Background: In the literature, there is no study investigating the relationship between thyroid hormones in pregnancies at 41 weeks and above and the birth timing, labor duration, frequency of fetal distress, premature rupture of membranes (PROM), and maternal hemogram values. Methods: A total of 68 nulliparous pregnant women who were admitted to Basaksehir Cam and Sakura City Hospital with indications of delivery between August 2023 and January 2024, between the ages of 20 and 38 and with no comorbidities, were included in the study. Pregnant women with ≥41 weeks of gestation were classified as the late-term pregnancy group (n = 37), and those between 37 and 38 weeks were classified as the control group (n = 31). The thyrotropin (TSH), free thyroxine (FT4), and hemoglobin levels and relevant parameters were evaluated. Results: The FT4 values of pregnant women diagnosed with fetal distress in the entire population were observed to be statistically significantly lower (p < 0.05). A statistically significant negative linear relationship was detected between the FT4 values of the entire population and the weights of newborns (p < 0.05). It was determined that, as the FT4 values decreased, the newborn weights increased. There was no statistically significant difference between the two groups in terms of the TSH/FT4 values, birth types, labor duration, or postpartum Hb/Htc decrease (p > 0.05). No statistically significant relationship was found between the TSH/FT4 values of the entire population and the diagnosis of PROM, labor duration, or Hb/Htc decrease amount (p > 0.05). Conclusions: TSH/FT4 levels may be important in the mature and late–mature periods of pregnancy. There may be an association between the FT4 levels and the fetal distress risk, type of birth, and newborn weight.

Immune checkpoint inhibitors have been increasingly used for many type of solid tumor, first line treatment of small cell lung cancer (SCLC) with chemotherapy combination with atezolizumab is one of them. Although usually well tolerated, autoimmune related side effects can be seen.We report of autoimmune myasetnia gravis that occured after treatment of atezolizumab, an anti-programmed-death (anti-PD-1) monoclonal antibody. Our patient is 71 year old woman with extensive stage small cell lung cancer receiving chemotherapy combined with atezolizumab. Although good oncological response to treatment after 8 cycle of atezolizumab, myastenia gravis was occured. This automimmune neurological syndrome is likely associated with atezolizumab treatment, patient had no any neurological disorder before. Symptoms were partially responded after steroid, piridostigmine and iv-ig therapy. The number of the patient that treated with immunotherapy will increase in the future so it should be important to know the adverse effects management of immunotherapy.

Objective: This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity. Methods: This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥ 10 μ mol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10–39 μ mol/L; n = 90) and severe (TBA ≥ 40 μ mol/L; n = 41) subgroups. Demographic data, routine blood parameters, and DNI values were evaluated across the groups. Results: The ICP group demonstrated significantly elevated white blood cell (WBC) counts, neutrophil counts, immature granulocyte (IG) levels, DNI values, and neutrophil-to-lymphocyte ratio (NLR) compared to controls (p < 0.05 for all). Both mild and severe ICP subgroups exhibited higher IG, DNI, and NLR than controls. Furthermore, DNI and IG values significantly differed between mild and severe ICP cases. Receiver operating characteristic (ROC) analysis revealed high diagnostic performance for both DNI (cut-off: 0.65; sensitivity: 82.4%; specificity: 78%) and IG (cut-off: 0.06; sensitivity: 77.1%; specificity: 82.2%). Conclusion: The DNI levels were markedly elevated in ICP and varied with disease severity, suggesting its potential as a noninvasive marker for both diagnosis and risk stratification.