Semaphorin 3A (Sema3A) plays a regulatory role in immune responses. The aim of this study was to evaluate Sema3A levels in patients with systemic sclerosis (SSc), especially in major vascular involvements such as digital ulcer (DU), scleroderma renal crisis (SRC), pulmonary arterial hypertension (PAH), and to compare Sema3A level with SSc disease activity. In SSc patients, patients with DU, SRC, or PAH were grouped as major vascular involvements and those without as nonvascular, and Sema3A levels were compared between the groups and with a healthy control group. The Sema3A levels and acute phase reactants in SSc patients, as well as their association with the Valentini disease activity index and modified Rodnan skin score, were evaluated. The Sema3A values (mean ± SD) were 57.60 ± 19.81 ng/mL in the control group (n = 31), 44.32 ± 5.87 ng/mL in patients with major vascular involvement SSc (n = 21), and 49.96 ± 14.00 ng/mL in the nonvascular SSc group (n = 35). When all SSc patients were examined as a single group, the mean Sema3A value was significantly lower than controls (P = .016). The SSc with major vascular involvement group had significantly lower Sema3A levels than SSc with nonmajor vascular involvement group (P = .04). No correlation was found between Sema3A, acute phase reactants, and disease activity scores. Also, no relationship was observed between Sema3A levels and diffuse (48.36 ± 11.47 ng/mL) or limited (47.43 ± 12.38 ng/mL) SSc types (P = .775). Our study suggests that Sema3A may play a significant role in the pathogenesis of vasculopathy and can be used as a biomarker in SSc patients with vascular complications such as DU and PAH.

Background/Objectives: Head and neck cancer (HNC) is a heterogeneous group of malignancies in which staging plays a critical role in guiding treatment and prognosis. Large language models (LLMs) such as ChatGPT, DeepSeek, and Grok have emerged as potential tools in oncology, yet their clinical applicability in staging remains unclear. This study aimed to evaluate the accuracy and concordance of LLMs compared to clinician-assigned staging in patients with HNC. Methods: The medical records of 202 patients with HNC, who presented to our center between 1 January 2010 and 13 February 2025, were retrospectively reviewed. The information obtained from the hospital information system by a junior researcher was re-evaluated by a senior researcher, and standard staging was completed. Except for the stage itself, the data used for staging were provided to a blinded third researcher, who then entered them into the ChatGPT, DeepSeek, and Grok applications with a staging command. After all staging processes were completed, the data were compiled, and clinician-assigned stages were compared with those generated by the LLMs. Results: The majority of the patients had laryngeal (45.5%) and nasopharyngeal cancer (21.3%). Definitive surgery was performed in 39.6% of the patients. Stage 4 was the most common stage among the patients (54%). The overall concordance rates, Cohen’s kappa values, and F1 scores were 85.6%, 0.797, and 0.84 for ChatGPT; 67.3%, 0.522, and 0.65 for DeepSeek; and 75.2%, 0.614, and 0.72 for Grok, respectively, with no statistically significant differences between models. Pathological and surgical staging were found to be similar in terms of concordance. The concordance of assessments utilizing only imaging, only pathology notes, only physical examination notes, and comprehensive information was evaluated, revealing no significant differences. Conclusions: Large language models (LLMs) demonstrate relatively high accuracy in staging HNC. With careful implementation and with the consideration of prospective studies, these models have the potential to become valuable tools in oncology practice.

The objective of this study is to evaluate the clinical presentations and adverse outcomes of Coronavirus Disease 2019 (COVID-19) in patients with systemic sclerosis (SSc) and assess the impact of SSc features on the clinical course of COVID-19.Materials and methods: In this multicenter, retrospective study, SSc patients with COVID-19 were included. Clinical features of SSc, along with detailed COVID-19 data, were extracted from medical records and patient interviews.Results: The study included 112 patients (mean age 51.4 ± 12.8 years; 90.2% female). SSc-associated interstitial lung disease (ILD) was evident in 57.1% of the patients. The findings revealed hospitalization in 25.5%, respiratory support in 16.3%, intensive care unit admission in 3.6%, and a mortality rate of 2.7% among SSc patients with COVID-19. Risk factors for respiratory failure, identified through univariate analysis, included ILD (OR: 7.49, 95% CI: 1.63–34.46), ≥1 comorbidity (OR: 4.55, 95% CI: 1.39–14.88), a higher physician global assessment score at the last outpatient visit (OR 2.73, 95% CI: 1.22–6.10), and the use of mycophenolate at the time of infection (OR: 5.16, 95 %CI: 1.79–14.99). Notably, ≥1 comorbidity emerged as the sole significant predictor of the need for respiratory support in COVID-19 (OR: 5.78, 95% CI: 1.14–29.23). In the early post-COVID-19 period, 17% of patients reported the progression of the Raynaud phenomenon, and 10.6% developed new digital ulcers. Furthermore, progression or new onset of dyspnea and cough were detected in 28.3% and 11.4% of patients, respectively.Conclusion: This study suggests a potential association between adverse outcomes of COVID-19 and SSc-related ILD, severe disease activity, and the use of mycophenolate. Additionally, it highlights that having comorbidities is an independent risk factor for the need for respiratory support in COVID-19 cases.

Cancer patients require a tailored vaccination strategy. This study aims to assess the vaccination status of cancer patients, evaluate disease incidence and severity in vaccinated individuals, identify reasons for noncompliance with guideline-recommended vaccines, and explore vaccine hesitancy. A cross-sectional survey, including 36 multiple-choice and 6 open-ended questions, was conducted in across Turkey. A total of 506 patients participated between September 1, 2024, and December 31, 2024. Among the participants, 59% (n = 302) were receiving active treatment. At the time of diagnosis, 90.5% did not have an ongoing vaccination program. Coronavirus Disease 2019 (COVID-19) (86.2%) and influenza (22.0%) were the most frequently received vaccines before treatment.The most common reason for not being vaccinated (except for COVID-19) was the absence of a medical recommendation. Higher education levels were associated with increased vaccination rates for hepatitis B, influenza, 13-valent pneumococcal conjugate vaccine (PCV13), and 23-valent pneumococcal polysaccharide vaccine (PPSV23) (p < .01). No significant relationship was found between disease stage and vaccination rates. The most frequently reported barrier to vaccination was the absence of a medical recommendation, highlighting the pivotal role of clinician engagement in improving vaccine uptake in this vulnerable population. Although international guidelines strongly recommend routine vaccination for patients with cancer, real-world data on vaccination practices, associated barriers, and health system - level implementation in middle-income countries are scarce. To address this evidence gap, this study provides real-world data on vaccination rates, determinants, and perceived barriers among cancer patients receiving care in a Turkish oncology setting.

Objectives: This study aimed to translate the Scleroderma Skin Patient-Reported Outcome (SSPRO) questionnaire to the Turkish (SSPRO-T) language and to assess its validity and reliability. Patients and methods: Fifty-four systemic sclerosis (SSc) patients (51 females, 3 males; mean age: 49.8±10.4 years; range, 22 to 65 years) participated in the reliability and validity analysis between October 2022 and December 2022. The translation and cross-cultural adaptation of the SSPRO-T was applied in accordance with the procedure described by the Beaton guidelines. The SSPRO-T, the Scleroderma Health Assessment Questionnaire (SHAQ), the Health Assessment Questionnaire Disability Index (HAQ-DI), Skindex-29, and patient global skin severity were conducted in all participants for construct validity. The SSPRO-T was retested to assess its reliability after seven days. Results: The SSPRO-T had a four-factor structure. The total SSPRO-T score and its subgroups correlated positively with SHAQ, HAQ-DI, Skindex-29, and patient global skin severity. The internal consistency and reliability were excellent in overall SSPRO-T and in the subgroups: physical effect, emotional effect, physical limitation, and social effect (Cronbach’s α=0.94, 0.80, 0.95, 0.93, and 0.84, respectively). The SSPRO-T had excellent test-retest reliability (r=0.91, p

Background: Regorafenib is a standard late-line treatment for refractory metastatic colorectal cancer (mCRC), yet clinical outcomes remain heterogeneous. Identifying accessible biomarkers to predict therapeutic benefit is crucial for balancing efficacy and toxicity. This study evaluated the prognostic value of early dynamic changes in carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA-19-9). Methods: We conducted a retrospective real-world analysis of 61 heavily pretreated mCRC patients receiving regorafenib. Tumor markers were assessed at baseline and after the third cycle (approximately 12 weeks). Systematic threshold optimization using Cox proportional hazards regression and Akaike Information Criterion (AIC) was performed to identify optimal percentage change cutpoints for predicting survival. Results: The optimal thresholds for defining unfavorable marker increases were +14.6% for CEA and +23.5% for CA-19-9. Patients with CEA changes below the cutoff demonstrated significantly superior progression-free survival (PFS) (median 6.1 vs. 4.0 months, p = 0.012) and overall survival (OS) (11.05 vs. 6.0 months, p = 0.035). CA-19-9 changes below the cutoff were associated with improved PFS (p = 0.022) but did not reach statistical significance for OS (p = 0.23). In multivariable analysis, neither marker retained independent significance, likely due to collinearity. Conclusions: Early dynamics of routine tumor markers are prognostic in regorafenib-treated mCRC. specifically, a CEA increase of <14.6% significantly predicts improved survival outcomes. These findings support the utility of serial marker monitoring in real-world practice, though prospective validation is warranted.