Purpose Diabetic foot ulcer (DFU) remains a major complication of diabetes mellitus and is a leading cause of non-traumatic lower extremity amputations. Biomarkers are used to predict disease prognosis and guide treatment decisions. This study aimed to evaluate the prognostic utility of three systemic inflammation and nutrition-based biomarkers HALP score, CRP/Albumin ratio, and CALLY index in predicting the major amputation risk among patients with DFU. Methods A retrospective analysis was conducted on 252 DFU patients who underwent surgical debridement and/or amputation between January 2018 and December 2023. Demographic, clinical, and laboratory data were collected. Patients were grouped based on surgical intervention (minor vs. major amputation). The HALP score, CRP/Albumin ratio, and CALLY index were calculated from admission laboratory values. Cut-off values were determined using ROC analysis. Results Major amputation was performed in 19% of the patients. The HALP score was significantly lower, while the CRP/Albumin ratio was higher, and the CALLY index was lower in the major amputation group (p < 0.001 for all). The optimal cut-off values to predict major amputation were 19.96 for HALP (AUC = 0.750), 2.29 for CRP/Albumin (AUC = 0.853), and 0.71 for CALLY (AUC = 0.830). All three markers demonstrated significant correlations with markers of infection, inflammation, and ulcer severity. Conclusion The HALP score, CRP/Albumin ratio, and CALLY index are easily accessible prognostic tools that may assist clinicians in identifying DFU patients at higher risk for major amputation. Integration of these biomarkers into routine patient monitoring can improve risk assessment and guide timely surgical decision-making.

Objective: Gallbladder cancer is a rare neoplasm. We report our experience with gallbladder cancer that was incidentally diagnosed during or after laparoscopic cholecystectomy performed for gallstone disease. Method: This study included all laparoscopic cholecystectomies due to gallstone disease undertaken from January 2010 to April 2015. Exclusion criteria were suspicion of malignancy and/or existence of gallbladder polyps detected with ultrasonography preoperatively. Patients with incidentally diagnosed gallbladder cancer were recorded, and the clinical and demographic characteristics of these patients were reviewed. Results: Of 6,114 patients in whom laparoscopic cholecystectomy was attempted, 5,948 were included in this study. Incidental gallbladder cancer was found in thirty-six patients, with a mean age of 64.08 years. The histological tumor stages were adenocarcinoma in situ in seven patient, pT1b in nine patient, pT2 in eleven patient, and pT3 in nine patients. Sixteen patients who underwent laparoscopic cholecystectomy alone underwent no additional surgery because of the low stage of the tumors. The twenty remaining patients, whose laparoscopic cholecystectomies were converted to open surgeries, underwent cholecystectomy, excision of the liver bed and lymph node dissection. The overall median survival time was 28 months. Conclusion: The incidence of incidental gallbladder cancer has been reported to vary, up to 2.85%. In this single-center study, the rate of incidental gallbladder cancer was found to be 0.60%. Female gender and advanced age are demographic risk factors for gallbladder carcinoma. Although gallbladder cancer is well known for its poor prognosis, tumors that are incidentally diagnosed are often found at an early stage and have a better prognosis.

Amaç: Kolorektal kanserin erken dönemde tespit edilmesi için ulusal kolorektal kanser tarama programla-rı yürütülmektedir. Sağlık çalışanlarının tarama programlarına yönelik bilgi düzeyi toplumun programlara katılımını etkileyen önemli bir faktördür. Çalışmamızda hastanemizde çalışan hekim ve hekim dışı sağlık çalışanlarının kolorektal kanser tarama programına yönelik farkındalıkları ve davranış düzeyleri irdelenmiş-tir. Materyal ve metod: Çalışmaya 366 sağlık çalışanı dahil edildi. “Kolorektal kanser tarama programına yönelik farkındalık ve davranış düzeyi” isimli anket uygulandı. Kolorektal kanser tarama programına yöne-lik bilgi düzeyleri, tarama testlerine katılım oranları, tarama programına yönelik doğru bilgiye sahip olma ve kolonoskopi yaptırma durumunu etkileyen faktörler araştırıldı. Kategorik değişkenler arasındaki ilişki-nin incelenmesinde ki kare testinden yararlanıldı. Bulgular: Katılımcıların yaş ortalaması 41,05±8,69, %82,2’si 50 yaş altı, %73,2’si kadın idi. GGK tarama sıklığını %20,2 ve kolonoskopi tarama sıklığını %7,1 katılımcı doğru cevapladı. Katılımcıların %12,8’inde aile hikayesinin olduğu ve 50 yaş üzerinde kolonoskopi yaptırma oranının %12,3 olduğu izlendi. Kolorek-tal kanser ve tarama programına yönelik bilgi düzeyini etkileyen faktörler eğitim durumu ve meslek idi. Kolonoskopi yaptırma oranı 50 yaş ve üzerinde, hekimlerde, yüksek lisans mezunlarında ve aile hikayesi olanlarda daha yüksekti (p=0,027, p=0,002, p=0,003, p=0,003 sırasıyla) Sonuç: Sağlık çalışanlarının ulusal kanser tarama programı hakkındaki bilgilerinin yetersiz ve katılım oran-larının düşük olduğu izlenmiştir. Eğitim düzeyinin artması ile tarama programına yönelik bilgi sahibi olma durumu ve taramaya katılım oranı artmaktadır. Yapılacak eğitim ve tanıtım faaliyetleri ile erken tanı için hastaların yönlendirilmesinde büyük önem taşıyan sağlık çalışanlarının farkındalığı artırılmalıdır.

Objective This study aimed to investigate the cytomorphological effects of heavyweight and lightweight mesh on the ilioinguinal nerve in an experimental animal model. Methods Sixteen New Zealand male rabbits were included in the study. The left inguinal regions of the first six animals were assigned as controls and the right inguinal regions were assigned as the sham group. The left inguinal regions of the remaining 10 animals were assigned as the lightweight mesh group and the right inguinal regions were assigned as the heavyweight mesh group. No intervention was performed in the control group. In the sham group, only ilioinguinal nerve exploration was performed. In mesh groups, ilioinguinal nerve exploration was performed and the mesh was implanted on the ilioinguinal nerve. After three months, ilioinguinal nerve specimens were excised from both sides for cytomorphological examination. Results Myelin sheath thickening, separation of the myelin layers, and myelin vacuolization were more pronounced in the heavyweight mesh group compared to the lightweight mesh group. The G-ratio was moderately increased in the heavyweight mesh group when compared to other groups. The ratio of fibers with ≤4 µm diameter was higher in the lightweight mesh group compared to other groups, and the ratio of fibers with ≥9 µm diameter was higher in the heavyweight mesh group than in the other groups (p<0.05). Conclusion Both of the meshes induce cytomorphological alterations on the adjacent nerve tissues caused by foreign body reaction and compression. Ilioinguinal nerve degeneration was more pronounced in the heavyweight mesh than in the lightweight mesh. Histological alterations on the ilioinguinal nerves caused by different meshes may be related to chronic pain after hernia surgery. We believe our study will serve as a guide for future studies on the topic.