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The aim of this study was to assess vitamin D serum levels in autoimmune thyroid disease, Hashimato thyroiditis in the Turkish population. the subjects with Hashimato thyroiditis (HT, n=67, mean age 45.1±10.9,F/M-61/6), control subjects (mean age 42.1±15.7, n=29, F/M-26/3) were recruited for the study. Thyroid function tests, thyroid antibodies (AntiTg, AntiTPO, TSHRAb), ultrasound features, demographic and antropometric variables were recorded. Vitamin D level was not different between the HT and the control groups (53.1±24.7 nmol/L and 54.1±19.8 nmol/L, as mean, respectively, p = 0.482) in the HT group, 35.8% of subjects had vitamin D insufficiency, only 16.4% of subjects with HT were vitamin D sufficient. There was no significant difference between the HT and the control groups according to the vitamin D classification status (p = 0.666). Vitamin D levels were significantly higher in the subjects who were taking replacement compared to subjects who were not (58.7 ± 26.0 vs. 46.0 ± 23.3, as mean, respectively, p = 0.033). There was no significant correlation between vitamin D levels and TgAb and TPOAb levels in HT group (p = 0.754 r = -0.039, p = 0.134 r = -0.290, respectively). in both HT and control groups, vitamin D levels were significantly correlated only with the fT4 levels (p

The achievement of euthyroid state has been suggested in patients with thyrotoxicosis undergoing surgery to reduce the risk of thyroid storm. However, euthyroid state could not always be achieved by antithyroid drugs. Therefore, therapeutic plasma exchange (TPE) is an option in this condition. A 58-year-old male patient with a history of type-2 diabetes using 200 mg amiodarone per day, admitted for diabetic ketoacidosis (DKA), induced by thyrotoxicosis. with palpitation, sweating, polyuria, and polydipsia. Euthyroid state could not be achieved, despite all apropriate treatments for thyrotoxicosis. Therefore, preparation with TPE followed by total thyroidectomy was planned. A 35% decrease in fT3 (free T3) and fT4 (free T4) levels were achieved, after two sessions of TPE. A 74-year-old male patient, admitted for acute anterior myocardial infarction (AMI) induced by thyrotoxicosis due to Graves disease. Multiple vessel disease was detected on primer percutanous coronary angiography, and an emergency coronary artery bypass grafting (CABG) was planned. Therefore, preperation with TPE was planned before surgery. A substential decrease in fT4 and fT3 levels (45% and 72%, respectively) levels were achieved, after one session of TPE. Most of the studies evaluating the efficacy of TPE in patients with thyrotoxicosis are including patients with Graves disease and toxic multinodular goiter, and TPE was indicated as an effective option for preparation of these patients for surgery. However, as presented in case 1, TPE may not be effective in amiodarone induced thyrotoxicosis (AIT) as in cases with thyrotoxicosis due to Graves disease. [Med-Science 2019; 8(1.000): 233-6]

Gastric cancer comprises 10% of all cancers in the world and is rarely seen before the age of 30. Different genetic interactions or molecular changes like e-cadherin, P16, APC, c-erb B2, c-met, ras, or c-myc have been described in the pathogenesis of the disease. MiRNAs play critical roles in various biological processes such as cell proliferation, cell differentiation, apoptosis, repairing of DNA damage, angiogenesis, stress response, and stem cell division. The aim of this study is to investigate the relationship between miRNA gene expressions and gastric cancer. Method: Sixty-four patients with gastric cancer diagnosed consecutively in our pathology laboratory and 30 consecutive participants with normal gastric tissue, as a control group, were included in our study between 2011 and 2013. Total miRNAs were obtained by using genomic miRNA extraction kit (QIAGEN Sample & Assay Technologies, Hilden, Germany) after the samples had been deparaffinized. MiR-21, 107, 141, 150, 192, 202, 218, 331 gene expressions were evaluated by using real time-PCR (RT-PCR) from the whole miRNA. Results: MiR-331 was downregulated in the stage 2 patients and the rest of the miRNAs were significantly upregulated (p < 0.001). All miRNAs were significantly upregulated in the stage 3a patients (p < 0.001). In the antrum localized tumors, miR-107, -150, -202, -218, and -331 were significantly upregulated, whereas miR-21, -192 were statistically downregulated (p < 0.05). In the cardia localized tumors, miR-21 (p > 0.05) was downregulated and miR-107, -150, -202, -218, and -331 were upregulated (p < 0.05) Different gene expressions of miRNAs according to the different localizations of gastric cancer and different stages suggest that it can be tumor marker to predict the stage and localization of gastric cancer. [Med-Science 2019; 8(1.000): 255-9]

Chest pain (CP) is the major presenting symptom of coronary artery disease (CAD) wherein history remains to be a fundamental and challenging diagnostic step. Despite the clarity of typical CP characteristics in guidelines; interpretation and description of CP by patients are open to wide variations. The aim of this study was to define the components of CP that most closely associate to presence of obstructive CAD and determine the influence of gender on CP features. Herein, consecutive patients with suspected stable CAD who were scheduled for a coronary angiography(CAG) were prospectively enrolled. The data on demographic and pain characteristics were collected by a questionnaire. Patients were categorized into CAD and Normal groups with respect to presence of obstructive CAD in CAG. Among 402 patients, 86 had chest discomfort or equivalent symptoms but denied CP. Patients with CAD were more commonly male; with older age, lower BMI, more frequent prior revascularization, clopidogrel use, higher creatinine and lower HDL levels. When classical features of CP such as quality; location, duration, relationship to exertion were compared; stabbing/sharp pain, CP related to cold or emotional stress and CP that radiates to back were significant factors against CAD; while absence of precipitating factors was related to CAD. Yet, none of the features of typical angina pectoris were significantly related to presence of CAD. Determinants of CAD were; prior revascularization (OR= 22.7, p=0.021), body mass index (OR=1.4, p=0.007), clopidogrel use(OR=55.5, p=0.018) and blood glucose (OR=1.02, p=0.046) in women; and age (OR=1.2, p=0.029) was the single predictor of CAD in men. This study demonstrated no association between classical features of typical CP and presence of CAD in patients with stable angina pectoris. Clinical factors that influenced presence of CAD in different genders were also different. [Med-Science 2019; 8(1.000): 88-92]

HHV-8 is associated with Kaposi sarcoma, multicentric Castleman disease and primary effusion lymphoma mostly in immunocompromised patients. in this report, we describe a female patient without any immunosuppressive state, encountering those three malignancies throughout her lifetime. A-69-year-old female patient was diagnosed with Kaposi sarcoma in 2009 and multicentric Castleman disease in 2011. She received several chemotherapy regimens during 4 years and stayed in remission during following 5 years. Then, she was diagnosed with primary effusion lymphoma, extracavitary/solitary variant on excisional biopsy of her cervical lymphadenopathy. Despite having 5 different lines of chemotherapy protocols, including autologous stem cell transplantation, and systemic cidofovir treatment, she died because of progressive disease. HHV-8 associated malignancies are not prevalent in immunocompetent patients. Our patient, who has suffered from all three malignancies related to HHV-8, is the only HIV negative patient in the literature with primary effusion lymphoma, extracavitary/solitary variant.

Endometrial cancer is the most common gynecological cancer. Increased postmenopausal endometrial thickness may be an indicator of endometrial cancer. Transvaginal ultrasound (TV-USG) is the primary imaging method for evaluating endometrial thickness in the postmenopausal period. The aim was to employ transvaginal ultrasonography in the evaluation of adnexal masses synchronously seen in postmenopausal women with increased endometrial thickness. The work was designed as a retrospective study. The medical records of 155 patients evaluated for increased postmenopausal endometrial thickness were examined. Ultrasonography had been performed on the women in the study for routine follow-up, postmenopausal hemorrhage, pelvic pain, pelvic mass on examination and family history of gynecological cancer. All patients had undergone endometrial evaluation with fractional dilatation and curettage (D & C) or pipelle endometrial sampling. Histopathological diagnosis was based on endometrial sampling results. Adnexal mass was present simultaneously in 17.4% (n = 27) of the women included in the study, while 82.6% (n = 128) had no gynecological pathology other than increased endometrial thickness. The endometrial thickness in the women with postmenopausal adnexal masses was greater than in those without adnexal mass (11.7 mm vs. 7.8 mm, p = 0.009). Non-atypical and atypical endometrial hyperplasia was more frequent in the group with postmenopausal adnexal mass (11.1% vs. 2.8%, 11.1% vs. 3.79, p = 0.03, p = 0.04, respectively). Final histopathological evaluation of patients operated on for adnexal masses revealed tubo-ovarian abscess in 1.9% (n = 1), benign ovarian tumor in 25.9% (n = 7) and malignant ovarian tumor in 11.1% (n = 3) of the patients. In postmenopausal women, adnexal masses can be seen simultaneously with increased endometrial thickness. In this regard, transvaginal ultrasound offers important opportunities for evaluation of both the endometrium and adnexa. Pre-surgery transvaginal ultrasound as well as multivariate serum markers may be used in evaluation models. [Med-Science 2018; 7(4.000): 848-51]

Recent studies suggest a potential link between Alzheimer's disease (AD) and cancer yet lack of evidence exists to understand the shared mechanism underlying both diseases. Accumulating research investigating the association between AD and specific types of cancers such as breast, lung and prostate cancer claim inverse relationship between them however possible molecular relationship between AD and hepatocellular carcinoma (HCC) has not been well studied. In this study, we reanalyzed RNA-sequencing data sets related to late-onset AD (LOAD) and HCC to identify common differentially expressed genes (DEGs), molecular pathways as well as key miRNA regulators that may involve in the pathogenesis of both diseases. The data sets were retrieved from NCBI-GEO omnibus database and analyzed by GREIN web tool. Overlapped DEGs were identified and their functional enrichments were analyzed by NetworkAnalyst. Cytoscape software was used to visualize network and identify hub genes. MicroRNAs targeting the hub genes were also determined by mirDIP database. A total of 33 DEGs were found to be dysregulated in both datasets and five genes (HLA-A, HLA-C, TRIM31, HLA-DQB2, HLA-DRB1) were identified as hub genes that possibly involve in the shared molecular etiology of both diseases. Our analyses revealed that common DEGs are enriched in molecular pathways related immune system and multiple miRNA regulators are likely to coregulate the expressions of shared hub genes. The results emphasize in silico evidence of common molecular background for LOAD and HCC, which can be ultimately utilized for risk assessments and drug development approaches for both diseases., Son zamanlardaki çalışmalarda Alzheimer hastalığı (AH) ve kanser arasında bir bağlantı olduğu ortaya konmuş fakat ortak mekanizmayı açıklayacak yeterince kanıt mevcut değildir. Bu bağlantıyı araştıran birçok çalışmada özellikle meme, prostat ve akciğer gibi kanser türleri ile AH arasında ters ilişki olduğu gösterilmekle beraber hepatosellüler karsinom (HCC) ve AH arasındaki ilişki henüz aydınlatılmamıştır. Bu çalışmada, geç başlangıçlı AH (LOAD) ve HCC ile ilişkili RNA dizileme (RNA-seq) verilerini biyoinformatik araçlarla analiz ederek iki hastalığın patogenezinde etkin olması muhtemel ortak moleküler yolakları, ortak diferansiyel olarak ifade olan genleri (DEG) ve aday anahtar miRNA’ları tespit etmeyi amaçladık. RNA-seq veri setleri NCBI-GEO omnibus veri tabanından alınarak GREIN web uygulaması ile analiz edildi. Ortak DEG’ler tespit edilerek, fonksiyon zenginleştirme analizleri NetworkAnalyst ile yapıldı. Network görselleştirme ve hub gen tespiti Cytoscape programı ile gerçekleştirildi. Hub genleri hedef alan miRNA’lar mirDIP veri tabanı ile belirlendi. Analiz sonucunda iki veri setinde ortak disregüle olan 33 DEG tespit edildi ve network analizinde iki hastalığın moleküler etiyolojisinde olası rolü olan ortak 5 hub gen (HLA-A, HLA-C, TRIM31, HLA-DQB2, HLA-DRB) belirlendi. Ortak DEG'lerin immun sistemle ilişkili moleküler yolaklarda ve biyolojik süreçlerde etkin olduğunu gözlemlendi. Ortak hub genlerin koregülasyonunda potansiyel düzenleyici rolleri olabilecek iki hastalıkla da ilişkili olduğu tahmin edilen birçok miRNA bulundu. Sonuçlarımız, her iki hastalık için risk değerlendirmesi ve ilaç geliştirme yaklaşımları için kullanılabilecek ortak moleküler mekanizmayı in silico kanıtlarla vurgulamaktadır.

Amaç: Bu çalışmada acil serviste çalışan sağlık personelinin uğradığı şiddet türleri ve şiddetin nedenleri ele alınmıştır. Temel amaç, şiddetin nedenleri ve türlerini ortaya koymak ve bu konuda alınması gereken koruyucu ve önleyici tedbirler konusunda farkındalığı arttırmaktır. Gereç ve Yöntem: Bu araştırma betimsel tarama modelini esas alan bir çalışmadır. Bu araştırmanın çalışma grubu, İstanbul Üniversitesi Cerrahpaşa, Cerrahpaşa Tıp Fakültesi Dekanlığına bağlı hastanenin acil servisinde çalışan tüm sağlık personeli (Doktor, hemşire, acil tıp teknisyenleri, gibi sağlık hizmetleri sınıfı, idari hizmetler olan güvenlik, bilgi işlem gibi)’nden oluşmaktadır. Acil serviste çalışan 121 sağlık personeli çalışmaya katılmayı kabul etmiştir. Bulgular: Araştırmada elde edilen sonuçlara göre, sağlık personeline şiddet uygulayanlar sıralamasında %64 oran ile hasta yakınları ilk sırada, %33,3 oran ile hastalar ikinci sırada yer almıştır. Acil serviste şiddet en fazla 24:00–08:00 saatleri arasındaki vardiyada (%40) uygulanmakta, personelin %52,1 daha önce şiddete maruz kalmış, kaldıkları şiddet türü sıralamasında %52 ile sözel şiddet ilk sırada, fiziksel şiddet ikinci sırada, duygusal şiddet üçüncü sırada ve son sırada ise cinsel taciz yer almaktadır. Sonuç: Acil servis personeline göre, acil servislerde şiddetin ortaya çıkmasında en etkili nedenler; hastaların sabırsız olması, hasta ve sağlık çalışanları arasında etkili iletişim kurulamaması, bekleme sürelerinin uzun olması ve personel sayısının eksiliği en önemli faktörler olarak karşımıza çıkmaktadır. Objective: the main purpose of this study is to show the reasons for violence and the types of violence against health staff who work in emergency rooms and to raise awareness of protective and preventive precaution to be taken in this regard. Material and Method: This research is based on a descriptive survey model. the study group for this study consists of all health personnel working in the emergency room department of the hospital of Istanbul University Cerrahpaşa Medical Faculty (doctors, nurses, emergency medicine technicians, security services, administrative services etc.). 121 medical staff working in the emergency department consented to participate in the study. Results: According to the results obtained in the study, 64% of the patients’ relatives in the first place who commit violence towards health personnel, the rate of 33.3% with patients took the second place. Violence in the emergency department is mostly commited in shifts between 00:00–08:00 am. (40%), 52.1% of staff have been subjected to violence in the past, verbal violence is the most common with a rate of 52%, the second place was by physical violence and emotional violence took third place and sexual harassment was the fourth most common form of violence reported. Conclusion: the most common reasons for the emergence of violence in emergency rooms, according to emergency room personnel; impatient patients, communication problem between patients and health workers, long waiting times and lack of workers are the most important factors.

Objective: To evaluate the outcomes of pregnancies with maternal heart disease. Material and Method: the results of 115 patients in our clinic between 2013 and 2018 were retrospectively analyzed. the type of heart disease and functional classification of the New York Heart Association were taken into consideration when evaluating the cases. Results: According to the New York Heart Association classification, the distribution of patients was 67.1% for stage I, 18.2% for stage II, and 14.7% for stage III–IV. There was no maternal or perinatal mortality. the incidence of rheumatic and congenital heart diseases was 51.3% and 27.8%, respectively. Maternal morbidity was observed in 18 cases (15.6%). Mean gestational age and birth weight were significantly higher in the stage I–II functional capacity group (p0.05). Conclusion: It is possible to obtain satisfactory results for both mother and fetus in the majority of pregnant women with heart disease when managed with a multidisciplinary approach. Amaç: Maternal kalp hastalığı bulunan gebeliklerin sonuçlarını değerlendirmek. Gereç ve Yöntem: 2013-2018 yılları arasında bir kliniğimizdeki 115 maternal kalp hastalığı olan olgunun sonuçları retrospektif olarak incelenmiştir. Olgular değerlendirilirken kalp hastalıklarının türü ve New York Kalp Derneği’nin fonksiyonel sınıflaması göz önünde bulundurulmuştur. Bulgular: New York Kalp Derneği sınıflamasına göre hastaların dağılımı evre I için %67,1, evre II için %18,2, evre III–IV için ise %14,7 idi. Maternal ya da perinatal mortalite saptanmadı. Romatizmal ve konjenital kalp hastalıklarının görülme oranı sırasıyla %51,3 ve %27,8 olarak bulundu. Maternal morbidite 18 olguda (%15,6) gözlendi. Ortalama doğum haftası ve doğum kilosu evre I–II fonksiyonel kapasiteli grupta belirgin yüksekti (p0,05). Sonuç: Multidisipliner bir yaklaşımla yönetildiğinde kalp hastalığı bulunan gebelerin çoğunluğunda hem anne hem fetüs için memnun edici sonuçların alınması mümkündür.

Objective: Previous studies showed that obstructive sleep apnea syndrome (OSAS) was associated with liver diseases such as elevated liver enzyme levels and hepatic steatosis. The aim of this study was to assess the relationship between serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and OSAS and its severity. Methods: A total of 617 patients who underwent PSG (polysomnography) between January 2016 and May 2017 were evaluated in this study. AST, ALT, total cholesterol, triglyceride levels and body mass index were analyzed. The data were analyzed using the Student t-test, ANOVA, Chi-square test, and Pearson's correlation coefficient. Results: Five hundreds and thirty patients with OSAS and 60 healthy controls were included in the study. Of the patients in the OSAS group, 17.7% had an elevated ALT level and 7.9% had an elevated AST level. There was a statistically significant difference in ALT and AST levels between the OSAS and control groups (p < 0.001 and p < 0.001, respectively). In the OSAS group, there was a statistically significant positive relationship between serum ALT and AST levels and apnea-hypopnea index (AHI), apnea index, oxygen desaturation index. Both AST and ALT levels were statistically significantly higher in obese patients than in non-obese patients (p < 0.001 and p < 0.001, respectively). ALT level was statistically significantly higher in patients without hypertension than in patients with hypertension (p < 0.001). In OSAS patients without hypertension, there was a statistically significant relationship between serum ALT and AST levels and AHI (r = 0.223, p < 0.001 and r = 0.142, p = 0.007; respectively). Conclusion: OSAS is a risk factor for elevated liver enzyme levels. Hypoxia plays an important role on liver enzymes in OSAS patients.

Aim: In this study, we aimed to investigate the potential role of lung mast cells in migraine by using a nitroglycerin-induced migraine model in rats. Materials and Methods: Thirty-five adult male Wistar rats were divided into five groups. Each treatment being performed intraperitoneally, the NS group received 0.2 ml normal saline, the NTG group 10 mg/kg nitroglycerin, the NTG vehicle group 0.2 ml 0.1% ethanol in normal saline, the L-NAME+NTG group 50 mg/kg L-NAME + nitroglycerin, and the NS+NTG group normal saline + nitroglycerin. Two hours after the nitroglycerin and other treatments, the rats under anesthesia were intracardially perfused with a solution of 150 ml 4% paraformaldehyde. The lungs were harvested and stained with toluidine blue to observe mast cells. The data were analyzed by using one-way ANOVA. Results: Nitroglycerin increased significantly both number (from 94±3.8 to 131±6.7, p=0.0035) and percent of degranulation (from 11.8±1.3% to 35.5±5.7%, p=0.003) of lung mast cells. However, L-NAME prevented the effects of nitroglycerin on the number and degranulation of lung mast cells, attenuating the increase in both number (from 136±5.1 to 93±2.5, p=0.0011) and degranulation percentage of lung mast cells (from 37.3±1.0% to 13.6±3.1%, p=0.001) induced by nitroglycerin. Discussion and Conclusion: Our findings demonstrate that nitroglycerin treatment leads to an increase in the number and degranulation of lung mast cells in a rat model of migraine induced by nitroglycerin. Moreover, L-NAME prevented these effects, suggesting that nitric oxide released from nitroglycerin directly or indirectly leads to the activation of lung mast cells. The results obtained in the current study can pioneer new research on the role of lung mast cells in migraine. Amaç: Bu çalışmada sıçanlarda nitrogliserin ile oluşturulan migren modeli kullanılarak akciğer mast hücrelerinin migrendeki muhtemel rolünü araştırmak amaçlanmıştır. Gereç ve Yöntemler: Otuz beş yetişkin erkek Wistar sıçan beş gruba bölündü. Tüm uygulamalar intraperitoneal yoldan olmak üzere; NS grubuna 0,2 ml normal salin (serum fizyolojik), NTG grubuna 10 mg/kg nitrogliserin, vehikül NTG grubuna 0,2 ml normal salin içinde %0,1’lik etanol, L-NAME+NTG grubuna 50 mg/kg L-NAME + nitrogliserin, NS+NTG grubuna ise 0,2 ml normal salin + nitrogliserin uygulandı. Nitrogliserin ve diğer uygulamalardan iki saat sonra sıçanlar anestezi altında 150 ml %4’lük paraformaldehit ile intrakardiyak olarak perfüze edildi. Akciğerler alındı ve mast hücrelerini gözlemlemek için toluidin mavisi ile boyandı. Veriler tek yönlü varyans analizi ile incelendi. Bulgular: Nitrogliserin akciğer mast hücrelerinin hem sayısında (94±3,8’den 131±6,7’ye; p=0,0035) hem de degranülasyon yüzdesinde (%11,8±1,3’ten %35,5±5,7’ye; p=0,003) anlamlı bir artış sağladı. L-NAME ise akciğer mast hücrelerinin sayı ve degranülasyonu üzerinde nitrogliserinin yol açtığı bu etkileri önledi, böylece akciğer mast hücrelerinin nitrogliserin ile tetiklenerek artan sayısını ve degranülasyon yüzdesini ayrı ayrı azalttı. Tartışma ve Sonuç: Bulgularımız nitrogliserin ile oluşturulan migren sıçan modelinde nitrogliserin uygulamasının akciğer mast hücrelerinin sayısında ve degranülasyonunda bir artışa yol açtığını göstermiştir. Ayrıca L-NAME’nin bu etkileri önlemiş olması, nitrogliserin kaynaklı nitrik oksidin direkt veya indirekt olarak akciğer mast hücrelerinin aktivasyonuna yol açtığını düşündürmektedir. Bu çalışmada elde edilen sonuçlar akciğer mast hücrelerinin migrendeki rolü üzerine yapılacak yeni araştırmalara öncülük edebilir.

Amaç: Bu çalışmada, Istranca meşesi (Quercus hartwissiana Steven) kabuğu ekstraktlarının bakteriyelve fungal patojenlere karşı antimikrobiyal aktivitesini araştırmak amaçlanmıştır.Gereç ve Yöntemler: Istranca meşesinin, etanol, formaldehit, aseton, etil asetat ve metanol çözücüleriile ekstraksiyonu gerçekleştirilmiştir. Bu ekstraktlardan 50 µl alınarak steril disklere emdirildiktensonra ekstraktlarda bulunan çözücülerin sonucu etkilememesi amacıyla diskler 24 saat steril ortamdakurutulmuştur. Disk difüzyon yöntemiyle Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichiacoli, Klebsiella pneumoniae, Salmonella spp., metisilin dirençli Staphylococcus aureus, metisilinduyarlı Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus spp., Candida albicans,Candida glabrata ve Candida tropicalis türlerine karşı antimikrobiyal aktivite araştırılmıştır.Bulgular: En geniş zon çapının etanolle hazırlanan ekstraktta Enterococcus spp. (8 mm) ve S. epidermidis(8 mm) suşlarına, formaldehit ve etil asetatla hazırlanan ekstraktlarda E. Coli suşuna (16 mm,28 mm), asetonla hazırlanan ekstraktta Enterococcus spp. suşuna (21 mm), metanolle hazırlananekstraktta ise metisilin duyarlı S. aureus suşuna (28 mm) karşı oluştuğu görülmüştür. Mayalarda iseen geniş zon çapının etanolle hazırlanan ekstraktta C. glabrata suşuna (12 mm), formaldehitle hazırlananekstraktta C. albicans (28 mm) ve C. tropicalis (28 mm) suşlarına, aseton, etil asetat ve metanollehazırlanan ekstraktlarda C. albicans suşuna (19 mm, 30 mm, 22 mm) karşı oluştuğu saptanmıştır.Tartışma ve Sonuç: Etil asetat ile hazırlanan ekstraktın diğer çözücülerle hazırlanan ekstraktlara kıyaslaçalışılan suşlara karşı daha geniş zon çapı oluşturduğu saptanmıştır. En geniş zon çapı E. coli, S. aureusve C. albicans türlerinde oluştuğundan, ülkemizde doğal olarak yetişen Istranca meşesinin inhibeedici etkilerine yönelik in vivo antimikrobiyal çalışmalar yapılmasının önemli olduğunu düşünmekteyiz. Aim: This study aimed to investigate the antimicrobial activity of extracts from the Istranca oak (Quercushartwissiana Steven) against bacterial and fungal pathogens.Materials and Methods: Extraction of the Istranca oak was carried out with ethanol, formaldehyde,acetone, ethyl acetate, and methanol solvents. After injecting 50 ?l of these extracts into sterile discs,the discs were dried in a sterile environment for 24 hours in order for the results not to be affected bythe solvents present in the extracts. Antimicrobial activity against the species Pseudomonas aeruginosa,Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Salmonella spp., methicillin-resistantStaphylococcus aureus, methicillin-susceptible Staphylococcus aureus, Staphylococcusepidermidis, Enterococcus spp., Candida albicans, Candida glabrata and Candida tropicalis was investigatedby disc diffusion method.Results: It was observed that the extract prepared with ethanol showed the widest zone diameteragainst Enterococcus spp. (8mm) and S. epidermidis (8mm), the extracts with formaldehyde and ethylacetate against E. coli (16mm, 28mm), the extract with acetone against Enterococcus spp. (21mm),and the extract with methanol against methicillin-susceptible S. aureus (28mm). For the yeasts, theextract prepared with ethanol showed the widest zone diameter against C. glabrata (12mm), the extractwith formaldehyde against C. albicans (28mm) and C. tropicalis (28mm), and the extracts preparedwith acetone, ethyl acetate, and methanol against C. albicans (19mm, 30mm, 22mm).Discussion and Conclusion: It was determined that the extract prepared with ethyl acetate showedwider zone diameter against the strains studied, compared to extracts prepared with the other solvents.Given that the widest zone diameters were observed against the strains E. coli, S. aureus and C.albicans, we think that it is important to conduct in vivo antimicrobial studies on the inhibitory effectsof the Istranca oak indigenous to our country.

Objective. The aim of this study was to determine the clinical presentation of tuberculosis cases from our center for the last nine years. Methods. This study was set as descriptive and retrospective. The data was obtained from the hospital records. Subjects who had been diagnosed as tuberculosis and received treatment in our center between the years 2007 and 2015 were included. The cases were classified as newly diagnosed, relapse, transferred, and returning after default. Results. There were 276 (171 males and 105 females) patients with a mean age of 41.5 ± 19.2 years. Pulmonary involvement is the most common presentation and seen in 155 (56.2%) patients. Lymph node and pleura are the most common extrapulmonary involvements those are seen in 53 (19.2%) and 23 (8.3%) patients, respectively. Number of the cases seems to decreased after 2012. Most (85.1%) of the patients were newly diagnosed. Among the subjects, 55.2% of them had bacteriologic diagnosis, 35.1% had histopathologic diagnosis. Two subjects died during the treatment period whereas 274 of them completed the treatment program. Conclusions. Our results show that tuberculosis is seen mainly in the adult age group. While pulmonary involvement is the most common presentation, lymph node and pleura involvements are the most common extrapulmonary presentations. Number of the tuberculosis seems to decrease for the recent years. Strict preventive measures and treatment strategies should be administered.

Ortodontik tedavinin amacı; bireyin dentofasiyal fonksiyonlarını ve estetiğini geliştirerek yaşam kalitesini artırmaktır. Başarılı bir tedavinin kriterleri; en az histolojik hasar ve ağrı, hızlı diş hareketi, kısa tedavi süresi ve stabil sonuçlardır. Son yıllarda ortodontik tedavi talebi giderek artmaktadır. Ortodontik tedavi sürelerinin uzun olması, hem hastaların psikolojik motivasyonlarını etkilemekte, hem de çürük, dişeti çekilmesi ve kök rezorpsiyonu gibi birçok istenmeyen duruma yol açmaktadır. Bu sebeple son yıllarda araştırıcılar ortodontik diş hareketinin hızlandırılması üzerine çalışmalar yapmaktadır. Ancak daha hızlı diş hareketi elde etmek için laboratuvar ve klinik olarak birçok girişimde bulunulmasına rağmen, bu tekniklerle ilgili belirsizlikler ve cevaplanmamış sorular halen mevcuttur. Literatürde ortodontik diş hareketini hızlandırmak amacıyla çoğu henüz hayvanlar üzerinde denenmiş ve insanlar üzerinde uygulanabilirliği kuşkulu olan cerrahi teknikler, fiziksel ve kimyasal uygulamalar bildirilmiştir. Ancak diş hareketi multifaktöriyel bir olgu olduğu için konu hakkında gelecekte daha fazla araştırma yapılması gerekmektedir. Bu derlemede literatürde şu anda var olan ortodontik diş hareketi hızlandırma yöntemlerinden bahsedilecektir., The purpose of orthodontic treatment is to enhance patients’ life quality by improving their dentofacial functions and aesthetics. Minimal histological damage and pain, rapid tooth movement, short treatment duration, and stability of results are the major criteria for successful treatment. In recent years, the demand for orthodontic treatment has been increasing gradually. Prolonged duration of orthodontic treatment affects the psychological motivation of the patients and leads to several undesirable situations, such as caries, gingival recession, and root resorption. Thus, in recent years, related research has investigated the acceleration of orthodontic tooth movement. However, despite the various laboratory and clinical interventions designed to achieve faster tooth movement, uncertainties and unanswered questions about these techniques persist and warrant further investigation. Several surgical techniques as well as physical and chemical applications have been reported by previous studies to accelerate orthodontic tooth movement, most of which have been conducted on animals, with debatable applicability on humans. However, as tooth movement is a multifactorial phenomenon, further research is needed in the future. In this review, we describe the orthodontic tooth movement acceleration methods reported thus far.

We sought to investigate the prevalence of skin tumors in Muğla, which has a Mediterranean climate and a high population of elderly people. This was a cross-sectional study conducted on patients, 65 years old and older, who consulted at our dermatology outpatient clinics between January 2014 and January 2015. Diagnoses of the patients were obtained and retrospectively evaluated from the electronic medical records of the hospital. Of 2297 geriatric patients, 50.8% were females and 49.2% were males. Of these patients, 12% had actinic keratosis, 5.4% had seborrheic keratosis, 2.1% had basal cell carcinoma, 0.8% had squamous cell carcinoma, and 0.1% had malignant melanoma. In patients

Depression is a major mental health issue worldwide, and university students with heavy burdens of study are at a high risk for depression. The purpose of this study was to determine the prevalence of depressive symptoms among nursing students, and to explore the association between socio-demographic factors, health-related quality of life and depressive symptoms. This study adopted a cross-sectional design. A total of 345 nursing students from a Faculty of Health Sciences were assessed by the questionnaire consisted of demographic information, Beck Depression Inventory (BDI), a 12-item Short Form Health Survey. SPSS software, version 16, was used to analyze the data. Pearson Chi-Square, Fishers Exact Test and Independent-Samples T-Test were used to compare different categorical variables. A total of 345 nursing students participated in the study (282 females and 63 males). Overall, 92 (26.7%) of the participants had depression of various grades based on the BDI diagnostic criteria using a cut point of more than 17. The depressive symptoms were statistically associated with gender and the parental attitudes. BDI score at the cut point of 17 was statistically associated with the Physical and Mental Health Composite Scores. This study seems to indicate an alarming rate of depressive symptoms. Female gender, non-democratic parental attitude have the highest association with depressive symptoms. The findings suggested that in order to prevent depression among undergraduate nursing students, school-and family based strategies should be developed and implemented. [Med-Science 2018; 7(1.000): 154-157]

Diabetic retinopathy (DR) is a complication of diabetes mellitus (DM) that may causes blindness. The vitreous is an extracellular matrix and it may have changes through liquefaction and syneresis in patients with DM, even in those without apparent DR. Diffusion-weighted imaging (DWI) is a new technique provide tissue contrast relying on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to investigate the vitreous of patients in different stages of DR using diffusion-weighted imaging technique. This prospective study included a group of 100 patients with DR and 100 members of an age- and gender-matched control group. All groups were tested using a head coil in conduction with a Achieva 1.5T magnetic resonans imaging (MRI) system (Philips Medical Systems, Best, The Netherlands). The mean ADC values were calculated and used for statistical comparisons. Mean duration of diabetes was 12.22±10.13 years in patients. Compared to controls, both eyes of the DR group had statistically and significantly lower values of ADC (p=0.025 and p=0.002, respectively). No significant correlations were found among the ADC values and central macular thickness, disease duration and stage of DR (all p>0.05) in patients. Mean ADC values revealed no significant differences among the subgroups of patients at different stages of DR (all p>0.05). Decreased ADCs in the vitreous of diabetes patients seem to be associated with the presence of diabetic retinopathy. [Med-Science 2018; 7(1.000): 106-109]

GIRIS ve AMAC: KOAH tanisi olan hastalarda pulmoner rehabilitasyonun (PR) ustunlugu hastaligin major rehberlerine girmistir ve KOAH’ li hastalarin standart bakimi olarak kabul edilmistir. Bizde mevcut hastaliklari hakkinda bilgi duzeylerini olcmek ve eksersizegitimleri, isbirlikci ozyonetimi tesvik eden programlariyla davranissal mudahaleleri destekleyen, pulmoner rehabilitasyonun hastalar tarafindan bilinip bilinmedigini arastirmak istedik YONTEM ve GERECLER: Calismaya 200 hasta dahil edildi. Global Initiative for Chronic Obstructive Lung Disease (GOLD) kriterlerine gore KOAH tanisi almis, en az 1 yildir takipte, anketteki sorulari cevaplayabilecek fizik ve mental yeterli kapasiteye sahip olan hastalar calismaya dahil edildi. Calismada kullandigimiz literatur derlenerek hazirlanan anket, 3 bolumden olusmaktadir. Birinci bolum hastanin yas, cinsiyet, egitim duzeyi, yasadigi yer gibi sosyodemografik ozellikleri sorgulayan bolumdur. Ikinci bolum (1-9 arasi sorular) KOAH bilgi duzeyi ve farkindaligini, ucuncu bolum (10-22 arasi sorular) ise PR farkindaligini degerlendiren bolumdur. BULGULAR: Hastalarin %93 (n=186)’ u erkek, %7 (n=14) kadindi. Ortalama yaslari ise 65,11±10.00. Ortalama KOAH suresi ise 7,8±6,69. KOAH’da ilac tedavisi disinda bir tedavi duydunuz mu ve pulmoner rehabilitasyon isimli bir tedavi duydunuz mu sorularina verilen dogru cevap orani %14,5 ve %7,5 dur. TARTISMA ve SONUC: KOAH hastalarinda pulmoner rehabilitasyonun farkindaligini oldukca dusuk bulduk. Bu nedenle bu hastalarda farkindaligi artirmak icin yeni stratejiler, yeni methodlar gelistirilmelidir. Turkce Kisa Baslik: KOAH’ da pulmoner rehabilitasyon

The incidents of hip fractures rise as the population gets older. Weakness of bones cause fractures easily due to falling, which can occur by balance deficiency, side effects of medications and maneuvering difficulties through environmental hazards. Patients with hip fractures are cared by clinicians in different specialties who should be familiar with the management of these injuries. The fascia iliaca compartment block, an easy to perform and low-cost procedure, provides efficient perioperative analgesia for patients who suffer from hip or femur fractures. Increased success rates are due to the facilitation of the block via ultrasound which is easily accessible in many operation theaters and emergency services. Anterior thigh and knee surgery as well as analgesia following hip and knee procedures are the basic indications for this block. In this case, we performed an ultrasound guided fascia iliaca compartment block for postoperative analgesia after a hip fracture surgery. [Med-Science 2019; 8(1.000): 239-41]

Celiac disease is an autoimmune disease of the small intestine, resulted from villusdamage and malabsorbtion due to ingestion of gluten; and production of antibodies to gliadin. Thedisease can manifest with various presentations. Celiac crisis was described as an acute, serious,life-threatening form of celiac disease about sixty years ago with a higher incidence among pediatric patients than adults. It is characterized by gastrointestinal symptoms like profuse diarrhea andsevere metabolic distubances like hyponatremia and hypoproteinemia. Early suspicion and detection is important. This case report presents a 54-year-old female patient who died from celiac crisis and sepsis.

Harlequin ichthyosis (HI) is a rare and severe form of congenital ichthyosis caused by truncating mutations in the ABCA12 gene. Although it has many distinctive signs on perinatal sonography such as short limbs, wide gaping mouth, joint contractures, edema of the hands and feet and cloudy amniotic fluids, it usually can not be diagnosed until birth. Herein, we report a case of recurrent HI, which remained undiagnosed until labor at 38 weeks of gestational age. A multiparous woman presented to hospital at 38th weeks of gestation. There were no personal or family history. Vaginal delivery was performed and a 3300 gram baby was delivered. The body of the neonate was covered with thick, armor like skin, have generalized edema and erythematous fissures, scanty hair, everted eyelids with exposed swollen conjunctiva, open mouth were noted at the first examination. Newborn was diagnosed to be having Harlequin ichthyosis and was given to neonatal intensive care unit (NICU) for supportive care and additional examination. Genetic counseling is important and should be recommended to affected families. With the growing technology electron microscopes, invasive prenatal diagnostic tools and 3D sonography may reveal suggestive features of the disease. In addition, new treatment regimens, experienced and competent NICU facilities may increase survival rates.

Distant metastasis of breast carcinoma frequently occurs within five years after the diagnosis of the primary tumor. A 58-year-old female sharing a history of mastectomy for invasiveductal carcinoma six years previously admitted to our clinic with dyspnea progressively ongoing forpast two weeks. A right-sided massive pleural effusion was diagnosed and also pleural catheterdrained. Radiologic studies and cytological examination of the fluid did not introduce any evidenceof malignancy while she lately underwent thoracoscopy for the residuary effusion and atelectasis.Pathological study of the punch biopsies through the parietal pleura reported the pleural metastasis of the breast carcinoma but still negative evidence of malignancy for the pleural fluid. After discharge, evaluation with positron emission tomography also did not verify an uptake in any of thepleura, lungs or primary malignancy site. This event is of importance revealing that the patientssharing a past of malignancy should be approached with more caution and suspicion since the routine diagnostic algorithms pending to be reliable may not be applicable for all patients.

Dieulafoy lesion (DL) is an important cause of acute gastrointestinal hemorrhage (GIH) because endoscopic diagnosis is very difficult. We report an ileal DL in a patient with Glanzmann Thrombasthenia (GT). A forty-year old female presented with bloody stool. Records showed that she was diagnosed with GT at 3 years of age. Physical examination on admission, she was clinically stable, except for tachycardia (110 bpm). Rectal examination revealed bright red blood. Her haemoglobin level was 8.7 g/dl. Colonoscopy revealed a DL at the terminal ileum. It was treated with combined endoscopic therapy of epinephrine injection followed by two clips application. Haemoglobin values were stable in the post-procedural period. DL in the terminal ileum is very rare. There have been fewer than 20 cases reported in the literature to date. Also GT is a rare congenital bleeding disorder. This case report revealed the coincidence of two rare disorders.

In this study; we tried to compile risk scoring systems (Original EuroSCORE, EuroSCORE II and STS) used in robotic surgery, minimally invasive cardiac surgery and open-heart surgery in the context of the literature.As a result, literature study of risk scoring systems in the robotic surgery was not found. In minimally invasive cardiac surgery, few studies are available. The effectiveness of existing risk scoring systems has not been established in these studies. Therefore, further investigations are required for developing risk scoring systems in robotic surgery and minimally invasive cardiac surgery. In open heart surgery, there is still no gold standard scoring system in all populations. Due to the increased case diversity, we believe that the commonly used risk scoring systems must be updated. Widely used risk-scoring systems are not effective in minimally invasive cardiac surgery and this is supporting our idea. Each clinic should choose the appropriate risk scoring system according to their own experience and case diversity. [Med-Science 2018; 7(4.000): 959-61]

Histopathologically, calvarial lesions are congenital, inflammatory, neoplastic and traumatic origin and these are rarely seen. The calvarial lesions most commonly manifest as palpable mass on physical examination or they are diagnosed incidentally during a radiological test. Defect, lysis and sclerosis in the bony structure are evaluated with radiography and computed tomography (CT) and relationships of the lesions with the soft tissue components and surrounding soft tissue are evaluated with CT and magnetic resonance imaging (MRI) and especially with MRI. Based on the radiological findings, benign-malignant discrimination of the calvarial lesions can be made and it may be possible to estimate their histopathological diagnoses., Kalvarial lezyonlar histopatolojik olarak, kongenital, enflamatuar, neoplastik ve travmatik kökenli olup, nadir olarak izlenmektedir. Kalvarial lezyonlar en sık klinik muayenede ele gelen kitle şeklinde ya da radyolojik bir tetkikde insidental olarak tanı konur. Kemik yapıdaki defekt, lizis ve skleroz radyografi ve bilgisayarlı tomografi (BT) ile, lezyonların yumuşak doku komponentleri ve çevre yumuşak doku ile ilişkisi, BT ve manyetik rezonans görüntüleme (MRG) ile ve özelikle MRG ile değerlendirilir. Radyolojik değerlendirme sonucu, radyolojik bulgulara göre kalvarial lezyonların benignmalign ayrımı ve histopatolojik tanısını tahmin etmek mümkün olmaktadır.

Purpose:To determine the role of anthropometric indices such as waist circumference, waist-to-hip ratio, waist– height ratio, and weight for height in predicting metabolic syndrome in obese children and adolescents. Materials and methods: A total of 291 obese children and adolescents aged 6–16 years were included in this study. Anthropometric and biochemical parameters were evaluated. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Results:The prevalence of metabolic syndrome was 22.3% and significantly higher in pubertal obese group than in pre-pubertal ones (p=0.004). Higher waist circumference and weight for height were found in obese children and adolescents with metabolic syndrome (p

Amaç: Tamamlayıcı ve alternatif tıp (TAT) yöntemlerinin kullanımı yaşlılar arasında artmıştır. Bakım kalitesini yükseltmek için sağlık profesyonelleri TAT yöntemlerinin kullanımını değerlendirmelidir. Bu çalışma İstanbul’da iki huzurevinde kalan yaşlılarda TAT yöntemlerini kullanma durumunu saptamak amacıyla yapıldı.Materyal ve Metot: Bu çalışma Aralık 2012 ve Mayıs 2013 tarihleri arasında İstanbul’da iki huzurevinde yapıldı. Çalışmanın örneklemini 230 yaşlı birey oluşturdu. Bulgular: Yaşlıların %59,1’i TAT yöntemlerinden birini kullanıyordu. Bitkiler (%55,2) ve bitkisel olmayan destekler (%53,5) en çok kullanılan TAT yöntemleriydi. Ortaokul mezunu, kronik bir hastalığı olan ve düzenli tıbbi tedavi alan yaşlılar arasında TAT kullanım oranı yüksekti (p, Aim: Complementary and alternative medicine (CAM) usage has increased among the elderly. To promote comprehensive quality care, health professionals should assess for CAM usage. This study was planned to determine the CAM usage among elderly living in nursing homes in Istanbul. Material and Method: This study was made in two nursing homes in Istanbul between December 2012 and May 2013. The study sample consisted of 230 elderly. Results: A percentage of 59.1 of elderly (n=136) used CAM. Herbs (55.2%) and non-herbal supplements (53.5%) were the most frequently used therapies. CAM usage rate was higher among elderly who graduated from secondary school, had chronic disorder, and used medicine regularly (p

To test the null hypothesis that bony pelvis dimensions are different in women with and without polycystic ovarian syndrome (PCOS). In this case-control study all subjects underwent hysterosalphingography examination. The interspinous, intertuberous diameters and subpubic angle were measured from the images independently by author blinded to the clinical and laboratory data of the patients. Women with PCOS had shorter interspinous diameter. There was no significant differences in the length of intertuberous diameters and subpubic angles between the two groups. Significant difference in interspinous diameter was identified when comparing reproductive-aged women with PCO and their similar aged controls. [Med-Science 2018; 7(3.000): 681-3]

In recent years, medication-related diseases have become a major concern in elderly care. Elderly people tend to experience more negative drug events than younger patients due to accompanying diseases, multiple drug use, and age-related changes in pharmacodynamics and pharmacokinetics of drugs. Vancomycin is a nephrotoxic and ototoxic antibiotic commonly used in gram (+) bacterial infections, especially in Methicillin-resistant Staphylococcus aureus (MRSA), which can cause important problems such as flushing, muscle spasm, redman syndrome. It was aimed to report vancomycin drug reaction, which emerges of elevated eosinophilia. [Med-Science 2018; 7(2.000): 453-5]

Mushroom poisoning has an important place in thepoisonings applied to emergency department (ED).Patients may present with different toxoids according tothe fungus and toxin fecalin. Pantherina syndrome is atablature that can interfere with cerebrovascular diseasesdue to clinical presentation. Three patients from thesame family were admitted to our ED with newlydeveloped symptoms of confusion, aphasia andmydriasis. When the first patient was evaluated, thediagnosis of hypertensive encephalopathy was firstconsidered with the current symptoms. However, afterthe application of the second and third patients withsimilar symptoms, the anamnesis was deepened and thestory of eating a mushroom was questioned. Patients aretreated in the emergency ICU. Two patients recoveredwithin 24 hours, and the symptoms of one patientcontinued for up to 72 hours. Pantherina syndrome is atoxicoma characterized by early onset, confusion,neurological symptoms such as aphasia and mydriasis.Treatment is generally supportive treatment. Stomachlavage and activated charcoal will be useful in the earlyperiod. Benzodiazepines can be used in extremeagitation. Pantherina syndrome is one of the diagnosesthat clinicians should actually have in patients presentingwith an acute confusional condition. Mantar zehirlenmeleri günlük acil servis pratikuygulamasında zehirlenmeler içinde önemli bir yeresahiptir. Hastalar mantara ve toksinin türüne göre farklıklinik tablolar ile hastaneye başvurabilirler. Pantherinasendromu, serebrovasküler hastalıklarla k arışabilen birklinik tablodur. Aynı aileden üç hasta, yeni gelişen bilinçbulanıklığı, afazi ve midriyazis belirtileri ile acil servisebaşvurdu. İlk hasta değerlendirildiğinde, mevcutsemptomlarla birlikte hipertansif ensefalopati tanısıkonuldu. Bununla birlikte, benzer semptomlara sahipikinci ve üçüncü hastada anamnezin derinleştirilmesi ilemantar yemekten kuşkulanıldı. Hastalar acil yoğun bakımünitesinde tedavi edildi. İki hasta 24 saat içinde düzeldive bir hastanın semptomları 72 saate kadar devam etti.Pantherina sendromu erken başlangıçlı, konfüzyon, afazive midriyaz gibi nörolojik semptomlarla karakterize birklinik durumdur. Tedavi genellikle destek tedavisidir.Mide yıkama ve aktif kömür erken dönemde faydalıolacaktır. Benzodiazepinler aşırı ajitasyon durumundakullanılabilir. Pantherina sendromu, akut konfüzyonel birdurumla başvuran hastalarda klinisyenlerin düşünmesigereken tanılardan biridir.

Amaç: Sferoid kültürleri, hücrelerin kendi iç dinamikleri ve diğer hücrelerle olan etkileşimleri açısından tek tabakalı kültürlere kıyasla tümör dokusunun özelliklerini daha iyi yansıtmaktadır. Bu çalışmanın amacı, üç boyutlu (3D) ve iki boyutlu (2D) kültür ortamlarında üretilen CD133+/CD44+ prostat kanser kök hücrelerinin (KKH) makromoleküllerindeki benzerlik ve farklılıklarının araştırılmasıdır. Gereç ve Yöntem: DU-145 prostat kanser hücre hattı içerisindeki CD133+/CD44+ yüzey belirteç özelliklerine sahip KKH’leri akış sitometrisi (FACS) kullanılarak izole edilmiştir. Agarla kaplı kültür kapları ile sferoid yapıları oluşturulmuştur. 2D ve 3D kültür ortamlarındaki KHK hücreleri Fourier dönüşümü kızılötesi (FTIR) spektroskopisi ile karşılaştırılmıştır. Bulgular: CD133+/CD44+ hücrelerin birinci haftada agarlı kültür ortamlarında mikro-agregatlar oluşturduğu gözlenmiştir. İkinci haftada ise, olgun sferoid yapıların oluştuğu saptanmıştır. 2D ve 3D (multisellüler tümör sferoidleri) kültür ortamlarında üretilen hücreler ile yapılan FTIR analizleri KHK hücre yapısındaki proteinler, lipitler, karbonhidratlar ve nükleik asitlerde (DNA, RNA) önemli derecede farklanmalar olduğunu göstermiştir. Membran lipit açil zincir uzunluğu ve hücre zarı kalınlığı, proteinlerin sekonder yapıları ve DNA oligonükleotitlerin baz sekanslarında veya fonksiyonel gruplarında önemli farklanmaların olduğu tespit edilmiştir. Elde edilen sonuçlar, 3D kültür ortamında üretilen sfreoid yapılarının in vivo tümör dokusu ile benzer özellikler sergilediğini göstermiştir. Sonuç: Hücre ortam koşulları ile yaratılmış olan fiziksel, kimyasal ve biyolojik özellikler hücrelerin kendi iç dinamiğini ve mikroçevresi içerisindeki etkileşimlerini önemli derecede etkilemektedir. 2D kültür ortamları ile hücreleri tek boyutta indirgemek hücrelerin gerçek özelliklerini yansıtmamaktadır. Bu nedenle, 3D kültür ortamları ile hücre dinamiklerinin incelenmesi gerekmektedir. Bu çalışmadan elde edilen sonuçlar, kanserde önemli bir hücre popülasyonunu oluşturan KKH’lerin membran yapısı, lipitler, proteinlerin sekonder yapıları ve DNA oligonükleotit yapılarının terapötik hedef olabileceğini göstermektedir., Objective: Spheroid cultures reflect properties of tumor tissue better than monolayer cultures in terms of internal dynamics and interaction with other cells. the aim of this study is to investigate the similarities and differences in CD133+/CD44+ prostate cancer stem cells (CSCs) produced in threedimensional (3D) and two-dimensional (2D) culture media. Material and Method: CSCs with CD133+/CD44+ surface marker properties in the DU-145 prostate cancer cell lines were isolated using flow cytometry (FACS). Spheroid structures were formed with agar-coated culture vessels. CSCs in 2D and 3D cultures were compared with Fourier transform infrared (FTIR) spectroscopy. Results: CD133+/CD44+ cells were observed to form micro-aggregates in cultured media in the first week. in the second week, mature spheroid structures were formed. FTIR analysis revealed that the 2D and 3D (multicellular tumor spheroids) models of CSCs exhibit significant differences in proteins, lipids and nucleic acids. Significant differences were detected in membrane lipid acyl chain length, membrane thickness, protein secondary structures and DNA oligonucleotides. the results showed that spheroids in 3D culture medium exhibit similar properties to in vivo tumor tissue. Conclusion: Physical, chemical and biological properties generated by environmental conditions significantly affect internal dynamics of cells and their interactions within the microenvironment. Reducing the cells in one dimension through the 2D culture medium does not reflect actual properties of cells. Therefore, cell dynamics in 3D culture media should be investigated. This study demonstrates that cellular lipids, membrane structure, protein secondary structures and nucleic acids of CSCs constituting an important cell population in cancer may be therapeutic targets.

Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disorder. Micro RNAs (miRNAs) can function as either oncogenes or tumor suppressor genes. Altered miRNA expression has been implicated in the pathogenesis of several diseases. Therefore, we aimed to explore the effects of miR-196a2T/C (rs11614913) variant profile on susceptibility to AS in a Turkish population. Materials and Methods: Blood samples were collected from 78 AS patients and 79 healthy controls. miR-196a2T/C variant was genotyped by PCR-RFLP. Odds ratio (OR) with 95% confidence interval (95%CI) were calculated using the χ2 test. Results: The frequency of T/C and T/T genotypes of the miR196a2T/C were higher in AS patients compared to healthy controls (p=0.034 and p=0.028, respectively). The subjects carrying the miR-196a2T/C variant T/T genotype showed a 2.542-fold increased AS risk than the control group. However, no difference was observed in the allele frequencies of miR-196a2T/C between AS patients and the controls. It was found that C/C genotype of miR-196a2T/C variant was more frequent in AS patients with enthesitis than AS patients without enthesitis (p=0.042). Conclusion: The miR-196a2T/C variant represents a genetic risk factor for increased susceptibility to AS and is associated with enthesitis in the Turkish population., Amaç: Ankilozan spondilit (AS) kronik, enflamatuar bir hastalıktır. MikroRNA’lar (miRNAlar) onkogen veya tümör baskılayıcı genler olarak fonksiyon yapabilirler. Çeşitli hastalıkların patogenezinde miRNA ekspresyonunun değişmesi bulunmaktadır. Bu nedenle, Türk toplumunda AS yatkınlığında miR-196a2T/C (rs11614913) varyant profilinin etkilerini araştırmayı amaçladık. Gereç ve Yöntem: 78 AS hastası ve 79 kontrolden kan örnekleri toplandı. miR-196a2T/C varyantı PCR-RFLP ile genotiplendi. χ2 testi kullanılarak %95 güven aralığı ile Odds oranı (OR) hesaplandı. Bulgular: miR-196a2T/C T/C ve T/T genotipleri AS hastalarında sağlıklı kontrollere kıyasla daha yüksekti (sırasıyla, p=0.034 and p=0.028). miR-196a2T/C varyant T/T genotipini taşıyan kişiler kontrol grubundan 2,542 kat artmış AS riski gösterdiler. Ancak, miR-196a2T/C allele frekansları açısından AS hastaları ve kontroller arasında fark saptanmadı. miR-196a2T/C varyant C/C genotipinin entezitli AS hastalarında entezit bulunmayan AS hastalarından daha çok olduğu bulundu (p=0.042). Sonuç: miR-196a2T/C varyantı Türk toplumunda AS ve hastalığın entezit ile ilişkisine yatkınlık sağlayan genetik risk faktörü rolü göstermektedir.

Amaç: Bu çalışmada Konya ilinde yaşayan 6-18 yaş arası öğrencilerin vücut kitle indeksleri (VKİ) ölçülerek obezite sıklığının belirlenmesi, elde edilen verilerle persentil eğrilerinin oluşturulması amaçlanmıştır.Gereç ve Yöntem: Çalışma Konya il merkezi ilk ve ortaöğretim okullarında öğrenim gören 6-18 yaş arası 3171çocukta gerçekleştirildi. Antropometrik ölçümler sonrası hesaplanan VKİ değerleri 5. persentilin altında olanlardüşük kilolu, 5. ile 85. persentil arası normal kilolu, 85. ile 95. persentil arası fazla kilolu, 95. persentil ve üzeriolanlar ise obez olarak tanımlandı.Bulgular: Öğrencilerin yaş ortalaması 12,683,25 yıl; % 51,2’si (1624) erkek, % 48,8’i (1547) kız idi. Kız çocukların ortalama VKİ’i 20 4 kg/m2, erkek çocukların 20,1 4,2 kg/m2 olarak hesaplandı. Her bir yaş aralığındaki değerlere bakıldığında obezite (% 12,3) ve fazla kilolu olma sıklığı (% 11,9) 15 yaşında anlamlı derecede(sırasıyla; p0,018-p0,02) yüksek bulundu. Elde edilen veriler ışığında Konya ili için 6-18 yaş arası çocuklarınboy, vücut ağırlığı ve VKİ persentil eğrileri çıkarıldı. Buna göre öğrencilerin toplamda % 4,9’si obez, % 9,4’üfazla kilolu, % 79,2’si normal kilolu, % 6,5 düşük kilolu olarak saptanırken; erkeklerin % 5,4’ü obez, % 9,5’i fazlakilolu, kızların % 4,3’ü obez, % 9,4’ü fazla kilolu olarak tespit edildi.Sonuç: Tüm dünyada olduğu gibi ülkemizi de etkileyen obezite sıklığındaki artış Konya ilinde de etkisini göstermekteydi. Bununla birlikte obezitenin doğru teşhisi için hali hazırda kullanılan standart büyüme persentillerinyanısıra il bazlı verilerle oluşturulacak bölgesel eğrilere ihtiyaç duyulmaktadır ki; çalışmamız bu bağlamda yapılacak daha ileri çalışmalara ışık tutacaktır., Objective: In this study, it was aimed to determine the frequency of obesity by measuring the body massindexes (BMI) of 6-18 year old students living in Konya and to ob-tain anthropometric percentile curves.Materials and Methods: The study was carried out in 3171 children aged between 6 and 18 years, whowere going to primary and secondary schools in Konya city center. Children with a BMI value lower than5th percentile were defined as underweight, BMI between 5th and 85th percentile as normal weight, BMIbetween 85th and 95th percen-tile overweight, and BMI above 95th percentile were defined as obese.Results: The average age of the students was 12,683,25 years, 51,2% (1624) were male and 48,8% (1547)of female. The mean BMI of girls and boys were 20 4 kg / m2 and 20.1 4.2 kg / m2, respectively. Whenthe frequencies of obesity (12.3%) and overweight (11.9%) examined for each age, they were both foundto be significantly higher at the age of 15 years (p 0.018-p 0.02, respectively). With the obtained data,the height, body weight and BMI percentile curves of the children aged 6-18 years were achieved for Konyaprovince. According to study results 4.9% of the students were obese, 9.4% were overweight, 79.2% werenormal weight and 6.5% were underweight. While 5.4% of boys were obese and 9.5% were overweight, 4.3%of girls were obese and 9.4% were overweight.Conclusion: The increase of the frequency of obesity, affects our country as in the whole world, also showsits effect in the province of Konya. However, for the correct diag-nosis of obesity, there is a need for regionalanthropometric curves in addition to currently used standard growth percentages. Our work will shed light onfurther works to be done in this context.

Background: The first decision rule developed to identify clinically significant injuries in blunt cervicaltrauma patients is National Emergency X-Radiography Utilisation Study (NEXUS). In the NEXUS study, thenegative predictive value (NPV) has been determined as 99.8%. Sensitivity of Canadian Cervical Spine Rules(CCR) was reported as 99.4%, specificity as 45.1% and NPV was reported as 100%. The objective of this studyis to determine the reliability and utility of NEXUS and CCR for Turkish patient population that has a risk ofcervical injury.Methods: This prospective observational study included 225 patients, all stable, conscious patients over 16years of age who had acute trauma and were brought to the hospital with ambulances or using their ownmeans and who had been injured by a mechanism that may cause cervical trauma, and without exclusioncriteria. The patients included in the study were then evaluated for NEXUS and CCR validity.Results: When CCR was evaluated as a whole, it was determined that all pathological cases were identifiedusing these rules. In terms of identifying the presence of pathological imaging finding the sensitivity of CCRwas 100% (95% CI % 56-100) and specificity was 3.2% (95% CI 1.4-6.7%). NEXUS's sensitivity was calculatedas 93% (95% CI 83-97) and specificity as 1.3%(95% CI 0.2-5.1).Conclusion: CCR and the NEXUS were determined to be useful in the emergency department for theexclusion of cervical pathologies. CCR were more reliable and useful when compared with the NEXUS. Giriş ve amaç: Künt servikal travma hastalarında klinik olarak anlamlı yaralanmaları tanımlamak için geliştirilen ilk karar kuralı National Emergency X-Radiography (NEXUS). NEXUS çalışmasında, negatif prediktif değer(NPV)% 99,8 olarak belirlenmiştir. Kanada Servikal Omurga Kurallarının (KSOK) duyarlılığı % 99.4, özgüllük % 45.1 ve NPV % 100 olarak bildirilmiştir. Bu çalışmanın amacı, servikal yaralanma riski olan Türk hasta popülasyonu için NEXUS ve KSOK’'nın güvenilirliğini ve yararlılığını belirlemektir. Gereç ve yöntem: Bu prospektif gözlemsel çalışmaya, 1 Ocak 2012 - 1 Nisan 2012 tarihleri arasında, akut travma geçiren ve ambulansla ya da kendi imkanlarıyla hastaneye başvuran, servikal travmaya yol açabilecek bir mekanizma ile yaralanan 16 yaşın üzerindeki, gebe olmayan, stabil, bilinçli hastaları kapsayan 225 hasta dahil edilmiştir. Bu hastalar daha sonra NEXUS ve CCR geçerliliği için değerlendirildi. Veriler güncel istatistik programında analiz edildi. Bulgular: 225 hastanın 7’sinde servikal patoloji tespit edilmiştir. Patolojik görüntüleme bulgusu varlığını belirleme açısından NEXUS’un duyarlılığı %93(%95 GA 83-97) ve özgüllüğü %1,3(%95 GA 0,2-5,1) olarak bulunurken, KSOK’nin duyarlılığı %100 (%95 GA %56-100) ve özgüllüğü %3,2 (%95 GA %1,4-6,7) olarak tespit edildi. Sonuç: KSOK ve NEXUS düşük risk kriterlerinin acil serviste servikal patolojilerin dışlanmasında faydalı olduğu, KSOK’nın, NEXUS düşük risk kriterleri ile karşılaştırıldığında daha güvenilir ve yararlı olduğu tespit edilmiştir.

Amaç: Antitrombotik ilaçlar birçok farklı hastalığın tedavisinde kullanılan yüksek riskli ilaçlardır. Bu çalışmanın amacı, Türkiye’deki serbest eczacıların antitrombotik tedavi ile ilişkili faaliyetlerinin nitelik ve içeriğinin belirlenmesi ve serbest eczacıların antitrombotik tedavi yönetimine katkıda bulunabilecek farmasötik bakım aktivitelerine yaklaşımlarının belirlenmesidir. Gereç ve Yöntem: Web ortamında hazırlanan kesitsel anket çalışmasına Türkiye’de 53 ilden 321 eczacı kendi kendine uygulama yöntemiyle katılmıştır. Ankette evet/hayır soruları, kapalı uçlu çoktan seçmeli sorular, yarı kapalı uçlu çoktan seçmeli sorular, 0-100 arası derecelendirme ve 5 noktalı Likert ölçeği kullanılmıştır. Bulgular: Eczacılar verdikleri farmasötik bakım hizmetlerinin %21,84 ± 1,05’inin antitrombotik tedavi görmekte olan hastalara yönelik olduğunu bildirmiştir. Eczacıların %99,1’inin birden fazla antitrombotik ilaç hakkında bilgi verdiği belirlenmiştir. Eczacıların sadece %33,0’ü antitrombotik ilaçların kullanıldıkları tıbbi durumlar ve ilgili tedavi protokolleri ile ilgili bilgi düzeylerinin yeterli olduğunu düşündüğünü bildirmiştir. Verilen çeşitli farmasötik bakım hizmetleri ile eczacıların bilgi düzeyi arasında zayıf pozitif korelasyon bulunmaktadır. Eczacılar hastaların %82,2’sinin ilaçları/tedavileri konusunda bilgisinin yeterli olmadığını düşünmesine rağmen %85,7’si hastalara yazılı bilgilendirme materyali vermemektedir. Eczacıların farmasötik bakım hizmeti sağlarken hastalar ile ilgili faktörlerden en çok kullandığı diğer ilaçlar (%88,8), yaş (%78,8), sağlık okuryazarlığı (%72,9) ve eğitim durumunu (%71,7) dikkate aldığı belirlenmiştir. Eczacıların diğer sağlık profesyonellerinin eczacı hizmetlerine verdikleri öneme ilişkin öz değerlendirme sonucu ile olası tedavi sorunları için hekimle iletişime geçme sıklığı arasında istatistiksel olarak anlamlı zayıf pozitif korelasyon bulunmuştur. Sonuç: Bu çalışmanın sonuçları Türkiye’de antitrombotik tedavi yönetiminde serbest eczacıların sundukları farmasötik bakım hizmetleri ile ilgili bir çerçeve sunmaktadır. Sonuçlar doğrultusunda serbest eczacılık hizmetlerin geliştirilmesi ülkemizde güvenli ve etkin antitrombotik ilaç kullanımının artışına katkı sağlayabilir., Objective: Antithrombotic drugs are high risk drugs used in treatment of various conditions. the purpose of this study was to determine the nature of pharmaceutical care activities related to antithrombotic therapy management and the attitudes of community pharmacists in this area. Material and Method: 321 pharmacists from 53 provinces of Turkey completed this cross-sectional self-administered web-based survey. the questionnaire consisted of yes/no, closed-ended multiple choice, semi-closed multiple choice, 0-100 rating and 5-point Likert scale questions. Results: 21.84 ± 1.05% of the pharmaceutical care services provided by pharmacists were directed toward patients using antithrombotic drugs. 99.1% of pharmacists provided information on more than one antithrombotic drug. Only 33.0% of the pharmacists reported that their knowledge on antithrombotic drugs was adequate. There was a weak positive correlation between the pharmacists’ level of knowledge and various pharmaceutical care services provided. Although pharmacists don’t think that 82.2% of patients have enough knowledge about treatments, 85.7% don’t hand out written information to patients. Other drugs (88.8%), age (78.8%), health literacy (72.9%) and education status (71.7%) were the most frequently considered factors while providing pharmaceutical care services. There was a weak positive correlation between pharmacist's perceived value for pharmacy services by other healthcare professionals and frequency of communication with physicians for possible treatment problems. Conclusion: the results of this study provide a framework for pharmaceutical care services provided by community pharmacists in the management of antithrombotic therapy in Turkey. the improvement of community pharmacy services may contribute to the increase of safe and effective antithrombotic drug use in our country.

Objective: Foreign body aspiration is a potentially life-threatening emer-gency in children. Urgent rigid bronchoscopy should be performed when presentation includes severe respiratory failure with suspicion for FBA. To the best of the knowledge, this is the first study that evaluates URB in English literature.Methods: Forty-eight patients who underwent urgent rigid bronchoscopy were included in this study. From the medical records, the patients’ demo-graphic characteristics, hospital arrival time, endotracheal intubation status, peripheral oxygen saturation, bronchoscopy results, type and location of for-eign body , intraoperative and postoperative complications, mortality, X-ray results, length of hospital stay were evaluated. Results: Twenty-four of the 48 patients were non-intubated. Peripheral oxy-gen saturation values were 60±14.40 in the preoperative period. There was not any statistically significant difference between intubated and non-intu-bated patients in terms of intraoperative and postoperative complications. There was not any statistically significant difference between patients with negative and positive results for bronchoscopy in terms of intraoperative and postoperative complications. Conclusions: Bronchoscopy is not without risk; however, it is a life-sav-ing procedure. Despite negative foreign body results, urgent bronchoscopy should be performed in suspicious cases.

Aim: Thyroidal incidentalomas (Tis) detected by F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18FDG PET/CT) may be associated with three different causes that include metastasis of another malignancy, primary thyroid gland malignancies and lastly benign thyroidal nodules, all require different clinical approaches. For appropriate treatment, quick characterization of the Ti is important, preferably with a lesser invasive method. Our aim was to determine whether the characterization of TIs can be performed with FDG-PET/CT, due to contribute faster diagnosis, and initiation of the therapy.Material and Methods: Forty-four patients with detected TIs in FDG-PET/CT were included in the study. The relationship between metabolically/morphological parameters and pathology results were evaluated statistically. If two subsequent cytology were negative, nodule accepted as benign. If cytology result was suspected or malignant, histopathological confirmation was made. For these patients, histopathological results were accepted as definite diagnosis. Results: Malignant thyroidal pathologies were detected in 29.5% of patients. We could not find any significant relationship between age, nodule size and SUVmax value and pathology results. According to ROC analysis, there were not any cut-off value for nodule size and SUVmax. Similar results were also obtained for papillary carcinoma as a special subgroup.Conclusion: Characterisation of TIs could not be performed by using age, nodule size and SUVmax. Therefore, TIs which detected by FDG-PET/CT should be examined pathologically due to high risk of malignancy.Keywords: Thyroidal incidentalomas; FDG-PET/CT; malignant; characterization.

Aim: The aim was to analyze the outcome of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vinblastine,and dacarbazine (ABVD) chemotherapy adjuvant radiotherapy according to the risk groups and determine the adverse prognosticfactors affecting survival in Hodgkin lymphoma.Material and Methods: A retrospective study was performed on 52 pediatric patients with Hodgkin lymphoma who were treated withABVD between 1997 and 2018. Patients with early-stage favorable disease received 4 cycles of ABVD radiotherapy. Early-stageunfavorable and advanced-stage patients received 6 cycles of ABVD radiotherapy.Results: Thirty (57.7%) boys and 22 (42.3%) girls were included in the study. The median age of the patients was 9 years and 3months (1 year and 10 month – 17 years and 7 months). Overall survival rate was 94.2% and the mean survival time was 19.50.70(95% CI, 18.1 - 20.9) years. The mean event-free survival time was 9.56.5 years. Overall survival rate was 90%, and the meanevent-free survival time was 8.26.1 years in early-stage favorable disease. Overall survival rate was 100%, and the mean eventfreesurvival time was 1.97.0 years in early-stage unfavorable disease. Overall survival rate was 94.1 %, and the mean event-freesurvival time was 8.96.3 years in advanced-stage disease. Presence of bulky disease, nodular sclerosing histologic subtype andleukocytosis had a negative prognostic effect on relapse and bulky disease had adverse effect on overall survival (p0.05).Conclusion: Four courses of ABVD chemotherapy radiotherapy (IFRT or ISRT) in early-stage favorable patients and 6 courses ofABVD chemotherapy radiotherapy (IFRT or ISRT) in both early-stage unfavorable and advanced-stage Hodgkin lymphoma patientsbenefited from promising outcomes in terms of OS and FFS.Presence of bulky disease, nodular sclerosing histologic subtype and leukocytosis have adverse prognostic effects on relapse andpresence of bulky disease have adverse effect on OS.

Aim: Cutaneous lupus erythematosus (CLE) has a multifactorial pathogenesis involving genetic and environmental triggers and congenital and acquired immune response. The aim of this study was to investigate the effects of Glutathione S-Transferases (GST) isoenzymes including GSTT1, GSTM1, and GSTP1 in the CLE patients with an etiology of solar radiation exposure. Material and Methods: Paraffin-embedded skin biopsy sections from the patients were stained by immunohistochemical methods. The results were evaluated under a light microscope by a pathologist. The pattern, localization, and distribution of the immunohistochemical staining were recorded for each patient. Staining of the nucleus or cytoplasm was considered as positive staining. The accuracy of staining was determined based on the intensity and percentage of staining. Results: No significant difference was found between the patient and control groups regarding staining intensity. In terms of staining percentage, the prevalence of GSTP1-3 genotype was significantly lower in the patient group compared to the control group (25% vs. 63.33%) (p=0.002). Conclusion: No significant difference was observed in the staining intensity of GSTP1, GSTT1, and GSTM1 between the patient and control groups and the staining percentage in some genotypes was even higher in the control group compared to the patient group.

Cryptococcus neoformans is an opportunistic fungal agent, which may cause infectiondepending on the state of immunity. The agent is especially prone to be localized in the centralnervous system. Fingolimod is an immunomodulatory drug that is used in the treatment of Multiple Sclerosis (MS). The use of this drug leads to a decrease in lymphocyte count and thus might result in the occurrence of the opportunistic infections like Cryptococcosis. In this article, we presenta MS patient that underwent fingolimod treatment and developed Cryptococcus meningoencephalitis.

Aim: Endometrial polyps are frequently associated with abnormal uterine bleeding. The kispeptin family is one of the peptides that play a role in reproductive functions and whose expression varies in various uterine pathologies. The aim of the study was to determine the relationship between serum Kisspeptin levels and endometrial polyps in women with premenopausal status.Material and Methods: The blood was collected prior to endometrial sampling from women admitted to the hospital due to abnormal uterine bleeding. According to the pathology results, patients were identified as polyp group (n=38) (endometrial polyps) and control group (n=50) (normal endometrial findings). Kisspeptin-54 levels were determined by ELISA method from serum obtained from venous blood. Results: There were no difference was found between the patients’ age, body mass index, gravida, para, abortus and the number of living children were compared (p>0.05). There was no statistically significant difference between the groups in terms of follicle stimulating hormone, luteinizing hormone and thyroid stimulating hormone values (p>0.05). Plasma kisspeptin (1.84±0.93 ng/dL and 1.32±0.47 ng/dL, p= 0.008) and estradiol (90.34±13.02 pg/mL and 81.75±12.36 pg/mL, p=0.002) levels were significantly higher in the polyp group than in the control group. After the Receiver Operating Characteristic (ROC) analysis the area under the curve (AUC) was 1.26 (p= 0.08), (95% CI, 0.550-0.782). The sensitivity value was 0.684 (0.512-0.819), the specificity was 0.620 (0.471-0.750).Conclusion: The serum Kisspeptin-54 and estradiol levels were found higher in patients with endometrial polyps.Keywords: Abnormal uterine bleeding; endometrial polyps; kisspeptin.

Aim: Alopecia areata is an auto-immune skin disease characterized by non-scarring hair loss. Nail changes are strongly associatedwith prognosis. In patients with Alopecia areata, the nail examination should not be neglected for an optimal follow-up.Material and Methods: A retrospective study involving 207 patients with Alopecia areata was undertaken in a tertiary hospitalbetween April 2016 and May 2017. Patients whose nail changes were registered in the database were included in the study. Gender,age, disease severity, sites affected, and nail changes of those patients were noted.Results: 114 patients (55%) had nail involvement. The most common nail finding was leukonychia (n 84). Nail pitting was detectedin 29 patients.11 patients had both leukonychia and nail pitting. The mean age of the patients with leukonychia was 23.3, while themean age of nail pitting patients was 31.7 and the mean age of the patients without nail change was 34.1.Conclusion: Leukonychia is the most common nail change in this study, as a different finding from all previous studies

Objectives: Lung cancer accounts for 20% of cancer-related deaths worldwide. Several studies have shown that Vitamin D levels at the time of diagnosis are prognostic in lung cancer. In this study, we evaluated the relationship between pre-diagnosis Vitamin D replacement levels and platinum-based chemotherapy results. Methods: In this cross-sectional study, we retrospectively analyzed archive records of all 247 patients diagnosed with lung cancer from an oncology center in Turkey, between 2012-2018. The chemotherapy outcomes, Vitamin D levels and replacement doses of these patients up to 6 months ago were recorded. Results: Vitamin D levels of 153 patients were below 15 ng/mL, 65 patients had a level of 15-30 ng/mL, and 29 patients had a vitamin D level higher than 30 ng/mL. In the study population, 215 had a replacement below 300.000 IU whereas 32 had a replacement above 300.000 IU. When the patients were evaluated based on their chemotherapy responses, no difference was observed between the patients with below and above 300.000 IU. In our study, Vitamin D and replacement level at the time of diagnosis did not change the chemotherapy response. Conclusion: Vitamin D replacement levels were not significantly associated with chemotherapy outcomes in our study.

Günümüzde genel anestezinin santral sinir sistemine etkisi sağlıklı genç yetişkinlerde önemli bir sorun olarak karşımıza çıkmazken, yapılan bir çok hayvan deneyi yanında az ama önemli klinik çalışmalar, yaşamın erken veya geç dönemlerinde santral sinir sistemi üzerine anestezik toksisite kuşkusunu güçlendirmektedir., Nowadays, while the effects of general anesthesia on central nervous system is not considered to be an important problem on healthy young adults, alongside many experiments on animals, few but significant clinical studies strengthenthe suspicion of anesthetic toxicity on the central nervous system in early or late ages

Objectives: Lung cancer is the most common cause of cancer-related deaths worldwide. The use of tobacco and tobacco products is among the leading risk factors with proven association with lung cancer, although various environmental and dietary factors have been also implicated. Vitamin D deficiency has been identified as a poor prognostic factor in advanced stage colon cancer and breast cancer. The aim of the present study was to compare 25-hydroxyvitamin D [25(OH)D] levels between patients with non-small cell lung cancer (NSCLC) at the time of diagnosis and healthy controls and to evaluate the differences in serum 25(OH)D levels across the subgroups and stages of NSCLC., Methods: A total of 462 patients with NSCLC who were followed and treated in three participating centers were compared retrospectively with and age- and sex-matched 462 healthy controls who underwent testing for serum calcium, lactate dehydrogenase (LDH), magnesium, phosphorus, creatinine, and vitamin D levels in the between January 2016 and June 2018. The patients with NSCLC were further classified according to the histological subtype., Results: The mean age was 63.46 +/- 8.86 years. The patient group was composed of 58 females (12.6%) and 404 males (87.4%). Serum 25(OH)D, calcium, LDH, and magnesium levels were significantly different between the patient and the control group (p=0.0001, p=0.0001, p=0.0001, p=0.0001, respectively). Among patients with NSCLC, serum 25(OH) D was significantly lower in patients with adenocarcinoma subtype than in patients with squamous-cell carcinoma subtype (p=0.001). There was a significant correlation between advanced stage with decreased serum 25(OH)D and increased LDH levels (p=0.0001, p=0.0001, respectively)., Conclusion: The study is the most extensive study in our region in terms of the number of participating patients. Demonstration of a difference in serum 25(OH)D levels between histological subtypes also contributes to the literature.

As in all living cells, cancer cells are evaluating is very important in the frames of tumor development and treatment. As in all evolutionary process, the environment of living cells has an important role. Tumor cells have an environment is called tumor microenvironment, affects the therapeutic response and clinical results. Tumor microenvironments involve various cell types, extracellular matrix substances that are in the niche of cancer cells. The microenvironment is not only important in tumorigenesis but it is effective on therapeutic efficacy. In this review, we carried out the interaction between non-small cell lung cancer and its microenvironment to point out the significance of the tumor environment.

Objectives: Megestrol acetate (MA) can induce significant secondary adrenal suppression. We designed this study todetermine the extent of adrenal insufficiency in cancer patients receiving MA and whether ther was any predictivefactor for this.Methods: Thirty-one patients (aged 48–83 years) who were receiving MA took part in this study. Serum concentrationsof TSH, ACTH, free T4, cortisol were measuresd in samples obtained at 7 AM, at baseline and 1st month. Standart ACTH(250 mg) stimulation test was performed if cortisol levels were below 18 µg/dl at any time.Results: 1 month after drug initiation, 32% of patients were accepted as adrenal insufficient. There wasn’t any correlation between the basal cortisol, ACTH levels, any biochemical parameter and overall survival. There was negativecorrelation between 1 month cortisol levels and survival time (p=0.04) If cortisol levels were lower at month of theraphysurvival time was longer. Cox regression analysis showed that patients having lower cortisol levels at first month had98% lower risk of death compared to patients having higher cortisol levels (p=0.02: OR 0.12 (0.02-0.75)).Conclusion: It is important to evaluate adrenal functions especially during episodes of infection or after withdrawalof MA therapy since this may require prompt corticosteroid treatment.

Objectives: Lung cancer has been the leading cause of cancer mortality, and its incidence is growing throughout the world. This study aims to compare the distribution of the six World Health Organization by configural frequency analysis (CFA). Methods: The National data (GLOBOCAN 2012) were included in the analysis. Data were analyzed by CFA which is used for the analysis of multiway contingency tables. Results: In Africa, East Mediterranean, Europe, and Southeast Asia, lung cancer incident cases were observed to be higher than expected. Under the years

Aim: We aimed to determine whether Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), D-dimer, and troponin values were correlated with the simplified Pulmonary Embolism Severity Index (sPESI) in patients diagnosed as having Pulmonary Embolism (PE) in the emergency room. Material and Methods: Forty-three patients diagnosed as having PE in the emergency departmentwere divided into low and high-risk groups according to the sPESI. We investigated whether NLR, MLR, and PLR, d-dimer, troponin-I, and Pulmonary Artery Pressure (PAP) had any effect in determining the severity of PE. Also, patients were divided into groups as those with PAP ≤20 or >20 mm Hg, Systolic Blood Pressure (SBP) ≤100 or >100 mm Hg, and those receiving or not receiving thrombolytic treatment, and compared. Results: There was a statistically significant difference between patients with low sPESI (n=10) and those with high sPESI (n=33) in terms of age (p=0.001), pulse (p=0.016), oxygen saturation (p=0.039), troponin-I (p=0.029) and PAP (p=0.032), but there was no difference between the groups in terms of NLR (p=0.796), MLR (p=0.656), PLR (p=0.863), and d-dimer (p=0.343). There was a statistically significant difference between patients who did (n=6) and did not (n=37) receive thrombolytic treatment in terms of troponin-I (p=0.012), but there was no difference between the groups in terms of NLR (p=0.861), MLR (p=0.335), and PLR (p=0.277). Conclusion: NLR, MLR, PLR and d-dimer levels were found not to be effective in determining the severity of PE. Troponin-I was associated with sPESI and was considered as an effective marker in determining the thrombolytic treatment.

Aim: This study was planned to determine cut-off values of the Tinetti Performance Oriented Mobility Assessment (POMA) and the Self-Assessment Fall Risk Questionnaire (FRQ) in older adults with mild cognitive impairment.Material and Methods: This study included a total of 213 individuals aged 65 years and over in the study. These individuals were divided into two groups according to Mini Mental Test (MMT) scores: 116 individuals with an MMT score of 18-23 (mild cognitive impairment) and 97 individuals with an MMT score of 24 or more (normal cognitive function). Balance and gait performance was assessed by the POMA, the fall risk self-assessment by older adult susing a FRQ.Results: In Older Adults with mild cognitive function, the clinical cut-off points for the POMA and FRQ were determined according to ROC curve analysis. The clinical cut-off point for the POMA was determined as 15.5 points; and 15.5 points or more in the POMA were considered normal with a 95% confidence level. The clinical cut-off point for the FRQ was determined as 4.5 points; and 4.5 points or less in the FRQ were considered normal with a 95% confidence level.Conclusions: We think that it is important to take the values obtained in the present study into account in interpreting the above-mentioned commonly used tests when cognitive status is considered related to falling. Therefore, it is suggested that these tests used in the clinic should be examined considering the risk of falling in older adults with mild cognitive function.