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It is important for postmenopausal women to acquire bone health protective behaviors to protect them from fractures. For this reason, it is necessary to evaluate bone health during menopause and to inform women. PURPOSE: This study was conducted to examine osteoporotic fracture protection behaviors, quality of life, and self-efficacy in postmenopausal women. METHODS: In the study, the data were evaluated with the socio-demographic data form, Osteoporotic Fracture Protection Scale, Osteoporosis Self-Efficacy-Efficacy Scale, European Osteoporosis Foundation Quality of Life Questionnaire-41, which includes introductory information on socio-demographic characteristics. RESULTS: It was determined that the postmenopausal women included in our study were between the ages of 45-92; more than half of them had chronic diseases; their average BMI was 29; and their DEXA score was - 3.00 ± 0.41. Among the people included in our study, those with a history of fractures had lower self-efficacy scores. It was determined that the fracture prevention scale scores of the participants were above the average, and the average of the osteoporosis-related quality of life score was high. In addition, it was determined that there was a strong positive correlation between self-efficacy and fracture prevention scale. CONCLUSION: It is important to determine behaviors to prevent osteoporotic fractures in postmenopausal women, to raise the necessary awareness and to inform patients about the precautions to be taken. It is thought that it will increase patients' quality of life by increasing their disease-related self-efficacy. Therefore, there is a need for research on providing education to op patients and examining the results.

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One of the well-known postoperative complications that requires a number of prophylactic and curative treatments is infection. The implications of postsurgical infections are further exacerbated by the emergence of antibiotic-resistant strains. Reduced effectiveness of synthetic antibiotics has led to an interest in plant-based substances. Extracts obtained from Nigella sativa have been shown to possess effective anti-infectious agents against bacteria frequently seen in bone infections. In this study, a fiber-based bone scaffold containing polycaprolactone, poly(lactic acid), and hydroxyapatite with N. sativa oil at varying concentrations was developed. Solvent electrospinning was used to fabricate the fibers with the specified composition. According to FE-SEM analysis, fibers with average diameters of 751 ± 82, 1000 ± 100, 1020 ± 90, and 1223 ± 112 nm were formed and successful integration of N. sativa oil into the fiber's structure was confirmed via FTIR. Staphylococcus aureus showed moderate susceptibility against the fibers with a maximum inhibition zone diameter of 11.5 ± 1.6 mm. MTT assay analysis exhibited concentration-dependent cell toxicity against fibroblast cells. In short, the antibacterial fibers synthesized in this study possessed antibacterial properties while also allowing moderate accommodation of CDD fibroblast cells at low oil concentrations, which can be a potential application for bone healing and mitigating postsurgical infections.

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AIM: The aim of this study was to evaluate the correlation of the pathological response in breast tissue and the axilla of patients with breast cancer who underwent surgery following neoadjuvant chemotherapy. METHOD: This retrospective cohort study included patients with T1-4, N1-3, M0 breast cancer who underwent surgery following neoadjuvant chemotherapy at Gaziosmanpasa Training and Research Hospital between 2013 and 2022. The response of the breast tissue to chemotherapy was evaluated with the Miller-Payne grading system, and the response of the axillary lymph nodes to chemotherapy was evaluated with the Pinder grading system. The patients were grouped histopathologically as luminal A, luminal B, Her-2 enriched, or triple negative breast cancer (TNBC). RESULTS: The study was completed with 140 patients. Pathological complete response (pCR) was seen in the breast in 40 patients and in the axilla in 34. Of the patients with pCR in the breast, pCR was also determined in the axilla in 45%. In the patients with pCR in both the breast and axilla, Her-2 enriched subtype, estrogen receptor negativity, progesterone receptor negativity, Her-2 neu positivity, and Ki-67 level >25% were determined to be effective (p<0.05). Her-2 neu positivity was evaluated as statistically significant in the development of pCR in both the breast and axilla (OR: 4.06, 95% CI:1.2-13.6, p=0.023). CONCLUSION: The development of pCR in the breast, especially in the Her-2 enriched subgroup, can be accepted as a predictive factor for the evaluation of axillary response in patients with breast cancer. The least compatibility was seen in the luminal A subgroup. KEY WORDS: Breast cancer, Miller-Payne, Neoadjuvant chemotherapy Pathological complete response, Pinder.

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Background: The nodules diagnosed as the "atypia of undetermined significance" category are a heterogenous group with an indeterminate risk of malignancy. This study aimed to perform a detailed cytological examination of the preparations to determine the cytomorphological criteria that may be useful to distinguish benign cases from malignant ones, correlate them with ultrasonographic findings, and compare them with the final pathological result in surgically treated patients. Methods: The preparations of patients classified as Bethesda 3 were re-evaluated; presence or absence of one of 11 parameters (hypochromasia, oval nucleus, colloid, intra-nuclear pseudoinclusions, nuclear grooving, nuclear moldering, isolated nuclear enlargement, nuclear irregularity, nuclear size, microfollicular pattern, distinct nucleoli) and correlating with surgical outcomes by adding ultrasonographic findings to statistically significant parameters. Results: Two hundred and six fine needle aspirations (FNA) procedures were classified as Bethesda 3. A total of 53 patients underwent surgery; 28 (52.8%) of them were benign, and 25 (47.1%) were malignant. Thirty-two (15.5%) accepted direct surgery; 53 patients underwent repeat FNA at 3-6 month intervals and those with malignancy and repeated Bethesda 3 interpretation were operated. One hundred twenty-one (69.5%) patients who did not undergo biopsy were invited for ultrasonographic controls at 3-6 month intervals. Among the 11 cytomorphologic parameters evaluated, 7 were found to be statistically significant (p 0.05) with malignancy. When at least 3 of these parameters were positive, the malignancy rate was 92%. Malignancy was present in 19 (61.3%) of the patients with high risk nodules (TIRADS = 4), compared to only 6 (35.8%) of the low-risk (TIRADS = 3); there was a significant correlation between the presence of malignancy and TIRADS score (p=0.015). The preparations that displayed nucleus atypia were closely associated with the ultrasonographically high-risk group. Conclusion: The parameters indicating nuclear atypia, presence of more than 3 cytomorphological factors, TIRADS score 4 were significantly associated with malignancy; nuclear atypia were closely associated with the ultrasonographically high TIRADS. No significant correlation was found between the presence of "microfollicular pattern" and malignancy.

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BACKGROUND: Appendix neoplasms are rare tumors of the gastrointestinal system. Appendiceal adenocarcinoma, appendiceal mucinous neoplasm, and neuroendocrine tumors (NETs) are the most encountered appendix-related neoplasms. The patients are usually got diagnosed after histopathological examination. This study aimed to explore the epidemiology, pathological subtypes, and treatment modalities of appendix neoplasms. METHODS: A retrospective examination was made with 2821 patients who underwent appendectomy between April 2010 and August 2020. Demographic, clinical, radiological, surgical findings, and histopathological results were collected from the patient files. RESULTS: Appendix neoplasms were detected in 1.06% of the patients included in the study. The mean age was 44.6±17.5 (17-83) years. Eight NETs, seven adenocarcinomas, fourteen mucinous neoplasms, and one neuroma were diagnosed with patients. CONCLUSION: Appendiceal neoplasms are generally asymptomatic and often diagnosed with postoperative histopathological ex-amination. If the result is adenocarcinoma, right hemicolectomy recommends. Treatment of NETs depends on factors such as tumor size, location, mesoappendix invasion, and lymph node involvement. In the presence of mucinous neoplasm, surgical intervention is determined according to the pathological subtype and involvement of mesoappendix. The need for additional surgical intervention or medical treatment for patients with tumor, histopathological results must be followed carefully after appendectomy.

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Background: This study aims to estimate the total number of infected people, evaluate the effects of NPIs on the healthcare system, and predict the expected number of cases, deaths, hospitalizations due to COVID-19 in Turkey. Methods: This study was carried out according to three dimensions. In the first, the actual number of infected people was estimated. In the second, the expected total numbers of infected people, deaths, hospitalizations have been predicted in the case of no intervention. In the third, the distribution of the expected number of infected people and deaths, and ICU and non-ICU bed needs over time has been predicted via a SEIR-based simulator (TURKSAS) in four scenarios. Results: According to the number of deaths, the estimated number of infected people in Turkey on March 21 was 123,030. In the case of no intervention the expected number of infected people is 72,091,595 and deaths is 445,956, the attack rate is 88.1%, and the mortality ratio is 0.54%. The ICU bed capacity in Turkey is expected to be exceeded by 4.4-fold and non-ICU bed capacity by 3.21-fold. In the second and third scenarios compliance with NPIs makes a difference of 94,303 expected deaths. In both scenarios, the predicted peak value of occupied ICU and non-ICU beds remains below Turkey's capacity. Discussion: Predictions show that around 16 million people can be prevented from being infected and 94,000 deaths can be prevented by full compliance with the measures taken. Modeling epidemics and establishing decision support systems is an important requirement.

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PURPOSE: The gallbladder and the biliary tract are structures in close connection with the adjacent organs and may show a number of variations and anomalies. It is therefore important for surgical purposes to know their anatomy and variations in detail. Various methods are used in the imaging of the variations of the biliary tract and its pathologies, including ultrasonography, computed tomography; direct cholangiographic methods like endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, intravenous cholangiography and T-tube cholangiography, as well as indirect methods like magnetic resonance cholangiopancreatography (MRCP) or cholescintigraphy. The aim of this study is to investigate the frequency of the anatomic variations of the biliary tract using 3-T MRCP and to compare the findings with the data in the literature. MATERIALS AND METHODS: For the purposes of this study, patients who underwent MRCP at our hospital (Dicle University Hospital) between November 2009 and February 2012 were investigated retrospectively. A total of 590 patients (between 6 and 88 years of age; mean age: 51 ± 9 years) were included in the study. The MRCP imaging was carried out with an magnetic resonance imaging (MRI) device supplied with 3-T magnetic power and by obtaining T2-weighted images through the single-shot fast spin echo technique using the standard body coil. The axial and coronal source images and the reformatted images were evaluated together in terms of the possible anatomic variations. RESULTS: Among the 590 patients included in the study, of 233 (39.5 %) showed anatomic variations at different levels in the intra- and extrahepatic biliary tracts. Among these variations, a right posterior hepatic duct insertion to the left hepatic duct at the level of the bifurcation has been observed in 71 patients (12.1 %), trifurcation was observed in 30 patients (5.1 %) and insertion into the main hepatic duct at the proximal aspect of the cystic duct was observed in 18 patients (3.1 %). At the level of the cystic duct, medial insertion of the cystic duct was viewed in 58 patients (9.8 %), distal medial insertion was seen in 40 patients (6.8 %), a short cystic duct was detected in 10 patients (1.7 %), pancreatobiliary junction anomaly was viewed in two patients (0.4 %) and duplicate anatomic variations have been observed in 42 patients (7.2 %). CONCLUSION: MRCP studies conducted using 3-T MRI devices may reveal similar or greater numbers of variations when compared to the existing MRCP studies in the literature. 3-T MRI shows a couple of variations. Pointing out these anatomical variations before the surgical intervention may prevent possible iatrogenic traumas. Donors with unsuitable variations for liver transplant may be spotted out at an early phase through the MRCP and certain operations with a high morbidity rate may thus be avoided.

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