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1. Paroxysmal sympathetic hyperactivity syndrome after recurrent stroke: A case report

Author

Fatma Bilgili, Serpil Yıldız, Şule Aydın Türkoğlu, and Sadettin Ersoy

Subjects
Paroxysmal sympathetic hyperactivity, Ischemic stroke, Autonomic dysfunction, Medicine
Abstract

Paroxysmal sympathetic hyperactivity (PSH) is a state of autonomic dysfunction characterized by symptoms such as tachypnea, tachycardia, hypertension, hyperthermia, sweating, and dystonia. It can occur after traumatic brain injury, hypoxic-ischemic encephalopathy, and diseases such as stroke. Hypoxia, extensive axonal damage, and young age are believed to predispose to the development of PSH. These patients may be diagnosed with pulmonary embolism, septicemia, or epileptic seizures. Delays in diagnosis prolong hospital stay. Here, we present an 81-year-old man who developed PSH after a recurrent stroke and our management.

Published
2024
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2. Radiograph accelerated detection and identification of cancer in the lung (RADICAL): a mixed methods study to assess the clinical effectiveness and acceptability of Qure.ai artificial intelligence software to prioritise chest X-ray (CXR) interpretation

Author

Alex McConnachie, Evi Germeni, David J Lowe, David B Stobo, Mark Hall, John D Maclay, O Wu, Dennis Robert, Shamie Kumar, Sean F Duncan, James Blackwood, and Banu Bilgili

Subjects
Medicine
Abstract

Introduction Diagnosing and treating lung cancer in early stages is essential for survival outcomes. The chest X-ray (CXR) remains the primary screening tool to identify lung cancers in the UK; however, there is a shortfall of radiologists, while demand continues to increase. Image analysis by machine-learning software has the potential to support radiology workflows with a focus on immediate triage of suspicious X-rays. The RADICAL study will evaluate Qure.ai’s ‘qXR’ software in reducing reporting time for suspicious X-rays in NHS Greater Glasgow & Clyde.Methods and analysis This is a stepped-wedge cluster-randomised study consisting of a retrospective technical evaluation and prospective clinical effectiveness study alongside the assessment of acceptability via qualitative work and evaluation of cost-effectiveness via a cost utility analysis. The primary objective is to assess the clinical effectiveness of qXR to prioritise patients suspected with lung cancer on CXR for follow-up CT. Secondary objectives will look at the utility, safety, technical performance, health economics and acceptability of the intervention. The study period is 24 months, consisting of an initial 12 month data collection period and a 12 month follow-up period. All the standard care CXRs from outpatient and primary care requests will be securely transmitted to Qure.ai software ‘qXR’ for interpretation. Images with features of cancer will be flagged as ‘Urgent Suspicion of Cancer’ and be prioritised for radiologist review within the existing reporting workflow.Ethics and dissemination The study will follow the principles of Good Clinical Practice. The protocol was granted REC approval in August 2023 from North West—Greater Manchester West Research Ethics Committee (REC 23/NW/0211). This study was registered on clinicaltrials.gov (NCT06044454). An interim report will be produced for use by the Scottish Government. The results from this study will be presented at artificial intelligence, radiology and respiratory meetings and published in peer-reviewed journals.Trial registration number NCT06044454.

Published
2024
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3. Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study

Author

Mehmet Akif Topçuoğlu, Atilla Özcan Özdemir, Ethem Murat Arsava, Aygül Güneş, Özlem Aykaç, Elif Sarıönder Gencer, Murat Çabalar, Vildan Yayla, Hacı Ali Erdoğan, Mücahid Erdoğan, Zeynep Özdemir Acar, Semih Giray, Yüksel Kablan, Zeynep Tanrıverdi, Ülgen Yalaz Tekan, Talip Asil, Çetin Kürşad Akpınar, Vedat Ali Yürekli, Bilgehan Acar, Hadiye Şirin, Ayşe Güler, Recep Baydemir, Merve Akçakoyunlu, Levent Öcek, Mustafa Çetiner, Bijen Nazliel, Hale Batur Çağlayan, Nedim Ongun, Alper Eren, Zülfikar Arlıer, Utku Cenikli, Mustafa Gökçe, Songül Bavli, Erdem Yaka, Ayça Özkul, Bahar Değirmenci, Ufuk Aluçlu, Canan Togay Işıkay, Eda Aslanbaba, Mine Sorgun, Emrah Aytaç, Halil Ay, Refik Kunt, Songül Şenadım, Yaprak Özüm Ünsal, Neslihan Eşkut, Zekeriya Alioğlu, Arda Yılmaz, Hamit Genç, Ayşe Yılmaz, Aysel Milanoğlu, Erdem Gürkaş, Eylem Değirmenci, Hesna Bektaş, İrem İlgezdi, Adnan Burak Bilgiç, Şenol Akyol, İ. Levent Güngör, Nilüfer Kale, Eda Çoban, Nilüfer Yeşilot, Esme Ekizoğlu, Özgü Kizek, Oğuzhan Kurşun, Özlem Kayım Yıldız, Aslı Bolayır, Ayşın Kısabay, Birgül Baştan, Zeynep Acar, Buket Niflioğlu, Bülent Güven, Dilaver Kaya, Nazire Afşar, Duran Yazıcı, Eren Toplutaş, Esra Özkan, Faik İlik, Fatma Birsen İnce, Gülseren Büyükşerbetçi, Halil Önder, Hasan Hüseyin Karadeli, Hasan Hüseyin Kozak, Hayri Demirbaş, İpek Midi, İsa Aydın, M. Tuncay Epçeliden, Murat Mert Atmaca, Mustafa Bakar, Mustafa Şen, Nilda Turgut, Ahmet Onur Keskin, Özlem Akdoğan, Ufuk Emre, Özlem Bilgili, Pınar Bekdik Şirinocak, Recep Yevgi, Sinem Yazıcı Akkaş, Tahir Yoldaş, Taşkın Duman, Tuğba Özel, Ali Ünal, Babür Dora, H. Tuğrul Atasoy, Bilge Piri Çınar, Tülin Demir, Turgay Demir, Ufuk Can, Yıldız Aslan, Demet Funda Baş, Ufuk Şener, Zahide Yılmaz, Zehra Bozdoğan, Gökhan Özdemir, Yakup Krespi, and Şerefnur Öztürk

Subjects
acute stroke, thrombolytic therapy, thrombectomy, prognosis, treatment window, metric, Medicine, Neurology. Diseases of the nervous system, RC346-429
Abstract

Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neuro-interventional therapy in Türkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0–2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 +- 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 +- 6; hospital stay, 24 +- 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 +- 13 years; NIHSS: 14.1 +- 6.5; length of hospital stay, 33 +- 31 days), 19% in those who received combined treatment (age: 66 +- 14 years; NIHSS: 15.6 +- 5.4; length of hospital stay, 26 +- 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 +- 13 years; NIHSS: 7.6 +- 7.2; length of hospital stay, 21 +- 28 days). The symptom-to-door time was 87 +- 53 minutes in the IV treatment group and 200 +- 26 minutes in the neurointerventional group. The average door-to-needle time was 66 +- 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 +- 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0–2 was 41%, while the rate of mRS 0–1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0–2 was 31% and mRS 0–1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 +- 107 and 95 +- 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Türkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the 'Directive on Health Services to be Provided to Patients with Acute Stroke.'

Published
2023
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4. Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study

Author

Mehmet Akif Topçuoğlu, Ethem Murat Arsava, Atilla Özcan Özdemir, Özlem Aykaç, Mustafa Çetiner, Elif Sarıönder Gencer, Aygül Güneş, Yakup Krespi, Erdem Yaka, Levent Öcek, Zeynep Tanrıverdi, Ülgen Yalaz Tekan, Ayça Özkul, Esra Özkan, Hadiye Şirin, Ayşe Güler, Oğuzhan Kurşun, Refik Kunt, Utku Cenikli, Bilgehan Acar, Yüksel Kablan, Ayşe Yılmaz, Canan Togay Işıkay, Eda Aslanbaba, Mine Sorgun, Hesna Bektaş, Murat Çabalar, Vildan Yayla, Hacı Ali Erdoğan, Mustafa Gökçe, Songül Bavli, Nedim Ongun, Ahmet Onur Keskin, Özlem Akdoğan, Ufuk Emre, Özlem Kayım Yıldız, Aslı Bolayır, Çetin Kürşad Akpınar, Hasan Hüseyin Karadeli, Tuğba Özel, Ali Ünal, Babür Dora, Zülfikar Arlıer, Alper Eren, Aysel Milanoğlu, Bijen Nazliel, Hale Batur Çağlayan, Bülent Güven, Mücahid Erdoğan, Zeynep Özdemir Acar, Mustafa Bakar, Semih Giray, Songül Şenadım, Talip Asil, Turgay Demir, Yaprak Özüm Ünsal, Neslihan Eşkut, Yıldız Aslan, Demet Funda Baş, Ufuk Şener, Bahar Değirmenci, Ufuk Aluçlu, Birgül Baştan, Zeynep Acar, Buket Niflioğlu, Duran Yazıcı, Emrah Aytaç, Fatma Birsen İnce, Halil Ay, Halil Önder, Hasan Hüseyin Kozak, İrem İlgezdi, Adnan Burak Bilgiç, Şenol Akyol, İ. Levent Güngör, Murat Mert Atmaca, Mustafa Şen, Recep Yevgi, Sinem Yazıcı Akkaş, Tahir Yoldaş, H. Tuğrul Atasoy, Bilge Piri Çınar, Arda Yılmaz, Hamit Genç, Ayşın Kısabay, Faik İlik, Hayri Demirbaş, İpek Midi, Pınar Bekdik Şirinocak, Taşkın Duman, Tülin Demir, Ufuk Can, Vedat Ali Yürekli, Zehra Bozdoğan, Zekeriya Alioğlu, Dilaver Kaya, Nazire Afşar, Erdem Gürkaş, Eren Toplutaş, Eylem Değirmenci, Gülseren Büyükşerbetçi, İsa Aydın, M. Tuncay Epçeliden, Nilda Turgut, Nilüfer Kale, Eda Çoban, Nilüfer Yeşilot, Esme Ekizoğlu, Özgü Kizek, Özlem Bilgili, Recep Baydemir, Merve Akçakoyunlu, Zahide Yılmaz, and Şerefnur Öztürk

Subjects
acute stroke, transient ischemic attack, anticoagulant, relapse, therapeutic dose, holter monitoring, Medicine, Neurology. Diseases of the nervous system, RC346-429
Abstract

Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in our country. Within the scope of NeuroTek-Turkey, hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute stroke algorithms. Materials and Methods: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Türkiye. Within the scope of NöroTek-Türkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received 'effective' treatment [international normalization ratio ≥2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NöroTekTR revealed the high but expected frequency of AF in acute stroke in Türkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Türkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF.

Published
2023
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5. Turkish Primary Care Patients’ Overviews and Attitudes About Traditional and Complementary Medicine: A Cross-Sectional Study

Author

Pinar Bilgili, Raziye Sule Gumustakim, Murat Cevik, Duygu Ayhan Baser, Adem Doganer, Erkut Coskun, Ozgur Akbaba, Selda Handan Karahan Saper, Melahat Akdeniz, and Ahef Bilim Kurulu

Subjects
complementary alternative medicine, family health center, attitude, knowledge, Medicine, Medicine (General), R5-920
Abstract

Aim:Primary care physicians need to be aware of the types of traditional and complementary medicine (TCM) used by patients to be able to guide patients away from harmful approaches and to aim them toward useful or at least seeming benign approaches. This study aimed to determine the prevalence of the usage of TCM methods in Turkey and the level of knowledge and attitudes of applicants about these methods.Methods:The universe of this cross-sectional study consisted of individuals aged 18 and over who applied to the Family Health Centers and agreed to participate in the study in 12 provinces in different regions of Turkey between July and December 2016. The questionnaires were applied to the volunteer participants by the researchers using face-to-face interview techniques. The questionnaire had 25 questions.Results:80.6% of the participants benefited from TCM, and 86.4% stated they believed in the effectiveness of TCM. Women, university graduates of college who had private insurance used TCM (respectively; p=0.031; p=0.004; p=0.000), and women (83.3%) found TCM more useful than men (p=0.005). The most frequent reason for using TCM was “heard that it was useful”.Conclusion:The results of our study indicated that a large portion of Turkish primary care patients use TCM and recommend it to their relatives. Therefore, health policies and academic knowledge should be developed in this sense.

Published
2023
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6. An AI based classifier model for lateral pillar classification of Legg–Calve–Perthes

Author

Zafer Soydan, Yavuz Saglam, Sefa Key, Yusuf Alper Kati, Murat Taskiran, Seyfullah Kiymet, Tuba Salturk, Ahmet Serhat Aydin, Fuat Bilgili, and Cengiz Sen

Subjects
Medicine, Science
Abstract

Abstract We intended to compare the doctors with a convolutional neural network (CNN) that we had trained using our own unique method for the Lateral Pillar Classification (LPC) of Legg–Calve–Perthes Disease (LCPD). Thousands of training data sets are frequently required for artificial intelligence (AI) applications in medicine. Since we did not have enough real patient radiographs to train a CNN, we devised a novel method to obtain them. We trained the CNN model with the data we created by modifying the normal hip radiographs. No real patient radiographs were ever used during the training phase. We tested the CNN model on 81 hips with LCPD. Firstly, we detected the interobserver reliability of the whole system and then the reliability of CNN alone. Second, the consensus list was used to compare the results of 11 doctors and the CNN model. Percentage agreement and interobserver analysis revealed that CNN had good reliability (ICC = 0.868). CNN has achieved a 76.54% classification performance and outperformed 9 out of 11 doctors. The CNN, which we trained with the aforementioned method, can now provide better results than doctors. In the future, as training data evolves and improves, we anticipate that AI will perform significantly better than physicians.

Published
2023
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7. The Effect of Convalescent Plasma Infusion in the Intensive Care Unit on Mortality of COVID-19 Patients: A Retrospective Cohort Study

Author

Mehmet Süleyman Sabaz, Fethi Gül, Beliz Bilgili, Safiye Tuba Kaplan, Burçin Doruk Oktay, and İsmail Cinel

Subjects
convalescent plasma, covid-19, sars-cov-2, intensive care unit, mortality, Medicine, Internal medicine, RC31-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objective: This study investigates the effect of convalescent plasma (CP) addition to the standard treatment on mortality in critical coronavirus disease-2019 (COVID-19) patients. Materials and Methods: This retrospective cohort study was conducted by evaluating the data of 255 critical COVID-19 patients in Marmara University Medical Faculty Hospital, Pandemic Intensive Care Unit (ICU), between April and November 2020. Results: The patients were divided into two groups, a control group that received standard treatment (153; 60.0%) versus a second group that received CP in addition to standard treatment (102; 40.0%). The ICU mortality rate was found to be lower (p

Published
2022
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8. Work-related Health Problems in Emergency Health Services Workers

Author

Levent Şahin, Ali Gur, Muhammed Ekmekyapar, and Mehmet Ali Bilgili

Subjects
emergency health services, health problems, sentry, Medicine
Abstract

INTRODUCTION: In this study, it was aimed to investigate the physical, psychological and familial problems of the healthcare provider working in emergency health care services that develop due to their work and working conditions. METHODS: 297 people working in emergency health services in three different cities were included in the study. The study was carried out between November 15 and December 15, 2020 by conducting an online questionnaire. The participants in the study were asked questions about their physiological and psychological health conditions through the questionnaire. The answers received were evaluated statistically. RESULTS: In this study conducted with 297 people working in emergency health services (EHS), 189 (63.6%) people had health problems, 249 (83.8%) people worked even though they were ill, 186 (62.6%) people did not go to regular check-ups about their diseases, 282 (94.9%) were found to be under occupational stress and 141 (47.5%) of them needed psychological support. It has been determined that women have more health problems than men, are constantly using medication and need psychological support more (p=0.002, p=0.001, p=0.001). The health status of EHS employees who worked on duty was worse than those working overtime. This situation was statistically significant (p=0.002). DISCUSSION AND CONCLUSION: It is observed that emergency health care workers have some physical and mental problems. All stressful situations on healthcare provider should be identified and working conditions should be improved.

Published
2021
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9. CORONAL PLANE GROWTH MODULATION FOR GENU VALGUM IN SKELETAL DYSPLASIA

Author

YAVUZ SAĞLAM, MEHMET DEMIREL, AHMET MUÇTEBA YILDIRIM, FUAT BILGILI, and CENGIZ ŞEN

Subjects
Bone Dysplasia, Genu Valgum, Growth Plate, Epiphyses, Retrospective Studies, Medicine, Orthopedic surgery, RD701-811
Abstract

ABSTRACT Objective: To investigate the efficiency and rates of correction by hemiepiphysiodesis using 8-plate to manage genu valgum deformity in children with skeletal dysplasia. Methods: Eleven children with skeletal dysplasia (three female, eight male; mean age = 10.5 years; age range = 7-13) who underwent temporary hemiepiphysiodesis using 8-plates for genu valgum deformity were retrospectively reviewed. There were nine bilateral cases and two unilateral cases. The mean follow-up time from the index surgery to the final follow-up was 45 (ranging from 24 to 72) months. Radiographical assessment including preoperative and final follow-up measurements of joint orientation angles and mechanical axis deviation (MAD) were conducted. Results: Deformities were completely corrected in nine lower extremities (45%) and partially corrected in seven extremities (35%). In four extremities of two children with Morquio syndrome, MAD worsened. The correction rate of MAD was 1.25 ± 1.62 mm/mo. Conclusion: Though hemiepiphysiodesis using 8-plate requires a longer treatment period, it seems to be an effective treatment for correction of genu valgum in children with skeletal dysplasia. Level of Evidence IV, Case Series.

Published
2022
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10. The Retrospective Evaluation of Resuscitation Patients in The Emergency Department: Two-Year Analysis

Author

Ali Gür, Erdal Tekin, İbrahim Özlü, Mehmet Ali Bilgili, and Hayrettin Meftun Kaptan

Subjects
cardiopulmonary resuscitation, emergency department, return of spontaneus circulation, mortality, Medicine
Abstract

INTRODUCTION: In this study, we aimed to examine the demographic data of patients underwent cardiopulmonary resuscitation, the causes for resuscitation and to evaluate our resuscitation success rate in patients underwent cardiopulmonary resuscitation. METHODS: In this retrospective study, patients who underwent resuscitation in the emergency department (ED) between 01.01.2019-31.12.2020 were examined. The patients who died in the emergency room were evaluated as Group-1 and the patients who received ROSC as Group-2. These patients age, gender, chronic disease, time of arrival month and day to the emergency department, admitted conditions to ED, the duration of the resuscitation, forensic case, whether defibrillation is applied to the patient, the patient fate in the ED, time of death, cause of death, the sleeping circulation after cardiopulmonary resuscitation of patients with clinic and hospital stays in the hospital in the last days, the duration of status and laboratory values were evaluated statistically. RESULTS: It was determined that 72 (23.5%) patients in group 1 and 64 (32.7%) patients in group 2 presented to the emergency service with the highest rate between 12: 01-16: 00. This ratio was significantly different between the groups (p = 0.025). Myocardial infarction was the most common cause of death in patients who died in the hospital and emergency department. While the rate of patients who received ROSC in the emergency department was 39%, the rate of discharge from the hospital was 9.2%. DISCUSSION AND CONCLUSION: In addition to the principles of cardiopulmonary resuscitation, the medical characteristics of resuscitation patients also affect the success of resuscitation in patients.

Published
2021
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11. Relationship between 25-OH Vitamin D level and liver histopathology in patients with chronic Hepatitis B

Author

Şevki Konür and Mehmet Ali Bilgili

Subjects
vitamin d, fibrosis, histological activity index, chronic hepatitis b, Medicine
Abstract

INTRODUCTION: Hepatitis B virus (HBV) infection continues as a global health problem. In vitamin-D deficiency, which has an immunomodulating effect, chronic hepatitis, cirrhosis progression and viral replication have been increased. In our study, we aimed to examine the relationship between vitamin-D and liver histopathology in chronic HBV patients. METHODS: 137 patients with chronic HBV diagnosis from the outpatient clinic of our hospital between September/2017-November/2019 were included in the study. The demographic data, vitamin-D levels, histopathological data, accompanying comorbid diseases, medications and previous operations were recorded. The relationship between fibrosis, inflammation level and vitamin-D was analyzed. RESULTS: A total of 137 patients, 62(45.2%) women, were included in the study. As a result of liver biopsy; while 25(18.2%) patients had no fibrosis, 77(56.2%) patients had mild fibrosis and 35(25.6%) patients had significant fibrosis. It was observed that age increased with increasing fibrosis-stage (p

Published
2021
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12. Idiopathic Hypereosinophilic Syndrome as a Rare Cause of Stroke: A Case Report

Author

Esra Turğut, Murat Alpua, Selim Yalçın, Oya Coşkun, Mirace Yasemin Karadeniz Bilgili, Ergin Ayaşlıoğlu Açıkgöz, and Özlem Coşkun

Subjects
cerebrovascular accident, hypereosinophilic syndrome, ischemic stroke, hypereosinophilia, Medicine, Neurology. Diseases of the nervous system, RC346-429
Abstract

Hypereosinophilic syndrome (HES) is a rare hematological disease that causes organ damage by eosinophil infiltration in the tissue with increased eosinophil production in the bone marrow. HES is a rare but important cause of stroke. Central nervous system involvement findings can be serious and life-threatening. Eosinophil values should be examined as the cause of stroke, and hypereosinophilia should be suspected, especially in young patients with no etiology. Reported herein is a case of a 47-year-old female patient who was followed up with the diagnosis of acute cerebrovascular disease due to idiopathic HES.

Published
2021
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13. Evaluation of Geriatric Patients Applying to the Emergency Department

Author

Mehmet Ali Bilgili and Mehmet Reşit Öncü

Subjects
geriatric diseases, elderly patients, emergency service, Medicine
Abstract

INTRODUCTION: By increasing elderly population in the world and in Turkey, the number of elderly patients admission to emergency services is also increasing. In this study, it was aimed to determine the complaints during admission, common observed diseases, hospitalization rates and hospitalized services of the elderly patients over 65 years old who applied to the emergency service. METHODS: The patients aged 65 years and over who applied to Medical Faculty Hospital emergency department between 01.01.2015 and 31.12.2015 were retrospectively evaluated. The patients' gender, age, date and time of admission to the hospital, complaints about admission to the hospital, discharge of the patient after the medical treatment, referral to the hospital or intensive care unit, hospitalized departments and preliminary diagnosis were evaluated. RESULTS: 12,998 (10,1%) of the emergency department admissions were 65 years of age or older. 6571 of the patients were male (50,6%) and 6427 (49,4%) were female. The mean age was 73,72 +- 6,6 (65-111). The patients most frequently admitted to the hospital with headache (25,1%) and chest pain complaints (15,9%). 84,2% of the patients were treated as outpatient and discharged from the emergency service while, 15,4% of the patients were admitted to the hospital, 22 patients (0,2%) were referred to other centers for various reasons and 18 patients (0,1%) were exitus. 13 of the patients (0,1%) were left the hospital without accepting treatment. DISCUSSION AND CONCLUSION: In our study, the most common necessity of emergent interventions of geriatric patients who admitted to emergency service were, cardiac problems, respiratory system diseases and gastrointestinal diseases.

Published
2021
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14. Retrospective Analysis of Poisoning Cases Admitted to Kayseri City Hospital Adult Emergency Department as a Result of Suicidal Attempt by Drug Ingestion

Author

Taner Sahin, Nihal Koç, Onur Türkön, Hasan Tüle, Ahmet Ceylan, and Mehmet Ali Bilgili

Subjects
suicide attempt, drug intoxication, emergency service, retrospective analysis, Medicine
Abstract

INTRODUCTION: Suicide attempts and suicide acts are a severe cause of morbidity and mortality for individuals. In the study, It is aimed to retrospectively examine the patients over 18 years of age who applied for suicidal attempts due to excessive drug intake and to describe the characteristics of the patients, causes and consequences of the suicide attempts. METHODS: In this study, 615 patients with suicide attempts due to excessive drug intake over the age of 18 who applied to the emergency service of Kayseri City Hospital by an ambulance or outpatient within one year were included. While analyzing the data; descriptive statistics were presented with frequency and percentage values. p

Published
2021
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15. The Diagnostic Value of sTWEAK in Acute Ischemic Stroke

Author

Ertan Comertpay, Sevilay Vural, Oğuz Eroğlu, Nermin Dindar Badem, Yasemin Karadeniz Bilgili, and Figen Coşkun

Subjects
ischemic area volume, ischemic stroke, magnetic resonance imaging, stweak, Medicine
Abstract

Background: Considering the critical role of early diagnosis and management of acute ischemic stroke, biomarkers that can reliable assist in the diagnosis are still needed. These biomarkers should rapidly analyze, have high specificity for brain damage, and be available in the emergency settings for early diagnosis and exclusion of other conditions that mimic acute ischemic stroke. Soluble tumor necrosis factor-like weak inducer of apoptosis, a protein involved in the regulation of several biological functions, could be a potential acute ischemic stroke biomarker. Aims: To investigate the diagnostic value of soluble tumor necrosis factor-like weak inducer of apoptosis in patients with acute ischemic stroke and examine the relationship between ischemic area volume determined at diffusion-weighted magnetic resonance imaging and soluble tumor necrosis factor-like weak inducer of apoptosis. Study Design: A prospective, case-control study. Methods: This case-control prospective study included 36 patients with acute ischemic stroke and 36 healthy volunteers. Information on age, sex, presence of chronic disease, neurological examination findings, times of presentation to the emergency department after acute ischemic stroke, soluble tumor necrosis factor-like weak inducer of apoptosis levels, ischemic area volumes at diffusion-weighted magnetic resonance imaging, and 6-month mortality rates after stroke were recorded. The results were analyzed on SPSS 22.0 software (SPSS Inc., Chicago, IL, USA), and p

Published
2020
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16. The Relationship Between Helicobacter Pylori Infection and Blood Group

Author

Şevki Konür, Yusuf Kayar, Ramazan Dertli, Adnan Özkahraman, Mehmet Ali Bilgili, and Ümit Haluk İliklerden

Subjects
helicobacter pylori, blood group, risk factors., Medicine
Abstract

INTRODUCTION: Our aim in this study is to investigate the relationship between Helicobacter Pylori (HP) and blood group and other risk factors. METHODS: 373 patients who underwent gastrointestinal system (GIS) endoscopy and gastric tissue biopsies were taken into the study between March-2017 and June-2018. Demographic data, risk factors, endoscopic appearance and histopathological data of all patients were documented. Patients were divided into two groups according to the presence of HP. Patients were divided into two groups as HP-positive and HP-negative according to the presence of HP. The groups were compared in terms of blood group and risk factors. RESULTS: 190 (50.9%) of the cases included in the study were women and the mean age of all patients was 45.1 +- 14.9 (range: 18-86) years. HP was positive in 53.8% of cases included in the study. HP positive patients were seen to be younger (p 0.05). DISCUSSION AND CONCLUSION: As a result, in this study, soso-demographic factors such as age, working status, hand hygiene, smoking and alcohol use were found to be a risk factor for HP positivity, while no significant relationship was observed between ABO blood groups and HP.

Published
2020
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17. A Case Report: Isolated Pontine Lesion in Hypertensive of a Pregnant Patient with Idiopathic Thrombocytopenia

Author

Ilknur Yardimci, Mehmet Tunc, Bahar Say, Cemile Dayangan Sayan, Mirace Yasemin Karadeniz Bilgili, Selim Yalcin, and Ozlem Coskun

Subjects
isolated pontine lesion, posterior reversible encephalopathy syndrome (pres), pregnancy, thrombocytopenia, spreading depression, Medicine
Abstract

Posterior reversible encephalopathy syndrome (PRES) is a neuroradiologic diagnosis characterised by headache, seizures, altered mental status, and a spectrum of visual deficits ranging from visual neglect to cortical blindness. PRES manifestation is a situation of medical emergency; however, it is a fully reversible condition, especially when diagnosed and treated immediately. The main problem lies in the impairment of cerebral blood flow autoregulation which, in turn, leads to endothelial dysfunction and vasogenic brain oedema. MRI indicates cerebral oedema in the occipital, temporal, and parietal lobes. Brainstem involvement is very rare in the literature. Idiopathic thrombocytopenia-related PRES is also rare in the literature. In this article, a case of PRES with only pons involvement in MRI after hypertensive attack in a pregnant patient with idiopathic thrombocytopenia is presented. PRES may present only brainstem involvement, as seen in this present case. Whether or not mild hypertension and mild thrombocytopenia found in this case are associated with limited disease should be evaluated. Prolonged spreading depression may have a role in the pathophysiology of PRES.

Published
2020

18. The Relationship Between Helicobacter Pylori and Reflux Esophagitis in Children

Author

Mehmet Ağın, Yusuf Kayar, Ramazan Dertli, Şevki Konür, and Mehmet Ali Bilgili

Subjects
helicobacter pylori, reflux esophagitis, grade., Medicine
Abstract

INTRODUCTION: The aim of this study was to determine the prevalence of Helicobacter Pylori (HP) in patients with esophagitis and to investigate the relationship between HP and the presence and severity of esophagitis. METHODS: 361 patients with recurrent dyspeptic complaints admitted to Van Training and Research Hospital, Pediatric Gastroenterology Outpatient Clinic between August-2017/April-2019 were included in the study. Upper gastrointestinal endoscopy was performed and esophageal and gastric tissue biopsies were obtained. Demographic data, clinical complaints, endoscopic appearance and histopathological data of all patients were documented. Patients were divided into two groups according to the presence of HP. The groups were compared for the presence and severity of esophagitis. RESULTS: 35.5% of the cases were male and 64.5% were female. The mean age was 11.6+-1.6 years. The most common presenting complaints were nausea (56.8%), retching and belching (39.6%), regurgitation (39.1%) and stomach pain (38.2%). HP was positive in 63.3% of the cases and esophagitis was found in 23% of the cases. Esophagitis was detected in 21.9% of HP positive cases and 24.6% of HP negative cases. 96% of the patients with HP positive esophagitis had grade A, 2% had grade B and 2% had grade C esophagitis. There was no statistically significant difference between HP positivity with presence and severity of esophagitis (p>0.05). DISCUSSION AND CONCLUSION: In conclusion HP positivity did not affect esophagitis and esophagitis severity in children. Addition, we have shown that the presence of HP does not play a role in the pathogenesis and complications of GERD.

Published
2020
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19. A case of hypomelanosis of Ito accompanied by unilateral abnormal limb overgrowth and delayed speech

Author

Mustafa Özçetin, Ayse Kilic, Yakup Çağ, Fuat Bilgili, and Büşra Aksoy

Subjects
delayed speech, hypomelanosis of ito, limb asymmetry., Medicine, Medicine (General), R5-920
Abstract

Hypomelanosis of Ito (HI) is characterized by unilateral or bilateral hypopigmented skin lesions and usually presents as a multisystemic disorder. Skin lesions may develop in different textures, such as linear, whorled, or patchy, and are often accompanied by abnormalities of the central nervous system, skeletal system, eyes, and teeth. HI is associated with sporadic gene mutations but not gender. Presentation of the current case may be of use in reminding practitioners of the common extracutaneous findings of HI, along with some rare manifestations, such as delayed speech and asymmetric limb growth.

Published
2020
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20. The Effect of Tenofovir Treatment on Renal Function in Chronic Hepatitis B Patients

Author

Yusuf Kayar, Ramazan Dertli, Mehmet Agin, Neslihan Sürmeli, Şevki Konür, Adnan Özkahraman, Nur Düzen Oflas, and Mehmet Ali Bilgili

Subjects
antiviral therapy, chronic hepatitis b, renal function, Medicine
Abstract

INTRODUCTION: It is known that chronic hepatitis B virus (HBV) infection is associated with chronic kidney disease. The agents used in the treatment of chronic HBV are safe and well tolerated, but their long-term side effects are largely unknown. We aimed to investigate the effects of antiviral treatments on renal function in patients with chronic HBV follow-up. METHODS: In this study, 156 patients who were followed-up with the diagnosis of chronic HBV in the outpatient clinic of our hospital between 2013-2019 were included. Demographic data of all patients (age, sex), anthropometric characteristics, disease duration, duration of treatment, which antiviral treatment was taken and body mass index were documented. Serum samples were taken from the patients for laboratory analysis before and after treatment. RESULTS: While 92(58.9%) of the patients were male, the mean age of the patients was 48.47+-15.1. Mean duration of disease was 91.8+-13.6 and mean duration of treatment was 54.9+-13.6. There was no significant difference between the antiviral groups in terms of demographic data, anthropometric measurements and liver function tests (p>0.05). In addition, there was no statistically significant difference between the treatment groups in the laboratory measurements performed before and after treatment (p> 0.05). DISCUSSION AND CONCLUSION: In our study, there was no significant change in renal functions before and after treatment in groups receiving antiviral therapy. However, it is recommended that individuals with chronic HBV who have risk factors such as basal renal dysfunction and comorbidity accompany renal function closely during the Tenofovir treatment.

Published
2019
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21. Analysis of Patients Hospitalized in Thoracic Surgery Clinic from Emergency Department of a University Hospital

Author

Muhammed İkbal Şaşmaz, Burcu Özen, Mehmet Ali Bilgili, Mehmet Reşit Öncü, and Ufuk Çobanoğlu

Subjects
emergency department, thoracic surgery, thoracic emergencies, Medicine
Abstract

INTRODUCTION: Thoracic surgery consultation is frequently requested for traumatic and nontraumatic reasons in the emergency department. Diagnosis and treatment of these patients is very important for the clinician who competes with time. In this study, we aimed to investigate the diagnosis, treatment and prognosis of patients who were hospitalized to thoracic surgery department from the emergency department. METHODS: 435 patients who were hospitalized by thoracic surgery were retrospectively reviewed. The patients' admission complaints, diagnosis and prognosis were examined. SPSS (Statistical Package for Social Sciences) Windows 23.0 program was used to analyze the data. RESULTS: The mean age of the patients was 47.63 +- 20.9, 284 (65.3%) were male and 151 (34.7%) were female. 269 of the cases (62%) were admitted for traumatic reasons and 166 (38%) were for nontraumatic reasons. The most common diagnosis was pneumothorax (n: 134), followed by isolated rib fracture (n: 73) and massive pleural effusion (n: 59). The most common treatment modality was tube thoracostomy (n: 180). Only 4 patients had died. DISCUSSION AND CONCLUSION: Consultation of the thoracic surgery in the emergency department is requested in patients who are affected by respiratory function and require emergency thoracic intervention or surgery. The most common finding in these patients is pneumothorax and the most common treatment is tube thoracostomy. As in our study, the early diagnosis and treatment of these patients has a positive effect on mortality.

Published
2019
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22. Demographic, Histopathological and Clinical Features of Patients with Celiac Disease

Author

Yusuf Kayar, Neslihan Sürmeli, Ramazan Dertli, Mehmet Ali Bilgili, Mehmet Ağın, and Narin Yıldırım Doğan

Subjects
celiac disease, demographic characteristics, clinical features, Medicine
Abstract

INTRODUCTION: Celiac disease (CD) is common in the world. In our study, we retrospectively evaluated the demographic, anthropometric, histopathological and clinical features of the patients followed up with the diagnosis of CD in our clinic. METHODS: Out of 23,250 patients admitted to our outpatient-clinic between 2009-2019, 250(1.07%) were diagnosed with CD. Total of 115 patients (18-65 years) were included in the study. Age, gender, onset of disease, duration of illness, family history, smoking, alcohol use, education, marital status, body mass index (BMI), waist-hip circumference and the symptoms of the patients at the time of admission were recorded. RESULTS: Of the patients, 85 (73.9%) were female and 30 (26.1%) were male. The mean age was 33+-10.6 years and the age of onset was 29.9+-5.8 years. The duration of the disease was between 0-17 years and the mean duration was 4.96+-3.6 years. Family history was seen in 26 (22.6%) patients. The number of smokers was 26(22.6%) and the number of patients using alcohol was one. Although the average BMI level is 22.1+-4.2; 20(17.3%) patients were weak. The waist-to-hip ratio of the patients ranged from 0.63-0.98, with an average of 0.81+-0.07. When the first presentation symptoms of the patients were evaluated; 83(72.2%) patients had symptoms related to gastrointestinal system (GIS), 22(19.1%) had non-GIS symptoms and 10(8.7%) had both GIS and non-GIS symptoms. DISCUSSION AND CONCLUSION: Although the classic findings such as grow thretardation and chronic diarrhea may be stimulating in celiac disease, they may present with atypical findings.

Published
2019
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23. Evaluation of 62 bullous pemphigoid patients

Author

Ibrahim Halil Yavuz, Goknur Ozaydin Yavuz, Serap Gunes Bilgili, Kubra Tatar, and Irfan Bayram

Subjects
bullous pemphigoid, smoking, pruritus, Medicine
Abstract

Bullous pemphigoid (BP) is an acquired autoimmune disease often manifesting with subepidermal bullae. Autoantibodies against hemidesmosomes constitute the main cause of BP. In this study, we aimed to evaluate the clinical and histopathological characteristics of BP patients and to discuss them in light of the studies conducted in Turkey and around the world. The retrospective study included 62 patients that were diagnosed with BP in our clinic between 2005 and 2017. Diagnosis of BP was established based on clinical, histopathological, and DIF microscopy findings. Age, gender, duration of disease, presence of pruritus, peripheral eosinophilia, significant histopathological findings, history of smoking, and family history were recorded for each patient. Patients under 18 years of age were excluded from the study. The 62 patients comprised 24 (38.7%) men and 38 (61.3%) women with a median age of 72.0 years. The male-to-female ratio was 1.5. The median age at disease onset was 67.0 (range, 50-75) years and the median duration of disease was 1.0 (0.5-3.0) years. Of the 62 patients, 35 (56.5%) had a history of smoking and mucosal involvement was found in 27 (43.5%) patients. BP is a disease of the elderly and more common in women than in men. Oral mucosa should be an integral part of the physical examination in BP patients. Pruritus is a significant clinical symptom and eosinophilia is an important laboratory marker in the diagnosis of BP, particularly in patients with difficult diagnosis. [Med-Science 2019; 8(2.000): 426-9]

Published
2019
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24. Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making

Author

Fuat Bilgili, Yavuz Sağlam, Süleyman Bora Göksan, Önder Murat Hürmeydan, Fevzi Birişik, and Mehmet Demirel

Subjects
Decisioion making, Graf type IIa, Hip dysplasia, Ultrasonography, Medicine
Abstract

Background: The rate of spontaneous normalization in type IIa hips is reported to be high, whereas dysplsia persists or worsens in 5%-10% of cases. Aims: To evaluate the natural course of type IIa hips using Graf’s own perspective of physiological immaturity and maturational deficit. Study Design: A single center, retrospective cohort study. Methods: This was an institutional review board-approved retrospective review of all patients diagnosed with type IIa hip dysplasia at a single institution from 2012 to 2014. All patients included in the study had hip ultrasonography at about 6 weeks and 3 months of age. To assess reliability in α and β angles, ultrasonography measurements were carried out on the same image individually by all observers. The α and β angles were used as the main outcome measurements to evaluate hip maturation at the last follow-up. A receiver operating characteristics curve was drawn at the 3 month ultrasonography to evaluate the cut-off values for α and β angles for persistent dysplasia. Results: Sixty-four patients and 88 affected hips (63% unilateral and 37% bilateral) were included. The mean age at diagnosis was 6.4±2.7 weeks. Fifty-four hips were type IIa(+) (physiologically immature) and 34 hips were type IIa(-) (maturational deficit) at the initial ultrasonography evaluation. Improvement to type I was seen in 52 type IIa(+) and 17 type IIa(-) hips. Receiver operating characteristic analyses showed that patients do well if the α angle was >55° (area under the curve: 0.86; p

Published
2018
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25. Evaluation of the smile esthetic index of patients in Van Yüzüncü Yıl University Faculty of Dentistry

Author

Hacer Şahin Aydınyurt and Ersen Bilgili

Subjects
smile esthetic, smile esthetic index, tooth, esthetic, Medicine
Abstract

INTRODUCTION: Aesthetic perception varies from person to person. It is accepted that personal experience and social environmental are influential on the aesthetic perception of the person. Various methods are used to apply aesthetic properties to the dentofacial structure. The most recent of these methods is the evaluation of the smile esthetic index (SEI). The purpose of this study is to evaluate the smile aesthetics of patients by using SEİ in Van Yüzüncü Yıl University. METHODS: A total of 100 patients, 50 female and 50 male, were included in this study. The smile aesthetics were evaluated according to the criteria of SEI on the photographs taken from the patients. RESULTS: According to the results obtained, men's SEI scores were found to be higher than women, although not statistically significant. There was no statistically significant difference between the age groups in terms of SEI score. Mean SEI score was calculated as 6.545 in this study. Factors that are most frequently encountered by the individuals participating in this study and which negatively affect aesthetics were; absence of the correct facial midline, correct toot/crown alignment, existence of visible diastema and interdental papillary loss. DISCUSSION AND CONCLUSION: SEI is a clinically applicable index that evaluates soft and hard tissues together and most importantly reveals objective values. This is the first study in the literature SEI with clinically applied, comparing male-female and age-group assessments. It should be considered that smile aesthetics is an important factor and it is thought that further literature study is needed.

Published
2018
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26. Etiopathogenesis of Acne Vulgaris

Author

Sema Elibüyük Aksaç, Serap Güneş Bilgili, İbrahim Halil Yavuz, and Göknur Özaydın Yavuz

Subjects
acne, propionibacterium acnes, etiology, Medicine
Abstract

Acne vulgaris is a disease of pilosebase unity which is seen generally in adolesans. Clinically lesions may appear chest, back and face and they can be mild comedonal form to cystic acne. The primary lesions of acne is comedon. Excess sebum production, abnormal follicle keratinisation, colonization of propniobacterium acnes and inflamatory mediators can play role the pathogenesis of acne. Sebaceous gland and its regulation( peroxisome proliferator activated receptors, growth hormon and insülin like growth factor regulate the sebaceous gland ) may cause the development of acne. In addition the sebaceous gland behave like a neuroendocrine-inflammatory organ which is activated corticotropin-releasing hormones in response to stress and normal functions. Pathogenic theories on acne is reviewed in this review.

Published
2018
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27. Investigation of Unilateral Mandibular Coronoid Hyperplasia Cases Using Cone Beam Computed Tomography

Author

Ersen Bilgili

Subjects
coronoid process, coronoid hyperplasia, cbct, Medicine
Abstract

INTRODUCTION: Hyperplasia of Mandibular Coronoid Process (HMCP) is first described by Langenbeck in 1853. Cases are mostly seemed bilateral therefore unilateral ones may exist. Aim of this retrospective study is; to evaluate the vertical measurements statistically of the coronoid and condylar processes in hyperplasia seen and unseen sides in unilateral HMCP cases whose cone beam computed tomography (CBCT) images are taken for different reasons. METHODS: Unilateral HMCP in 32 of 502 patients whose CBCT images were taken for different reasons is analyzed. In boths hyperplasia forseen and unseen sides of each patient; coronoid length, condyl length and the ratio between them statistically evaluated. RESULTS: According to measurements, In hyperplasia seen sides of the patients; avarage length of coronoid process was 15,72 mm (+- 0,40), avarage length of the condylar process was 13,23 mm (+- 0,51) and the ratio between them was calculated 1,24. Avarage length of coronoid process was 13,75 mm (+- 0,33), avarage length of the condylar process was 15,32 mm (+- 0,39) and coronoid/condylar length ratio was 0,90 in the normal side. According to results of t test; with the value of p= 0,023 (p

Published
2017
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28. Investigation of Bilaterally Elongated Styloid Process Case Using Cone Beam Computed Tomography

Author

Ersen Bilgili

Subjects
elongated styloid process, eagle's syndrome, cbct, Medicine
Abstract

Mean length of styloid process is 2,5 cm; furthermore 3 cm or above styloid processes are defined as elongated. Complex symptoms like ear and throat ache, swallowing difficulty, sense of a foreign body in throat and limitation in mouth opening caused by a calcificated stylohyoid ligament or elongated styloid process are firstly described by Eagle in 1937 and named as Eagle's Syndrome. 4% of elongated styloid process (ESP) cases have symptoms of Eagle Syndrome. In this case report; bilaterally elongated (especially left: 7,63 cm and right 3,8 cm) styloid processes of a 32 year old male patient with no systemic disease which is incidentally detected in radiographic examination is diagnosed as 'Bilaterally Elongated Styloid Process'. Clinical examination and investigation with cone beam computed tomography (CBCT) of the patient will be presented.

Published
2017
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29. Evaluation of the distribution of mechanoreceptors in the hip joint with severe coxarthrosis in 9 patients: A histologic and stereological study

Author

B. Tekin, G.E. Senturk, M.G. Bilgili, P. Shojaolsadati, A. Atasever, B. Kolbasi, and E. Edipoglu

Subjects
musculoskeletal diseases, Stereology, Osteoarthritis, Hip, Hip replacement (animal), Mechanoreceptor, Transverse acetabular ligament, Joint capsule, medicine, Humans, Femur, Hip joint, business.industry, Acetabular labrum, Acetabulum, Anatomy, musculoskeletal system, Insicion, medicine.anatomical_structure, Ligaments, Articular, Ligament, Coxarthrosis, business, Mechanoreceptors, Surgical incision
Abstract

Due to its high mobility, hip joint plays a crucial role in executing many movements such as standing, sitting, running, crouching. The distribution of mechanoreceptors and neural elements in anatomical structures that provide stabilization of the hip joint is important in determining the optimal surgical incision site for the hip joint stabilizers in patients with coxarthrosis. Various studies have been conducted about the mechanoreceptors and distribution of neural elements in structures such as the transvers acetabular ligament, teres (round) ligament of femur, acetabular labrum and hip joint capsule with using various staining methods. To our knowledge, there is insufficient information about the mechanoreceptor distribution within the anatomic structures that participate in stabilization of the hip joint. This study is planned to examine the distribution of mechanoreceptors in the transverse acetabular ligament, teres ligament, acetabular labrum and joint capsule in samples obtained during the surgery who are operated for hip replacement surgery due to severe coxarthrosis. Each specimen was stained with silver impregnation technique and density of mechanoreceptors were estimated by stereological method. Teres ligament has the highest number of mechanoreceptors among all other specimens. Within the joint capsule, mechanoreceptors were most abundant at its antero-inferior part, whereas its anterior part contained the lowest number of mechanoreceptors. These results suggest that, as the anterior part of hip capsule bears the lowest number of mechanoreceptors, it might be safer for incision during total hip arthroplasty surgery. Istanbul Medipol University

Published
2022
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30. Localization Features of Loose Bodies in Secondary Synovial Chondromatosis of the Knee Joint

Author

Çiğdem Özkara Bilgili, Tuba Selçuk, Fuat Bilgili, Hafize Otcu, Ferhat Çengel, and Nurdan Göçgün

Subjects
Synovial chondromatosis, magnetic resonance imaging, secondary, knee joint, Medicine, Medicine (General), R5-920
Abstract

Aim: To investigate the relationship of cartilage loss in tibiofemoral and patellofemoral joints with the number, size and location of loose bodies in secondary synovial chondromatosis (SC). Methods: Eighty-eight patients with secondary SC were evaluated retrospectively. The size and location of loose bodies were evaluated by both X-ray and magnetic resonance imaging. The relationship between cartilage lesions and the number, location and size of loose bodies were assessed by Chi-square test and Fisher’s exact test. Results: When the relationship between the presence of loose body and cartilage damage was evaluated, it was observed that 83% of subjects (n=74) had cartilage loss at the tibiofemoral joint, 75% (n=66) on the medial and 9% (n=8) of patients had on the lateral side. It was determined that when the number of loose bodies was ≤5, the mean diameter was 7.3 mm (2-21 mm). It was 12.7 mm (2-30 mm) when the number was >5. The most frequently affected locations were the posterior compartment of the posterior cruciate ligament and the superior compartment of the popliteal fossa, regardless of the degree of cartilage loss. Conclusion: We concluded that the higher the cartilage damage, the higher the number and size of loose bodies. We assume that our study provides insight into further investigations to study new classification system for secondary SC in the knee joint.

Published
2015
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31. Fast and Accurate Registration of the Proximal Femurs in Bilateral Hip Joint Images by Using the Random Sub-Sample Points

Author

Songul Varli, Fuat Bilgili, and Abbas Memis

Subjects
musculoskeletal diseases, medicine.diagnostic_test, Computer science, 0206 medical engineering, Biomedical Engineering, Biophysics, Point cloud, Iterative closest point, Magnetic resonance imaging, 02 engineering and technology, 020601 biomedical engineering, Sample (graphics), 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Region of interest, Coronal plane, medicine, Point (geometry), Segmentation, Biomedical engineering
Abstract

Background and Objective As is known, point clouds representing the objects are frequently used in object registration. Although the objects can be registered by using all the points in the corresponding point clouds of the objects, the registration process can also be achieved with a smaller number of the landmark points selected from the entire point clouds of the objects. This paper introduces a research study focusing on the fast and accurate rigid registration of the bilateral proximal femurs in bilateral hip joint images by using the random sub-sample points. For this purpose, Random Point Sub-sampling (RPS) was analyzed and the reduced point sets were used for an accurate registration of the bilateral proximal femurs in coronal hip joint magnetic resonance imaging (MRI) slices. Methods In registration, bilateral proximal femurs in MRI slices were registered rigidly by performing a process consisting of three main phases named as MR image preprocessing, proximal femur registration over the random sub-sample points and MR image postprocessing. In the stage of the MR image preprocessing, segmentation maps of the bilateral proximal femurs are obtained as region of interest (RoI) images from the entire MRI slices and then, the edge maps of the segmented proximal femurs are extracted. In the registration phase, the edge maps describing the proximal femur surfaces are represented as point clouds initially. Thereafter, the RPS is performed on the proximal femur point clouds and the number of points representing the proximal femurs is reduced at different ratios. For the registration of the point clouds, the Iterative Closest Point (ICP) algorithm is performed on the reduced sets of points. Finally, the registration procedures are completed by performing MR image postprocessing on the registered proximal femur images. Results In performance evaluation tests performed on healthy and pathological proximal femurs in 13 bilateral coronal hip joint MRI slices of 13 Legg-Calve-Perthes disease (LCPD) patients, bilateral proximal femurs were successfully registered with very small error rates by using the reduced set of points obtained via the RPS and promising results were achieved. The minimum error rate was observed at RPS rate of 30% as the value of 0.41 (±0.31)% on all over the bilateral proximal femurs evaluated. When the range of RPS rate of 20-30% is considered as the reference, the elapsed time in registration can be reduced by almost 30-40% compared to the case where all the proximal femur points were included in registration. Additionally, it was observed that the RPS rate should be selected as at least 25% to achieve a successful registration with an error rate below 1%. Conclusion It was concluded from the observed results that a more successful and faster registration can be accomplished by selecting fewer points randomly from the point sets of proximal femurs instead of using all the points describing the proximal femurs. Not only an accurate registration with low error rates was performed, but also a faster registration process was performed by means of the limited number of points that are sub-sampled randomly from the whole point sets.

Published
2022
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32. Cytokine Adsorption in Critically Ill COVID-19 Patients, a Case-Control Study

Author

Ruslan Abdullayev, Fethi Gul, Beliz Bilgili, Seda Seven, Ismail Cinel, and Abdullayev R., Gül F., Bilgili B., Seven S., Cinel I.

Subjects
Internal Diseases, Critical Illness, STORM, Yoğun Bakım, Sağlık Bilimleri, Critical Care and Intensive Care Medicine, intensive care unit, İç Hastalıkları, Clinical Medicine (MED), BLOOD PURIFICATION, HEMOPERFUSION, Health Sciences, INJURY, Humans, Klinik Tıp (MED), Retrospective Studies, Internal Medicine Sciences, Klinik Tıp, Intensive Care, Fibrinogen, COVID-19, Dahili Tıp Bilimleri, CLINICAL MEDICINE, cytokine filtration, Tıp, Intensive Care Units, YOĞUN BAKIM, adsorption, Case-Control Studies, Cytokines, Medicine, CRITICAL CARE MEDICINE
Abstract

Aim: New coronavirus disease (COVID-19) has become an international emergency. As many of the intensive care unit (ICU) patients with the disease also present multiple organ failure, blood purification techniques might be a good choice in their treatment. In this study we aimed to investigate the role of cytokine removal in COVID-19 patients managed in ICUs. Methods: For this case-control study we have investigated the role of the cytokine removal by means of two resin membranes (HA330 and Mediasorb) in COVID-19 patients managed in ICUs. Particularly, we investigated the overtime variation in clinical severity scores, laboratory variables, and effects on hospital and ICU stay and mortality. Results: Seventy-two patients have been evaluated, of which half constituted Cytokine Filtration (CF) Group, and other half the Case-Control (CC) Group. Mortality was 55.6% and 50% in CF and CC groups, respectively. In the CF Group, there was decrease in C-reactive protein (CRP) and fibrinogen levels measured at the end of cytokine adsorption; lymphocyte count and ratio were increased, whereas neutrophile ratio was decreased. There were no differences between the groups regarding other laboratory variables, SOFA scores and vasopressor uses. Conclusions: We have demonstrated decrease in CRP, fibrinogen and increase in lymphocyte count in the patients having cytokine adsorption, but there was no clinical reflection of these benefits, and no decrease in mortality as well. Even though there is physio-pathologic rationale to use cytokine adsorption techniques for immunomodulation in critically ill COVID-19 patients, it is early to make strong suggestions about their benefits.

Published
2022

33. Effectiveness of Using Dual-source CT and the Upshot it creates on Both Heart Rate and Image Quality

Author

Tuba Selçuk, Hafize Otçu, Zeyneb Yüceler, Çiğdem Bilgili, Mesut Bulakçı, Yıldıray Savaş, and Ömer Çelik

Subjects
Computed tomography angiography, coronary arteries, high-pitch, low radiation dose, heart rate, Medicine
Abstract

Background: Early detection of coronary artery disease (CAD) is important because of the high morbidity and mortality rates. As invasive coronary angiography (ICA) is an invasive procedure, an alternative diagnostic method; coronary computed tomography angiography (CTA), has become more widely used by the improvements in detector technology. Aims: In this study, we aimed to examine the accuracy and image quality of high-pitch 128-slice dual-source CTA taking the ICA as reference technique. We also aimed to compare the accuracy and image quality between different heart rate groups of >70 beates per minute (bpm) and ≤70 bpm. Study Design: Retrospective cross-sectional study. Methods: Among 450 patients who underwent coronary CTA with the FLASH spiral technique, performed with a second generation dual-source computed tomography device with a pitch value of 3.2, 102 patients without stent and/or bypass surgery history and clinically suspected coronary artery disease who underwent ICA within 15 days were enrolled. Image quality was assessed by two independent radiologists using a 4-point scale (1=absence of any artifacts- 4=non-evaluable). A stenosis >50% was considered significant on a per-segment, per-vessel, and per-patient basis and ICA was considered the reference method. Radiation doses were determined using dose length product (DLP) values detected by the computed tomography (CT) device. In addition, patients were classified into two groups according to their heart rates as ≤70 bpm (73 patients) and >70 bpm (29 patients). The relation between the diagnostic accuracy and heart rate groups were evaluated. Results: Overall, 1495 (98%) coronary segments were diagnostic in 102 patients (32 male, 70 female, mean heart rate: 65 bpm). There was a significant correlation between image quality and mean heart rate in the right coronary artery (RCA) segments. The effective radiation dose was 0.98±0.09 mili Sievert (mSv). On a per-patient basis, sensitivity, specificity, and positive and negative predictive values were 93.8%, 88.8%, 93.8% and 88.8%, respectively. These values were also similar in per-vessel and per-segment basis. Two different groups categorized by mean heart rate had almost similar results in terms of the diagnostic power of dual-source CTA. Conclusion: CTA with a high pitch value is a reliable, non-invasive diagnostic method that can CAD with low radiation doses not only in patients with a heart rate below 70 bpm, but also in patients with higher heart rates.

Published
2016
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34. Hand Hygiene Compliance in Some Intensive Care Units of Turkey: Results of Multicentre Asklepeion Study

Author

Ayşe UYAN ÖNAL, Firdevs AKSOY, Emel AZAK, Meliha MERİÇ KOÇ, Sevil ALKAN ÇEVİKER, Çiğdem ATAMAN HATİPOĞLU, Ramazan GÖZÜKÜÇÜK, Emine SEHMEN, Kenan UĞURLU, Güneş ŞENOL, Gül DURMUŞ, Habibe Tülin ELMASLAR MERT, Handan ALAY, Filiz KOÇ, Derya ÇAĞLAYAN, Demet DİKİŞ, Nilay BİLGİLİ KORKMAZ, Nilgün Deniz KÜÇÜKER, Nurhayat KEPELİ, Behiye ULUSOY, Şükran AKŞİT BARİK, Hüsnü PULLUKÇU, Hilal SİPAHİ, Bilgin ARDA, Sercan ULUSOY, and Oğuz Reşat SİPAHİ

Subjects
infection control and prevention, epidemiology, nosocomial, hospital-acquired infections, healthcare-associated infections, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Introduction: Hand hygiene is one of the most cost-effective infection control measures. In this multicenter study we analyzed the hand hygiene compliance observation results of 15 hospitals in Turkey. Materials and Methods: This study was performed in the intensive care units of 15 hospitals (eight tertiary-care educational hospitals, six state hospitals, and one private hospital) from 11 cities located in six regions of Turkey. The observations were made by infection control practitioners according to the World Health Organization (WHO) - Five Moments for Hand Hygiene (WHO-5) indications rule for hand hygiene and overall compliance rates were calculated. Observations were unblinded (healthcare professionals knew that they were observed). The study period included 2015 and 2016 calendar years. Results: There was a statistically significant increase in hand hygiene compliance rates in 2016 versus 2015. The overall number of hand hygiene opportunities and instances of compliance in 2015 and 2016 were 60071/78116 (76.9%) and 66551/83607 (79.6%) (p=0.0001), respectively. Nurses were the most compliant group in both years. The highest compliance was after body fluid exposure (88.2% in 2015 and 91.4% in 2016), while the lowest compliance was before patient contact (61.3% in 2015 and 65% in 2016). Conclusion: The presented data suggest that under unblinded observations, hand hygiene compliance seems to be in relatively acceptable rates in Turkey. Centers with compliance rates below the 50th percentile in any of the five moments should increase efforts to enhance compliance for that indication.

Published
2018
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35. Relationship Between Recurrent Adductus Deformity of the Forefoot and Achilles Tendon Elongation Following Ponseti Treatment in Children with Idiopathic Clubfoot

Author

Ömer Naci Ergin, Mehmet Demirel, Çiğdem Özkara Bilgili, Yener Temelli, Fuat Bilgili, and Serkan Bayram

Subjects
Male, musculoskeletal diseases, Clubfoot, Achilles Tendon, Metatarsus adductus, Deformity, Humans, Medicine, Child, Retrospective Studies, Metatarsus Varus, Orthodontics, Achilles tendon, business.industry, Forefoot, Infant, General Medicine, medicine.disease, Ponseti method, Tendon, Casts, Surgical, Treatment Outcome, medicine.anatomical_structure, Child, Preschool, Female, medicine.symptom, Ankle, business, Follow-Up Studies
Abstract

Background: Many authors have highlighted the role of muscle strength imbalance around the ankle in the development of recurrent clubfoot following Ponseti treatment. However, this possible underlying mechanism behind recurrence has not been investigated sufficiently to date. This study aimed to explore whether there is a relationship between Achilles tendon elongation and recurrent metatarsus adductus deformity in children with unilateral clubfeet treated by the Ponseti method. Methods: A retrospective chart review was performed on 20 children (14 boys and six girls; mean age, 7 years; age range, 5–9 years) with a recurrent metatarsus adductus deformity treated by the Ponseti method for unilateral idiopathic clubfoot. At the final follow-up, isometric muscle strength was measured using a portable, hand-held dynamometer in reciprocal muscle groups of the ankle. The length of the tendons around the ankle was measured ultrasonographically. Results: The plantarflexion-to-dorsiflexion ratio was lower on the involved side (P = .001). No significant differences in the strength ratio of inversion to eversion were found (P = .4). No difference was observed in lengths of tibialis anterior and posterior tendons (P = .1), but the Achilles tendon was longer on the involved side (P = .001; P < .01). A significant negative correlation was discovered between involved-to-uninvolved Achilles tendon length ratios and involved-to-uninvolved plantarflexion strength ratios (r = –0.524; P = .02) Conclusions: Achilles tendon elongation may be a contributor to the muscle imbalance in clubfeet with relapsed forefoot adduction treated by the Ponseti technique.

Published
2022
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36. Using Peer Supports to Encourage Adolescents With Autism Spectrum Disorder to Show Interest in Their Conversation Partners

Author

Amanda Weir, Irem Bilgili-Karabacak, Amanda Thomas, Christine L. Cole, Linda M. Bambara, Alana Telesford, and Kathleen Bauer

Subjects
Linguistics and Language, Generality, Adolescent, Autism Spectrum Disorder, Communication, media_common.quotation_subject, Peer relationships, Language difficulty, medicine.disease, Peer Group, Language and Linguistics, Developmental psychology, Speech and Hearing, Autism spectrum disorder, Generalization (learning), Intervention (counseling), Communication Disorders, medicine, Humans, Relevance (law), Conversation, Students, Psychology, media_common
Abstract

Purpose: This study was conducted to evaluate the effects of a multicomponent peer-mediated intervention (PMI) on teaching adolescents with autism spectrum disorder (ASD) how to show interest in peer conversation partners by asking partner-focused questions about the person, their interests, or their experiences and by making partner-focused comments that positively affirm peer statements or express concern. Method: A multiple-baseline design across three verbally fluent high school students with ASD was used to assess the effects of the PMI, which involved training peers ( n = 10) to support conversation and the students' use of target skills, and training the students to use partner-focused skills with the aid of a self-reflection cue sheet during conversation with trained peers in a high school cafeteria. Ten-minute samples of student–peer conversations were transcribed and analyzed. Generalization with untrained peers was assessed. Results: The PMI was highly effective in increasing all students' use of partner-focused skills. Gains were maintained by two students in a return-to-baseline condition. Generalization was evident for all students with varied results. Peers and students with ASD perceived the intervention to be beneficial. Conclusions: This study adds to the limited research showing that PMI can be used in high school settings to improve target conversational skills and provides preliminary evidence that PMI can successfully address an underresearched pragmatic language difficulty (i.e., introducing and maintaining topics of conversation of relevance and interest to conversation partners) common among adolescents with ASD. These findings invite replication to extend generality and assess the impact of the intervention on peer relationships. Supplemental Material https://doi.org/10.23641/asha.16915663

Published
2021
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37. Determining the relationship between the impairment of selective voluntary motor control and gait deviations in children with cerebral palsy using simple video-based analyses

Author

Fuat Bilgili, Rasmi Muammer, R. Sert, N.E. Akalan, and C. Sardoğan

Subjects
medicine.medical_specialty, Adolescent, Knee Joint, Biophysics, Cerebral palsy, Physical medicine and rehabilitation, Gait (human), Edinburgh Visual Gait Score, medicine, Humans, Orthopedics and Sports Medicine, Child, Gait, Gait Disorders, Neurologic, SCALE, Selective Motor Control, business.industry, Cerebral Palsy, Rehabilitation, Motor control, Gross Motor Function Classification System, medicine.disease, Trunk, Sagittal plane, medicine.anatomical_structure, Lower Extremity, Child, Preschool, Gait analysis, Ankle, business
Abstract

Background: The impairment of selective voluntary motor control (SVMC) in children with cerebral palsy (CP) has been shown to correlate with their gait characteristics using complex 3D gait analysis systems (3DGA); however, this relationship has not been investigated using simple video-based observational gait analysis (VBOGA). The aim of this study was to determine the relationship between VBOGA and SVMC of the lower extremities in children with CP. Methods: Forty-two CP children 10.9 +/- 5.7 years old with Gross Motor Function Classification System (GMFCS) levels I-III participated in the study. Their gait characteristics were assessed using the Edinburgh Visual Gait Score (EVGS), and selective voluntary motor control was tested using the Selective Control Assessment of the Lower Extremity (SCALE). Spearman's rho correlation test with Cohen's classification were used in the statistical analyses. Results: The GMFCS levels (r = 0.604, p < 0.001), foot clearance (r = -0.584. p < 0.001), and maximum ankle dorsiflexion (r = -0.567, p < 0.001) during the swing phase had strong correlations with total SCALE scores. There was also a moderate correlation between total SCALE scores and total EVGS (r = -0.494, p < 0.001), knee extension in the terminal swing phase (r = -0.353, p < 0.001), peak sagittal trunk position (r = -0.316, p < 0.005), and maximum lateral shift (r = -0.37, p < 0.001). Conclusion: Impaired lower extremity SVMC was noticeably related to the foot and ankle movements in the swing phase and initial stance during walking as well as the total EVGS scores and sagittal and frontal trunk movements. The SCALE correlations with VBOGA were similar those observed in the complex 3DGA in the literature; therefore, we suggest that SVMC impairment of gait could be evaluated using simple VBOGA. These findings may help to tailor physical therapy programs for CP children to increase their motor control and walking quality.

Published
2021
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38. Development of Zoledronic Acid Containing Biomaterials for Enhanced Guided Bone Regeneration

Author

Mehmet Salih Deveci, Mete Toptaş, Umut Can Oz, Burcu Devrim, Elif Ünsal, Asuman Bozkir, Hasan Bilgili, Berrin Küçüktürkmen, and Ongun Mehmet Saka

Subjects
Bone Regeneration, Pharmaceutical Science, Lamellar bone, Connective tissue, Biocompatible Materials, 02 engineering and technology, Zoledronic Acid, 030226 pharmacology & pharmacy, Bone and Bones, 03 medical and health sciences, 0302 clinical medicine, Fibrosis, medicine, Animals, Bone regeneration, Chemistry, Biomaterial, Membranes, Artificial, Poloxamer, 021001 nanoscience & nanotechnology, medicine.disease, Epithelium, medicine.anatomical_structure, Zoledronic acid, Female, Rabbits, 0210 nano-technology, Biomedical engineering, medicine.drug
Abstract

In recent years, biomaterial-based treatments, also called guided bone regeneration (GBR), which aim to establish a bone regeneration site and prevent the migration of gingival connective tissue and / or peripheral epithelium through the defective area during periodontal surgical procedures have come to the fore. In this report, we have developed a nanoparticle bearing thermosensitive in situ gel formulation of Pluronic F127 and poly(D,L-lactic acid) based membrane to reveal their utilization at GBR by in-vivo applications. In addition, the encouragement of the bone formation in defect area via inhibition of osteoclastic activity is intended by fabrication these biodegradable biomaterials at a lowered Zoledronic Acid (ZA) dose. Both of the developed materials remained stable under specified stability conditions (25 degrees C, 6 months) and provided the extended release profile of ZA. The in-vivo efficacy of nanoparticle bearing in situ gel formulation, membrane formulation and simultaneous application for guided bone regeneration was investigated in New Zealand female rabbits with a critical size defect of 0.5 pound 0.5 cm in the tibia bone for eight weeks. Based on the histopathological findings, lamellar bone and primarily woven bone formations were observed after 8 weeks of post-implantation of both formulations, while fibrosis was detected only in the untreated group. Lamellar bone growth was remarkably achieved just four weeks after the simultaneous application of formulations. Consequently, the simultaneous application of ZA-membrane and ZA-nanoparticles loaded in-situ gel formulations offers enhanced and faster GBR therapy alternatives. (c) 2021 American Pharmacists Association. Published by Elsevier Inc. All rights reserved.

Published
2021
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39. Comparison of the Pretzelflex Retractor and Nathanson Retractor in Laparoscopic Sleeve Gastrectomy Surgery

Author

Ayşe Tuba Fersahoğlu, Ali Cihan Bilgili, Nuriye Esen Bulut, Mehmet Mahir Fersahoğlu, Anıl Ergin, Hüseyin Çiyiltepe, Kemal Memisoglu, and Bülent Kaya

Subjects
Laparoscopic sleeve gastrectomy, medicine.medical_specialty, Nutrition and Dietetics, medicine.diagnostic_test, business.industry, Endocrinology, Diabetes and Metabolism, Ischemia, Fundus (eye), medicine.disease, Obesity, Morbid, Surgery, Retractor, Dissection, Hematoma, Liver Function Tests, Gastrectomy, Humans, Medicine, Laparoscopy, Liver damage, business, Liver function tests, Retrospective Studies
Abstract

Retraction of the left lobe of the liver is an important step in most bariatric surgical procedures. The left lobe of the liver may be enlarged, and laceration, hematoma, or necrosis may develop in the liver due to retraction. In this study, the results of use of the Nathanson retractor (NR) and PretzelFlex retractor (PFR) in the patients undergoing laparoscopic sleeve gastrectomy (LSG) were compared. The patients who underwent LSG were divided into three groups based on the type of liver retraction device used. Group 1: NR was used fixed during the operation; Group 2: PF retractor was used; Group 3: NR were used only for fundus dissection and when necessary. All groups were evaluated in terms of demographic characteristics, liver function tests, and developing complications. The study was conducted with a total of 120 consecutive patients. Operation time in the second group was found to be significantly lower than the other two groups (p = 0.009; p = 0.001; p

Published
2021
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40. Evaluation of olfactory bulb volume in patients with diabetic olfactopathy and comparison with healthy individuals

Author

Ahmet Mert Bilgili, Mustafa Caner Kesimli, Defne Gurbuz, Hacı Ömer Durmaz, İstinye Üniversitesi, Sağlık Hizmetleri Meslek Yüksekokulu, Ağız Ve Diş Sağlığı Bölümü, and Kesimli, Mustafa

Subjects
Hyposmia, business.industry, Anosmia, Physiology, Olfactory bulb, Diabethic Olfactopathy, Smell Disorder, Otorhinolaryngology, RF1-547, Management of Technology and Innovation, Healthy individuals, Diabetes Mellitus, Medicine, Olfactory Bulb Volume, In patient, business, Volume (compression)
Abstract

Objective: Diabetic olfactopathy is defined as olfactory dysfunction in patients with diabetic neuropathy. In this study, we evaluated the olfactory bulb volume (OBV) using magnetic resonance imaging in patients with diabetic olfactopathy and compared the results with those of healthy individuals. Methods: This study included 12 patients who were diagnosed with type 2 diabetes mellitus (T2DM) and were found to have diabetic olfactopathy using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test (Group 1); their OBV was evaluated using MRI. For comparison, 13 healthy individuals of a similar age, without any medical problems, were included as a control group (Group 2); their OBV and olfactory functions were also evaluated. Results: Total CCCRC scores were 4.27 +/- 0.67 in Group 1 and 6.42 +/- 0.31 in Group 2; these scores significantly differed between the groups. The mean CCCRC scores in Groups 1 and 2 were moderately hyposmic and normosmic, respectively. The mean OBV values were 65.04 +/- 6.97 mm(3) and 76.46 +/- 11.36 mm(3) in Groups 1 and 2, respectively. Group 1 had significantly lower OBV values and CCCRC scores, compared with Group 2 (p < 0.01 for both groups). Conclusion: The OBV was lower in patients with T2DM who developed diabetic olfactopathy than that in healthy individuals; the olfactory bulb was adversely affected by diabetes mellitus. This is the first study to demonstrate that the olfactory bulb is adversely affected by the presence of diabetic olfactopathy. WOS:000723003900008 Q4

Published
2021

41. Varikosel ve İnfertilitenin Volumetri ve Shear-wave Elastografi Üzerindeki Etkilerinin Değerlendirilmesi

Author

Mustafa BİLGİLİ, Gamze TÜRK, Mustafa ÖZDEMİR, and Ali KOÇ

Subjects
infertility, varicocele, shear-wave elastography, testis stiffness, testis volume, infertilite, varikosel, shear-wave elastografi, testis sertliği, testis hacmi, Medicine, Tıp
Abstract

Aim: This study aims to compare the volumetry and shear-wave elastography findings in infertile and fertile patients and evaluate the effect of presence of varicoceles on the parameters. Materials-Methods: 40 infertile and 20 fertile patients (120 testes) (mean age 29,3±6,7) between January 2018-November 2018 were included in this prospective study. All patients underwent testicular B-mode and doppler ultrasonography (US) and shear-wave elastography (SWE). Patients were sub-grouped according to fertility status and presence or absence of varicoceles. Results: Testis stiffness was significantly higher in testes without varicoceles than those with varicoceles (p=0.021). It was also higher in fertile patients than infertile patients (p=0.015). Testes volumes were higher in fertile patients and patients with varicoceles (p=0.011 and p=0.028, respectively).Conclusion: SWE is a non-invasive, cheap and reproducible technique with promising results for diagnosis and follow-up in the evaluation of infertility., Amaç: Fertil ve infertil hastalarda volumetri ve shear-wave elastografi (SWE) bulgularının; ve varikosel varlığının bu parametreler üzerindeki etkisinin araştırılmasıGereç-Yöntem: Ocak 2018-Kasım 2018 arasında radyolojiye yönlendirilmiş 40 infertil ve 20 fertil hasta (120 testis) (ortalama yaş 29,3±6,7) bu prospektif çalışmaya dahil edildi. Tüm hastalara testise yönelik B-mod, doppler USG ve SWE yapıldı. Hastalar fertilite durumu ve varikosel varlığına göre alt gruplara ayrıldı.Bulgular: Varikoseli olmayan hastalarda varikoselli hastalara göre testis sertliği anlamlı şekilde artmıştı (p=0.021). Fertil hastalarda infertil hastalara göre testis sertliği anlamlı şekilde artmıştı (p=0.015). Fertil hastalarda ve varikoselli hastalarda testis hacmi daha yüksekti (sırasıyla p=0.011 ve p=0.028).Sonuç: SWE invaziv olmayan, ucuz ve tekrarlanabilir bir teknik olup infertilite tanı ve takibinde kullanımı umut vaat etmektedir.

Published
2022

42. BJS commission on surgery and perioperative care post-COVID-19

Author

E. Abahuje, A. Abbas, M. Abd El Aziz Abd El Maksoud, A. Abdelhady, S. Abdelhamid, H. Abdelkarem Ahmed Faraj, B. Abdelqader, T. Abdelrahman, H. Abdou, A. Abdullah, M. Abedua Harrison, E. Abem Owusu, A. Aboalazayem, R. Aboulhosn, S. Abu Oda, A. Abubakar, A. Abutaka, D. Acevedo Fontalvo, S. Acuna, A. Adefemi, S. Adegbola, T. Adenuga, A. Adeyeye, A. Adil Hilmi, A. Adisa, K. Aditya, T. Adjeso, R. Aftab, A. Afzal, V. Aggarwal, A. Aggarwal, R. Aguilera, M. -L. Aguilera-Are´valo, E. J. Aguirre Salamanca, I. Aguirre-Allende, D. Ahari, H. Ahmad, F. Ahmad Rauf, A. Ahmad Zartasht Khan, S. Ahmed, N. Ahmed Fieturi, S. Ahmed Mohamed, Z. Ahmed-Bakhsh, M. Ahsan Javed, L. Akano, A. Akbar, M. Akhbari, P. Akhmedov, G. Aksit, Y. Akula, A. S. Alagaratnam, S. Al Majid, O. Al Mukhtar, H. Al Omran, N. AlAsali, M. Al-Azzawi, R. Al-Habsi, H. Al-Iraqi, H. Al-Naggar, E. Alameer, H. Albirnawi, D. Alderson, F. Aldulaijan, R. Alejandro Miranda Ojeda, A. AlHasan, S. Ali, A. Ali, M. Ali Khan, Y. Alimova, F. Aljanadi, R. Aljubure, N. Allopi, H. Almedbal, M. Almubarak, Z. Alqaidoom, N. Alselaim, M. Alshaar, R. Alshammari, K. Altaf, S. Altıner, B. Altunpak, L. A. Alvarez Lozada, E. Amal Nahal, A. Amer, K. Amin, U. Aminu, N. Amisi Numbi, T. Amjad, R. Amoah, Y. An, N. -A. Anastasopoulos, J. Andre´s Urrutia, F. Angarita, K. -L. Angarita, M. A´ ngel FreirI´a Eiras, A. Antypas, M. A. Anwar, H. Anwar, T. O. Apampa, K. Apostolou, C. Aquina, R. Arachchige Adithi Himika Randeni, M. I. Archila Godı´nez, O. Arez, A. A. Arezzo, P. Armonis, S. Arshad, M. Arshad Salman, A. Arshid, P. C. Arteaga Asensio, T. Arthur, A. Arumuga Jothi, F. Aryo Damara, L. Asensio Gomez, J. Ashcroft, S. Ashraf, A. Asif, M. Atif, M. Attaullah Khan, N. Avellaneda, S. Awad, M. Awadh, A. Axiaq, A. Ayad Mohammed Shuwayyah, D. Ayalew, E. Aytac, F. Azam, J. Azevedo, B. Azhar, J. Aziz, A. Aziz, A. Azzam, A. Baba Ndajiwo, M. Baig, D. Baker, F. Bakko, R. Balachandran, G. Balachandran, J. Balagizi Mudekereza, E. Balai, B. Balci, A. Balduzzi, A. Balhareth, S. Bandyopadhyay, D. Banerjee, D. Bangalore Mahalinga, B. Bankhead-Kendall, N. D. A. Bankole, V. Banwell, F. Baris Bengur, B. Baris Ozmen, M. Barnard, R. Barnett, J. A. Barreras Espinoza, A. Barrios, G. Bass, M. Bass, A. Bausys, A. Bavikatte, J. Bayram, M. Belousov, A. G. Berardi, A. Beamish, C. Beattie, F. Belia, V. Bellato, S. Bellikatti, S. Benjamens, C. Benlice, S. Bennedsgaard, S. Bennett, Z. Bentounsi, H. Bergenfeldt, A. Bergenfelz, M. Besselink, G. Bhandoria, E. Bhangu, M. Bhatia, M. T. Bhatti, Z. Bilgili, G. Bislenghi, C. Bisset, S. Biswas, J. Blake, R. Blanco, L. Boccalatte, R. Boden, C. Bojanic, M. Boland, P. Boland, E. Bollen, E. -A. Bonci, L. Boni, A. Booth, R. Booth, A. Borakati, G. E. Borunda Escudero, S. J. Bosco, P. Bostro¨ m, P. Botelho de Alencar Ferreira Cruz, K. Bouchagier, A. Bouhuwaish, M. Boutros, K. Boyce, C. Boyle, L. Bradshaw, A. Brandl, A. Brar, G. Brat, H. Brenkman, C. Brennan, C. Brines, A. Brookmyre, C. Brosnan, L. Brouwers, A. Brown, L. Brown, C. Brown, J. Brown, V. BS, M. Buksh, M. Bunani Emmanuel, D. Burbano, A. Burelli, A. Burke, J. Burke, N. Burlov, A. Burns, O. Burton, A. Butt, B. Buzra Ozkan, L. Cabrera Silva, E. Y. Caicedo, T. Calderbank, W. Cambridge, G. Campelo, O. Can Tatar, F. Carbone, F. Carrano, D. Casallas, D. Casanova Portoles, F. Casciani, I. Cassimjee, O. A. Castaneda Ramı´rez, V. Catala´ n, J. Caviedes, L. Cayetano, M. ~ Ceresoli, M. Chan, V. Chan, P. Chandrasinghe, S. Chapman, A. Chaturvedi, D. Chaudhry, H. Chaudry, H. W. Chen, A. Cheng, M. Chernykh, A. M. Cherrie, I. Cheruiyot, J. Cheung, C. Chia, J. Chica, N. Chinai, A. Chirwa, J. Chiwaligo, A. Choi, J. Choi, M. R. Chowdhury, E. Christopher, N. Christou, T. Chu, D. Chua, H. W. Chua, C. Chung, A. Cihat Yildirim, M. Cillo, S. Cioffi, H. Claireaux, S. Clermonts, R. Clifford, M. Climent, A. Clynch, R. -J. Coelen, E. Cola´ s-Ruiz, A. Collar, M. Collard, K. C. Conlon, T. Connelly, K. Connor, J. A. Cook, T. Correia de Sa´, N. Cos¸gun Acar, T. Costa, D. Couch, S. Cowper, B. Creavin, B. Crook, A. Curell, R. D’alessio, J. Dale, J. Damgaard Eriksen, I. Dario Martin Gonzalez, A. Darwish, M. Das, R. Das, K. Das, R. Dave, S. O. David, T. Davies, C. Davis, S. Davison, V. Davletshina, A. Dawidziuk, A. Dawson, M. de Andres Crespo, H. de Berker, P. de Dieu Ngo, E. Dekker, R. de la Caridad Espinosa Luis, B. de Lacy, N. Demartines, A. de Montserrat Medina Sifuentes, S. De Silva, C. del Rio, V. Delaune, A. Dell, I. Demirbas¸, S. Demirli Atici, M. Deniz Tepe, M. Derebey, G. Desai, M. Desai, S. Devarakonda, N. Deveras, G. Di Franco, M. Di Martino, F. Di Marzo, A´ . Dı´az, G. Diaz del Gobbo, C. DiazCastrillon, L. Dick, K. Dickinson, E. Diego, I. Dimasi, A. Ding, S. Dingemans, L. Dixon, B. Dixon, W. Doherty, D. Dooreemeah, C. Donohue, M. Dornseifer, F. Dossa, W. Dossou, T. Drake, I. Drami, G. Drevin, M. C. du Plessis, N. Dudi-Venkata, R. Dudley, S. Duffy, D. Duklas, B. -D. Dumbrava, F. Duygu Avlar, A. Dworzynska, W. Ebrahim, A. Ebrahim, E. Efre´n Lozada Herna´ ndez, N. Ehigie, M. El Boghdady, C. El Hasnaoui, M. El Sheikh, A. El-Hussuna, O. Eldurssi, H. Elfeki, M. Elhadi, M. Elhassan, A. Elhissi, B. Elliot, C. Elsenbroek, B. Elsolh, N. Elson, H. Eltyeb, H. Emerson, S. H. Emile, G. Endalle, W. English, C. Ercisli, G. Espinosa, M. Essam Abdelraheem, H. Essangri, P. Etienne, M. D. Evans, T. Evans, C. Ezeme, F. Ezzahraa, T. Fadalla, J. Fagan, M. Fahmy, C. Fairfield, O. Falade, S. Famularo, F. Faqar-Uz-Zaman, Y. Farid, A. Farooq, H. Farooq, F. Farooqui, B. Farquharson, A. Faruqi, R. Faulder, M. Faut, K. Fechner, T. Feenstra, M. Fehervari, L. Fernandez, J. Ferna´ ndez Alberti, L. Ferrario, D. Field, L. Fiore, S. Fingerhut, S. Finlayson, N. Fleming, C. Fleming, E. Florial, M. Fok, D. Fokin, M. Foley, M. P. Forero, T. Forgan, M. Fornasiero, H. Fowler, G. Fowler, E. Franchi, L. Franklin, A˚ . Fredriksson, P. Fruhling, G. Fuentes Navarrette, A. Fu¨ lo¨ p, M. Furtado, T. Gaarder, N. Galbraith, I. T. K. Gallagher, G. Gallo, T. Gana, E. Gaskin, M. Gasparini, R. G. Gatan, E. Geary, K. Gelaye Wudineh, G. Gemenetzis, M. Georgi, H. Ghalige, W. Ghareeb, T. Ghatwary Tantawy, C. Ghomsi, A. Ghuman, P. Giannakis, F. Giron, K. Gjengedal, E. Gkotsis, J. Glasbey, S. Godahewa, D. Godula, P. Goffredo, S. Goh, M. Golriz, L. Gomez, D. Gomez Gomez, R. Gonzalez, D. Gonzalez, E. Gonzalez Gutierrez, D. Gopar, L. Gordini, A. Gori, S. Gorta´ zar, N. Gousy, R. Gowda, M. Gowda, J. Gqada, M. Grechenig, J. Greer, L. Grego´ rio, A. Grigorova, H. Grimes, V. Groot, R. C. Grossman, R. Gruber, A. Gru¨ ter, R. Guest, R. Gujjuri, E. Gu¨ lc¸ek, B. Gulcu, K. Gull, M. Gulmez, V. Gupta, A. Gutlic, T. Guven, T. Gwatirisa, G. Gwini, P. Gwodog, S. Gysling, M. Habib, A. B. Hafeez Bhatti, J. Hallesmith, S. Halloran, M. Hamza Sadiq, C. Haney, N. Hanna, L. Hanna, M. Hannington, J. Harbjerg, D. Haribaskaran, N. Harran, B. Harrington, E. Harrison, R. Hasan, S. Hashmi, M. Hassan, A. Hassan, L. Haverkamp, S. Hazen, B. Heer, J. Heil, J. Helliwell, N. 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Zhukova, L, Zivanovic, M, Zmuc, J, Zope, M, Zubayraeva, A, Zucker, B, Aguilera-Arévalo, M -L, Aguirre Salamanca, E J, Al-Asali, N, Altıner, S, Alvarez Lozada, L A, Anastasopoulos, N -A, Andrés Urrutia, J, Angarita, K -L, Ángel FreirÍa Eiras, M, Anwar, M A, Apampa, T O, Archila Godínez, M I, Arteaga Asensio, P C, Bankole, N D A, Barreras Espinoza, J A, Bhatti, M T, Bonci, E -A, Borunda Escudero, G E, Bosco, S J, Boström, P, Botelho de Alencar Ferreira Cruz, P, Caicedo, E Y, Castañeda Ramírez, O A, Catalán, V, Chen, H W, Chowdhury, M R, Chua, H W, Coelen, R -J, Colás-Ruiz, E, Correia de Sá, T, Coşgun Acar, N, D’Alessio, R, David, S O, de Andres Crespo, M, de Berker, H, de Dieu Ngo, P, de la Caridad Espinosa Luis, R, de Lacy, B, de Montserrat Medina Sifuentes, A, del Rio, C, Demirbaş, I, Díaz, Á, Diaz del Gobbo, G, Diaz-Castrillon, C, du Plessis, M C, Dumbrava, B -D, Efrén Lozada Hernández, E, Fernández Alberti, J, Forero, M P, Fredriksson, Å, Fülöp, A, Gatan, R G, Gortázar, S, Gregório, L, Grüter, A, Gülçek, E, Hafeez Bhatti, A B, Hoh, S M, Hölmich, E, Hüttner, F, Alhasan, A J M S, Perez Rivera, C J, Jácome, F, Jariod-Ferrer, Ú, José, J, José Núñez Ju, J, José Pizarro, M, Khan, M F, Kırımtay, B, Kmezić, S, Koëter, T, König, D, Leyva Moraga, F A, Li, H L, Londoño, M A, Lopes de Freitas, R, López, A I, Mafla Herrería, C A, Manzano Nuñez, R, Marín, D, Martín Martín, G, Masior, Ł, Möckli, B, Mohamed, H M, Mohammad, S A, Mohammed, T O, Montcusí Ventura, B, Mora-Guzmán, I, Morán, R A R, Morera, Á, Moss, J -L, Moyón, M, Müller, P, Muñoz, F, Muñoz, E, Muñoz, A, Muñoz Balderas, D C, Ng, C E, Fhearaigh, R N, Nikolousakis, T -K, Kristensen, H Ø, O’Brien, L, O’Brien, S, O’Reilly, J, O’Rourke, S, O’Sullivan, M, O’Dwyer, M, Oh, K E, Öhlberger, L, Ölçüm, M, Oscullo Yepez, J J, Osei-kuffour, N, Ottlakán, A, Pavan Kumar, O M, Peña Gallardo, M T, Peña Velazquez, A, Pérez-Sánchez, L E, Pompeu Sá, M, Ponniah, H S, Ponte de Sousa, X, Portilla, A L, Pulido Segura, J A, Quimbaya Rodríguez, A S, Racoviţă, A, Rahiri, J -L, Rey Chaves, C E, Roalsø, M, Rodríguez, F, Rodriguez, M C, Ruiz-Úcar, E, Rutegård, M, Sá-Marta, E, Sam, Z H, Emile, Sameh H, Sánchez Fonseca, S, Sgrò, A, Sia, T C, Smart, Y W, Sneep-van Kessel, C, Solórzano Pineda, O, Stephen, B -J, Takoutsing Dongmo, A B, Tamás, T, Tan, J L, Thyø, A, Tölgyes, T, Torrent Jansà, L, Tovani Palone, M R, Valdez Gonzalez, R A, van Beek, D -J, van Dalen, A S, van den Hondel, D, van der stok, E, van Dorp, M, van Oostendorp, S, van Praag, E, van Rees, J, van Silfhout, L, Vasilica, A -M, Vásquez Ojeda, X, Vilar Alvarez, M E, Viscasillas Pallàs, G, Vizcaya Rodríguez, V, Wang, Y Y, Wellington, M J, Wirsik, M M, Wong, W J, Wong, K -Y, Wright, O Wroe, Yang, P -C, Yanzon de la Torre, A, Younis, M U, Zamora, A T, and Surgery

Subjects
Adult, Male, medicine.medical_specialty, Biomedical Research, Coronavirus disease 2019 (COVID-19), International Cooperation, Practice Patterns, Commission, Global Health, Health Services Accessibility, Perioperative Care, Education, Surgeon, COVID-19, surgery, perioperative care, Medical, Pandemic, Humans, Medicine, Practice Patterns, Physicians', Graduate, Pandemics, Surgeons, Health Resource, Infection Control, Physicians', Surgical Procedures, business.industry, General surgery, Middle Aged, Operative, Education, Medical, Graduate, Surgical Procedures, Operative, Perioperative care, Health Resources, Surgery, Female, business, Human
Abstract

Background Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues’ experiences and published evidence. Methods In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.

Published
2021
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43. Hip Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip: Bakırköy Experience

Author

Altuğ Duramaz, Gökhan Peker, Levent Arslan, Mustafa Gökhan Bilgili, Ersin Erçin, and Cemal Kural

Subjects
Developmental hip dysplasia, newborn, ultrasonography, Medicine, Medicine (General), R5-920
Abstract

Aim: The purpose of the study was to determine the prevalence, incidence, and etiology as well as the risk factors for developmental dysplasia of the hip in newborns in whom we performed ultrasonography for screening using Graff’s method in our clinic. Methods: We retrospectively evaluated 2632 hip ultrasonography records of 1316 babies performed between 2008 and 2013. We analyzed the questionnaires of the Turkish Pediatric Orthopaedic Society which were filled by the physician during examination. The babies were divided into two groups according to ultrasonographic hip angles as pathological and normal. Results: The study is made on 1316 babies [680 girls (51.6%), 636 boys (48.4%)]. The risk for developmental dysplasia of the hip was higher in girls, babies with a family history, babies with metatarsus adductus and those have been swaddled before. The mean gestational age and gestational weight was statistically significantly lower in the pathological group (p=0.0011). Conclusion: In our cross-sectional study, the incidence of developmental dysplasia of the hip was 0.5%. Female gender, positive family history of developmental dysplasia of the hip,metatarsus adductus and swaddling are still risk factors. Researching risk factors carefully, patient education and adding hip ultrasonograpy to newborn routine screening program are important measures in preventing developmental dysplasia of the hip.

Published
2014
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44. Outcomes of Four Different Surgical Techniques in the Treatment of Geriatric Intertrochanteric Femur Fractures

Author

Altuğ Duramaz, Cihangir Sarı, Mustafa Gökhan Bilgili, Ersin Erçin, Cemal Kural, and Mustafa Cevdet Avkan

Subjects
technique, mortality, Intertrochanteric fracture, activity, Medicine, Medicine (General), R5-920
Abstract

Aim: The aim of this study was to evaluate the suicide and intoxication cases between April 2011 and April 2013. Methods: One hundred eighty-two patients operated due to intertrochanteric femur fracture in our clinic were divided into four groups: hemiarthroplasty (HA), proximal femoral nail (PFN), sliding hip screw (SHC), and external fixator (EF) groups. Time to surgery, comorbidities, anesthesia techniques, postoperative ambulation time, mortality rates and daily activity levels were compared. The patients were evaluated via outpatient follow-up and telephone interview. The Barthel index of activities of daily living was used for evaluation. Results: Patient distribution was: HA: 17 patients, PFN: 26 patients, SHC: 71 patients, and EF: 68 patients. The gender distribution (F/M) and the mean age were: HA: 11/6, 83.4 years, PFN: 18/8, 81.2 years, SHC: 48/23, 82.1 years, and EF: 44/24, 84.5 years. There was no statistically significant difference between the groups in gender, comorbidities, anesthesia techniques, mean follow-up period, and Barthel index scores. In HA group, walking with double support duration was shorter (p=0.028). Conclusion: Elderly intertrochanteric femur fractures should be operated as soon as possible in order to prevent eventual complications preferably by regional anesthesia and internal fixation.

Published
2014
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45. Efficiency and Cost Analysis of Cell Saver Auto Transfusion System in Total Knee Arthroplasty

Author

Mustafa Gökhan Bilgili, Ersin Erçin, Cemal Kural, Altuğ Duramaz, Cevdet Avkan, Gökhan Peker, and Serdar Hakan Başaran

Subjects
Cell saver system, cost, total knee arthroplasty, Medicine
Abstract

Background: Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS) were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. Aims: Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure. Study Design: Retrospective comparative study. Methods: Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA) were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost. Results: No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (p

Published
2014
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46. Resveratrol Attenuates Both Small Bowel and Liver Changes in Obstructive Jaundice

Author

Volkan Temi, Erdem Okay, Abdullah Güneş, Turgay Şimşek, Mustafa Çekmen, Ümit Bilgili, and Yeşim Gürbüz

Subjects
Experimental, ischemia modified albumin, jaundice, obstructive, resveratrol, Medicine
Abstract

Background: It is well known that mucosal changes and alterations in liver function occur in the experimental obstructive jaundice model. Aims: We aimed to evaluate the effect of resveratrol on obstructive jaundice-induced changes in the small bowel mucosa and liver using ischaemia-modified albumin as a marker of oxidative damage. Study Design: Animal experimentation. Methods: The study used a rodent experimental model of obstructive jaundice, including a sham group (1), a control group (2), and a study group (3). Wistar albino rats were used. Jaundice was produced by ligation of the bile duct in Groups 2 and 3. In Group 3, resveratrol was administered intraperitoneally for 14 days. Results: In terms of the structure and the size of the mucosal villi, significant thickening and blunting were detected in Group 2 compared with Group 1. These changes were significantly less noticeable in Group 3 compared with Group 2. Levels of ischaemia-modified albumin were significantly higher in Group 2 compared with those in Group 1, and they were significantly decreased in Group 3 compared with Group 2. Conclusion: Resveratrol administration to obstructive jaundiced rats reduced the organic effects of obstructive jaundice on small bowel mucosa and liver oxidative stress. We believe that this reduction might attenuate bacterial translocation and systemic effects of secreted cytokines. (Balkan Med J 2014;31:95-99).

Published
2014
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47. Effect of Web-Based Training on Complication Control and Quality of Life of Spinal Cord Damaged İndividuals: Randomized Controlled Trial

Author

Elif Ates, Naile Bilgili, and Acibadem University Dspace

Subjects
medicine.medical_specialty, business.industry, education, General Medicine, Spinal cord, Education, home care services, law.invention, Quality of life (healthcare), medicine.anatomical_structure, nursing, quality of life, Randomized controlled trial, Health Care Sciences and Services, law, Education,spinal cord injuries,nursing,quality of life,home care services, Physical therapy, Medicine, Web application, spinal cord injuries, Sağlık Bilimleri ve Hizmetleri, Complication, business
Abstract

Objectives: This study was conducted to determine the effect of web-based training on complication control and quality of life of spinal cord-injured patients. Methods: A pre-test-post-test, semi-experimental study including a control group. A total of 62 men participated from two different physical therapy and rehabilitation hospitals. The training, monitoring, and data collection steps were provided via a webpage (www.omurgahemsirelikegitim.com) and telephone. Results: It was determined that there was a statistically significant difference between the experimental and control groups regarding the complications related to respiration, circulation, gastrointestinal, urinary, and musculoskeletal systems. Regarding the complications related to sexual life, comparing experimental and control groups the pre and post evaluations, detected an increase in difficulty in sexual life after the injury both experimental and control groups. There was no statistically significant difference between the two groups in terms of quality of life scale subscale scores. Conclusion: These results show that telephone monitoring plus web-based training is effective in controlling disease complications in patients with spinal cord injury. However, to improve the quality of life, it is important to establish interventions involving individuals and families, and physical, social and mental health services.

Published
2021
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48. Is cervical swab an efficient method for developing a new noninvasive prenatal diagnostic test for numerical and structural chromosome anomalies?

Author

Erkan Yurtcu, Pinar Calis, Gülsüm Kayhan, Hasan Hüseyin Kazan, Tuğrul Kaymak, Merih Bayram, Mustafa N. Ilhan, Sezen Guntekin Ergun, Gamze Özçürümez Bilgili, Deniz Karcaaltincaba, Halis Özdemir, Ferda Percin, Meral Yirmibeş Karaoğuz, and Mehmet Ali Ergun

Subjects
Male, fluorescence-activated cell sorting (FACS), Placenta, Chorionic villus sampling, Prenatal diagnosis, Human leukocyte antigen, Article, Chromosomes, Andrology, Pregnancy, Prenatal Diagnosis, Humans, Medicine, CMA (comprehensive meta-analysis), magnetic-activated cell sorting (MACS), Chromosome Aberrations, biology, medicine.diagnostic_test, Diagnostic Tests, Routine, business.industry, Cervical swab, General Medicine, Cell sorting, Alkaline Phosphatase, Placental alkaline phosphatase, Testis determining factor, biology.protein, Amniocentesis, Female, Antibody, business
Abstract

Background/aim: Prenatal diagnosis is vital to obtain healthy generation for risky pregnancies. There have been several approaches, some of which are routinely applied in clinics to evaluate the possible prenatal deficiencies and/or diseases. In the present study, we aimed to isolate the fetal cells from endocervical samples and try to identify possible anomalies which were proved by Amniocentesis (AS) and chorionic villus sampling (CVS) methods. Materials and methods: Endoservical specimens were collected from 100 pregnant women. Cells were separated in parallel by fluorescence-activated cell sorting (FACS) and magnetic-activated cell sorting (MACS) using human leukocyte antigen (HLA) G233 and placental alkaline phosphatase (PLAP) antibodies. CMA (comprehensive meta-analysis) were carried out and male fetuses were confirmed with Sex determining region Y (SRY) amplification. Results: The percent of HLA G233 and placental and placental alkaline phosphatase (PLAP) positive cells were 4.55% and 84.59%, respectively. The percent of cells positive for both markers was 14.75%. CMA analyses were not informative. (SRY) was amplified in 67% of the samples. Conclusion: However, the success rate of the both cell sorting and scanning of DNA anomalies by aCGH and/or RT-PCR was limited, preventing the applicability of this proposal in the clinics. Still, the success of the proposed method depends on the development of the novel fetal cell-specific antibodies and the improvements in the sorting systems.

Published
2021
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49. Kedi ve Köpeklerde Deri Mantar Enfeksiyonlarının İnsanlarda Oluşturduğu Sağlık Riskleri, Kontrol ve Sağaltım Seçenekleri

Author

Basak Hanedan, Ali Bilgili, and Muhammet Haydar Uysal

Subjects
medicine.medical_specialty, biology, Transmission (medicine), business.industry, Context (language use), General Medicine, Disease, biology.organism_classification, medicine.disease_cause, Dermatology, medicine.anatomical_structure, Canis, Nail (anatomy), medicine, Dermatophyte, Livestock, Trichophyton, business
Abstract

Dermatofitozlar sıcak, nemli koşullar ve hijyenik olmayan ortamlarda çoğalarak deri, kıl, tırnak gibi yapıları etkileyen dermatofitlerden kaynaklanan yüzeysel mantar enfeksiyonlarıdır. Deri ve tırnakta görülen mantar enfeksiyonlarının dünya nüfusunun %20-25’ini etkilediği bilinmektedir. Kedi ve köpeklerde yaygın şekilde görülen dermatofit türü öncelikli olarak Microsporium canis (M. canis)’tir, ayrıca M. nanum, M. gypseum, Trichophyton mentagrophytes (T. mentagrophytes), T. terrestre gibi başka türlerin de taşıyıcılarıdır. Sağlıklı evcil kedi ve köpekler enfeksiyon rezervuarıdır ve genellikle M. canis’in taşıyıcılarıdır. Kontamine ortam ve hayvanlarla temas halinde olan insanlara bulaşarak deride ve baş bölgesinde mantar lezyonlarına neden olurlar. Vücutta herhangi bir hastalık, yetersiz beslenme, yüksek sıcaklık, nem, deride meydana gelen travma, ektoparazitlere bağlı deri hasarı, aşırı kalabalık ve hijyenik olmayan ortamlar dermatofitoz oluşturan risk faktörleridir. Belirtilen bilgiler ışığında bu derleme kapsamında başta veteriner hekimler olmak üzere, hayvancılıkla uğraşanlar, kedi-köpek sahipleri, veteriner teknisyenler ve mandıra işçileri de dahil riskli meslek grupları hakkında özlü bilgiler verildi. Türkiye ve Dünya’da son yıllara ait hayvanlar ve insanlardaki dermatofitoz prevalans verileri sunularak, hastalığın önemi ve mevcut durumuna değinildi. Ayrıca hastalığa ait klinik bulgular, tanı, sağaltım seçenekleri ile koruma ve kontrol yöntemlerine yönelik en son bilimsel kaynaklara dayanan özlü bilgiler sunuldu.

Published
2021
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50. Which inflammatory marker is more reliable in diagnosing acute septic arthritis in the pediatric population?

Author

Ahmet Müçteba Yıldırım, Fuat Bilgili, Mehmet Demirel, Serkan Bayram, Taha Furkan Yağcı, and Doğan Kıral

Subjects
Male, medicine.medical_specialty, Neutrophils, Blood Sedimentation, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, White blood cell, Internal medicine, Humans, Medicine, Lymphocyte Count, Lymphocytes, Neutrophil to lymphocyte ratio, Child, Blood urea nitrogen, Retrospective Studies, Arthritis, Infectious, biology, medicine.diagnostic_test, business.industry, C-reactive protein, Infant, medicine.disease, C-Reactive Protein, medicine.anatomical_structure, Alanine transaminase, Erythrocyte sedimentation rate, Pediatrics, Perinatology and Child Health, Absolute neutrophil count, biology.protein, Female, Septic arthritis, business, Biomarkers
Abstract

BACKGROUND The present study aimed to investigate diagnostic values of C-reactive protein (CRP), white blood cell (WBC), erythrocyte sedimentation rate (ESR), neutrophil to lymphocyte ratio (NLR), and the platelet to lymphocyte ratio as possible indirect inflammatory markers in children with septic arthritis (SA) for diagnosis process. METHODS The medical records of pediatric patients with SA who underwent debridement surgery between February 2005 and November 2018 were obtained from the hospital records. A total of 59 children with SA and 60 age- and gender-matched healthy controls were enrolled in the study. Hemograms parameters including WBC count, neutrophil count, lymphocyte count, hemoglobin, platelet count, CRP, ESR, NLR, and platelet to lymphocyte ratio. Biochemical parameters including alanine transaminase, aspartate aminotransferase, blood urea nitrogen, creatinine, glucose, and albumin were investigated and compared between both groups. RESULTS Fifty-nine patients, 30% female (n: 18) and 70% male (n: 41), who had received operations for SA were included in the study. The mean age of the patients was 7.1 (range 6 days to 15 years) years and mean follow up 56.6 (12-140) months. No significant differences were observed in any biochemical parameters between the groups. However, a significant difference was found between the septic arthritis and the control group in all hemogram parameters. CONCLUSIONS Although the sensitivity and specificity of the NLR are lower than CRP, ESR, and WBC which are most commonly used inflammatory parameters in diagnosis process of septic arthritis, NLR may be useful in confirming the diagnosis in the clinical practise, with an optimum diagnostic cut-off value of 4.05.

Published
2021
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