INTRODUCTION: Anesthesia management, surgical techniques, and patient variables all affect postoperative recovery. After anesthesia and surgery, the Quality of Recovery-15 questionnaire is used to evaluate the quality of recovery. Pneumoperitoneum can affect respiratory mechanics and raise the risk of atelectasis during laparoscopic cholecystectomy. Protective mechanical ventilation techniques, such as recruitment maneuvers and positive end-expiratory pressure, may improve postoperative recovery by increasing oxygenation and lowering pulmonary problems. This study investigates the effects of different ventilation strategies during laparoscopic cholecystectomy on oxygenation, respiratory mechanics, hemodynamics, and postoperative recovery quality.
METHODS: Two groups of sixty laparoscopic cholecystectomy patients were randomly assigned.
Control (Group C) receiving 5 cmH2O positive end-expiratory pressure and Recruitment (Group R) receiving the same positive end-expiratory pressure plus recruitment maneuvers. Hemodynamic parameters, blood gas values, and Quality of Recovery-15 scores were recorded and analyzed using statistical methods.


RESULTS: The Recruitment group showed significantly higher partial pressure of oxygen (PO2) measurements at all intraoperative time points T1 (5 minutes after insufflation), T2 (5 minutes after desufflation), and T3 (1 hour postoperatively) compared to the Control group. The Recruitment group exhibited a higher peak airway pressure (Ppeak) at both T1 and T2. At fifteen minutes postoperatively, the mean arterial pressure in the recruitment group was considerably lower. Better postoperative recovery was shown by the Recruitment group's considerably higher Quality of Recovery-15 scores.
DISCUSSION AND CONCLUSION: Recruitment maneuvers during laparoscopic cholecystectomy improve oxygenation and postoperative recovery quality, as evidenced by higher Quality of Recovery-15 scores. These findings suggest the potential benefits of integrating recruitment maneuvers into perioperative care plans to enhance patient outcomes.

INTRODUCTION: Prosthetic infection is a serious complication that can develop after knee and hip arthroplasty and remains a common reason for revision surgery. Guidelines recommend various measures to prevent infection, howewer some professional associations argue that there is insufficient evidence for single-dose antibiotic prophylaxis. Our study compares the outcomes of patients receiving short- and long-term antibiotic prophylaxis in arthroplasty surgery.
METHODS: In this retrospective study of 424 patients undergoing knee or hip arthroplasty, two prophylaxis protocols were compared. Group 1 (190 patients, 44.8%) received cefazolin pre- and postoperatively on day 1, while group 2 (234 patients, 55.2%) received extended cefazolin (5 days postoperatively) and oral amoxicillin clavulanic acid (5 days). Early postoperative infection rates were evaluated.
RESULTS: In this study, 83.4% of 424 patients who had knee and hip arthroplasty were female. Knee operations were performed in 86.8% and hip in 13.2% of patients. The mean age showed no significant difference. There was no significant difference in periprosthetic infection rates (p=0.828) or postoperative wound complications between groups (p=0.704). No difference in wound complications and prosthesis infection rates was found between groups with risk factors (p>0.05).
DISCUSSION AND CONCLUSION: In primary joint arthroplasty, extended oral antibiotic prophylaxis did not provide additional protection against single-day antibiotic prophylaxis. The results were similar in both risk and non-risk groups. Considering antibiotic resistance, side effects and costs, it is concluded that extended prophylaxis is unnecessary. However, further large-scale studies on this subject are required.

INTRODUCTION: COVID-19 has profoundly impacted global health systems since its emergence in 2019. The association between various biomarkers and COVID-19 has been investigated, with a particular focus on CRP, ferritin, fibrinogen, and D-dimer levels. Although these biomarkers alone are not diagnostic for COVID-19, their elevation is associated with disease severity and prognosis.
In recent years, new horizons have opened in radiology with artificial intelligence and computer software that can obtain quantitative or semi-quantitative data. The 3D slicer program is completely open free software that can be used to obtain this data and has many medical patch support programs.
This study aimed to quantitatively evaluate lung parenchymal involvement in COVID-19 patients using 3D Slicer software and correlate it with biochemical parameters.
METHODS: In a retrospective analysis of 213 hospitalized patients with COVID-19 pneumonia, this study evaluated CRP, ferritin, and their ratios for disease severity and lung involvement potential. Examining gender differences in biochemical parameters.
RESULTS: According to the study results, the study included 54,5% males and 45,5% females. Mean CRP levels were significantly higher in males (88,74±75,78) than in females (68,26±66,07) (P=0.034). Ferritin levels were significantly higher in males than in females (P<0,001). CRP, ferritin, and fibrinogen levels were correlated with lung involvement, indicating prognostic potential.
DISCUSSION AND CONCLUSION: The findings underscore the importance of biochemical markers in assessing disease severity and highlight gender-specific differences in COVID-19 management. However, no significant correlation was found between the ferritin/CRP ratio and lung involvement rates. These insights provide personalized strategies for pandemic control.

INTRODUCTION: BCR-ABL fusion gene is targeted in the treatment of chronic myeloid leukemia and is essential in its follow-up. MicroRNAs are small RNA molecules with oncogenic and tumor suppressor properties. The aim of this study is to elucidate the roles of BCR-ABL1-related miRNAs in TKI resistance in CML.
METHODS: This study was carried out on peripheral bloods collected from 25 imatinib-sensitive and 25 imatinib-resistant CML patients, and 50 healthy controls. miR-23a, miR-138, miR-181, miR-152-3p and miR-101 expression levels were determined by qRT-PCR.
RESULTS: Our results showed that miR-23a, miR-101, miR-152 and miR-181 were downregulated in CML patients while miR-138 was downregulated in imatinib resistant group compared to sensitive group.
DISCUSSION AND CONCLUSION: To the best of our knowledge, our study is the first study comparing miRNA expression levels in imatinib-sensitive and resistant CML cases. miR-138 may have a potential to be an indicator of imatinib resistance. This may provide evidence for potential therapeutic targets as well as novel prognostic biomarkers of imatinib resistanc e in CML.

INTRODUCTION: Aim: This study investigates the relationship between serum tetrahydrobiopterin (BH4) and folic acid levels in pregnant women during the second and third trimesters and the development of preeclampsia.
METHODS: Method: This case-control study was conducted from June 2022 to February 2024 with 160 pregnant women with and without preeclampsia (PE). Participants were divided into PE and control groups and further categorized by folic acid usage into four groups: non-PE without folic acid, non-PE with folic acid, PE without folic acid, and PE with folic acid. Groups were compared in terms of demographic characteristics and various laboratory parameters.
RESULTS: Results: The PE group had significantly higher blood pressure, lower albumin and total protein levels, and higher urinary protein levels than the control group (P<0.001). BH4 levels were significantly lower in the PE group (P<0.001). The group without folic acid supplementation had significantly lower folate and haemoglobin levels than those with folic acid supplementation (P<0.001).
DISCUSSION AND CONCLUSION: Conclusion: There is a significant association between serum BH4 and folic acid levels and the development of preeclampsia. Lower BH4 levels were observed in preeclamptic pregnant women, while folic acid supplementation positively influenced folate and haemoglobin levels. BH4 and folic acid may play a role in the pathogenesis of preeclampsia and could be potential biomarkers for assessing preeclampsia risk.

INTRODUCTION: Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions that result from a sudden occlusion or severe narrowing of the coronary arteries, leading to myocardial ischemia. The frontal QRS-T angle, a parameter measured on the electrocardiogram (ECG), has been proposed as a potential marker for cardiovascular events. This study aims to evaluate the effectiveness of the frontal QRS-T angle in differentiating between various subtypes of ACS (STEMI, non-STEMI, USAP) and stable angina pectoris (SAP).
METHODS: A prospective observational study was conducted on patients admitted to the emergency department between January 9, 2023, and January 3, 2024. The study population included patients diagnosed with ACS or SAP and a control group without cardiac pathology. The frontal QRS-T angle was calculated from 12-lead ECGs. Statistical analyses, including Kruskal-Wallis and ROC curve analysis, were performed to assess the diagnostic utility of the QRS-T angle.
RESULTS: The study included 169 patients, with a mean age of 61.96±13.90 years. The frontal QRS-T angle was significantly higher in the STEMI group compared to other groups. ROC analysis demonstrated that the QRS-T angle could significantly differentiate between non-cardiac patients and those with STEMI, non-STEMI, and USAP. The frontal QRS-T angle was also significant in predicting mortality, with a cutoff value of 58.00, AUC of 0.825, sensitivity of 84.20%, and specificity of 72.00%.
DISCUSSION AND CONCLUSION: The frontal QRS-T angle is a significant marker for distinguishing between different ACS subtypes and non-cardiac patients. Its role in identifying STEMI and predicting mortality highlights its potential utility in clinical practice.