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Background: In our study, we aimed to compare the efficiency and reliability of using semirigid ureteroscopy (S-URS) and flexible ureteroscopy (F-URS) in the treatment of patients with stones smaller than 2 cm in isolated renal pelvis. Materials and Methods: The data of 45 patients who underwent ureteroscopic stone treatment for isolated renal pelvis stones smaller than 2 cm were evaluated retrospectively. S-URS was routinely applied to all patients. If the stones can be accessed in the renal pelvis with S-URS, direct treatment with holmium laser was applied. If the stone was not accessible, F-URS was made. Groups were compared in terms of stone-free rates, operation times, hemoglobin reduction, and complications. Results: S-URS was performed in 24 (53.3%) patients and F-URS in 21 (46.7%) patients. There was no significant difference between the two groups in terms of age, degree of hydronephrosis, mean stone size and stone side. Mean operation time was 64.62 ± 9.34 minutes in the S-URS group and 96.43 ± 14.26 minutes in the F-URS group (p=0.001). There was no statistically significant difference between the groups in terms of postoperative complications (p = 0.548). In the postoperative 1st day and 1st month follow-up, stone-free rates were 79.2% and 83.3% in the S-URS group, and 80.9% and 85.7% in the F-URS group, respectively (p = 0.768 and p = 0.574). Conclusions: We observed that the use of S-URS and F-URS were very successful and safe methods in kidney stones smaller than 2 cm. S-URS is a safe treatment method that can be applied if the stone in the renal pelvis can be reached without any problem, especially in selected cases. [ABSTRACT FROM AUTHOR]

Background: Our a im i s t o e valuate t he t reatment r esults o f c hildren w ho u nderwent E SWL f or urolithiasis Materials and Methods: Records of children who underwent ESWL between October 2018 and October 2020 were retrospectively reviewed. The patients were divided into two groups according to success and compared in terms of age, gender, stone size, stone location, complications, and additional interventions. Results: Of the 50 cases, 34(68%) were boys and 16(32%) were girls. The mean age was 8.8 ± 5.0 years. 36 of the stones were located in the kidney and 14 were in the proximal ureter. The average stone size was 9.4±1.8 mm in the successful ESWL group and 13.8±3.2 mm in the unsuccessful group (p <0.05). While the success was 90% for stones less than 10 mm, it was found to be 56.7% for stones over 10 mm (p <0.05). T otal success w as 70%. T here w as no significant correlation between age, gender, side and localization of stones and ESWL success (p> 0.05). Conclusion: ESWL is an effective and safe treatment method for children with urolithiasis. Stone size is an important factor affecting success. Especially for stones ≥10 mm, there is a need for studies that will provide the maximum benefit per session and reveal the predictions that can prevent an unsuccessful application. [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: We aimed to evaluate the epidemiological and clinical characteristics, laboratory and imaging findings and outcome of patients with COVID-19 diagnosis who were hospitalized during the first wave of the COVID-19 pandemic. Methods: A total of 124 cases followed with the diagnosis of COVID-19 were evaluated, retrospectively. Patients with SARSCoV- 2 RT-PCR test result positivity in respiratory specimen were accepted as the confirmed cases. Despite of a negative RT-PCR test result, patients having a combination of compatible symptoms and typical findings of viral pneumonia on thorax computed tomography (CT) were accepted as possible cases. Severe illness was defined as SpO2 ≤93% on room air and to need supplemental oxygen support or mechanical ventilation (MV) or extracorporeal membrane oxygenation. Patients achieving clinical improvement were defined by defervescence of fever for 48 hours, improvement of leukopenia and increase in lymphocyte and thrombocyte count, decrease in demand for oxygen support or weaning from MV. Results: The median age of 124 cases was 54 (minimum-maximum 17-98) years and 59.7% of them were male. Among the overall population, 58% had comorbidities. Most frequent was hypertension (33.9%) followed by diabetes mellitus (16.1%) and cardiac disorders (13.7%). Most common clinical complaints were fever 73.4%), cough (70.2%), and shortness of breath (30.7%). SARSCoV- 2 RT-PCR tests of 81 (65.3%) patients were positive. Severe illness was present in 43 (34.6%) patients and 18 of them were followed in the intensive care unit. Patients with severe illness had higher mean ages, more accompanying comorbidities, and prolonged hospitalization compared to the patients with non-severe illness. Among the laboratory findings, leukocytosis was more than leukopenia. In addition to presence of lymphopenia, thrombocytopenia and hypoalbuminemia, increases in levels of creatinine, D-dimer, and acute phase reactants were more prominent in patients with severe illness. Main thorax CT findings were ground glass opacities (93.3%), often bilateral (73%), involving the lower and lower-middle lobes (48.7%) and showing a peripheral distribution (49.6%). No serious side effects developed during the treatment given according to the recommendations of Ministry of Health Guidelines. Overall mortality rate was 3.2%, and 2 (2.2%) patients died were confirmed cases. Conclusions: The sensitivity of available RT-PCR tests is not sufficient for diagnosis and management of COVID-19. Therefore, combining the imaging methods and serum antibody testing are also needed for management of the disease process. [ABSTRACT FROM AUTHOR]

Objectives: Interictal electroencephalography (EEG) is an electrophysiological test used in daily practice and important in the diagnosis and treatment process for epileptic patients. Accurate assessment of the interictal epileptiform discharges (IEDs) and recognition of secondary bilateral synchrony (SBS) are important for the evaluation of appropriate treatment options. In this study, we investigated whether the presence of SBS is a risk factor for seizure frequency, treatment response, and localization. Methods: In this study, the data of 126 patients who were followed up with the diagnosis of epilepsy in the Neurology Outpatient Clinic of Namık Kemal University Education and Research Hospital were analyzed retrospectively. Demographic characteristics, seizure frequency, localization, treatment response and EEG characteristics of the patients were investigated and the results of 122 patients were obtained. Results: Fifty-eight (46%) of the patients were female, and 68 (54%) were male. The mean age was 36.5±16.4 (15-78) years. EEG of 15 patients (12.2%) was reported as SBS. Focal epileptiform abnormality was detected in 54 patients (44.2%) and focal irregular background activity (non-epileptic findings) was found in 12 patients (9.8%). When semiological features and EEG findings were evaluated together, 44 patients (34.9%) were classified as frontal lobe seizures, 66 patients (52.4%) as temporal lobe seizures, 16 patients (12.6%) as the others. Forty-six patients (36.5%) had no seizures, while 15 (11.9%) had one seizure per year, 46 (36.5%) had one seizure in one to six months, and 19 (15.1%) had daily or weekly seizures. Twenty-nine (23%) of the 46 seizure-free patients became seizure-free in an early stage, 17 patients (13.5%) became seizure-free after the sixth month of the treatment. Conclusion: Although the presence of IED and SBS in interictal EEG is not a risk factor for seizure frequency and treatment response, and the rate of SBS is higher in frontal lobe seizures. The presence of IED and SBS in the management of treatment may lead to false results. [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]

Background: This study aimed to compare the effect of vaginal, intramuscular (IM) or combined (vaginal + IM) progesterone preparations initiated under the indication of threatened abortion at early gestational week on serum progesterone levels. Materials and Methods: First-trimester pregnant women who applied to our clinic between December 2018 and December 2019 due to the threatened abortion and who received progesterone were included in the study. The participants were divided into three groups according to whether they received vaginal progesterone, IM progesterone or vaginal + IM progesterone treatment. The serum progesterone levels measured on the 3rd hour and 7th day after the first drug dose of the groups and the rates of serum progesterone reaching the optimal value were compared. Results: Sixty-four patients who received progesterone treatment participated in our study. Twenty-three (35.9%) of these patients were using intramuscular progesterone, 19 (%29.7) were using vaginal progesterone and 22 (34.4%) were using vaginal + intramuscular progesterone. There was no significant difference between the groups in terms of progesterone onset week, age, gravida and parity characteristics. The levels of progesterone at admission of the group using vaginal + IM progesterone were significantly lower than the other groups (p = 0.013). The increased rate of serum progesterone levels in both the 3rd hour and the 7th day of the group using vaginal + IM progesterone was found to be significantly higher compared to the other two groups (vaginal and IM) (p = 0.001, p = 0.006, respectively). Conclusion: There is no definitive treatment for patients with threatened abortion in early gestational weeks, but studies in which progesterone treatment is recommended in recent years are increasing. In this study, it was determined that vaginal + IM combined progesterone preparations increased serum progesterone levels faster. However, our study on the subject is not sufficient and additional studies are needed. [ABSTRACT FROM AUTHOR]

Background: Although many grafting techniques and surgical approaches have been described, repair of tympanic membrane anterior quadrant perforations is technically challenging for otorhinolaryngology specialists. In this study, it was aimed to evaluate the surgical and functional results of endoscopic cartilage tympanoplasty in repair of tympanic membrane anterior quadrant perforations. Materials and Methods: Thirty-four patients who had anterior quadrant tympanic membrane perforation and underwent transcanal endoscopic Type 1 cartilage tympanoplasty between January 1, 2015 and April 30, 2019 were included in the study. The graft success, audiological data and complications of patients were retrospectively analyzed. Patients who had ossicular chain reconstruction, who had cholesteatoma or who did not have regular follow-up and those whose tympanic membrane perforation was not in the anterior quadrant were excluded. Results: Medical records of 34 patients who underwent endoscopic transcanal cartilage tympanoplasty were examined. There were 15 male (44,1%) and 19 female (55,9%) patients. The average age was 35,44 ± 9,84. Fifteen of the patients underwent surgery on the right ear (44.1%) and 19 on the left ear (55,9%). The mean operation time was 31.56 ± 4.04 minutes. Graft success rates were 94,1% in the 3rd postoperative month and 91,2% in the 6th postoperative month. Postoperative air-bone gap values improved statistically significantly compared to preoperative values according to the pure tone audiometry measurements performed at the sixth month after surgery (p<0,001). Conclusion: Endoscopic transcanal Type 1 cartilage tympanoplasty is a minimally invasive, effective and reliable surgical treatment option to repair tympanic membrane anterior perforations. [ABSTRACT FROM AUTHOR]

Objective: Colistin is a concentration-dependent antibiotic which belongs to the polymyxin group of cyclic cationic polypeptide antibiotics. Clinical use of colistin varies due to its complex pharmacokinetic and pharmacodynamic features. In this study, we aimed to evaluate the use of colistin in multidrugresistant Gram-negative bacterial infections. Methods: 193 patients aged ≥18 years who were hospitalized from May 2014 to January 2015 and who received colistin were included in the study. Patient's data were retrospectively evaluated. Pathogens, their resistance rates, dose of colistin, its duration and route of administration, its side effects, and clinical and microbiological responses were recorded. Results: Colistin was administered to the patients with confirmed or suspected infections due to multidrug-resistant Gram-negative organisms approximately on the 20th day of hospital admission. Another antimicrobial was used in combination with colistin administered by IV or intrathecal route in all patients and a carbapenem was the drug most used for combination therapy. IV colistin doses varied widely among patients and a loading dose was not administered in 98% of patients. Inhaled and intrathecal treatment doses were administered in accordance with the literature. Intrathecal colistin administration was always with IV colistin, however inhaled colistin was occasionally administered without IV form. When inhaled colistin alone and combined with IV form were compared, no difference was found in cure rates. The most common side effect of colistin was nephrotoxicity in 33 (25.4%) patients and neurotoxicity in 7 (3.6%) patients. Analyses revealed that advanced age was the only factor which affected the development of nephrotoxicity (p<0.001). Colistin treatment was terminated in 19 patients out of 193 due to side effects. Rate of colistin resistance among infectious agents was 4.3%. Colistin resistance developed on the 19.9±9.4 days of treatment. Cure rate in colistin receiving patients was 56% and the most crucial factor determining the mortality was advanced age (63.9±2) (p=0.001). Conclusions: Nephrotoxicity is the most common side effect of colistin which is one of the treatment options for multidrug-resistant Gramnegative bacterial infections. It has been observed that there were different modes of administration in the same hospital regarding the application of colistin, and the loading dose recommended in the drug package and in the literature was not applied in almost all patients. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to investigate the infections and their clinical outcomes in pregnant women who were hospitalized with a diagnosis of any infectious disease. Methods: Distribution of bacterial and viral infections in 60 pregnant women who were hospitalized due to any infectious disease between years 2015 and 2018 during a three-year period were evaluated retrospectively. Results: Urinary tract infections (65%) and gastroenteritis (8.3%) were the most common bacterial infections, and human immunodefficiency virus (HIV) infection and chickenpox were most common viral infections. All patients were followed at the inpatient clinic except two patients who had hospitalized in intensive care unit due to influenza and Listeria meningitis. An HIV-positive pregnant woman received zidovudin intrapartum and was followed up later. All the other infections recovered without complications. Conclusions: Urinary tract infection was the most common infectious disease among pregnant women. The necessity of hospitalization due to community-acquired but avoidable and vaccine-preventable diseases verified that informing pregnant women about the prevention of infections and screening them before pregnancy against vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]

Objectives: Lacosamide is a third-generation antiepileptic agent that selectively enhances slow inactivation of sodium channels that take part in generation and propagation of action potentials and results in the diminution of neuronal excitability. Because of this new mechanism of action, it is expected to be efficacious in patients with drug-resistant epilepsy. In this study, we aimed to assess the efficacy and tolerability of lacosamide add-on treatment in refractory epilepsy patients by presenting our experience in a tertiary referral center. Methods: Medical records of refractory focal epilepsy patients who were followed in epilepsy outpatient clinic between October 2014 and May 2017 were retrospectively reviewed in this study. Patients who were treated with add-on lacosamide and completed minimum of six months follow-up period were included. ≥50% reduction in seizure frequency was defined as treatment response. Results: In this study, 88 patients were included. The percentage of seizure-free patients after six months follow-up was 4.6% and the treatment response rate was 55.6%. We also evaluated the effect of concomitant use of sodium channel blockers, the presence of abnormal findings on magnetic resonance imaging and the introduction stage of lacosamide. No significant difference was observed in the response rate regarding the mentioned parameters. 19% of the patients reported side effects, the majority of which were dizziness, vertigo and somnolence. None of them discontinued treatment because of side effects. Conclusion: Our findings suggest that lacosamide add-on therapy is effective in refractory focal epilepsy and has an appropriate tolerability and safety profile since none of the patients stopped treatment due to side effects. [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 was to investigate the effects of ear acupuncture and NLP (Neuro Linguistic Programming) applications on weight loss. Methods: This study, planned as a prospective intervention study, was conducted between 15 March and 15 June 2018. A total of 60 patients with excess weight and obesity, who applied to the Acupuncture and Complementary Medicine Methods Application and Research Center of Ataturk University Faculty of Medicine, Family Medicine Department, were included in the study. Two groups of 30 people were formed and NLP was applied to one group and acupuncture was applied to the other group as 12 sessions with 15 days intervals. Results: 70% (n = 42) of the patients were female and 30% (n = 18) were male. The number of female participants was significantly higher in the ear acupuncture group (p <0.005). At the end of the study, mean weight loss in the groups was 7.07 ± 3.85 kg in the acupuncture group and 4.87 ± 2.55 kg in the NLP group (p = 0.016). Conclusions: Our study suggests that ear acupuncture and NLP applications provide the desired level of weight loss in obese patients, however ear acupuncture is a more effective method. [ABSTRACT FROM AUTHOR]

Aim: To demonstrate the demographic data, subgroup distributions, responses to treatment and outcomes of long-term follow-up in patients who were followed up and treated in our clinics with a diagnosis of juvenile idiopathic arthritis, and to compare these data with national and international data. Material and Methods: The files of 116 patients who had been diagnosed as having juvenile idiopathic arthritis, were initiated on treatment and presented for regular follow-up visits between January 2012 and January 2018, were examined. Their demographic findings, treatments, active/inactive disease states (on-medication and off-medication) and treatment response states were evaluated. Results: According to the International League of Associations for Rheumatology criteria, the subtypes were specified as enthesitis-related arthritis (n=38), oligoarticular (n=37), rheumatoid factor (-) polyarticular (n=17), systemic (n=15), rheumatoid factor (+) polyarticular (n=5), and psoriatic juvenile idiopathic arthritis (n=4). In total, the female/male ratio was found to be 1.5. The mean delay time between the first complaint and the diagnosis was found to be 5.7±5.2 months. The patients with systemic type were diagnosed at the earliest, while the patients with polyarticular and enthesitis-related subtypes were diagnosed at the latest. Thirty-two percent of the patients were treated with methotrexate alone, and 38% were given additional biologic drugs. In both treatment groups, the time to achieve inactive disease was the shortest in the oligoarticular group and the longest in the enthesitis-related arthritis group. In the study period, 38 patients were in remission off-medication (the highest rate (53.3%) was observed in the systemic group) and 71 patients were in remission on-medication (the highest rate (70.2%) was observed in the oligoarticular group). Remission was obtained in 94% of the patients. Conclusion: Enthesitis which is the remarkable finding of enthesitis-related arthritis, should not be overlooked in routine physical examination. Awareness of enthesitis can contribute to the prevention of diagnostic delay in children with enthesitis-related arthritis. [ABSTRACT FROM AUTHOR]

Objective: Approximately 10-16% of patients with hepatitis C virus (HCV) infection develop kidney disease and the prevalence of HCV infection in patients with impaired renal function is higher than the general population. HCV-positive patients undergoing hemodialysis (HD) have a higher mortality rate compared to HCV-negative patients, not only because of liver-related complications, but also because this contributes to atherogenesis and chronic inflammation. The purpose of antiviral treatment in chronic HCV infection is to eliminate HCV RNA, to obtain a sustained virologic response (SVR), i.e. negative HCV RNA at the end of the 3-month treatment, and to prevent liver complications. Introduction of direct-acting antivirals (DAAs), for the treatment of HCV infection has provided over 90% SVR in the general population. In this study, we aimed to evaluate the demographic characteristics, laboratory values and treatment results of HCV-infected hemodialysis patients treated with DAA. Methods: In this retrospective, single-center observational study, patients undergoing HD in Istanbul Training and Research Hospital Hemodialysis Unit were evaluated. Anti-HCV-positive patients with HCV RNA >15 IU/ml were divided into 2 groups as patients receiving and not receiving DAA treatment. Age, gender, duration of hemodialysis, laboratory values and treatment protocols were recorded. Results: Of the 289 patients followed in the HD unit, 11.4% (33/289) were anti-HCV-positive and 63.6% (21/33) were male, with a mean age of 50.87±7.18 years and HD treatment was given for 84.58±43.44 months. Only 13 patients were using DAA among 18 patients with HCV RNA >15 IU/ml. Standard dose of paritaprevir/ritonavir-ombitasvir/dasabuvir (PrOD) therapy was applied as the DAA protocol and ribavirin was added to the treatment protocol in HCV genotype 1a. All patients were found to have SVR. The most common side effects were fatigue and loss of appetite, and none of the patients had any side effects requiring discontinuation of the drug. Four of the five patients who did not receive treatment were foreign nationals and their DAA treatments could not be provided by Social Security Institution. Conclusions: In HD patients, detection of HCV infection after its screening, and started treatment protocols with low side effects and high SVR will provide source control of HCV infection and decrease mortality and morbidity related to this infection. [ABSTRACT FROM AUTHOR]

Background: One of the most common causes of trauma related deaths is hemorrhage due to splenic injury. The aim of the study was to compare the effects of hemostatic activities of Ankaferd blood stopper (ABS®), Oxidized Cellulose (Surgicel®) and FloSeal® in rats with experimental splenic injuries. Materials and Methods: In this study we used twenty-four female Wistar Albino rats. Grade 2 spleen laceration was performed on all rats. Rats were randomly divided into four groups each consist of 6 rats, as control, ABS, Surgicel and FloSeal. After performing grade 2 spleen laceration, sponge compression was applied to the control group and hemostatic agents were applied to the other groups. The amount and duration of bleeding and preoperative-postoperative hematocrit (Hct) levels were statistically compared between the groups. Results: The amount and duration of bleeding was at least in the group using FloSeal, followed by ABS, Surgicel and control group, respectively. The amount of bleeding was; 0.27±0.04gr, 0.38±0.08gr, 0.63±0.09gr and 1.0±0.2gr respectively. The duration of bleeding was; 65.66±10.63s, 70.16±8.13s, 214.00±17.98s and 381.83±59.09s respectively. The amount and duration of bleeding was less in all groups using hemostatic agent compared to the control group (p<0.001). In the groups using FloSeal and ABS, the amount and duration of bleeding were significantly lower than Surgicel group (the amount of bleeding was p<0.001 and p=0.011, bleeding time p<0.001 and p<0.001, respectively). Although the amount and duration of bleeding was found at least in the FloSeal group, but this difference was not statistically significant when compared with ABS group (bleeding amount p=0.476, duration p=0.842). Conclusion: In our study, hemostatic agents that can be used in hemorrhage due to splenic laceration were found much more effective in stopping bleeding than the control group. In particularly, it was observed that FloSeal and ABS provide hemostasis and reduce the amount of bleeding more effectively than oxidized cellulose. [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: To evaluate the clinical characteristics, risk factors, and prognosis of pertussis in the pediatric intensive care unit. Material and Methods: Patients who were hospitalized in pediatric intensive care unit between January 2017 and January 2019 and diagnosed as having pertussis were retrospectively evaluated. Samples were taken from tracheal aspirate material in intubated patients and nasopharyngeal swabs in the other patients. Samples for Bordetella pertussis were studied using multiplex real-time polymerase chain reaction. Results: Eighteen patients were admitted to our pediatric intensive care unit with a diagnosis of pertussis. Ten patients were female (55.5%), and all patients were unvaccinated. The median age was 40 (range, 38-47.5) days and the median intensive care unit stay was 9 (range, 5-14) days. All patients had respiratory distress, 14 patients had cough (77.7%), four patients had fever (22.2%), and three patients had convulsions (16.6%). Seven patients were intubated. Three patients died of multiple organ failure and cardiogenic shock despite extracorporeal treatment. Respiratory syncytial virus was found in two patients and rhinovirus was found in one patient. The median leukocyte count was significantly higher in non-survivors than in survivors. Blood exchange was performed in three patients due to hyperleukocytosis. Pulmonary hypertension was the most common cardiac pathology detected in echocardiographic examinations. Conclusion: We found that high leukocyte count, viral co-infection, and severe pulmonary hypertension were associated with mortality and morbidity in pertussis. [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]

Objectives: The aim of this study was to examine the effect of antiepileptic drugs on memory and executive functions in drug-responsive mesial temporal lobe epilepsy with unilateral hippocampal sclerosis (MTLE-HS). Methods: The patients were classified according to the 2017 International League Against Epilepsy classification of seizures. Thirty-four patients with the diagnosis of MTLE-HS and 30 matched controls were enrolled. Patients treated with a maximum 2 anti-epileptic drugs and experiencing no more than 2 instances of focal impaired awareness per month or 2 focal to bilateral tonic-clonic seizures in a year were accepted as drug-responsive. Patients receiving monotherapy (PRM) and polytherapy (PRP) were compared in terms of memory and executive functions. Results: There were 19 (55.8%) monotherapy patients in the group and 15 (44.2%) polytherapy patients. The maximum number of learned words recorded in a verbal memory test, the immediate and delayed recall score, and the logical memory score were all statistically significantly lower in the PRP group compared with the PRM group (p<0.05). The results of the verbal attention test and verbal fluency test were also significantly lower in the PRP group (p<0.01). Conclusion: Significantly greater impairment was observed in several aspects of cognitive function in the PRP group. These results indicate that antiepileptic drugs may have a negative impact on cognition. [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]

Aim: Atherosclerotic peripheral arterial disease is frequently seen with critical leg ischemia. Despite the benefits of pharmacological agents in the lesions, the most effective treatment method is revascularization. In this study, we aimed to compare the results of drug-eluting balloon and standard balloon endovascular treatment methods. Material and Methods: One hundred and ninety-six patients who underwent infrapopliteal revascularization in Cardiovascular Surgery clinic in Namık Kemal University Hospital between January 2015 and June 2017 were included in the study. During the study, 100 patients were treated with drug-eluting balloon (DEB) (Lutonix, Bard, USA), while 96 patients were treated with standard balloon (PTA) (Nanocross, Medtronic, USA). The one-year patency rates were compared between the two groups. The patients were followed up at 1st, 3rd, 6th and 12th months after the procedure and followed by Ankle-Brachial Index (ABI) measurements and Rutherford classification. Results: Eighty three female and 113 male patients were included in the study. The mean age of the patients was 63.56±11.21. The median Rutherford classification was 4 (3-5) in the drug-eluting group according to the Rutherford classification and 4 (3-5) in the naked balloon group. During the 12-month follow-up period, limb salvage rate was 82.0% (n=82) in drug-eluting balloons and this rate was found to be 65.6% (n=63) in naked balloon group. In terms of amputation rates, the drug-eluting balloon group was found to be statistically superior (p=0.009). Conclusion: In this study, 12-month patency rates were found to be superior to naked balloons at 12-month patency rates and clinical follow-up. [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]

Purpose: To evaluate the safety and efficiency of Riboflavin and Ultraviole A (UVA) supported corneal collagen crosslinking treatment (CXL) in the keratoconic eyes. Materials and Methods: One hundred nineteen eyes of 71 patients with progressive keratoconus were included in this prospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, slit lamp examination, corneal topography, contrast sensitivity,central corneal thickness (CCT) with ultrasound pachymeter were evaluated at baseline and at 1,3,6 and 12 months follow-up. Results: The mean age of the patients was 19.4±3.5 years. There was a mean of 1 snellen line improvement in both UDVA and CDVA (P=0.01). No patient lost 2 or more snellen lines of CDVA. At month-12 follow-up, mean manifest refraction spherical equivalent and mean keratometry readings showed a significant decrease of 1.13 and 0.41 diopters (P=0.04). The CCT decreased significantly during the first 3 months (P<0.05). Sight threatening complications were not encountered in any patient eye. Conclusion: Corneal collagen crosslinking seems to be safe and effective in keratoconic eyes. The visual acuity may increase and progression was not encountered during 1 year follow-up. [ABSTRACT FROM AUTHOR]

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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: We presented Salter pelvic osteotomy performed developmental hip dysplasia patients results with preoperative and postoperative avascular necrosis(AVN) grade and evaluated the effect of preoperative AVN on operation results. Materials and Methods: We examined eightteen patients' twenty two hips retrospectively whom open reduction and Salter pelvic osteotomy performed between 2002 and 2008. Clinical and radiological evaluation and AVN grading were done. Preperative and postoperative AVN grades were determined and compared. Results: Twenty two hips (19 girls, 3 boys; mean age 32.8months) were evaluated retrospectively . Mean follow up period was 26.7 months. Clinical results were excellent according to McKay's criteria in 18 hips (81%), good in 4 (18 %) and there were no bad or moderate result. In radiologic evaluation according to Severin's grade, 18 hips (81%) were evaluated as very good or good. The mean acetabular index which was 39,3±5,8 degree preoperatively decreased to 22,7± 5,4 degree postoperatively. There were avascular necrosis in five hips (22 %) preoperatively and in 10 hips (45 %) postoperatively. An increase in avascular necrosis grade or development of new avascular necrosis was seen in 8 (%36) patients postoperatively. Conclusions: Postoperative short term AVN rates are high in late diagnosed developmental hip dysplasia patients whom pelvic osteotomy were performed. Preoperative avascular necrosis grade and grade I avascular necrosis cases should be taken into consideration for more significant and comparable postoperative evaluation. [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: In this study we aimed to compare the final follow-up pelvic radiographic views and computed tomographic views of combined proximal femoral valgus osteotomy and tectoplasty in the treatment of Herring group C Perthes disease with hinge abduction. Methods:This study was carried out in 11 male patients who underwent combined proximal femoral valgus osteotomy and tectoplasty related to Herring group C Perthes disease. The mean follow-up was 5.5 (2.2-9.3) years. The final follow-up pelvic radiographic views and computed tomographic views were compared in terms of femoral head subluxation ratio, femoral head coverage ratio, femoral head size ratio, Sharp angle, center-edge angle, neck-shaft angle, caput index and acetabular depth index. Results: In the comparison of datas obtained from pelvic radiographic views and computed tomographic views, only the caput index values showed significance with a p=0.031. The three diamentional tomographic comparison of the operated hip and non-operated hip in terms of femoral head coverage showed no significance with a p=0.494. Conclusions: The combination of proximal femoral valgus osteotomy and tectoplasty in the treatment of Herring group C Perthes disease provided consistent results with normal anatomy in terms of femoral head coverage. Computed tomography is a useful method in the measurement of caput index which is an important parameter in the assesment of surgical results in Perthes disease. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to evaluate demographic and clinical findings of patients who underwent follow-up at the newly established epilepsy outpatient clinic of the Muğla University Faculty of Medicine. Methods: Included were 208 patients who underwent follow-up at the clinic between March 2014 and September 2015. Results: Mean age was 29.42±15.86, with a range of 5-84 years. Eighty-three patients were men (39.9%); 125 were women (60.1%). The most common risk factors included head trauma, febrile convulsion, and family history of epilepsy. Seizures of 155 patients (75.5%) were partialonset, those of 22 (10.6%) were generalized, and those of 9 (4.3%) were unclassified. Sixty-seven patients (37.2%) had normal electroencephalogram, 96 patients (53.3%) had partial, and 10 patients (5.6%) had generalized epileptiform abnormalities. Of the 172 patients (28.5%) to whom antiepileptic drugs had been administered, 49 were resistant to medical treatment. Of the patients with modified therapy, 22 (41.5%) were seizure-free, 7 (13.2%) experienced >50% reduction in seizure frequency, and 8 experienced <50% reduction. Seizure frequency of 16 patients (30.2%) did not change. Conclusion: Regular monitoring of patients in certain centers significantly increases compliance, success of treatment, seizure-free rate, and the monitoring of side effects. [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: We aimed to compare the effectiveness of holmium YAG laser and pneumatic lithotripsy in the treatment of ureteral stones. Material and methods: A total of 216 patients who had established indications of ureteroscopy between November 2011 and June 2012 were included in this study. Patients' files were retrospectively reviewed by dividing cases as groups that underwent pneumatic (PL) or laser lithotripsy (LL) procedures. Age, sex, stone burden and localization, duration of follow-up, operative times were evaluated. Stone-free rates were evaluated by ureteroscopical examination, postoperative scout films and ultrasonography. Results: Group PL consisted of 109 and group LL of 107 patients. Median age was 43.93±15.94 years in Group PL and 46.15±14.54 years in Group LL. Male to female ratio, stone burden and localization were similar for both groups. Overall success rate was 89.9% in Group PL and 87.9% in Group LL, respectively (p<0.791). With the aid of additional procedures, success rate was 100% for both groups at the end of the first month. Groups were not different as for operative time, rate of insertion of an ureteral catheter and its removal time. Hospitalization period was apparently somewhat shorter in Group LL (p=0.00). Conclusion: Pneumatic lithotripsy can be as efficacious as laser lithotripsy and be used safely in the endoscopic management of ureteral stone. In comparison of both methods, we detected no differences as to operative time, success of operation and the time to removal of the catheter, however, hospitalization period was shorter in Group LL. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery. Material and methods: Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded. Results: The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm² in the PNL, 1.4±0.1 cm² in the RIRS, and 3.1±0.9 cm² in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups. Conclusion: PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity. [ABSTRACT FROM AUTHOR]