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Objective: The study aimed to evaluate the clinical effects of levofloxacin (LEVO) and moxifloxacin (MOXI) prophylaxis during the treatment of acute myeloid leukemia (AML). Methods: This study had a prospective observational design and included AML patients who were scheduled for standard remission-induction (RI) or consolidation (C) chemotherapy. Prophylactic LEVO or MOXI was started at a ratio of 1:1 when neutropenia developed, and two groups were created. The primary endpoint was the frequency of febrile neutropenia (FN) and the time to FN. Results: 120 patients (60 patients in each group) were enrolled in the study. The frequency of FN tended to be higher in the LEVO group but was statistically insignificant (82.1% vs. 75.5%; p=0.702). The time to FN was 10.8±5.7 days and 10.1±5.7 days in the LEVO and MOXI groups, respectively (p=0.393). Microorganisms were izolated in 50.8% of patients who developed FN. The documented infection and bacteremia rate tended to be higher in the MOXI group (71.1% vs. 56.6%; p=0.331 and 87.5% vs. 80.5%; p=0.906). The rates of quinolone resistance were 69.2% and 75% in the LEVO and MOXI groups, respectively (p=0.451). The frequency of FN was higher during the RI phase than the C phase (89.1% vs. 70%; p=0.010). The frequency of documented infection was higher during the C phase than during the RI phase (77.1% vs. 49.1%; p=0.008). Conclusion: This study showed that prophylactic MOXI and LEVO have similar efficacy in AML patients. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis is the most common nonobstetric cause of acute abdomen in pregnant women. In this study, we aimed to evaluate pregnant patients who were operated on for acute appendicitis in our center, which has a large pregnant population, in the light of the literature. Materials and Methods: The data of patients operated on for acute appendicitis between November 2015 and August 2022 were retrospectively examined and recorded electronically. The patients' complaints, physical examination findings, radiological data, operation type, and pathological data were recorded and examined in the light of the literature. Results: The average age of 37 patients who underwent appendectomy was 27.7 (20-42) years. In these patients, acute appendicitis was diagnosed most frequently in the 2nd trimester (48.6%). The most common presenting complaint of the patients was abdominal pain, and the most common physical examination finding was abdominal tenderness. Considering the admission time of the patients, it was observed that a delay of more than 24 hours increased the risk of perforation. Although the most common histopathological finding was acute appendicitis, malignancy was detected in one patient and enterobius vermicularis was detected in another. Conclusions: Acute appendicitis should be kept in mind in patients with new-onset right lower quadrant abdominal pain during pregnancy. Because delay in diagnosis and therefore surgery causes serious morbidity and mortality for both the fetus and the mother. [ABSTRACT FROM AUTHOR]

Objective: There is not a definitive virological treatment for chronic hepatitis B . Withdrawal of nucleos(t)ide analogue (NA) therapy frequently results in viral recurrence, necessitating lifetime treatment. We aimed to look into the results of discontinuation of nucleos(t)ide analogue therapy in HBeAg negative patients. Methods: Treatment of HBeAg-negative patients without cirrhosis who had suppressed HBV DNA for a mean of ≥7 years and underwent nucleos(t)ide analogue therapy for a mean of ≥7 years were stopped according to the EASL guideline stopping rule. Standard laboratory tests, such as HBV DNA viral load, HBsAg, alanine aminotransferase, and adverse events, were monitored for more than four years during therapy and afterwards. Results: HBsAg loss was not observed in any of the patients during the four-year follow-up period. After the first 12 weeks, HBV-DNA was detected in all patients whose nucleos(t)ide analogue treatment was discontinued. The percentage of patients with HBV DNA >2000 IU/mL was 70% at 6 months, 74% at 12 months, 78% at 24 months, and 79.7% at 36 months, HBV DNA >2000 IU/mL was not detected in remaining patients over a four-year period. In the first year, 26% (n=18) of patients were started treatment for relapse, 46% (n=32) in the second year, 49% (n=34) in the third year, and 55% (n=38) in the fourth year. 45% (n=31) of the patients were still being followed without treatment at the end of the fourth year. Conclusion: Although the follow-up of hepatitis B e antigen-negative CHB patients on NA therapy was longer than in the literature, our recurrence rates were similar to other studies, and no patient lost HBsAg. The most significant benefit was that we were able to follow half of the patients without therapy for more than four years, eliminating the need for the patients to use drugs. [ABSTRACT FROM AUTHOR]

Objective: Urinary tract infections are the most common bacterial infections among community-acquired infections in all age groups. In this study, we aimed to evaluate the distribution of Escherichia coli and Klebsiella spp. in community-acquired urinary tract infections by years and the resistance rates to trimethoprim-sulfamethoxazole (TMP-SXT) and ciprofloxacin antibiotics, which are used as the first choice in community-acquired urinary tract infections. Methods: All urine culture samples from all age groups admitted to the medical microbiology laboratory from outpatient clinics and emergency services between January 2011 and August 2021 were retrospectively analyzed. Samples with E. coli and Klebsiella spp. detected as causative agents in urine cultures were included in the study. Conventional methods and automated systems were used to identify bacteria and for antibiotic susceptibility tests. Results: E. coli (n=50 430) and Klebsiella spp. (n=7763) isolated from urine cultures between January 2011 and August 2021 were evaluated. The lowest and highest resistance rates for ciprofloxacin and TMP-SXT for E. coli were 25-40% and 35-51%, respectively. Ciprofloxacin and TMP-SXT resistance rates for Klebsiella spp. were the lowest and highest at 17-43% and 31-43%, respectively. Conclusion: Knowing the resistance rates of antibiotics used as the first choice against common agents such as E. coli and Klebsiella spp. in treating community-acquired urinary tract infections may guide the empirical antimicrobial therapy. [ABSTRACT FROM AUTHOR]

Background: Cutaneous leishmaniasis (CL) is a skin disease caused by protozoan parasites belonging to the Leishmania genus. The most commonly preferred treatment option for CL treatment is pentavalent antimony compounds. The aim of this study is to investigate the clinical characteristics and treatment responses of patients diagnosed with CL treated with systemic antimony. Materials and Methods: This retrospective study included 52 patients diagnosed with CL and treated with systemic antimony in our skin and venereal diseases clinic between May 2018 and May 2020. The clinical and demographic characteristics recorded in the patients' files were examined. Systemic antimony (intramuscular meglumine antimonate (IM MA)) was administered Results: 30 (57.7%) of the patients in our study w ere female a nd 22 (42.3%) were male. The average age of the patients was 26.5±14.23 years. Lesions were most frequently located in the facial region, and noduloulcerative type lesions were most frequently seen. The diagnosis of CL was made by observing amastigotes in the cutaneous smear in 48 (92.3%) patients and in the histopathological examination of the lesioned skin in 4 (7.7%) patients. When the patients receiving IM MA treatment were evaluated at the 12th week in terms of treatment response, complete clinical recovery of the lesions was observed in 50 (96.1%) patients and partial clinical improvement was observed in 2 (3.9%) patients. Conclusions: As a result, the data in our study were similar to the clinical and demographic data on CL previously published in our country. [ABSTRACT FROM AUTHOR]

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]

Background: The aim of our study is to compare laparoscopic and abdominal myomectomies performed in our clinic and to evaluate the feasibility and safety of laparoscopic myomectomies. Materials and Methods: In this study, we retrospectively evaluated 314 cases who were threated with myomectomy operation in our clinic between 2012-2022. All of the cases were divided into two groups with respect to the surgical procedure performed. 314 patients were in the abdominal myomectomy group, 47 patients were in the laparoscopic myomectomy group and the groups were compared. Results: There was no statistically significant difference between the groups in terms of demographic data (p>0.05). When the groups were evaluated in terms of postoperative white blood cell(WBC), hemoglobin, hematocrit, platelet values, operation time, hospitalisation time, postoperative blood transfusion and perioperative complications, no statistically significant difference was observed (p>0.05). There were no statistically significant difference in terms of preoperative WBC and CRP values between the groups, but postoperative WBC and CRP values were lower in the laparoscopic myomectomy group (p<0.05). Conclusions: Laparoscopic myomectomy has a short recovery time and aesthetic advantage. However, equipment and the need of experienced surgeons limit its applicability. With the development of laparoscopic technologies and increasing the experience of surgeons with laparoscopic surgery, it will provide a serious advantage over the abdominal method in terms of less blood loss, less hospital stay, shorter operation times, less trauma and better cosmetic results. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to compare the perioperative outcomes and complications of Olympus and Karl Storz bipolar transurethral bladder resection in the treatment of bladder tumors in non-invasive bladder cancer patients. Materials and Methods: After obtaining approval from the Ethics Committee (Decision No. 2023/5-17), all patients who underwent transurethral bladder tumor resection using Olympus and Karl Storz bipolar systems between January 01, 2019 and February 28, 2023 were evaluated. The demographic data of the patients, transfusion requirement, tumor size, and perioperative complications were compared. Results: It was observed that out of the 75 patients included in the study, 45 were operated on with Olympus, and 30 were operated on with Karl Storz. In the Olympus group, the change in hemoglobin (hgb) was found to be 1.11±0.61 gr/dl, while in the Karl Storz group, it was 1.35±0.82 gr/dl, and no statistically significant difference was observed (p= 0.180). Tumor size was 3.20±1.55 cm in the Olympus group and 4.20±2.79 cm in the Karl Storz group. Similarly, no statistically significant differences were found between the two groups in terms of obturator reflex, presence of bladder perforation, blood transfusion, and postoperative clot retention. Conclusions: The use of both bipolar systems' technology is safe and effective in the transurethral resection of non-invasive bladder cancer. [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]

Background: Gonadotropin-releasing hormone (GnRH) analogues have been widely used in the treatment of patients with central precocious puberty (CPP) for many years. In previous studies regarding the effects of GnRH analogues therapy on body mass index (BMI), conflicting results have been obtained. In this study, it was aimed to evaluate the effects of GnRH analogues therapy on BMI in girls diagnosed with CPP. Materials and Methods: In the study, a total of 145 female patients, who were treated and followed up due to CPP between September 2016 and June 2021, were included. In the retrospective review of medical records of the patients, age at admission, height, weight, BMI and standard deviation scores (SDS), bone age, Tanner stage, serum follicle-stimulating hormone (FSH) levels, luteinizing hormone (LH) levels, estradiol (E2) levels and the peak LH level in the GnRH stimulation test in the beginning and after the first year of treatment were evaluated. Results: The mean age of 145 patients with central precocious puberty in the beginning of treatment was 7.27±0.97 years, and the mean bone age was 9.12±1.10 years. At the beginning of treatment, 118 (81.38%) of the patients were at a normal weight or underweight, and 27 (18.62%) patients were overweight or obese. In terms of stages of puberty, 109 (75.17%) of the patients were Tanner stage 2, 30 (20.69%) patients were Tanner stage 3, and 6 (4.14%) patients were Tanner stage 4. While the mean BMI-SDS of all patients was 0.11±0.99 before the treatment, it increased significantly (p<0.001) by the end of the first year of treatment and was found as 0.35 ± 0.95. While the mean BMI-SDS of patients who were at a normal weight or underweight was -0.21± 0.78 before the treatment, it was found as 0.09±0.84 after the treatment (p < 0.001). The initial BMI-SDS of overweight or obese patients was 1.53±0.40, and it was found as 1.48±0.49 after the treatment (p=0.412). Conclusions: cious puberty increased the BMI-SDS in patients who were at a normal weight or underweight, but it did not cause any change in patients who were overweight or obese. [ABSTRACT FROM AUTHOR]

Background: It was aimed to evaluate the oncological outcomes in patients with primary Ta, high grade pathology, to determine possible risk factors for recurrence, and to show the effect of secondary TUR (re-TUR) on oncological outcomes. Materials and Methods: Data of patients who underwent TUR-BT in our clinic between January 2000 and December 2020 were retrospectively analyzed. Patients with pTa, high grade or G3 urothelial carcinoma were included. The demographic and histopathological data, development of relapse and progression and their duration time were scanned. The patients were divided into two groups, those with and without recurrence, and those with re-TUR or not. Comparison of categorical variables was done with Pearson chi-square test and Fisher's Exact test. In quantitative data, Student's t-test was used for normally distributed variables and Mann-Whitney U test was used for others. Type I error probability was accepted as α = 0.05 for all tests. Kaplan-Meier survival curves with 95% CI were used to determine the effect of re-TUR on bladder tumor recurrence. Results: Total of 63 patients were male (87.5%) among 72 patients. 21 patients had recurrence and 4 patients had progression at 25 months of followup. Recurrence occurred in 14 patients (66.7%) within the first year. The majority of recurrent pathologies were pTa (82%) bladder tumors. Radical cystectomy and urinary diversion were applied to one of 2 patients with muscle invasion, and multimodal therapy was applied to the other. Occupational chemical exposure was statistically significantly higher in the recurrent group (p = 0.001). There was no statistically significant difference in terms of recurrence-free survival between with and without re-TUR (p=0.432). Conclusions: This study demonstrated the negative effect of occupational chemical exposure on recurrence in highgrade pTa bladder cancers. Even 5 years after the first diagnosis, recurrence and progression can be observed. [ABSTRACT FROM AUTHOR]

Background: Gout is an inflammatory disease characterized by acute arthritis attacks, which occurs as a result of the accumulation of monosodium urate crystals in the joints and tissues as a result of long-term hyperuricemia. In this study, demographic data and comorbid diseases of patients diagnosed with gout were investigated retrospectively. Materials and Methods: This study was performed retrospectively in Kahramanmaraş Necip Fazıl City Hospital Rheumatology Clinic between January 2020 and December 2021. Patients over the age of 18 who were diagnosed with gout according to the 2015 EULAR/ACR classification criteria were included in the study. Results: In totals, 110 patients who diagnosed gout were included, 77 of whom males (70%), 33 of whom females (30%).The mean age of the patients was 60.3. The most common joint involvement was observed in the first metatarsal and in 89 patients (80.9%). The most common comorbidity in patients with gout was Diabetes mellitus and evaluated in 77 patients (70%). The other comorbidities, Hypertension in 59 patients (53.6%), Chronic renal failure in 49 patients (44.5%), Hyperlipidemia in 42 patients (38.2%), coronary artery disease in 35 patients (31.8%), Cerebrovascular events was observed in two patients (1.8%). Mean laboratory parameters are as falloows: wbc: 8268, Hgb: 14.17 g / dl, uric acid: 7.79 mg / dl, sedimentation: 19.7 mm / hour, CRP: 8.5 mg / l, Urea: 41 mg / dl, creatinine :1.2mg/dl . As medical treatment, colchicine was used in 80 patients (72.7%), allopurinol was used in 104 patients (94.5%), and febuxostat was used in two patients (1.8%). The uric acid level was observed to be within the target value in 30 patients (27.3%) and not at the target value in 80 patients (72.7%). Conclusions: In this study, demographic data, comorbid diseases and medical treatment responses of gout patients were evaluated. These findings were found to be compatible with the literature. Diabetes mellitus, Hypertension, Coronary artery disease, Chronic renal failure, Obesity and diet are the main risk factors for the disease. Metabolic diseases should also be considered in the treatment of gout. [ABSTRACT FROM AUTHOR]

Background: Ferric carboxymaltose (FCM) has been an alternative to blood transfusion because of its practical use, rapid effect and no serious advers events (sAE). In this article, we aimed to evaluate patients who received FCM. Materials and Methods: 185 patients who were followed up in Gastroenterology and Internal Medicine Clinics of Harran University Medical Faculty Hospital between January 2018 and July 2020 were evaluated retrospectively. Diagnosis, laboratory results, blood transfusion and hemoglobin (hb) values were investigated before and after FCM theraphy. Results: 113 (61%) of 185 patients had iron deficiency anemia (IDA), 40 (21%) gastrointestinal system (GIS) bleeding, 16 (9%) inflammatory bowel disease (IBD), 5 liver cirrhosis (3%), 11 (6%) were other diseases. 129 patients (70%) were female and the mean age was 41.45 ± 17.7 (range 17 to 93) years. While the mean hb before FCM was 9.21 ± 1.82 (4.37 - 13.9) g / dl in all patients, the mean hb values of 92 patients reached after 2 weeks were 11.68 ± 1.64 (6.26 - 15.5) g / dl (p< 0.05). Of the 49 patients (27% of all patients) who received erythrocyte suspension (ES). ES was given to 23 (58%) of 40 patients with GI bleeding, 21 (18%) of 113 patients with IDA, 3 (6%) of 5 patients with cirrhosis and 2 (12%) of 16 patients with IBD. In none of the patients, FCM infusion was discontinued due to sEA and no sEA was observed. Conclusions: Approximately two-thirds of the patients were treated with IDA, one-third with GIS hemorrhage and IBS, especially GIS bleeding, and one-third of patients received blood transfusion. FCM significantly increased hb values by 2.5 g / dl in 2 weeks all patients. The greatest need for blood transfusion was in patients with GI bleeding, whereas in other patients, FCM was generally sufficient. FCM infusion did not cause sEA in any patient. [ABSTRACT FROM AUTHOR]

Background: In this study, it was aimed to determine the distribution and antibiotic resistance rates of bacteria isolated from endotracheal aspirate (ETA), blood and catheter samples taken from COVID-19 patients admitted Adana City Training and Research Hospital. Materials and Methods: Between April 1, 2020 and March 31, 2021, 254 patients PCR positive patients were included in the study. Blood, catheter and respiratory tract culture growths and antibiotic susceptibility test results were retrospectively analyzed from the microbiology laboratory database. Results: 433 bacterial growths were detected in clinical samples taken from 254 COVID-19 PCR positive patients. Among the bacterial agents, Acinetobacter baumannii (25.17%; n =109) was the most common pathogens, followed by Escherichia coli (5.54% n =24) and Klebsiella pneumoniae (5.31%; n =23). While imipenem and meropenem resistance rates for A. baumannii were 86.8% and 85.9%, ertapenem and meropenem resistance rates for K. pneumoniae and E. coli were 83.3%, 75%, and 12.5%, 4,1%, respectively. I n this study, 15 o f 21 S.aureus strains were found to be MRSA (Methicillin-resistant S.aureus) (71,4%). Conclusions: Avoiding unnecessary antibiotic use in COVID-19 patients is critical to prevent resistance development and increase culture sensitivity. [ABSTRACT FROM AUTHOR]

Background: Pancreatic neuroendocrine tumors (pNET) are rare diseases and surgical treatment is promising. In this study, we retrospectively analyzed the patients who underwent surgical treatment for pancreatic neuroendocrine tumor in our hospital in the last 11 years; We aimed to present our findings to the literature. Materials and Methods: The files of the patients who applied for pNET between January 2011 and March 2022 were retrospectively analyzed. Patients with multiple data deficiencies, who did not undergo surgery, and who were younger than 18 years of age were excluded from the study. The patients were evaluated in terms of age, gender, type of operation, tumor size, type and histological features, hospital stay, recurrent disease and survival. Results: Of the 33 patients included in the study, 13 were female and 20 were male, and the median age was 56 (18-86). There were 8 patients with functional tumors, one was somatostatinoma and the others were insulinomas. Enucleation in 7 of the patients; Pancreatectomy was performed in 26 of them. There were three patients whose main lesion was adenocarcinoma and serous cystadenoma, who underwent resection and whose specimen pathology had incidental pNET. We had 23, 7 and 3 patients with grade 1,2 and 3 tumors, respectively. The median value of tumor diameter was 24 (3-80) mm. The median value for hospital stay was 7 (2-50) days. The median value of follow-up was 24 (1-71) months; disease-free survival was 14 (1-71) months. Conclusions: pNETs are a rare disease that can be detected incidentally and should be carefully managed. Studies with larger series are needed to reach a consensus on the surgical and conservative treatment of pNET. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study, is to investigate the presence of Helicobacter pylori (H. pylori) infection by culture, histology and rapid urease test (RUT) in gastric antrum biopsy samples taken from patients presenting with dyspeptic complaints and to determine the resistance of the isolates to amoxicillin, clarithromycin, levofloxacin and metronidazole by antibiotic gradient method (E-test). Methods: Microbiological and histopathological examinations of 278 biopsy specimens taken from antrum and corpus regions were performed. The presence of H. pylori in biopsy samples was investigated by culture, histology and RUT. Antimicrobial resistance of the isolates against amoxicillin, clarithromycin, levofloxacin and metronidazole was determined by antibiotic gradient method. Sensitivity and specificity of histology and RUT were calculated by accepting culture as the gold standard. Sensitivity and specificity for culture was also calculated by taking the co-positivity of both histology and RUT as the gold standard. Results: H. pylori positivity was detected in 140 of 278 patients with culture, 174 with histology, and 191 with RUT. Sensitivity and specificity of the culture, histology and RUT methods of the patients were 76.5% and 88.3%, 87.8% and 63%, 94.2% and 57.2%, respectively. Antibiotic resistance was investigated by antibiotic gradient method in 140 H. pylori strains isolated from culture. The resistance rates of H. pylori strains to the amoxillin, clarithromycin, levofloxacin and metronidazole were detected as 9 (%6.4), 22 (%15.7), 17 (%12.1), 57 (%40.7), respectively. Conclusions: In the study, RUT was found to be the most sensitive test among culture, histology and RUT methods. Although the specificity of the culture method was high, its sensitivity was found to be quite low compared to other methods. The low sensitivity of H. pylori culture may be caused by factors that affect the chances of direct isolation such as dealing with a fastidious microorganism, clinical sample retrieval and transport conditions. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to compare the time-course of effect of rocuronium, a non-depolarizing neuromuscular blocker in anesthesia practice between smokers and non-smokers by neuromuscular and BIS monitorization. Materials and Methods: 58 patients with 29 patients in each group were included the study. All patients were divided smokers (n=29) who smokes >10 cigarettes per day during the last two years and nonsmokers (n=29). Total intravenous anesthesia with target controlled infusion was used in all patients. All hemodynamic parameters and BIS values were noted intraoperatively. The dose requirements and "lag-time", "onset-time", "deep neuromuscular blockade time", "T1 %10 time", "time of clinical action", "recovery index" were recorded for all patients. Results: The lag time values were 60±17 seconds and 60±11 seconds for non-smokers and smokers respectively (p>0.05). While the onset time values were 105±34 seconds and 120±46 seconds, deep neuromuscular block time values were 28±13.7 minutes and 33.7±9.3minutes for nonsmoker and smokers. The duration to 10% and time of clinical action values were 15.5±7.6 minutes, 17.2±5.8 minutes, and 16.5±11.1 minutes, 18.25±7.3 minutes for non smokers and smokers respectively (p>0.05). Similarly recovery index values showed no difference between nonsmokers (12.7±7.3 minutes) and smokers (12.4±6.6 minutes). Conclusion: The results of the present study suggest that chronic nicotine exposure does not change the dose requirements and "lag-time", "onset-time", "deep neuromuscular blockade time", "T1 %10 time", "time of clinical action", and "recovery index". [ABSTRACT FROM AUTHOR]

Objective: Hepatitis B virus is an important health problem leading to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. This study aimed to compare the efficacy and side effects of antiviral drugs used in chronic hepatitis B (CHB). Methods: Five hundred seventy-two patients who were followed and treated with CHB in our clinic were evaluated retrospectively. Results: Fifty-six point five of 572 patients were male, 43.5% were female, and the mean age of the patients was 43.4 ± 12.4. Of the patients, 153 (26.8%) used tenofovir disoproxil fumarate (TDF), 134 (23.4%) telbivudine (LdT), 114 (20%) entecavir (ETC), 92 (16%) lamivudine (LAM), 26 (4.5%) adefovir (ADV), 27 (4.7%) pegylated interpheron alpha (PEG-IFN-α), and 26 (4.6%) used PEG-IFN-α + nucleoside analogue (NA). No significant difference was detected between the treatment groups in terms of age, sex ratio, fibrosis, histological activity index (HAI) score, baseline platelet, international normalized ratio (INR), alpha-fetoprotein (AFP) values (p> 0.05). Seventy (12.3%) of 568 patients were HBeAg (+), 498 (87.7%) were HBeAg (-). At the end of the first year, the virological response rates were 92.5% in LdT, 82.6% in LAM, 72.8% in ETV, 60.7% in TDF, 26.9% in ADV, 22.2% in PEG-IFN-α, 65.3% in PEG-IFN- α+NA groups. Twenty-three point eight of the patients had treatment changes, and 76.3% of these patients preferred TDF as a new treatment. Virological breakthrough was observed at 43.5% in LAM, 13.4% in LdT, 7% in ETV and 0.6% in TDF groups. At the end of 3, 4, and 5 years without treatment change, all patients who continued TDF, ETV, LdT, ADV, and LAM treatment were HBV DNA negative. HBsAg clearance developed in 13 (2.3%) patients. At least one side effect was observed in 169 (29.5%) of all patients, and the group with the most frequent side effects was PEGIFN- α+NA (92.3%) and PEG-IFN-α (77.8%). Amylase increase in LAM (%3.2), CPK increase in LdT (%27.6), CPK increase in TDF (%3.2) groups were the most common side effects. Conclusions: The drug with the lowest virological response rate and the most common side effect is PEG-IFN-α, so its use should be limited to selected patient groups. Treatments with the lowest incidence of side effects and development of resistance were found to be with TDF and ETV. Considering the high virological response rates, TDF and ETV should be preferred in the treatment of CHB. When all treatments are evaluated, HBsAg loss and cure rates are inadequate. [ABSTRACT FROM AUTHOR]

Background: In this study, male patients who underwent urethroplasty in our clinic were examined, and the outcome of the cases and the risk factors affecting the success of urethroplasty were investigated. Materials and Methods: In this retrospective study, univariate and multivariate analyzes were used to determine the factors affecting treatment success following different urethroplasty techniques performed by a single surgeon in male patients with urethral stricture. Results: In the urethroplasty cases performed in 102 male patients, the mean age was 49 years, the mean stenosis length was 3.9 cm, and the success rate was 84%. According to the results of the multivariate analysis, the presence of diabetes mellitus (DM), the number of previous urethratomy interna (IU) and the length of the stenosis were defined as the factors predicting the success of urethroplasty. (OR 1.257; 95% CI 0.073-0.909; p=0.035, OR 5.343; 95% CI 2.233-12.782; p=0.005 and OR 8.683; 95% CI 2.950-25.561; p=0.025) Conclusions: Although urethroplasty is the gold standard surgical procedure in the treatment of urethral strictures, the presence of DM, multiple IU history, and long strictures are associated with treatment failure. Urethroplasty techniques should be evaluated with multiple factors and performed in experienced centers. [ABSTRACT FROM AUTHOR]

In the practice of pediatric gastrointestinal endoscopy, which has increased in recent years, deep sedation is needed for patient comfort and easier application of the procedure. Our aim in this study is to investigate the efficacy of ketamine and propofol combination in pediatric gastrointestinal endoscopy. Materials and Methods: Patients who was applied sedoanalgesia with a combination of ketamine and propofol for pediatric gastrointestinal endoscopy between December 2017 and March 2019, were screened. The patients' age, gender, need for additional medication, comorbid conditions, indications of the procedure, complications, duration of the procedure, recovery time and waiting period after the procedure were recorded. Results: A total of 397 patients, 202 male and 195 female, were included in the study. Their mean age was 9.22±4.72 years. When the endoscopic prediagnoses of the cases were examined, the highest rate (53.4%) was abdominal pain and the second prediagnosis of celiac disease (15.3%) was found. The duration of the procedure was 19.77±8.48, the recovery period was 10.3±3.83 and the waiting time after the procedure was 17.41±4.19. Additional propofol was needed in 20.7% of the patients. Complications were seen in 3.3% (13 cases) of cases. Conclusion: In our retrospective review, sedation was successfully achieved with the combination of propofol and ketamine in 397 patients, and low complication rates were detected. Therefore, we think that the combination of propofol and ketamine can be safely applied in pediatric gastrointestinal endoscopy applications. [ABSTRACT FROM AUTHOR]

There is a link between aging and gastric diseases. The aim of this study was to evaluate the effects of ghrelin on gastric morphology in ovariectomized rats. Materials and Methods: Under ketamine-chlorpromazine anesthesia (100 mg/kg, 0.75 mg/kg), Sprague-Dawley rats (n=12) underwent bilateral ovariectomy, while control group (G1) had shamsurgery (n=6). Four weeks after surgery, half of ovariectomized rats (G3) were treated intraperitoneally with ghrelin (1 mg/kg/week) for 4 weeks, while others (G2) were not treated. Rats were euthanized by cardiac puncture at the end of 8th weeks, and serum levels of estradiol were measured. Gastric tissue was analyzed with light and scanning electron microscopy. Results: Increased body weights in ovariectomized (G2 and G3) rats (p<0.001) recorded at the end of 2 months was not changed with ghrelin. In ovariectomized groups (G2 and G3) serum estradiol levels were reduced (p<0.05) verifying altered gonadal hormone status. Apical mucus cells and gastric pits were observed in regular morphology in sham group while vascular dilatation and degeneration was observed i n o variectomized r ats ( G2 a nd G 3), w hereas i n t he g hrelin g roup ( G3) i t w as g enerally observed similar to sham group (G1). Conclusion: In conclusion, mild dyslipidemia and hepatic degeneration in early post-menopausal period appear to be attenuated by ghrelin treatment, and it is required further investigations. [ABSTRACT FROM AUTHOR]

Objective: Skull base osteomyelitis (SBO) is a rare, life-threatening infection and frequently followed and treated by otolaryngologists previously. In this study, we analyzed the diagnosis, treatment and long-term outcomes of SBO from the perspective of infectious diseases and clinical microbiology (IDCM). Methods: Hospitalized patients with SBO between 2012-2019 were evaluated retrospectively. Epidemiological, clinical, laboratory data of the patients were recorded. The patients who recovered with and without sequelae were compared. Results: The mean age of 16 SBO cases was 66 years, 75% of them were male and 87.5% had diabetes mellitus (DM). Cranial nerve and vascular/dural involvement were present in 75% and 56.3% of them, respectively. The most common isolated microorganism were P. aeruginosa, staphylococci and Candida spp. 81.2%, 43.7%, and 56% of the patients received anti-pseudomonal antibiotics, additional glycopeptide and additional antifungal drugs, respectively. The sequelae rate was 46.7% in a 24-month follow-up. Hypertension (p=0.041), duration of complaints (p=0.003), bilateral involvement of skull base (p=0.001), vascular thrombosis/inflammation or dural involvement (p=0.007), previous surgical intervention (p=0.041) and elevated ESR at the end of treatment (p=0.014) were defined as risk factors for permanent sequelae. There was no in-hospital mortality. Conclusions: SBO mainly affects older male patients with DM and causes significant sequelae in half of them. In the cases unresponsive to anti-pseudomonal agents, the addition of antifungal therapy empirically may provide a clinical response. Permanent sequelae are more common in cases with delayed diagnosis/treatment, bilateral, vascular or dural involvement, and elevated ESR at the end of treatment. ESR can be used to determine the treatment response and duration. The follow-up and treatment of SBO cases by IDCM with the support of experienced surgeons may contribute to the positive clinical results. [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]

Background: Our research was conducted to examine the retrospective data of patients who underwent Endoscopic Tympanoplasty in our clinic. Materials and Methods: This study is a retrospective study of the data of 60 patients who underwent endoscopic tympanoplasty and followed up in Harran University Faculty of Medicine Otorhinolaryngology clinic from January 2018 to June 2019. Patients who were followed for at least 3 months after surgery were included in the study. Patients who were operated with a non-endoscopic method and whose data were not available were excluded from the study. Pre-op and post-op audiometric values of patients were compared. The success of the graft was checked in the patients' controls. Results: Of the 60 patients we underwent endoscopic tympanoplasty, 25 were male and 35 were female. While preoperative air bone gap mean was 21.5±9.40 dB, the mean air bone gap was 13.1±7.68 dB in the audiometry performed during postoperative follow-up. The graft success rate was 80% (48 patients). In 20% of the patients (12 patients) there was a graft patency. 12 (20%) of the patients were marginal perforated, 6 (10%) were total perforated, 42 (70%) were central perforated. Bone cement reconstruction was required in 10 (6%) patients and ossicular prosthesis was applied in 3 (5%) patients. Conclusion: As a result, when compared with microscope, endoscopic tympanoplasty has similar success results and it was found to be less invasive and more comfortable for the patient. [ABSTRACT FROM AUTHOR]

Objective: Carbapenem-resistant Klebsiella pneumoniae (CRKp) is among the leading causes of hospital-acquired infections worldwide and causes serious and life-threatening infections. Treatment options are very limited for blood stream infections (BSIs) and prognosis is poor due to increasing multi-drug resistance. The aim of this study was to assess risk factors for the mortality due to CRKp-BSI. Methods: A retrospective study was conducted in a university hospital from September 2013 to October 2017. Patients (aged >16 years) with CRKp-BSI were included in this study. Data, including demographics, Charlson comorbidity index (CCI), acute physiology and chronic health evaluation II (APACHE II) score on hospitalisation date, minimum inhibitory concentration (MIC) of CRKp, antibiotic treatment and outcome (30-day mortality) data were collected from the electronic medical records and microbiology databases. Results: A total of 82 patients with CRKP-BSIs were analysed. The median age was 54.5 years, and 48 (58.5%) of them were male. The median APACHE II score on hospitalisation was 14 (IQR 6-28) and CCI was 4.0 (IQR 0-12). Forty-six (56.1%) patients had ICU-acquired bacteremia and 36 (43.9%) had central-line associated bacteremia and 25 (30.5%) had primary bacteremia. Fifty (61.0%) patients had combination therapy, colistin/tigecycline (28%) was the most used antibiotic combination. The mortality of all patients was 56.1% (46/82) and 65.2% (30/46) in ICU patients. In univariate analysis, risk factors for the mortality of CRKp-BSI were high CCI, not having clinical response on the fifth day of treatment, high APACHE II score on hospitalisation and infection date and multiple organ dysfunction syndrome. In multivariate analysis, the most significant risk factor for mortality was APACHE II score on infection day (OR: 1.190; 95% CI: 1.088-1.301). Treatment regimens and combination therapy vs. monotherapy were not found to be significantly associated with survival. In addition, MIC values of CRKp were not associated with mortality. Conclusions: Patients with CRKp-BSI had high mortality (56.1%). APACHE II score on infection day was significantly associated with mortality. The outcome was similar between patients receiving combination (54.3%) or monotherapy (45.7%). [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]

Background: Stroke account for 15% of all deaths in Turkey. In acute ischemic stroke (AIS), neuronal damage continues every minute until the occluded vessel is not opened. Currently, the most important treatment of AIS is the rapid and effective opening of the occluded vessel. In this study, we aimed to share our experience of endovascular treatment of AIS patients in our center. Materials and Methods: Between January 2015 - November 2018, the first 100 consecutive patients who presented with the diagnosis of AIS and received endovascular treatment were included in this study. We recorded the clinical and demographic characteristics and endovascular procedure characteristics of all patients. Results: Of the 100 patients included in the study, 49 were female and 51 were male, and the median age was 65 (55-74). Hypertension was present in 74%, hyperlipidemia in 25%, diabetes mellitus in 38%, atrial fibrillation in 26%, coronary artery disease in 36%, and smoking in 39% patients. The Median NIHSS score was 15.5 (13-19) prior to treatment. At the 3-month follow-up, 31 patients died and the mortality rate was calculated as 31%. At the end of the 3-month, good outcome was observed in 40% of patients (modified Rankin scale score 0-2). Our effective recanalization rate (Thrombolysis in Cerebral Infarction [TICI2b-3]) was found to be 75%. Conclusions: AIS patients with suspected large artery occlusion should be transferred to centers where endovascular treatment is available, as soon as possible. Better results can be achieved as experience of endovascular treatment in centers increases. [ABSTRACT FROM AUTHOR]

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]

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]

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: 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: 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: 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]

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: 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]

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]

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]

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]

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]

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]

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: 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]