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The most important disadvantage of surgical mask usage is that it can aversely affect communication. This study aimed to evaluate the possible effects of face masks on the cognitive test performance of older adults.A total of 198 geriatric patients were enrolled after applying the exclusion criteria. Within the comprehensive geriatric assessment (CGA), cognitive status assessment was performed with the Mini-Mental State Examination test (MMSE) and Quick Mild Cognitive Impairment Screening test (Q-MCI) tests.The median age was 70 (66-77) years, and there were 119 female (60.7%) patients. Patients were divided into normal cognitive status (NC), mild cognitive impairment (MCI), and probable Alzheimer's disease (AD) groups. There were 129 (65.2%), 30 (15.2%), and 37 (18.7%) patients in each group, respectively. For differentiating MCI from NC, calculated optimal cut-offs for the Q-MCI and MMSE total scores were ≤50 (sensitivity 83.3%, specificity 90.7%) and ≤26 (sensitivity 63.3%, specificity 87.5%), respectively. For differentiating AD from MCI, calculated optimal cut-offs for the Q-MCI and MMSE total scores were ≤28 (sensitivity 76.8%, specificity 86.7%), and ≤24 (sensitivity 94.4%, specificity 64.5%), respectively.Our results revealed that screening tests are still sensitive in discriminating cognitive disorders although cut-offs are lower with mask usage than for previously validated cut-offs. This is the first study revealing the impact of surgical mask usage on cognitive test performance, indicating that cut-offs validated before the pandemic may cause overdiagnosing of cognitive disorders since the previous cut-offs are not validated for mask usage. Large sample studies are needed to determine new cut-offs validated with mask usage.

Objective: COVID-19 increases risk of malnutrition. With proper nutritional management, clinical outcomes are more positive but nutritional management is often overlooked. Aim of our study is to determine competences and attitudes of internal medicine research assistants working in COVID-19 services in terms of nutritional management and the factors that may affect this. Materials and Methods: A 12-question survey was applied to internal medicine research assistants worked/still working in the inpatient service and intensive care units where COVID-19 patients were followed up. Their competences and attitudes about nutrition were learned. Results: A hundred research assistants participated in the study. Ratio of those who considered their knowledge sufficient about nutrition management was 48% (n=48), enteral nutrition was 62% (n=62) and parenteral nutrition was 55% (n=55). There were 92 (92%) research assistants who thought that nutrition was a problem in COVID-19 patients, however there are only 6 (6%) research assistants who have read publications on nutritional management in COVID-19 patients. Research assistants who have performed intensive care or geriatrics rotation stated themselves more competent in nutrition (p = 0.001 & p

Objectives: This study examined the relationship between comorbidity indices and comprehensive geriatric assessment including psychologic, social frailty, and geropsychiatric evaluation. Methods: A cross-sectional analysis was conducted with 136 community-dwelling older adults. The relationship of 4 comorbidity indices (CIRS-G, ACCI, GIC, ICED) with 3 different frailty scales (FRAIL, CFS, TFI) was examined. Results: Overall, 58.8% of the participants were living with frailty according to the TFI, 47.7% of them living with psychological frailty, and 28.6% of them living with social frailty. There were significant and moderate correlations between CIRS-G and FRAIL, CFS and TFI total scores, TFI-Psychological scores and TFI-Social scores (respectively; pConclusion: The CIRS-G index was found to be superior to other indices in predicting the presence of frailty of comorbidity indices, and only GIC scores showed significant results in predicting mortality. However, it would be incomplete to conclude with a comorbidity index alone by ignoring the results of comprehensive geriatric assessment.

Amaç: Gastrointestinal stromal tümörler (GIST) sindirim sisteminin en sık görülen mezenkimal kaynaklı tümörleridir. Bu çalışmada cerrahi tedavi uygulanmış olan GIST hastalarının erken dönem cerrahi sonuçları sunulmaktadır. Materyal-Metod: Sakarya Üniversitesi Eğitim Araştırma Hastanesi Genel Cerrahi Kliniğinde 2008-2021 tarihleri arasında opere edilen ve histopatolojik olarak GIST tanısı doğrulanan hastaların sonuçları retrospektif olarak incelendi. Hastalar demografik veriler, klinik-patolojik özellikleri ve erken dönem cerrahi sonuçları açılarından ayrıntılı olarak değerlendirildi. Bulgular: Ameliyat edilen 55 hastanın E/K oranı 3/2, yaş ortalaması 57.82 yıl (45-81 yıl) idi. Karın ağrısı (37 hasta - %67.2) en sık başvuru şikayetiydi. Mide (37 hasta - %67.2) en sık etkilenen organdı. CD117 pozitifliği 53 hastada (%96.3) oranında görüldü ve Ulusal Sağlık Enstitüsü (NIH) kategorisine göre hastaların %56.6’sı yüksek risk sınıfı olarak kategorize edildi. 52 hastaya (%94.6) primer cerrahi rezeksiyon uygulandı. En sık açık ameliyat 40 hastada (%72,7) tercih edildi, çalışmanın son 6 yılı için ise açık/laparoskopi tercih edilme oranı 1/1 olarak belirlendi. Segmental rezeksiyon 29 hastayla (%52,7) açık veya laparoskopik en sık uygulanan rezeksiyon tipi idi. Tümör boyutları ortalama 7.03 cm (1-18 cm), ortalama hastanede yatış süresi 10.44 gün (5-45 gün) idi, enterokütan fistül gelişen bir hasta çalışma dışı bırakıldığında ise ortalama hastane yatış süresi 8.2 gün (5-19 gün) olarak belirlendi. Sonuç: GIST, uygun endikasyonlarda açık veya laparoskopik teknikle primer tedavi şekli komplet cerrahi rezeksiyon olarak deneyimli kliniklerde kabul edilebilir komplikasyon oranlarıyla güvenle tedavi edilebilir.

Frailty, orthostatic blood pressure changes (OBPC), and orthostatic intolerance syndrome (OIS) are common in geriatric patients. However, the results of the studies evaluating the relationship between these entities are discordant. We aimed to investigate the association between frailty and OIS with or without OBPC.Comprehensive geriatric assessment (CGA), frailty assessment, OBPC evaluations in the active-standing test (1st, 3rd, 5th, and 10th min), OIS investigation both in history before the test (self-reported OIS) and emerged during the active-standing test, and sarcopenia assessment via BIA and handgrip strength (HGS) were performed in 102 geriatric outpatients.Patients were divided into three categories according to their frailty status (non-frail, prefrail, and frail) by Modified Fried Frailty Index (FFI) and Clinical Frailty Scale (CFS). Prevalence of self-reported OIS and OIS during the test were statistically higher in the frail group assessed by both frailty scales (P value: 0.001 for CFS, P value 0.0001 for FFI, and P value: 0.001 for CFS, P value: 0.007 for FFI, respectively). Logistic regression analysis showed that OIS significantly increased frailty assessed both by FFI and CFS, when adjusted for age, sex, comorbidities, CGA, and sarcopenia (For FFI, OR: 19.37; 95% CI: 2.38-157.14; P value: 0.006 and for CFS OR: 4.32; 95% CI: 1.184-11.47; P value: 0.003, respectively).To the best of our knowledge, this is the first study defining OIS as symptoms both self-reported and provoked during the test, and showed a strong correlation between OIS and frailty. OIS may be defined as a multifactorial and independent marker for frailty, regardless of OBPC. Further prospective investigations are warranted to support the relationships between OIS and frailty.

We aimed to investigate the effects of colchicine, an important anti-inflammatory agent, on cognitive functions in a geriatric population diagnosed with gout or osteoarthritis by comparing it to non-colchicine users.138 geriatric patients (67 colchicine users and 71 non-users) were enrolled. Within comprehensive geriatric assessment (CGA), cognitive status assessment via Mini-Mental State Examination test (MMSE), Quick Mild Cognitive Impairment Screening test (Qmci), clock drowning test (CDT), and digit span tests were performed.Median age was 68 (65-72), and there were 82 female (59.4%) patients. The scores of CDT, Backward Digit Span Test, MMSE-Total, MMSE-Attention, MMSE-Motor Function, Qmci-Total Score, Qmci-Clock drawing, and Qmci-Logical Memory were significantly higher in the colchicine user group (p .005), showing better cognitive function. Adjusted model analysis showed that colchicine usage is independently correlated with higher Qmci-Total Score and Qmci-Logical Memory Score (For Qmci total score β = 7.87 95%CI = 5.48-10.27, p = 0.0001, and for Qmci Logical memory score β = 3.52, 95%CI = 2.12-4.91, p = 0.0001).To the best of our knowledge, this is the first study revealing that colchicine usage is associated with better cognitive performance in older adults. Further investigations with a prospective, larger-sampled and randomized design are needed to show the causal relationship between colchicine and cognition.

Osteosarcopenic obesity (OSO; also known as adiposity) is the combination of three critical conditions. This study aimed to define OSO using muscle ultrasonography (US), and examine the relationship between OSO and frailty compared with its constituent components.A total of160 geriatric patients with a body mass index of ≥30 were enrolled in the study. We obtained US measurements of the rectus femoris thickness and cross-sectional area (RFCSA). OSO was defined as the combination of low muscle function (defined by handgrip strength27 kg in men and16 kg in women), low muscle mass (RFCSA ≤5.22 cmThe median age of participants was 72 y, and 83% (n = 137) were female. Patients were divided into four categories: Obese (n = 72; 43.6%), osteoporotic obese (n = 44; 26.7%), sarcopenic obese (n = 19; 11.5%), and osteosarcopenic obese (n = 25; 15.2%). In the subgroup analysis, the prevalence of frailty was significantly higher in the OSO group than in the other groups on both frailty scales (P0.05). The regression analysis showed that OSO significantly increased frailty status when adjusted for confounders detailed in Table 1 (Fried Frailty Index: odds ratio: 5.10; 95% confidence interval, 1.669-15.132; P = 0.004; Clinical Frailty Scale: odds ratio: 3.765; 95% confidence interval, 1.236-11.465; P = 0.020).US-defined OSO is strongly associated with frailty in older adults according to the first study to define OSO using RFCSA measures.

Spinal paragangliomas are the neuroendocrine tumors of the extra-adrenal paraganglionic system. Spinal para- gangliomas are very rare. A 64-year-old female patient admitted to our clinic with non-specific complaints. Intradural mass ex- cision and lumbar posterior stabilization were performed with the diagnoses of degenerative narrow canal and intradural mass at L3 level following after the examinations. The pathological diagnosis came out as a paraganglioma. Full body scan images showed no multiple paragangliomas at any other location. Spinal paragangliomas are difficult to diagnose preoperatively due to the absence of any specific radiological and clinical findings and its very rare occurrence. We chose to present this case because of its formation in lumbar spinal canal, an unusual location for paragangliomas.

The survival of patients, who have cancer, is getting longer due to the developments in cancer treatment modalities. Nowadays Breast cancer is the most common type of cancers being identified at women. (%24.1) Distant metastasis are mostly seen at vertebral column in breast cancer. 60 years old woman was applied to our clinic with back pain and radiological images showed toracal spine fracture with spinal cord compression. The compression was removed urgently and pathology noticed breast cancer metastasis. Our purpose in this report is to emphasize that early surgical treatment improves the quality of life in such similar cases., Kanser tedavisindeki gelişmelere paralel olarak kanserli hastaların yaşam süreleri de uzamaktadır. Meme kanseri günümüz şatlarında kadınlarda en sık görülen kanser türüdür(%24.1). Meme Ca olgularında uzak metastazlar iskelet sisteminde en sık vertebral kolona olmaktadır. Sunduğumuz 60 yaşında olgu ağrı şikayetiyle kliniğimize başvurmuş yapılan radyolojik tetkikler sonucu gözlenen spina kord kompresyonu acil şartlarda kaldırılmış ve patoloji raporu meme kanseri metastazı olarak bildirilmiştir. Amacımız, erken cerrahi girişim hayat kalitesinin artmasında önemini vurgulamaktır.

Amac: Bu calismada; hemsirelerin klinik ornekler hakkindaki bilgi duzeylerinin degerlendirilmesi ve hizmet ici egitim ihtiyaclarinin belirlenmesi amaclandi.Gerec ve Yontem: Calismaya dahili ve cerrahi kliniklerinde calisan toplam 102 hemsire dahil edildi. Katilimcilara klinik orneklerle ilgili bilgi duzeylerinin ve sosyodemografik ozelliklerinin belirlenmesi icin iki bolumden olusan anketler yuz yuze gorusme ile uygulandi. Genel laboratuvar bilgisi, klinik ornekler, ornek alim teknikleri ve orneklerin tasinma/saklanma kosullari bilgileri ana basliklari altinda toplam 20 soru soruldu. Hemsirelerin sosyodemografik ozelliklerine gore anket sorularina verdikleri cevaplar istatistiksel olarak degerlendirildi.Bulgular: Gorev yeri ile dogru cevap sayisi arasinda anlamli istatistiksel fark (p=0.007) saptandi, Dahili kliniklerde calisan hemsireler daha basarili bulundu. Yas ve klinik ornekler ile ilgili bilgi duzeyi arasinda anlamli istatistiksel fark (p=0.009) saptandi ve 35 ustu yas gruplari basarisiz bulundu. Egitim duzeyi ile bilgi duzeyi arasinda anlamli fark (p=0.645) saptanmadi. Is tecrubesi gruplari arasinda bilgi duzeyi bakimindan anlamli istatistiksel fark (p=0.289) saptanamadi. Hemsirelerin 20 sorudan 8'ine anlamli istatistiksel fark olusturacak sekilde siklikla dogru yanit verdikleri (F > 4.679; p < 0.05) gozlendi. Sorulara verilen yanitlarin dagilimi incelendiginde hemsirelerin klinik orneklerle ilgili bilgi duzeylerinin yetersiz oldugu saptandi.Sonuc: Hastanemizde hemsirelik hizmetleri kalite programlari cercevesinde uygulanan hizmet ici egitimlerin klinik orneklerle ilgili kisminin yetersiz kaldigi goruldu. Hizmet ici egitim programlari duzenlenirken klinik orneklerle ilgili bilgi eksiklerinin dikkate alinarak mikrobiyoloji, biyokimya ve patoloji ile ilgili konularin kapsaminin genisletilmesi ve performans degerlendirilmelerinin de bu kapsamda tekrar gozden gecirilmesinin yararli olabilecegi dusunuldu.

Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare disease, occurring mostly at birth and adolescence, presents as erythematous and verrucous papules, which are pruritic and arranged in a linear array. Adult onset of the condition is very rare. ILVEN is a treatment-resistant disease. The lesions of the patient were presented at the age of 30 years and they were clinically and histopathologically consistent with ILVEN disease. Patient was treated with topical agents successfully. We presented the case since adult onset of ILVEN was seen rarely.

Sarcoidosis is a systemic granulomatous disorder and most often involve in lung, rarely may present with bone marrow involvement. Hematologic anomalies can be determined in patients with bone marrow involvement, but it is not a rule. A 47-year-old woman patient having complaints from backache, difficulty in walking and weakness in bilateral lower extremities admitted to our hospital we detected bicytopenia and lesion in L2-L3 vertebrae. Patient was operated. After pathological investigation of lesion we diagnosed bone marrow involvement of sarcoidosis. Lung and the other organs systems were normal. A-74-year-old woman patient having complaints from malaise and fatigue admitted to our hospital, we detected pancytopenia and vertebral lesion than we applied bone marrow biopsy from the lesion. After bone marrow biopsy we diagnosed bone marrow involvement of sarcoidosis. In other investigations lung involvement with mediastinal lymphadenopathy was detected and the other organ systems were normal. Here we presented two cases diagnosed with bone marrow involvement of sarcoidosis which is seen rarely., Sarkoidoz sistemik granülomatöz bir hastalıktır ve en sık akciğerleri tutar, nadir olarak kemik iliği tutulumu ile seyredebilir. Kemik iliği tutulumu olan hastalarda hematolojik anormallikler saptanabilmektedir. 47 yaşında bel ağrısı, yürümede güçlük ve çift taraflı alt ekstremitelerde güçsüzlük şikayetleri olan bayan hastada bisitopeni ve L2-L3 vertebrada lezyon saptandı. Hasta opere edildi. Lezyonun patolojik incelemesi sonucu sarkoidoz tanısı kondu. Yapılan diğer incelemeler sonucunda Akciğerde sarkoidoz tutulumu saptandı. 74 yaşında halsizlik ve yorgunluk şikayetleri olan bayan hastada yapılan tetkiklerde pansitopeni saptanması üzerine kemik iliği biyopsisi yapıldı. Kemik iliğinin patolojik olarak incelemesi sonucunda sarkoidozla uyumlu non-kazeifiye granülom saptandı. Yapılan diğer incelemelerde başka bir tutulum saptanmadı. Burada nadir görülen kemik iliği sarkoidozu saptanan iki olguyu sunduk.