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When postbariatric surgery patients cannot perform the behavior of excessive eating that they used to perform for coping with negative feelings in the preoperative period, they may adopt other new and inappropriate coping behaviors. This study was conducted to determine the risk of substance use and internet addiction in patients with and without food addiction before bariatric surgery. The descriptive cross-sectional study was conducted with 203 patients. The results showed that 54.7% of the patients who had food addiction before undergoing bariatric surgery were at risk of internet addiction, and 22.0% were at risk of substance use.

Aim: To investigate the epidemiological characteristics of patients with pelvic fractures. Material and Methods: We evaluated age, gender, comorbid disease, admission season, mechanisms of the injury, type of the fractures (Young Burgess classification), associated injuries, and mortality of patients with pelvic fractures in the emergency department (ED). Results: Of the 919 patients included in the study, 307 (33.4%) were female and 612 (66.6%) were male. The mean age was 36,5±14,82 (18-80) years. The mean age of males was 35.1 ± 13.63 years, and it was 39.2 ± 16.63 years for females. Of the males, 46.4% were in the 28-37 years range. Comorbid diseases were found in 254 (27.6%) patients. Of the patients, 302 (32.9%) were admitted in winter and 285 (31%) in summer. It was mostly occurred due to automobile accidents 268 (29.2%), followed by falls from height 211 (23%). Automobile accidents were most common in the winter season, while falls from height was more common in the summer. While automobile accidents, falls from height, motorcycle accidents were more common in males compared to females, falls from own height, pedestrians hit by a car, and other injuries were observed more frequently in females than males (p

Objective: We aim to evaluate the demographic and clinical characteristics of patients with acute carbon monoxide (CO) poisoning, who had a Glasgow Coma Score (GCS) below 15, and who had cerebral lesions detected in magnetic resonance imaging (MRI). Method: The age, gender, causes of CO intoxication, clinical signs, neurological findings, GCS, blood carboxyhemoglobin level (COHb), serum pH, lactate, creatine kinase (CK), creatinine kinase-myocardial band MB (CK-MB), troponin-I level, brain MRI findings, treatment, and mortality status of 327 patients were evaluated retrospectively. Results: The median age of patients was 31.5 years (IQR=19.5 years), 72.2% of the patients were women. Neurological findings were detected in 34 (10.4%) of the patients. The frequency of dyspnea was significantly higher in patients with neurological findings (p0.05). Patients with neurological findings were found to have a significantly longer follow-up period, more frequently received hyperbaric oxygen therapy (p

Basilar trunk artery aneurysms are extremely rare lesions that account for only 2.1% of all intracranial aneurysms. They are mostly recognized in patients around the age of 60, show a slight male predominance, and are associated with high morbidity and mortality. Chronic mural bleeding ectasia is the most common subtype of basilar trunk artery aneurysms. Its median maximum diameter ranges between 11 and 21 mm and is incidentally detected in more than half of the cases. Herein, we present a 58-year-old male patient who presented with brain stem stroke due to a chronic mural bleeding ectasia with a maximum diameter of 27 mm and died in the first week after admission. Keywords: Aneurysm, Fusiform, Dolichoectatic, İschemic stroke

Spiritual well-being has been evaluated as an important factor for both physical and mental recovery. The aim of this study was to determine the correlation between spiritual well-being and medication adherence in individuals diagnosed with mental illness. The study was conducted as a correlational descriptive study. The study sample consisted of 410 individuals diagnosed with mental illness. The study was conducted in the psychiatry clinic of a university hospital. The data were collected using a descriptive information form, the spiritual well-being scale, and the Morisky medication adherence scale. There was a statistically significant positive correlation between spiritual well-being and treatment adherence (r = 0.856, p = 0.002). Patient spiritual well-being was significant in explaining medication adherence (R2 = 0.48, p = 0.000). This study showed that spiritual well-being affected medication adherence in individuals diagnosed with mental illness.

Objectives Measurement of the nasal bone is an important part of the genetic sonogram. This study aimed to compare nasal bone length measurements taken in 2 different planes and to determine whether there is consistency between the measurements. Methods The nasal bone was measured in 103 fetuses whose mothers were admitted to our clinic for second-trimester ultrasound examinations and who did not have any accompanying diseases. In this prospective study, the gestational ages of fetuses ranged from 19 to 23 weeks. Nasal bones were measured in both coronal and midsagittal planes, and the similarity between the measurements was evaluated. Pearson correlation, Wilcoxon signed rank, and Kruskal-Wallis tests were used to evaluate the results. Results The median nasal bone length increased with increasing gestational age in both planes, as expected. There were no statistically significant differences between the fetal nasal bone lengths taken in the midsagittal and coronal planes at 19 to 23 weeks' gestation (P > .05). Conclusions The coronal plane may be used as an alternative to evaluate the nasal bone in the second trimester of pregnancy.

PURPOSE The purpose of this study is to determine the effect of negative automatic thoughts on hope in patients with schizophrenia. DESIGN AND METHODS The sample size of the study was calculated to be 94 patients through the power analysis. The study was completed with 115 patients who met the inclusion criteria. "descriptive characteristics form," "automatic thoughts questionnaire-negative," and "dispositional hope scale" were used to collect the data. FINDINGS In the study, it was found that there was a negative strong correlation between negative automatic thoughts and hope levels. In addition, the negative automatic thoughts of the patients had a statistical significance in accounting for hope (p

Background: The aim of our study was to present the prevalence of thyroid nodules we incidentally discovered by routine Magnetic Resonance Imaging (MRI) of the cervical spine, to evaluate their clinical significance, and to discuss the current clinical approach to incidental thyroid nodules. Methods: We retrospectively evaluated the cervical spinal MRI studies of 512 patients. Thyroid glands were evaluated for morphologic and signal characteristics and examined for the presence of nodule(s). The nodules with a maximum diameter of 5 mm or more were taken into analysis. Results: Of 512 MRI studies, 254 revealed incidental thyroid nodule(s) (49.6%). The mean maximum nodule diameter was 7.48±2.92 mm. Thirty-eight of 254 incidental thyroid nodules were radiologically reported, 35 reported nodules were evaluated by US, and 22 were further analyzed by fine needle aspiration cytology. The final diagnosis of 11 aspirated nodules was an adenomatous nodule, whereas 3 were papillary thyroid carcinoma. One of the patients with papillary thyroid carcinoma was a 32-year-old man with a nodule with a maximum diameter of 7 mm. Conclusion: Incidental thyroid nodule is a frequent non-spinal lesion detected by routine cervical spinal MRI. The 3-tiered system which is recommended in the clinical approach to incidental thyroid nodules may miss some clinically significant thyroid nodules. We suggest the criteria of this system to be re-evaluated and modified if necessary. In addition, we would like to emphasize the need for a guideline for radiologists for reporting incidental thyroid nodules on MRI on the basis of a standard clinical approach.

Meromelia refers to the partial absence of at least 1 limb and is also referred to as “terminal transverse hemimelia.” It can occur in either isolation or with other congenital malformations. There are very few publications in the literature that report meromelia cases accompanied by other congenital anomalies. Proximal focal femoral deficiency is another rare congenital skeletal abnormality and is characterized by the underdevelopment of the proximal part of the femur and shortening of the entire lower extremity. A case of upper limb meromelia accompanied by proximal focal femoral deficiency and fibular hemimelia in a neonate has previously been reported. However, to our knowledge, the association of upper limb meromelia with intermetatarsal coalition has never been reported to date. Here, we present an adult patient showing an unusual association of multiple rare congenital skeletal abnormalities including meromelia, proximal focal femoral deficiency, fibular hemimelia, and intermetatarsal coalition.

Objective: We investigated the role of betatrophin in the etiopathogenesis of gestational diabetes mellitus (GDM) and its association with lipid and carbohydrate metabolism in patients with GDM and normoglycemic pregnant women. Materials and Methods: A total of 60 patients [30 pregnant women with GDM (study group) and 30 healthy age-, body mass index-, and gestational agematched pregnant women (control group)] were included in this study. Serum betatrophin, fasting glucose, insulin, glycated hemoglobin A1c (HbA1c), and C-peptide levels, as well as lipid parameters, were measured. Results: Serum betatrophin, fasting glucose, HbA1c, insulin, and C-peptide levels were significantly higher in the GDM group than in the control group (p

OBJECTIVE: The aim of this study was to compare the functional results of internal fixation of both forearm bones versus fixation of the radius alone in the treatment of distal both-bone forearm fractures in children. METHODS: This study included a total of 34 children who were treated for distal forearm both-bone fracture. Patients were divided into two groups according to the technique used, which depended on the date of their surgery. Group 1 consisted of 18 children (14 males and four females; mean age: 10.3 years; age range: 7–16 years) who underwent both-bone fracture fixation using closed reduction and percutaneous pinning; Group 2 consisted of 16 children (12 males and four females; mean age: 10.1 years; age range: 6–15 years) who underwent only radius fracture fixation. The average follow-up was 65.6 months in Group 1 and 38.9 months in Group 2. Operating time, fluoroscopy exposure time, functional results (Mayo Wrist Score, visual analogue scale score, and range of motion), radiological results (time to union and malunion), and complications were recorded as outcome parameters. RESULTS: The mean operating time was 35 min (range: 30–45 min) in Group 1 and 19 min (range: 10–25 min) in Group 2 (p

Highlights • Osteoid osteoma typically occurs in children or in adolescents. However, it should be noted that this tumor can be detected in older age groups as well. • Although extremely rare, osteoid osteoma may occur in the hallux. • CT is the method of choice in the diagnosis of osteoid osteoma. • Osteoid osteoma should be included in the differential diagnosis list in all patients presenting with foot pain., Introduction Osteoid osteomas are benign osteoblastic bone tumors mostly seen in patients in the second or third decade of life, and they most frequently involve the femur and tibia. Hallux osteoid osteoma is an extremely rare occurrence with only 14 reported cases to date. Presentation of case A 46-year-old woman with a right hallux pain for the last 18 months was admitted. Her foot radiographs showed a small sclerotic focus on the distal phalanx and degenerative changes in the interphalangeal joint of the hallux. The complaints of the patient were attributed to osteoarthritis involving the interphalangeal joint and non-steroidal anti-inflammatory drugs were administered; however, the patient’s condition did not improve, and hallux osteoid osteoma could not be correctly diagnosed until a CT scan was performed. Discussion We present a case of hallux osteoid osteoma in which the diagnosis was delayed greatly due to the unusuality of the lesion location, the advanced age of the patient, and the uncertainty of the clinical and radiographic appearance. Conclusion Although rare, osteoid osteoma may occur in the hallux. Even if the patient age, pain pattern, and radiographic findings do not exactly meet the classical definitions for osteoid osteoma, this tumor should always be included in the differential diagnosis list in patients presenting with foot pain.

ÖZETAmaç: Cerrahi tedavi uygulanan endometrial hiperplazili hastalarda eşzamanlı endometrial kanser insidansını belirlemeyi amaçladık.Gereç ve yöntem: Çalışmamız retrospektif olarak dizayn edildi. 2007 - 2017yılları arasında Eskişehir Osmangazi Üniversitesi (ESOGÜ) jinekolojik Onkolojibölümünde endometrial biyopsi ile endometrial hiperplazi (EH) tanısı alan vecerrahi tedavi uygulanan hastaların tıbbi kayıtları incelenerek çalışmaoluşturuldu. Endometrial örnekleme sonucu endometrial hiperplazili 522 hastanınverileri değerlendirildi. 187 hasta medikal tedavi uygulandığı için, 35 hastatıbbi kayıtları yetersiz olduğu için ve15 hasta endometrial kanser şüphesi olduğu için çalışma dışı bırakıldı.Çalışmaya endometrial hiperplazili 285 hasta dahil edildi.Bulgular: Çalışmaya alınan 285 hastanın 64'ü (% 22.4) basit hiperplazi, 31'i (%10.8) basit atipili hiperplazi, 72'si (% 25.2) kompleks hiperplazi ve 118'i (%41.4) kompleks atipili hiperplazi idi. Histerektomi spesmenlerininincelenmesiyle 84 (% 29.4) hastada endometrial patoloji izlenmezken , 36hastada (% 12.6) endometrial kanser, 165 hastada (% 57.8) endometrialhiperplazi bulduk. Basit hiperplazide 1 (% 1,5) hastada endometrial kanserbulduk.Basit atipili hiperplazide 1 (% 3,2) hastada endometrial kanser tespitedildi. Kompleks hiperplazide 6 hastada(% 8.3) endometrial kanser vardı. Kopleks atipili hiperplazide 28 (% 23,7) hastada endometrial kanser tespit edildi. 2014 DünyaSağlık Örgütü sınıflandırma sistemine göre, eş zamanlı endometrial kanseroranları atipili endometrial hiperplazide % 19.4, atipi olmayan endometrial hiperplazide % 5.1 olarak tespitedildi.Sonuç: Basit hiperplazide eşzamanlıendometrial kanser oranı% 5.1, bu oran kompleks hiperplazide % 8,3 olarakbulundu. Atipi olmayan endometrial hiperplazili hastaların tedavisinde medikal tedavi seçilecekse bu oranlar göz önünde bulundurulmalıdır.Endometrialhiperplazi yönetiminde endometrialkanser için tüm risk faktörlerinin detaylı değerlendirilmesi önerilir., Objective: we aimed to determine the incidence of simultaneous endometrial cancerin patients with endometrial hyperplasia who underwent surgical treatment.Materialand method: Our studywas designed retrospectively.The medical data of patients who wasdiagnosed endometrial hyperplasia(EH) bythe endometrial biopsy and accepted surgical treatment were examined and collected between 2007 -2017 at the gynecologic oncology depertmant of Eskişehir Osmangazi University(ESOGÜ).The data of 522 patients with endometrial hyperplasia as a result of endometrialsampling were evaluated. Due to 187 patients received medicaltreatment, 35 patients lacked medical data and 15 patients suspected endometrial CA were excluded from the study.Atotal of 285 patients with endometrial hyperplasia were included in the study.Result:Of the 285 patients included in the study, 64 (22.4%) were simple hyperplasia,31 (10.8%) were simple atypia hyperplasia, 72 (25.2%) were complex hyperplasiaand 118 (41.4%) were complex atypia hyperplasia. Endometrialhyperplasia could not be detected in 84 (29.4%) patients after a finalpathology. We found endometrial cancer in 36 (12.6%) patientsand endometrial hyperplasia in 165 (57.8%) patients. We found 1 (1.5%) patientEC in simple hyperplasia. EC was detected in 1 (3.2%) patient in SAH. 6patients (8.3%) had EC in CH. 28 (23.7%) EC’s were detected in patients withCAH. According to the 2014 WHO classification system,Concurrent endometrial cancer rates were determined as AEH 19.4% and EH without atypia was 5.1%.Conclusion: Concurrent EC ratio in simple hyperplasia was5.1% this rate was found to be 8.3 % inCH. Management of patients with endometrialhyperplasia without atypia If medical treatment is to be chosen, these ratesshould be considered and it is recommended to consider all risk factors for EC.

ObjectiveSpondylodiscitis is an important clinical a problem requiring serious approaches. In this study, we sought to raise awareness by examining the epidemiology and laboratory, clinical, and radiological findings of spondylodiscitis, which sometimes has a delayed diagnosis and which can be difficult to treat.MethodsIn total, 343 patients with spondylodiscitis were included in the study.ResultsThe patients were classified as having as pyogenic (n = 153, 44.6%), brucellar (n = 138, 40.2%), or tuberculous (n = 52, 15.2%) spondylodiscitis. Meanwhile, 281 patients underwent magnetic resonance imaging, 71 underwent computed tomography, and 17 underwent scintigraphy for diagnosis. The rates of involvement at more than two segments and paraspinal abscess were significantly higher in tuberculous spondylodiscitis. However, disc involvement was significantly more common in brucellar and pyogenic spondylodiscitis.ConclusionThe incidence of spondylodiscitis has increased substantially, especially in the young population. The invasive procedures and high rate of culture negativity make the diagnosis difficult. Therefore, clinical and radiological findings are useful in the diagnosis of spondylodiscitis. Despite the high rate of culture negativity, every effort should be made to identify the causative organism using invasive methods.

This study was conducted to determine the effect of religious belief on depression and hopelessness in advanced cancer patients. The sample size of this cross-sectional study was determined as 267 as a result of the power analysis. The study was carried out between February 2018 and December 2018. “The Patient Information Form”, “The Religious Attitude Scale”, “The Beck Depression Inventory (BDI)”, and “The Beck Hopelessness Scale (BHS)” were used to collect the data. It was determined that the total mean score of the cancer patients participating in the study for Religious Attitude Scale was 4.51 ± 0.44 (high level), their total mean score for depression inventory was 19.06 ± 9.38 (moderate level), and their total mean score for hopelessness scale was 10.23 ± 1.94 (moderate level). In the study, the difference between the religious beliefs and depression and hopelessness levels of the cancer patients was statistically significant (p

BACKGROUND: Intimate partner violence (IPV) is an important human rights problem faced by one in three women worldwide. The aim of this study is to evaluate the demographic, trauma, and radiological characteristics of patients admitted to a tertiary emergency department due to IPV. METHODS: Sociodemographic characteristics (age, gender, education level, and marital status), trauma characteristics (severity, type, and location), radiological imaging findings (radiography, computed tomography, and magnetic resonance imaging) of patients diagnosed with IPV were evaluated. RESULTS: In the study, 1225 patients were evaluated, and 98.7% of them were women (mean age 35 [IQR: 17] years). Of the patients, 63.1% were high school and university graduates. The rate of married women was 74.6%. No relationship was found between gender, age, educational status, and marital status (p>0.05). Most of the traumas were minor (85.4%) and blunt (81.9%) trauma, and the most common types of trauma were kicking (49.9%) and punching (47.3%). It was found that the most frequently affected areas of the patients were the head and neck (76.7%), and the frequency of pelvic trauma was high in male patients (p

Fanconi anemia (FA) is a disease that could be accompanied by multiple abnormalities, such as growth retardation, bone marrow abnormalities, and cancer susceptibility. Among the FA patients, head and neck squamous cell cancer (HNSCC) is the most observed solid cancer. The life expectancy of patients with FA has increased with recent medical advances. Furthermore, HNSCC is diagnosed in 3% of FA patients, and half of these patients die because of their HNSCC. The median age of HNSCC patients with FA is 31, and according to the literature HNSCC incidence of FA, patients is more than 700-fold of the normal population. Here, we reported the treatment details and challenges we faced during hypopharyngeal cancer treatment in a FA patient.

Emergency medical treatment in remote areas often requires immediate medical decision and on-board medical treatments in ambulances before patients could arrive hospitals. For example, a heart attack (Myocardial Infarction) particularly needs prompt treatments to save life. Amid all acute heart diseases, the ST-Elevation Myocardial Infarction (STEMI) is de facto one of the main causes of death. Adequate and immediate treatments for STEMI patients in ambulances before arriving the hospital could largely improve the chance of survival. This paper proposes an online mobile application for real time STEMI ECG pattern recognition. In the cloud AI computing server, a Deep Learning based mechanism is developed to accurately recognize STEMI ECG pattern. On the side of mobile clients, the developed system exploits the salient properties of seamless connections and prompt responses of a wireless mobile network. The main component of our system is an online AI Bot which can help paramedics to recognize STEMI and then to give patients appropriate treatment, such as giving therapeutic drugs and carrying them to the emergency medical center. Collaborating with a teaching hospital, the proposed system is under a testing run and the results show that our system has a very high STEMI recognition accuracy and could be a great help for saving lives of those patients encountering STEMI in remote areas far away from the hospital.

The aim of this study was to investigate the correlation of critical shoulder angle (CSA) in rotator cuff arthropathy patients with number of damaged rotator cuff tendons and muscle fatty degeneration. Rotator cuff arthropathy patients were included in this study. True antero-posterior radiographs (Grashey view) were used to measure the angle by the first author. The critical shoulder angles were measured on radiographs. The Magnetic resonance images (MRI) of same patients were assessed in terms of number of tendon involvements and fatty degeneration of rotator cuff muscles. There were 28 rotator cuff arthropathy patients comprising 16 females and 12 males. The mean age was 69.928.84 years. The right shoulder was affected in 20 patients. The left side was affected in 8 patients. The damaged rotator cuff tendons were as follows; supraspinatus tendon was affected in all patients, infraspinatus tendon was affected in 25 patients, teres minor was affected in 14 patients, and subscapularis tendon was affected in 24 patients. The critical shoulder angle was found 37.601.66 CSA values were found to be higher in patients having fatty degeneration than others having no fatty degeneration, and it was statistically significant (p, Bu çalışmanın amacı rotator manşet artropatili hastalarda kritik omuz açısının (KOA) hasarlı rotator manşet tendon sayısı ve kasların yağlı dejenerasyonu ile ilişkisini araştırmaktı. Rotator manşet artropatisi hastaları bu çalışmaya dahil edildi. İlk yazar tarafından açıyı ölçmek için gerçek ön-arka radyografiler (Grashey görünümü) kullanıldı. Kritik omuz açıları radyografilerde ölçüldü. Aynı hastaların Manyetik rezonans görüntüleri (MRG), tendon tutulumlarının sayısı ve rotator manşet kaslarının yağlı dejenerasyonu açısından değerlendirildi. 16 kadın ve 12 erkekten oluşan 28 rotator manşet artropati hastası vardı. Ortalama yaş 69.928.84 idi. 20 hastada sağ omuz etkilenmişti. 8 hastada sol taraf etkilenmişti. Hasarlı rotator manşet tendonları şu şekildeydi; Hastaların tamamında supraspinatus tendonu, 25 hastada infraspinatus tendonu, 14 hastada teres minör ve 24 hastada subskapularis tendonu etkilenmişti. Kritik omuz açısı 37.601.66olarak bulundu. Yağlı dejenerasyonu olan hastalarda KOA değerleri, yağlı dejenerasyonu olmayanlara göre daha yüksek bulundu ve istatistiksel olarak anlamlıydı (p

The aim of this study was to investigate the effect of lithium treatment on renal function and to determine influencing factors. In addition, the utility of spot urine protein/creatinine ratio in detection of lithium induced nephropathy was also investigated.Serum concentrations of lithium, blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), and urinalysis including protein/creatinine ratio were measured in 375 patients using lithium.Patients taking lithium for ≥8 years had higher BUN, creatinine levels, percentage of proteinuria, percentages of stage 2 and 3 chronic kidney disease (CKD); lower urine density and eGFR compared to patients taking lithium8 years. Urine density was lower in groups with0.8 and 0.6-0.8 mmol/L lithium level than0.6 mmol/L. Predictors of CKD were serum level of lithium, dose of lithium, cumulative duration of lithium use, age at onset of illness, and caffeine consumption.Detrimental effects of lithium on renal functions were detected after lithium use for ≥8 years. Proteinuria measured by spot urine protein/creatinine ratio can be detected even when eGFR is90 ml/min/1.73 m

BACKGROUND Intracranial pressure (ICP) monitoring is of profound importance concerning prognosis and treatment among children with traumatic brain injury (TBI). Measurements of the optic nerve sheath diameter (ONSD) are one of the methods recommended for ICP monitoring. In this study, we aimed to evaluate the correlation of ONSD change in brain computed tomography (CT) with pediatric Glasgow Coma Score (pGCS) in the follow-up of pediatric cases with TBI, and also to evaluate the usability of the ONSD, which is the indicator of ICP. METHODS The data of 921 pediatric patients who were admitted to the emergency department with head injury between January 2016 and January 2018 were retrospectively evaluated in this study. Age, gender, trauma type, brain CT finding, pGCS, type of intracranial hemorrhage (ICH), and isolated skull fracture (ISF) were investigated. The patients were evaluated in three groups based on CT findings: (i) patients with parenchymal brain injury, (ii) patients with ISF, and (iii) patients with normal brain CT results. The measurements of ONSD were performed using CT. Whether the ONSD measurement results of the patients were compatible with the clinical data was investigated. RESULTS The median age of the patients was 36 months (interquartile range [IQR] = 64) and 64.2% were male. The ONSD values and pGCSs of the patients with parenchymal injury were found to be significantly higher than patients with ISF and normal brain CT findings (p

Ebru Celik Kavak,1 Funda Gulcu Bulmus,2 Ozgur Bulmus,3 Salih Burcin Kavak,1 Nevin Kocaman4 1Department of Obstetrics and Gynecology, 2Vocational School of Health Services, 3Department of Physiology, 4Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkey Aim: The aim of the present study was to assess the protective effects of magnesium sulfate (MgSO4) on ischemia/reperfusion (I/R) induced ovarian damage in a rat ovarian torsion model.Methods: Forty-two female Sprague Dawley rats were included in the study. They were divided into six groups as Group 1, sham; Group 2, bilateral ovarian torsion; Group 3, bilateral ovarian torsion–detorsion; Group 4, MgSO4–sham; Group 5, MgSO4–bilateral ovarian torsion; Group 6, bilateral ovarian torsion–MgSO4–detorsion. Both torsion and detorsion periods lasted 3 hours. In Groups 4, 5 and 6, MgSO4 (600 mg/kg) was administered by intraperitoneal route 30 minutes before sham operation, torsion and detorsion, respectively. At the end of the study period, both ovaries were removed. One of the ovaries was used for histopathological analyses and the other for biochemical analyses.Results: In the torsion–detorsion group, all the histopathological scores were higher compared to the sham and torsion only group (p

This study tested the effects of mindfulness-based stress reduction (MBSR) training on multiple outcomes in patients with schizophrenia. We compared MBSR, psychoeducation, and control groups in a randomized controlled research design. Outcome measures assessed hope, psychological wellbeing, and functional recovery over three time points in 137 participants. The results of this study indicate that MBSR training was more effective in terms of increasing the level of hope, psychological well-being, and functional recovery of schizophrenia patients when compared with psychoeducation and control patients.

Postpartum bleeding is a life-threatening obstetric complication. The most common cause is uterine atony. There is no method that can treat PPH with 100% effectiveness and therefore, efforts for the development of more effective conservative treatment methods continue. The aim of the study is to compare the effectiveness of the isthmic circumferential suture technique and the Bakri balloon tamponade in the treatment of postpartum bleeding due to uterine atony during cesarean operation.This study was conducted by retrospectively evaluating the cases who developed uterine atony during cesarean section. Group 1 (The groups were similar with regard to age, obstetric characteristics, preoperative complete blood count, neonatal outcomes and there was no statistically significant difference between groups. The operative time was significantly shorter in Group 1 (61.86 ± 6.7 vs. 69.53 ± 3.2 min;Both methods are effective in the uterine atony during cesarean section. However, due to the shorter operative time and less pre-operative blood loss, the isthmic circumferential suture technique may be a better alternative.

This study aimed to determine the effect of spiritual well-being on hope in immobile patients suffering from paralysis due to spinal cord injuries. The sample size of this cross-sectional study was determined to be 100 immobile patients suffering from paralysis due to spinal cord injuries via power analysis. "Descriptive Characteristics Form," "Spiritual Well-being Scale," and "Dispositional Hope Scales" were used to collect the data. It was determined that participants' spiritual well-being scores were 22.25 +/- 9.62 and their hope scores were 29.53 +/- 9.83. There was a weak but positive correlation between the total scores on the hope scale and the spiritual well-being scale (p = 0.001, r = 0.477). Among immobile patients suffering from paralysis due to spinal cord injury, spiritual well-being levels accounted for 22% of the variance in hope levels (p = 0.001, R-2 = 0.22). This study showed that as patients' spiritual well-being levels increased, their hope levels also increased.

Objective: To evaluate the level of effect on the sensorimotor functions of the hand in patients with rheumatoid arthritis (RA) and investigate the relationship between this level and patients’ daily life activities and disease-specific parameters. Material and Method: This case-control study involved the evaluation of 80 patients with RA and 50 healthy volunteers aged 20-65 years. The coarse and fine grip strength of the patients was evaluated with hand dynamometer and pinch meter. The sensory evaluation of the hand was undertaken using the Semmes-Weinstein monofilament test (SWMT). The hand skill level was evaluated with Duru Oz Hand Index (DHI). The daily living activities of the patients were investigated using the Health Assessment Questionnaire (HAQ). The Disease Activity Score 28 (DAS28) was used to evaluate disease activity. Results: The mean DAS28 score of the RA group was at a mild level (DAS 28

Hypertrophic olivary degeneration is a rare occurrence in which different pathological processes including enlargement and vacuolation of the neurons, demyelination of the white matter, and fibrillary gliosis of the inferior olivary nucleus take place. It mostly develops secondary to a destructive lesion involving the Guillain–Mollaret pathway. The mostly reported destructive lesions causing hypertrophic olivary degeneration are stroke, trauma, tumors, neurosurgical interventions, and gamma knife treatment of brainstem cavernoma. It presents with symptomatic palatal tremor, and typically appears as an expansive nonenhancing nodular lesion that shows increased signal intensity on magnetic resonance imaging (MRI). The identification of hypertrophic olivary degeneration on MRI is of great importance as its MRI appearance is very similar to those of more severe pathologies, including tumors, infarction, demyelinating lesions, and infections. We present a case of hypertrophic olivary degeneration in a patient with a history of ischemic stroke two years before the development of palatal tremor.

To determine the radiologic imaging characteristics of the trauma-related lesions of elderly patients determined to be abused, and to raise awareness among all types of physicians, foremost radiologists, about elder abuse. The most striking features of our findings regarding the fractures were that almost all rib fractures were in the posterior segment and that the long bone fractures were in a distal diaphyseal location in over than half of the cases. The rates of concurrent joint dislocation, soft-tissue lesion(s) and old fracture(s) were 12%, 54.3% and 19.6%, respectively. Specific fracture features and certain accompanying findings can be identified in abused elderly patients. The aim of the study was to determine the radiologic imaging characteristics of the trauma-related lesions of elderly patients determined to be abused, and to raise awareness among all types of physicians, foremost radiologists, about elder abuse. Clinical records and radiological images of 92 patients with the diagnosis of elder abuse were retrospectively evaluated in terms of age, gender, the reason for admission to the hospital, the presence or absence of comorbid disease(s), bone fracture location and number, characteristics of the fracture(s), the presence or absence of soft-tissue damage or old fracture(s), and the mortality. Of the patients, 85.9% were brought to the hospital because of a fall. Upper extremity was the most common body segment subjected to trauma (37%), followed by head and neck (30.4%) and chest (30.4%). The most commonly fractured bones were costae, and they were mostly multiple and located in the posterior segment. In long bone fractures, the lesions were located in the distal end of the bone and diaphyseal segment in 56.9% and 53.8% of the cases, respectively. The rates of concurrent joint dislocation, soft-tissue lesion(s) and old fracture(s) were 12%, 54.3% and 19.6%, respectively. The mortality rate was 9.8%. Specific fracture features and certain accompanying findings can be identified in abused elderly patients. We recommend that radiologists increase their skills in interpreting radiographs from potential victims of abuse, prioritise this work over more routine reporting and collaborate with clinicians in a multidisciplinary approach to the detection and secondary prevention of violence and neglect of older people.

In our study we aimed to evaluate the clinicopathologic features of patients diagnosed with atyipcal glandular cells on cervical cytology.The records of 9375 patients who were examined in the gynecology outpatient clinic between 2010 and 2018 and underwent cervicovaginal smear were retrospectively reviewed. Seventy-three (0.8%) patients were diagnosed as atypical glandular cells. Colposcopic examination, cervical biopsy, endocervical and endometrial curettage were performed in patients diagnosed with atypical glandular cells. Age, gravida, parity, systemic diseases and clinicopathological features of the patients were examined and recorded.Cervical and endometrial abnormal histological findings were detected in 26 (35.6%) of 73 patients with atypical glandular cells. Of these 26 patients, 14 (19.1%) had cervical intraepithelial lesions, 3 (4.1%) had endometrial hyperplasia and 9 (12.3%) had invasive cancer. Five (6.8%) of the 9 patients with the diagnosis of invasive cancer had adenocarcinoma (endocervical and endometrial), in 3 (4.1%) patients cervical squamous carcinoma, and in 1 patient. endocervical lymphoma was observed.The majority of cancers detected in our study were in the age group of 50 years and older.Invasive cancer is seen in 12.3% of the patients diagnosed with atypical glandular cells, and most of these patients are 50 years or older. Therefore patients diagnosed with atypical glandular cell in cervicovaginal smear should be carefully evaluated with all clinical features.Çalışmamızda servikovajinal smear sonrası atipik glandüler hücre tanısı konan hastaların klinikopatolojik özelliklerini değerlendirmeyi amaçladık.Kadın hastalıkları polikliniğinde 2010-2018 yılları arasında muayene edilen ve servikovajinal smear yapılan 9375 hastanın kayıtları retrospektif olarak incelendi. Yetmiş üç (% 0,8) hastaya atipik glanduler hücreler tanısı kondu. Atipik glandüler hücreler tanısı konulan hastalarda kolposkopik muayene, servikal biyopsi, endoservikal ve endometriyal küretaj yapıldı. Hastaların yaş, gravida, parite, sistemik hastalıklar ve klinikopatolojik özellikleri incelendi ve kaydedildi.Atipik glandüler hücreli 73 hastanın 26’sında (%35,6) servikal ve endometrial anormal histolojik bulgular saptandı. Bu 26 hastanın 14’ünde (%19,1) servikal intraepitelyal lezyon, 3’ünde (%4,1) endometrial hiperplazi, 9’unda (%12,3) invaziv kanser mevcuttu. İnvaziv kanser tanısı alan 9 hastanın beşinde (%6,8) adenokarsinom (endoservikal ve endometrial), 3’ünde (%4,1) servikal skuamöz karsinom gözlendi. Bir hastada endoservikal lenfoma izlendi. Çalışmamızda tespit edilen kanserlerin büyük çoğunluğu 50 yaş ve üstü yaş grubundaydı.Atipik glanduler hücre tanısı konan hastaların %12.3 de invaziv kanser görülmektedir ve bu hastaların çoğunun yaşı 50 yaş ve üzeridir. Bu nedenle servikovaginal smear nedeniyle atipik glandüler hücre tanısı konan hastalar tüm klinik özelliklerle dikkatlice değerlendirilmelidir.

Absrtact: Postaxial hypoplasia of the lower extremity, formerly termed as fibular hemimelia, is characterized by lower limb length discrepancy and a broad spectrum of anomalies involving the ipsilateral limb. It is a rare skeletal abnormality with an incidence of 5.7-20 cases per 1 million births. Herein, we present a young man with postaxial hypoplasia of the lower extremity who admitted to the hospital for a reason other than musculoskeletal complaints. While his limb length discrepancy was rather mild, the accompanying tarsal coalition was of an extensive form involving talus, calcaneus, navicular, and cuboid. Such extensive fusions of the hindfoot are very rare, and they are commonly associated with congenital syndromes such as postaxial hypoplasia of the lower extremity and Alpert syndrome. Therefore, further investigation for accompanying abnormalities is needed in cases with extensive fusions of the hindfoot. Keywords: Anisomelia, Fibular hemimelia, Subtalar coalition

Purpose To measure the frequency, type, purpose of complementary medicine (CM) use among people with diabetes mellitus. Materials and methods The population of this descriptive study consisted of the patients hospitalized in the endocrine clinic of a university hospital in Eastern Turkey who were diagnosed with diabetes. Data were collected from 316 patients. Results 43.0% of the patients were using CM, and 97.0% of those using CM tried herbal methods. The patients who had variable glycated haemoglobin values (60.3%) and those who had DM-related complications (60.3%) used CM more. Conclusion It was determined that CM usage was prevalent among the patients. The most frequently used CM method was herbal therapy. We found that the use of CM was more common in patients with poor metabolic control. Therefore, healthcare professionals must be assess use of CM and provide suitable counseling.

Meromelia is a rare skeletal abnormality characterized by the partial absence of at least one limb. Several mechanisms have been postulated to explain the etiopathogenesis of the disorder. Most of the cases of meromelia are reported to be sporadic. It can occur either in isolation or with other congenital malformations. VACTERL association, gastroschisis, atrial septal defect, proximal femoral focal deficiency, and fibular hemimelia are the congenital abnormalities reported to be in association with meromelia. However, no other congenital abnormalities in association with meromelia have been recorded to date. We herein present an unusual case of bilateral upper limb meromelia accompanied by unilateral oligodactyly and brachymesophalangy of the foot.

Purpose: The aim of the current study was to establish a normative data set for the morphometric parameters of the facial nevre (FN) and cochlear nevre (CN) according to age and sex in the adult population, using 3-dimensional constructive interference in steady state (3D-CISS) sequence on magnetic resonance imaging. Methods: We retrospectively analyzed 157 ears of 102 adults with no hearing impairment, facial palsy or Ménière's disease. The vertical (VD) and horizontal (HD) diameters as well as cross-sectional areas (CSAs) of the FNs and CNs were measured on the parasagittal oblique image created using the axial 3D-CISS sections passing through the internal acoustic canal. We related the measurement results with side, sex and age. Results: The mean VD, HD and CSA of the FNs were 1.09 ± 0.18 mm, 0.84 ± 0.17 mm, and 0.75 ± 0.27 mm2, respectively, whereas those of the CNs were 1.34 ± 0.17 mm, 1 ± 0.15 mm and 1.06 ± 0.3 mm2, respectively. There was no statistically significant difference between the morphometric parameters of both the nerves according to side or sex (P > 0.05). However, except for the CSA of the FNs among males, we found a statistically significant decrease in all the morphometric parameters of both the nerves with ageing (P

Purpose The study was conducted for the purpose of determining the relationship between internalized stigma and loneliness in patients with schizophrenia. Design and methods The population of this correlational-descriptive study consisted of a total of 200 in patients with schizophrenia. The data were collected using "Form of Descriptive Characteristics", "Internalized Stigma of Mental Illness Inventory (ISMI)", and "UCLA Loneliness Scale". Findings It was determined that the loneliness level of the patients who participated in the study was 57.20 ± 10.38 and level of of internalized stigma was 79.65 ± 13.48. There was a statistically positive and strong correlation between loneliness and internalized stigma total mean scores of the patients (P = 0.001, r = 0.854). Practise implications It was found that the schizophrenic patients had high levels of internalized stigma and loneliness.

The prevalence of multiple sclerosis (MS) and the age of affected patients are increasing owing to increased longevity of the general population and the availability of effective disease-modifying therapies. However, ageing presents unique challenges in patients with MS largely as a result of their increased frequency of age-related and MS-related comorbidities as well as transition of the disease course from an inflammatory to a neurodegenerative phenotype. Immunosenescence (the weakening of the immune system associated with natural ageing) might be at least partly responsible for this transition, which further complicates disease management. Currently approved therapies for MS are effective in preventing relapse but are not as effective in preventing the accumulation of disability associated with ageing and disease progression. Thus, ageing patients with MS represent a uniquely challenging population that is currently underserved by existing therapeutic regimens. This Review focuses on the epidemiology of MS in ageing patients. Unique considerations relevant to this population are discussed, including the immunology and pathobiology of the complex relationship between ageing and MS, the safety and efficacy of disease-modifying therapies, when discontinuation of treatment might be appropriate and the important role of approaches to support wellness and cognition.

Aim:We aimed to evaluate and compare the performance of BIG score (Base deficit, INR, GCS), pediatric trauma score, revised trauma score, injury severity score, new injury severity score (NISS) in mortality and stay intensive care unit.Materials and Methods:One thousand five hundred ten pediatric patients aged less than 18 years who were admitted to the emergency department with multi-trauma between 1 July 2012 and 1 July 2016 were included in the retrospective research. Demographic data, vital signs in the emergency department, trauma location, injury severity indexes and follow up of patients were examined.Results:One thousand five hundred ten patients were included, 40.5% were female and 59.5% were male. Mean age was 7.81±4.8; mortality was 4.2%. The best score to evaluate mortality was “probability of survival 2014 (PS14)”. The best score to force the stay in ICU was found as NISS, the most sensitive system was NISS and PS14 (94.9%) and the most specific was NISS (86.7). PS14 was the first to evaluate the survival. In our research, 94.3% of patient had blunt trauma and 5.7% had penetrating trauma. PS14 was found the best score to determine survival and mortality for blunt trauma patients.Conclusion:Although all scoring systems appeared similarly predictive among pediatric trauma patients, The PS14 score was more predictive for mortality and survival, and the NISS score for the need of intensive care admission. The NISS score was the most predictive score for intensive care admission in blunt and penetrating traumas combined. Particularly the newly developed PS14 score can be used as a powerfully predictive scoring system for outcomes among all pediatric trauma patients, irrespective of trauma mechanism.

The purpose of this study is to determine the relation between spiritual wellbeing and psychological resilience among patients diagnosed with advanced gastrointestinal cancer. The study was performed as a descriptive correlational study, with the participation of patients hospitalized in the oncology clinics of three university hospital. The study population comprised 1318 patients aged 18 or older who were admitted to the two oncology clinics and policlinics of the university hospital. The sample size was determined as 297, the significance level of 0.05, the effect size of 0.08, and the ability to represent the population of 0.95 by the power analysis performed to determine the sample of the study. The study was completed with 302 patients. The Patient Introduction Form prepared by the researcher, FACIT Spiritual Well-Being Scale (FACIT–Sp), and The Brief Resilience Scale (BRS) were used to collect data. In the study, the minimum score obtained by the patients participating in the study from the FACIT-Sp was 15; whereas, their maximum score was 41; the total mean score of the scale was 31.41 ± 4.83. For the BRS scale, their minimum score was 6, their maximum score was 30, and the scale total mean score was 19.17 ± 4.89. When examining FACIT-Sp and BRS mean scores of the patients, it was found that their spiritual wellbeing levels were high and their psychological resilience was moderate A statistically positive correlation was found between the FACIT -Sp and BRS total mean scores of the patients in the study (p = 0.00). With increasing spiritual levels of in advanced gastrointestinal cancer patients, their psychological resilience also increased in the study. Cancer not only affects the patients physically, but also spiritually. It can be recommended for nurses, who take significant roles in the patient care, to approach patients holistically by involving their spiritual side into care.

Azathioprine (AZA), a purine antagonist, is an immunosuppressive agent. It is used to treat inflammatory bowel diseases and various autoimmune diseases. It is commonly used for immunosuppression af...

Purpose This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked. Design/methodology/approach The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title. Findings A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively. Originality/value In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.

•Abrikossoff tumor is a rare tumor but not always benign.•Re-excission for positive margins in benign tumors may not be invariably necessary.•Cosmetic issues may play role in the treatment and follow-up in benign tumors.

Background We aimed to test the clinical relevance of a newly introduced anatomical classification system of the frontal sinus and to investigate the relation between the frontal sinus type according to this system and the development of frontal sinusitis. We retrospectively evaluated the computed tomography images of 808 frontal sinuses of 404 patients and classified the sinuses as small, medium-sized, and large, based on their size and relation to the orbital roof. We related this classification to the presence or absence of the findings of frontal sinusitis including mucosal thickening, retention cyst/polyp, and/or fluid collection. Results We found that the most common frontal sinus type is medium-sized (65.84%), followed by the small (22.89%) and large (11.26%) types, respectively. There was no significant difference between the right and left sides in terms of frontal sinus type (PP values were 0.001 and 0.015, respectively for the right, and 0.005 and 0.001, respectively for the left side). Conclusion The result obtained in this study may be considered the first step in demonstrating the clinical benefit of this classification. However, there is no doubt that further comprehensive studies with large series are needed to fully determine the clinical relevance of this newly introduced classification system.

This study was conducted to determine the association between religious belief and treatment adherence among those with mental illness. The sample size of this cross-sectional study was determined to be 255 patients diagnosed with mental illness via power analysis. A descriptive characteristics form prepared by the researcher, the Systems of Belief Inventory, and the Morisky Medication Adherence Scale were used to collect data. Patients were listed and chosen by using a simple random sampling method. This study found no significant correlation between religious belief and treatment adherence (p > .05). It was determined that treatment adherence was moderate in patients with high religious beliefs and that treatment adherence was low in patients with low religious beliefs. Religious belief was not a factor influencing treatment adherence among those with mental illness.

Background and purpose Combining intra-arterial mechanical thrombectomy (IAMT) and intravenous thrombolysis (IVT) has shown to have an excellent recanalization rate and better clinical outcome in acute ischemic stroke (AIS) patients. Hyperdense middle cerebral artery sign (HMCAS) on pretreatment non-contrast head CT scan of AIS patients is one of the early ischemic radiological findings in middle cerebral artery territory AIS. We aimed to evaluate whether the presence of HMCAS predicts the outcome of AIS patients receiving combination therapy with IAMT and IVT. Methods We retrospectively reviewed medical records and cerebrovascular images of the patients treated with IAMT and IVT for AIS in our center. Patients with occlusion in the terminal internal carotid artery or middle cerebral artery on pretreatment CT angiogram of the head were included. Clinical outcome was compared between subjects with HMCAS and those without. Modified Rankin Score (mRS) and symptomatic intracranial hemorrhage (sICH) were used as measures of efficacy and safety, respectively. Results Of 93 patients, 46 (49%) had HMCAS on their initial head CT scan. Both groups had comparable baseline characteristics and stroke severity. After adjusting for age, NIHSS score, time from symptom onset to starting IVT, and history of diabetes mellitus in multivariate logistic regression analysis, there was no difference in terms of a poor outcome (mRS >2) (OR = 0.5 [CI 0.2–1.4], p = 0.188) or rate of sICH (OR = 3.3 [CI 0.6–19.0], p = 0.190) between the two groups. Conclusions HMCAS is not a predictor of poor outcome in AIS patients receiving combination therapy with IAMT and IVT and does not affect treatment safety.

Aim: Brucellosis is an important problem all over the world. The most common form is bone-joint involvement. In this study, we planned to reveal our experiences by examining the epidemiological, clinical, laboratory and radiological features of brucellosis cases with and without bone-joint involvement.Material and Methods: This retrospective clinical study includes the data of 443 patients who were followed up with the diagnosis of brucellosis between December 2014 and August 2019. The epidemiological, clinical, laboratory and radiological findings of the patients were obtained from the patient files and hospital database. Patients were divided into two groups as with and without bone-joint involvement and their data were compared statistically.Results: A total of 443 patients who were followed up with a diagnosis of brucellosis were included in the study. 92 (20.8%) of these patients had bone-joint involvement of brucellosis (sacroileitis, spondylodiscitis, arthritis, bursitis, synovitis). Magnetic resonance imaging method was used for diagnosis in patients with bone-joint involvement. Patients with bone-joint involvement had longer duration of complaints, and acute phase reactants and agglutination titers were higher.Conclusion: Bone-joint involvement in brucellosis is very important as it may cause inadequate treatment and may end with sequelae. Radiological imaging is important in the diagnosis of bone-joint involvement, but unnecessary requests should also be avoided. Symptom duration, acute phase reactants, agglutination titer may be guiding for this., Amaç: Bruselloz tüm dünyada hala önemli bir halk sağlığı sorunudur. En fazla görülen formu kemik-eklem tutulumudur. Biz bu çalışmada kemik-eklem tutulumu olan ve olmayan bruselloz olgularının epidemiyolojik, klinik, laboratuar ve radyolojik özelliklerini irdeleyip tecrübelerimizi ortaya koymayı planladık.Gereç ve Yöntemler: Bu retrospektif klinik çalışma, Aralık 2014-Ağustos 2019 tarihleri arasında bruselloz tanısıyla takip edilen toplam 443 hastanın verisini içermektedir. Hastaların epidemiyolojik, klinik, laboratuar ve radyolojik bulguları hasta dosyalarından ve hastane veri tabanından elde edilmiştir. Hastalar kemik-eklem tutulumu olan ve olmayan olarak iki ayrı gruba ayrılıp verileri istatistiksel olarak karşılaştırıldı. Bulgular: Çalışmaya bruselloz tanısıyla takip edilen toplam 443 hasta dahil edildi. Bu hastaların 92 (%20,8)’si bruselloza ait kemik-eklem (sakroileit, spondilodiskit, artrit, bursit, sinovit) tutulumuna sahipti. Kemik-eklem tutulumu olan hastaların tümünde tanı da manyetik rezonans görüntüleme yöntemi kullanılmıştı. Kemik-eklem tutulumu olan vakalarda şikayet süresi daha uzun, akut faz reaktanları ve aglütinasyon titresi daha yüksekti.Sonuç: Brusellozda kemik-eklem tutulumu hem tedavi yetersizliğine neden olabileceğinden hem de sekelle sonlanabileceğinden oldukça önemlidir. Kemik ve eklem tutulumunun tanısında radyolojik görüntülemenin önemi büyüktür fakat gereksiz istemlerden de kaçınılmalıdır. Bunun için semptom süresi, akut faz reaktanları, aglütinasyon titresi yol gösterici olabilir.

Introduction: Systematic screening for breast cancer is performed to reduce the current mortality rate and incidence by diagnosing the patients during the early stage and asymptomatic phase of the disease. A high quality screening program may produce a long-lasting decrease in mortality only if the treatment is of an equal standard. Patients and Method: 350 patients’ medical records, including breast physical examinations, age, gender, mammography findings, number of gravidity, parity and abortion, curettage, whether or not there is systemic and endocrinological disease present and pelvic masses were analyzed retrospectively. Result: Most of the patients (91.1%) had no breast pathological findings. 2.6% of patients had fibroadenoma and 4.6% had fibrocystic breast changes exhibited through mammography. One patient was found to have a breast mass. In that patient, tru-cut biopsy revealed infiltrating ducal carcinoma. Conclusion: A multidisciplinary cancer screening program should be maintained. With such a process, the aim is to reduce the morbidity and mortality of the disease without adversely affecting the health conditions of asymptomatic individuals based on the screening. Success is brought about by the combination of individual features. [Arch Clin Exp Surg 2017; 6(1.000): 23-27]

Laboratory factors associated with hemorrhagic conversion (HC) after Intravenous thrombolysis with rtPA (IVT) for Acute Ischemic Stroke (AIS) remain nebulous despite advances in our knowledge of AIS. This study aimed to investigate the laboratory factors predisposing to HC in AIS patients receiving IVT.We retrospectively reviewed the medical records of patients who received IV tPA for AIS at our comprehensive stroke center over a 9.6-year period. Besides age, gender, NIHSS, history of diabetes mellitus (DM), history of atrial fibrillation (Afib), we gathered their laboratory data including International Normalized Ratio (INR), lipid panel, serum albumin, serum creatinine, hemoglobin A1c (HbA1c), and admission blood glucose. Post-thrombolysis brain imagings were reviewed to evaluate for symptomatic ICH (sICH). The mean values of above mentioned laboratory data were compared between the group with sICH and patients with no sICH. Univariate and multivariate logistic regression were performed to evaluate the association of the laboratory findings with presence of sICH. sICH was defined as ICH causing an increase in NIHSS ≥4.Of the 794 subjects in this study 51 (6.4%) had sICH. In the univariate analysis, patients who developed sICH had significantly higher NIHSS on admission (14.2 ± 5.4 vs 11.2 ± 6.5, p .001), LDL-cholesterol (113.3 mg/dl ±36.9 vs. 101.8 mg/dl ± 38.2, p = .032), HbA1c (6.9% ± 2.3 vs. 6.1 ± 1.3, p = .003) and lower levels of Albumin (3.5 g/dl ±0.4 vs. 3.9 g/dl ± 0.5, p .001). Furthermore, a higher prevalence of history of DM (45% vs. 21.6%, p = .020) and Afib (25.4% vs. 10.4%, p = .028) was found in subjects who developed sICH. There were no significant group differences regarding age, sex, total cholesterol, blood glucose on admission, serum creatinine or INR levels (p .05). After adjusting for multiple covariates, lower Albumin level and and higher HbA1c were significantly associated with an increased risk for sICH development (p .05). Chances of sICH increased by 33% for every 1 g/dl below a normal albumin level of 4.0 g/dl (p .05).Lower endogenous albumin level and higher HbA1c have shown to predispose to a higher risk of sICH after IVT for AIS and might be good predictors of sICH post IVT.

Background/Aim: Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition that has the potential to cause sexual dysfunction and reduction in patients’ life quality. We aimed to evaluate the quality of life and sexual function in female patients with VLS.Methods: This prospective case-control study was conducted with women who presented to the gynecology clinic with a biopsy-proven diagnosis of VLS or for routine gynecological check-ups between June 2017-January 2018. The patients were grouped according to the presence or absence of VLS. Effects of VLS on quality of life and sexual functions were analyzed with the Dermatology Life Quality Index (DLQI) and Female Sexual Function Index (FSFI) questionnaires.Results: A total of 86 women were included in this study. Thirty-seven VLS patients were compared with 49 patients without VLS. The total DLQI scores of the VLS and control groups were 6.14 (6.87) and 1.92 (2.41), respectively (P=0.001), and the total FSFI scores, 15.42 and 24.22, respectively (P

Proximal focal femoral deficiency (PFFD) is a rare congenital skeletal abnormality characterised by the partial absence of the proximal femoral segment with shortening of the entire lower extremity. It typically presents as a shortened thigh, which is flexed, externally rotated and abducted. Some other skeletal anomalies, especially fibular hemimelia, usually accompany the disorder. The diagnosis of PFFD is made in early childhood and based mainly on conventional radiography. However, the radiographic appearance of the disease evolves as the child grows. In addition, treatment procedures applied to the child affect the radiographic presentation of the disease in adulthood. Almost all cases of PFFD reported to date are in young children and in the current literature, there is a paucity of radiographic images of PFFD in mature skeleton. The aim of this case report is to present the radiographic appearance of PFFD in an adult patient and to increase awareness among radiologists about this disease.

Bouveret’s syndrome is defined as gastrointestinal obstruction due to an impacted gallstone secondary to biliary-enteric fistula. This is often observed with nonspecific symptoms such as epigastric pain, nausea, and vomiting. The diagnosis is made by visualization of pneumobilia, gastric outlet obstruction and ectopic gallstone. In this report, we discussed an elderly patient who was admitted to the emergency department with abdominal pain and vomiting without any signs of bowel obstruction in plain x-ray and ultrasound imaging. We aimed to remind the importance of clinical suspicion and the diagnostic value of computed abdominal tomography for emergency physicians.