Search

Objectives: Medical education develops day by day with the effect of its unique dynamics, excessive information load and changing education approach depending on its professional characteristics.The aim of this study wasto determineeffects on the knowledge and attitude gains of story usage in education. Material and Methods: This is a training intervention study with a twenty-five study group and twenty-five control group students. A 20-question test was applied to the students before and after the study, including the topics of course. In addition, students were asked to provide feedback on the educational practice. Results and Dıscussion: According to the results of this study applied with twenty-five students study and control groups; in addition to theoretical lessons, reading and discussing patient stories covering lesson topics significantly increases students’ academic knowledge (p

Objective: There are some studies about the significance of the peripheral blood parameters in breast cancer. However, there is very few studies about prognostic importance of peripheral blood parameters in human epidermal growth factor-2 receptor (Her-2) positive breast cancer. We aimed to evaluate whether prognostic significance of peripheral blood parameters in patients Her-2 positive metastatic breast cancer with treated Pertuzumab, Trastuzumab, Docetaxel (PTD) Material and Methods: We included 56 patients with Her-2 positive metastatic breast cancer patients who were treated with PTD. We recorded patients' clinical,demographic features and we obtained peripheral blood parameters such as neutrophil-lymphocyte ratio (NLR), red blood cell distribution (RDW), mean platelet volume (MPV), lymphocyte, neutrophil after the sixth cycle of the treatment and before the treatment. We separated the patients into two groups depending on the progression status. Progression-free survival was analyzed by Kaplan-Meier statistical analysis. Results: Patients mean age was 50.7. Progression was detected in 34 patients. When we explored and compared hemogram parameters in the groups before the treatment, there wasn’t statistically any significant difference between these parameters such as neutrophil, lymphocyte, neutrophil to lymphocyte ratio, mean platelet volume, red blood cell width. In the progressive group;,while pretreatment NLR was 3.83, it was detected 2.72 after six cycle treatment and difference was meaningful ( p: 0.043). The pretreamtent MPV was 8.63, and It was 8.15 after six cycle treatment, and difference between these counts was statistically important (p: 0.006). PFS was 18.0 months in the study group. Conclusion: Peripheral blood parameters were not statistically significant in both group comparisons. In the progression group, the difference between NLR and MPV count was statistically significant after the sixth cycle of the treatment and before the treatment.

Amaç: Non-invaziv tanısal yöntemler olan shear wave elastografi (SWE) ve difüzyon ağırlıklı magnetik rezonans görüntülemenin (DAG), toraksta plevra tabanlı kitlelerde benign ve malign lezyonların ayırımında kullanılabilirliklerinin histopatolojik bulgular ile karşılaştırılarak değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Mart 2015 ile Mart 2018 tarihleri arasında girişimsel radyoloji ünitesine transtorasik biyopsi amacıyla başvuran, bilgisayarlı tomografide (BT) plevra tabanlı kitle izlenen ve biyopsiye uygun bulunan 63 olgu çalışmaya dahil edilmiştir. Tüm olgulara DAG yapılmış ve kitlelerin ADC değerleri ölçülmüştür. Tüm olgulara SWE uygulanmış ve en yüksek SW hızı ölçülen alandan transtorasik biyopsi yapılmıştır. Histopatolojik olarak benign ve malign olduğu belirlenen lezyonların DAG ve SWE bulguları karşılaştırılmıştır.Bulgular: Olguların 56’sı erkek, 7’si kadındı. Ortalama yaş 64.68±10.13 idi (41-85). Olguların 44’ü malign, 19’u ise benigndi. Malign olgularda maksimum SW hızı ortalama 4.13±0.59 m/sn, benign olgularda ise 3.55±0.71 m/sn ölçülmüş olup fark anlamlı idi (p=0.001). Malign olgularda mean ADC 1.04±0.30 x 10-3 mm2/sn, benign olgularda ise 1.32±0.33 x 10-3 mm2/sn ölçülmüş olup fark anlamlı idi (p=0.002). Malign olgularda minimum ADC 0.73±0.29 x 10-3 mm2/sn; benign olgularda ise 0.99±0.44 x 10-3 mm2/sn ölçülmüş olup fark yine anlamlı idi (p=0.024). ROC analizi sonucu maksimum SW hızı değeri ≥ 4.08 m/sn, mean ADC değeri ≤1.01x10-3 mm2/sn ve minimum ADC değeri ≤ 0.8x10-3 mm2/sn malign tanısı için cut-off değeri olarak alındığında, başarılı şekilde malign-benign ayrımı yapılabilmekteydi.Sonuç: Transtorasik US elastografi ve difüzyon MR, uygun olgularda malign-benign lezyon ayrımında yararlıdır. Hem SWE, hem de difüzyon MR incelemesi, radyasyon içermemeleri ve non-invaziv olmaları nedeniyle rutin kullanımda kullanışlı yöntemlerdir. Özellikle SWE, biyopsi kılavuzluğu için uygun olup yetersiz materyal olasılığını engelleyebilir., Objective: The study aims to evaluate the usefulness of non-invasive diagnostic methods, shear wave elastography (SWE), and diffusion-weighted magnetic resonance imaging (DWI) to differentiate benign and malignant lesions in the thoracic pleural based masses by comparing them with histopathological findings.Materials and Methods: Sixty-three patients having a pleural-based peripheral mass on CT, admitted to the interventional radiology department for transthoracic biopsy, were included in the study. All patients underwent DWI, and ADC values of the groups were measured. Transthoracic biopsy was performed with the guidance of US from the area where the highest shear wave velocity (SWV) value was calculated. ADC and SWV values of histopathologically proven benign and malignant lesions were statistically compared.Results: Fifty-six patients were male, and seven were female. The mean age was 64.68±10.13 years (41-85 years). Fourty-four patients were malignant, and 19 were benign. The maximum SWV was found to be 4.13±0.59 m/s in malignant cases and 3.55±0.71 m/s in benign cases, and the difference was significant (p = 0.001). Mean ADC value was measured as 1.04±0.30 x 10-3 mm2/s in malignant cases and 1.32±0.33 x 10-3 mm2/s in benign cases on DWI and the difference was significant (p = 0.002). In malignant cases, the minimum ADC was 0.73±0.29 x 10-3 mm2/s, and 0.99±0.44 x 10-3 mm2/s in benign cases, the difference was significant (p = 0.024). ROC analysis revealed a cut-off value of ≥4.08 m/s for SWVmax, ≤1.01x10-3 mm2/s for mean ADC, and ≤0.8x10-3 mm2/s for minimum ADC showed a significant performance in distinguishing malignant and benign lesions. Conclusions: Transthoracic US elastography and DWI are useful in differentiating malignant and benign lesions in appropriate cases. Both SWE and DWI are useful in routine use because they are non-invasive and do not contain radiation. In particular, SWE is suitable for biopsy guidance and may prevent the possibility of insufficient material.

Amaç: Yaşa bağlı makula dejenerasyonu (YBMD), retina pigment epitel kompleksinin nörodejenerasyonunun neden olduğu görme kaybı ile karakterize kronik bir hastalıktır. Fazla oluşan reaktif oksijen türleri (ROS), makula dejenerasyonu başta olmak üzere retina hastalıklarının gelişmesinde önemli rol oynar. Başlıca ROS’lar ise; peroksinitritler, süperoksit radikaller ve hidrojen peroksitlerdir. Çalışmamızda hücre kültürü ortamında hidrojen peroksit (H2O2) ile oluşturulan oksidatif hasar öncesi oksiresveratrolün koruyucu etkisini araştırmayı amaçladık.Gereç ve Yöntemler: İnsan retina pigment epitel (ARPE-19) hücrelerinde H2O2 ile oksidatif stres oluşturuldu. Oksidatif hasar öncesi oksiresveratrol 7 farklı konsantrasyonda uygulandı. Koruyucu etkiler, XTT hücre proliferasyonu testi ile hücre canlılığındaki değişiklik izlenerek araştırıldı. Oksiresveratrolün koruyucu etkisini moleküler düzeyde araştırmak için kaspaz-3 ve hücre ölüm tespit kiti kullanıldı.Bulgular: Çalışmamızda ARPE-19 hücre hattında H2O2 ile oluşturulan oksidatif hasar öncesi oksiresveratrol uygulaması hücre canlılığını arttırarak hücrede oksidatif hasara karşı koruyucu etkinlik göstermiştir. Çalışmamız sonucunda elde ettiğimiz bulgularda; oksiresveratrol ARPE-19 hücrelerinde H2O2 ile oluşturulan oksidatif hasar oluşum öncesi uygulandığında 100 µM konsantrasyonda hücre hasarını yaklaşık %15 oranında azaltmıştır, buna ek olarak, hücre ölüm tespiti ve kaspaz-3 sonuçlarına göre, oksiresveratrolün oksidatif hasara karşı apoptotik hücre ölümünü azaltarak koruyucu etkinlik göstermektedir.Sonuç: Bu in vitro çalışma oksiresveratrolün koruyucu etkisinin geliştirilmesi için ön çalışma niteliğindedir. Oksiresveratrol, deney hayvanları ve klinik çalışmalar sonrasında, başta YBMD olmak üzere retina hastalıklarının önlenmesinde etkin bir terapötik ajan olarak geliştirilebilir., Objective: Age-related-macular-degeneration (AMD) is a chronic disease characterized by vision loss caused by neurodegeneration of the retinal pigment epithelial complex. Excess reactive oxygen species(ROS) play an important role in the development of retinal diseases, especially macular degeneration. The main ROS are; peroxynitrides, superoxide radicals and hydrogen peroxides. In our study, we aimed to investigate the protective effect of before oxidative damage induced by hydrogen peroxide(H2O2) in cell culture.Materials and Methods: Oxidative stress was induced with H2O2 in human retinal pigment epithelial(ARPE-19) cells. Oxyresveratrol was applied at 7 different concentrations before oxidative damage. Protective effects were investigated by monitoring the change in cell viability with the XTT cell proliferation assay. Caspase-3 and cell-death-detection kit were used to investigate the protective effect of oxyresveratrol and its molecular mechanism.Results: In our study, oxyresveratrol application before oxidative damage induced by H2O2 in ARPE-19 cell line increased cell viability and showed protective activity against oxidative damage in the cell. In the findings we obtained as a result of our study; When oxyresveratrol was applied to ARPE-19 cells before the oxidative damage induced by H2O2, it reduced cell damage by about 15% at 100 µM concentration. In addition, according to cell death detection and caspase-3 results, oxyresveratrol showed protective activity against oxidative damage by reducing apoptotic cell death.Conclusion: This in vitro study is a preliminary study for the development of the protective effect of oxyresveratrol. Oxyresveratrol can be developed as an effective therapeutic agent in the prevention of retinal diseases, especially AMD, after experimental animals and clinical studies.

Aim: Coronavirus disease-2019 caused an epidemic that started in China about two years ago but affected the whole world. It was aimed to evaluate patients followed up with coronavirus disease-2019 infection, to determine risk factors and indicators for severe infection. Material and Methods: Patients who received treatment as inpatient with coronavirus disease-2019 infection between March 15- June 01 2020 were investigated. Patients were divided into two groups according to their oxygen saturation; patients with oxygen saturation over 90% were group 1, patients with 90% or less were determined as group 2. This two groups were compared in terms of aggravating risk factors. Results: In this study, 90 patients (46 female, 44 male) were included. Moderate-severe pneumonic involvement in computed tomography of thorax (p=0.002) and high fever (p

The purpose of this study was to evaluate the incidence of primary headache and potential biomarkers in patients diagnosed with Hashimoto thyroiditis.Patients with Hashimoto thyroiditis referred to the outpatient endocrinology clinic were included in the study. The demographic data, thyroid function test results, and autoantibody titers were recorded. The headache's clinical characteristics were also determined. The same researcher used the visual analog scale for headache severity rating in all patients.155 patients with Hashimoto thyroiditis were included the study. There were 95 (61.3%) cases diagnosed with headache consisting of 20 (21.1%) migraine cases, 17 (17.9%) tension type headaches (TTHs), and 20 (21.1%) new daily persistent headaches (NDPHs). 38 of 155 (24.5%) had hypothyroidism related headaches (HRHs). There was no statistically significant relationship between the headache type and a high blood antibody level anti thyroid peroxidase antibody (p=0.135), while a positive correlation was found with thyroid stimulating hormone (TSH) (p0.001). Hashimoto patients with migraine (n=14, 70.0%) were found to have higher blood antibody levels, while these ratios were found as 86.8% (n=33) in HRH-patients, 76.5% (n=13) in TTH-patients, and 60.0% (n=12) in NDPH-patients. 86 of 155 (55.5%) patients reported new onset headaches after a Hashimoto's thyroiditis diagnosis, and the headaches persisted without hormone therapy in 48 (84.2%) of these patients. These patients diagnosed with primary headache and this was interpreted as demonstrating comorbidity between Hashimoto's disease and primary headaches.Detection of only the relationship between TSH level and headache suggested that different mechanisms play a role in the pathophysiology. In the diagnosis of primary headache, it is important to look into secondary reasons.

This study aimed to compare combined hypothermia (CH) to the 2 classical therapeutic hypothermia (TH) methods selective head cooling (SHC) and whole-body cooling (WBC). This retrospective cohort study included neonates who underwent CH, SHC, and WBC between 2012 and 2020. Mean rectal temperature was maintained at 33.5 ± 0.5°C by cooling the head and the body in the CH group, at 34.5 ± 0.5°C by cooling the head in the SHC group, and at 33.5 ± 0.5°C by cooling the body in the WBC group. The groups were compared in terms of side effects, magnetic resonance imaging (MRI) scores, and status at discharge. The study included 60 neonates in the CH group, 112 in the WBC group, and 27 in the SHC group. There was no significant difference in side effects between the groups (

Purpose: Testicular cancer is the most common solid tumor in young men between the ages of 20-35 and has excellent clinical outcomes with appropriate treatment. Neutrophil-to-lymphocyte-ratio (NLR) is related with prognosis and relapse in different solid tumors. We aimed to investigate the relation of presence and size of regional lymph node metastasis with NLR in testicular cancer. Materials and Methods: A total of 72 testicular cancer patients were included in the study. All medical records were retrospectively collected. NLR was calculated as the count of neutrophil divided by the count of lymphocyte. Chest and abdomen computed tomograpy (CT) scans of all patients were evaluated for metastases. Results: The mean age was 32.18±8.89 years. The pathologic classification was seminoma in 43% and nonseminoma in 57% of patients. Of 72 patients, 32 (44.4%) had lymph node positivity and 40 (55.6%) hadnot. The mean NLR value was 2.63±1.79 for all cohort. The mean NLR was significantly lower in patients with lymph node negative disease (for lymph node positive and negative disease 3.19±2.32 and 2.25±1.06, respectively.). In the ROC analysis, 2.5 was determined as the cut-off value for NLR to assess lymph node status. Conclusion NLR is a cheap and readily available index that can be used to determine lymph node metastases in testicular GCTs., Amaç: Testis kanseri 20-35 yaş arası genç erkeklerde en sık görülen solid tümördür ve uygun tedavi ile çok iyi klinik sonuçlara sahiptir. Nötrofil-lenfosit oranının (NLR), farklı solid tümörlerde prognoz ve nüks ile ilişkili olduğu gösterilmiştir. Testis kanserinde lenf nodu metastazını varlığını göstermede NLR ile ilişkisini araştırmayı amaçladık.Gereç ve Yöntem: Çalışmaya toplam 72 testis kanseri hastası alındı. Tüm veriler geriye dönük olarak toplandı. NLR, nötrofil sayısının lenfosit sayısına bölünmesiyle hesaplandı. Tüm hastaların toraks ve batın bilgisayarlı tomografi (BT) taramaları metastaz açısından değerlendirildi. Bulgular: Ortalama yaş 32.18±8.89 idi. Patolojik sınıflama hastaların %43'ünde seminom ve %57'sinde nonseminom şeklindeydi. 72 hastanın 32'sinde (%44,4) lenf nodu pozitif, 40'ında (%55,6) lenf nodu negatifti. Hastaların ortalama NLO değeri 2,63±1,79 idi. Ortalama NLO, lenf nodu negatif hastalığı olan hastalarda anlamlı olarak daha düşüktü (lenf nodu pozitif hastalık için 3.19±2.32 ve lenf nodu negatif hastalık için 2.25±1.06). ROC analizinde, lenf nodu durumunu değerlendirmek için NLR için cut-off değeri olarak 2.5 belirlendi.Sonuç: Çalışma verilerimiz, NLR'nin testiküler GHT'lerde lenf nodu metastazlarını belirlemede kullanılabilecek düşük maliyetli ve hazır bir indeks olduğunu göstermektedir.

Amaç: Bu çalışma; aile hekimliği polikliniğine başvuran 5-18 yaş arası çocuklarda serum Anti-Hbs antikor düzeyleri ile hepatit B aşılanma durumlarını araştırmak için yapılmıştır. Materyal ve Metod: Çalışma tanımlayıcı- kesitsel bir çalışmadır. Çalışmaya bir Aile Sağlığı Merkezine periyodik muayene ve okul sağlık taramaları için başvuran 5-18 yaş arası 84 çocuk dahil edilmiştir. Çalışmaya dahil edilen çocukların ailesinden çocuğun aşılanma durumu, kronik hastalık varlığı, anne baba eğitim ve meslek bilgisini içeren kısa bir form doldurması istendi. Bu yanıtlarla çocukların cinsiyet, yaş ve Anti-Hbs düzeyi arasındaki ilişki sorgulandı. Düzce Halk sağlığı laboratuarında Mikro-ELİSA yöntemi ile bakılan Anti-HBs düzeyi 10 mIU/ml’nin üzerinde olan antikor değerleri seropozitif olarak kabul edildi. Bulgular: Çalışmamıza alınan çocukların 45’i (%53,6) erkek, 39’u (%46,4) kız çocuk idi. Çalışmamızdaki çocukların yaş ortalaması 12,13±2,73 olarak tespit edildi. Çalışmamızda yaş artışı ile birlikte Anti HBs antikor titresinde anlamlı bir düşüş saptanmadı(p=0,571). Cinsiyete göre anti-HBs seropozitifliği arasında anlamlı fark bulunmamıştır. Çalışmamızda çocukların yaşı arttıkça aşı yapılmamış olma durumu daha küçük yaştakilere göre anlamlı olarak yüksek bulundu (p

Background: COVID19 pandemic is currently affecting every aspect of daily life of communitiesy throughout the world. We aimed to check how this situation affects the metabolic control of children with type 1 diabetes. Methods: We analyzed all patients with type 1 diabetes a HbA1c test after at least two months ensuing the start of the epidemic in Turkey. We compared the results with the most recent HbA1c test in the hospital’s automation system before the epidemic. In addition, diabetic ketoacidosis (DKA) and severe hypoglycemia rates were compared. Results: Among the eligible 219 cases 77.6% had decreased HbA1c levels according to their former result. Mean drop was about 9.71% compared to the former test in the whole group. Age, sex and time interval between two tests were not found to affect this tendency. Diabetic ketoacidosis rate was the same as before the pandemic, whereas severe hypoglycemia rates increased. Conclusions: Despite the potential of the pandemic to affect routine care of chronic diseases in a negative way the short term metabolic control of type 1 children with type 1 diabetes improved. Telemedicine support by the diabetes team and increased care in the family environment might be possible explanations.

Amaç: Bu çalışmada, obezite polikliniğine başvuran hastalarda; hematolojik ve biyokimyasal parametreler ile kardiyovasküler risk skorlamasının karşılaştırmalı değerlendirilmesi amaçlanmıştır. Yöntem: Tanımlayıcı-kesitsel olarak planlanan bu araştırmada, Düzce Üniversitesi Araştırma ve Uygulama Hastanesinin Obezite Polikliniğine 2017-2018 yılları arasında başvuran hastaların, dosya verileri retrospektif olarak değerlendirildi. Hastaların yaş, cinsiyet, sigara kullanımları, DM tanılarının varlığı, BKİ (Beden kitle indeksi), NLR (Nötrofil-lenfosit oranı), MPV(ortalama platelet hacmi) ve RDW (eritrosit dağılım aralığı) değerleri geriye dönük olarak değerlendirilmiştir. Kardiyovasküler risk faktörleri Avrupa ve Türkiye Kardiyoloji Dernekleri risk skorlamasına göre değerlendirildi. Bulgular: Çalışmaya %75,1’i kadın, %24,9’u erkek, 631 katılımcı dahil edilmiştir. Yaş ortalaması 38,9±12,1 (min=21-maks=65) olarak bulunmuştur. Hastaların %19,2’sinin sigara kullandığı, %4,6’sında DM ve %36,9’unda insülin direnci olduğu görülmüştür. Katılımcıların %3,3’ü zayıf, %7,3’ü normal kilolu, %22,5’i fazla kilolu ve %66,9’u obezdir. Türkiye Kardiyoloji Derneği risk skorlamasına göre hastaların %51,4’i düşük , %20,5’i orta ve %28,1’i yüksek risklidir. Avrupa Kardiyoloji Derneği risk skorlamasına göre ise hastaların %83,5’i düşük, %10,9’u orta ve %5,5’i yüksek risklidir. Her iki risk skorlamasına göre risk grupları arasında yaş, cinsiyet, beden kitle indeksi ve DM varlığı açısından anlamlı farklılık görüldü (p

Objective: Obesity is an important health problem with the potential to cause secondary diseases in children. In these patients, increased intra-abdominal and intra-vesical pressure leads to changes in voiding physiology. In addition, insulin and glucose metabolism disorders can also affect lower urinary system functions. However, the relationship between obesity and sleep disorders is also known. Materials and Methods: The questionnaire, which was prepared to determine voiding and sleep disorders, was applied to 100 obese pediatric patients aged between 9 and 18 and 100 normal weight healthy individuals in the similar age group. Results: Daytime urinary incontinence was present in 17% of the patient group and 2% of the control group. Nocturnal enuresis was present in 25% of the patient group and 2% of the control group. The frequency of overactive bladder was also higher in the patient group compared to the healthy controls (15% and 5%, respectively; p

Aim: The health system is undergoing a rapid transformation with the constantly developing world. The Covid-19 pandemic that threatens humanity seems to change the health system as in every field. The study aimed to determine the use of the e-Health system before and after the pandemic and how health services have changed after the pandemic. Methods: The study was designed with a mixed method that includes analysis of qualitative and quantitative data. The quantitative data of the study were collected with the help of a questionnaire before the pandemic. Qualitative data acquisition and analysis were carried out after the pandemic. Results: According to the results of the study, the rate of participants who did not use the e-Health system before the pandemic was 73.5% (n=155). When asked about the reasons for not using the e-Health system; 43.2% of the participants (n=67) stated that they did not need it, 28.4% (n=44) were not aware of the system and 28.4% (n=44) stated that they did not know how to use the system. According to the qualitative data results, five main themes were obtained after the Covid -19 outbreak. The themes were; getting health information and guidance remotely during the pandemic is the best alternative, creating a sense of trust, compliance with the new situation, expectations from the health system in the new period, and expectations for guidance in accessing e-health information. Conclusion: The most important result of this study, the increase in the use of distance health and e-health, seems to be the framework of the new health service. When the results are read in this context, it can be predicted that a large share of the investments in the field of health will be shifted to digital health systems. Keywords: e-Health, digital health, COVID-19, expectations, pandemics

We evaluated the cost and efficacy of radiobasilic and brachiobasilic arteriovenous fistula (AVF) methods in terms of forearm autogenous arteriovenous access in hemodialysis patients. We used a decision tree to compare the cost-effectiveness of proximal radiobasilic AVF (pRBAVF) and brachiobasilic AVF (BBAVF), considering the mean direct medical costs and patency rates. The overall mean cost of pRBAVF per patient (1767.59 Turkish lira [TL]) was lower than that of BBAVF (1877.99 TL). Also, the mean patency duration per patient was higher for pRBAVF (25.72 months) than BBAVF (20.21 months). The incremental cost-effectiveness ratio (ICER) showed that pRBAVF was 20.04-fold more effective than BBAVF. The monthly ICERs also favored pRBAVF, which was less costly and more effective. The pRBAVF provided clinical and economic benefits for hemodialysis patients requiring forearm autogenous arteriovenous access. pRBAVF was more effective in terms of patency than BBAVF, and was also less expensive. WOS:000654045000001 2-s2.0-85106444740 PubMed: 33973703

Objective: Urinary incontinence (UI) is a health problem affecting women's quality of life. Since it is not a life-threatening disease, women with urinary incontinence usually do not seek treatment in this regard. This causes them not to benefit from treatment opportunities that will improve their lives. The study aims to investigate the UI status in women living in rural areas and to determine its reflection on the quality of life.Methods: A total of 589 patients were included in the study. The data was collected with a questionnaire including socio-demographic characteristics questions along with the Urogenital Distress Inventory (UDI-6) scale and the Incontinence Impact Questionnaire (IIQ-7). Results: 157 (26.7%) patients who participated in our study suffered from UI. 70 (44.6%) of these patients suffered from stress incontinence (SUI), 40 (25.5%) were urge incontinence (UUI) and 47 (29.9%) were mixed incontinence (MUI). BMI, constipation, and menopause were found to be aggravating factors for incontinence (p

Background/aim: Hantavirus is a rodent borne zoonosis caused by the members of the virus family Bunyaviridae, genus Hantavirus. In this study, we aimed to determine the role of peripheral blood leukocyte ratio in differential diagnosis of Hantavirus disease. Materials and methods: The medical records of patients at the Duzce University Medical Faculty were examined retrospectively. A total of 20 patients diagnosed with hantavirus infection confirmed by serologic tests were included in the study (Group 1). The other group consisted of 30 patients suspected of hantavirus infection but found negative (Group 2). Demographic, clinical and laboratory characteristics, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte (LMR) ratios of both groups were compared. Results: As a result of the istatistics analysis, no difference was found between the groups' age, sex, and clinical complaints except lethargy-weakness (P = 0.004) and diarrhea (P < 0.001). Hemogram analysis showed a significant difference between the groups in terms of leukocyte, hemoglobin, hematocrit, platelet, mean platelet volume (P < 0.05) and PLR (P = 0.001) and LMR (P = 0.003) values from peripheral blood leukocyte ratios. Conclusion: In conclusion, NLR, PLR, and LMR ratios may be useful for clinicians in differential diagnosis of Hantavirus in patients presenting with similar symptoms of Hantavirus disease. WOS:000623196400035 2-s2.0-85102263620 PubMed: 33021756

Malignant peripheral nerve sheath tumors (MPNSTs), glioblastomas (GBMs), and malignant melanomas (MMs) are neural crest-originating aggressive tumors with a poor prognosis. Signal transducer and transcription activator 3 (STAT3) plays a role in many biological processes, including cell life and proliferation, the acute phase response, chronic inflammation, autoimmunity, metabolism, and cancer progression, It is also known to be a prooncogenic transcription factor. Vascular endothelial growth factor (VEGF) is one of the most potent proangiogenic stimuli ever identified. It mediates tumor neovascularization, and is associated with angiogenesis and lymphangiogenesis. The prostate-specific membrane antigen (PSMA) folate hydrolase I, despite its name, has been found in tissues other than the prostate. It is overexpressed in prostate cancer cells and several other cancers, and has the potential to be a target for radioligand therapy. We investigated the value of STAT3, VEGF and PSMA immunohistochemical expression patterns and their effects on survival in MPNSTs, GBMs, and MMs. Their expression patterns were evaluated in 25 MPNSTs, 27 GBMs, and 25 MM cases. All GBM cases stained positively for STAT3 and VEGF. In the other groups, the staining patterns were heterogeneous. None of the cases showed positive staining with PSMA. There was no statistically significant difference in survival between cases with differing VEGF and STAT3 staining patterns in the MPSNT and MM groups, but there was an increase in mortality as the VEGF score increased in the GBM group. The suppression of VEGF and STAT3 may be a promising avenue for treatment of MPNSTs, GBMs, and MMs, although further research is needed.

Biomonitoring studies are important tools to understand the effects of endocrine-disrupting compounds on human health. Up to now, there have been no biomonitoring and risk assessment studies conducted in Turkish population in which urinary bisphenol A (BPA), 4-nonylphenol (4-NP), and 4-t-octylphenol (4-t-OP) levels were measured simultaneously. The aim of this study is to measure urinary BPA, 4-NP, and 4-t-OP on Turkish population and conduct a risk assessment using urinary levels of chemicals of interest. During the study, liquid chromatography with tandem mass spectrometry (LC-MS/MS) was used to measure urinary levels of above-mentioned chemicals, and human biomonitoring was used as a risk assessment tool in 103 volunteers, living in Mersin Region, Turkey. Urinary BPA, 4-NP, and 4-t-OP were founded as 0.0079 mu g/g creatinine, 0.0177 mu g/g creatinine, and 0.0114 mu g/g creatinine, respectively. The obtained estimated daily intakes (EDIs) were calculated as 0.095 mu g/kg bw/day, 0.041 mu g/kg bw/day, and 0.091 mu g/kg bw/day, for BPA, 4-NP, and 4-t-OP, respectively. In conclusion, although no potential health risk due to BPA and 4-NP exposure was observed, there might be health risks associated with 4-t-OP exposure in the Turkish population.

Klasik schwannomalar periferik sinir kılıfından köken alan iyi sınırlı benign tümörlerdir. Tüm schwannomaların yaklaşık %5 kadarını sellüler schwannomlar (SS) oluşturur. Fasiküler patern, yüksek sellülarite ve mitotik aktivite varlığı bazı vakalarda yanlış değerlendirme sonucu malign olarak tanı alabilir. Bursa Uludağ Üniversitesi ve Düzce Üniversitesi Tıp Fakültesi Patoloji Laboratuarı arşivlerindeki 16 SS olgusu yeniden değerlendirildi. En sık görülen yerleşim yeri paravertebral/paraspinöz bölge olup bunu mediasten, ekstremiteler, gövde, adrenal bez ve dil takip ediyordu. İmmünohistokimyasal boyama uygulanan 15 vakanın tamamında S100 ile kuvvetli pozitivite görüldü. Ki 67 ile boyanma düşük-orta seviyelerde olup sellüler alanlarda %25’e varan ki 67 proliferasyon indeksi mevcuttu. SS tanısı bazen zorlayıcı olabilir ve histopatolojik özelliklerinin bilinmesi olası yanlış tanı ve gereksiz tedavileri önlemek açısından önemlidir. Bu çalışmada iki merkezin arşivlerindeki SS olgularının klinikopatolojik özelliklerinin incelenmesi ve literatür ile karşılaştırılması amaçlanmıştır.

The European Health Literacy Survey Questionnaire was translated into Turkish following a validity and reliability study, but there is no comprehensive short form available. We aimed to suggest a short form of the 47-item Turkish version of European Health Literacy Survey Questionnaire in this study. Data were obtained from a cross-sectional study that included a total of 686 students, 345 male and 341 female, conducted in nine different faculties of a university using the Turkish version of European Health Literacy Survey Questionnaire. The development process of the short form was conducted using principal component analysis with exploratory factor analysis, and correlation and regression analyses. The validation process was done using confirmatory factor analysis and regression analysis. Based on the results, a 12-item short form was developed, retaining the conceptual framework of the European Health Literacy Survey Questionnaire. The short form was shown to have adequate psychometric properties with high reliability, good validity, a high and moderate level of correlation, and a good model fit with the independent dataset in this cross-sectional study. The short form developed in this study was demonstrated to be a valid and reliable tool to measure health literacy easily and rapidly in Turkey.

Amaç: Tıpta uzmanlık eğitimi, hizmet ve eğitimin birlikte yürüdüğü dinamik bir süreçtir. Bu çalışmadaki amacımız, XXXXX Üniversitesi Tıp Fakültesi Araştırma Hastanesi’nde uzmanlık eğitimi alan uzmanlık öğrencilerinin, eğitimin niteliği, sosyal destek algıları ve özerklik algıları bakımından değerlendirmektir. Gereç ve Yöntemler: Çalışmanın evrenini XXXX Üniversitesi Tıp Fakültesi Hastanesi’nde uzmanlık eğitimi alan tıpta uzmanlık öğrencileri oluşturmakta olup, çalışmaya katılmayı kabul eden uzmanlık öğrencilerinden bir örneklem oluşturulmuştur. Çalışmada veri toplama aracı olarak; uzmanlık öğrencilerinin sosyo-demografik özellikleri, beklenti ve çalışma ortamlarını değerlendirmek amacıyla hazırlanan bir anket formu ile “Mezuniyet Sonrası Hastane Eğitim Ortamı Ölçeği” (MESHEÖ) kullanılmıştır. Bulgular: Çalışmamıza katılmayı kabul eden ve anketleri tam olarak dolduran %58,2 (n=53)’si kadın %41,7(n=38)’si erkek 91 uzmanlık öğrencisinin verileri dahil edildi. Tüm öğrencilerin MESHEÖ toplam skor değerlendirmesine göre ortalaması 90,22±18,79 olup ‘’Olumlu ancak geliştirilmesi gereken eğitim ortamı’’ şeklinde değerlendirdikleri görülmüştür. Tüm uzmanlık öğrencilerinin %58,2(n=53)’si eğitimleri sırasında tuttukları nöbet sayısının uzmanlık alanları ile uygun olmadığını düşünmekte olup, nöbet sayısından memnun olmayan asistanların MESHEÖ puanları diğerlerinden anlamlı olarak düşük bulunmuştur (p, Objective: Medical residency education in medicine is a dynamic process in which service and education work together. The aim of this study was to evaluate the quality of education, social support perceptions and autonomy perceptions of the students who received residency education in xxxxx University Medical Faculty Research Hospital.Materials and Methods: The population of the study consisted of assistant physicians who received specialist training in XXXX University Medical Faculty Hospital and a sample of the residents who agreed to participate in the study was formed. As data collection tool; Post Graduation Hospital Education Environment Measure”( PHEEM) was used with a questionnaire prepared to evaluate sociodemographic characteristics, expectations and working environments of resident physicians. Results: The data of 91 residents, 58.2% (n = 53) female and 41.7% (n = 38) male, who agreed to participate in the study and completed the questionnaires completely were included in our study. The average score of all residents was 90.22 ± 18.79 according to the total score of PHEEM and it means ‘’ Positive but educational environment that needs improvement’’. 58.2% (n = 53) of all residents thought that the number of seizures they held during their training was not appropriate with their specialty, and the PHEEM scores of residents who were not satisfied with the number of seizures were found to be significantly lower than the others (p

Amaç: Bu çalışmanın amacı, pandemi döneminde sigara içme alışkanlıklarının özelliklerinde meydana gelen değişiklikleri incelemektir.Materyal ve Metod: Bu çalışma Düzce Üniversitesi Tıp Fakültesi Sigara Bırakma Polikliniğine Haziran 2020-Ocak 2021 tarihleri arasında sigara bırakmak için başvuran hastalar ile benzer yaş, cinsiyet ve eğitim özelliklerine sahip kontrol grubu hastalar üzerinde yapılmıştır.Bulgular: Pandemi döneminde sigarayı bırakan 165 hastadan oluşan çalışma grubu ve 163 hastadan oluşan kontrol grubu çalışmaya dahil edildi. Pandemi döneminde sigarayı bırakan hastaların sigarayı bırakmaya devam edenlere göre anlamlı düzeyde daha az denediği saptandı (p, Objective The aim of this study is to examine the changes in characteristics of smoking habits during the pandemic period.Methods This study was conducted on the patients who admitted to Düzce University Medical Faculty Smoking Cessation Outpatient Clinic between June 2020 and January 2021 and a control group with similar age, gender, and educational background characteristics. Results The study group with 165 patients who quit smoking during the pandemic period and the control group with 163 patients were included in the study. It was detected that patients who quit smoking during the pandemic period had attempted to quit smoking significantly less compared to those who continue smoking (p

Biomonitoring studies are important tools to understand the effects of endocrine-disrupting compounds on human health. Up to now, there have been no biomonitoring and risk assessment studies conducted in Turkish population in which urinary bisphenol A (BPA), 4-nonylphenol (4-NP), and 4-t-octylphenol (4-t-OP) levels were measured simultaneously. The aim of this study is to measure urinary BPA, 4-NP, and 4-t-OP on Turkish population and conduct a risk assessment using urinary levels of chemicals of interest. During the study, liquid chromatography with tandem mass spectrometry (LC-MS/MS) was used to measure urinary levels of above-mentioned chemicals, and human biomonitoring was used as a risk assessment tool in 103 volunteers, living in Mersin Region, Turkey. Urinary BPA, 4-NP, and 4-t-OP were founded as 0.0079 μg/g creatinine, 0.0177 μg/g creatinine, and 0.0114 μg/g creatinine, respectively. The obtained estimated daily intakes (EDIs) were calculated as 0.095 μg/kg bw/day, 0.041 μg/kg bw/day, and 0.091 μg/kg bw/day, for BPA, 4-NP, and 4-t-OP, respectively. In conclusion, although no potential health risk due to BPA and 4-NP exposure was observed, there might be health risks associated with 4-t-OP exposure in the Turkish population.

Aim: The aim of this study was to determine how to eliminate the treatment uncertainties, and correct and prevent inappropriate treatment in patients with renal failure.Material and Methods: We retrospectively evaluated the biochemistry department’s records of 438 patients with creatinine values >1.5 mg/dL that were followed-up at our hospital for the last five years. Demographics, type of renal dysfunction, related risk factors (use of nephrotoxic agents, surgical procedures, comorbidity, etc.), dialysis treatment, complications, and clinical outcome of these patients were recorded and analyzed.Results: The most important result of the study is that the quality of the medical data recorded was very poor. The most common type of acute renal injury was prerenal acute renal injury. Among the cases, the most common etiological factors were dehydration and use of nephrotoxic agents. Surgical procedures and comorbid conditions facilitated the development of renal dysfunction, and all complications observed were more common and serious in the elderly patients. Among the patients with chronic renal injury, more of those with diabetic nephropathy required hospitalization. Interestingly, nosocomial infections were the most common cause of mortality in the patients hospitalized due to renal dysfunction.Conclusion: Only a few medical records were suitable for retrospective evaluation. We think that if the quality of hospital data collection/storage systems could be improved, the quality of research data obtained in such studies would likewise improve and these data will bring preventive and corrective approach to mortality and morbidity., Amaç: Bu çalışmanın amacı, böbrek hasarı olan hastalarda tedavi belirsizliklerinin nasıl giderileceğinin belirlenmesi ve tedavideki uygunsuzlukların düzeltilmesi ve önlenebilmesidir.Gereç ve Yöntemler: Kreatinin değeri >1,5 mg/dL olan ve hastanemizde son beş yılda takip edilen 438 hastanın biyokimya anabilim dalı kayıtları geriye dönük olarak değerlendirilmiştir. Hastaların demografik özellikleri, böbrek fonksiyon bozukluğu tipleri, ilişkili risk faktörleri (nefrotoksik ajanların kullanımı, cerrahi prosedürler, komorbidite, vb.), diyaliz tedavisi, komplikasyonlar ve klinik sonuçları kayıt altına alındı ve analiz edildi.Bulgular: Çalışmanın en önemli bulgusu, kaydedilmiş olan tıbbi verilerin kalitesinin çok düşük olmasıdır. En sık görülen akut böbrek hasarı tipi prerenal akut böbrek hasarı idi. Olgular arasında en yaygın etiyolojik faktörler dehidratasyon ve nefrotoksik ajanların kullanımı idi. Cerrahi işlemlerin ve eşlik eden hastalıkların böbrek fonksiyon bozukluğu gelişimini kolaylaştırdığı, gözlenen tüm komplikasyonların yaşlı hastalarda daha sık ve ciddi seyirli olduğu belirlendi. Kronik böbrek hasarı olan hastalar arasında, diyabetik nefropatisi olanların çoğunun hastaneye yatması gerekiyordu. İlginç olarak, böbrek fonksiyon bozukluğu ile izlenen yatan hastalarda en önemli mortalite nedeninin nozokomiyal infeksiyonlar olduğu belirlendi.Sonuç: Retrospektif değerlendirme için sadece birkaç tıbbi kayıt uygundu. Hastane veri toplama/depolama sistemlerinin kalitesinin iyileştirilebilmesi durumunda, bu tür çalışmalarda elde edilen araştırma verilerinin kalitesinin de aynı şekilde gelişeceğini ve bu verilerin mortalite ve morbidite konusunda önleyici ve düzeltici bir yaklaşım getirmeyi kolaylaştıracağını düşünmekteyiz.