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Article Clinicopathological Predictors of Central Lymph Node Metastasis in Clinically Node-Negative Papillary Thyroid Carcinoma: A Retrospective Cohort Analysis(Springer, 2025) Sakiz, Davut; Calapkulu, Murat; Sencar, Muhammed Erkam; Unsal, Ilknur Ozturk; Kartal, Mehmet Zabit; Ucan, Bekir; Cakal, ErmanPurposeThis retrospective cohort study aimed to identify clinicopathological predictors of central lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC).MethodsA total of 503 patients with PTC who underwent thyroidectomy with central lymph node dissection were included. Preoperative clinical data, ultrasonographic features, and postoperative histopathological characteristics were analyzed.ResultsCLNM was detected in 209 (41.55%) patients. Male sex (odds ratio [OR] = 3.12, 95% CI: 1.82-5.35), irregular nodule borders (OR = 2.02, 95% CI: 1.25-3.26) and higher risk categories in the American Thyroid Association (ATA) ultrasonographic pattern stratification system (OR = 13.312, 95% CI: 8.623-20.551) were identified as independent preoperative predictors of CLNM. A simplified model incorporating only the ATA ultrasonographic pattern stratification system and male sex achieved 83.5% accuracy in predicting CLNM. Histopathological evaluation revealed lymphovascular invasion (OR = 4.61, 95% CI: 2.81-7.55), extrathyroidal extension (OR = 2.41, 95% CI: 1.52-3.83), and multifocality (OR = 1.58, 95% CI: 1.04-2.40) as independent predictors of CLNM, while lymphocytic thyroiditis (OR = 0.59, 95% CI: 0.39-0.89) was a protective factor.ConclusionThis study establishes that ATA ultrasonographic suspicion patterns combined with the male sex provide an accurate and simplified model for preoperative CLNM prediction in PTC, outperforming complex nomograms. Key independent predictors included male sex, irregular nodule margins, ATA high-risk patterns, lymphovascular invasion, extrathyroidal extension, and multifocality, while lymphocytic thyroiditis was protective. According to the current study, risk assessment and personalized management should favor a holistic approach, rather than focusing solely on individual risk factors.Article Effect of COVID-19 Infection on the Performance of Elite Adolescent Overhead Athletes(SAGE Publications Ltd, 2025) Uluǧ, Naime; Kodak, Seyde Büşra; Kodak, Muhammed Ihsan,; Karahan, Zehra Can; Kiliç, ErdenBackground: COVID-19 might have a negative impact on sports performance. There are few studies in the literature that assess how the sports performance of adolescent athletes is affected by COVID-19. Objective: This study aimed to compare the sports performance of adolescent overhead athletes who had COVID-19 infection with those who had not. Methods: The study involved adolescent elite overhead athletes from basketball, volleyball, handball, and tennis. Athletes’ performance were assessed using core muscle endurance, hand grip strength, upper extremity functional performance, reaction time and agility performance, and the 3-min step test. Results: Study included 47 adolescent overhead athletes (mean age 15.15 ± 1.51 years). The COVID-19 group showed significantly higher Borg Scale scores and decrease in oxygen saturation levels only after the step test (p = 0.02, p = 0.02, respectively). Additionally, COVID-19 group had lower grip strength in both right and left hands compared to the non-COVID group (p = 0.01, p = 0.05, respectively). No significant association was found between core muscle power and endurance, upper extremity functional performance, reaction time and agility performance (p > 0.05). Conclusions: Our results showed reduced hand grip strength and increased fatigue following COVID-19 infection in adolescent overhead athletes. Time period after COVID-19 infection had a negative correlation with sports performance and core endurance. © 2025 Elsevier B.V., All rights reserved.Article The Effect Of Constructivist Training On The Rate Of Catheter-Associated Urinary Tract Infections in The Intensive Care Unit(Anestezi Dergisi, 2025) Yarimoglu, Saliha; Erdinç, Fatma Şebnem; Kaymak, Çetin; Tulek, Eren, N.; Basa̧r, Hulya; Tuncer-Ertem, Günay,; Kinikli, SamiObjective: Catheter-associated urinary tract infections (CA-UTIs) are common healthcare-associated infections. Constructivist training is based on integrating new knowledge with previously learned knowledge. The aim of this study was to evaluate the effects of constructivist training on the rate of CA-UTIs in the Anesthesia and Reanimation Intensive Care Units (ARICU). Methods: This study was a retrospective-prospective intervention study. Over the period of one month, a total of 62 healthcare staff (seven doctors, 38 nurses, and 17 cleaning staff) working in ARICUs were organized into groups of 4-5 people and received forty-five minutes of constructivist training on preventing CA-UTI. Personnel from each of three ICUs participated in the same number of training sessions. Comparisons were made of the rates of CA-UTI and catheter use in the six-month periods before and after the training. A 4-item questionnaire was administered to the study participants six months after completion of the training. Results: The catheter-associated urinary tract infection rates before and after training were observed to be 8.3 and 8.7 per 1000 catheter days, respectively in ARICU-1, 7.0 and 8.1 per 1000 catheter days in ARICU-2, and 7.3 and 9.9 per 1000 catheter days in ARICU-3. No statistically significant difference was observed in the CA-UTI rate in each unit after constructivist training compared to the pre-training period. The intervention of constructivist training alone did not reduce the CA-UTI rates in the ICUs. According to the results of the survey conducted six months later, 92% of the nurses and 88% of the cleaning staff stated that constructivist training had positive effects. Conclusion: The intervention of constructivisit training alone did not reduce the rates of CA-UTIs in the ARICUs, but an increase was observed in the awareness of ICU nurses and cleaning staff. © 2025 Elsevier B.V., All rights reserved.
