Purpose: Tumor heterogeneity is one of the important factors affecting treatment response in malignant diseases, and this heterogeneity can be estimated by positron emission tomography-computed tomography (PET/CT) metabolic parameters. This study aimed to evaluate the efficacy of intratumoral metabolic heterogeneity indices in predicting survival in patients with wild-type metastatic colorectal cancer (mCRC). Materials and Methods: This retrospective analysis included 79 patients with wild-type mCRC who were followed between 2018 and 2023 and who underwent PET/CT at the time of diagnosis for staging. The relationship between heterogeneity indices and survival and mortality was assessed. Results: The median heterogeneity index-1 (HI-1) value was higher in the non-survivor group compared to the survivor group, but did not reach a statistically significant level (3.32 vs. 2.91). The median heterogeneity index-2 (HI-2) value was also higher in the non-survivor group compared to the survivor group, and there was a statistically significant difference between the groups (10.36 vs. 7.65). The median overall survival (OS) of the patients was 42.2 (95% CI 28.9-55.5) months, and the median progression-free survival (PFS) was 19.6±3.9 months. Median OS was longer in patients with lower HI-2 (61.8±15.3 months vs. 33.9±5.2 months). Conclusion: Our findings support the potential of PET/CT-based calculated heterogeneity indices as a noninvasive prognostic marker in wild-type mCRC patients. In wild-type mCRC patients, HI-2 can be used to predict patients who will benefit less from treatment.

Purpose: This study aims to investigate whether dynamic microvascular imaging (MVI) performed during mechanical provocation provides added diagnostic value in the ultrasound evaluation of lateral epicondylitis and explore its relationship with pain severity and functional impairment. Materials and Methods: This retrospective study included 94 patients with unilateral chronic lateral epicondylitis. Each symptomatic elbow was compared with the contralateral asymptomatic elbow. All patients underwent gray-scale ultrasound, Power Doppler (PD), and MVI at rest during mechanical provocation. Common extensor tendon thickness, structural abnormalities, and intratendinous vascularity were evaluated. Pain severity was assessed using a visual analogue scale (VAS), and functional impairment was evaluated using the Patient-Rated Tennis Elbow Evaluation (PRTEE). Results: Symptomatic elbows demonstrated significantly greater common extensor tendon thickness compared with contralateral asymptomatic elbows (5.29 ± 0.45 mm vs. 4.43 ± 0.41 mm). Structural tendon abnormalities were observed in 40.0% of symptomatic elbows. Following mechanical provocation, intratendinous vascularity increased on both modalities; however, MVI demonstrated more extensive and clearly delineated vascular signals compared with PD. Higher post-provocation vascularity grades were significantly associated with increased VAS and PRTEE scores. Conclusion: Dynamic MVI during mechanical provocation provides additional diagnostic value beyond static ultrasound assessment in lateral epicondylitis and demonstrates meaningful associations with pain severity and functional impairment.

Purpose: This study aimed to examine the impact of food addiction on treatment adherence in patients with type 2 diabetes. Materials and Methods: The study included a total of 176 patients with type 2 diabetes, including 103 women and 73 men. Data were collected using a Sociodemographic and Clinical Data Form, the Yale Food Addiction Scale (YFAS), and the Morisky Medication Adherence Scale-8 (MMAS-8). Results: Food addiction was identified in 11.9% (n = 21) of the patients with type 2 diabetes who participated in the study. No significant association was found between food addiction levels and treatment adherence among patients with type 2 diabetes. Patients who reported adhering to their diet and participating in regular physical activity demonstrated significantly higher medication adherence. Food addiction levels were significantly lower in patients without a history of psychiatric illness than in those with such a history. Conclusion: The findings of this study indicate that food addiction does not significantly impact medication adherence among patients with type 2 diabetes, whereas dietary adherence and regular physical activity significantly improve medication adherence. Further research with larger sample sizes and long-term follow-up is needed to elucidate more clearly the potential effects of food addiction on treatment adherence in individuals with type 2 diabetes.

Purpose: Fragmented QRS (fQRS) is an electrocardiographic marker of depolarization abnormalities related to myocardial fibrosis. Although fQRS has been linked to adverse cardiovascular outcomes, its relationship with vascular remodeling in hypertension remains unclear. This study aimed to investigate the association between fQRS, left ventricular hypertrophy (LVH), and carotid artery disease in hypertensive patients. Materials and Methods: A total of 292 patients with essential hypertension were enrolled and stratified into two groups according to the presence (n = 128) or absence (n = 164) of fQRS on 12-lead electrocardiography. All participants underwent transthoracic echocardiography to determine left ventricular mass (LVM) and left ventricular mass index (LVMI), as well as carotid ultrasonography for measurement of carotid intima-media thickness (CIMT) and plaque detection. Results: Baseline demographic and laboratory parameters, including lipid profile and inflammatory markers, did not differ significantly between groups. However, patients with fQRS exhibited higher systolic and diastolic blood pressure, greater LVM and LVMI, and a markedly increased prevalence of LVH (60.9% vs. 14.6%). Carotid ultrasound revealed significantly higher CIMT values (Right: 0.87 vs. 0.71; Left: 0.86 vs. 0.70) and plaque burden (32.8% vs. 11%) in the fQRS group. Multivariable analysis identified right CIMT >0.72 mm, left CIMT >0.74 mm, LVM >145 g, LVMI >91 g/m², and carotid plaque presence as independent associates of fQRS. Conclusion: Fragmented QRS is strongly associated with both myocardial and vascular target-organ damage in hypertension. Its presence may serve as a non-invasive marker for identifying high-risk patients who warrant intensified cardiovascular risk assessment and management.

The Ukraine-Russia conflict has triggered a severe public health emergency marked by damaged healthcare infrastructure, disrupted disease control, mental health crises, and massive displacement. Over 300 attacks on healthcare facilities have crippled essential services, while infectious diseases like tuberculosis and COVID-19 face increased risks due to service interruptions. The war’s mental health toll is especially high among children and adolescents. Environmental hazards and contamination further threaten safety. Türkiye’s strategic location and diplomatic engagement position it as a key mediator, hosting ongoing peace talks that include prisoner exchanges and ceasefire discussions. Lasting agreements remain elusive, however, amid competing political interests. Integrating public health priorities into peace negotiations is critical to rebuilding healthcare systems, managing disease, and addressing mental health. Türkiye’s balanced diplomacy offers an important pathway to link human security with conflict resolution, emphasizing health resilience as essential for sustainable regional stability and peace.

Dropped gallstones following laparoscopic cholecystectomy are a recognized complication that may lead to the development of late-onset intra-abdominal abscesses. These collections often present with nonspecific clinical features and can mimic malignant processes, posing considerable diagnostic challenges. A 49-year-old male was evaluated for a four-month history of cough, hemoptysis, and night sweats that developed after undergoing laparoscopic cholecystectomy. An initial computed tomography (CT) scan raised suspicion for a neoplastic process. Subsequent multimodality imaging—including positron emission tomography-computed tomography (PET-CT), magnetic resonance imaging (MRI), and repeat contrast-enhanced CT—demonstrated a perihepatic-subdiaphragmatic abscess containing internal dense foci, suggestive of dropped gallstones. The diagnosis was confirmed during surgical exploration and subsequent histopathological analysis. This case underscores the importance of including spilled gallstones among key differential diagnoses in patients who develop late-onset subdiaphragmatic collections following laparoscopic cholecystectomy. Recognition of characteristic imaging features—such as intralesional hyperdense foci on CT, internal hypointense nodules on MRI, central diffusion restriction, specific metabolic patterns on PET-CT, and other supportive MRI findings—is essential to prevent misdiagnosis and guide appropriate clinical management.

Purpose: This study aimed to examine the effects of psychoeducation on quality of life, functionality, medication adherence, health anxiety, and sleep quality in individuals diagnosed with bipolar disorder. Material and Methods: A total of 25 individuals diagnosed with bipolar disorder according to DSM-5 criteria and in remission were prospectively followed. Eligible participants were between 18 and 65 years old and had been on a stable medication regimen and euthymic for at least one year. The Sociodemographic Data Form, Global Assessment Scale (GAS), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Scale of Perceived Social Support (MSPSS), Functioning Assessment Short Test for Bipolar Disorder (FAST), Morisky Medication Adherence Scale (MMAS), and Short Health Anxiety Inventory (SHAI) were administered. Results: Of the participants, 68% were female (n=17) and 32% male (n=8), with a mean age of 40.4 ± 13.2 years and mean age at diagnosis of 27.2 ± 7.3 years. After psychoeducation, WHOQOL-BREF scores (from 52.05 to 60.80) and GAS scores (from 74.18 to 83.40) significantly increased, while SHAI scores decreased (from 18.50 to 15.73). Medication adherence improved from 48% to 100%. Knowledge test scores significantly improved (from 83.18 to 89.55). Conclusion: Psychoeducation improved quality of life and medication adherence while reducing health anxiety in individuals with bipolar disorder. These findings suggest that brief, structured psychoeducation may positively influence treatment adherence and overall well-being.

Purpose: This study aims to delineate the plasma amino acid profile in patients undergoing coronary angiography (CA) and identify potential biomarkers associated with Coronary artery disease (CAD). Materials and Methods: A targeted metabolomics approach was employed to analyze plasma levels of 41 amino acids in 25 CAD patients (pre- and post-CA) and 25 healthy controls. Plasma samples from patients pre- and post-CA, as well as from healthy controls, were analyzed using high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS) to determine free amino acid profiles. Amino acid concentrations were quantified. Results: In pre-CA patients, levels of arginine (35.124±14.476 µmol/L), asparagine (34.386±6.41 µmol/L), aspartic acid (11.266±4.788 µmol/L), glutamic acid (136.502±54.193µmol/L), and branched-chain amino acids such as leucine (168.451±85.247µmol/L) and isoleucine (66.067±14.605 µmol/L) were markedly lower than in controls. Conversely, hydroxyproline (27.16±21.173 µmol/L), hydroxylysine (0.21±0.116µmol/L), cystine (27.039±11.978 µmol/L), and ethanolamine (13.136±5.812 µmol/L) were elevated. Post-CA, further reductions were observed in asparagine (30.408±7.121µmol/L), leucine (106.362±25.446 µmol/L), isoleucine (57.637±11.83 µmol/L), threonine (81.422±16.043 µmol/L), and tryptophan (36.548±12.014 µmol/L). Conclusion: These findings highlight the potential of amino acid profiling as a diagnostic and therapeutic tool for CAD, providing insights into disease pathogenesis and opportunities for targeted interventions.

Purpose: The aim of this study was to reveal the relationship between iron metabolism, hepcidin, and hemoglobin A1c (HbA1c) in type 1 diabetes mellitus (T1DM) patients with better and poor metabolic control. Materials and Methods: The study included 30 T1DM patients with poor metabolic control (HbA1c value >7.5%), 30 T1DM patients with better metabolic control (HbA1c value ≤7.5%), and 30 healthy controls who were of similar age and gender. Routine, hemogram, biochemical tests, iron, transferrin, and ferritin levels were evaluated. Results: The hepcidin level of the poor metabolic patient group (519.52±114.58) was significantly higher than the control group (431.94±124.05). The ferritin level of the poor metabolic patient group (52.10±36.53) was significantly higher than that of the better metabolic patient group (35.13±36.18) and the control group (28.63±18.08). Positive relationships were found between HbA1c and hepcidin and ferritin. In receiver operating characteristic (ROC) analysis, hepcidin was at the threshold value of 445.20 and had 61.7% sensitivity and 56.0% specificity in diagnosing T1DM. Conclusion: Hepcidin and ferritin levels have been shown to increase in T1DM patients and both show a positive correlation with HbA1c. Hepcidin may be a promising marker contributing to the follow-up and diagnosis of T1DM.

Purpose: This study aimed to compare inflammatory marker levels during manic episodes and early remission in patients with bipolar disorder (BD), in light of increasing evidence linking mood episodes to alterations in systemic inflammation. Furthermore, it sought to examine the association between inflammatory markers and illness severity, as well as to explore potential gender-related differences in these inflammatory responses. Materials and Methods: This retrospective clinical study included 61 patients diagnosed with BD manic episodes and treated and 64 healthy control subjects. Hemogram values, C-reactive protein (CRP), albumin levels and Young Mania Rating Scale (YMRS) scores were measured within 24 hours of admission and at discharge. Results: In patients with BD experiencing a manic episode, CRP (0.96 ± 2.02 mg/L), CRP/albumin ratio (CAR) (0.24 ± 0.534), neutrophil count (5.81 ± 3.42 × 10³/µL), and mean platelet volume (MPV) (8.11 ± 1.302 fL) levels were higher compared to healthy controls [control group: CRP (0.21 ± 0.34 mg/L), CAR (0.046 ± 0.075), neutrophil count (4.22 ± 1.26 × 10³/µL), MPV (9.78 ± 1.97 fL)]. Albumin levels in the patient group (4.19 ± 0.43 g/dL) were lower than those in the controls (4.65 ± 0.23 g/dL). The monocyte level and systemic immune response index values significantly increased after treatment in female but not in male patients. A negative correlation was identified between the YMRS scores and inflammatory markers in females for albumin and monocytes, while in males, a negative correlation was identified for CRP and CAR. Conclusion: These findings highlight the role of systemic inflammation in BD and suggest gender-specific differences in disorder characteristics and treatment responses, warranting further investigation.