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The genetic cause of 46, XY Disorder of Sex Development(DSD) still cannot be determined in about half of the cases. GATA-4 haploinsufficiency is one of the rare causes of DSD in genetic males (46, XY). Twenty-two cases with 46, XY DSD due to GATA-4 haploinsufficiency (nine missense variant, two copy number variation) have been reported in the literature. In these cases, the phenotype may range from a mild undervirilization to complete female external genitalia. The haploinsufficiency may be caused by a sequence variant or copy number variation (8p23 deletion). The study aimed to present two unrelated patients with DSD due to GATA-4 variants and to review the phenotypic and genotypic characteristics of DSD cases related to GATA-4 deficiency.

Amaç: Bu araştırma, hemşirelik öğrencilerinin pandemi sürecinde COVID-19 korkusu ve klinik uygulama eğitimine ilişkin görüşlerini incelemek amacıyla yapılmıştır. Yöntem: Tanımlayıcı bir çalışmadır. Araştırmaya Türkiye'de hemşirelik lisans eğitimi veren bir üniversitenin 2., 3. ve 4. sınıflarında öğrenim gören öğrenciler dahil edilmiştir. Katılımcılar 235 öğrencilik bir popülasyondan seçilmiştir. Araştırmanın verileri; veriler, araştırmacılar tarafından literatür taranarak hazırlanan Tanıtıcı Bilgi Formu ve "COVID-19 Korku Ölçeği" kullanılarak toplanmıştır. Veri analizi SPSS 23.0 ile yapıldı. Verilerin değerlendirilmesinde sayı, yüzde ve Kruskal Wallis H testi kullanıldı. Bulgular: Araştırmaya katılan öğrencilerin yaş ortalaması 20.65 ± 1.36, COVID-19 puan ortalaması 15.43 ± 16.14 olarak bulundu. Öğrenciler; klinik uygulamada hasta bakımına yönelik tutumları, klinik uygulamalarının sosyal yaşamlarına etkisine ilişkin düşünceleri, öğrencilerin klinik uygulamaya gitmeye ilişkin düşünceleri, korku seviyeleri ve ağrı hissetmeye ilişkin düşünceleri ile COVID-19 durumları arasında anlamlı bir fark bulundu. p, Aim: This research was conducted to examine the views of nursing students on fear of COVID-19 and clinical practice training during the pandemic process. Methods: It is a descriptive study. Students studying in the 2nd, 3rd and 4th grades of a university providing undergraduate nursing education in Turkey were included in the study. Subjects were recruited from a population of 235 students. The data of the research; the data were collected using the Introductory Information Form prepared by the researchers by scanning the literature and the "COVID-19 Fear Scale". Data analysis was done with SPSS 23.0. Number, percentage and Kruskal Wallis H test were used to evaluate the data. Results: The mean age of the students participating in the study was found to be 20.65 ± 1.36 and the mean score of COVID-19 was 15.43 ± 16.14. Students; a significant difference was found between their attitudes towards patient care in clinical practice, their thoughts on the impact of their clinical practice on their social lives, students' thoughts about going to clinical practice, and their thoughts about experiencing pain, and their COVID-19 fear levels p

This study was supported by Bolu Abant Izzet Baysal University Scientific Research Projects (2018.08.19.1385). Objective: To analyse partial and total gastrectomy specimen in items of immunohistochemical staining of the stem cell CD44 and CD133; and to determine their relationship to pathological stage, other clinicopathological prognostic parameters, and their predictive value. Study Design: Derscriptive study. Place and Duration of Study: Department of Pathology, Bolu Abant Izzet Baysal University, Medical School, Turkey, from 2013 to 2018. Methodology: Eighty-three cases, diagnosed with adenocarcinoma from stomach partial and total gastrectomy slides and blocks, were included in the study. Adenocarcinoma cases, that had received neoadjuvant treatment before gastrectomy, cases diagnosed with lymphoma and other malignancies and cases of resection performed for reasons other than tumours, were excluded. Formalin-fixed and paraffin wax-embedded gastric adenocarcinoma blocks were sliced. CD44 and CD133 were stained onto the slides in a Leica Bond Max staining device in compliance with immunohistochemical staining datasheets. Membranous staining for CD44 and cytoplasmic, membranous or luminal staining for CD133 were evaluated. Mann-Whitney U-test and Kruskal- Wallis test were used for group comparisons. For pairwise comparisons, post-hoc Dunn's tests were used. The results were assessed on the significance level of p < 0.05. The analyses were performed using the Statistical Package for the Social Sciences version 22.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Results: Considering CD44 and CD133 expressions in terms of pathological stage, there was significantly more intense expression in the T3 and T4 cases (p=0.009, and p=0.002, respectively). Conclusion: Although CD44 is regarded to be associated with more prognostic parameters compared to CD133, both immunohistochemical stains were shown to be related to pathological stage. Thus, these may be guiding for determining the tumour depth. Bolu Abant Izzet Baysal University Scientific Research Projects [2018.08.19.1385]

OBJECTIVE: To determine the perinatal mortality rate in patients with HELLP syndrome in our clinic and to investigate the factors affecting perinatal mortality. It also makes recommendations to reduce perinatal mortality and contributes to the literature. STUDY DESIGN: Three-hundred-and-eighty-three patients were retrospectively evaluated in this cohort study. The patients' demographic, clinical data, laboratory results, gestational week at delivery, method of delivery, neonatal birth weight, fetal gender, 1- and 5-minute APGAR scores, place of delivery, maternal morbidity, mortality rates, and perinatal mortality rates were recorded. The relationship of these factors with perinatal mortality was investigated. RESULTS: The rate of perinatal mortality was determined as 6%. Patients with HELLP syndrome who experienced perinatal mortality showed significantly lower birth weight, gestational age at delivery, and 1- and 5-minute APGAR score values (p

Hayvanlarda son zamanlarda sıkça karşılaşılan epilepsi, nöbetlere veya olağandışı davranış, duyumlara ve farkındalık kaybına neden olan nörolojik bir bozukluk olarak tanımlanmaktadır. Epilepsi hem beşerî hekimlikte hem de veteriner hekimlikte hastaların hayatları boyunca refahlarını olumsuz etkilemektedir. Günümüzde halen epilepsinin neden şekillendiği tam olarak açıklanamamaktadır. Bu derlemede paylaşılan epilepsinin etiyopatogenezine ilişkin bilgiler, hastalığın patogenezinin geliştirilmesine ve tam olarak anlaşılmasına katkıda bulunacak ve böylece etkili tedavi metotlarının geliştirilmesinde ve antiepileptik ilaçlar üzerindeki çalışmaların yoğunlaşmasında büyük rol oynayacaktır.

Systemic pseudohypoaldosteronism is a rare salt wasting syndrome that is caused by inactivating variants in genes encoding epithelial sodium channel subunites. Hyponatremia, hyperkalemia, metabolic acidosis, increased aldosteron and renin levels are expected findings of this disease. It is difficult to manage this disease due to high dose oral replacement therapy. Furthermore patients with systemic pseudohypoaldosteronism require life-long therapy. Here we report a patient with systemic PHA due to SCNN1B variant whose hyponatremia and hyperkalemia was detected at the 24th hour of life. Hyperkalemia did not improve with conventional treatments and dialysis was required. Also he developed myocarditis and hypertension in follow-up. Difficulties in diagnosis and treatment of this patient were discussed in this report. Also we review the literature on common features of patients with SCNN1B variant.

Objective: To retrospectively analyze the data of patients who underwent relaparotomy in our clinic, to indicate the incidence, indications and mortality rate of relaparotomy. Methods: Our study included 47 patients who underwent relaparotomy in our clinic between the study dates. Demographic characteristics of the patients, indications for the first operation and the surgical procedure performed during the first operation, the center where the first operation was performed, the indications for relaparotomy and the surgical procedure performed during relaparotomy, the time between two operations, the number of blood transfusion products given, and the mortality after relaparotomy were noted. In our clinic, the incidence of obstetric and gynecological relaparotomy and the mortality rate after relaparotomy were calculated. Results: Of the patients included in our study, 89.4% consisted of patients who underwent obstetric relaparotomy, and 10.6% underwent gynecological relaparotomy. In our clinic, the incidence of obstetric relaparotomy was 0.1%, and the incidence of gynecological relaparotomy was 0.06%. We found the mortality rate of our clinic after relaparotomy to be 2.1% (1/47). We found that the first operations of patients who underwent obstetric relapatomy were cesarean section most frequently with a rate of 81% (34) and a previous cesarean section was the most common indication in 23.8% (10). It was determined that total abdominal hysterectomy was performed most frequently in 80% (4) of the first operations of patients who underwent gynecological relaparotomy, and abnormal uterine bleeding was the most common indication in 60% (3). We determined that the most common indication for both obstetric and gynecological relaparotomy in patients who underwent relaparotomy was hematoma-hemorrhage (64.3% and 40%, respectively). We found that hematoma evacuation-bleeding control was the most common procedure performed in relaparotomy in both obstetric and gynecological relaparotomy (52.4% and 40%, respectively). Conclusion: After the necessary preparations are made, the decision to relaparotomy should be made without delay. Patients with risk factors should be informed in advance and we should recommend that their first surgery be performed in tertiary hospitals as much as possible. We think that we can reduce the need for relaparotomy by controlling the bleeding during the first operation.

Lymphomatoid granulomatosis is a rare extranodal Epstein-Barr virus-driven B-cell lymphoproliferative disease, involving predominantly lung, less often skin, kidney, and central nervous system. Here, we present a pediatric case with primary immunodeficiency, diagnosed with pathologically proven pulmonary grade-III lymphomatoid granulomatosis.18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging demonstrated18F-FDG avid pulmonary masses with central air-bronchograms and cavitations. Although the definitive diagnosis depends on biopsy,18F-FDG PET/CT serves as a complementary imaging tool to evaluate the extent of the disease and response to treatment.

Background: The relationship between placental localization and fetus is unclear. This study was aimed to determine the relationships between placental localization, ultrasound findings and pregnancy outcomes of the third trimester of pregnancies.Materials and Methods: Three-hundred and two women were included in the study. Maternal age, gravidi-ty, parity, abortion and live birth numbers, types of previous births, gestational age, femur length (FL), bipa-rietal diameter (BPD), head circumference (HC), abdominal circumference (AC), placental localization (ante-rior/posterior/lateral/fundus), umbilical artery systolic/diastolic ratio (S/D), fetal presentation, type of deliv-ery, post-partum parameters of infant were obtained from archive records.Results: The placentas were located in the anterior, posterior, fundal and lateral uterine wall in 38.1%, 30.1%, 19.9%, and 11.9% of individuals, respectively. Measurements of the HC in the third trimester were differed according to the localization of the placenta, and the HC measurements were significantly higher if the placental localization was anteriorly (p=0.045). There were no differences in other ultrasonographic measurements (S/D, BPD, AC ve FL), in the height, weight, and gender of the baby, gestational week at delivery, APGAR scores and type of delivery according to the placental localization (p>0.05).Conclusions: In this study, we found that placental localization did not affect pregnancy outcomes, type of delivery and gender of the baby in risk-free, spontaneous and single pregnancies in the third trimester. Also, we stated that the previous birth type did not give an idea about placental localization. We think that placenta implantations, except placental location anomaly and invasion anomaly, do not provide precise information about pregnancy outcomes and type of delivery., Amaç: Plasenta lokalizasyonu ve fetüs arasındaki ilişki belirsizdir. Bu çalışmada, gebeliğin üçüncü trimesterindeki plasenta lokalizasyonu ile ultrasonografi bulguları ve gebelik sonuçları arasındaki ilişkilerin belirlenmesi amaçlanmıştır.Materyal ve metod: Çalışmaya 302 kadın dahil edildi. Anne yaşı, gravidite, parite, düşük ve canlı doğum sayısı, önceki doğum şekilleri, gebelik yaşı, femur uzunluğu (FL), biparietal çap (BPD), baş çevresi (HC), abdominal çevre (AC), plasenta lokalizasyonu (anterior/posterior/lateral/fundus), umblikal arter sistolik/diyastolik oranı (S/D), fetal prezentasyon, doğum şekli, bebeğin doğum sonrası parametreleri arşiv kayıtlarından elde edildi.Bulgular: Plasenta lokalizasyonları sırasıyla bireylerin %38.1, %30.1, %19.9 ve %11.9'unda anterior, posterior, fundal ve lateral uterin duvarda bulunuyordu. Üçüncü trimesterde HC ölçümleri plasenta lokalizasyonuna göre farklılık gösteriyordu ve plasenta lokalizasyonu anteriorda ise HC ölçümleri anlamlı olarak daha yüksekti (p=0.045). Diğer ultrasonografik ölçümlerde (S/D, BPD, AC ve FL), bebeğin boy, kilo ve cinsiyeti, doğum haftası, APGAR skorları ve doğum şeklinde plasenta lokalizasyonuna göre farklılık yoktu (p>0.05).Sonuç: Bu çalışmada üçüncü trimesterdeki risksiz, spontan ve tekil gebeliklerde plasenta lokalizasyonunun fetal sonuçları, doğum şeklini ve fetal cinsiyeti etkilemediğini saptadık. Ayrıca önceki doğum şeklinin plasenta lokalizasyonu hakkında fikir vermediğini tespit ettik. Plasenta lokalizasyon anomalisi ve invazyon anomalisi dışındaki plasenta implantasyonlarının fetal sonuçlar ve doğum şekli hakkında kesin bilgi vermediğini düşünmekteyiz.

Aim:Kidney transplantation is the most preferred long-term treatment of children with end stage renal disease since 1954. Graft dysfunction has been divided into three categories based on timing of presentation. In this article, we aim to present the etiologic factors of acute graft dysfunction in the first year of renal transplantation in children.Materials and Methods:The patients, diagnosed with acute allograft dysfunction in first year of kidney transplantation, in University of Health Sciences Turkey, Tepecik Training and Research Hospital between March 2005 and October 2017 were analyzed prospectively in this study.Results:Over the 15 year period, 56 pediatric renal allograft patients were followed in University of Health Sciences Turkey, Tepecik Training and Research Hospital. During this period, 25 patients had diagnosed with early allograft dysfunction. Five patients were admitted two times in a year with allograft dysfunction. The mean age of patients was 12.6 (4.0±21.0) years, with a male and female ratio of 17:8. Delayed graft function was occurred in four patients (16%). Among 25 renal allograft recipients showed early graft dysfunction on average of 4.2 months (1-10 months) after transplantation. The etiology of early graft dysfunction showed 10% immunologic diseases and 90% non-immunologic factors. Five patients (16.7%) diagnosed with urinary tract infection, one patient (3.3%) diagnosed with cytomegalovirus nephropathy, five patients (16.7%) diagnosed with BK nephropathy, eight patients (26.7%) diagnosed with acute cyclosporine toxicity, seven patients (23.3%) were diagnosed with dehydration and one patient (3.3%) diagnosed with urologic anomalies. Twelve patients had performed renal allograft biopsy. The histological findings were consistent with T-cell mediated rejection in two patients; B-cell mediated rejection in one patient and viral nephropathy in five patients. Non-specific histological findings were determined in five patients.Conclusion:Early recognition of the etiology of graft dysfunction that develops at 1 year and appropriate treatment will contribute to the preservation of long-term graft dysfunction.

In this paper, we summarize the local fractal calculus, called F-alpha-calculus, which defines derivatives and integrals of functions with fractal domains of non-integer dimensions, functions for which ordinary calculus fails. Hyers-Ulam stability provides a method to find approximate solutions for equations where the exact solution cannot be found. Here, we generalize Hyers-Ulam stability to be applied to oi-order linear fractal differential equations. The nuclear decay law involving fractal time is suggested, and it is proved to be fractally Hyers-Ulam stable.

Background/aim Ganglioside antibodies are identified not only in patients with inflammatory neuropathies but also several central nervous system disorders and paraneoplastic neuropathies. Our aim was to investigate whether ganglioside antibodies are found in autoimmune encephalitis patients and may function as a diagnostic and prognostic biomarker. Materials and methods Sera and cerebrospinal fluid (CSF) samples of 33 patients fulfilling the criteria for probable autoimmune encephalitis were collected within the first week of clinical manifestation. None of the patients had evident symptoms and findings of peripheral polyneuropathy. Well-characterized anti-neuronal and paraneoplastic antibodies were investigated in sera and CSF and anti-ganglioside (anti-GM1, GM2, GM3, GD1a, GD1b, GT1b and GQ1b) IgG and IgM antibodies were measured in sera using commercial immunoblots. Results Twenty-eight of 33 autoimmune encephalitis patients displayed antibodies against neuronal surface or onco-neural antigens with N-methyl-D-aspartate receptor (NMDAR), glutamic acid decarboxylase (GAD) and Hu antibodies being the most prevalent. While no anti-ganglioside IgG antibodies were found, 4 patients (2 anti-NMDAR+, 1 anti-GAD+ and 1 antibody negative) with autoimmune limbic encephalitis displayed anti-GM1, anti-GM2, anti-GM3 or anti-GQ1b IgM antibodies. There was no apparent association between anti-ganglioside positivity and clinical and demographic features. Conclusion Serum ganglioside IgM antibodies may infrequently emerge during the clinical course of autoimmune limbic encephalitis without evident polyneuropathy. Absence of the IgG response suggests that these antibodies might have developed as a hyperacute immune response to neuro-axonal destruction. Nevertheless, potential impact of ganglioside antibodies on axonal degeneration and neuronal loss in limbic encephalitis pends to be further investigated.

Background/aim Limited research has focused explicitly on the association between neonatal jaundice and autism spectrum disorder (ASD), and inconclusive evidence exists in the literature within this framework. This study aimed specifically to investigate whether neonatal jaundice is a potential risk factor for ASD and whether there is a connection between the types of neonatal jaundice and the severity of ASD. Materials and method This study involved 119 children with ASD [90 males (75.6%), 29 females (24.4%), mean age: 45.39 ± 11.29 months] and 133 healthy controls [100 males (75.2%), 33 females (24.8%), mean age: 46.92 ± 11.42 months]. Psychiatric disorders were diagnosed through the Diagnostic and Statistical Manual of Mental Disorders criteria. Childhood Autism Rating Scale (CARS) was used to assess the screening and diagnosis of autism. A specially prepared personal information sheet was employed to investigate socio-demographic characteristics and birth and clinical histories. Results The rate of the history of jaundice and pathological jaundice requiring hospitalization and phototherapy were significantly higher in the ASD group compared to the controls. CARS total score and the mean scores of nearly all items were statistically higher in children with a history of pathological jaundice than those with a history of physiological jaundice. Conclusion Neonatal jaundice, depends on its severity, seems to be one of the possible biological factors associated with subsequent development of and the severity of ASD. Establishing a causal relationship between neonatal jaundice and ASD by more comprehensive studies may contribute to alleviating of the severity of ASD for individuals at risk.

Objective:In this study; it was aimed to determine the frequency of Restless Legs Syndrome (RLS) in smokers and to investigate the relationship with the level of addiction.Methods:This prospective study was designed as a descriptive and single-centered study. Following the ethics committee’s approval, the study was conducted with the smokers who applied to a tertiary hospital for any reason between 01/03/2017 and 01/07/2017. The Restless legs syndrome diagnosis form consisting of the International Restless Leg Syndrome Study Group (IRLSSG) consensus criteria was applied to all cases. Those who had all five criteria were diagnosed with RLS. The Fagerström Test for Nicotine Dependence (FTND) was applied to evaluate the nicotine addiction of the participants. Significance was accepted at the level of p

Androgen receptor (AR) drives prostate cancer (PCa) development and progression. AR chromatin binding profiles are highly plastic and form recurrent programmatic changes that differentiate disease stages, subtypes and patient outcomes. While prior studies focused on concordance between patient subgroups, inter-tumor heterogeneity of AR enhancer selectivity remains unexplored. Here we report high levels of AR chromatin binding heterogeneity in human primary prostate tumors, that overlap with heterogeneity observed in healthy prostate epithelium. Such heterogeneity has functional consequences, as somatic mutations converge on commonly-shared AR sites in primary over metastatic tissues. In contrast, less-frequently shared AR sites associate strongly with AR-driven gene expression, while such heterogeneous AR enhancer usage also distinguishes patients’ outcome. These findings indicate that epigenetic heterogeneity in primary disease is directly informative for risk of biochemical relapse. Cumulatively, our results illustrate a high level of AR enhancer heterogeneity in primary PCa driving differential expression and clinical impact., We would like to acknowledge the NKI Genomics Core Facility for Illumina sequencing and bioinformatics support and the NKI Research High-Performance Computing (RHPC) facility for computational infrastructure. We express gratitude to all members of the Zwart and Bergman lab, and members of the NKI Oncogenomics division for helpful scientific discussion. This work was supported by the Prostate Cancer Foundation (21CHAL04), Department of Defense (W81XWH-21-1-0234, W81XWH-19-1-0565), Oncode Institute and Alpe d’HuZes/KWF Dutch Cancer Society (10084).

Early prediction and diagnosis of perforation in acute appendicitis allow surgeons to choose the most appropriate treatment. The purpose of this study is to evaluate whether pre-operative routine laboratory examinations have a role in predicting complicated acute appendicitis.In the study, 783 patients operated with the diagnosis of acute appendicitis between the years 2014 and 2019 were analyzed retrospectively. Among the patients with non-perforated and perforated acute appendicitis, pre-operative laboratory tests include leukocyte (WBC), neutrophil, lymphocyte, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), C-reactive protein (CRP), and neutrophil-to-lymphocyte rate (NLR) parameters were compared.Appendicitis was not detected histopathologically in 81 cases. In the study, 89.9% (n=631) of the 702 patients were non-perforated and 10.1% (n=71) were perforated acute appendicitis cases. Perforation rate was higher in elderly patients (p0.01). It was seen that lymphocyte count was significantly lower in the perforated group, and CRP and NLR were significantly higher (p=0.048, p=0.001, p=0.028, respectively). In the diagnosis of perforated acute appendicitis, cutoff values were 44.0 mg/dL for CRP, 7.65 for NLR and 1.7/mm3 for lymphocytes. There was no statistical difference between the groups in terms of WBC, neutrophil, PLT, MPV, and PDW values.Low lymphocyte count, high CRP, and high NLR were found to be reliable and strong predictive parameters in the diagnosis of complicated acute appendicitis.

Retrospective cohort. The objective of the study is to evaluate a relationship between idiopathic intracranial hypertension (IIH) and superior semicircular canal dehiscence (SSCD) of bone overlying the superior semicircular canal (SSC). A total of 57 (114 ears) individuals, 20 of whom were controls and 37 of whom were IIH, were included in the study. Individuals were evaluated with 0.8 mm slice thickness computed tomography (CT) images for SSC bony roof thickness and SSCD. Thickness of the bony roof over the SSC was graded from Grade 1 to Grade 4. Grade 3 was defined as pre-dehiscence and Grade 4 as dehiscence. Bony roof thickness was 1.25 mm in the control group and 0.76 mm in the IIH group. When bony roof thickness was compared between the groups, it was found to be significantly thinner in the IIH group (p = 0.012). In the IIH group, while dehiscence was detected in 25 of 74 ears, no dehiscence was detected in 49 ears. In the control group, while dehiscence was detected in 5 ears, no dehiscence was detected in 35 ears. The difference is statistically significant (p = 0.015). The correlation between bony roof thickness and cerebrospinal fluid (CSF) pressure in the IIH group was not statistically significant (p = 0.343; rho = 0.110). The correlation between bony roof thickness and age in the IIH group was not statistically significant (p = 0.082; rho = − 0.164). Increased CSF pressure in patients with IIH may cause chronic, progressive, and irreversible damage to the bone of the SSC and, according to our study, the rate of SSCD was found to be high in IIH patients.

Vallecular cyst (VC) can cause difficult intubation. If a double-lumentube (DLT) has to be placed, difficulty in tracheal intubation becomes more complicated. The gum elastic bougie (GEB) is a widely used device for facilitating tracheal intubation.However, there is not enough study with DLT to make a predictionfor success of GEB-guided intubation. Here, we aimed to describe our approach during unexpected difficult intubation due to VC in a patient required DLT insertion. We emphasize that, in case of confronting a patient with asymptomatic VC as a cause of difficult intubation, a successful DLT intubation is possible by sliding endobronchial lumen of DLT over pediatric GEB.

Aging is associated with declines in attention, but also with a tendency to attend to emotionally positive information. When attention is engaged in an ongoing task, an unexpected stimulus may not be detected, resulting in inattentional blindness. Inattentional blindness increases in older age, due to reduced attentional capacity. In the present study, age differences in inattentional blindness to emotional unexpected stimulus were investigated. Younger and older adults completed an inattentional blindness task in which a positive and a negative unexpected stimulus appeared concurrently while attention was engaged in a counting task. Overall, the findings replicated previous results showing greater inattentional blindness for older adults. While both groups were more likely to detect the positive stimulus, this tendency was stronger in older adults. The participants who detected only the positive stimulus were more likely to be the older ones. There were no group differences in the detection of the negative stimulus. The results are partially consistent with age-related positivity effect, demonstrating that older adults’ positive mood affects their attentional filter. The results emphasize the role of emotional and motivational changes in older age and show that higher inattentional blindness for older adults cannot solely be explained by reductions in attentional capacity.

OBJECTIVE: To evaluate the efficiency of CA-125, menopausal status, ultrasound features and risk malignancy index in predicting malignancy in patients with an adnexal mass.STUDY DESIGN: This study was designed prospectively and 212 patients who applied to our hospital and met the study criteria were included. Preoperatively RMI value was calculated for the differentiation of benign from malignant patients. The diagnosis was confirmed by histopathology. Kolmogorov-Smirnov, Yates correction, Pearson Chi-Square and Student's t-test were used for statistical analysis. ROC curves were drawn as diagnostic tests and the test results were presented.RESULTS: Of 212 patients included in our study, 174 (82%) patients’ were reported as benign, 6 (3%) borderline and 32 (15%) malignant. In predicting malignancy, the malignity risk index with 200 cutoff value the sensitivity and specivity was 87% and 80% respectively. However, when the cutoff value of malignity risk index taken as 112, the sensitivity was unchanged but the specificity increased to 90%. Similarly, when CA-125's cutoff value was taken as 46U/mL, the sensitivity did not change but the specificity increased from 68% to 72%.CONCLUSION: Malignancy risk index is a method that has high sensitivity and specificity. Preoperative-op RMI calculation can provide accurate predictions for the establishment of an appropriate surgical plan for pelvic masses or referral to tertiary centers.

The Coronavirus Disease 2019 (COVID-19) pandemic has led individuals to experience psychological distress as a result of their perceptions of the disease. This study aimed to determine the factors associated with these perceptions, the sources of information about the pandemic that may have contributed to them, and the level anxiety felt by adults living in Turkey in the initial phase of COVID-19, with a primary focus on generalized anxiety. The study had a web-based cross-sectional survey design 482 (327 female, 155 male) Turkish responders completed the Generalized Anxiety Disorder-7 (GAD-7) self-reported questionnaire, a measurement tool related to their perceptions of COVID-19 and questions about their sources of information about the pandemic between 3 and 19 April, 2020. Women experienced higher levels of anxiety than men. Those with severe symptoms of generalized anxiety disorder (GAD) believed that the COVID-19 pandemic would have a long duration, stated that the risk of transmission had had serious effects on their lives, felt little personal control with regard to the risk of transmission and did not believe that existing treatments would be effective against the risk of transmission. Moreover, those with severe GAD symptoms had little comprehension of how the disease was transmitted. Finally, it was concluded that those with severe GAD symptoms used the internet and, in particular, Instagram as their main sources of information about the pandemic. Although the anxiety levels were found to be moderate in general, women were more vulnerable. Using the internet and, in particular, Instagram as sources of information affected individuals' perceptions of the pandemic, and led to psychological distress.

OBJECTIVE: The aim of the study was to evaluate the interobserver agreement and diagnostic accuracy of COVID-19 Reporting and Data System (CO-RADS), in patients suspected COVID-19 pneumonia. METHODS: Two hundred nine nonenhanced chest computed tomography images of patients with clinically suspected COVID-19 pneumonia were included. The images were evaluated by 2 groups of observers, consisting of 2 residents-radiologists, using CO-RADS. Reverse transcriptase-polymerase chain reaction (PCR) was used as a reference standard for diagnosis in this study. Sensitivity, specificity, area under receiver operating characteristic curve (AUC), and intraobserver/interobserver agreement were calculated. RESULTS: COVID-19 Reporting and Data System was able to distinguish patients with positive PCR results from those with negative PCR results with AUC of 0.796 in the group of residents and AUC of 0.810 in the group of radiologists. There was moderate interobserver agreement between residents and radiologist with κ values of 0.54 and 0.57. CONCLUSIONS: The diagnostic performance of CO-RADS for predicting COVID-19 pneumonia showed moderate interobserver agreement between residents and radiologists.

Cytotoxic lesion of the corpus callosum (CLOCC) stems from a variety of causes such as malignancies, drug treatments, metabolic disorders, subarachnoid hemorrhage, and infections, and often presents as encephalitis or encephalopathy. During this pandemic, we saw 2 cases with this lesion; the first one was a 42-year-old male who presented to the emergency department with complaints of headache, fever, and cough. There was a ground-glass opacity in the thorax computed tomography, and diffusion restriction was found in the corpus callosum splenium in the cranial magnetic resonance imaging (MRI) performed for headache that did not resolve with analgesic treatment during hospitalization due to the preliminary diagnosis of Coronavirus diseases-2019 (COVID-19) pneumonia. In the second case, Severe Acute Respiratory syndrome Coronavirus-2 polymerase chain reaction was found to be positive in the examinations performed during his admission to the emergency service due to weakness and presyncope, and diffusion restriction was observed in the corpus callosum splenium like the first case in cranial imaging. The follow-up cranial MRI was normal in both cases, so they were diagnosed with CLOCC. We aimed to report the present cases with COVID-19 associated CLOCC since they presented only as a headache and a presyncope without any mental deterioration.

Background/aim There are numerous debates in the management of Gastroschisis (GS). The current study aimed to evaluate perinatal outcomes, surgical and clinical characteristics among Gastroschisis (GS) patients based on their type of GS, abdominal wall closure method, and delivery timing. Materials and methods This study was a retrospective analysis of prospectively collected data of 29 fetuses with GS that were prenatally diagnosed, delivered, and managed between June 2015 and December 2019 at the Obstetrics and Pediatric Surgery Clinics of Kanuni Sultan Suleyman Training and Research Hospital. Results Twenty-three of the patients were simple GS, and six of them were complex GS. The reoperation requirement, number of operations, duration of mechanical ventilation, time to initiate feeding, time to full enteral feeding, total parenteral nutrition (TPN) duration, TPN-associated cholestasis, wound infection, sepsis, and necrotizing enterocolitis were significantly lower in the simple GS group than the complex GS group. The mean hospital length of stay was 3.5 times longer in the complex GS group (121.50±24.42 days) than that of the simple GS group (33.91±4.13 days, p=0.009). There were no cases of death in the simple GS group. However, two deaths occurred in the complex GS group. Conclusion This study indicated that simple GS, compared with complex GS, was associated with improved neonatal outcomes. We suggest that the main factor affecting the patients? outcomes is whether the patient is a simple or complex GS rather than the abdominal wall closure method.

Çalışmamızda amacımız idiopatik parmak ucu yürüyen çocuklarda “Toe Walking Tool (TWT)” ölçeğinin Türkçe versiyonu ile geçerlik ve güvenirliğini belirlemektir. "Toe Walking Tool" tıbbi, doğum ve gelişim öyküsünü ve değerlendirmeyi ölçen 21 maddeyi içerir. 34 çocuğun demografik bilgileri kaydedildi. Ölçek çeviri adımlarıyla Türkçeye çevrildi. Güvenilirlik analizleri için iç yapı tutarlılığı ve test-tekrar test güvenilirliği kullanılmıştır. Her bir madde için Cronbach alfa katsayısı ve madde-toplam puan korelasyonları hesaplanmıştır. “Toe Walking Tool”'un Türkçe Versiyonu (TWT-TR) iyi test-tekrar test güvenilirliği göstermiştir (ICC: 0,674). İç yapı tutarlılık analizinde Cronbach alfa katsayısının alt ve üst sınır aralıkları 0,476-0,823 arasında hesaplanmıştır. Sonuçlarımız TWT-TR'nin idiyopatik parmak ucu yürüyen çocuklarda geçerli ve güvenilir bir klinik ölçek olduğunu göstermiştir., The aim of our study was to determine the reliability and the validity of the Turkish-language version of the Toe Walking Tool (TWT) in idiopathic toe walking children."Toe Walking Tool” contains 21-items which measure medical, birth & developmental history and assessment. Demographic information of 34 children was recorded. The tool was translated into Turkish with the following translation steps. Internal structure consistency and test-retest reliability were measured for reliability analyses. For each item on the tool, Cronbach's alpha coefficient and item-total score correlations were calculated. Turkish Version of Toe Walking Tool (TWT-TR) showed good test-retest reliability (ICC: 0.674). Lower and upper bound ranged of Cronbach's alpha coefficient in the internal structure consistency analysis was calculated between 0.476-0.823. These data suggest that the TWT-TR is a valid and reliable clinical tool in idiopathic toe walking children.

IntroductionObstruction of the ureter may occur due to congenital, iatrogenic or other reasons. This can cause hydronephrosis in the early stage and can lead to cellular inflammation, necrosis and atrophy in the kidney tissue. The aim of this paper is to evaluate the protective effect of pheniramine maleate (PM) and zofenopril on renal damage caused by hydronephrosis due to unilateral partial ureter obstruction.Material and methodsTwenty-four female Sprague Dawley rats were divided into 4 groups. Group 1: sham group, group 2: partial unilateral ureteral obstruction (PUUO) group, group 3: PUUO + PM group, group 4: PUUO + zofenopril group. Paraoxonase (PON), total antioxidant status (TAS) and total oxidant status (TOS) of tissue and blood samples were measured and calculated. Tissue samples were evaluated histopathologically.ResultsAn increase in tissue TAS and a decrease in tissue TOS and OSI levels were detected in groups 3 and 4 compared to group 2 (both: p < 0.01). Tissue PON levels showed an increase in groups 3 and 4 compared to groups 1 and 2 (both: p < 0.01). Histopathological evaluation showed a decrease in interstitial inflammation and congestion in groups 3 and 4 compared to the control group (p < 0.001). The decrease was observed to be more significant in group 4 compared to group 3 (p < 0.01).ConclusionIn our experimental study, we observed that PM and zofenopril reduce the oxidation and tissue damage caused by unilateral partial obstruc­tion.

Healthcare workers are the group with the highest risk of COVID-19 transmission. The illness of healthcare workers poses a risk to patients admitted to the hospital, colleagues and households besides their own health. In this study, it was aimed to determine the risk assessment and the factors associated with risk status of an university hospital healthcare workers after risky COVID-19 contact. The data of the descriptive study were obtained from 773 follow-up records of 555 healthcare workers who applied with COVID-19 risky contact between 06.04-10.05.2020. Employees who were positive for RT-PCR evaluated as "patients" and others as "risky contact". Risk assessment was classified as no risk, low, medium and high risk contact according to the "Algorithm of Assessment of Health Workers with COVID-19 Contact" of the Ministry of Health. The relationship between the risk levels of the participants and their demographic and workplace characteristics and their usage of personal protection were evaluated. Mean, standard deviation, percentage, chi-square and ANOVA tests were used in the analysis of the data. The average age of the healthcare workers was determined as 34.4 ± 7.6 years. It was determined that 56.2% of those who had contact were female, 62.9% were married and 17.5% had an additional disease. It was determined that 45.6% of the risky contacts were nurses, 18.4% were supportive personnel and 16.9% were doctors. While 46.5% of the contacts were found as medium, 28.0% low, 17.1% high risk and 8.4% risk free. 38.2% of risky contacts occurred while working in internal/surgical clinics. While 66.0% of the employees had risky contact during patient care and treatment, 25% had risky contact with colleagues in social settings. High-risk contact was higher in social relations between employees. The source of the contact was a colleague in 73.2% of the employees. The average age of high-risk employees was smaller than those of low-risk. While 54.5% of the employees wore surgical masks during contact, 67.8% of the patients did not have a mask. Of 555 employees followed, 37 (6.7%) were diagnosed as COVID-19; 48.6% of the patients were nurses and 18.9% were doctors. It was determined that 48.6% of the healthcare workers were working in the COVID-19 service, outpatient clinic or intensive care unit at the time of diagnosis. The source of the infection was thought to be a colleague in 51.6% of the patients. COVID-19 was more common in nurses and doctors. It was determined that risky contact also occurred in services other than the units where COVID-19 patients were treated and risky contact often took place while providing healthcare to the patients and during social relations between the employees. Unprotected contact of the employees with each other in the workplace was identified as an important risk source. Inadequate use of personal protective equipment by healthcare workers led to an increase in medium and high risk contacts. The use of masks by patients and their relatives during the health service delivery and the proper use of personal protective equipment by healthcare professionals will reduce the risk. With the physical improvement of the rest areas of the employees and the arrangement of the breaks, the risky contact between colleagues in the social areas will be reduced.

Background Diagnostic shifts at early ages may provide invaluable insights into the nature of separation between autism spectrum disorder (ASD) and typical development. Recent conceptualizations of ASD suggest the condition is only fuzzily separated from non-ASD, with intermediate cases between the two. These intermediate cases may shift along a transition region over time, leading to apparent instability of diagnosis. Methods We used a cohort of children with high ASD risk, by virtue of having an older sibling with ASD, assessed at 24 months (N = 212) and 36 months (N = 191). We applied machine learning to empirically characterize the classification boundary between ASD and non-ASD, using variables quantifying developmental and adaptive skills. We computed the distance of children to the classification boundary. Results Children who switched diagnostic labels from 24 to 36 months, in both directions, (dynamic group) had intermediate phenotypic profiles. They were closer to the classification boundary compared to children who had stable diagnoses, both at 24 months (Cohen's d = .52) and at 36 months (d = .75). The magnitude of change in distance between the two time points was similar for the dynamic and stable groups (Cohen's d = .06), and diagnostic shifts were not associated with a large change. At the individual level, a few children in the dynamic group showed substantial change. Conclusions Our results suggested that a diagnostic shift was largely due to a slight movement within a transition region between ASD and non-ASD. This fact highlights the need for more vigilant surveillance and intervention strategies. Young children with intermediate phenotypes may have an increased susceptibility to gain or lose their diagnosis at later ages, calling attention to the inherently dynamic nature of early ASD diagnoses.

Background We recently showed headache to be common in children (aged 7–11 years) and adolescents (aged 12–17) in Lithuania. Here we provide evidence from the same study of the headache-attributable burden. Methods Following the generic protocol for Lifting The Burden’s global schools-based study, this cross-sectional survey administered self-completed structured questionnaires to pupils within classes in 24 nationally representative schools selected from seven regions of the country. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH; defined as mild headache with usual duration Results Questionnaires were completed by 2505 pupils (1382 children, 1123 adolescents; participating proportion 67.4%), of whom 1858 reported headache in the preceding year, with mean frequency (±SD) of 3.7 ± 4.5 days/4 weeks and mean duration of 1.6 ± 1.9 h. Mean proportion of time in ictal state, estimated from these, was 0.9% (migraine 1.5%, probable medication-overuse headache [pMOH] 10.9%). Mean intensity on a scale of 1–3 was 1.6 ± 0.6 (mild-to-moderate). Symptomatic medication was consumed on 1.5 ± 2.8 days/4 weeks. Lost school time was 0.5 ± 1.5 days/4 weeks (migraine 0.7 ± 1.5, pMOH 5.0 ± 7.8) based on recall, but about 50% higher for migraine according to actual absences recorded in association with reported headache on the preceding day. More days were reported with limited activity (overall 1.2 ± 2.4, migraine 1.5 ± 2.2, pMOH 8.4 ± 8.5) than lost from school. One in 30 parents (3.3%) missed work at least once in 4 weeks because of their son’s or daughter’s headache. Emotional impact and quality-of-life scores generally reflected other measures of burden, with pMOH causing greatest detriments, followed by migraine and tension-type headache, and UdH least. Burdens were greater in adolescents than children as UdH differentiated into adult headache types. Conclusions Headache in children and adolescents in Lithuania is mostly associated with modest symptom burden. However, the consequential burdens, in particular lost school days, are far from negligible for migraine (which is prevalent) and very heavy for pMOH (which, while uncommon in children, becomes four-fold more prevalent in adolescents). These findings are of importance to both health and educational policies in Lithuania.

Giriş: B hepatiti dünya çapında en sık görülen enfeksiyöz hastalıklardandır. Viral bulaşın önemli bir kısmı anneden bebeğe geçiş şeklinde olmaktadır. Bazı çalışmalarda maternal-fetal bulaş dışında gebelikte gestasyonel diyabet (GDM), gebeliğin hipertansif hastalıkları, preterm doğum ve haftasına göre düşük doğum ağırlığı (DDA) gibi olumsuz gebelik sonuçları daha sık gözlenmiştir. Amaç: Gebelikte Hepatit B taşıyıcılığının maternal veya fetal kötü obstetrik sonuçları (gestasyonel diyabet, gebeliğin hipertansif hastalıkları, preterm doğum, düşük doğum ağırlığı, gebelik kolestazı) arttırması ile ilgili yapılan çalışmalarda literatürde görüş birliği bulunmamaktadır. Biz bu çalışmada hepatit B taşıyıcılığının gebelik ve perinatal sonuçlar üzerine etkisini araştırmayı planladık Gereç ve Yöntem: Bu retrospektif kohort araştırmaya çalışma grubu olarak Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı Hastalıkları Eğitim ve Araştırma Hastanesi Kadın Doğum Kliniği’nde 2009-2019 yılları arasında takipleri yapılan ve sonrasında doğumları gerçekleşen hepatit B taşıyıcısı gebeler dahil edildi. Gestasyonel diyabet, gebeliğin hipertansif hastalıkları, preterm doğum, düşük doğum ağırlığı, gebelik kolestazı riski hepatit B negatif olan kontrol grubu ile karşılaştırldı. Bulgular: Çalışmamıza 237 HBsAg pozitf , 260 kontrol olmak üzere 497 hasta dahil edildi. Kontrol grubu ile çalışma grubu arasında demografik karakterlerden yaş, gravida, parite ve VKİ açısından istatistiksel fark saptanmadı. Her iki grupta obstetrik ve perinatal sonuçlar arasında istatistiksel fark tespit edilemedi Sonuç: Hepatit B taşıyıcısı gebelerde kötü obstetrik sonuçlarda artış tespit edilmemiştir; ancak bu konuda daha büyük randomize prospektif çalışmalara ihtiyaç duyulmaktadır.

OBJECTIVE We investigated the relationship of baseline sarcopenia with toxicities, treatment response, and survival in patients who had non-small cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation and received erlotinib.METHODS Computed tomography images from PET/CT scans before erlotinib treatment were retrospectively assessed. Skeletal muscle index, calculated as skeletal muscle area at third lumbar vertebra level/square of height, was used to define sarcopenia with < 52.4 cm2/m2 for males and < 38.5 cm2/m2 for females. Cox hazard models were conducted to determine predictors of survival.RESULTS The study included 30 patients, and 11 (36.7%) were sarcopenic. All-grade and Grade 3 toxicities were more frequent in sarcopenic group, although it was statistically insignificant (81.8% vs. 63.2%, p=0.282 for all-grade, and 18.2% vs. 10.5%, p=0.552 for grade 3). Response rates were 63.6% in sarcopenic and 68.4% in non-sarcopenic patients (p=0.789). Median progression-free survival was 7.9 and 9.2 months in sarcopenic and non-sarcopenic cases, respectively (p=0.561). However, median overall survival (OS) of sarcopenic patients was significantly shorter than non-sarcopenic ones (11.8 vs. 30.2 months, p=0.023), and sarcopenia predicted OS independently in multivariate analysis (Hazard ratio=2.63, p=0.029).CONCLUSION Early recognition, treatment, and prevention of sarcopenia may improve long-term survival in EGFRmutant NSCLC patients treated with first-line erlotinib.

Öz.Amaç: Toplumda yeni evlenmiş çiftlerde sık rastlanan ilk koitus sonrası gerçekleşen vajinal yaralanmaların araştırılması amaçlanmıştır.Materyal ve Metod: Bu retrospektif çalışma Ocak 2017 ve Aralık 2020 tarihleri arasında vajinal ilişki sonrası kanama şikayetiyle hastanemizin kadın hastalıkları ve doğum kliniğine başvuran 89 hastayı kapsamaktadır.Bulgular: Postkoital yaralanma nedeniyle çalışmamıza dahil edilen 89 hastanın yaş ortalaması 26 ± 8 idi. 89 hastanın tamamındaki genital yaralanmaların ilk koitusa bağlı olduğu saptandı. Lezyonların ortalama sayısı 1.4 ± 0.73 ve ortalama uzunluğu 2.7 ± 0.96 cm idi. Hastaların % 65’inin ilkokul ve altı eğitim grubundan olduğu saptandı. Genital yaralanmalar en sık 29 hastada vajinal introitus bölgesinde saptanırken 13 hastada vajen sağ lateral duvarda, 10’ar hasta grubunda ise vajen sol lateral duvar ve forşette saptandı. Ortalama preoperative hemoglobin değeri 11.2 ± 1.78, postoperatif hemoglobin değeri 9.8 ± 1.3 bulundu. Ortalama müdahale süresi 21.2 ± 7 dakika ve hastanede kalış süresi 1.04 ±0.2 idi. Vajinal yaralanmaların onarım işlemi 19 hastada ofis koşullarında ve lokal anestezi altında, 70 hastada ise ameliyathane koşullarında spinal ya da sedo-analjezi altında gerçekleştirildi.Sonuç: Koitus sonrası vajinal yaralanmalar oldukça sıktır. Bu yaralanmalar sonrası hızlı gelişen ve hayatı tehdit edebilen kanamalar görülebilir. Evlilik öncesi çiftlerin psikoseksüel eğitim almaları, erken yaşta gebeliklerinin önlenmesi ve sosyokültürel temelli çalışmaların yapılması ilk cinsel ilişki sonrası genital yaralanmaların azalmasına yardımcı olabilir., Background: In this study, we aimed to investigate the outcomes of the first coitus injuries in newly married couples, which are common in our society.Material and Methods: This is a retrospective study involving 89 patients admitted to the obstetrics and gynecology clinic of our hospital with the complaint of bleeding secondary to postcoital vaginal discharge between January 2017 and December 2020. Results: The mean age of 89 patients admitted due to postcoital genital injury was 26 ± 8 years. All 89 of the patients had genital injury in the first coitus. The mean number of lesions was 1.4 ± 0.73 and their dimensions were 2.7 ± 0.96 cm. 65% of the patients were in primary and lower education groups.The main localizations of genital injuries were 29 in the vaginal introitus, 13 in the right lateral, 10 in the left lateral, and 10 in the posterior fourchette. Preoperative mean hemoglobin level was 11.2 ± 1.78 and postoperative hemoglobin level was 9.8 ± 1.3. The mean operation time was 21.2 ± 7 minutes and the hospital stay was 1.04 ±0.2 days. 19 of the interventions were repaired under local anesthesia under office conditions and 70 were repaired under spinal anesthesia or sedoanalgesia in the operating room. Conclusions: Vaginal injuries after coitus are considerably high. After these injuries, there is rapidly developing and life-threatening bleeding. Premarital couples receiving psychosexual education, preventing pregnancies at an early age, and conducting socio cultural-based studies may help to reduce genital injuries after the first coitus.

Erken evre meme kanserli hastalarda hızlandırılmış kısmi meme ışınlamasında Volümetrik Ark Terapi (VMAT) ve CyberKnife teknikleri kullanılarak hedef volüm ile kritik organ dozlarının karşılaştırılması amaçlanmıştır. Bu çalışma için radyoterapi almış 10 erken evre meme kanseri tanılı hasta seçilerek, günlük fraksiyon dozu 6 Gy ve toplam doz 30 Gy olacak şekilde VMAT ve CyberKnife (SBRT) sanal planları oluşturuldu. Homojenite indeksi (HI), konformite indeksi (CI), tedavi süresi (s), görünür hedef volümü (GTV) ve kritik organların aldığı doz değerleri karşılaştırıldı. Tedavi planları arasında GTV’nin D max (p=0,002) değeri VMAT tekniği lehine anlamlı fark bulundu. Aynı taraf memenin 30 Gy (V 30) (p=0,013) ve 15 Gy alan (V 15) volüm değerlerinin (p=0,007) CyberKnife tekniğinde daha az doz aldığı görüldü. Karşı memenin Dmax (p=0,218) değeri açısından anlamlı bir fark bulunmamıştır. Sağ meme yerleşimli olgularda kalbin D max (p=0,282) ve 1,5 Gy alan (V1,5 ) volümü için (p=0,548) anlamlı fark bulunmadı. Sol meme yerleşimli olgularda kalbin Dmax (p=0,095) değerinde anlamlı fark görülmedi; ancak kalbin 1,5 Gy alan (V 1,5 ) volüm değerinin (p=0,008) CyberKnife tekniğinde daha düşük olduğu görüldü. Tedavi süresi (s) (p

Objective The aim is to contribute to the literature by carrying out retrospective analysis of the cases who underwent amniocentesis in our clinic and sharing our relevant experience. Methods A total of 632 cases who underwent amniocentesis in the second trimester were included in our study. The cases’ demographic characteristics, weeks of gestation, amniocentesis indications, procedure-related complications, culture success, cytogenetic results, and the results and indications of the cases found to have chromosomal anomalies were evaluated. Chromosomal anomalies, their complications, culture failure rates and most common amniocentesis indications were reported. The results of the cases with chromosomal anomalies were presented as numerical and structural anomalies. Results The mean age of all cases included in our study was 33.7±6.8 years, and their mean weeks of gestation were 17.5±1.0 weeks. The rate of the cases found to have chromosomal anomaly by amniocentesis was 22.4%, the culture failure rate was 2.1%, and complication rate was 0.5%. The most common amniocentesis indications and the amniocentesis indications in cases found to have chromosomal anomaly were the same, and they were as following respectively: combined test being high risk, triple screening test being high risk and presence of anomaly in the ultrasonography (USG). The rate of detecting chromosomal anomaly was higher in the cases who had multiple indications and underwent amniocentesis. Conclusion Although USG and serum screening tests are used commonly for prenatal diagnosis, invasive tests such as amniocentesis are needed for the final diagnosis in patients with high risk. We concluded that amniocentesis is more important for prenatal diagnosis in cases who are under risk of having multiple chromosomal anomalies in the screening tests.

Background/aim The aim of this study is to evaluate the effects of preemptive oral pregabalin on hemodynamic response, anxiety, sedation, and recovery in patients who underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) under sedation with intravenous ketamine-propofol combination. Materials and methods Sixty patients were included in this study, and patients were randomly divided into two equal groups to receive the placebo (Group 1) versus pregabalin 150 mg (Group 2) one hour prior to EBUS- TBNA procedure. Patients received 0.25 mg kg-1 ketamine and 0.25 mg kg-1 propofol mixture (ketofol) for sedation. Timing of the parameters was defined as follows; T0: in hospital ward before pregabalin or placebo administration, T1: premedication, T2: in operating room, T3: before the procedure, T4: initiation, T5: 3 min after induction, T6: 6 min after induction, T7: 9 min after induction, and T8: 12 min after induction. Hemodynamic parameters, severity of coughing, sedation and anxiety scores, and complications were recorded. The level of satisfaction of the bronchoscopist and the patients were evaluated at the end of the procedure. Results The heart rate and mean arterial pressure were significantly higher in Group 1 (P = 0.008, P = 0.04). Total doses of anesthetics, recovery time, and desaturation rate were significantly higher in Group 1 (P = 0.014, P = 0.001, P = 0.045). In Group 2, SpO2 level was significantly higher at various time periods (T1; P = 0.025, T4; P =0.043, T6; P = 0.001, T7; P = 0.003, T8; P < 0.001). The severity of coughing was found significantly lower in Group 2 (T4; P = 0.011, T5; P = 0.01, T6; P = 0.02, T7; P = 0.03, T8; P < 0.01). Anxiety scores were significantly lower in Group 2 (P < 0.001). Conclusion Preemptive oral pregabalin, in addition to sedation with ketamine-propofol combination, was effective in providing limited hemodynamic response, restricted coughing reflex, and lower anxiety during EBUS-TBNA. Besides, with pregabalin usage, decreased anesthetics consumption, lower complication rate, and shorter recovery time might have contributed to safety of the procedure and comfort of the bronchoscopist.