Ferroptosis is defined as an iron-dependent, non-apoptotic programed cell death modality that occurs due to an imbalance of intracellular redox hemostasis. Recently, ferroptosis has attracted attention in cancer research and has been shown to play a role in numerous oncogenic pathways. Studies have revealed that increased levels of intracellular reactive oxygen species play critical roles in oncogenic processes such as tumorigenesis, angiogenesis, invasion, metastasis, and chemoresistance because of their role in ferroptotic cell death. Neuroblastoma is the most common extracranial solid tumor in children and represents 8-10% of all pediatric cancers and 1/3 of all malign diseases of infancy. As seen in all types of cancers, the development of chemoresistance seriously affects the success of neuroblastoma treatment. Tolerance to chemotherapy in neuroblastoma was associated with the induction of exogenous defense genes and reduction of ferroptosis susceptibility biomarkers. Therefore, ferroptosis is a potential druggable driver in cancer treatment. In this review, studies associated with ferroptosis and neuroblastoma to date were reviewed and literature data were assessed in terms of ferroptotic mechanisms in neuroblastoma and potential treatment targets.

Hyperbaric oxygen (HBO) therapy is a medical treatment method based on breathing 100% oxygen from a mask, hood placed over the head, endotracheal tube, or space at pressures higher than (1 atmosphere absolute =760 mmHg) in completely closed single or multi-person hyperbaric chambers. The most common emergencies in which HBO therapy is used are carbon monoxide poisoning and decompression sickness. However, acute traumatic ischemias such as crush injury and compartment syndrome that cause tissue hypoxia are among the indications for effective HBO therapy. This review aims to share general information about HBO therapy and its use in crush injury and compartment syndromes. Thus, the role of HBO therapy in reducing morbidity and mortality when used together with necessary surgical and medical treatments has been emphasized.

Objective: To present potential mechanisms for female authorship in intensive care research by evaluating the ratio of female first author to senior author in the top 100 most cited articles.
Methods: In the Web of Science search engine, by typing the search key “SU=CRITICAL CARE OR WC=CRITICAL CARE” and in advanced mode; to investigate the female sex ratio in the first and senior author in the top 100 most cited research articles in the international literature written in the field of intensive care.
Results: When the first 100 most cited articles were analyzed regarding the first name and last name gender difference, the rate of first name female authors was 16%. The country with the highest number of female authors writing first names was the United States. In the analysis, when the gender of the first name and the gender of the last name was evaluated, no statistically significant relationship was found between them (p=0.327). A statistically significant difference was found between the gender of the first author and the journal in which the article was published (p=0.021). A significant relationship was found between the gender of the first name and the country of the journal in which the article was published (p=0.032).
Conclusion: When evaluated in terms of article authorship, gender inequalities were identified in scientific activities and academic leadership positions in intensive care. Female gender is underrepresented in the international literature in the field of intensive care.

Objective: To evaluate the reflection of the pandemic on the management of acute stroke mechanical thrombectomy (MT).
Methods: We retrospectively evaluated 100 acute ischemic stroke patients between March 1, 2019-Februray 29, 2020, and between March 1, 2020-March 1, 2021, who underwent (MT) at our institute. Patients were divided into two groups as those who underwent thrombectomy before the Coronavirus disease-2019 (COVID-19) pandemic (group 1) and those who underwent thrombectomy during the period of COVID-19 pandemic (group 2). All the diagnosis of stroke patients was confirmed by magnetic resonance imaging and computed tomography. Demographics, clinical and laboratory data were recorded. The SPSS version 26.0 was used for statistical analysis.
Results: A total of 100 patients, 50 before and 50 after the pandemic, were included in the study. No statistically significant difference was observed between the groups in terms of demographic data and risk factors. The time from symptom onset to groin puncture was significantly longer during the pandemic period than before (p=0.001). No significant difference was observed in the time from groin puncture to recanalization (p=0.251), recanalization rates (p=0.806) and the number of passes (p=0.889). There was no difference between the pre-pandemic and post-pandemic groups in terms of the frequency of intracranial hemorrhage (p=0.501), complication (p=0.153) and decompression (p=0.538) after thrombectomy. The modified Rankin scores scores at 3 months were similar (p=0.316).
Conclusion: As a result, the time from symptom to procedure is prolonged in acute ischemic stroke patients who underwent MT in our center during the pandemic period. In the respect of procedural findings and outcomes of thrombectomy before and during pandemic, there had been no significant change at our center.

Objective: Axillary reverse mapping (ARM) has been described to protect against lymphedema. This study aimed to explore the oncological safety of ARM in terms of tumor characteristics and other factors.
Methods: The study included 81 patients who received mastectomy or breast-conserving surgery for diagnosis of breast cancer and undergo ARM as clinically axillary positive disease.
Results: No axillary reverse mapping lymph node (ARMLN) was found for 26 patients (32%). Of the 55 patients with ARMLN, 19 (34%) were malignant and 36 (66%) were benign. A statistically significant relationship was found between ARMLN and the number of lymph nodes dissected (p=0.004). The larger the size of ARMLN dissected, the more likely it is that the lymph nodes will be malignant (p=0.001).
Conclusion: Our study suggests that the higher the axillary burden, the more likely it is for ARMLN to be malignant and the less safe its preservation. Additional randomized prospective studies with a focus on patient survival time and recurrence are warranted to verify the potential feasibility of the ARM technique and confirm the reliability of the reported protocols.

Objective: This study investigated the effects of Coronavirus disease-2019 (COVID-19) related lockdowns and the pandemic in patients with muscular dystrophy who require regular hospital admissions and follow-ups. Moreover, the effects of “fear of COVID-19” on these effects were also measured.
Methods: One hundred and five muscular dystrophy patients who were admitted to the neuromuscular diseases tertiary care clinic were evaluated. The patients’ socio-demographic and clinical characteristics were recorded, and their fear of COVID-19 was assessed using the “fear of COVID-19 scale”, and they were asked about the problems they encountered during the pandemic and lockdowns.
Results: We found that the patients had major restrictions in their access to healthcare, physical therapy/rehabilitation, and reduced physical and social activities. Moreover, they subjectively stated that their disease worsened with the pandemic. These restrictions were found to correlate with their fear of COVID-19 levels.
Conclusion: Patients with muscular dystrophy were found to have changes in their physical activity, participation in rehabilitation, problems with reaching healthcare services, and social problems. These problems were associated with their fear of COVID-19. As routine access to healthcare and therapies is crucial for these patients, both patients and health professionals should keep the potential harm of restrictions and fear in mind and strive for optimal solutions.

Objective: Suicide attempts and related processes are a serious problem worldwide. Initial evaluation of patients who have attempted suicide is usually performed in the emergency department (ED). In this study, we examined the characteristic features of these cases.
Methods: The study was conducted with patients aged 18 years who were evaluated for suicide attempt over a one-year period in the ED of a comprehensive urban hospital. The data of the cases were retrospectively scanned through the electronic medical record system. The data obtained for each patient were systematically recorded in report forms and analyzed at the end of the study.
Results: In the study, 241 suicide attempt cases with a mean age of 30 (interquartile range: 22-37) were examined, and 167 (69.3%) of them were women. Of the patients, 170 (70.5%) were between the ages of 18 and 35, and 113 (46.9%) had primary education. Of the suicide attempts, 81.7% were self-poisoning with multiple drug ingestion. It was determined that 41.5% of the applications were made between 18: 00 and 00: 00. Of the patients, 142 (58.9%) were discharged after ED follow-up. ED follow-up could not be completed for 67 (27.8%) patients who refused treatment. Of the remaining patients, 15 (6.2%) were transferred to the intensive care unit and 14 (5.8%) to the inpatient service. A total of 3 (1.3%) patients who died after a suicide attempt were male and used the hanging method.
Conclusion: Most patients who attempted suicide were young women who were primary school graduates and poisoned by ingesting multiple drugs. Most suicide attempts are unsuccessful, but mortality is quite high in those who use the hanging method. Because patients who attempt suicide tend to leave the ED before their follow-up is completed, precautions should be taken.

Objective: Spontaneous rupture of the quadriceps tendon is more common in patients with chronic renal failure than in the healthy population. Recurrent microtrauma, hypoxia, hyperparathyroidism, and chronic acidosis are some predisposing factors for spontaneous rupture. This study aimed to evaluate tendon thickness and sonoelastography findings of the quadriceps tendon in patients with chronic renal failure undergoing a dialysis program.
Methods: Forty randomly allocated patients [24 male, 16 female; mean [± standard deviation (SD)] age: 58.18±14.41 years [range: 24-75] with chronic renal failure undergoing dialysis program, and 32 healthy volunteers 10 males, 22 females; mean age (± SD): 54.72±13.84 (range: 31-74)] were included. Measurements of quadriceps tendon thickness and strain elastography were performed in the right knees of all subjects. For the measurement of a strain ratio, two ROIs were placed on the tendon that was 1 cm proximal to the patellar insertion area (ROI A) and the prefemoral fat area (ROI B).
Results: The mean quadriceps tendon thickness values were 6.55±1.77 mm (range: 3.8-9.4 mm) in the chronic renal failure group and 5.81±0.93 mm (range: 4.3-8.3 mm) in the control group. The quadriceps tendons were significantly thicker in the patient group (p=0.03). The mean elasticity scores were 6.88±15.82 in patients with chronic renal failure group and 8.49±15.07 in the control group. Mean strain elastography values showed no statistically significant difference (p=0.66).
Conclusion: Compared with the control cases, the increase in the thickness of quadriceps tendons was found to be significant,but there was no significant difference in sonoelastography findings between the two groups.

Objective: Urethral stones are rare among all urinary system stones. There is limited data in the literature on the management of urethral stones. In this study, we aimed to present our experience of patients diagnosed with urethral stone in the light of the literature.
Methods: This retrospective study included 24 consecutive patients diagnosed with urethral stone between January 2017 and December 2020. Demographic data, clinical features, primary treatment approaches, peroperative and postoperative data were analysed.
Results: Twenty-four patients with a mean age of 44±20 years (2-73) were included in the study. The clinical presentation of the patients was acute urinary retention in 14 (58.3%) patients and lower urinary tract symptoms in 10 (41.6%) patients. The most common stone location was posterior urethra in 13 (54.2%) patients and anterior urethra in 11 (45.8%) patients. The mean stone size was 10±3 (5-15) mm. Fourteen patients had a history of previous stone surgery or stone expulsion. Two patients underwent internal urethrotomy and one patient underwent cystolithotripsy simultaneously. Surgical success stone-free rate (SFR) was 100%.
Conclusion: Urethral stones are rarely seen in urological practice. The management of urethral stone is uncertain and depends on personal experience. Holimum laser lithotripsy with URS which is minimally invasive with minimal damage to the urethral mucosa, should be considered as the first choice.

Objective: Continuous renal replacement therapy (CRRT) is a critical alternative among hemodialysis options in intensive care patients. Healthcare professionals provide access to health-related information using social media. Our aim in this study is to investigate the accuracy and effectiveness of their presentations on the international video sharing site YouTube.
Methods: A video scan was performed on the “www.YouTube.com” website on 21-22 April 2022 using the “CRRT” scan key without any filter. The quality, reliability and accuracy of the videos was determined by the “global quality score” (GQS), “Journal of American Medical Association (JAMA) quality test” and “Modified DISCERN” questionnaire, respectively.
Results: When the quality of the videos was evaluated with the GQS score, 81% of the videos were found to be low quality, 16% medium and 3% high quality according to the GQS results. When videos are analyzed according to their source, it has been determined that only 3% of the academically sourced videos are of high quality. Statistically significant correlation was found between the source of the videos and the results of the quality, reliability and accuracy scale GQS (p=0.026), JAMA (p=0.010), and modified DISCERN (p=0.003).
Conclusion: Our study determined that most of the YouTube videos about CRRT application in intensive care units contain poor quality and insufficient data. High-quality videos were found to be longer and academically sourced videos. However, low quality or erroneous videos should always be checked for accuracy and reliability before being used as educational and training material, as they may harm users.

Objective: Tuberculosis (TB) remains a leading cause of morbidity and mortality among people living with HIV (PWH). The coexistence of HIV and TB mutually enhances their pathogenicity and disrupts immunological functions. This study aims to analyze the biopsychosocial risk factors predicting HIV-TB co-infection in our center.
Methods: A retrospective cross-sectional cohort study was conducted using the records of PWH followed between 2019 and 2022 at the Infectious Diseases and Clinical Microbiology Clinic of University of Health Sciences Turkey, İzmir Tepecik Education and Research Hospital. Logistic regression analysis was employed to examine factors influencing the development of TB. Results were considered statistically significant when the p-value was less than 0.05.
Results: Among the 73 individuals living with HIV in the study, 22 (30.1%) had TB co-infection, with a median age of 40 years (32-50). Multivariate logistic regression analysis identified baseline BMI and the number of people living in the household as independent risk factors for TB co-infection in PWH. Each increase in baseline BMI was associated with a 0.73-times reduced risk of developing TB (0.57-0.94, p=0.016), while each additional person in the household increased the risk of TB co-infection by 1.16 times (1.00-1.35, p=0.047).
Conclusion: TB is influenced by various social factors, and this study demonstrates that PWHs with specific characteristics are at a higher risk of TB coinfection. Therefore, multicenter studies are needed to identify the risk factors predicting HIV-TB co-infection.

Objective: Clinical trials are an important tool for determining the efficacy and safety of medical treatments. They are scientific studies involving human volunteers and are conducted under the supervision of ethics committees. In recent years, many regulations and guidelines have been published to regulate clinical trials and set ethical standards for research.
Methods: In this study, the applications made to the Ethics Committee for Non-drug Clinical Research of University of Health Sciences Turkey, İzmir Tepecik Education and Research Hospital were retrospectively analyzed. The general characteristics of the applications made to the Ethics Committee, approval and rejection rates, problems and criticisms frequently encountered during the review of the applications were evaluated and the data were analyzed using SPSS.
Results: It was found that most of the files reviewed were approved, but were subject to significant criticism. During the 4 years studied, it was found that the number of files submitted to the ethics committee and the rate of approved files increased each year. It was noted that most of the applications were singlecenter studies, but the budget requests were low and the scientific basis of the investigators was inadequate.
Conclusion: The findings suggest that investigators should pay more attention to methodology and improve the informed consent process. By addressing these deficiencies, clinical trials can be conducted according to ethical and scientific standards.

Objective: To evaluate the predictive value of the fibrosis-4 (FIB-4) index for mortality among patients with Coronavirus disease-2019 (COVID-19).
Methods: This retrospective study included 325 patients diagnosed with COVID-19 via reverse transcription-polymerase chain reaction at a tertiary care hospital from January 2021 to January 2022. We calculated the FIB-4 index using age, aspartate aminotransferase, alanine aminotransferase, and platelet count. Data on demographics, clinical characteristics, comorbid conditions, and outcomes were analyzed.
Results: Patients were categorized into survivors (56.6%, n=184) and non-survivors (43.4%, n=151). The median FIB-4 index was significantly higher in non-survivors [4.02 interquartile range (IQR) 2.48-8.62)] than in survivors [2.57 (IQR 1.69-3.95)], p<0.001. ROC analysis showed that the FIB-4 index had a moderate predictive accuracy for mortality (area under the curve =0.693). A FIB-4 index cut-off of >3.80 provided the best balance between sensitivity (53.90%) and specificity (74.46%).
Conclusion: The FIB-4 index serves as a reliable predictor of mortality in patients with COVID-19, surpassing traditional liver function tests in prognostic accuracy. It offers a practical tool for the early identification of patients at higher risk of adverse outcomes.

Objective: Endometrial receptivity is a critical factor in achieving successful implantation; however, the precise molecular mechanisms underlying this process remain unclear. This study aimed to assess and compare the levels of corin and procalcitonin in the endometrial flushing fluid among women with unexplained infertility, polycystic ovary syndrome (PCOS), endometrioma, and fertile healthy women in relation to endometrial receptivity.
Methods: A study was undertaken on a cohort of women aged 20 to 40 from January 2013 to June 2015. The study cohort comprised 20 women diagnosed with unexplained subfertility, 20 women diagnosed with PCOS, and 20 women diagnosed with endometrioma. Additionally, a control group of 20 healthy fertile women was included. Corin and procalcitonin levels were assessed in endometrial flushing fluid from all patients during the implantation window, and compared between the different groups.
Results: Mean levels of corin (ng/mL) were 0.45, 0.54, 0.46, and 0.49 for PCOS, unexplained subfertility, endometrioma, and control groups, respectively (p=0.341). Mean levels of Procalcitonin (pg/mL) were 76.79, 112.21, 75.57, and 90.41 for PCOS, unexplained subfertility, endometrioma, and control groups (p=0.098). The corin and procalcitonin levels were seen to be lower in the PCOS and endometriosis groups in comparison to the control group. Nevertheless, this difference did not achieve statistical significance.
Conclusion: Understanding the molecular and biochemical aspects of endometrial receptivity can provide valuable insights for diagnosis and treatment. Further research is needed to elucidate the underlying mechanisms and establish the clinical relevance of corin and procalcitonin for endometrial receptivity.

Objective: To find out whether there is a benefit in aspirin prophylaxis for alleviating the adverse outcomes of preeclampsia even if it would not prevent the disease. Preeclampsia is one of the major complications of pregnancy, which has life-long consequences for the mother and the baby. For the past few decades, aspirin prophylaxis has taken attention as a prevention method. However, it does not ensure the prevention of the disease. This study investigated whether aspirin still has a beneficial effect in easing the clinic even if it does not prevent the disease.
Methods: This retrospective study includes 541 preeclamptic patients in a tertiary center. The patients were allocated into two groups: Those who took aspirin prophylaxis during pregnancy (study group) and those who didn’t (control group). Maternal clinical parameters, complications of preeclampsia, and fetal/neonatal outcomes were compared between the groups.
Results: No significant difference was found in clinical parameters suggesting preeclampsia with severe features. HELLP syndrome was significantly higher in the study group. Maternal complications like eclampsia, renal failure, pulmonary edema, disseminated intravascular coagulation, abruptio placenta, and transfusion of blood products didn’t differ between the groups. Neonatal outcomes were significantly worse in the study group.
Conclusion: In this study, aspirin was not found to improve maternal and neonatal outcomes in an already established preeclampsia clinic. However, the imbalance in maternal baseline risk profile remarkably affected the results. Future studies with larger sample sizes and groups with comparable risk profiles should be conducted.

Crigler-Najjar syndrome is a rare, inherited disease that causes unconjugated hyperbilirubinemia. Liver transplantation is a definitive treatment option for Crigler-Najjar syndrome. Two patients with Crigler-Najjar syndrome who received liver transplantation are presented in this case report. The first patient who was misdiagnosed with Gilbert’s syndrome was a 15-year-old male. He had speech and gait disturbances that partially recovered after liver transplantation. The second patient was a 22-year-old male. He developed liver fibrosis although he had a mild clinical form of the disease. Liver transplantation was successfully performed for both of these patients without significant morbidity.

Anthrax is a rare zoonotic infectious disease caused by Bacillus anthracis. Cutaneous anthrax constitutes most of the cases and occurs in exposed skin areas (arms,fingers,etc.). Here we report a case of periorbital cutaneous anthrax infection. An 8-year-old girl presented to our hospital with a necrotic black lesion on the upper left eyelid and swelling around the eye. She had a history of contact with a dead cow. Her father and brother also had necrotic ulcerative lesions on their forearms. Gram-positive rods were detected in the swab Gram strain taken from her lesion. In addition, Bacillus anthracis growth in swab culture taken from her father’s lesion. She was diagnosed as “Anthrax” and treated with intravenous penicillin-G and topical oxytetracycline for 10 days. She recovered without functional sequelae. Physicians should consider cutaneous anthrax in the differential diagnosis of ulcerative and necrotizing preseptal and orbital infections, particularly in underdeveloped and developing countries.