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

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

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

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

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

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

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

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

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

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

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

Objective: In cost-effectiveness analysis, treatment methods are ranked by cost and effectiveness, and a method more costly but less effective, is dominated. In models that none of the methods is absolutely dominated but one of them is extendedly dominated, selecting cost-effective method is complicated. Aim of this study was to propose a classification for magnitude of incremental cost-effectiveness ratio of extendedly dominated method, which can use for deciding about cost-effectiveness of this treatment.Methods: Simulated data based on actual data, and simulated hypothetical data in accordance with actual data were used. All possibilities were tried to consider by generating different costs, effectiveness and response rates. Proportional magnitudes of incremental cost-effectiveness ratios of treatments extendedly dominated were investigated. Descriptive statistics for each model, and weighted means by response rates were calculated and change in percentage of extended dominance were compared.Results: Magnitude of incremental cost-effectiveness ratio of the method extendedly dominated is a quite important factor for deciding about it, when response rates of alternative methods are similar or same. Slight changes were observed as the response rates differ from each other, but there was not an extreme impact on proportions of extended dominance.Conclusion: A very simple and practical classification which can be used to assess the proportional magnitude of the incremental cost-effectiveness ratio of extendedly dominated treatment method and be valid regardless of whether response rates of treatments in model are same or different was suggested.

Introduction: Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group. Materials and Methods: In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded. Results: CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was ≥3 in 23.1% of the patients in the CH group. Discussion and Conclusion: CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.

Background. Today, the concept of health literacy is used to determine the health needs of the population in parallel with ever-increasing health knowledge. Objectives. The aim of the study is to evaluate the health literacy level of patients who apply to the Family Medicine preventive health services of Duzce University Hospital and to investigate the relevant factors that may be related to health literacy. Material and methods. This study was a cross-sectional study carried out between October 2018 and April 2019. The patients were evaluated utilizing the Health Literacy Survey-European Union (HLS-EU) scale. The study took place in Duzce Medical Faculty Hospital, Turkey. Results. A total of 816 patients, 48.5% (n = 396) of them male and 51.4% (n = 420) female, were included in the study. The general health literacy levels of the patients were as follows: 30.6% (n = 250) insufficient, 33.4% (n = 272) limited, 28.9% (n = 236) sufficient, 7.1% (n = 58) excellent. According to all subdimensions and matrix averages of the scale used in the study, the mean score that patients received in understanding and applying health information in the disease prevention dimension (8.45 +/- 2.30, 8.10 +/- 2.38, respectively) was found to be lower than health care (11.20 +/- 2.72, 11.63 +/- 3.01, respectively). Conclusions. The study results revealed a lower level of health literacy in terms of disease prevention rather than healthcare utilization. Initiatives to increase people's knowledge of disease prevention should be planned. WOS:000675417000006 2-s2.0-85116354381

Aim: The study aims 1) to determine the clinical status of obese children at the admittance to the pediatric endocrinology referral center 2) to investigate the efficiency and compliance of the low-carb diet in a pediatric population with or without exercise, metformin Material and Methods: All subjects with the complaint of obesity and BMI percentile >95 were recruited from January 2012-August 2014. We evaluated basal retrospectively, recommended low carbohydrate family-wide eating practice and exercise to all, and metformin to selected cases, and recorded Self-reported adherence at first, third, sixth, and twelfth months. Results: Thirty-six subjects used metformin with a higher ratio of weight loss (90.0%, p=0.010) without a difference in the number of lost kilograms. In 160 cases without metformin; diet only, exercise only, and both diet and exercise groups lost weight significantly according to neither diet nor exercise group (OR:12.08, 95% CI 3.93-41.66, p

Background COVID-19 infection is severe in the presence of older age, male gender and risk factors. The aim of this study was to examine the relationship between the level of anxiety created by immensely spreading COVID-19-related information and age, gender and the presence of risk factors. Material and Methods The data used in this study were obtained by collecting a 25-question questionnaire created through Google forms with various communication tools. Results The data of 929 people who answered the questionnaire were used. The level of anxiety increased with age significantly, upon hearing that a person from their age group was harmed by the virus (P < .001). The feelings of being depressed and hopeless significantly increased as the age increased (P < .001). There was no significant difference between the genders in terms of feeling depressed and feeling of lack of joy in life (P = .066, P = .308, respectively). Participants with chronic diseases stated that they felt more depressed and hopeless and a lack of joy in life more frequently (P < .001). Conclusion Our results indicated that individuals with older age and having risk factors were more vulnerable to the stress caused by the pandemic. It is necessary for healthcare providers to identify high-risk groups by considering these situations, in order to make early psychological interventions. WOS:000631038200001 2-s2.0-85102838679 PubMed: 33720469

SUMMARY OBJECTIVE Cellulite infection is a non-necrotizing inflammation of the skin and subcutaneous tissue and is one of the most common reasons for admission to hospital. This retrospective study aimed to investigate the Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and Lymphocyte to Monocyte Ratio (LMR) in patients with cellulitis. METHODS In our study, we retrospectively analyzed 96 patients with cellulitis and 98 age- and sex-matched healthy controls. The study and control groups were compared regarding NLR, PLR, and LMR.0.001). When patients with cellulitis were divided into two groups, i.e., ≥65 years and

Amaç: Bu çalışma, kadınların serviks kanseri ve taraması hakkındaki tutum ve davranışları ile ilgili sağlık inançlarının değerlendirilmesi amacıyla yapılmıştır.Gereç ve Yöntemler: Bu prospektif çalışmaya Düzce Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Aile Hekimliği Polikliniği’ne Ocak – Mart 2019 tarihleri arasında başvuran ve çalışma kriterlerine uyan 360 kadın dahil edilmiştir. Verilerin toplanmasında ‘Rahim Ağzı Kanseri ve Pap smear Testi Sağlık İnanç Modeli Ölçeği’ ve ‘Hasta Bilgi Formu’ kullanılmıştır.Bulgular: Çalışmadaki katılımcıların yaş ortalaması 42,54 ± 10,13 (min:20-maks:65)’tür. Katılımcıların %37,2’si (n=134) iç Pap smear testi yaptırmamış, bunların %35,1’i (n=47) ihtiyaç duymadığı ve şikayeti olmadığı için testi yaptırmadığını belirtmiştir. Katılımcıların %23,3 (n=84)’ünün ailesinde/ çevresinde serviks kanseri olduğu ve ailesinde/çevresinde serviks kanseri olan katılımcıların olmayanlara kıyasla Pap smear işlemi yaptırma oranlarının daha yüksek olduğu bulunmuştur (p=0,017). Katılımcıların Rahim ağzı kanseri önemseme/ciddiyet (p=0,963), Rahim ağzı kanseri duyarlılık (p=0,897) ve Rahim ağzı kanseri sağlık motivasyonu (p=0,370) puanlarının Pap smear testini yaptırmama nedenlerine göre anlamlı farklılık göstermediği görülürken Pap smear yarar/motivasyon ve Pap smear engeller puan ortalamalarının Pap smear testini yaptırmama nedenlerine göre istatistiksel olarak anlamlı farklılık gösterdiği saptanmıştır (her iki p, Aim: This study was conducted to evaluate the health beliefs of women about their attitudes and behaviors about cervical cancer and screening. Material and Methods: This prospective study included 360 women who met the study criteria and applied to Düzce University Health Practice and Research Center Family Medicine Polyclinic between January - March 2019. Data were collected using ‘Cervical Cancer and Pap Smear Test Health Belief Model Scale’ and ‘Patient information form’.Results: The mean age of the participants was 42.54 ± 10.13 (min: 20-max: 65). 37.2% (n=134) of the participants had never had a Pap smear test before and 35.1% (n=47) of these participants stated that they did not have the test because they did not need the test or any complain. It was found that 23.3% (n=84) of the participants had cervical cancer in their family / around, and Having Pap smear tests rates were higher in participants with cervical cancer in their family/ around than in those without (p=0.017). While cervical cancer care/ severity (p=0.963), cervical cancer sensitivity (p=0.897) and cervical cancer health motivation (p=0.370) scores did not differ significantly according to the reasons for not having a Pap smear test, It was found that the mean scores of Pap smear benefit/ motivation and Pap smear barriers showed a statistically significant difference according to the reasons for not having the Pap smear test (both p

Background: Carotid endarterectomy (CEA) is a prophylactic operation that is used to mitigate the risk of stroke caused by embolism of atherosclerotic plaques in the carotid bifurcation. Previously, the large, multicentre, randomised, controlled GALA study found no significant differences in clinical outcomes between patients treated using general or local anaesthesia. While this study provided important insights into disease outcomes based on treatment modalities, it did not answer questions regarding the safety of CEA under local anaesthesia in patients at high risk for cardiovascular complications. Here, we examined the use of two different management plans in patients requiring both carotid endarterectomy and coronary artery bypass grafting (CABG), in terms of their effects on hospital mortality. Methods: Thirty-four patients consecutively operated on in our cardiovascular department were included in this analysis. The patients were divided into two groups based on the anaesthetic management plan. The first group consisted of patients who underwent CEA and CABG under general anaesthesia in the same session (GA group); the second group consisted of patients who initially underwent CEA under cervical block anaesthesia followed by CABG under general anaesthesia in a separate session (CB-GA group). These two groups were compared in terms of postoperative complications and hospital mortality. Results: The incidence of postoperative myocardial infarction was higher in the CB-GA group, with four patients experiencing postoperative myocardial infarction, compared to no patients in the GA group. Conclusion: For patients requiring CEA and CABG, performing both operations under general anaesthesia in the same session was safer than initially performing CEA under cervical block anaesthesia followed by CABG under general anaesthesia. WOS:000672606600004 2-s2.0-85112482410 PubMed: 33729273

Çalışmada 38 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.

Aim: The aim of the study is to determine the factors that may affect the demands of patients who come with the request to have a blood test without any chronic disease or a planned examination check.Methods: The data of this descriptive, cross-sectional study, were collected with a questionnaire that was prepared to examine the opinions of the patients who claim to have a blood test by coming to the family health center without any complaints. Patients over 18 years of age, who did not have any chronic disease and had no scheduled examination appointments were included in the study.Results: A total of 278 patients who wanted to have a blood test within the 6-months period were included in the study. Female patients who wanted to have a blood test were significantly more than male patients. When we look at the causes of patients who wanted to have a blood test; 61.2% (n=170) patients stated that they are concerned about their health and 6.1% (n=17) stated that they were affectedby media warnings. There was no significant relationship between the frequency of blood test requests of patients and their age, gender, education, and general health status.Conclusion: Patients with high expectations and anxiety may be more willing to perform blood tests at inappropriate intervals. Family physicians, whose primary role is preventive medicine, have consultancy and information duties in order to protect their patients from the risk of over-examination and diagnosis Amaç: Çalışmanın amacı, herhangi kronik bir hastalığı ya da planlanmış bir tetkik kontrolü olmadan kan tahlili yaptırma isteği ile gelen hastaların bu taleplerini etkileyebilecek faktörleri tespit etmektir. Yöntem: Tanımlayıcı-kesitsel planda olan çalışmanın verileri, herhangi bir şikayeti olmadan aile sağlığı merkezine gelerek kan tahlili yaptırmak isteyen hastalardan kan tetkik talepleri ile ilgili görüşlerini incelemek amacıyla hazırlanan bir anket uygulaması ile toplandı. Çalışmaya herhangi bir kronik hastalığı olmayan ve planlanmış bir tetkik randevusu olmayan 18 yaş üstü hastalar dahil edildi. Bulgular: Çalışma verilerinin toplanması için planlanan 6 aylık sürede kan testi yaptırmak isteyen 278 hasta ile görüşüldü. Kan tahlili yaptırmak isteyen kadın hastalar anlamlı olarak erkek hastalardan daha fazlaydı. Kan tahlili isteyen hastaların nedenlerine baktığımızda %61,2 (n=170) hasta sağlığı hakkında endişe duyduğunu, %6,1 (n=17)’i ise medya uyarılarından etkilendiğini belirtmiştir. Hastaların kan tahlili yaptırma sıklıkları ile yaş, cinsiyet, eğitim durumu, genel sağlık durumu değerlendirmesi arasında anlamlı bir ilişki bulunmamıştır. Sonuç: Beklentileri ve kaygıları yüksek olan hastalar, kan testlerini uygun olmayan sık aralıklarla yapmak için daha istekli olabilirler. Öncelikli görevi koruyucu hekimlik olan aile hekimlerinin hastalarını fazla tetkik ve teşhis riskinden korumak için danışmanlık ve bilgilendirme görevleri bulunmaktadır.

Background and objectives: Sepsis is defined as a life-threatening organ dysfunction syndrome, which occurs when the body's immune response to infection is impaired. The aim of the present study was to investigate serum Iron, Copper, Zinco, Cobalt, Chromium, Selenium, Vanadium, Nickel, Cadmium, and Aliminium levels in patients with sepsis. Materials and methods: This prospective and observational study was conducted at a tertiary care university hospital of Turkey from 2015 to 2016, and comprised patients with sepsis. Serum concentrations of 10 elements were analyzed using inductively coupled plasma mass spectrometry. Analyses were performed at the laboratory of Duzce University Scientific and Technological Research Application and Research Center. A total of 87 participants (52 men, 35 women; average age, 74.11 +/- 14.26) were enrolled. Results: When evaluated in terms of trace elements, a significant difference was noted between the sepsis and control groups in terms of the levels of the five elements. Chromium, Iron, Nickel, Copper, and Cadmium levels were significantly higher in the sepsis group. Conclusion: Our study indicated in particular, Iron, Copper, Chromium, Nickel, and Cadmium levels were elevated in patients with sepsis. WOS:000520576100001 2-s2.0-85082319489 PubMed: 32183594

Objectives: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes bethe only symptom in these patients. This retrospective and prospective study was an investigation of any differences in termsof clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) andcases with other concomitant findings (non-isolated headache [NIH]).Methods: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled inthis research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared.Results: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated byage group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IHgroup, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH groupduring follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group thanin the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in theNIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group.Conclusion: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an importantrole in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed. Amaç: Baş ağrısı serebral venöz sinüs trombozunda (SVST) en sık görülen şikayettir ve bazen CVST ile başvuran hastalarda görülen tek semptom olabilir. Bu retrospektif ve prospektif çalışmada, izole başağrısı (IB) ile başvuran SVST olgularında ve baş ağrısı ile ilişkili diğer bulguları olan (izole olmayan başağrısı-İOBA) olgularda klinik risk faktörleri, radyoloji ve prognoz açısından herhangi bir farklılık olup olmadığını araştırdık. Gereç ve Yöntem: Serebral venöz sinüs trombozu (VENOST) çok merkezli çalışmasından 1144 hasta çalışmamıza alındı. Tüm demografik, biyokimyasal, klinik ve radyolojik yönler 287 IBA vakası ve 857 İOBA vakası için karşılaştırılmıştır. Bulgular: Toplam grup içinde kadın oranı iki kat daha yüksekti. İBA grubunda cinsiyet dağılımını yaş gruplarına göre değerlendirildiğinde istatistiksel olarak anlamlı bir fark bulunmadı. İBA grubunda, baş ağrısının başlangıcı sıklıkla subakut ve kronikti, ancak akut başlangıç, İOBA grubunda daha yaygındı. İBA grubunda% 29’luk takip sırasında diğer nörolojik bulgular eklenmiştir. Daha önce serebral, derin ve diğer venöz tromboembolizm öyküsü İBA grubunda İOBA grubuna göre daha azdı. Transvers sinüs tutulumu İBA grubunda daha yüksek iken sagital sinüs tutulumu İOBA grubunda daha fazlaydı. Plazminojen aktivatör inhibitörü (PAI) mutasyonu IBA grubunda anlamlı olarak daha yüksekti. Sonuç: Hastaların subakut veya kronik baş ağrısı varsa SVST tanısı için IBA akılda tutulmalıdır. Trombolitik olaylar için önemli bir role sahip olan PAI, SVST’da bir risk faktörü olabilir, bu nedenle ayrıntılı hematolojik araştırmalar düşünülmelidir. Daha ileri çalışmalara ihtiyaç vardır WOS:000644197800002 2-s2.0-85105266958

Background. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results. The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34±9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38±9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

Amaç: Bu çalışmanın amacı derin anemisi olan hastalarda demir eksikliği anemisi sıklığını belirlemek ve demir eksikliği anemisi olan ve olmayan hastalar arasında hematolojik parametrelerdeki farklılığı incelemek ve karşılaştırmaktır.Gereç ve Yöntemler: Bu çalışmada Ocak 2012 ve Temmuz 2014 tarihleri arasında derin anemi tanısı almış olan toplam 119 hasta geriye dönük olarak incelendi. Derin anemi hastalarının demografik ve klinik özellikleri değerlendirildi. Hastalar demir eksikliği anemisi açısından değerlendirildi ve demir eksikliği anemisi olan ve olmayan hastaların klinik özellikleri ve laboratuvar bulguları karşılaştırıldı.Bulgular: Yüz on dokuz olgunun 49 (%41,2)’u erkek, 70 (%58,8)’i kız olup ortalama yaş 6,7±6,2 yıl idi. Hastalarda çeşitli eş zamanlı hastalıklar vardı. Tüm hastalarda, hemoglobin değeri 6 gr/dL’nin altında olan grup, 6 gr/dL’ye eşit ve üstünde olanlara göre anlamlı şekilde daha düşük trombosit sayısına sahipti (p=0,037). Tüm vakaların 52 (%43,7)’sinde demir eksikliği anemisi olduğu bulundu ve bunların 27 (%51,9)’si 5 ile 18 yaş arasında idi. Demir eksikliği anemisi olan hastaların ferritin düzeyi demir eksikliği anemisi olmayan hastalara göre daha düşük (p, Aim: The aim of this study was to determine the frequency of iron deficiency anemia in patients with severe anemia, and to investigate and compare the difference in the hematological parameters between patients with and without iron deficiency anemia.Material and Methods: A total of 119 patients diagnosed with severe anemia between January 2012 and July 2014 were retrospectively analyzed in this study. Demographic and clinical characteristics of severe anemia patients were evaluated. Patients were evaluated in terms of iron deficiency anemia, and clinical characteristic and laboratory findings of the patients with and without iron deficiency anemia were compared.Results: Of the 119 cases 49 (41.2%) were male and 70 (58.8%) were female, mean age was 6.7±6.2 years. Various comorbidities were present in the patients. In all patients, the group with a hemoglobin value below 6 g/dL had a significantly lower platelet count than those equal to or above 6 g/dL (p=0.037). It was found that 52 (43.7%) of all cases had iron deficiency anemia and 27 (51.9%) of them were aged 5 to 18 years. Patients with iron deficiency anemia had lower ferritin level (p

Introduction Osteoporosis is the most common metabolic bone disease characterized by low bone mass. Reproductive factors are known to affect bone mineral density (BMD). Calcium loss from maternal bone and decreased BMD have been observed especially during pregnancy and lactation, although this loss has been reported to recover within 6 – 12 months. There is no consensus on whether the effect of reproductive factors on the bone is positive or negative. The adolescent period is important for total bone mass, and total bone mass is significant in osteoporosis. The aim of this study was to investigate the effect of first gestational age, multiple births during adolescence, interpregnancy interval and reproductive history such as duration of breastfeeding on bone mineral density in postmenopausal women. Materials and Methods BMD was measured in a total of 196 postmenopausal patients and in accordance with the results, analysis was made of three groups as normal, osteopenia and osteoporosis. Dual Energy X-Ray Absorptiometry (DEXA) was used to take the lumbar, femoral and total bone BMD measurements. Results No statistically significant difference was determined between the groups in respect of total breastfeeding time (p = 0.596). It was detected that an increased interpregnancy interval decreased the risk of osteoporosis. In patients with osteoporosis, the mean interpregnancy interval was 1.4 ± 0.73 years, while it was longer in patients with osteopenia (1.92 ± 1.20) and normal BMD (2.45 ± 1.77) (p = 0.005). While no effect was determined of the first gestational age on BMD, in the univariate logistic regression analysis, multiple births in the adolescent period were seen to increase the risk of osteoporosis 6.833-fold (p = 0.001, OR = 6.833, 95% CI = 2.131 – 21.908; p = 0.001). The increase in the age of menopause was determined to decrease the risk of osteoporosis (OR = 0.911, 95% CI = 0.843 – 0.985; p = 0.019). Conclusion Having frequent births throughout the whole reproductive age and having more than one child in adolescence has an adverse effect on postmenopausal bone mineral densities.

Objective:Tocompare intraocular pressure, central cornea thickness, anterior chamber depth,axial length and thickness of retina nerve fiber layer between women withpolycystic ovary syndrome and healthy at the same age segment.Methods:Between August 2015-January 2016, 46 with polycysticovary syndrome and 53healthy, were included. After performing refraction measurements, Intraocularpressure, central cornea thickness, anterior chamber depth, axial length andretina nerve fiber layer thickness were investigated. Inthe statistical analysis of the data, the Independent Samples t test wasutilized in the comparison of groups.Results:Whilemean age was 23.43±4.52 (16-35) in the group with polycystic ovary syndrome,mean age level was found as 24.09±6.14 (18-41) among the controls (P=0,549).Intraocular pressure values were measured and found as 17.73±2.67 mmHg in thegroup with polycystic ovary syndrome, while the values were 15.21±2.42 mmHg inthe controls (P, Amaç: Aynı yaş segmentinde polikistik over sendromlu ve sağlıklı kadınlar arasındaki göz içi basıncı, santral kornea kalınlığı, ön kamara derinliği, aksiyel uzunluk ve retina sinir lifi tabakası kalınlığını karşılaştırmak.Gereç ve Yöntem : Ağustos 2015-Ocak 2016 tarihleri arasında polikistik over sendromlu 46 ve 53 sağlıklı kadın dahil edildi. Refraksiyon ölçümleri alındıktan sonra, göziçi basıncı, santral kornea kalınlığı, ön kamara derinliği, aksiyel uzunluk ve retina sinir lifi tabakası kalınlığı incelendi. Verilerin istatistiksel olarak değerlendirilmesinde grupların karşılaştırılması amacıyla Independent Samples t test kullanılmıştır.Bulgular: Polikistik over sendromlu grupta yaş ortalaması 23.43 ± 4.52 (16-35) iken, kontroller arasında ortalama yaş düzeyi 24.09 ± 6.14 (18.54) olarak bulundu (p = 0,549). Polikistik over sendromlu grupta göz içi basıncı değerleri 17.73 ± 2.67 mmHg, kontrollerde 15.21 ± 2.42 mmHg bulundu (P

Amac: Clostridium difficile enfeksiyonlari basit bir ishalden, hayati tehdit eden pseudomembranoz enterokolit tablosuna kadar genis bir klinik spektrumda karsimiza cikabilir. Tedavi amac i ile kullan i lan antibiyotikler, sitostatik ilaclar, radyasyon ve hastalara uygulanan invaziv islemler kolon floras i n i bozarak cevrede bulunan Clostridium difficile sporlar i n i n yerle s mesine, hastanede yatis suresinin uzamasina ve maliyetin artmasina neden olmaktadir. Gerec ve Yontemler Bu calisma 1 Temmuz 2015- 30 Eylul 2015 tarihleri arasinda, XXXX’de yapilmistir. Yatarak tedavi goren, 72 saat ve daha fazla yatis suresi olan, yatarken ishal gelismis 77 hasta calismaya dahil edilmistir. Bu hastalarin enfeksiyon ya da kolonizasyonun gelismesinde etkili risk faktorleri arastirilarak kaydedilmistir. 77 hastaya ait 104 gaita orneginde Clostridium difficile toksin A/B varligi Enzyme-Linked Immuno Sorbent Assay yontemi ile arastirilmistir. Bulgular SPSS v.22 paket programi ile analiz edilmistir. Bulgular: Calismaya dahil edilen 77 hastaya 104 ornegin yalnizca ucunde Clostridium difficile ToxinA/B pozitif bulunmustur. Pozitif bulunan uc hastada ortak ozellik olarak, ortalama bir aylik yatis suresi, altta yatan ciddi hastaliklarinin olmasi, yatisindan itibaren antibiyotik ve mide koruyucu ilac kullanmalari dikkat cekmistir. Tartisma ve Sonuc: Arastirmamiz, bu konuda yapilmis calismalarin son derece kisitli oldugu ulkemizde hastane ve bolgemizden bildirilen ilk arastirma olmasi acisindan onemlidir.

Peripheral nerve sheath tumors may occur sporadically or related to neurofibromatosis (NF). Unless the mechanisms of tumorigenesis in NF related malignant peripheral nerve sheath tumors (MPNST) are better understood, it remained unclear in sporadic cases. We aimed to investigate the genetic route for malignancy in both individuals with NF-1 and sporadic ones to open a way for targeted therapies in the future. We investigated the role of HER2 with Dual ISH DNA Probe Cocktail test, BRAF mutation (exon 15) and TERT promoter mutation frequency with Sanger sequencing method in respectively 25 sporadic neurofibromas, 25 NF-1 related neurofibromas and 25 MPNST cases from two institutes. Categorical data were analyzed and summarized as frequency and percentage. Statistical analysis was done with SPSS v.22 statistical package, and the statistical significance level was considered as 0.05. We identified TERT promoter mutation only in one sporadic MPNST (4%) and no BRAF mutation in any case. HER2 amplification is found in 10/25 (40%) MPNST cases. No mutations or gene amplification detected in neurofibromas (p < 0.001). MPNSTs are sarcomas with poor prognosis and limited treatment options. TERT promoter mutations and HER2 amplification may play a putative role in therapeutic purposes. BAP unit (Scientific Research Projects) of Duzce UniversityDuzce University This study is supported financially by BAP unit (Scientific Research Projects) of Duzce University. WOS:000553220700001 2-s2.0-85088702178 PubMed: 32580246

Düzce Tıp Fakültesi Dergisi’nin Yirmi Yılı, Twenty Years of Duzce Medical Journal

WOS: 000465130500010, PubMed: 29992235, Objective This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behcet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST). Methods VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis. Results BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%). Conclusions BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score 2).

Kozak, Hasan Huseyin/0000-0001-6904-8545; Sahin, Sevki/0000-0003-2016-9965; Batur Caglayan, Hale/0000-0002-3279-1842; GUNES, TASKIN/0000-0002-9343-0573; Afsar, Nazire/0000-0001-8123-8560; Uzuner, Nevzat/0000-0002-4961-4332 WOS: 000498868800011 PubMed: 31562041 Aim: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. Material and Method: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. Results: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 +/- 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. Conclusions: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.

Combined Otolaryngology Spring Meetings (COSM) -- APR 18-22, 2018 -- National Harbor, MD WOS: 000465464000005 PubMed: 30541726 OBJECTIVES: The purpose of this trial is to examine the clinical role of iron metabolism on development of Otitis media with effusion. MATERIALS and METHODS: This prospective study was conducted in a tertiary referral center. The study group made up of children who had surgery for Otitis media with effusion (OME). Control group was comprised of children who had surgery by a pediatric surgeon for inguinal hernia repair or circumcision operations with normal ear nose throat examination. Each group was evaluated depending on the serum iron metabolism parameters. RESULTS: One-hundred-thirteen children with OME and 117 control patients were included to the study. Iron deficiency anemia was detected in 18 out of 113 patients (15.9%) in study group while there were 4 out of the 117 patients (3.4%) in control group (p:0.001). The mean hemoglobin level was 12.16 +/- 1.16 in OME group and 12.93 +/- 1.08 in control group (p

Inflammation is believed to play a key role in the pathophysiology of meconium aspiration syndrome (MAS).The objective was to determine whether the recombinant human Erythropoietin (rhEPO) pretreatment could attenuate meconium-induced inflammation.In this study, 24 ventilated adult male rats were studied to examine the effects of recombinant human EPO (rhEPO) on meconium-induced inflammation. Seventeen rats were instilled with human meconium (1.5 mL/kg, 65 mg/mL) intratracheally and ventilated for 3 hours. rhEPO (1000 U/kg) (n = 9) or saline (n = 8) was given to the animals. Seven rats that were ventilated and not instilled with meconium served as a sham-controlled group. Analysis of the blood gases, interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α in blood and bronchoalveolar lavage (BAL) fluid samples, and lung tissue myeloperoxidase levels were performed.Intrapulmonary instillation of meconium resulted in the increase of TNF-α (p = 0.005 and p0.001, respectively) and IL-8 concentrations (p0.001 and p0.001, respectively) in BAL fluid in the EPO + meconium and saline + meconium groups compared with the sham-controlled group. rhEPO pretreatment prevented the increase of BAL fluid IL-1β, IL-6, and IL-8 levels (p0.001, p = 0.021, and p = 0.005, respectively), and serum IL-6 levels (p = 0.036).rhEPO pretreatment is associated with improved BAL fluid and serum cytokine levels. Pretreatment with rhEPO might reduce the risk of developing of meconium-induced derangements.

Summary Aim The aim of this study is to be informed about demographic features, the reasons for preferring medical oncology, career plans, and the educational problems of the residents training in the subspecialty of medical oncology. Method The responses to questionnaire forms sent by e-mail to subspecialty residents who are continuing their training in different educational institutions of our country were recorded and analyzed. Results Seventynine of 129 residents (61.2%) responded the survey forms. Median age of the participants was 33 years. Thirty six (45.5%) were female, and 43 (54.5%) were male. The responders stated different reasons for their preference of medical oncology but most of them (n:64, 81%) thought that medical oncology has a bright future. Of them, 38 (48.1%) the responders intended to refrain from their medical conscription was their most important concern. Fiftytwo (65.8%) of them were not satisfied much with their present education and academic activities. Sixtynine (87.3%) of the participants indicated that they had been suffering from the symptoms of burnout syndrome. Conclusion Recognition of the subspecialty residents who are the future of medical oncology, and determination of their needs, and problems will contribute to the development of recommendations for their solution. In our country their main problems are medical conscription, inadequate education, and burnout.

TOMBAK, ANIL/0000-0002-7195-1845 WOS: 000398084800017 PubMed: 28194064 Therapeutic plasma exchange (TPE) is a procedure that reduces circulating autoantibodies of the patients. TPE is commonly used in neurological disorders where autoimmunity plays a major role. We report our experience with regard to the indications, adverse events and outcomes of plasma exchange in neurological disorders. Sixty-three patients were included to this retrospective study. Median age was 48 years (range 1-85), there was a predominance of males. Neurological indications included Guillain-Barre syndrome (n = 22), myasthenia gravis (n = 21), chronic inflammatory demyelinating polyneuropathy (n = 7), polymyositis (n = 3), multifocal motor neuropathy (n = 2), acute disseminated encephalomyelitis (n = 2), neuromyelitis optica (n = 2), multiple sclerosis (n = 2), limbic encephalitis (n = 1) and transverse myelitis (n = 1). TPE was frontline therapy in 57 % of the patients (n = 36). Total number of TPE sessions was 517; median number of sessions per patient was 8 (range 1-66). TPE was done through a central venous access in 97 % and through a peripheral venous access in 3 % of the patients. Human albumin was used as replacement fluid in 49 %, hydroxyethyl starch (HES) in 49 % and fresh frozen plasma in 2 % of the cases. Adverse reactions were recorded in 60 % of the patients. Total ratio of complications in 517 TPE procedures was 10.8 % and these were mild and manageable such as allergic reactions and hypotension. Overall response rate was 81 %. Interestingly, complication and response rates were similar in both HES and human albumin groups. We conclude that TPE is an effective treatment in neurologic diseases in which autoimmunity plays an important role in the pathogenesis and HES can be used instead of albumin as replacement fluid in these disorders, since it is cost-effective, has similar efficacy and complication rates.

Background This study compared selective head cooling (SHC) and whole-body cooling (WBC) in newborns with hypoxic–ischemic encephalopathy (HIE). Methods We conducted a prospective randomized small-scale pilot study in newborns with HIE, born after >35 weeks of gestation. The patients were randomly assigned to receive SHC or WBC. Results The SHC group consisted of 17 patients, and the WBC group, 12 patients. There was no significant difference in adverse effects related to cooling therapy between the two groups. During the 12 month study period, seven patients in the SHC group and four in the WBC group died, but the difference was not significant (P = 0.667). Among the patients alive at 12 months after treatment, six in the SHC group and four in the WBC group had severe disabilities; the difference was not significant (P = 0.671). When the composite outcome of death or severe disability was evaluated, the difference between the SHC group (77%, n = 13) and the WBC group (67%, n = 8) was not significant (P = 0.562). Moreover, the number of survivors without disability at 12 months after treatment did not differ significantly between the SHC group (n = 3) and the WBC group (n = 4; P = 0.614). Conclusions There were no significant differences in adverse effects, 12 month neuromotor development, or mortality rate between SHC and WBC in newborns with HIE, born after >35 weeks of gestation.

Aim: Anxiety, known as worry, considered normal in everyday life, and also it is a type of behavior developed to protect the organism. The aim of this study is to investigate the effects of exogenous galanin given with exercise on anxiety.Material and Methods: In this study 96 adult male Wistar Albino rats were used. Rats were divided into 8 groups with twelve animals, and 4 of the groups were given regular exercise for 6 weeks. Galanin was administered intraperitoneally (IP) and intracerebroventricular (ICV) in half of the groups and saline was injected into the control group of each group with the same methods. At the end of the sixth week, open field and elevated plus maze tests were applied to the rats, and these tests recorded with the camera. The recordings of the both tests were analyzed, and total distance and speed values, the time spent in the open field test and the time spent in the closed arm of elevated plus maze were compared.Results: In the open field test were determined that in general, the total distance (p, Amaç: Anksiyete, kaygı olarak bilinen, günlük yaşamda normal kabul edilen ve organizmayı korumak amaçlı gelişen bir davranış türüdür. Bu çalışmanın amacı egzersizle birlikte verilen eksojen galaninin anksiyete üzerine etkilerinin araştırılmasıdır.Gereç ve Yöntemler: Çalışmada 96 yetişkin erkek Wistar Albino rat kullanıldı. Ratlar on ikişerli 8 gruba ayrıldı ve 4 gruba 6 hafta boyunca düzenli egzersiz yaptırıldı. Grupların yarısına galanin intraperitonal (IP) ve intraserebroventriküler (ICV) şekilde verildi ve her grubun kendi kontrol grubuna da aynı yöntemlerle salin enjekte edildi. Altıncı hafta sonunda ratlara açık alan ve yükseltilmiş artı labirent testleri uygulanarak kamera kayıtları alındı. Her iki testin de kayıtları incelenerek elde edilen katedilen toplam mesafeler ve hız değerleri ile açık alan testinde merkezde geçirilen süre ve yükseltilmiş artı labirent testinde kapalı kolda geçirilen süre karşılaştırıldı.Bulgular: Açık alan testinde, genel olarak ICV enjeksiyon yapılan ratlarda, IP enjeksiyon yapılan ratlara göre katedilen toplam mesafenin (p

WOS: 000493730200002, Objective: To analyze the indications, complications, and outcomes of pediatric tracheotomies. Material and methods: All tracheotomies performed in a tertiary referral center between January 2011 and December 2015 were reviewed retrospectively. Demographic characteristics of patients, types of referral to hospital, tracheotomy indications, preoperative evaluation findings, surgical technique, postoperative care and complications, discharge and follow-up results were analyzed. Results: A total of 152 pediatric patients underwent tracheotomy at our hospital during this five year period. The median age of patients at the time of tracheotomy was 15.8 months, ranging from 24 days to 17 years. Of the 152 patients, 91 had neurological diseases, 38 had cardiopulmonary diseases, 14 had craniofacial abnormalities, seven had upper airway obstruction, and two underwent tracheostomy for trauma. Eleven (7.2%) patients experienced early complications, and 15 (9.8%) experienced late complications. Twenty (13.1%) patients were decannulated during the follow-up period. Unfortunately, 9 patients (5.9%) died of primary disease and 3 patients (1.9%) died of tracheostomy-related complications Conclusions: The majority of procedures were performed for diseases leading to prolonged mechanical ventilator support such as neurological and cardiopulmonary diseases. This study demostrates the importance of tracheotomy indications, which are the main predictors of decannulation rates. The other significant predictor is pulmonary complications that may cause permanent dependence of mechanical ventilator support as a result of pulmonary failure.

Objective. We aimed to investigate iron metabolism and laboratory findings of anemia in children undergoing adenotonsillectomy for sleep disordered breathing. Methods. Consecutive children undergoing adenoidectomy/adenotonsillectomy for sleep disordered breathing between January 2013 and January 2015 were investigated. Routine preoperative blood tests including blood count and iron studies were analyzed. Subgroup analyses were performed addressing to the severity of sleep disordered breathing, age and duration of symptoms. Results were compared between subgroups and normal values. Results. The study included 171 children. The mean age was 5.44 ± 2.62 years. The mean hemoglobin level was 11.87 ± 1.125 gr/dL and 24 (14%) out of 171 patients had anemia (< 11 gr/dL). The mean ferritin levels were 23.23 ± 17.27 µg/L and 21.27 ± 15.44 µg/L in patients with anemia and non-anemic patients, respectively ( p = 0.572). Ferritin levels decreased in only 8 (33%) out of 24 patients with anemia. The mean age, body mass index, hematocrit, mean corpuscular volume, unsaturated iron binding capacity and serum iron levels decreased in patients with anemia. The rate of anemia significantly increased in children less than or equal to 3 years of age ( p = 0.020). There was no significant association between hemoglobin levels and sleep disordered breathing clinical score or duration of symptoms. Conclusion. The association between low iron status and sleep disordered breathing has previously published. Unfortunately, the type of anemia is still unclear. Our results supposed that the anemia of chronic disease secondary to chronic inflammatory process might play a role in pathogenesis of anemia in patients with sleep disordered breathing.

Topal, Zehra/0000-0001-8397-5636; KUTUK, OZGUR/0000-0001-9854-7220 WOS: 000454201400003 Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, which is generally treated with stimulant and non-stimulant medications. However, 10-30% of patients in clinical setting do not present with adequate response to initial stimulant treatment. Thereby, clonidine may be considered for those patients who have failed to respond to psychostimulant/atomoxetine monotherapy or as an augmentation for inadequate response/comorbidity. This observational study evaluated its effectiveness as a single drug in ADHD cases unresponsive to previous treatment trials. Seventeen ADHD cases that were non-responders to stimulant, non-stimulant and combination therapy for the primary symptoms of ADHD were included in the study. Four cases dropped out before follow up, leaving thirteen cases who were administered immediate release clonidine treatment alone with a mean dose of 0.2 +/- 0.05 mg/day at baseline. The trial lasted for 12 weeks, and treatment outcomes were evaluated by the Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S) and the Clinical Global Impressions-Severity (CGI-S) and Improvement (CGI-I) scales. Mean age of the sample was 12.5 years (SD = 3.0) and eleven of the subjects had another comorbid psychopathology. Only two cases were evaluated as "very much improved", while another patient was judged to be "minimally improved" after 12 weeks of clonidine treatment. Attrition during follow-up was associated with higher median scores on the hyperactivity and impulsivity subscales (Mann-Whitney U test, p = 0.02). According to the T-DSM-IV-S, CGI-S, and CGI-I scales, clonidine treatment by itself had minimal benefits in this sample of treatment of refractory cases with ADHD evaluated at the study center. Clonidine is not available in Turkey pharmaceutical marketing system and patients' access to drug is limited. Our results provide first data regarding the use of clonidine in Turkish ADHD patients.

Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: Osman Ozgur Yalin MD, Hacettepe University, Faculty Nursing, Ankara, Turkey Phone: +90 505 746 27 29 E-mail: osmanozguryalin@yahoo.com Re cei ved/Ge lifl Ta ri hi: 24.03.2015 Ac cep ted/Ka bul Ta ri hi: 23.04.2015 Objective: Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive nocturnal apnea episodes. Periodic limb movements (PLMs) is known as the nocturnal, stereotypic, repetitive movements of the lower extremities. The aim of this study was to investigate the presence of PLMs in patients with OSAS, and the relationship between PLM and OSAS severity. Materials and Methods: One hundred forty-one patients who had a pre-diagnosis of OSAS were enrolled into the study. All subjects’ blood pressure, heart rate measurements, and neurologic examinations were performed by the same neurologist. Sociodemographic characteristics were recorded. Overnight polysomnography (PSG) was performed in all patients and results were analyzed. Patients with an apnea-hypopnea index (AHI) of ≥5 were accepted as having OSAS, and a PLM index (PLMI) of ≥5 were accepted as having PLM. Results: One hundred two patients were diagnosed as having OSAS. The control group consisted of 39 patients who had normal polysomnographic findings. The patients with OSAS were older and their body mass indexes (BMI) were higher compared with the control group. Systolic blood pressure was higher in the OSAS group. Alcohol use was found to be a risk factor for OSAS. PLM was more common in the OSAS group than in the control group (30.3-10.2%). PLM frequency was associated with the severity of OSAS. Conclusion: The presence of PLM was associated with OSAS severity, higher systolic and diastolic blood pressure, and REM sleep depletion in OSAS. PLM seen in patients with OSAS may be regarded as an indicator of disease severity, and should alert the physician to increased complications.

Sahin, Gunsah/0000-0002-4215-6957; Arinci Incel, Nurgul/0000-0002-0012-8720 WOS: 000356810600002 PubMed: 25322735 OBJECTIVE: The aim of this study was to investigate sleep quality in patients with chronic low back pain (CLBP) and its relationship with pain, functional status, and health-related quality of life (HRQOL). METHODS: Two hundred patients with CLBP aged 20-78 years (mean: 50.2 years) and 200 sex- and age-matched pain-free healthy controls (HCs) aged 21-73 years (mean: 49.7 years) were included in this study. After lumbar region examination, in patients, pain was evaluated with the Short Form-McGill Pain Questionnaire (SF-MPQ), functional capacity with the Functional Rating Index (FRI), and health-related quality of life with the Short Form-36 (SF-36). The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality of both groups. The sleep quality was compared between the patients and HCs. In patients with CLBP, its relations with pain, functional status and HRQOL were also investigated. RESULTS: The patients had significantly higher total scores (8.1 +/- 4.3, 4.6 +/- 3.4, P < 0.001, respectively) and subscale scores (P < 0.001) for PSQI compared to HCs. The groups were only similar in use of sleeping medication (P > 0.05) Among the patients, sleep quality was worse in women, in the patients with complaints more than 11 years, in the patients with low back and two leg pain (P < 0.05). Mean scores of the FRI, SF-MPQ, and visual analog scale in the patients were 8.5 +/- 3.0, 16.7 +/- 8.0, 6.9 +/- 1.2, respectively. The PSQI total scores of patients were positively related with both SF-MPQ and FRI scores (P < 0.001). Also, there were negative relationships between the physical component summary score of the SF-36 and all subscale scores of the PSQI, without sleep duration of PSQI (P < 0.001). CONCLUSION: The sleep quality of patients with CLBP was worse compared to HCs, and there were positive relations between the sleep quality with pain and functional status. Also, the poor sleep quality had negative effect on the physical component of quality of life.

Aim: In this study, it was aimed to investigate which method was superior by applying selective head cooling or whole body cooling therapy in newborns diagnosed with moderate or severe hypoxic ischemic encephalopathy. Material and Methods: Newborns above the 35th gestational age diagnosed with moderate or severe hypoxic ischemic encephalopathy were included in the study and selective head cooling or whole body cooling therapy was performed randomly. The newborns who were treated by both methods were compared in terms of adverse effects in the early stage and in terms of short-term results. Ethics committee approval was obtained for the study (06.01.2010/35). Results: Fifty three babies diagnosed with hypoxic ischemic encephalopathy were studied. Selective head cooling was applied to 17 babies and whole body cooling was applied to 12 babies. There was no significant difference in terms of adverse effects related to cooling therapy between the two groups. When the short-term results were examined, it was found that the hospitalization time was 34 (7-65) days in the selective head cooling group and 18 (7-57) days in the whole body cooling group and there was no significant difference between the two groups (p=0.097). Four patients in the selective head cooling group and two patients in the whole body cooling group were discharged with tracheostomy because of the need for prolonged mechanical ventilation and there was no difference between the groups in terms of discharge with tracheostomy (p=0.528). Five patients in the selective head cooling group and three patients in the whole body cooling group were discharged with a gastrostomy tube because they could not be fed orally and there was no difference between the groups in terms of discharge with a gastrostomy tube (p=0.586). One patient who was applied selective head cooling and one patient who was applied whole body cooling died during hospitalization and there was no difference between the groups in terms of mortality (p=0.665). Conclusions: There is no difference between the methods of selective head cooling and whole body cooling in terms of adverse effects and short-term results. (Turk Ped Ars 2015; 50: 27-36)

WOS: 000426234500001, PubMed: 29447793, Objective: To investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion. Methods: This prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months

Amaç: Yaptığımız bu çalışmada Düzce Üniversitesi Araştırma ve Uygulama Hastanesine başvuran kadınlarda osteoporoz sıklığını ve osteoporoz tarama başlangıç yaşını belirlemeyi amaçladık. Materyal ve Metod: Düzce Üniversitesi Araştırma ve Uygulama Hastanesi fizik tedavi ve rehabilitasyon, kadın hastalıkları ve doğum ve ortopedi polikliniklerine 01.01.2015-31.12.2015 tarihleri arasında başvurarak DXA metoduyla femur boynu ve L1-L4 anterior vertebra KMY'ları ( Kemik mineral yoğunluğu) ölçülen 40 ile 70 yaş arasındaki 400 kadın çalışmaya dahil edildi. Majör osteoporotik kırık riskini belirlemek amacıyla FRAX çalışması anket soruları kadınlara sorularak bilgiler kaydedildi. İstatistik: İstatistiksel analiz; gruplar arası Sürekli değişkenler Independent Samples T-test, kategorik değişkenler ise Pearson's chi-square test kullanılarak yapıldı. Sürekli değişkenler arasındaki ilişkiyi belirlemek için Pearson's korelasyon analizi kullanıldı. Bulgular: Çalışmamıza katılan kadınlar arasında osteoporoz sıklığını 11.8% ve osteoporoz grubunun yaş ortalamasını 60.6 olarak bulduk. Sonuç: Hastanemizin hizmet verdiği bölgede majör osteoporotik kırık risk faktörü bulunmayan kadınlarda osteoporoz taraması 60 yaşında başlamalıdır. Aim: In our study, we aimed to determine the age of onset to the osteoporosis screening program and frequency of osteoporosis in the who admitted Düzce University Training and Research Hospital Material and Methods: Between the dates 01.01.2015 and 31.12.2015, 400 women between the ages of 40 and 70, who applied to Düzce University Training and Research Hospital, Departments of Physical Therapy and Rehabilitation, Gynecology and Obstetrics, and Orthopedics, and had got their femoral neck and L1-L4 anterior vertebra BMD (Bone Mineral Density) measured with DXA method, were included in our research. With the FRAX trial questionnaire have conducted to determine major osteoporotic fracture risk, patient data were recorded via asking questions to patients. Statistics: In the statistical analysis, Independent Samples T-test was evaluated for group comparison of continuous variables, Pearson's chi-square test was used for the analysis of relations between categorical variables, and Pearson's correlation analysis was used to review the relations between continuous variables. Results: In our study, we determined the mean age of osteoporosis group as 60.6 while the frequency was demonstrated as 11.8%. Conclusion: For our region, we determined the age of onset for osteoporosis screening as 60 for women without a major osteoporotic fracture risk factor.

WOS: 000412669100013 PubMed: 29033640 Introduction: Cutaneous allodynia is regarded as an expression of central sensitization in migraine. Although the gold standard is quantitative sensory testing, several practical assessment questionnaires have been developed to assess allodynia in migraine. We aimed to establish the first valid Turkish allodynia assessment questionnaire based on a 12-item allodynia symptom checklist and to evaluate the associated factors. Methods: The first part of the study included the translation and cultural adaptation of a Turkish version of the checklist. The Turkish version of the questionnaire was administered to 344 episodic and chronic migraine patients, who were chosen according to the International Classification of Headache Disorders -III beta criteria. Results: The total checklist score showed excellent test-retest reliability (r= 0.821). The internal consistency of the checklist was assessed using Cronbach alpha values and was found to be acceptable (Cronbach alpha for the checklist= 0.767). Data analysis revealed that 10 items of the questionnaire adequately identified allodynic subjects. Cutaneous allodynia was present in 218 (63.4%) migraine patients. Allodynia was more prominent in patients experiencing migraine with aura (p= 0.008) and in females (p< 0.001). Multiple logistic regression analysis found that female gender, aura existence, longer headache duration, and higher attack frequency were the major determinants of cutaneous allodynia. Conclusion: Allodynia is common and has clinical significance in migraine; therefore, establishing a validated Turkish questionnaire for the assessment of allodynia was necessary. In this study, a Turkish version of the allodynia symptom checklist was validated and found to be convenient for the identification of allodynia in migraine patients.