Aim: Annually, approximately 20 million pregnant women undergo cesarean sections worldwide. However, a global trend of increasing cesarean section rates has been observed. The objective of this study is to evaluate which factors affect the decision of physicians to perform cesarean sections, with the exception of the actual indications for such procedures. Material and Methods: Data were collected using questionnaires that were delivered through the internet and telephone. The questionnaires consisted of 24 questions, including age, year of professional experience, institution, working conditions, and economic expectations. Results: The present study included 327 clinicians. The findings indicated that clinicians demonstrated a higher degree of acceptance of pregnant women's preferences regarding the type of birth, particularly among physicians working in the private sector (62.9% vs. 21.2%, p<0.001). Furthermore, the data indicates a significant disparity in the rates of vaginal birth among clinicians in different sectors, with a higher proportion of clinicians in private practice (7.3%) compared to public health facilities (3.2%), a difference that is statistically significant at the p < 0.001 level. The study revealed no statistically significant differences between the private and public sectors, between judicial and legal cases, or between maternal and fetal fears (p > 0.05). Conclusion: Pregnancy preferences have been demonstrated to exert an active role in changing rates of birth type in the private sector. On the other hand, concerns related to forensic medicine may exert an equal influence on the change in cesarean rates across both the private and public sectors.

Objective: Screening for gestational diabetes mellitus with the oral glucose tolerance test is recommended between the 24th and 28th weeks of pregnancy. In recent years, views opposing the oral glucose tolerance test have gained prominence in the Turkish media, potentially influencing pregnant women's decisions. This study aimed to determine how often the oral glucose tolerance test is used and by which physicians, to examine the relationship between socioeconomic status and test use, and to assess the impact of the media on those who refuse the test. Methods: This descriptive, prospective, cross-sectional study was conducted between May and August 2020 with pregnant women who presented to, and were registered and followed up at, the family medicine outpatient clinics in Çankaya, Ankara. A total of 334 pregnant women who met the inclusion criteria participated in the study. Sociodemographic caracteristics, socioeconomic status, oral glucose tolarence test acceptance status, physician recommendation variability, effect of media influence of various media sources in decision-making process was questioned by a 16-question survey. Results: Of the participants, 68.0% (n=227) had obtained a university degree, and 56.3% (n=188) reported a high income. Overall, 41.6% (n=139) said the didn’t received any information about the oral glucose tolerance test from their primary care physician. Of the informed subjects 58.8% (n=114) received information from their family doctors. 15.6% (n=52) declined the test, while 33.8% (n=113) were undecided. For those who declined the test 53.8% (n=28) pointed at negative media or social media content to be the primary reason for their decision. Pregnant women from a lower socioeconomic background were more likely to decline the test or be undecided, particularly if they had not received information about it from a healthcare professional. Conversely, physician-provided information was associated with higher acceptance rates for the oral glucose tolerance test. Conclusion: A low socioeconomic status, combined with a lack of information provided by physicians and negative media influence, was associated with higher rates of refusal or indecision regarding oral glucose tolerance test. However, providing accurate and clear information about gestational diabetes screening through family physicians was found to significantly increase the likelihood of test acceptance.

One of the best treatment methods for end-stage organ failure is solid-organ transplant. Experiences gained in the postoperative treatment and follow-up of transplant recipients continue to guide the morbidity and mortality rates of patients. Evaluations regarding the increased risk of thyroid cancer after solid-organ transplant are still controversial. In this study, we aimed to examine the incidence of thyroid cancer development in solid-organ transplants cross-sectionally. We conducted a retrospective cross-sectional study at a single center, which included 23 patients who had undergone liver and kidney transplant and were diagnosed with thyroid cancer after transplant. Among the included patients, 21 had undergone kidney transplant and 2 had undergone liver transplant. The patients' thyroid cancer types, postoperative thyroglobulin and anti-thyroglobulin levels, and whether they received radioactive iodine therapy after surgery were examined. We also investigated whether the deceased patients died primarily from thyroid cancer. Among 1191 transplants were performed at our clinic, 851 were kidney transplants and 340 were liver transplants. Thyroid malignancy was detected in 23 (1.93%) of these cases. The mean age was 54.48 ± 11.41 years, ranging from 38 to 76 years. Fine needle aspiration biopsy results showed suspicious findings for malignancy in 1 case (4.35%), atypia of uncertain significance in 1 case (4.35%), and findings consistent with papillary carcinoma in 21 cases (91.30%). Seventeen patients (73.91%) had papillary carcinoma, whereas others had papillary microcarcinoma. Four patients (17.39%) in the study died, and retrospective review of the records for the primary causes of death showed that all were from causes unrelated to the thyroid. This study showed that the incidence of thyroid cancer has increased in solid-organ transplants, but mortality rates from thyroid cancer have not been affected.

Amaç: COVID-19’un yaşlı yetişkinlerde uzun süreli morbidite ve mortalite yaratan bir durum olduğu bilinmektedir. COVID-19 ve kırılganlık ilişkisi hakkında henüz yeterli bilgi yoktur. Çalışmamızda COVID-19’un uzun vadeli etkileri arasında sayılabilecek bir durum olan kırılganlığı arttırıp arttırmadığını araştırdık. Gereç ve Yöntemler: Çalışmaya Başkent Üniversitesi Tıp Fakültesi Hastanesi COVID-19 İzolasyon Servisi’nde yatan 65 yaş üstü, COVID-19 PCR testi pozitif olan 73 hasta dahil edildi. Hastalar hafif-orta pnömoni, ağır pnömoni ve yoğun bakım ünitesine yatış gerektiren ciddi pnömoni olarak kategorize edildi. Hastalara yatışının ilk gününde FRAIL Frailty ölçeği uygulandı. Taburculuk sonrası 3. ay kontrolünde tekrar FRAIL Frailty ölçeği uygulandı. Hastaneye yatışın ilk günü ve taburculuk sonrası 3. ay kontrol FRAIL indeksleri karşılaştırıldı. Bulgular: Çalışmamıza katılan hastaların %58,9’u erkek, %41,1’i kadındı. Ortalama yaşları 77,48±7,68 idi. Ortalama FRAIL skoru yatışın ilk günü 1,34±0,12 iken taburculuk sonrası 2,24±0,12 idi. İlk ve son FRAIL skorları arasındaki ortalama değişim %60,3 idi ve istatistiksel olarak anlamlıydı (p<0,001). FRAIL skorundaki değişim en fazla %95 ile yoğun bakım grubunda oldu (p<0,001). Sonuç: COVID-19 sistemik inflamasyonu arttırarak kırılganlığın artmasına neden olur. Yaşlı hastalar COVID-19 sırasında ve sonrasında kırılganlık açısından değerlendirilmelidir. Aim: COVID-19 is known to be a condition that creates long-term morbidity and mortality in older adults. There is not enough information yet about the relationship between COVID-19 and frailty. In our study, we investigated whether COVID-19 increases frailty, a condition that can be counted among its long-term effects. Materials and Methods: The study included 73 patients over the age of 65 who were hospitalized in the Başkent University Medical Faculty Hospital COVID-19 Isolation Service, with positive COVID-19 PCR test. Patients were categorized as mild-moderate, severe, and critical pneumonia requiring intensive care unit admission. The FRAIL Frailty scale was applied to the patients on the first day of hospitalization. The FRAIL Frailty scale was applied again at the 3rd month follow-up after discharge. FRAIL index were compared on the first day of hospitalization and 3 months after discharge due to COVID-19. Results: 58.9% of the patients participating in our study were male and 41.1% were female. Their mean age was 77.48±7.68 years. The mean FRAIL score was 1.34±0.12 on the first day of hospitalization and 2.24±0.12 after discharge. The mean change in FRAIL score between the first day of hospitalization and after discharge was 60.3% and was statistically significant (p<0.001). The change was the highest in the intensive care unit group, with 95% (p<0.001). Conclusion: COVID-19 increases systemic inflammation, leading to increased frailty. Elderly patients should be evaluated for frailty during and after COVID-19.

Background and Objectives: Courier-operated motorcycles and mopeds have become increasingly visible in urban traffic, raising concerns about injuries among both couriers and pedestrians struck by courier-operated vehicles. The study period coincided with the COVID-19 pandemic; however, this study was not designed to evaluate the effect of the pandemic on courier-related injuries. This multicenter retrospective study aimed to describe hospital-based injury patterns, injury severity, treatment requirements, complications, and mortality among selected courier-related casualties, including motorcycle couriers and pedestrians struck by courier-operated motorcycles or mopeds. Materials and Methods: This retrospective multicenter observational study included courier-related traffic casualties identified between 1 March 2020, and 1 June 2022, through nine hospitals in İstanbul and Ankara and, for fatal courier cases, linked emergency medical service and hospital records. The primary clinical cohort consisted of injured couriers and pedestrians evaluated or treated at participating hospitals. Linked prehospital and early fatal courier cases were analyzed separately for mortality-related and mechanism-specific fatality analyses. Injury severity was assessed using the New Injury Severity Score. Treatment was classified as conservative or surgical, including both fracture fixation and soft-tissue procedures. Results: A total of 857 courier-related traffic casualties were identified, including 491 couriers and 366 pedestrians. Among couriers, 111 fatal cases were verified through linked records. Clinical treatment and follow-up analyses were restricted to 380 hospital-treated surviving couriers and 366 pedestrians with available clinical records. In this selected hospital-treated courier cohort, multiple fractures, open fractures, higher injury severity scores, surgical treatment, and complications were more frequent than among pedestrians. All hospital-treated surviving couriers included in the orthopedic trauma cohort underwent surgery, reflecting the orthopedic trauma-based case-identification process, whereas most pedestrians were treated conservatively. Conclusions: Among this selected hospital-based cohort, courier casualties identified through hospital, trauma referral, emergency, forensic, and linked fatal-event records showed a more severe clinical profile than pedestrians evaluated after being struck by courier-operated motorcycles or mopeds. These findings should be interpreted as hospital-based injury-severity patterns rather than population-level estimates of accident incidence, relative injury risk, or public health burden.