) required tracheostomy, 72 (22%) gastrostomy, and 328 (100%) mechanical ventilation. Mortality occurred in 34 patients (14.8%), with 21 cardiac (13.4%) and 13 (1.4%) brain deaths. In patients requiring tracheostomy, the PICU stay was considerably prolonged due to causes other than the clinical condition of the patient.
DISCUSSION AND CONCLUSION: Patients admitted for social reasons had longer lengths of stay, with higher rates of tracheostomy, chronic ventilation support and underlying chronic diseases. Social reason-based admissions were increased after the pandemic. Developing different solutions for this group, which significantly uses intensive care resources, will help alleviate the burden on PICU’s.

INTRODUCTION: The transfer of patients from the intensive care unit (ICU) to general wards is a clinically challenging process. A carefully considered decision to transfer and close monitoring on the ward may reduce mortality and the need for ICU readmission. This study aimed to evaluate prognostic factors associated with one-month mortality in patients transferred from a tertiary intensive care unit to a pulmonary medicine ward.
METHODS: This retrospective observational study included patients who were transferred from a tertiary ICU to the pulmonary medicine ward between January 2024 and July 2024. Demographic, clinical, and laboratory data, as well as discharge status and one-month mortality outcomes, were evaluated.
RESULTS: A total of 114 patients were included in the study. The one-month mortality rate was 23.7% (27 patients). Patients who died had significantly lower levels of albumin and hemoglobin, as well as a higher mean heart rate upon admission to the ward. Additionally, ICU readmission and the presence of malignancy were significantly associated with mortality in univariate analysis. However, in multivariate logistic regression, only ICU readmission
remained an independent predictor of mortality (p=0.032), while malignancy and elevated heart rate were not statistically significant (p=0.297 and p=0.092, respectively).
DISCUSSION AND CONCLUSION: Patients transferred from a tertiary ICU to a pulmonary medicine ward are at high risk for short-term mortality. ICU readmission was identified as an independent prognostic factor. Moreover, high heart rate, low albumin and hemoglobin levels, and the presence of malignancy may help in identifying high-risk patients. Early identification and close monitoring of these patients may reduce mortality and ICU readmissions.

INTRODUCTION: The colposcopic evaluation of the high-risk human papillomavirus positive and abnormal cervical cytological test results from cervix uteri cancer screening tests taken during pregnancy and comparison of the cytological and histopathological results in the antenatal and postpartum periods were aimed.
METHODS: The study included 32 pregnant women over the age of 25 who had HPV positive and abnormal cytological results in cervix uteri cancer screening tests conducted during routine antenatal follow-ups between 2022-2025. Our study includes cases of women who presented during pregnancy, where HPV and cervicovaginal smear tests were conducted during the initial assessment and whose results showed high-risk HPV positive and/or abnormal cytological changes.
RESULTS: Upon examination of the overall results of our study. According to the smear cytology conducted at the 6th month postpartum, the NILM or healing rates were higher in the group without dysplasia compared to the group with dysplasia, 46% versus 11%, and a statistically significant difference was observed between the two groups (p: 0.038). When the colposcopic evaluation and biopsy results conducted at the 6th week postpartum were compared with the colposcopic evaluation and biopsy results taken during the antenatal period, it was observed that 9% of all cases progressed, 63% persisted, and 28% regressed. Upon examining the impact of the delivery method on histopathological results and associated rates, it was observed that there were regression rates of 38% in 6 cases in normal spontaneous vaginal delivery and 19% in 3 cases in caesarean delivery, and that the regression rates after normal delivery were significantly high.
DISCUSSION AND CONCLUSION: Based on the results of high-risk HPV positivity and/or abnormal cytological tests conducted during pregnancy, alongside colposcopic evaluation, only conservative approach during pregnancy and a colposcopy and biopsy approach in the postpartum period are readily implementable.

INTRODUCTION: Our study aimed to evaluate the demographic characteristics, clinical presentations, metabolic disorders, radiological findings, and treatment outcomes of pediatric patients diagnosed with urinary stone disease in a pediatric nephrology outpatient clinic.
METHODS: A retrospective, descriptive study was conducted involving 256 pediatric patients aged between 0-18 years, diagnosed with urinary stone disease from January to December 2016. Clinical data, laboratory results, radiological findings, and treatments were collected from patient files and analyzed statistically.
RESULTS: Among the patients, 52.3% were male, and the median age was 39.5 [15.0-87.0] months. The most common reason for presentation was known urinary stone disease follow-up (21.5%), followed by abdominal pain and restlessness. A positive family history of urinary stone disease was noted in 61.3%, and parental consanguinity was observed in 5.5%. Metabolic abnormalities were detected in 57% of cases, most frequently hypocitraturia (34.4%), hypercalciuria (20.7%), and hyperoxaluria (17.9%). Hypocitraturia was more prevalent in older children, while hypercalciuria was more common in infants. Medical treatment was initiated in 70.7% of patients, primarily with potassium citrate (69.1%). Surgical interventions included extracorporeal shock wave lithotripsy (12.6%), percutaneous nephrolithotomy (2%), and open surgery (3.1%).
DISCUSSION AND CONCLUSION: Pediatric urinary stone disease commonly presents with metabolic disturbances, particularly hypocitraturia, and frequently involves familial predisposition. Early diagnosis through appropriate imaging and metabolic screening, followed by targeted medical management, is essential for preventing renal complications and reducing the need for surgical interventions.

INTRODUCTION: High-flow nasal oxygenation (HFNO) is a well-established preoxygenation technique in non-pregnant patients. However, its efficacy in term parturients remains uncertain, with some studies reporting suboptimal results. Moreover, data on neonatal outcomes in this population are limited. To evaluate the effects of HFNO on neonatal outcomes in parturients undergoing cesarean section under general anesthesia, focusing on Apgar scores
as the primary outcome and umbilical cord venous blood gas parameters as the secondary outcome.
METHODS: Following Ethics Committee approval and clinical trial registration (NCT03903003), 102 term parturients were randomized into two groups: HFNO (n=50) and conventional face mask preoxygenation (n=52). The HFNO group received oxygen at 60 L/min, while the conventional group received 100% oxygen at 10 L/min. Induction was initiated once end-tidal oxygen (etO₂) reached 90%, and oxygenation continued during intubation. Neonatal Apgar scores at 1 and 5 minutes, umbilical cord venous blood gas values, and maternal hemodynamic parameters were recorded.
RESULTS: The HFNO group showed significantly higher Apgar scores at both 1 minute (9 (3-10) vs. 8 (3-10); p<0.001) and 5 minutes (10 (7-10) vs. 10 (4-10); p<0.001) compared to the conventional group. Cord venous blood gas parameters were comparable between the groups.
DISCUSSION AND CONCLUSION: HFNO use for preoxygenation before and during induction in parturients undergoing cesarean section improved neonatal Apgar scores compared to conventional face mask oxygenation. These findings support HFNO as a safe and effective preoxygenation method in obstetric anesthesia.

INTRODUCTION: The objective of this study was to compare the efficacy of a non-hormonal alternatives, vaginal hyaluronic acid, oral probiotics, to a standard of care therapy, vaginal estrodiol, for the treatment of genitourinary syndrome of menopause (GSM).
METHODS: This prospective study was conducted in the Obstetrics and Gynecology Clinic of the Education and Research Hospital between June and September 2024. Women with GSM were assigned to hyaluronic acid vaginal ovules, estradiol vaginal tablets or oral probiotics for 8 wk. The primary outcome was the change in the Vaginal Health Index (VHI) score. Secondary outcomes included changes in the Female Sexual Distress Scale-Revised (FSDS-R) and the Menopause Rating Scale (MRS).
RESULTS: Sixty participants (vaginal estrogen=20, vaginal HA=20, oral probiotic=20) provided data at week 8. All three treatment groups showed statistically significant improvements in VHI scores and significant reductions in FSDS-R and MRS scores from baseline to week 8 (p<0.001) for within-group comparisons). Changes in FSDS-R scores were similar across all three groups (p=0.176). No treatment-related serious adverse events occurred.
DISCUSSION AND CONCLUSION: This study found that vaginal estradiol, vaginal hyaluronic acid, and oral probiotics led to significant improvements in vaginal health, reductions in sexual distress, and alleviation of menopausal symptoms in women with GSM. In addition, oral probiotics and vaginal hyaluronic acid may represent promising non-hormonal alternatives for the management of GSM, particularly for women who prefer to avoid hormone therapy.

Sternal tumors are rare, but the majority of these tumors are chondrosarcomas. Chondrosarcomas are generally resistant to chemotherapy, and the first-line treatment is surgical resection. For malignancies located in the anterior chest wall, wide resection should be performed to prevent recurrence. After a wide resection, the defective area should be reconstructed in a way that preserves chest wall rigidity. This is crucial both to protect intrathoracic organs from trauma and to maintain effective respiratory mechanics. In this report, we aimed to present a case of a patient with Kartagener syndrome and sternal chondrosarcoma, in whom we performed a custom-made three-dimentional (3D) reconstruction.

This study investigates the application of human amniotic membrane in chronic wound care, focusing on its efficacy in promoting tissue regeneration and reducing the need for surgical interventions. Chronic wounds, often associated with comorbidities such as diabetes and vascular diseases, present significant treatment challenges. Human amniotic membrane, an avascular structure rich in extracellular matrix components and growth factors, offers a promising solution due to its immunomodulatory and regenerative properties. The study includes seven patients treated with human amniotic membrane for chronic wounds at a specialized wound care unit. Treatments were conducted over one to two-week intervals, emphasizing the importance of sterile application and consistent follow-up. Outcomes demonstrated significant wound size reduction, accelerated granulation and epithelialization, and minimized need for complex surgeries. Patients with comorbidities particularly benefited, showing improved wound bed preparation for simpler reconstructive procedures. Despite the promising results, limitations such as small sample size and lack of a control group were noted. The findings align with existing literature but emphasize the need for standardized protocols and further large-scale, controlled studies. Overall, human amniotic membrane demonstrates potential as a cost-effective, innovative therapy in chronic wound management, bridging gaps between conservative and surgical approaches.

A subtype of white blood cells called lymphocytes is the source of chronic lymphocytic leukemia (CLL), a malignancy of the bone marrow and blood. A single lymphocyte can transform into a cancer cell, proliferate over time, and finally displace normal lymphocytes in the lymph nodes and bone marrow. These cells can no longer fight infection, in contrast to normal lymphocytes. It has been demonstrated that lymphoid enhancer-binding factor-1 (LEF1), a member of the LEF/TCF transcription factor family, plays an essential role in regulating Wnt-pathway target genes. LEF1 plays a crucial role in many cancers. Recent studies have shown that LEF1 is overexpressed in CLL. LEF1 is specifically expressed at early stages of B-cell differentiation and is essential for survival and proliferation. In this review, the general course of the disease in CLL, the applied treatment strategies and the role of the LEF1 protein are analyzed in the light of current studies.