INTRODUCTION: DALK is a surgical treatment used for many stromal pathologies such as keratoconus, corneal scars, stromal dystrophy and stromal degeneration that do not affect the endothelium The aim of this study was to present the clinical results of keratoconus patients who underwent deep anterior lamellar keratoplasty (DALK) surgery.
METHODS: Data from 30 eyes of 30 patients who underwent deep anterior lamellar keratoplasty were retrospectively reviewed. Preoperative examinations, operative data, intraoperative and postoperative complications, additional interventions, and visual outcomes were evaluated. Descriptive statistical methods (mean, standard deviation) were used for data evaluation. The results were assessed at a 95% confidence interval, with a significance level of p < 0.05.
RESULTS: Out of the 35 keratoconus patients scheduled for DALK surgery, 30 eyes were included in the study. Five patients who developed macroperforation of Descemet's membrane (DM) during DALK surgery were excluded from the study. The patients were followed up for an average of 26.6±8.4 months (range: 6-48) after keratoplasty surgery. Preoperatively, visual acuity level ≤1/10 was present in 22 patients (73.3%), and between 1/10-2/10 in 8 patients (26.7%). Postoperatively, best-corrected visual acuity (BCVA) was ≤1/10 in 1 eye (3.3%); BCVA was ≥1/10 in 29 eyes (96.6%), and ≥5/10 in 23 eyes (%76.6). Stromal rejection developed in 1 of 30 patients (3.3%) who underwent DALK surgery.
DISCUSSION AND CONCLUSION: DALK surgery performed on patients with keratoconus significantly reduces the risk of immunological reactions and graft rejection. Therefore, it is the first surgical method to be considered especially in patients with keratoconus who require keratoplasty.

INTRODUCTION: Focused Assessment with Sonography for Trauma (FAST) is a widely used ultrasonographic protocol in emergency departments for rapidly detecting intra-abdominal free fluid in trauma patients. While effective, its limited sensitivity for small fluid collections and certain solid organ injuries underscores the need for complementary imaging modalities like computed tomography (CT). This study evaluates the diagnostic role of FAST, its concordance with CT findings, and its impact on clinical outcomes.
METHODS: This retrospective, single-center study analyzed trauma patients who underwent FAST at a tertiary hospital in İzmir, Turkey, over four years. Only patients with radiologist-reported FAST results were included. Demographics, trauma mechanisms, FAST findings, CT results, and clinical outcomes (surgery, admission, mortality) were collected and analyzed statistically.
RESULTS: Among 428 patients, 8.18% (35) had free fluid detected by FAST, while 10.05% (43) had free fluid identified by CT. Patients with free fluid detected exclusively on CT showed no significant association with mortality (16.7%) or gastrointestinal system (GIS) surgery (2.7%) but had higher ward and ICU admission rates (p=0.001). Patients with free fluid detected by both FAST and CT had worse outcomes, including Intensive Care Unit (ICU) admission (18.2%) and mortality (33.3%). Significant hemogram decreases and new-onset liver function abnormalities were associated with increased GIS surgery and adverse outcomes (p<0.05).
DISCUSSION AND CONCLUSION: FAST is an essential bedside tool for trauma assessment, but its limitations highlight the importance of integrating CT for comprehensive evaluation. Free fluid identified exclusively on CT emphasizes the need for enhanced monitoring despite no direct impact on mortality or surgery.

INTRODUCTION: Community-acquired pneumonia (CAP) is a major cause of infectious disease mortality and a burden on healthcare systems. CURB-65 and Pneumonia Severity Index (PSI) scores assess disease severity and guide hospitalization decisions, but their role in predicting hospital stay remains unclear. This study evaluates the effectiveness of CURB-65 and PSI scores in predicting hospital stay and their utility in forecasting ICU admission and mortality.
METHODS: This retrospective study included adult CAP patients admitted to the Pulmonology Department via the Emergency Department between September 2021 and September 2022. CURB-65 and PSI scores were calculated, and their correlations with hospital stay, ICU admission, and mortality were analyzed using SPSS 20.0.
RESULTS: A total of 82 patients (median age 67.69 years) were included. Patients hospitalized ≤7 days had a median CURB-65 score of 1 and PSI score of 83, while those >7 days had a CURB-65 score of 2 and PSI score of 115. CURB-65 scores ≥2 were linked to prolonged stays (>7 days) in 70% of patients, compared to 41% in those ≤7 days. PSI scores also differed significantly between groups (p < 0.01). Moderate positive correlations were observed between hospital stay and both CURB-65 (r = 0.411) and PSI scores (r = 0.472). ROC analysis showed an AUC of 0.754 for PSI, with 84.8% sensitivity and 46.9% specificity.
DISCUSSION AND CONCLUSION: CURB-65 and PSI scores effectively predict hospital length of stay in CAP patients, aiding clinical decision-making and resource allocation.

INTRODUCTION: In this study, we aimed to demonstrate the histopathological, clinical, demographic, and biochemical features of upper and lower gastrointestinal (GI) tract polyps. Additionally, we aimed to investigate the effect of polyp localization on endoscopic intervention indications, polyp size, and biochemical, histopathological, and demographic characteristics.
METHODS: Endoscopic procedures performed in the endoscopy unit at the XXX University XXX Medicine Center between 2016-2021 were scanned. 900 patients with polyps in the GI tract were included. Biochemical data, histopathological data, endoscopic procedure indications, and demographic data of the patients were evaluated by statistical analysis.
RESULTS: Polyps were divided into three groups according to polyp size: dimunitive polyps 61.3% (n=552); small polyps 30.3% (n=273); and large polyps 8.3% (n=75). The polyps were also divided into three groups according to their histological features: noeplastic polyps (including; adenomatous polyps (38.3%), and serrated polyps (0.3%), malignant polyps (3.7%), and non-neoplastic polyps (57.2%). The incidence of adenomatous and malignant polyps was significantly higher in the left colon, whereas that of non-neoplastic polyps were significantly higher in the upper GI tract (p=0.001). The incidence of adenomatous polyps was significantly higher in large polyps (p=0.001). We determined the CRP and leukocyte values to be significantly higher in large polyps than in other polyp sizes (p=0.01,p=0.008,respectively). The platelet count was significantly higher in malignant polyps(p=0.026).
DISCUSSION AND CONCLUSION: This study revealed significantly higher leukocyte counts in polyps with lower GI tract and left colon localization. Additionally, higher platelet counts in polyps with malignant pathology and higher CRP levels and leukocyte counts in large polyps were detected.

INTRODUCTION: This study aimed evaluate symptom resolution, size reduction and complications of transarterial chemoembolization (TACE) with Bleomycin-Lipiodol in giant liver hemangiomas.
METHODS: In this study evaluated 19 consecutive patients with giant hepatic hemangioma who underwent transarterial chemoembolization between June 2020 and May 2023. Inclusion criteria were as follows: (1) presence of a hepatic mass larger than 5 cm on dynamic cross-sectional examination with typical features of a hemangioma, (2) presence of symptoms secondary to hepatic hemangioma or compression effect of the mass on surrounding tissues, (3) TACE procedure performed in our center. Clinical success was defined as resolution of symptoms and radiologic success was defined as more than 50% reduction in giant hemangioma volume on 6 months follow-up CT or MRI compared.
RESULTS: A total of 19 patients were included in the study. The mean size of hemangiomas decreased from 9.35cm±3.5cm (5cm-16.9cm) to 5.76cm±1.52cm (3.5cm-9cm). The volume of hemangiomas before the procedure was between 27 cc-845 cc with a median value of 169 cc. After the procedure, the volumes ranged between 14 cc-182 cc with a median value of 45 cc. The changes in both size and volume before and after the procedure were found to be significant and p<0.0001. Radiological success, more than 50% reduction in volume, was achieved in sixteen patients (84.2%). Significant improvement in symptoms and other signs of compression was also achieved.
DISCUSSION AND CONCLUSION: Liver hemangioma embolisation with Bleomycin-Lipiodol is safe, reduces the size and volume of giant liver hemangiomas, and provides significant success both clinical and radiological results.

INTRODUCTION: Crimean-Congo hemorrhagic fever (CCHF) disease can be confused with many diseases due to flu-like nonspecific initial symptoms and laboratory findings in endemic areas. In this study, it was aimed to evaluate the final diagnosis of patients hospitalized with suspected CCHF diagnosis, but without CCHF virus detection.
METHODS: This retrospective cohort study was conducted between March 2016 and September 2022. We included 662 patients who met the definition of potential cases according to the CCHF case definition. The baseline symptoms, laboratory findings and epidemiologic characteristics of patients in whom CCHF virus was not detected were compared with patients in whom the diagnosis of CCHF disease was confirmed, and then grouped together with their final diagnosis.
RESULTS: There was no difference in baseline complaints, living in a rural area and frequency of thrombocytopenia in those without CCHF virus compared to CCHF patients. Of these patients, 80.1% were diagnosed with infectious diseases and 19.9% with non-infectious diseases. The most common infectious diseases were respiratory tract infections (22.2%) and brucellosis (17.7%); non-infectious diseases were hematologic diseases (8.2%).
DISCUSSION AND CONCLUSION: In endemic areas, the presence of fever and thrombocytopenia is not sufficient for the diagnosis of CCHF. Reference methods should be used rapidly for the definitive diagnosis of CCHF. After CCHF is excluded, it is important to know the infectious and non-infectious diseases in the differential diagnosis and their frequencies in order to prevent delay in diagnosis and treatment.

INTRODUCTION: Thyroid cancer is the most common endocrine gland malignancy and thyroid fine needle aspiration biopsy (TFNAB) is used for its detection. The aim of this study was to analyze the cytologically detected malignancy, the factors affecting it and the compatibility of surgical tissue pathology.
METHODS: Patients who underwent TFNAB in the Endocrinology Outpatient Clinic were retrospectively analyzed in terms of age, gender, TSH (Thyroid stimulating hormone) value, nodule size, localization, initial and rebiopsy results (Bethesta 2023), and malignancy and multinodularity in those who underwent thyroidectomy after TFNAB.
RESULTS: The study was conducted with data from 631 patients. A positive correlation was found between age and nodule size (p=0.040, r: 0.08). TSH was found to be significantly higher in patients with malignant and atypical cytology than in those with benign cytology (p=0.012). With the contribution of rebiopsy, the total cytological malignancy (Bethesta V, VI) rate was 7.29%. Of the 84 patients with tissue pathology, 50 (59.5%) were malignant and 34 (40.5%) were benign. In patients with malignant tissue pathology, 39 (78%) had multinodular goiter (MNG) and 11 (22%) had single nodules (p=0.031). TFNAB specificity was 60%, Negative Predictive Value (NPV) was 75%, False Positive Rate (FPR) was 40%.
DISCUSSION AND CONCLUSION: TSH was significantly higher in cases with malignant and atypical cytology results, and multinodularity was significantly higher in patients with thyroid cancer compared to solitary in tissue pathology. As a result of surgery the specificity and NPV for TFNAB were found to be low and FPR was high compared to the literature.

An 18-year-old male patient presented with excessive sweating on the palms of the hands and soles of the feet. X-ray showed periostosis in the carpal and tarsal bones. Genetic analysis revealed c.1807C>T(p.Arg603Ter), a homozygous mutation, and PHO was diagnosed. The patient was treated with dexketoprofen, methotrexate, and methylprednisolone for the first six months. No adequate response was obtained; infliximab was added to the existing treatment and continued for another six months. The number of tender and swollen joints decreased. However, a partial response was obtained. After the 12th month, dexketoprofen was discontinued, and celecoxib was added. Arthralgia, hyperhidrosis, acne and seborrhea, and minor joint arthritis responded utterly. COX inhibitors were effective on pachydermia and clubbing but did not affect arthralgia and hyperhidrosis. It seems effective in cases treated with MTX and IFX, especially on pustular lesions, arthralgia, and hyperhidrosis. We responded to almost all clinical phenotypes with combination therapy and put the patient into remission. The literature review shows that the number of patients in whom biologic therapy has been tried is very small. Our case is the first case with an almost complete response to combination therapy, and the second case was treated with infliximab.