This case report aimed to discuss a rare instance of septic pulmonary embolism (SPE) secondary to a gluteal abscess that was attempted to be treated using the traditional method of applying a Turkish delight dressing. A 58-year-old male patient was admitted with complaints of dyspnea and weight loss. A prominent abscess was observed in the right gluteal region, and the patient stated that he had been applying Turkish delight to the wound. Laboratory findings revealed elevated inflammatory markers, and radiological assessments indicated multiple cavitary lesions. Staphylococcus epidermidis was isolated from blood cultures, and the biopsy results confirmed an infection process. Broad-spectrum antibiotic therapy was initiated, and the source of infection was managed using a multidisciplinary approach. This case underscores the importance of aseptic techniques in wound care and highlights the pivotal role of early diagnosis and appropriate treatment in the prognosis of SPE.

Aim: This study aimed to evaluate the short-term clinical and functional outcomes of reverse shoulder arthroplasty (RSA) in patients with cuff tear arthropathy and complex proximal humeral fractures. Material and Methods: A retrospective review was conducted on 15 patients who underwent RSA between January 2019 and July 2024 at a single tertiary center. Clinical evaluations were performed preoperatively and at 3 and 6 months postoperatively. Pain was assessed using the visual analog scale (VAS), and functional status was measured using the quick disabilities of the arm, shoulder and hand (Quick DASH) questionnaire. Shoulder range of motion (ROM) was recorded in abduction, flexion, and external rotation. Internal rotation was assessed by the vertebral level reached. Results: The mean age was 74.3±6.8 years, and 80% (n=12) of the patients were female. Cuff tear arthropathy was the most common indication (86.7%, n=13). At 6 months postoperatively, the mean VAS score improved significantly from 7.9±1.2 to 2.3±1.1 (p<0.001), while the Quick DASH score decreased from 78.2±6.5 to 27.6±9.3 (p<0.001). Abduction and flexion increased from 68.4±17.3° and 71.2±16.1° to 115.6±21.2° and 105.7±18.5° postoperatively, respectively (p<0.001). No major complications were observed during follow-up. Conclusion: RSA provides substantial short-term improvements in pain reduction, functional capacity, and ROM in a rare and complex patient group. These findings support its use as a reliable surgical option in carefully selected cases with irreparable rotator cuff pathology and complex fractures.

Denys-Drash syndrome (DDS) is a rare autosomal dominant disorder characterized by genital abnormalities, nephropathy, and Wilms’ tumor (WT), typically caused by heterozygous mutations in the Wilms’ tumor suppressor 1 (WT1) gene. Here, a 2-year-old male admitted with fever and abdominal pain was presented. Physical examination revealed ambiguous genitalia and a palpable abdominal mass. Imaging identified a heterogeneous mass in the left kidney, consistent with WT. Genetic analysis detected a novel heterozygous frameshift mutation in exon 8 of the WT1 gene [p.H245Tfs*2 (c.1393delC)]. WT is the most common renal tumor in children and is frequently associated with WT1 gene mutations in DDS. Given the early onset and severity of symptoms, early genetic screening for WT1 gene mutations should be considered in patients admitted with ambiguous genitalia and nephrotic syndrome. This case contributes to the understanding of WT1 gene mutations and highlights the importance of molecular analysis in children with genitourinary anomalies.

Aim: This study aimed to compare neurological and functional outcomes, including cervical range of motion (ROM), in patients with cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) who underwent either open-door laminoplasty (LP) or posterior cervical fusion (PCF) surgery. Material and Methods: This retrospective, single-center study included 38 patients, 11 female and 27 male, diagnosed with CSM and OPLL who underwent LP (n=20) or PCF (n=18) between 2014 and 2016. Clinical outcomes were assessed using the Japanese Orthopedic Association (JOA), visual analog scale (VAS), and Nurick scores. Cervical ROM values, including flexion, extension, lateral flexion, and rotation, were measured preoperatively and six months postoperatively in collaboration with physical therapy specialists. Results: Both LP and PCF groups showed significant postoperative improvement in JOA, VAS, and Nurick scores (all p<0.001), with no significant differences between groups (p=0.405, p=0.708, and p=0.963, respectively). Cervical ROM values significantly decreased in all directions postoperatively in both groups. Flexion (p<0.001), left lateral flexion (p=0.007), and left rotation (p=0.003) declined more severely in the PCF group, whereas the difference between groups did not reach statistical significance level in extension (p=0.105), right lateral flexion (p=0.065), and right rotation (p=0.067). Conclusion: LP and PCF offer similar neurological recovery in patients with CSM. However, LP better preserves postoperative cervical ROM. Despite the observed ROM reduction, daily functional activities remained largely unaffected. Long-term, larger studies are recommended for further validate these findings.

Aim: Diabetes and thyroid dysfunctions have similar mechanisms, and they may be overlooked or undiagnosed. This study aimed to evaluate the effect of thyroid hormone levels on glycosylated hemoglobin (HbA1c) and the thyroid-diabetes relationship. Material and Methods: HbA1c, glucose, free T3 (fT3), free T4 (fT4), and thyroid-stimulating hormone (TSH) values measured in the same samples of patients aged 18 and 60 years were obtained. Normoglycemic individuals were divided into subgroups as normal, hypothyroidism, and hyperthyroidism according to their TSH levels (Model 1), and non-thyroid dysfunction patients were divided into normoglycemic, prediabetic, and diabetic subgroups according to their HbA1c levels (Model 2). Correlations and differences of the obtained data were analyzed. Results: In Model 1, the median HbA1c level was 5.44 (range, 5.08-5.68) in the hyperthyroidism group, which was significantly higher than normal (5.32; range, 4.96-5.69) and hypothyroidism (5.33; range, 5.02-5.65) groups (p=0.021). In Model 2, fT3 levels were found significantly higher in normoglycemic patients (3.11; range 1.95-3.75 pg/ml) than prediabetic (3.01; range, 2.13-3.82 pg/ml), and diabetic (3.00; range, 2.02-3.69 pg/ml) patients (p=0.001), while fT4 levels in diabetic patients (1.29; range, 0.56-1.74 ng/dl) were significantly higher compared to normoglycemic (1.23; range 0.72-1.89 ng/dl), and prediabetic (1.24; range, 0.73-1.66 ng/dl) patients (p=0.003). Conclusion: The results showed that HbA1c levels could be a marker for thyroid function in non-diabetic individuals. In diabetic patients, thyroid hormone balance and ratios are changing. For better glycemic control and the prevention of complications, regular thyroid function screenings are recommended, especially in individuals with a predisposition to diabetes.

Aim: Malnutrition is associated with postoperative morbidity and mortality in geriatric patients. This study investigated the prognostic value of geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) in geriatric orthopedic trauma patients. Material and Methods: Geriatric (≥65 years old) patients followed in the surgical intensive care unit after orthopedic trauma surgery between June 2019 and June 2022 were evaluated retrospectively. Patients were classified into mortality and survivor groups. GNRI was calculated according to the ratio of serum albumin level and actual body weight to ideal body weight. PNI was obtained from serum albumin level and blood lymphocyte count. Results: The study included 371 patients. American Society of Anesthesiologists (ASA) IV status was significantly higher in the mortality group (p<0.001). Mean BMI, albumin, lymphocyte levels, PNI, and GNRI were significantly lower in the mortality group (p=0.009, p=0.008, p=0.030, p=0.001, and p=0.003, respectively). While the median Glasgow coma scale (GCS) score was significantly lower, the median acute physiology and chronic health evaluation (APACHE)-II score and median injury severity score (ISS) were significantly higher in the mortality group (p<0.001 for all). Regression analysis revealed that ASA IV status, APACHE-II score, and ISS were independent predictors of mortality. In ROC curve analysis, the area under the curve (AUC) for GNRI was 0.660 (95% CI, 0.553-0.768), and the AUC for PNI was 0.654 (95% CI, 0.566-0.743). Conclusion: In geriatric orthopedic trauma patients, nutritional scores GNRI and PNI help predict in-hospital mortality. Although their prognostic values are not high, they are similar.

Aim: This study aimed to synthesize a novel pyrazole acridine derivative (3-ACH) and evaluate its anticancer properties on SH-SY5Y human neuroblastoma cells. Material and Methods: The pyrazole-4-carbaldehyde derivative was cyclized with dimedone and p-nitroaniline to synthesize the 3-ACH. Characterization of the compound was performed using FT-IR, NMR, HPLC-Q-TOF/MS, and elemental analysis. The cytotoxic impact of the 3-ACH compound on SH-SY5Y human neuroblastoma cells was evaluated using the WST-1 assay in a dose- (50, 100, and 150 μg/mL) and time-dependent (12, 24, and 48 hours) manner. The impact of 3-ACH on apoptosis was investigated through immunostaining for Caspase-3, -8, and -9, and BAX proteins. Results: 3-ACH reduced SH-SY5Y cell viability with the rate of 89.89±7.63% (p=0.002) at 100 μg/mL concentration after 24 hours of treatment. While a higher (150 μg/mL) concentration showed a similar reduction (90.53±2.88%, p=0.004), the lower (50 μg/mL) concentration maintained high cell viability (98.37±1.67%, p=0.903) at 24 hours. All doses of 50 μg/mL (94.55±0.65%), 100 μg/mL (95.18±1.41%), and 150 μg/mL (95.28±2.57%) significantly reduced cell viability rates, at 48 hours (all p<0.001). Immunostaining revealed a significant upregulation in the synthesis of BAX, Caspase-3, -8, and -9 proteins in cells treated with 3-ACH (100 μg/mL) for 24 hours compared to the control group. Conclusion: These results indicate that 3-ACH has the potential to induce apoptosis in SH-SY5Y cells by activating both the intrinsic and extrinsic pathways, which may contribute to its cytotoxic effects. This study provides promising evidence supporting the potential of the 3-ACH compound as an anticancer therapeutic agent.

Immune checkpoint inhibitors (ICIs) are highly effective in treating cancer and are increasingly used. Thus, awareness of various complications in the form of immunity-related adverse events is increasing. Transverse myelitis following ICIs is a rare but severe neurological adverse event, and information about this entity is minimal. ICI-associated transverse myelitis should be considered a rapid and comprehensive differential diagnosis after evaluating infective, metabolic, or other inflammatory-autoimmune pathologies. After diagnosis, early immunomodulation is required through intravenous high-dose methylprednisolone, IVIg, or plasmapheresis. It should be kept in mind that different etiologies may coexist or a superimposed condition may cause each other, and concurrent treatment should not be delayed. Further studies are needed to investigate the neurological manifestations that may develop in association with these therapies further and help establish guidelines for their management. In this case report, a rare case of ICI-associated transverse myelitis in a 62-year-old male patient was presented.

Aim: This study aimed to examine the self-concept and related psychological factors in children and adolescents with neurofibromatosis type 1 (NF1). Material and Methods: A total of 71 participants (35 patients and 36 controls) were included in this study. As measurement tools the Piers-Harris children’s self-concept scale (PHSCS), family assessment device (FAD), Turgay DSM-IV-based screening and rating scale for disruptive behavior disorders (T-DSM-IV-S), children's depression inventory (CDI), Beck depression inventory (BDI), state-trait anxiety inventory (STAI), children’s sleep habits questionnaire (CSHQ), and autism spectrum quotient-adolescent (AQ-adolescent) were used. Results: NF1 patients had lower intellectual functioning/academic achievement (p=0.002) and popularity/social appreciation (p