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During the COVID-19 outbreak, which is effective worldwide, the psychological conditions of healthcare professionals deteriorate. The aim of this study was to examine health professionals’ changes in their sexual lives due to the COVID-19 outbreak in Istanbul, Turkey. This online survey was conducted between 2 and 26 May 2020 with 232 healthcare professionals working in a pandemic hospital. After obtaining informed consent, a questionnaire was sent online from the hospital database and health institutions social media accounts (Twitter®, Facebook®, Instagram®, WhatsApp® etc.) and e-mail addresses. The first section of the four-part questionnaire included demographic data, the second and third sections of pre-and post-COVID-19 attitudes, and the last section to assess sexual functions (International Index of Erecile Function for male and Female Sexual Function Index for female), anxiety and depression. Dependent sample t-test, Mc Nemar test, and multivariate analysis were used.The study was completed with 185 participants in total. Healthcare workers’ sexual desire (3.49 ± 1.12 vs. 3.22 ± 1.17; p = 0.003), weekly sexual intercourse/masturbation number (2.53 ± 1.12 vs. 1.32 ± 1.27; p < 0.001), foreplay time (16.38 ± 12.35 vs. 12.02 ± 12.14; p < 0.001), sexual intercourse time (24.65 ± 19.58 vs. 19.38 ± 18.85; p < 0.001) decreased compared to the Pre-COVID-19 outbreak. In addition, participants prefer less foreplay (p < 0.001), less oral sex (p < 0.001) and anal sex (p = 0.007) during COVID-19 and more non-face to face sexual intercourse positions (p < 0.001). When factors affecting sexual dysfunction were analyzed as univariate and multivariate, sexual dysfunction was shown to be significantly more common in males (OR = 0.053) and alcohol users (OR = 2.925). During the COVID-19 outbreak, healthcare workers’ sexual desires decreased, the number of sexual intercourses decreased, their foreplay times decreased, and their sexual intercourse positions changed to less face to face.

Background and Objectives: Dentigerous cysts are benign odontogenic lesions associated with the crowns of impacted teeth and are the second most common odontogenic cyst after radicular cysts. Despite being described as slow-growing, their growth has not been numerically quantified. This study aims to determine the radiological growth rate of dentigerous cysts through quantitative analysis, to clarify their biological behavior, improve clinical management, and guide future research by filling a significant gap in the literature. Materials and Methods: In this retrospective study, records of 187 patients diagnosed with dentigerous cysts at Dicle University between 2020 and 2024 were reviewed. Twelve patients with cysts associated with mandibular impacted third molars and at least two high-quality panoramic radiographs taken at different time points were included. In all of these patients with adequate and suitable radiographic records, the dentigerous cysts were associated with mandibular third molars, which contributed to the standardization of imaging and measurements. All images were obtained using the same digital system and converted to DICOM format. Maximum anteroposterior (A–P) and inferosuperior (I–S) dimensions were measured twice by the same examiner, and mean values were recorded. Follow-up intervals were noted, and monthly dimensional changes were evaluated. Due to the rarity of untreated cases, a sample of only 12 patients was considered meaningful. Results: Most patients were female, with no significant gender differences in age or follow-up time. Cyst dimensions increased over time, showing marked enlargement in the anteroposterior (A–P) direction and a similar upward trend in the inferosuperior (I–S) dimension. Conclusions: In our study, growth in the anteroposterior direction was higher than that in the inferosuperior direction, and no significant differences in growth rates were observed with respect to sex or age.

Although congenital lobar emphysema is a rare lung disease, it can cause severe respiratory distress in the newborn. Lobectomy can be difficult because of the hyperinflated lobe and limited space to carry out surgery. During the past two decades, conservative treatment options have increased for patients with mild and moderate disease.

Aims The no-reflow phenomenon (NRP) is a common complication of saphenous vein graft (SVG) interventions. The aim of this study was to investigate the effect of the stress hyperglycemia ratio (SHR) on the development of NRP in patients with acute coronary syndrome (ACS) undergoing percutaneous SVG intervention. Methods The study included 223 patients who presented at our center with ACS, had a history of coronary artery bypass graft and underwent a saphenous graft procedure. The relationship between SHR calculated at the time of presentation from glucose and HbA1c values, and the development of NRP evaluated after the procedure with angiography was determined with univariate and multivariate binary regression analysis. Result The study population was separated into two groups as those who developed and did not develop NRP. Mean age was determined to be significantly higher in the group that did not develop NRP compared to the group with NRP ( p : 0.004). Angiographically, the thrombus burden was determined to be significantly higher in the group that developed NRP ( p  < 0.001). Patients were separated into 3 tertiles according to the SHR level (T1, T2, T3), and the rate of NRP development was determined at a significantly higher rate in the T3 group ( p  < 0.001). Conclusions This study showed that SHR, a parameter that can be easily calculated noninvasively, is an independent predictor of NRP development in ACS patients undergoing saphenous interventions. In addition, high thrombus burden and predilatation before stenting were also found to be factors that increase the likelihood of developing NRP.

3D Multi-User Virtual Environments (MUVEs) have increasingly become more practical with faster Internet connections, the high processing capacity of ICT devices, and the readiness of learners. However, the educational potential of these immersive worlds in academic settings is closely linked to the combination of appropriate pedagogical and technical design elements. 3D MUVEs that only offer a more immersive experience for their users run the risk of becoming purely performative platforms if they fail to offer appropriately enhanced pedagogical approaches. We, therefore, invite the academic community to focus more on the pedagogical approaches of 3D MUVEs. In this context, this collection of papers aims to outline pedagogical approaches and implementations based on immersive user experiences in 3D MUVEs. It contributes to this field of education with three distinguished papers ranging from theoretical frameworks of user acceptance to training practices for skill development. The findings and suggestions in these papers will provide valuable insights for the academic community and for practitioners willing to benefit from the affordances of 3D MUVEs for learning purposes.

Objectives: Atherosclerotic renal artery stenosis (ARAS) is the most frequently seen cause of secondary hypertension (HT). ARAS associated with adverse cardiovascular events independently of other traditional cardiovascular risk factors, and increased mortality. Percutaneous transluminal renal arterial stenting (PTRS) is important methods in ARAS treatment. The aim of this study was to investigate major adverse events (MAE) and potential predictors in patients undergoing PTRS for ARAS by evaluating variables before and immediately after the procedure, including the SYNTAX score. Methods: One hundred and five consecutive patients who underwent PTRS over a period of approximately 10 years were included in our study. Patients were divided into two groups, MAE negative (-) and MAE positive (+), according to the occurrence of MAE. After comparing both groups with difference tests, independent predictors were investigated with univariate and multivariate Cox regression analysis. Afterwards, Receiver Operating Characteristics (ROC) analysis was performed on independent predictors. Results: The average age of the patients was 63.32±11.62 years (range: 30-83 years) and 52 (49.5%) of them were male. Sixty-two patients constituted the MAE (-) and 43 the MAE (+) groups. In multivariate Cox regression analysis, chronic obstructive pulmonary disease (COPD), left ventricular ejection fraction (LVEF), and the total number of antihypertensives after the procedure were identified as independent predictors. As a result of the ROC analysis, a cutoff value of ≤55% for LVEF was determined to have area under the curve (AUC) 0.733, 69.8% sensitivity, and 77.42% specificity (P<0.001). The use of more than 3 antihypertensive drugs after the procedure was found to have AUC 0.624, 34.88% sensitivity, and 82.26% specificity (P=0.023). Conclusions: LVEF, COPD, and the postprocedural total number of antihypertensives were independent predictors for MAE seen after PTRS in ARAS patients. These predictors can be used to estimate the risk in these patients. To be able to prevent adverse events, it is important that patients with these markers are treated and followed up more closely.

Purpose Refractory bladder neck stenosis is a challenging entity for both clinicians and patients. We aimed to present our long-term results of subtrigonal inlay patch (SIP-BMG) technique via open approach that we previously described for refractory bladder neck stenosis (BNS). Method All 11 patients operated for recurrent BNS between 2019 and 2023 with SIP technique were retrospectively included. Demographic data, history of previous endourethral treatment, pre-operative voiding status and postoperative follow-up results were analysed. Patient evaluation in each visit included IPSS and OAB-V8 scores, uroflowmetry and questioning of adverse effects. Recurrence was defined as the need for any intervention for BNS on follow-up. Results Transurethral prostate surgery was the most common cause and all patients had at least two previous endourological operation for BNS. The median operative time was 88 min (60–170) and no intraoperative complications were observed. All postoperative complications were Clavien-Dindo grade 1–2. All patients were able to void on their first attempt after catheter removal. Average increase in Qmax at last-visit was 13.73 ml/sec and average improvement in IPSS and OAB-V8 scores was 19.90 and 10.4 respectively. De-novo urinary incontinence was reported in one patient and one patient required re-intervention for BNS on follow-up. Conclusions Recurrent BNS is a challenging problem for both clinicians and patients, especially when it becomes refractory to endourologic interventions. The present study demonstrates durable and promising success after SIP technique for recurrent BNS in long term follow-up. However, these results should be interpreted with caution and further prospective trials with larger patient cohorts are required.

Introduction:Decreased renal function is a significant public health issue, increasing the risk of various adverse outcomes. Thus, identifying potentially modifiable factors associated with the onset of chronic kidney disease (CKD) is imperative. Although CKD has been demonstrated to impact thyroid function through various mechanisms; there remains insufficient and contentious data regarding the association between albuminuria and thyroid function in patients diagnosed with CKD. This study aimed to elucidate the association between albuminuria and thyroid function tests in patients with CKD.Methods:We conducted a cross-sectional analysis involving 232 patients with CKD. Patients were categorized on the basis of albuminuria levels, measured by the urinary albumin/creatinine ratio (ACR), following the KDIGO 2012 criteria: ACR1 <30 mg/gr, ACR2 30-300 mg/gr, and ACR3 >300 mg/gr. Thyroid stimulating hormone (TSH), free thyroxine (free T4), and free triiodothyronine (free T3) levels were measured to assess thyroid function.Results:The ACR among subjects ranged from 1.0 mg/g to 10260.0 mg/g, with a mean urinary ACR of 485.7±1250.9 mg/g. Among the patients, 47.4% (n=110) had an ACR <30 mg/g, 25.4% (n=59) had an ACR 30-300 mg/g was, and 27.1% (n=63) had an ACR >300 mg/g. TSH levels ranged from 0.3 to 14 mU/L, free T3 ranged between 0.6 and 4.8 ng/L, and free T4 ranged from 5.5 to 17.8 ng/L. No significant differences were observed in TSH, free T4, and free T3 values among the ACR1, ACR2, and ACR3 groups (p>0.05). A significant positive correlation was found between glomerular filtration rate and free T3 (r=0.395, p<0.05), whereas a significant negative correlation was noted between ACR and free T3 (r=-0.264, p<0.05).Conclusion:Our findings suggest that albuminuria may contribute to a reduction in free T3 levels in patients with CKD. However, it is crucial for physicians to recognize that CKD patients with elevated albuminuria levels may exhibit abnormal thyroid function.

Aim:This study aimed to determine the change in neural tube defects (NTD) incidence in Trabzon, a province of the Eastern Black Sea region, and evaluate the efficiency of folic acid use on NTD.Methods:The present study was a retrospective case-control study. The case group of the study consisted of those diagnosed with fetal NTD in the intrauterine period between 2015 and 2020. The control group were selected by matching the ages in the case group with ± two standardized years. The total number of births in the province was obtained from the Turkish Statistical Institute data, and the NTD incidence was determined accordingly.Results:Between the aforementioned years, the number of cases who had NTD-complicated pregnancies and were delivered in our clinic was 88. When the use of folic acid before and in the first trimester of pregnancy was compared, a statistically significant difference was determined between the groups (p<0.001). The use of folic acid during pregnancy was similar in both groups (p=1).Conclusion:Neural tube defects is a preventable condition by using folic acid before and during the first trimester of pregnancy. Hence, the importance of using folic acid in family planning and prenatal counseling should not be forgotten.

Endotracheal/endobronchial metastases represent an extremely rare category of diseases, lacking population-based incidence studies. These metastases are generally classified into two types: pulmonary and nonpulmonary. Pulmonary metastases are considerably rarer than their nonpulmonary counterparts. We present a rare case of tracheal metastasis, diagnosed during a follow-up two years after the anatomical resection of early-stage lung cancer. This case was successfully treated. Tracheal metastases after lung cancer surgery are exceedingly rare. Patients often exhibit radiological findings before becoming symptomatic. Therefore, bronchoscopic evaluation is recommended when radiological and clinical suspicions arise.