Comparison of FGF-8, FGF-10, FGF-Receptor 2, Androgen Receptor, Estrogen Receptor-A and SS in Healthy and Hypospadiac Children.

In this study, we aimed to investigate the levels of Fibroblast Growth Factor-8 (FGF-8), FGF-10, FGF-Receptor-2 (FGFR-2), Androgen receptor (AR), Estrogen receptor alpha and beta (ER-α and ER-ß) in the foreskins of children with and without hypospadias. Methods: Samples from the foreskins of 20 children with hypospadias and 20 skin samples from children without hypospadias between the ages of 14 months and 12 years were taken during circumcision or hypospadias correction surgery for immunohistochemical (IHC) examination of these markers. In IHC examination, it was shown that ER-α, ER-ß and AR receptors were more involved in the foreskin of children with hypospadias than in the fore-skin of without hypospadias children, and FGF-8, FGF-10 and FGFR-2 were lower (p<0.05). ER and AR uptake were higher in hypospadias tissue samples and FGF-8, FGF-10, and FGFR-2 uptakes were lower compared to without hypospadias children's tissue samples, and these factors were supported by affecting each other in the development of hypospadias. The limited number of studies on this subject in the literature and the contradictory results of the findings indicate that more research should be done on this subject in the future.

The Investigation of Bone-Implant Connection and New Bone Formation in Fasting and High-Fatty Diet Rats.

BACKGROUND: Hyperlipidemia caused by a high-fat diet (HFD) has many adverse effects on the cardiovascular system, including vascular problems. In addition, a HFD also has significant adverse effects on bone health. AIM: The aim of this study is to examine bone-implant osteointegration and new bone formation in peri-implant defects in fasting and high-fatty diet applied rats. MATERIALS AND METHODS: In this study, 28 female Sprague Dawley rats were used. The rats were divided into four groups, with seven rats in each group: the control group on a normal diet (Group 1) (n = 7), the fasted group (Group 2) (n = 7), the high-fatty diet (HFD) group (Group 3) (n = 7), and the fasted and HFD group (Group 4) (n = 7). Titanium implants with a diameter of 2.5 mm and a length of 4 mm were placed in the right tibia bones of the subjects, and a bone graft corresponding to 2 mm of the implant length was placed in the bone defect applied to the neck region. All rats that continued the administered diet for 12 weeks were sacrificed at the end of the experiment period. The implants and surrounding bone tissue were surgically removed and subjected to biomechanical analysis to assess bone-implant osteointegration and peri-implant new bone formation. RESULTS: It was determined that there was no statistically significant difference between the rats in the control group and the other three groups in terms of bone-implant osteointegration and peri-implant new bone formation (P > 0.05). CONCLUSION: As a result of this study, it was determined that fasting or maintaining a HFD does not adversely affect bone-implant osteointegration or peri-implant new bone formation in the tibias of rats.

Early step-down weaning of dairy calves from a high milk volume with glutamine supplementation.

Weaning dairy calves from a high milk volume (≥8.0 kg/d) can negatively affect the growth and welfare even if it is performed in a step-down manner. Supplementation of Gln improved gut development of preweaning calves and mitigated weaning stresses of piglets to extents achieved with antibiotics. The study objective was to examine the effect of initiating a step-down weaning scheme with a Gln supplement at an early age on calf starter intake (CSI), average daily gain (ADG), and paracellular permeability of the intestinal epithelium of calves fed a high volume of milk (9.0 kg/d). Thirty-six Holstein heifer calves were assigned to 3 treatments (n = 12) as follows: (1) initiating weaning at 49 d of age (LW), (2) initiating weaning at 35 d of age (EW), and (3) initiating weaning at 35 d with a Gln supplement (2.0% of dry matter intake) from 28 to 42 d of age (EWG). Calves were fed 9.0 kg/d of whole milk until weaning was initiated by abruptly decreasing the milk volume to 3.0 kg/d. Weaning was completed once calves achieved ≥1.0 kg/d of CSI. The paracellular permeability of the intestinal epithelium was assessed with lactulose-to-mannitol ratio (LMR) in the blood on 1 d before, and 3 and 7 d after the initiation of weaning. The blood was analyzed for haptoglobin, lipopolysaccharide-binding protein (LBP), and metabolites including AA. The CSI increased once milk volume was restricted in all treatments. The CSI of LW was greater than that of EW and EWG during the first week of weaning. The LW, EW, and EWG took 11, 19, and 16 d to achieve ≥1.0 kg/d of CSI and were weaned at 60, 54, and 51 d of age, respectively. The body weight (BW) of LW, EW, and EWG at the initiation of weaning were 68.2, 58.7, and 59.5 kg, respectively. Both LW and EWG achieved similar ADG, but ADG of EW was lower than LW during the first week of weaning. All calves had similar ADG during the second week of weaning. The BW of LW, EW, and EWG at weaning were 74.8, 66.5, and 66.4 kg, representing a 2.0, 1.8, and 1.8-fold increase in birth weight, respectively. All calves had similar BW of 88.6 and 164.3 kg at 10 and 20 wk of age, respectively. Regardless of the age, serum haptoglobin and plasma LBP concentrations increased on d 3 and returned to baseline concentrations on d 7 during weaning. The EW had a lower plasma LBP concentration than LW and EWG on d 3 during weaning. The LMR was similar between treatments on d 3 but increased by 44% for EW and LW on d 7, whereas the LMR of EWG remained unchanged during weaning. The postprandial serum concentration of Gln, Met, Trp, and ß-hydroxybutyrate were greater for EWG than EW during weaning. Beginning step-down weaning at 35 d with a Gln supplement can help maintain the gut barrier function and wean dairy calves with a satisfactory CSI at 7 wk of age without affecting postweaning growth.

Effects of branched-chain amino acids on glucose uptake and lactose synthesis rates in bovine mammary epithelial cells and lactating mammary tissue slices.

Even though supplementations of essential AA (EAA) are often related to increased lactose yields in dairy cows, underlying mechanisms connecting EAA availability to the mammary glands and lactose synthesis are poorly understood. The objective of this study was to examine the effects of branched-chain AA (BCAA) including Leu, Ile, and Val on (1) glucose transporter (GLUT1) abundance and glucose uptake, (2) the abundance of proteins regulating lactose synthesis pathway, and (3) fractional synthesis rates of lactose (FSR) using bovine mammary epithelial cells (BMEC) and mammary tissues slices (MTS). The BMEC (n = 4) were allocated randomly to regular Dulbecco's Modified Eagle Medium with Ham's F12 (DMEM/F12) medium (+EAA) or +EAA deficient (by 90%) in all EAA (-EAA), all BCAA (-BCAA), only Leu (-Leu), only Ile (-Ile) or only Val (-Val). Western immunoblotting analyses, depletion of glucose in media, and a proteomic analysis were performed to determine the abundance of GLUT1 in the cell membrane, net glucose uptake, and the abundance of enzymes involved in lactose synthesis pathway in BMEC, respectively. The MTS (n = 6) were allocated randomly to DMEM/F12 medium having all EAA and 13C-glucose at concentrations similar to plasma concentrations of cows (+EAAp), and +EAAp deprived of all BCAA (-BCAAp) or only Leu (-Leup) for 3 h. The 13C enrichments of free glucose pool in MTS (EGlu-free) and the enrichments of glucose incorporated into lactose in MTS and media [ELactose-bound (T&M)] were determined and used in calculating FSR. In BMEC, -BCAA increased the fraction of total GLUT1 translocated to the cell membrane and the fraction that was potentially glycosylated compared with +EAA. Among individual BCAA, only -Leu was associated with a 63% increase in GLUT1 translocated to the cell membrane and a 40% increase in glucose uptake of BMEC. The -BCAA tended to be related to a 75% increase in the abundance of hexokinase in BMEC. Deprivation of Leu tended to increase glucose uptake of MTS but did not affect EGlu-free, ELactose-bound (T&M), or FSR relative to +EAAp. On the other hand, -BCAAp did not affect glucose uptake of MTS but was related to lower ELactose-bound (T&M), or FSR relative to +EAAp. Considering together, decreasing Leu supply to mammary tissues enhances GLUT1 and thus glucose uptake, which, however, does not affect lactose synthesis rates. Moreover, the deficiency of other BCAA, Ile, and Val alone or together with the deficiency of Leu seemed to decrease lactose synthesis rates without affecting glucose uptake. The data also emphasize the importance of addressing the effect of the supply of other nutrients to the mammary glands than the precursor supply in describing the synthesis of a milk component.

Ligula Intestinalis Infection in a Native Leuciscid Hybrid (Alburnus Derjugini x Squalius Orientalis) in The Kürtün Dam Lake, Northeast Anatolia.

Taxonomic evaluations are needed to accurately determine the host selection of fish parasites. The present study is a multidisciplinary research in the field of basic and fish diseases sciences. The description of the hybrid species of Squalius orientalis and Alburnus derjugini and infection of Ligula intestinalis in these hybrid fish were reported for the first time from the Kürtün Dam Lake in northeast Turkey. A total of 450 fish were sampled in March, August, and October in 2020 using gillnets. Detailed morphological characteristics (n = 24) were compared to determine the difference among ancestors and hybrid species. The prevalence of L. intestinalis between the sampling periods and the size groups of fish (0 - 10, 11 - 15, and ≥16 cm in length) were examined. Moreover, the highest prevalence of the parasite was observed in October (78.94 %), with a size range of 0 - 10 cm in length (77.8 %). In addition, the total prevalence of the parasite was 48.44 %. The results revealed that most of the diagnostic metric and meristic features of hybrid fish were ranging between the data of S. orientalis and A. derjugini. According to previous reports, when hybrid individuals were compared with their ancestors in terms of prevalence, hybrid individuals were more susceptible to L. intestinalis infections. This study was unique as it provided the first record of L. intestinalis in a hybrid fish population.

IS REPEAT FNAB NECESSARY FOR THYROID NODULES WITH ND / UNS CYTOLOGY?

Context/Objective: The standard approach is to perform repeat FNAB (rFNAB) in thyroid nodules with non-diagnostic (ND) / insufficient (UNS) cytology. However, due to the nature of these nodules, recurrent FNABs may also be insufficient. Therefore, by comparing the clinical-radiological-pathological parameters of nodules with a definite diagnosis of excision, we questioned the possibility of patient management without rFNAB. Methods: Clinical-radiological parameters of 275 nodules belonging to 264 patients in the ND/UNS aspiration group with definite pathological diagnosis after surgery were determined. Under the guidance of these parameters, those with and without rFNAB were compared. Results: The incidence of malignancy was found to be significantly higher in nodules without rFNAB compared to nodules with rFNAB (p = 0.036). In addition, the incidence of malignancy in BC-1 nodules without rFNAB was significantly higher than in nodules with rFNAB result also BC-1 (p = 0.009). In all cases, nodule size smaller than 10 mm and border irregularity were found to be statistically significant for malignancy (p <0.020, p <0.002). When looking at the distribution of rFNAB results, a significant correlation was observed with female gender, solid component, hypoechogenicity, border irregularity and halo loss around the nodule in patients with BC-4,5,6 cytology results (respectively, 0.005 / 0.031 / 0.001 / 0.012 / 0.004). Conclusion: rFNAB did not show the expected effect in ND / UNS nodules. We recommend direct surgical excision without rFNAB for nodules with border irregularity, solid structure, halo loss and hypoechogenicity, which should be considered more important in female patients.

WHICH FACTORS ARE ASSOCIATED WITH MALIGNANCY IN THYROID NODULES CLASSIFIED AS BETHESDA CATEGORY 3 (AUS/FLUS) AND HOW DO THEY INFLUENCE THE PATIENT'S MANAGEMENT?

BACKGROUND: Thyroid nodules are a common pathology worldwide. Fine needle aspiration biopsy (FNAB) is an important diagnostic method for the investigation of malignancy in thyroid nodules. However, according to the Bethesda System used to classify the results, patients with atypia of undetermined significance/follicular lesion of undetermined significance (AUS / FLUS) may not be classified as benign or malignant. Therefore, it may be necessary to determine some clinical risk factors to apply the best treatment in these patients. AIM: To determine the factors that increase the risk of malignancy in this patient group. METHODS: A retrospective study including 138 patients with an FNAB categorized as AUS/FLUS and operated between June 2015-September 2018. Demographical, Laboratory (TSH) and Ultrasound variables (number, size and characteristics of nodules) of the patients were compared among postoperative histopathological results. RESULTS: Hypo-echoic structure, microcalcification and irregular margin of the nodules were detected to be associated with malignancy in patients with FNAB results of AUS/FLUS (p <0.001). CONCLUSION: We suggest that surgical treatment should be considered if the patients have nodules with the hypo-echoic structure, microcalcification and irregular margin with an FNAB histopathological result of AUS / FLUS.

A new species of Petroleuciscus (Teleostei: Cyprinidae) from the Büyük Menderes River, southwestern Anatolia, Turkey.

Petroleuciscus ninae sp. nov. is described from the Büyük Menderes River drainage. The new species is distinguished by having a black lateral stripe from head to base of caudal fin, stripe distinct anteriorly and posteriorly, wider than eye diameter; numerous black pigments on anal-fin rays; body depth at dorsal-fin origin 27-30% standard length (LS ); head width at posterior margin of eye 16-19% LS ; and eye diameter smaller than snout length. Petroleuciscus ninae is also distinguished from other species in adjacent waters by having six fixed diagnostic nucleotide substitutions in the mitochondrial DNA coI barcode region.

A prospectively validated nomogram for predicting the risk of chemotherapy-induced febrile neutropenia: a multicenter study.

PURPOSE: There is clinical need to predict risk of febrile neutropenia before a specific cycle of chemotherapy in cancer patients. METHODS: Data on 3882 chemotherapy cycles in 1089 consecutive patients with lung, breast, and colon cancer from four teaching hospitals were used to construct a predictive model for febrile neutropenia. A final nomogram derived from the multivariate predictive model was prospectively confirmed in a second cohort of 960 consecutive cases and 1444 cycles. RESULTS: The following factors were used to construct the nomogram: previous history of febrile neutropenia, pre-cycle lymphocyte count, type of cancer, cycle of current chemotherapy, and patient age. The predictive model had a concordance index of 0.95 (95 % confidence interval (CI) = 0.91-0.99) in the derivation cohort and 0.85 (95 % CI = 0.80-0.91) in the external validation cohort. A threshold of 15 % for the risk of febrile neutropenia in the derivation cohort was associated with a sensitivity of 0.76 and specificity of 0.98. These figures were 1.00 and 0.49 in the validation cohort if a risk threshold of 50 % was chosen. CONCLUSIONS: This nomogram is helpful in the prediction of febrile neutropenia after chemotherapy in patients with lung, breast, and colon cancer. Usage of this nomogram may help decrease the morbidity and mortality associated with febrile neutropenia and deserves further validation.

A rare cause of recurrent priapism: hereditary angioedema.

Hereditary angioedema is a rare disease, which is caused by deficiency of compleman c1 esterase inhibitor regulatory protein in the compleman system. Priapism is involuntary, painful and prolonged erection of penis more than 4 h without sexual desire. In this case report, we elucidated a patient diagnosed with hereditary angioedema while he had recurrent priapism.

A successful management of a giant mucinous ovarian tumor with intraoperative controlled fluid aspiration.

BACKGROUND: The aim of this article was to present management of a giant ovarian mass. CASE REPORT: A 61-year-old patient was admitted with compliants of abdominal swelling and dyspnea. Ultrasound revealed a giant ovarian mass with dimesnions 47x43x30 cm. The patient underwent laparatomy and the cyst's content was aspirated before total cyst excision. The total weight of the mass was calculated to be 42.5 kg. Postoperatively, the patient was discharged on her postoperative seventh day. CONCLUSION: Giant ovarian cysts can be managed with controlled aspiration before total cyst excision.

Successful management of a second-trimester post-abortion hemorrhage with the Bakri balloon tamponade.

Hemorrhage after abortion is rare but it is a significant cause of abortion-related mortality and morbidity. Conservative management of hemorrhage is gaining popularity. The authors describe a case which a uterine tamponade balloon which was successfully used to control second-trimester post-abortion hemorrhage.

Comparison of injection pain caused by the DentalVibe Injection System versus a traditional syringe for inferior alveolar nerve block anaesthesia in paediatric patients.

AIM: To compare paediatric patients' pain during needle insertion and injection in inferior alveoler nerve block (IANB) anaesthesia injected by either a traditional syringe (TS) or the DentalVibe Injection Comfort System (DV). STUDY DESIGN: the study was a randomised controlled crossover clinical trial, comprised of 60 children aged 6-12 requiring an operative procedure with IANB anaesthesia on their mandibular molars bilaterally. One of the molar teeth was treated with TS and the contralateral tooth was treated with DV. On each visit, subjective and objective pain was evaluated using the Wond-Baker Faces Pain Rating Scale (PRS) and the Face, Legg, Cry, Consolability Scale (FLACC Scale). Patients were asked which anaesthesia technique they preferred. Data were analysed using Wilcoxon signed rank, Spearman correlation, and Mann-Whitney U tests. RESULTS: There were no statistically significant differences for pain evalution during needle insertion and injection of each injection system. However, a negative correlation was found on the FLACC between age and pain scores during injection after using DV. CONCLUSION: Paediatric patients experienced similar pain during IANB anaesthesia administered with TS and DV. With increased age, pain values reduced during anaesthetic agent injection with DV according to FLACC. The traditional procedure was preferred to DV in paediatric patients.

Is gynaecological laparoscopic surgery safe for elderly women? A comparison study.

The aim of this study was to evaluate the efficacy and safety of gynaecological laparoscopic surgery in an elderly group, by comparing the operative outcomes of the elderly group with those of the younger group. We analysed retrospective data of 121 women who underwent laparoscopic surgery for benign gynaecological disease. Women aged > 60 years were compared with women aged between 30 and 50 years who had the same operation. We evaluated body mass index, comorbidities, number of previous abdominal surgeries, operating time, haemoglobin change, postoperative complications, hospital stay and return of bowel activity. There were no significant differences between the elderly and a matched younger group in number of previous abdominal surgeries, operating time, ASA score distribution, changes in haemoglobin level, hospital stay and postoperative complications (p > 0.05). Laparoscopic surgery can be safely performed in elderly patients with benign gynaecological disease, and surgeons should not hesitate to perform laparoscopic surgery in elderly patients.

Uterine preservation in placenta percreta complicated by unscarred uterine rupture at second trimester in a patient with repeated molar pregnancies: a case report and brief review of the literature.

Placenta-percreta causing uterine rupture in unscarred uterus is a rare obstetric surgical emergency that can cause maternal and perinatal morbidity and mortality. A 25-year-old woman presented with abdominal pain for four days. Previously, she had undergone two suction curettages for complete hydatiform moles. Ultrasound revealed a non-viable fetus with an estimated gestational age of 21 weeks and free fluid and coagulum in the abdominal cavity. An emergency laparotomy was performed because of the acute abdomen. At exploration, the placenta had invaded the entire thickness of the myometrium and the non-viable fetus was in the abdominal cavity. The uterus was closed with a double-layer of interrupted sutures and uterine-sparing surgery was performed. The patient was discharged on postoperative day seven. The authors present a case of placenta-percreta in an unscarred uterus complicated with uterine rupture during the second-trimester that was managed successfully with uterine repair. They also review the literature briefly and discuss similar cases managed conservatively in the second-trimester.

Groin abscess due to a forgotten midurethral sling connector.

Midurethral slings (MUS) have been used for female stress urinary incontinence throughout the past decade on a worldwide scale. Although this minimally invasive treatment has high success rates, formation of groin abscesses, as well as vaginal and urethral erosions, can occur after the procedure. We report a patient presenting with groin abscess and sinus tract formation after a transobturator tape procedure. The patient exhibited a swollen sinus tract, which drained the abscess at the site of the tape entry to the obturator foramen within her inner left groin. She was referred to our department after unsuccessful medical and surgical treatments. Surgical exploration revealed a forgotten MUS connector located between the mesh and hook within the skin incision. To the best of our knowledge, this is the first report of such a case.

Is laparoscopic surgery safe in patients with an elevated shock index due to ruptured ectopic pregnancy?

PURPOSE: To evaluate the effectiveness of laparoscopic surgery in patients with elevated shock index (SI), which is a unique determinant of acute hemorrhage. MATERIALS AND METHODS: A retrospective chart review of all patients treated for ectopic pregnancy (EP) in the present gynaecology department between January 2007 and March 2011 was performed. For each measurement of heart rate (HR) and systolic blood pressure (SBP), a SI was calculated by dividing HR by SBP (normal, 0.5 - 0.7). RESULTS: One hundred sixty patients were selected as SI above 0.7. There were 111 (69.4%) patients in the laparotomy group and 49 (30.6%) patients in the laparoscopy group. The postoperative hemoglobin (Hb) level was 8.46 +/- 1.56 (g/dl) in the laparotomy group and 9.37 +/- 1.52 (g/dl) in the laparoscopy group, with lower postoperative levels in the laparotomy group. The mean duration of postoperative hospital stay was 2.37 +/- 0.74 days in the laparotomy group and 2 +/- 0.84 days in the laparoscopy group. CONCLUSION: The availability of suitable operative equipment, nursing teams, and advanced laparoscopic skills, all justify operative laparoscopy for the surgical treatment of EP in women with elevated SI.

The reliability of microleakage studies using dog and bovine primary teeth instead of human primary teeth.

AIM: This was to investigate if dental restorations on human, dog and bovine primary teeth are equitable for microleakage analysis, and the respective marginal adaptation deficiency in in vitro conditions. MATERIALS AND METHODS: In order to determine the level of microleakage in Class V poly acid-modified composite restorations of human, dog and bovine primary teeth, samples were evaluated by dye-leakage method in sections of the inner area of the restorations. RESULTS: We found no leakage in 6 out of 10 (60%) human restorations, in 7 out of 10 (70%) of dog and in 7 out of 10 (70%) of bovine teeth. The levels of dye-microleakage were tested with Kruskal-Wallis one-way variant analysis method. The relative leakage differences were not statistically significant among all species (p>0.05). CONCLUSION: We concluded that dog and bovine primary teeth might be suitable for in vitro studies instead of human ones.

Analysis of expression of TNF-alpha and TGF-beta3 in intrinsic ureteropelvic junction obstruction.

OBJECTIVES: Ureteropelvic junction (UPJ) obstruction is of critical importance to understand the histopathology of UPJ obstruction in terms of therapy planning and follow-up. For this purpose, our study was conducted with TNF-α and TGF-ß markers to investigate possible underlying problems in intrinsic UPJ obstruction. METHODS: Of the patients who had undergone surgery in our clinic, 36 UPJ segments of patients who had undergone dismembered pyeloplasty surgery due to UPJ obstruction and 14 UPJ segments of the patients who had undergone nephrectomy were collected to form 2 groups. All histological sections were examined by applying immunohistochemical transforming growth factor beta 3 (TGF-ß3) and tumour necrosis factor alpha (TNF-α) monoclonal antibody dyes. RESULTS: The mean staining values for TNF-α in mucosal tissue and mucosa were 0.53±0.84 and 0.58±0.84, respectively in the obstruction group, whereas the values observed in the control group were 0.86±0.36 and 0.93±0.47, respectively. While the mean staining values in the obstruction group in mucosal tissue and mucosa for TGF-ß3 were 1.75±0.73 and 2.17±0.77, respectively, the values established in the control group were 1.14±0.66 and 1.43±0.93, respectively. The difference between the obstruction and control groups were statistically significant for both values (p<0.05). CONCLUSION: Only a limited number of studies have been carried out on this particular issue. Data from the present study indicate that TGF-ß3 and TNF-α may play a role in the histopathogenesis of UPJ obstruction (Tab. 1, Fig. 1, Ref. 18).

Appropriateness of aspirin use among diabetic patients in primary prevention of atherosclerotic cardiovascular diseases: an analysis of the ASSOS study.

OBJECTIVE: Aspirin is an essential drug in the prevention of atherosclerotic cardiovascular disease (ASCVD). It is ultimately indicated in a patient with ASCVD. However, its role is debated in primary prevention. We aimed to investigate the appropriateness of aspirin use in diabetic patients according to recommendations of recent guidelines. PATIENTS AND METHODS: ASSOS was a multicenter observational study investigating aspirin use in cardiology outpatient clinics. We evaluated aspirin use in diabetic patients in primary prevention from the ASSOS study. We also assessed the appropriate use of aspirin according to the European Society of Cardiology (ESC), American College of Cardiology/American Heart Association (ACC/AHA), American Diabetes Association (ADA), Consensus Statement of Endocrinology, Cardiology, and Nephrology (ENCARNE), and the United States Preventive Services Task Force (USPTF). RESULTS: A total of 5,007 patients of whom 1,537 had type 2 diabetes mellitus (DM) were included in the study. 1,132 of the total participants used aspirin for primary prevention; 313 of them had type 2 DM. Only 248 (76.7%), 132 (40.8%), and 128 (39.6%) diabetic patients indicated aspirin use according to the ESC/INCARNE, ACC/AHA, and ADA/USPTF guidelines, respectively. CONCLUSIONS: Inappropriate aspirin use was common among diabetic patients, according to clinical practice guideline recommendations. In addition, the differences between the indications for the use of aspirin in diabetic patients according to the guidelines were remarkable. Guidelines that minimize these differences are needed for clinicians, and compliance with these guidelines in clinical practice could reduce inappropriate aspirin use.