Background: Ultrasonography is widely used in neonatological practice and studies investigating the hemodynamic effects of various treatment protocols or clinical situations. On the other hand, pain causes changes in the cardiovascular system; so, in the case of ultrasonography leading to pain in neonates, it may cause hemodynamic alterations. In this prospective study, we evaluate whether ultrasonographic application causes pain and changes in the hemodynamic system. Methods: Newborns undergoing ultrasonographic examination were enrolled in the study. Vital signs, cerebral and mesenteric tissue oxygenation (StO₂) levels, and middle cerebral artery (MCA) Doppler measurements were recorded, and NPASS scores were calculated before and after ultrasonography. Results: We enrolled 39 patients in the study. After ultrasonography, Neonatal Pain, Agitation, and Sedation Scale (NPASS) scores were significantly higher (p < 0.01), and all vital signs (heart rate, respiratory rate, SpO₂, diastolic and systolic blood pressure; p = 0.03; p < 0.01, p < 0.01, p < 0.01, p = 0.02, p = 0.03, respectively) were altered. Cerebral (p = 0.008) and mesenteric (p = 0.039) StO₂ levels were significantly lower in the whole study group, MCA end-diastolic velocity decreased (p = 0.02), and the resistive index (p = 0.03) increased in patients whose NPASS score was >7 after ultrasonography. Conclusions: This study is the first to show that ultrasonography may cause pain in newborn patients, and alters vital signs and hemodynamic parameters. Therefore, precautions should be taken to protect newborn babies from pain during ultrasound applications, as they are already exposed to many noxious stimuli. Furthermore, pain scores should be considered in studies using ultrasonography and evaluating hemodynamic parameters to increase the reliability of the studies.

Objective: To investigate the impact of the presence and the severity of the nasal septal deviation (NSD) on the paranasal pneumatization. Methods: Initially, the deviated and contralateral sides was compared to evaluate the impact of the presence of NSD on pneumatization. Then, NSD classification groups were categorized according to the severity of deviation degree; 1: mild (15°). Pneumatization of all paranasal sinuses, osteomeatal complex (OMC), frontoethmoid recess (FER) and variant structures were compared according to the NSD classification groups separately both for the deviated and the contralateral sides. Results: Although there was no statistically significant difference in pneumatization of the paranasal sinuses between the deviated and contralateral sides, a significant difference was observed in OMC and FER diameters. In the deviated side, there was statistically significant difference in ethmoid sinus volume, in FER and OMC diameters between NSD classification groups. In the contralateral side, FER and OMC diameters were found to be significantly different between group 1 and group 2 and between group 1 and group 3, respectively (P = 0.04 and 0.06, respectively). Both the presence and severity of the NSD did not statistically significant influence the pneumatization of variant structures, air cells and vital structures. Conclusion: The severity of NSD effects the ethmoid sinus volume. The relationship of FER and OMC with NSD is evident, however this may not always be in a proportional pattern. The paranasal pneumatization did not affect Keros type, bone integrity of carotid canal and optic canal.

Background/Objectives: This study aimed to evaluate the ability of ChatGPT-5, a multimodal large language model, to perform automated ASPECTS assessment on non-contrast CT (NCCT) in patients with acute ischemic stroke. Methods: This retrospective, single-center study included 199 patients with anterior circulation AIS who underwent baseline NCCT before reperfusion therapy between November 2020 and February 2025. Each NCCT was evaluated by two human readers and by ChatGPT-5 using four representative images (two ganglionic and two supraganglionic). Interobserver agreement was measured with the intraclass correlation coefficient (ICC), and prognostic performance was analyzed using multivariable logistic regression and receiver operating characteristic (ROC) analysis for 3-month functional independence (mRS ≤ 2). Results: ChatGPT-5 demonstrated good-to-excellent agreement with expert consensus (ICC = 0.845; 95% CI, 0.792–0.884; κ = 0.79). ChatGPT-ASPECTS were independently associated with 3-month functional independence (OR = 1.28 per point; p = 0.004), comparable to consensus-ASPECTS (OR = 1.31; p = 0.003). Prognostic discrimination was similar between ChatGPT-5 and consensus scoring (AUC = 0.78 vs. 0.80; p = 0.41). Conclusions: ChatGPT-5 achieved high reliability and strong prognostic validity in automated ASPECTS assessment without task-specific training. These findings highlight the emerging potential of large language models for quantitative image interpretation, though clinical implementation will require multicenter validation and regulatory approval.

Aim: This study aimed to demonstrate the feasibility of the percutaneous endobiliary radiofrequency ablation (ERFA) method, which is used to increase stent patency in malignant biliary strictures. Material and Methods: A total of 25 patients, 9 (36%) female and 16 (64%) male, who developed malignant biliary stenosis secondary to various advanced tumors and underwent ERFA and metallic stenting after percutaneous biliary drainage were retrospectively evaluated. The types of malignancies causing obstruction and the follow-up after the procedure were evaluated to demonstrate the median survival and stent patency values of the patients. Stent patency and survival rates were calculated using the Kaplan-Meier method. Results: The results of the study demonstrated that 17 (68%) out of these 25 patients displayed a significant decrease in their first-week postoperative bilirubin values, with a reduction of greater than 50% compared to the pre-biliary drainage values. The study determined that this treatment approach's overall clinical success rate was 68%. Stent occlusion developed within 180 days in 8 (32%) out of the 25 patients who underwent ERFA and metallic stenting. Additionally, 18 (%72) patients died as a result of malignancy progression. The mortality rates at post-treatment 30 and 180 days were determined to be 24% and 72%, respectively. The median survival and stent patency times were 65 and 70 days, respectively. Conclusion: Percutaneous ERFA and metallic stenting have the potential to improve survival and stent patency, especially in selected patient groups with distal biliary stenosis. Randomized controlled studies are needed to confirm these results.