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Background and Design: Various lasers, mainly nanosecond Q-switched (QS), and picosecond lasers, have been successfully used to treat solar lentigines. However, picosecond lasers are expensive, and QS lasers have a higher risk of post-inflammatory hyperpigmentation (PIH) in darker skin types. The aim of our study is to examine retrospectively the efficacy and safety of long-pulsed alexandrite laser in the treatment of solar lentigines, compare our findings to previous studies with nano and pico-second lasers, and evaluate long-term outcomes regarding recurrence. Materials and Methods: We retrospectively analyzed 39 patients with a clinical diagnosis of solar lentigo treated by long pulsed alexandrite laser. Patients' photographs and clinical charts were reviewed in terms of demographic features, areas of treatment, number of sessions, laser settings, recurrence of lesions, Fitzpatrick's skin type, and any side effects observed. Results: The rate of improvement was excellent in 33 (84.6%), moderate in 4 (10.3%), and mild in 2 (5.1%) patients. Seven (17.9%) patients with Fitzpatrick's skin type III and IV developed PIH. Lesion recurrence was observed in 5 patients (12.8%). Mean time to recurrence was 57.98±4.45 months. Conclusion: Our study suggests that long pulsed alexandrite laser is an effective and safe option in the treatment of solar lentigines. [ABSTRACT FROM AUTHOR]

Introduction: Acute leukemias are the most common malignancy of childhood, and acute lymphoblastic leukemia (ALL) is the most common subtype. In this study; we aimed to asses to acute endocrine and metabolic complications which occurs during treatment. Newly diagnosed ALL patients were included in the study. Materials and Methods: The endocrine and metabolic complication of 293 patients aged 1-18 years old who were newly diagnosed ALL between January 2007 and December 2017 in Uludağ University Faculty, Department of Pediatric Hematology were analyzed. Patients' age, gender, risk groups, leukemia subtypes, and chemotherapy phases at the time of endocrine complications were noted. Results: In total, 250 patients were follow-up with B-ALL and 43 patients with T-ALL. 64% (n=188) of patients were male and 36% (n=105) were female. In our study, 36.4% of patients were in the high risk group but ten of the patients died before the risk group could be determined. During the two-year treatment, We found that 83% of the patients developed at least one endocrine complication. Hyperglycemia, osteoporosis and avascular necrosis were observed more frequently in patients older than 10 years at the time of diagnosis. The difference between the sexes was found only in vitamin D and was lower in girls. In regression analysis, only to be high risk group were found to be effective for the development of endocrine complications. Conclusion: Although the chemotherapeutics used today have prolonged the survival time, they have caused an increase in the incidence of complications. We think that these complications can be reduced by determining the risk factors in advance. [ABSTRACT FROM AUTHOR]

Introduction: The seizure is one of the most common neurological problems in neonatal intensive care units (NICU). Its frequency and etiology differ between preterm and term babies. This study aimed to investigate the properties, causes, response to treatment, and prognostic factors of neonatal seizures in term and preterm babies. Materials and Methods: The files of patients with a diagnosis of neonatal seizure in the NICU between 01/01/2014 and 01/09/2019 were analyzed retrospectively. Gross motor function classification, hearing test results and epilepsy rates were examined for neurological outcomes. Results: A total of 86 patients (43 preterm and 43 term infants) were included in this study. The most common etiological factors were hypoxic-ischemic encephalopathy (HIE) (35%) in term infants and intraventricular hemorrhage (IVH) in preterm infants (54%). The most common seizure type was subtle seizures in preterm babies and clonic seizures in term babies. The first seizure day was more on the first day and between the 4-7 days in term babies and after seventh days in preterm babies (p <0.05). The onset time of seizures in preterm babies was more after seven days at IVH, and on the first day at HIE (p<0.05). Status epilepticus frequency is higher in preterm (30%) than term (9.3%) (p = 0.015). The response rate to phenobarbital treatment was 71% in term infants and 50% in preterm infants (p = 0.06). According to the criteria (death, epilepsy, hearing loss, autism and gross motor function scale> 2) in our study, the poor prognosis rates were (52%) in term infants and (75%) in preterm infants (p = 0.051). Conclusion: In the etiology of neonatal seizures, IVH in preterm infants and HIE in term infants were the first. The neurological outcomes of patients who had convulsions in the neonatal period should be followed closely. [ABSTRACT FROM AUTHOR]

Objective: Central or mixed apneas may accompany obstructive apneas in patients with Obstructive Sleep Apnea syndrome (OSAS). There is scant evidence about the potential impact of mixed apneas on the therapy modalities. Here, apneas/hypopnoeas' central and/or mixed effects on the positive airway pressure (PAP) modes chosen to be effective in patients with OSAS were evaluated. Materials and Methods: Patients who underwent a whole night polysomnography within last 2 years in our Sleep and Disorders Unit were consecutively examined. The patients included were those diagnosed with OSAS associated with central and/or mixed apneas. To determine the effective PAP modes, a second night polysomnography for titration was performed in these patients. Results: A total of 70 patients were included in the study, wherein 55 (78.6%) were males, with a mean age of 55.4±11.7 years. Continuous mode PAP (CPAP) therapy was effective in 60 patients (85.7%, group 1), whereas other modes (as BPAP-ST/ASV) were needed in 10 patients (14.3%, group 2). No statistically significant difference was found between the two groups in terms of gender, age or comorbid diseases (p=0.314, p=0.193 and p=0.081, respectively). Although BPAP-ST/ASV mode was needed in the presence of central apneas (p=0.039), CPAP mode was effective in OSAS patients with mixed apneas (p=0.055). Conclusion: The results showed that gender, age or comorbid conditions did not play a significant role in the determination of effective PAP mode. Mixed type abnormal respiratory events differed from central apneas/hypopnoeas as they did not require the use of BPAP-ST/ASV mode, and CPAP mode was effective enough in OSAS patients that manifested mixed type abnormal respiratory events. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome is the most common periodic fever syndrome. The aim of this study was to evaluate the clinical and laboratory findings of patients with PFAPA syndrome at the time of the attack and the response to the given treatments. MATERIALS and METHODS: Sixty-three individuals that applied to the pediatric rheumatology policlinic due to recurrent fever and throat infection and diagnosed with PFAPA syndrome were enrolled in this study. Patients' folders were evaluated retrospectively concerning demographic, clinical and laboratory data. RESULTS: Forty-two (66.7%) of the patients were male, 21 (33.3%) were female. The age of onset of complaints was 2.72±1.59 years. The average delay in diagnosis was 1.71 ± 1.28 years. The remarkable finding which was seen all of our patients was the high fever. Lymphadenitis was detected in 59 (93.7%) of the patients and aphthous stomatitis was found in 56 (88.9%) of the patients. As a laboratory finding, leukocytosis, the increase in C-reactive protein and sedimentation was observed in patients. Fever decreased within a mean of 2.24 ± 1.13 hours after steroid treatment. Another remarkable finding after the first steroid treatment was the resolution of exudative tonsillitis 24 hours after the treatment. CONCLUSIONS: Signs and symptoms of PFAPA syndrome are among the most common signs and symptoms in pediatric outpatient clinics. With increased awareness of PFAPA syndrome in clinicians, patients will be prevented from unnecessary laboratory procedures and medical treatments. [ABSTRACT FROM AUTHOR]

Objective: Resistin is an important factor in the pathogenesis of obesity-induced insulin resistance and endothelial dysfunction-mediated cardiovascular system diseases. Endothelial dysfunction is one of the most important causes of erectile dysfunction. Polyphenol resveratrol has several pharmacological functions, such as preventing endothelial dysfunction and inducing endothelium-dependent vascular relaxation via redox regulation and nitric oxide production. The present study tested the hypothesis that resveratrol restores endothelium-mediated responses that are disrupted by resistin. Materials and Methods: After a 24 h incubation period of tissues with resistin, endothelium-dependent and independent relaxation responses and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase level were evaluated in the presence and absence of resveratrol in rabbit corpus cavernosum (CC). Results: Resistin caused no impairment in the endothelium-dependent and -independent relaxation responses. In the presence of resistin, NADPH oxidase levels increased by 28% in the CC tissues. However, the difference was not statistically significant. Resveratrol administration caused a significant decrease in NADPH oxidase activity in the resistin-treated group compared with the resistin-alone group. Conclusion: Resistin caused no changes in the functional responses of CC and NADPH oxidase activity, but resveratrol incubation significantly reduced NADPH oxidase activity in penile tissue. Based on the results of the study, resveratrol may be a treatment target under conditions in which NADPH oxidase activity is increased in penile tissue. In line with the results of this study, the effect of resistin on CC must be investigated at different concentrations and incubation times. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to evaluate and compare the sperm parameters and spontaneous pregnancy rates of patients with varicocele and primary infertility at three and six months after surgery. Materials and Methods: We retrospectively evaluated the sperm parameters of 134 male patients who presented with clinical varicocele and primary infertility between July 2016 and May 2019. All the patients underwent microscopic inguinal varicocelectomy. We compared the sperm parameters (count, movement, and morphology) and spontaneous pregnancy of the patients preoperatively, and at three and six months postoperatively. Results: In total, 134 patients with a mean age of 26.2 (20-38) years underwent the surgery. We found an increase in all the sperm parameters in the third and sixth months postoperatively. We also examined the differences among the sperm parameters in the third month and sixth month, and found a significant increase in the sperm count and motility at six months (p<0.001). The postoperative third-month pregnancy rates were 2.9% (n=4) and 26.8% (n=36) in the sixth month. Conclusion: The improvement in sperm parameters in the third month after varicocele operation continued and increased by the postoperative sixth month. Therefore, patients with varicocele and primary infertility should be aware that the rate of spontaneous pregnancy could increase within six months and should wait for at least that period before applying for assistive reproductive techniques. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate the results of contraction- and relaxation-based biofeedback (BF) in children with lower urinary tract dysfunction (LUTD). Materials and Methods: Between 2007 and 2017, we randomly directed children with the diagnosis of LUTD and refractory to standard urotherapy modifications via BF by using two different animations: animation A with relaxation nature BF (RBF) and animation B with contraction nature BF (CBF). The categories of non-response, partial response, and full response were defined as a 0-49% decrease, 50-99% decrease, and 100% decrease in the LUTD Symptom score, respectively. Results of biofeedback using RBF or CBF were compared. Results: There were 100 and 70 children in the RBF and CBF groups, respectively. Patients with an abnormal voiding pattern (abnormalVP) and a positive electromyography (EMG) activity (positive EMG) had a better resolution with RBF (p=0.001), whereas patients with abnormalVP and a negative EMG activity (negative EMG) had a better resolution with CBF (p=0.039). Despite being statistically insignificant, patients with a normal voiding pattern (normalVP) and positive EMG had a better resolution with CBF (p=0.452), whereas patients with normalVP and negative EMG had a better resolution with RBF (p=0.083). Conclusion: The EMG activity identifies the BF nature in children with LUTD and abnormalVP. Importantly, positive EMG had better results with RBF, whereas negative EMG had better results with CBF. [ABSTRACT FROM AUTHOR]

Objective: To show our retrograde intrarenal surgery (RIRS) experience in anomalous kidney stones and compare its safety and efficiency with normal kidney stones. Materials and Methods: Between 2012 and 2018, patient data was reviewed retrospectively and 1700 procedures were taken into consideration. Forty-seven anomalous kidney stones were included in the study (group A). In these patients, 18 had calyx diverticulum, 12 had horseshoe kidney, 8 had ureteral duplication, 2 had ectopic kidneys, 1 had malrotation, and 1 had bifid pelvis. After making a matched pair analysis, 47 normal kidney stones with similar demographic and stone characteristics were included in our study (group N). Demographic, stone, intraoperative and postoperative data were recorded. We compared these groups regarding efficiency and safety. Results: Average scope time, hospitalization time, and postoperative double J-stent rate were higher in group A. The difference was statistically insignificant (p>0.05). Ureteral access sheath usage was higher in group N, though the difference was statistically insignificant (p=0.63). Stonefree rates and success rates were higher in group N though the difference was not statistically significant (p>0.05). The rate of complications was statistically significantly higher in group A (p=0.02). Conclusion: RIRS can be used in the management of anomalous kidney stones. It is an efficient and safe method. Prospective and larger patient numbered studies are needed. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The aim of this study was to evaluate the clinical and laboratory findings and treatment responses of patients with arthritis. MATERIALS and METHODS: The medical records of 111 children (0-18 years) were evaluated who were hospitalized with the diagnosis of arthritis between January 2010 and January 2019 retrospectively. The aim of this study was to evaluate the clinical and laboratory findings and to investigate the treatment and prognostic features of the patients. RESULTS: A total of 111 patients, 66% were male and the mean age was 91±56 (median 83,1-215) months. The most of the patients (n=62,56%) were between 3-10 years of age. Septic arthritis was diagnosed in 60% (n=67) of the patients. This diagnosis was followed by reactive arthritis (10%), juvenile idiopathic arthritis (10%), toxic/transient synovitis (5%) and other arthritis. On admission, there were pain in 96%, joint swelling in 63%, redness in 21%, increased temperature of the joint in 41%, decreased range of motion in 64%, and inability to walk in 38% of the patients. The most frequently involved joints were knee (51%) and hip (35%). The possibility of septic arthritis was significantly higher in patients with high fever (p=0,0001). The response to ibuprofen was higher in non-septic arthritis (p=0,0001). Arthrocentesis was performed in 55% (n=61) of the cases and 34% (n=38) of the patients had underwent intra-articular debridement surgery. Staphylococcus aureus and Streptococcus pyogenes were the most common microorganisms growth in joint fluid culture. When septic arthritis and other arthritis cases were compared, the effusion amount, the amount of fluid taken by puncture were significantly higher and the level of CRP and leukocytes were higher in septic arthritis group (p=0,001; p=0,025; p=0,018; p=0,032, respectively). Osteomyelitis was observed in 19% (n=21) of the cases. CONCLUSIONS: In this study, the probability of septic arthritis was found to be statistically significant in patients with fever, leukocyte>12100/mm³, CRP>3 mg/dl, and effusion measured 8.5 mm or more by ultrasonography. Also, ibuprofen response was higher in non-septic arthritis group. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to assess the effect of hypnotherapy on sleep quality levels of obesity patients, who applied to hypnotherapy for healthy and balanced nutrition. Materials and Methods: Studying group; consisted of 44 individuals who applied to a state hospital psychiatry outpatient clinic, who voluntarily agreed to participate in the study, who had a Body Mass index of 30 and above, and completed at least 10 weeks of sessions. Firstly, an information form was prepared for the participants and body mass index were determined. Pittsburgh Sleep Quality index was applied to each participant before starting to session. Then, hypnotherapy session was applied to participants for at least 10 weeks, one session per week. After at least 10 sessions of hypnotherapy, Body Mass index and Pittsburgh Sleep Quality index were measured. The efficacy of hypnotherapy was assessed by the comparison of Body Mass index and Pittsburgh Sleep Quality index at the beginning and end of the therapy. Results: Statistically significant differences were detected in the comparison of body mass index and Pittsburgh Sleep Quality index scores before and after the hypnotherapy (p<0.001). There was no significant correlation between the scores of Body Mass index and Pittsburgh Sleep Quality index. Conclusion: This study showed that hypnotherapy in the treatment of obesity has a positive effect on sleep quality in obese patients. There is a need for new studies that will examine the effectiveness of this group by establishing a control group in more people and the long term. [ABSTRACT FROM AUTHOR]

Objective: Clinical studies in childhood multiple sclerosis (MS) are very limited compared with adults. Although first-line injection therapies are well tolerated in this patient group, there are difficulties in the long-term treatment of patients due to the difficulty and adverse effects of injections for children. Oral therapies are better tolerated for use and adverse effects compared with injection therapies. This study aimed to evaluate the clinical features and treatment outcomes of patients aged under 18 years with relapsing-remitting MS (RRMS) who received fingolimod treatment. Materials and Methods: In this study, the clinical records of 22 patients with RRMS who received fingolimod treatment were examined. The patients were prospectively followed up between February 2015 and December 2018. The patients were evaluated in terms of relapse rate, Expanded Disability Status Scale (EDSS) scores, brain and cervical magnetic resonance imaging, and adverse effects before and after fingolimod treatment. Results: The median age of 13 (59%) female and 9 (41%) male patients was 18 (range: 10-21) years. The median fingolimod treatment duration was 2.5 (range: 1.3-3.9) years. The median age of disease onset was 13 (range: 8-17) years. Fifteen patients (68%) received a first-line treatment prior to fingolimod. The reason for switching to fingolimod was inefficacy in 33%, adverse effects in 40%, and both in %27 of patients. In 32% of patients, fingolimod was started as a first-line treatment. A total of three patients had recurrent relapses under treatment with fingolimod. The median annualized relapse rate (ARR) before fingolimod was 1.9 (range: 0.3-8.0), and the ARR with fingolimod was 0 (range: 0-2.0) (Wilcoxon's signed-rank test; p<0.001). The median EDSS was 1.5 (range: 1.0-4.0) before fingolimod, and the EDSS after treatment was 1.5 (range: 1.0 to 5.0) (Wilcoxon's signed rank test; p=0.3). None of the patients had any adverse effects during the first dose monitoring. Conclusion: Our study shows that fingolimod is an effective and safe treatment alternative in childhood MS. [ABSTRACT FROM AUTHOR]

Objective: Patients with drug-resistant focal or generalized epilepsy are important in terms of treatment and polytherapy necessity, adverse effect profiles of drugs, and seizure control difficulties. Clobazam (CLB), which has a lesser sedative effect than other benzodiazepines, is frequently used in different countries. In this study, we aimed to present the results related to the demographic characteristics, adverse effects, and treatment efficacy of patients under CLB treatment. Materials and Methods: Patients who were followed up in the outpatient clinic of Cerrahpaşa Medical Faculty were screened retrospectively. Sex, age of seizure onset, duration of epilepsy, seizure type, duration of drug use, frequency of seizures before and after CLB, and drug adverse effects were investigated. The decrease in seizure frequency could not be quantitatively evaluated in some patients because the study was retrospective. For this reason, two groups were identified as having a significant reduction in seizure frequency and being seizure-free according to the information provided by the parents and the recorded data. Results: Forty-one patients with CLB who were followed in the epilepsy clinic were examined. The mean age of 26 male and 15 female patients was 30.30 years. The mean duration of epilepsy was 20.4 years. It was determined that 16 patients were either seizure-free or had intervening rare, mild seizures. There was a significant decrease in seizure frequency in nine patients. Headache was observed in one patient, and sedation and dizziness in two patients. Conclusion: CLB is especially recommended for add-on therapy in Lennox-Gastaut syndrome. In this study, it was observed that in focal/generalized, idiopathic/ cryptogenic different groups, 39% of the patients were seizure-free. However, this effect was not lost during the mean follow-up period of 12.2 months. Although the value of this data decreases due to its retrospective nature, the place of CLB in the treatment of focal/generalized epilepsy is important. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare the procedure duration and complications of standard percutaneous dilatational tracheostomy (PDT) with PDT via fiberoptic bronchoscopy. Methods: Patients over 18 years of age who were dependent on mechanical ventilation were included in this prospective study. The patients were divided into two groups as PDT (group F n=28) performed by using fiberoptic bronchoscopy and standard PDT (group S, n=30) performed without fiberoptic bronchoscopy. Age, gender, cause of hospitalization, hemogram, blood gas values, duration of tracheostomy and complications during and after the procedure were recorded in all patients. Results: A total of 58 patients were included in the study. Twenty-one (36.2%) patients were female. There was no difference between the two groups in terms of demographic characteristics except age, and laboratory values (p=0.006). The most common cause of hospitalization were respiratory diseases in both groups (28.6% in group F and 40% in group S). There was no difference in the duration of the procedure (6.07±4.72 and 7.50±1.79 minutes in group F and group S, respectively (p=0.12). The most common postoperative complications were minor bleeding (28.5% in group F and 43.3% in group S) and bleeding around the stoma (21.4% in group F and 20% in group S), respectively. None of the patients had pneumothorax, subcutaneous emphysema, major bleeding, or tracheal posterior wall damage. Conclusion: In our study, there was no difference in terms of procedure duration and early complications between patients undergoing PDT with and without bronchoscopy. In the tracheostomy procedure, the method to be used should be decided by considering the patient's condition and the materials available to the practitioner. [ABSTRACT FROM AUTHOR]

Aim: Valganciclovir is the preferred drug for chemoprophylaxis for the prevention of cytomegalovirus (CMV) infection in kidney recipients. Low-dose (450 mg/day) valganciclovir use is gaining popularity because standard dose (900 mg/day) has negative effect on renal function and side effects such as leukopenia. We present our results with low-dose valganciclovir prophylaxis in kidney recipients. Methods: One hundred thirteen kidney transplant recipients who were operated between 1 December 2017 and 1 September 2018 in İstanbul Aydın University Faculty of Medicine, Training and Research Hospital and İstinye University Training and Research Hospital were retrospectively evaluated. Demographic data, preoperative CMV status, incidence of CMV infection and leukopenia rates were recorded. Results: A total of 113 patients (46 women, 67 men) with a mean age of 42.85 years were evaluated. All the recipients and donors were preoperative CMV IgG-positive. The mean follow-up was seven (6-13) months. In this period, only two (1.76%) CMV infection occurred and treated with intravenous ganciclovir. There were no complications due to CMV infection. There was no leukopenia related with valganciclovir. Conclusion: This study showed that low-dose valganciclovir is an effective prophylaxis for CMV infection in kidney transplantation with CMV-positive donors and recipients. We recommend low-dose valganciclovir due to low incidence of CMV infection found in our study. [ABSTRACT FROM AUTHOR]

Aim: To analyze the effect of double-J stent placement on shockwave lithotripsy (SWL) success in the treatment of relatively large (15-25 mm) upper and middle calyceal stones. Methods: A total of 167 patients who had 15-25 mm opaque upper or middle calyceal stones and scheduled for SWL were included in the study. Patients with solitary kidney, urinary system anomalies, skeletal anomalies, previous urologic surgery, severe calyceal dilatation, untreated urinary tract infection, bleeding disorder, eGFR<60 and suspected pregnancy were excluded from the study. The remaining 148 patients were randomized into two groups as stented and non-stented. Thirty-one patients whose stones could not be fragmantated despite three sessions were also excluded. A total of 117 patients (30 stented and 87 non-stented) were further analyzed. The groups were compared in terms of patient- and stone-related factors. Results: Eighty-nine (76%) patients were male and 28 (24%) were female. There was no significant difference between the groups in terms of age, gender, body mass index, stone side, stone size, skin-to-stone distance, Hounsfield unit and renal parenchymal thickness. The success rate was 70% and 51.7% in the stented and non-stented groups, respectively (p=0.31). Conclusion: Prestenting does not affect the success of SWL in the treatment of 15-25 mm upper and middle calyceal stones. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the effects of preoperative aspirin use on postoperative complications, especially risk of bleeding, in patients undergoing bilateral total thyroidectomy. Methods: A total of 201 patients who underwent bilateral total thyroidectomy between 15 August 2016 and 1 February 2019 were included in the study. The patients were divided into two groups: preoperative aspirin group (n=42, 20%) and aspirinnaïve group (n=168, 80%). Parameters, including demographic characteristics, complications and length of hospital stay were compared between the groups. Results: Eight (4.4%) patients in aspirin-naïve group and three (7.1%) in preoperative aspirin group had minor hematoma and ecchymosis not requiring any intervention. There was only one patient in aspirin-naïve group (0.5%) who required surgical intervention due to bleeding in the postoperative period, whereas there were not any in the other study group. Conclusion: The results of this study showed that aspirin had no significant effect on the development of postoperative complications in patients undergoing bilateral total thyroidectomy. However, large-scale prospective and randomized series are warranted for more accurate and precise results. [ABSTRACT FROM AUTHOR]

Aim: Hyperthermic intraperitoneal chemotherapy with cytoreductive surgery has a positive effect on survival in advanced abdominal cancers. We aimed to present our experience with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer patients with peritoneal carcinomatosis and a review of the literature. Methods: Ten patients (seven male, three female) who were diagnosed with gastric cancer between June 2017 and November 2018 were included in the study. Data on demographic characteristics, short-term follow-up results, surgical findings, peritoneal carcinomatosis index score, completeness of cytoreduction score, and morbidity and mortality rates were retrospectively analyzed. Results: The mean age of the patients was 60.3 years. The mean follow-up period was six months (1-15 months). One patient developed an anastomotic leak. In the other nine cases, there was no morbidity leading to mortality. Conclusion: While gastric cancer with peritoneal carcinomatos has a poor survival, less than six months with non-operative approach, treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy offers better outcomes and overall survival. Our first results in our study with a limited number of patients are satisfactory and multicentric randomized studies are needed on this subject. [ABSTRACT FROM AUTHOR]

Background and Design: Rosacea is a skin disease characterized by erythema, telangiectasia, inflammatory papulopustular eruption and flashing, preferentially affecting the convexities of the face. Among the various treatment options, 595 nm pulsed dye laser (PDL) has been reported to be a good option to treat the erythematotelengiectatic subtype of the disease. Rosacea affects the quality of life negatively, and can cause and clinical findings in patients. The aim of this study was to investigate the effect of PDL on the quality of life in patients with erythematotelengiectatic rosacea. Materials and Methods: Twenty three patients with erythematotelengiectatic rosacea who were treated with three sessions of PDL were asked to complete the Rosacea Investigator Global Assessment scale and Dermatology Life Quality Index (DLQI) questionnaires before and after treatments. Results: The mean pre-treatment DLQI score of the patients was 16.1±0.44, and the mean DLQI score of the patients was 4.3±0.01 after the third treatment. PDL had positive effects on six subcategories of the DLQI. When the patients were asked about the improvement of their disease, there was no significant difference between the first and second PDL applications. However, there was a significant difference between the second and third post-treatment scores. Laser therapy has revolutionized the treatment of erythematotelengiectatic rosacea according to other treatment modalities, and PDL shows a positive effect on the DLQI in patients with erythematotelengiectatic rosacea. Conclusion: PDL is a safe and effective treatment option in erythematotelangiectatic rosacea. It also helps to improve the quality of life in patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the efficacy and safety of trabeculectomy performed with mitomycin C (MMC) at a concentration of 0.2 mg/mL for 3 minutes in glaucoma patients with high risk of surgical failure. Methods: Forty-seven eyes of 45 patients (30 male, 15 female) undergoing glaucoma filtration surgery using MMC were retrospectively reviewed. All patients who had chronic closed angle, neovascular, aphakic, pseudophakic, pseudoexfoliation glaucoma and glaucoma after keratoplasty had a high risk of surgical failure. During standard trabeculectomy, triangular sponges impregnated with MMC at a concentration of 0.2 mg/mL were applied to tenon and episcleral space in sub-conjunctival regions and under the scleral flap for 3 minutes. Postoperative IOP, appearance of filtration bleb, anterior chamber depth, leakage detected with Seidel test and other complications were recorded. The patients were evaluated on the 1st day, 1st week, 1st month, 3rd month, 6th month and 12th month. Results: The mean preoperative IOP values of patients with a mean age of 64.5 (7-83 years) were 31.6 mmHg (17-60 mmHg). Mean postoperative IOP values of patients were 15.08 mmHg at 1st week, 15.32 mmHg at 1st month, 15.57 mmHg at 3rd month, 16.42 mmHg at 6 months, 16.28 mmHg at 12 months, and 16.87 mmHg at the last follow-up. Conclusion: For eyes with high risk of surgical failure, trabeculectomy performed with MMC at low dose and optimal time is an effective and reliable method with high success rate. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the differences between shear wave elastography findings responders and non-responders in the follow-up of breast cancer patients receiving neoadjuvant chemotherapy (NAC). Materials and Methods: Between September 2015 and August 2018, 47 patients were evaluated retrospectively. The patients were measured by tru-cut biopsy before and after the diagnosis and at the end of the treatment with shear wave elastography (SWE). Measurements were taken from the hardest part of the mass and from the environment normal parenchyma. In addition, the ratio of the mass and parenchyma to each other (R) was recorded. Patients were followed up in the interim period. Results: The SWE value of the mass was higher in the patients who responded to NAC, whereas the SWE value decreased after the treatment (p=0.00). In patients without response, SWE values of the mass did not decrease significantly at the end of NAC. After the NAC, parenchymal SWE values were found to be increased in all patients. In patients without response, SWE values of the masses were significantly higher than those in patients with no response (p=0.029). When the values at the end of NAC treatment were examined, the patients with unresponsive response had higher SWE values than the patients with response (respectively; p=0.05, p=0.02). Conclusion: There is a statistically significant relationship between the response of NAC to breast tumors and the SWE values measured before and after treatment. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to evaluate the clinical and radiological results of surgically treated pediatric medial humeral epicondyle fractures which were fixed with screw or K wire. Materials and Methods: The study was designed retrospectively. Twenty two patients were evaluated clinically and radiologically. Functional outcomes were assessed with the Mayo elbow performance index (MEPI) and the Turkish language version of the shortened version of the Disabilities of Arm, Shoulder, and Hand (Quick DASH) scale. Results: All fractures were healed. The mean MEPI was 99.3 points (range, 85-100), with 21 patients as excellent and 1 good results. The mean MEPI was 100 points for patient who was fixed with K wires (group A). Excellent results were obtained for all patients. The mean MEPI was 97.9 points (range, 85-100) for patients with screw fixation (group B). Excellent results were obtained for all patients, except one. The mean Quick DASH score was 0.63 (range, 0-9). It was found 0.33 (range 0-5) and 1.3 (range, 0-9) for group A and group B, respectively. Two (13%) minor complications were developed in group A and 4 (57.3%) in group B. The difference for Quick DASH and MEPI scores were statistically insignificant (p>0.05). Conclusion: Both of fixations with K wire or screw provide enough stability until the fracture healed. Fracture union could be obtained for both fixation type and the clinical and radiological results were similar. The need for secondary operation for implant removal and higher complication rates seems the negative side of screw fixation. [ABSTRACT FROM AUTHOR]

Objective: To describe the causes of intubation in patients who have been diagnosed with middle cerebral artery (MCA) infarction requiring mechanical ventilation (MV) by evaluating the clinical and radiologic features in the neurological intensive care unit (NICU). Materials and Methods: The patients with MCA infarction who required MV in the NICU were evaluated retrospectively. All patients' age, sex, risk factors of stroke, lesion topography, etiology and treatment of stroke, cause of intubation, percentage of extubation, death/discharge status were recorded. Results: It is found that between June 1st, 2009, and December 31st, 2015, 91 patients with stroke with MCA infarction were mechanically ventilated in the NICU. Fifty patients were intubated with neurologic causes and 40 patients needed intubation due to cardiopulmonary problems. One patient was treated in the NICU after surgery for a diaphragmatic hernia. Conclusion: The patients with MCA infarction who are followed up on a mechanical ventilator have poor prognosis. This group of patients constitutes elderly individuals who are at risk for vascular and organ failure. Their follow-up must be conducted in NICUs. [ABSTRACT FROM AUTHOR]

Background and Design: Striae gravidarum (SG) has been reported to be associated with various factors, but the role of complementary therapies in the prevention of SG is still not well understood. The aim of this study was to determine complementary therapies for prevention of SG. Materials and Methods: This descriptive research was conducted on 120 pregnant women in a maternity clinic at a university hospital. Of 120 women, 49 were going through the last trimester and 71 were going through their first postpartum 24 hours. Data were collected using a 25-item-questionnaire through face-to-face interviews between June and July in 2016. Obtained data were evaluated by using descriptive statistics, chi-square test and the Kruskal-Wallis test. Results: 90.8% of women had SG. For the prevention of SG, 46.7% of women used massage, a manipulative body-based complementary therapy, 55.2% used oils, 28.6% used creams and 8.0% used a mixture of creams and oils for massaging. 42.9% of women started to use complementary therapies in their first trimester. Half of the women stated that they had received information about complementary therapies. A significantly lower rate of women using massage had SG compared to those not using massage (p=0.023). Conclusion: It was concluded that nearly half of the women used massage for the prevention of SG. In addition, massage application was found to reduce the occurrence of SG [ABSTRACT FROM AUTHOR]

Background and Design: Vitiligo is a chronic skin disease. To reduce side effects associated with current treatment modalities, new treatment methods are required. Microphototherapy was introduced to treat vitiligo patients with a limited number of lesions (lesions affecting <10% of the body surface area). Materials and Methods: Our study has aimed to evaluate the efficacy of microphototherapy in vitiligo patients with localized lesions. In this unblinded and prospective study, patients were treated thrice weekly for at least 50 sessions using an MedLight CupCUBE Grimed® microphototherapy device which emits ultraviolet B spectrum with a starting dose of 150 mJ/cm² for 5 seconds and with increments of 30 mj/cm², 1 second at each session. At the end of the 50th session, 50% reduction in Vitiligo Area Scoring Index (VASI) score was accepted as the required minimum response. Results: Thirty-three lesions from 14 patients were treated. Treatment outcome was evaluated based on the VASI. Between 0th and 50th sessions, the mean VASI score in 33 lesions decreased from 2.25 to 1.79 showing 20.4% decline (p<0.05). Twenty-one of 33 lesions exhibited decrease in VASI scores at the end of the 50th session although only 11 of these 21 lesions reached the target of VASI 50% while the remaining 10 lesions did not reach the target. As a result, 11 lesions (33.3%) reached VASI 50% while the remaining 22 lesions (66.7%) did not reach the target. Conclusion: The efficacy of the MedLight CupCUBE Grimed® microphototherapy device was poor with these starting doses, durations and increments for the treatment of patients with vitiligo who had localized lesions. Trying topical therapies initially, calculating minimal erythema dose and, thus, measuring the beginning ultraviolet doses and durations as a way to decrease the number of in-hospital sessions are feasible rather than applying this technique as the first option or alone in vitiligo patients with non-segmental and localized lesions. [ABSTRACT FROM AUTHOR]

Aim:Our aim in this study was to evaluate the surgical treatment of hyperhidrosis versus oxybutynin medical treatment comparing the response and long-term complications. Methods: We evaluated medical and surgical treatment results of 56 palmar and axillary hyperhidrosis patients (29 female, 27 male). Patients mean age was 26.6±6.3 (minimum: 18 - maximum: 48) years old. Sympathetic ganglion ligation was performed in patients treated with surgery.In patients we used medical treatment, oxibutinin treatment was started at 2.5 mg/day and the doses of the drug were increased according to the treatment response. The quality of life index implemented by Amir was adapted into Turkish and used for evaluating life quality of the patients in the study. Results: Postoperative the quality of life scores of palmar hyperhidrosis patients were found to be higher in T3-T4 levels than in T2-T3-T4 levels (p=0.015). In patients with axillary hyperhidrosis, there was no difference between T2-T3-T4 and T4-T5 level surgical operations (p>0.05). The average the quality of life score of patients who received medical treatment was 28.54±5.74. There was no significant difference in the quality of life scores between patients treated with surgery and medical therapy with oxybutynin. Conclusion: We assume that the response rates to oxybutynin are as favorable as surgery in the treatment of hyperhidrosis. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to investigate safety and effectiveness of titanium elastic nailing (TEN) in paediatric tibia shaft fractures caused by high-energy pedestrian versus motor vehicle accidents. Material and Methods: We conducted a retrospective review for children with unstable tibial shaft fractures treated with TEN caused by pedestrian versus motor vehicle accidents between June 2010 and December 2012. Eleven patients were included in study. Six patients (54.5%) were boys and five patients (45.5%) were girls. The mean age of the patients was 7.4 years (3-12). Five patients (45.5%) had closed and six patients (54.5%) had open fractures according to Gustilo-Anderson classification. At the follow-ups, patients were evaluated clinically and radiologically. Also, we investigated tibial torsion deformity by using MRI in our patients at last follow-up. Results: In all patients were obtained complete bone healing radiologically and clinically. In our patients, the average angulation was 1.5 degrees (0-3.9) on the coronal plane and the average angulation was 2.6 degrees (0-8.4) on the sagittal plane at the last follow-up. In four patients (36.4%) were found more than 10 mm the tibial length discrepancy. Also, we encountered more than 10 degrees the external tibial torsion deformity in three patients. Conclusion: TEN is a safe and effective treatment options in the high-energy pediatric open or closed tibia shaft fractures caused by pedestrian versus motor vehicle accidents. It should be kept in mind that these fractures also might develop in the tibial torsional deformity. [ABSTRACT FROM AUTHOR]

Background and Design: Oral lichenoid lesions (OLL) are contact stomatitis characterized by white reticular or erosive patches, plaque-like lesions that are clinically and histopathologically indistinguishable from oral lichen planus (OLP). Amalgam dental fillings and dental restoration materials are among the etiologic agents. In the present study, it was aimed to evaluate the standard and dental series patch tests in patients with OLL in comparison to a control group and evaluate our results. Materials and Methods: Thirty-three patients with OLL or OLP and 30 healthy control subjects, who had at least one dental restoration material and/or dental filling, were included in the study. Both groups received standard series and dental patch test and the results were evaluated simultaneously. Results: The most frequent allergens in the dental series patch test in the patient group were palladium chloride (n=4; 12.12%) and benzoyl peroxide (n=2, 6.06%). Of the 33 patients with OLL; 8 had positive reaction to allergents in the standard patch test series and 8 had positive reaction in the dental patch test series. There was no significant difference in the rate of patch test reaction to the dental and standard series between the groups. Ten patients were advised to have the dental restoration material removed according to the results of the patch tests. The lesions improved in three patients [removal of all amalgam dental fillings (n=1), replacement of all amalgam dental fillings with an alternative filling material (n=1) and replacement of the dental prosthesis (n=1)] following the removal or replacement of the dental restoration material. Conclusion: Dental patch test should be performed in patients with OLL and dental restoration material. Dental filling and/or prosthesis should be removed/replaced if there is a reaction against a dental restoration material-related allergen. [ABSTRACT FROM AUTHOR]

Background and Design: Classic Kaposi's sarkoma (CKS) is a rare disease, generally seen across Mediterranean and the Middle East region. It's an angioproliferative disorder associated with human herpes virus-8 infection. There is a few data on epidemiology and clinical characteristics among Turkish patients with CKS. This study aims to evaluate epidemiologic, clinical characteristics and treatment results in patients with the diagnosis of CKS in Zonguldak. Materials and Methods: We retrospectively evaluated the hospital records of patients with CKS who attended the dermatological and venereal diseases department between 2003 and 2014. Seventy-four patients were included in this study. Demographic and clinical characteristics, applied treatments and responses to treatments were evaluated. Results: During the eleven year examination period, 74 CKS patients have been diagnosed in the dermatology clinic. The prevalence of CKS among dermatologic patients was found to be 0.02%. Patient age at diagnosis ranged from 33 to 90 years (mean: 70.2±11.7). Fifty-two patients were male (70.3%) and 22 patients were female (29.7%). Multiple nodules were the most frequently seen clinical forms and the distal lower extremity was the most common site of involvement (80.6%). According to the CKS staging system, it was observed that 47 patients (62.7%) were at stage 1, 11 patients (15.49%) at stage 2, eight patients (10.7%) at stage 3, and six patients (8%) were at stage 4. Treatment options were excision for 35.1% of patients (n=26), radiotherapy for 25.7% of patients (n=19), cryosurgery for 14.9% of patients (n=11), and chemotherapy for 10.8% of patients (n=8). Relapse was found to occur most commonly after excision (58.3%). Conclusion: Larger, multicenter studies are needed in order to determine the prevalence of CKS and characteristics of patients with CKS in our country. [ABSTRACT FROM AUTHOR]

Background and Design: Pemphigus vulgaris (PV) is a severe, chronic, potentially life-threatening autoimmune blistering disease that affects the skin and mucous membranes, associated with the loss of cell-cell adhesion and blister formation. Systemic steroids in combination with immunosuppressive agents are the mainstay of therapy in pemphigus. Rituximab, a chimeric monoclonal anti-CD20 antibody, has been tried increasingly for the treatment of PV. Materials and Methods: We sought to test the efficacy and safety of rituximab as an adjuvant therapy by retrospective analysis of clinical and immunological data of patients. We performed a retrospective analysis of 13 patients with refractory pemphigus vulgaris who were treated with rituximab at Akdeniz University Hospital, Clinic of Dermatology and Venereology, Bullous Disease Unit. We evaluated clinical and immunological data with last treatments. Results: The patients were treated with one cycle of two biweekly infusions of rituximab at a dose of 1000 mg on days 1 and 15, except one received four doses of 375 mg/m2 weekly. The mean follow-up time was 18.5 months. All patients had a decrease in antibody titers or antibodies were completely undetected after treatment. Rituximab use resulted in a significant reduction in steroid dosage during follow-up. At the end of the follow-up period, 7 patients achieved complete disease remission without therapy, 1 patient achieved partial disease remission without therapy, 2 patients achieved complete remission on minimal therapy, 1 patient achieved complete remission on therapy, 1 patient achieved partial remission on minimal therapy, and one patient was lost to follow-up. Rituximab was well tolerated by all patients. Clinical relapse was seen in 7 patients (53.8%) in the mean period of 13.8 months. Relapses have been managed with additional infusions of rituximab. Conclusion: Rituximab is beneficial in the management of refractory PV, induces prolonged clinical remission and has a steroid-sparing effect. (Turkderm 2015; 49: 117-24) [ABSTRACT FROM AUTHOR]

Background and Design: Despite the development of effective systemic treatments and new biological agents for psoriasis nowadays, topical medications are still the mainstay of treatment. Topical calcineurin inhibitors are currently used in various skin diseases. We investigated the efficacy and safety of tacrolimus, which is an alternative in topical treatment, in comparison with the present medications in plaque psoriasis. Materials and Methods: This prospective double-blind placebo-controlled study was conducted in 24 patients with the diagnosis of plaque psoriasis who were seen in Uludağ University Hospital dermatology outpatient clinic. 0.1% tacrolimus ointment, 0.1% mometasone furoate ointment, 0.005% calcipotriol ointment and placebo in encrypted bottles were randomly applied under occlusion to 27 psoriatic plaques in test chambers, every other day, for a period of 19 days. Clinic sum scores, side effects, and epidermal thickness measured by superficial ultrasound were noted before and after treatment in all microplaques. Besides, histopathologic scoring and epidermal thickness were measured in 9 patients at the end of the study. Results: The clinic sum scores and ultrasonographic epidermal thickness at the end were both significantly lower than the beginning values in all microplaques (p<0.05). The reduction in these two values with tacrolimus were significantly higher than that with placebo (p<0.001), but no difference was observed with calcipotriol (p=0.287, p=0.813, respectively). On the other hand, the reduction in these values with mometasone was significantly higher than with tacrolimus (p<0.05). Mometasone furoate was the most effective when the three ointments were compared with placebo in terms of total histopathological score and epidermal thickness. Conclusion: Tacrolimus ointment applied under occlusion is an alternative topical medication in the treatment of plaque psoriasis. Occlusion in practice requires patient compliance. Thus, studies to find a new formulation that will increase absorption of drug from thick psoriatic plaques are needed. (Turkderm 2015; 49: 107-11) [ABSTRACT FROM AUTHOR]

Objective: Rheumatoid Arthritis (RA) is a chronic destructive inflammatory disorder. This study is aimed to investigate the effects of balneotherapy and aquatherapy in the treatment of RA patients. Materials and Methods: A total of 59 patients who fulfilled the American College of Rheumatology diagnostic criteria for RA were included this study. Patients were randomly assigned into three groups. Group 1 (n=20) received balneotherapy, group 2 (n=20) received an aquatic exercise program and group 3 (n=19) was accepted as control group. These programs were applied five times a week, over three weeks (15 sessions). Patients were evaluated for clinical and laboratory parameters. Clinical parameters included pain,duration of morning stiffness, number of swollen and tender joints, disease activity score (DAS28), Modified health assessment questionnaire (mHAQ), physician's and patient's global assessment and hand grip strength. Laboratory evaluation included erythrocyte sedimentation rate(ESR) and C-reactive protein (CRP). The assessment parameters were measured before, at the end of and after 3 months of the therapy. Results: The mean age of the patients was 54±10.7 (25-75) years and the mean disease duration was 122.3±98.1 (1-424) months. In aquatic exercise group we observed an improvement in DAS28 scores (p<0.001), in the number of tender joints (p<0.005), in VAS scores (p<0.005), mHAQ (p<0.05), physician's and patient's global assessments (p<0.05). Also there was a statistically significant decrease in ESR results in aquatherapy group compared to other groups (p<0.05). However no statistically significant difference was obtained between three groups (p>0.05). Conclusion: This study shows that aquatic exercise program is beneficial in the management of DAS28, pain, HAQ parameters and should be taken in to consideration in planning exercise therapy for RA patients. [ABSTRACT FROM AUTHOR]

Background and Design: Er: YAG lasers are precise ablation systems used in the treatment benign epidermal and dermal skin lesions. In this study, we retrospectively analysed the efficiency of Er: YAG laser therapy in the treatment of benign epidermal and dermal skin lesions. Materials and Methods: We retrospectively investigated the medical records of 116 patients treated with Er: YAG laser in our clinic between April 2011 and April 2013. The clinical data of 103 patients (47 men, 56 women) with xanthelasma, solar lentigo, epidermal nevus, seborrheic keratosis, nevus of ota, syringoma, cafe au lait macules (CALM) or other than these were included in the study. Treatment parameters, demographic features of the patients, and before and after photos of the lesions were investigated from patients’ records in order to evaluate the efficiency of Er: YAG laser therapy. Results: The patients included in the study were evaluated in 8 groups: xanthelasma (n=21), syringoma (n=17), solar lentigo (n=16), epidermal nevus (n=11), seborrheic keratosis (n=9), nevus of ota (n=5), CALM (n=3) and other than these (n=21). In the Er: YAG laser treatment, the average energy flow was 3-7 J/cm2, the average pulse duration was 300 ms, the average number of passes was 3-5 repeats, and the average pulse frequency was 3-7 Hz. While no improvement was observed in 4.9% of patients, 59.2% of subjects showed marked improvement, 26.2% showed moderate and 9.7% of patients showed mild improvement. Treatment responses in xanthelasma, syringoma, epidermal nevus, solar lentigo and CALM lesions were statistically significant. The observed side effects were hyperpigmentation in 4 patients, hypopigmentation in 3 patients, hypertrophic scar in 2 patients and persistent erythema in one patient. The treatment was well tolerated by all the subjects. Conclusion: Er: YAG laser is an effective and safe treatment option in the treatment of benign skin lesions especially in epidermal lesions. [ABSTRACT FROM AUTHOR]

Background and Design: Intense Pulsed Light (IPL) is a light system of 500-1200 nm wavelength which is used for hair removal and nonablative skin resurfacing as well as for the treatment of hyperpigmentation and superficial vascular lesions. The mechanism of action is thought to be the focal epidermal coagulation due to selective photothermolysis in the epidermal keratinocytes and melanocytes. A variety of laser systems can be used in the treatment of solar lentigo. The aim of this study was to investigate the effectiveness of IPL in solar lentigo. Materials and Methods: We retrospectively reviewed the medical records of patients with the diagnosis of solar lentigo in our Cosmetology Unit from March 2007 to November 2010. There were 139 files of patients who received clinical and dermoscopic diagnosis of solar lentigo and treated by IPL (L900 A&M). Informed consent was taken from all patients. Among them, 42 patients, who had attended regular follow-up visits and had pictures taken both before and after treatment, were included in the study. Results: A total of 52 lesions in 42 female and 1 male patients were included in the study. The mean age of the patients was 42±9.6 (33-88) years. Thirty-seven lesions (51.9%) were on the cheek, 7 lesions (13.5%) were on the zygoma, 6 lesions (11.5%) were on the chin, 4 lesions (7.7%) were on the hands, 4 lesions (7.7%) were on the forehead, 2 lesions (3.8%) were on the nose, and 2 lesions (3.8%) were on the forearm. The mean number of sessions was 3.28, ranging between 1 and 7. After treatment, more than 75% improvement was observed in 57.7% of the lesions, 50-75% in 17.3% of the lesions, 25-50% in 17.3% of the lesions, and less than 25% improvement was obtained in 7.7% of the lesions. Conclusion: According to the results of our work, IPL can be considered to be an effective, cheap and safe method in terms of its side effects in the treatment of solar lentigo. [ABSTRACT FROM AUTHOR]

Background and Design: Ultraviolet (UV) radiation can affect dermoscopic features of melanocytic nevi by inducing melanin synthesis or melanocyte proliferation. Despite widespread use of UV radiation in the treatment of several skin diseases, there have been only a few studies on its effects on the dermoscopic features of melanocytic nevi. The present study was designed to determine the effects of narrowband UVB, UVA1 and psoralen and UVA (PUVA) treatments on dermoscopic features of melanocytic nevi. Material and Method: A total of 55 patients, who were referred to our phototherapy unit for the treatment of various skin disorders, were enrolled in this prospective study. Twenty-one patients underwent narrowband UVB, 18 patients underwent UVA1 and 16 patients underwent PUVA treatment. Dermoscopic images of 233 nevi in narrowband UVB group, 233 nevi in UVA1 group and 229 nevi in PUVA group were evaluated for the alterations in dermoscopic structures at the end of three months. Total dermoscopic scores (TDSs) of melanocytic nevi were calculated according to the ABCD rule. Results: There was no statistically significant increase in the size of melanocytic nevi in the therapy groups. Narrowband UVB, UVA1, and PUVA resulted in statistically significant changes in the dermoscopic structures of melanocytic nevi. In narrowband UVB therapy group, de novo dot formation was documented (p=0.002). Only in narrowband UVB group, de novo dot formation was observed. There was no statistically significant change in the mean TDS. Conclusion: Narrowband UVB, UVA1 and PUVA therapies have significant effects on dermoscopic features of melanocytic nevi. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of artificial tears on corneal higher order aberrations in dry eye patients. Materials and Methods: 30 right eyes of 30 newly diagnosed dry eye patients were evaluated in this prospective study. After routine ophthalmological examination, Schirmer test and tear break-up time (TBUT) test were performed in all patients. Anterior corneal aberrations were derived from conversion of the corneal elevation profile into corneal wavefront data with 6.0 mm pupil diameter using Zernike polynomails by corneal topography before and 5 minutes after instillation of artificial tear (Eyestil®). Corneal optical aberrations were compared before and after instillation of eyedrop. Results: The study included 17 women and 13 men; the average age of the patients was 44.36±13.22 years. Mean TBUT was 4.78±2.78 seconds and mean Schirmer value was 3.58±2.45 mm/5 minutes. After instillation of artificial tear, significant reductions in corneal total aberration from 1.120±0.35 μm to 0.960±0.34 μm, higher order aberration from 0.674±0.26 μm to 0.464±0.18 μm, coma-like aberration from 0.283±0.10 μm to 0.238±0.09 μm, and spherical-like aberration from 0.254±0.11 μm to 0.221±0.08 μm were detected (all, p<0.001). After eyedrop instillation, statistically significant increment was observed in Strehl ratio (p<0.001). Conclusion: As well as reducing the dry eye symptoms, artificial tears also cause increment in optical quality of the eye. Benefits of artificial tears on visual quality can be evaluated objectively via corneal wavefront aberrations. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the indications and outcomes of amniotic membrane transplantation (AMT). Materials and Methods: A total of 87 eyes who underwent amnion membrane transplantation in our clinic between February 2010 and April 2013 were included in this study. Mean follow-up period was 7.49±7.84 months (range 1-29 months). Amnion membrane defrosted at room temperature and washed three times with saline covered all over the cornea independent of the position and size of the lesion and was sutured to the peripheral cornea circumferentially by 10/0 monofilament suture. At the end of the operation, therapeutic contact lens was placed. All cases were evaluated with respect to duration of surface epithelial healing, visual acuity, presence of recurrence, and infection. Results: Forty-six of the 87 patients (52.8%) were men and 41 (47.1%) were women. The mean age was 57.02±19.74 years (range 31-89 years) in men and 66.69±16.56 years (range 8-88 years) in women. The indications were: ulcers in 27 eyes, keratitis in 24 eyes, topical anesthetic abuse in 10 eyes, bullous keratopathy in 7 eyes, conjunctival mass in 7 eyes, symblepharon in 3 eyes, chemical burns in 3 eyes, pterygium in 2 eyes, endophthalmitis in 2 eyes, dellen in 1 eye, and conjunctival laceration in 1 eye. After AMT, 12 patients required second AMT, and 2 cases required third AMT. 2 eyes were eviscerated, 1 eye was exenterated. At the final follow-up visit, except for patients who underwent evisceration and exenteration, improved visual acuity was observed in 45 of the 84 eyes (53.5%). The average of healing time was between 4 and 6 weeks. No infectious, inflammatory, immunologic, or toxic/allergic reactions related to AMT was observed. Conclusion: Amniotic membrane transplantation is a safe and effective technique in ocular surface diseases. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the indications, intra- and post-operative complications, and visual results of combined cataract surgery and pars plana vitrectomy. Materials and Methods: Medical records of patients who underwent combined surgery between January 2008 and January 2011 were retrospectively evaluated. Indications for surgery, complications, pre-operative and post-operative visual acuities were recorded. Results: Sixty-four eyes of 64 patients were included in the study. Thirty-fve (55%) of the patients were men and 29 (45%) were women; mean age was 53±21 (6-88) years. Mean follow-up time was 13±12 (1-51) months. The main indications for combined surgery were intravitreal hemorrhage in 19 patients (29.7%), epiretinal membrane in 12 (18.8%), intraocular foreign body in 11 (17.2%), retinal detachment in 9 (14.1%), and macular edema in 7 (11%) patients. Posterior capsule rupture in 3 cases and corneal edema in 2 cases were the complications encountered during surgery. Postoperatively, hypotonia occurred in 5 cases and corneal edema in 1. Intraocular pressure elevation was observed in 1 silicon-injected case and 1 propane gas-injected case. The average preoperative visual acuity was 1.90±1.9 (0.22 to 3.10) LogMAR. The average postoperative visual acuity at the last visit was 1.1±1.0 (0.00 to 4.00) LogMAR. The visual acuity increase was statistically signifcant (p<0.001). Conclusion: Combined surgery is a feasible option for patients with vitreoretinal diseases and cataract. Visual results and complications depend primarily on the underlying posterior segment pathology. [ABSTRACT FROM AUTHOR]

Objectives: To compare the outcomes of external dacryocystorhinostomy (DCR) and transcanalicular multidiode dacryocystorhinostomy (TC-DCR) operations in our clinic. Materials and Methods: This retrospective study included patients diagnosed with acquired nasolacrimal duct obstruction. The results of external DCR surgery performed in 15 eyes of 15 patients were compared with the results in 15 eyes of 13 patients who underwent TC-DCR surgery. The patients with external DCR were followed for an average of 9.7±3.2 months, and the cases that underwent TK-DSR were followed for an average of 8.3±2.9 months. Results: The surgical success rate was 53.3% in patients with TK-DCR, while it reached 87% in cases with external DCR. Mean operative time was 50.0±2.5 minutes in external DCR group and 30.0±2.0 minutes in TK-DCR group. There was no significant complication during operations in both groups. Conclusion: In dacryostenosis surgery, external DCR is the golden standard with high success rates. Even though success rate of TCDSR is less than that of external DSR, no need of skin incision, less damage to the lacrimal pump system, less bleeding, and a shorter duration of the operation are the main advantages of this method. [ABSTRACT FROM AUTHOR]

Purpose: To present our results of limbal conjunctival autograft technique (LCAT) for recurrent pterygium which developed after different surgical techniques for primary pterygium. Material and Method: Cases, who underwent LCAT for the treatment of recurrent pterygium, were evaluated. The cases were divided into three groups based on the primary surgery performed. Recurrent pterygium developed after bare sclera technique in group 1, LCAT in group 2, and amniotic membrane graft technique in group 3. Corneal epithelization, recurrence rate, and postoperative complications were compared among groups. Results: Forty-two eyes of 42 patients were evaluated. Nineteen eyes of 19 patients formed group 1, 11 eyes of 11 patients - group 2, and 12 eyes of 12 patients - group 3. Mean age (years) was 45.38±12.22 (24-72) in group 1, 46.81±13.41 (25-73) in group 2, and 44.83±11.92 (27-66) in group 3. Follow-up (months) was 19.38±6.03 (9-32) in group 1, 21.37±7.41 (11-34) in group 2, and 20.93±7.26 (10-34) in group 3. Postoperative corneal epithelization was completed after 5.62±1.74 (2-7) days in group 1, 4.33±0.91 (2-7) days in group 2, and 4.79±1.39 (2-7) days in group 3 (p=0.035). Recurrence was detected in 4 eyes in group 1 (21%), 3 eyes in group 2 (27%), and 3 eyes in group 3 (25%) (p=0.092). Postoperative complications were not observed in neither of the groups. Discussion: LCAT seems to be an efficient treatment for recurrent pterygium with high success and low recurrence rates regardless of the primary surgery. Low recurrence rates in LCAT may be due to the limbal stem cells transplanted with conjunctival autograft to pterygium excision area. Early corneal epithelization in recurrences following LCOT may be an indication of the maintenance to a certain degree of activities of the limbal stem cells transplanted in the primary surgery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of amniotic membrane transplantation (AMT) in the treatment of corneal ulcers resulting from herpetic keratitis (HK) and bacterial keratitis (BK). Material and Method: Forty-six patients (25 HK, 21 BK) treated with AMT for HK or BK-related corneal ulcers between January 2009 and September 2011 were followed prospectively. The visual acuities and ulcer characteristics (depth and localization) prior to AMT and epithelialization time, as well as final visual acuities after AMT, were evaluated. Results: The mean age was 51.9±17.0 years in HK and 53.3±22.0 years in BK and the mean follow-up time was 12.6±6.1 (5-33) months and 10.2±6.8 (3-27) months, respectively. The ulcers were mostly central in HK (72%) and paracentral in BK (52.4%) (p=0.03). Ulcer depth was deeper than 1/2 of the cornea in 14 (56%) HK and in 7 (33.3%) BK (p=0.290). Eight HK patients had scars from previous herpetic keratitis episodes. The mean epithelialization time was 22.3±8.5 (12-50) days in HK and 22.1±10.9 (8-45) days in BK (p=0.488). While epithelialization was achieved in all the patients with BK, 3 HK patients needed adjunctive surgeries (conjunctival flap, tectonic penetrating keratoplasty) in spite of three AMTs. Although visual acuities improved significantly in both groups, this improvement was more evident in BK cases (p=0.018 for HK and p<0.001 for BK). Discussion: Amniotic membrane transplantation is an effective and safe treatment for bacterial and herpetic corneal ulcers. The reason for the lower final visual acuities in the herpetic group was thought to be related to a more central location, deeper involvement and scars due to previous attacks [ABSTRACT FROM AUTHOR]

Purpose: To compare pain response of patients undergoing panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) using 532 nm standard laser versus multispot pattern scan laser and to evaluate the relationship between pain response and patient characteristics. Material and Method: Thirty-five patients had PRP with the Pascal system in a single session, while other 35 patients had PRP with conventional laser in 2 sessions. Parameters used in conventional laser were as follows: spot size 200 μm, exposure time 0.2 s, and power sufficient to produce visible grey-white burns. We used same spot size, 20-30 ms exposure time, and higher levels of laser power in order to get a similar endpoint in the Pascal system. The patients were required to evaluate the severity of pain on a visual analog scale (VAS) and verbally 5 minutes after PRP with Pascal and 5 minutes after the first session of PRP with conventional laser. The relationship between pain experienced and patient characteristics was evaluated. Results: At baseline, both groups did not differ significantly (p >0.05, for all) with respect to sex, age, duration of diabetes, most recent HbA1c, treatment regimen, or patient experience. The patients in the Pascal group had a mean pain score of 0.55±0.70 on verbal scale and 1.54±1.22 on VAS compared to 2.17±1.18 and 5.54±3.28, respectively in the conventional laser group which was, statistically, significantly different in both scales (p<0.05). Discussion: Our study confirms that new generation pattern scanning photocoagulators satisfactorily decrease the pain by shortening the exposure time while increasing the laser power. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of 23-gauge (23G) pars plana vitrectomy (PPV) in dislocated intraocular lens (IOL) cases: In early- and late-term follow-up. Material and Method: In this retrospective study, the medical records of 17 patients who underwent 23 G PPV treatment for dislocated IOL between January 2009 and June 2011 were analyzed. Detailed ophthalmologic examination was performed in all patients; intraoperative and postoperative complications were recorded. Results: In this study, mean follow-up time was 9.0 (4-22) months and mean age was 60.8 (8-82) years. Mean time after cataract surgery was variable (mean of 28.3 (0-80) months). Four patients had trauma history, five patients had pseudoexfoliation syndrome, and two patients had pathologic myopia. Dislocated IOL was placed into the sulcus in nine patients (52.9%). In two cases (11.7%), the IOLs were removed, and the patients were left aphakic. In two cases out of other 6 (11.7%), the dislocated IOL was changed with scleral fixation lens, whereas in the other four cases (23.5%), IOL was changed with iris claw lens. One patient (5.8%) remained at the same level of vision, while twelve (70.5%) cases increased two or more lines in BCVA. The vision was decreased in two cases. Intraocular pressure elevation controlled by medication was observed in one case. For two days, hypotony was observed in one patient. Discussion: 23 G PPV technique is an effective and safe method for removing and repositioning of dislocated IOL in the vitreous. [ABSTRACT FROM AUTHOR]

Background and Design: Although gingival hyperpigmentation is not a medical problem, people who have moderate or severe gingival pigmentation, particularly patients having a gummy smile, frequently request cosmetic treatment. For gingival depigmentation, different treatment modalities have been reported such as surgical treatment, cryotherapy, electrosurgery, and laser therapy. Materials and Methods: Twenty-one patients with gingival melanin pigmentation were included in the study. We applied liquid nitrogen to the hyperpigmented area for 5-10 seconds using open spray technique with a cryogun. Clinical observations for intensity of pigmentation were recorded at baseline and 3 months after the treatment. Clinical parameters, such as bleeding, swelling, redness, and healing, were evaluated immediately after the cryotherapy and 24 hours, and 1 week after the treatment. We used a numeric pain scale to evaluate the pain level. Results: Three months after the treatment, the mean gingival melanin pigmentation score decreased from 41.62±16.58 to 19.28±11.85. The difference between pretreatment and posttreatment mean scores was found to be statistically significant.Discussion: Removal of gingival melanin pigmentation can be performed safely by open spray cryotherapy in dermatology clinics. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the intraoperative complications and postoperative visual outcomes of phacoemulsification surgery for the secondary cataract in vitrectomized eyes. Material and Method: We retrospectively evaluated 51 previously vitrectomized eyes of 51 patients who had undergone phacoemulsification and intraocular lens (PHACO+IOL) implantation surgery. PHACO+IOL surgery was performed in our clinic between October 2008 and May 2011. Intraoperative complications and postoperative best-corrected visual acuity (BCVA) outcomes were analyzed. Results: In this study, 31 out of 51 eyes had posterior subcapsular cataract. Cataract surgery was performed after a mean of 21.39±26.4 (6- 120, median 10.75) months following PPV. Mean preoperative and postoperative BCVA was measured to be 1.52±0.88 logMAR and 0.74±0.73 logMAR, respectively. In 25 eyes which had been filled with silicon oil, mean BCVA was 1.95±0.91 logMAR preoperatively and 1.15±0.84 logMAR postoperatively. In 18 (35.3%) eyes which had been filled with sulfur hexafluoride tamponade, mean BCVA was 1.17±0.47 logMAR preoperatively and 0.38±3.6 logMAR postoperatively. Peroperative zonular dialysis with instable deep anterior chamber occurred in two eyes, and posterior capsular tear occurred in one eye. Four eyes had Nd:YAG capsulotomy due to the posterior capsular opacity during the follow-up period. Discussion: Despite the well-known difficulties encountered in vitrectomized eyes such as zonular weakness, increased mobility of the lens-iris diaphragm, posterior capsular instability and posterior capsular plaques, phacoemulsification in vitrectomized eyes proved to be a safe surgery, and increase in visual acuity can be achieved. [ABSTRACT FROM AUTHOR]

Background and Design: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Oral antibiotics and topical retinoids are effective in the treatment of acne. Materials and Methods: In this study, 60 patients with moderate acne vulgaris were evaluated; the patients were randomized into two equal groups. The groups were matched with respect to age, gender and clinical severity of acne. The patients in group 1 received oral azithromycin (500 mg daily on 3 consecutive days per week) and the patients in group 2 received doxycycline (100 mg daily) for 12 weeks. Topical adapalene gel was added to the systemic treatment in both groups. Clinical evaluation was performed at baseline and at the end of first, second and third months. Side effects were recorded. Quality of life in patients was measured with Skindex-29 and Acne Quality of Life Scale before treatment and at the end of third month. Results: At the end of the treatment, the patients in the two treatment groups had clinical improvement of more than 50%. Twenty-one patients in the azithromycin-adapalene group and 23 patients in the doxycycline-adapelene group had more than 80% clinical improvement. There was not any statistically significant difference in the clinical efficacy between the two combinations. Both treatment regimens were safe with minimal side effects. There was statistically significant difference in Skindex-29 and Acne Quality of Life Scale scores at baseline and at the end of the treatment (p< 0.05). There was not any statistically significant difference in the mean scale scores of both quality life scales between the two groups (p>0.05). Conclusion: Both treatments were efficient and safe. There was significant improvement in quality of life scale scores in both groups. [ABSTRACT FROM AUTHOR]

Aim: Minerals and trace elements affect bone formation and resorption through direct or indirect effects on bone cells or bone mineral. Strontium has several effects on bone cells and anabolic activity. Materials and Methods: The effects of strontium ranelate on pain and bone mineral density were assessed in an open, noncontrolled trial conducted in postmenopausal women. Oral strontium ranelate was given at a daily dose of 2 g for six months in 31 patients. All women received calcium and vitamin D supplements. Measurements of bone mineral density were performed before treatment and at the sixth month. Blood biochemistry analysis was performed at the beginning and at the 6th month. Results: Pain (visual analog scala) score was 6.12±1.05 at baseline and 4.25±0.92 at sixth month of treatment. Pain decreased significantly at 6th month (p<0.05). New fractures did not occur during the study. Strontium renalate treatment increased bone mineral density at 6th month at the total lumbar spine and the femoral total region. The changes were found to be statistically significant (p<0.05). There were no serious adverse events. None of the patients discontinued treatment due to adverse effects. The blood biochemistry was normal at baseline and end of the trial. Global efficacy was good in 64.5% of patients at sixth month. Tolerability was excellent during the study (80.6%). Conclusion: Treatment of postmenopausal osteoporosis with strontium ranelate can decrease pain, and increase bone mineral density beginning at six months following treatment. The results have to be considered as preliminary, the study was planned for a longer duration on a greater number of patients. (Turkish Journal of Osteoporosis 2012;18: 53-7) [ABSTRACT FROM AUTHOR]

Background and Design: There are numerous therapeutic methods for hair removal with various success rates. The aim of this study was to evaluate the efficacy of Intense Pulse Light (IPL) method for hair removal. Materials and Methods: Ninety patients, who applied for their unwanted hair, were included in the study. IPL was applied to the face, neck, axillary areas, bikini line, sternal area, periareolar areas, and upper and lower extremities. An IPL device (L900 A&M, France) was used for hair removal. The results were evaluated according to the clinical improvement (0-25%, 25-50%, 50-75%, 75% and more) and patients' satisfaction (very satisfied, satisfied, less satisfied, not satisfied). All results were analyzed using Chi-square test and statistical analysis was performed by SPSS 15.0 for Windows. Results: There were eighty-eight female (97.8%) and two male (2.2%) patients. The mean age of the patients was 33.62±11.11 (15-55) years. 13.3% of patients had polycystic ovary syndrome. The mean number of treatments was 6.5 (min-max= 2-11). 53.2% of patients had 50-75% clinical response and 53.2% of patients were satisfied. There were no side effects except mild erythema. Conclusion: We observed that IPL for hair removal was safe and moderately effective in our patients. (Turkderm 2012; 46: 94-7) [ABSTRACT FROM AUTHOR]

Background and Design: In this study, we aimed to evaluate the effects of a formula composed of millet extract, wheat germ oil, calcium pantothenate and L-cystine in women with diffuse alopecia by using Digital Phototrichogram (Trichoscan). Materials and methods: We evaluated female patients who presented to Gazi University Faculty of Medicine Department of Dermatology between January 2008 and November 2008 with the complaint of diffuse hair loss. Digital phototrichogram was performed in the frontal and occipital regions of the patients. Using this method, anagen:telogen ratios were determined. 53 female patients whose ages were between 18 and 50 and who were diagnosed as having telogen effluvium type diffuse alopecia were included in the study. The patients were given a capsule containing 140 mg millet extract, 271 mg wheat germ oil, 2 mg L-cystine and 10 mg calcium pantothenate three times a day for three months. The criteria for assessing the efficacy of the therapy included number of hair loss per day, hair pull test and digital phototrichogram. Results: The reduction of daily average hair loss after the treatment was statistically significant. Statistically significant difference was found between the pre- and post-treatment results of the hair pull test. Before the treatment, the average anagen ratio was determined to be 69.0±11.2 in the frontal region, and 72.3±9.4 in the occipital region. After the treatment, the anagen ratio increased to 76.4±11.2 in the frontal region and to 79.9±8.6 in the occipital region. The increase in the anagen hair rate in the frontal and occipital regions after the treatment was found to be statistically significant. Conclusion: As a result, it was found that the formula composed of millet extract, wheat germ oil, L-cystine and calcium pantothenate may be effective in the treatment of telogen effluvium. However, controlled studies including larger groups of diffuse alopecia patients and placebo groups are needed. (Turkderm 2012; 46: 78-83) [ABSTRACT FROM AUTHOR]