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Objective We aimed to evaluate fetal left modified myocardial performance index and renal artery Doppler parameter in fetuses with isolated oligohydramnios and normal amount of amniotic fluid. Material and methods In a prospective cohort study, 25 pregnancies with isolated oligohydramnios and 25 healthy gestational age matched controls between 24+0 to 36+6 weeks of gestation were recruited. Primary outcome was to compare left modified myocardial performance index and mean fetal renal artery PI and secondary outcome was to compare adverse perinatal outcomes between the groups. Results Mean modified myocardial performance index was significantly higher and isovolumetric relaxation time was longer in the isolated oligohydramnios group (p=0.001, p=0.009). Mean renal artery PI values were not different between the groups. Birthweight and gestational age at birth were significantly lower (p=0.041, p=0.001), and incidences of delivery before 37 weeks and Cesarean section due to non-reassuring fetal heart rate testing were significantly higher (p=0.034, p=0.021) in women with isolated oligohydramnios than the control group. We found no significant relationship between modified myocardial performance index and adverse perinatal outcomes. Conclusion Fetuses with isolated oligohydramnios have increased left modified myocardial performance index which may be due to mild cardiac diastolic dysfunction. Increased modified myocardial performance index is not associated with adverse perinatal outcomes and does not seem to help in the management of pregnancies before 37 weeks of gestation with isolated oligohydramnios.

Aim: Covid-19 mortality rate varies according to age and the presence of chronic disease. In this study, demographic characteristics, comorbidities, presenting symptoms, physical examination findings, laboratory findings, and administered drugs of the discharged or deceased patients admitted to our hospital and hospitalized with the COVID-19 diagnosis were compared to investigate the factors that affect mortality Methods: A retrospective study was performed and included COVID-19 pneumonia patients. 390 consecutive discharged or deceased patients, who were hospitalized in our hospital between March 20 and May 20, 2020, after detection of pneumonia and diagnosis of COVID-19, were included in the study. Result: Of the 390 patients included in the study, 352 (90.25%) were discharged after recovery, while 38 (9.75%) were deceased. The average age of all the patients was 49.46±17,86, the average age of the discharged patients was 47.19±16.76, and the average age of the deceased patients was 70.42±13.7. The average age of deceased patients was significantly higher. Of all the patients, 40.8% was PCR positive Conclusion: The present study revealed that the drugs that patients take due to their comorbidities have no effect on the prognosis of the disease and that the presence of comorbidity itself is indicative of the poor prognosis. Taking into account the PCR positivity of 57.9%, even in deceased patients, we believe PCR is inadequate in the diagnosis, and CT is much more valuable in this regard.

OBJECTIVES This study aimed to evaluate cognitive function in individuals with chronic neck pain (CNP) and investigate the effects of different variables on cognition. METHODS The sociodemographic characteristics of the individuals who participated in this study were recorded. Pain intensity of the individuals was evaluated using the Visual Analog Scale, pain-related disability was evaluated with the Neck Disability Index and cognitive function was evaluated using Montreal Cognitive Assessment (MoCA). RESULTS For this study, 95 patients with CNP were recruited. The mean age was 45.61 ± 11.14, and the median MoCA score was 24 (20-26), and 64.2% of the patients scored below the original cutoff (

OBJECTIVES The incidence of pneumomediastinum (PNMD), its causes of development and its effect on prognosis in the coronavirus disease 2019 (COVID-19) are not clear. METHODS Between March 2020 and December 2020, 427 patients with real-time reverse transcriptase-polymerase chain reaction-confirmed COVID-19 admitted to the intensive care unit were analysed retrospectively. Using receiver operating characteristic analysis, the area under the curve (AUC) for initial invasive mechanical ventilation (MV) variables such as initial peak inspiratory pressure (PIP), PaO2/FiO2 (P/F ratio), tidal volume, compliance and positive end-expiratory pressure was evaluated regarding PNMD development. RESULTS The incidence of PNMD was 5.6% (n = 24). PNMD development rate was 2.7% in non-invasive MV and 6.2% in MV [odds ratio (OR) 2.352, 95% confidence interval (CI) 0.541–10.232; P = 0.400]. In the multivariate analysis, the independent risk factors affecting the development of PNMD were PIP (OR 1.238, 95% CI 1.091–1.378; P, Severe acute respiratory syndrome coronavirus 2, the cause of the coronavirus disease 2019 (COVID-19), is associated with considerable morbidity and mortality [1].

Background A malreduction or missed scaphoid fracture may lead to nonunion or avascular necrosis (AVN). The aim of this study was to analyze the radiological and clinical outcome of patients with scaphoid nonunion (SN), who were treated with 1,2-intercompartmental supraretinacular artery pedicled vascularized bone graft (1,2-ICSRA-VBG) fixed with K-wires or screws between 2014 and 2018. Methods Radiological assessment included posteroanterior, lateral, oblique, and angled posteroanterior projection. The wrist active joint range of motion was assessed with a universal goniometer, and grip and pinch strength with a dynamometer. The disabilities of the arm, shoulder and hand (DASH) questionnaire was used to evaluate functionality. Statistical analysis was performed using SPSS software (v16.0). Results A total of 68 patients (65 male) with a mean age 29.7 ± 8.5 years were evaluated in the study, and union was achieved in 55 (81%). A total of 45 (66%) patients had scaphoid waist fracture and 48 (71%) had AVN. Fixation was achieved with K-wires in 48 of the patients, and with screw in 20. The mean length of follow-up was 31.6 ± 14.6 (12–72) months. The mean radioulnar range of motion and DASH scores improved significantly after treatment (p Conclusions The findings of this study showed that scaphoid unions can be treated successfully with high rates of union using the 1,2-ICSRA-VBG. This surgical technique requires special surgical experience. The functional outcome of patients improved after treatment, although smoking was found to be an important factor affecting functional results.

Objective: Neurofibromatosis (NF) is the most common autosomal dominantly inherited neurocutaneous syndrome. The characteristic features of NF type 1 (NF-1) are café au lait spots, axillary and inguinal freckling, peripheral neurofibromas, optic pathway glioma, and Lisch nodules. The present study aimed to analyze the clinical features of children with NF-1. Materials and Methods: In this study, the children with NF-1 diagnosed and followed-up in our center between 2000 and 2020 were retrospectively evaluated. Demographic and clinical features of patients were defined. Results: The study group consisted of 52 patients. Of those, 25 were boys and 27 were girls. The children’s median age at diagnosis was 5.9 years (1-15.8). Café au lait (CAL) spots and axillary/inguinal freckling were observed in 50 and 24 patients, respectively. Neurofibroma was present in 22 cases. Ten of the cohort had optic gliomas, and 39 of them had cranial hamartomas. Orthopedic complications such as scoliosis, tibial pseudoarthrosis, and osteoporosis were observed in 13 patients. Eleven children had neurocognitive disorders. Conclusions: Early diagnosis is important in neurofibromatosis to prevent the complications of the disease. Also, neurological development and secondary malignancy follow-up should be done carefully in this group of patients.

Parkinson's disease (PD) is a neurological disease that progresses further over time. Individuals suffering from this condition have a deficiency of dopamine, a neurotransmitter found in the brain's nerve cells that is critical for coordinating body movement. In this study, a new approach is proposed for the diagnosis of PD. Common Average Reference (CAR), Median Common Average Reference (MCAR), and Weighted Common Average Reference (WCAR) methods were primarily utilized to eliminate noise from the multichannel recorded walking signals in the resulting PhysioNet dataset. Statistical features were obtained from the clean walking signals following the Local Binary Pattern (LBP) transformation application. Logistic Regression (LR), Random Forest (RF), and K-nearest neighbor (Knn) methods were utilized in the classification stage. A high success rate with a value of 92.96% was observed with Knn. It was also determined that signals on which foot and the signals obtained from which point of the sole of the foot were effective in PD diagnosis in the study. In light of the findings, it was observed that noise reduction methods increased the success rate of PD diagnosis.

Objectives: To evaluate the demographic and clinical characteristics of patients with Behcet's syndrome (BS), and to define their associations with the presence of major organ involvement (MOI).Method: Medical records of 2118 patients (964 males, 1154 females) were analysed retrospectively. MOI was defined as the presence of at least one of vascular, eye, nervous, or gastrointestinal system involvement. Univariable and multivariable binary and ordinal logistic regression analyses were applied to assess the factors that were potentially associated with MOI.Results: The mean ± sd age at diagnosis was 30.5 ± 9.4 years. Genital ulcer and joint involvement were more common in females (both p < 0.001), while MOI was more frequent in males (p < 0.001). Genital ulcer (p < 0.001) and vascular involvement (p = 0.006) were more common in patients with a younger age at diagnosis, while joint involvement was more common in older patients. A total of 1097 patients (51.8%) had at least one MOI, 322 (15.2%) at least two MOIs, and 48 (2.3%) at least three MOIs. Male gender, smoking history, and absence of genital ulcer were significantly associated with MOI in multivariable binary logistic regression. Multivariable ordinal regression analyses confirmed the association between MOI and male gender and smoking, but not the protective effect of genital ulcers. In both regression analyses, we found no significant effects of age, human leucocyte antigen-B51, skin involvement, or joint involvement on MOI.Conclusion: Male gender and positive smoking history have a significant influence on the presence of MOI in patients with BS.

In Chiari malformation, some symptoms are known to recur after decompression surgery. To our knowledge, this is the first case for symptomatic outcome after suboccipital release and stabilization exercises the patient with type 1 Chiari malformation who has experienced surgery. The present study aims to investigate the efficacy of suboccipital release and stabilization exercise training in a patient with Type 1 Chiari Malformation undergoing surgical treatment. A 47- year-old female patient with Chiari malformation received suboccipital release and stabilization exercise training for 10 weeks. Her symptomatic parameters were evaluated, such as pain, grip and pinch strength, deep cervical flexor strength, balance and gait. After the treatment, there were improvements in pain perception, the score of performance index of deep cervical muscles, grip force, static balance and gait parameters. Suboccipital oscillation and stabilization exercises are thought to be safe and effective in patients with Chiari malformation undergoing decompression surgery

We aimed to determine the parameters that affect the mortality of patients operated on for gastric cancer and to investigate whether fibrinogen affects mortality or not. This retrospective clinical study included patients who underwent surgery due to gastric adenocarcinoma between January 2011 and January 2014. Patients’ demographic data, laboratory values, (hemogram parameters, fibrinogen, albumin, and tumor markers), operations, lymph node dissections, parameters of histopathology reports, stages, mortality/survival status, metastasis status at follow-up, and admission/operation/follow-up were obtained from the hospital automation system and recorded using the statistical software. Patients were divided into two groups: deceased and survivors. Analyses were carried out to determine whether the parameters of the patients, including fibrinogen, affected survival. A total of 130 patients were included in the study. Of the patients, 91 were men and 39 were women. The mean age of the patients was 63.99 SD 11.22 years. The results of the analysis of the patients’ parameters revealed that the presence of lymphatic invasion, lymph node positivity, high metastatic lymph node ratio, and advanced stage were statistically significantly correlated with low survival (p

Objective Difficulties encountered in the diagnosis and treatment of vascular anomalies located in the extremities of the children. The most common vascular lesions are hemangiomas and venous malformations. The complex malformations, such as, Klippel-Trenaunay Syndrome are much less commonly encountered lesions. Treatment of vascular malformations are variable based on the etiology of the lesion and clinical presentation. In this study, we aimed to share our experience on the clinical features of vascular lesions in the extremities of the children. Material and methods The demographic, clinical and prognostic features of 330 children with vascular anomalies followed at IUC, Cerrahpasa Medical Faculty, Department of Pediatric Hematology and Oncology were retrospectively reviewed. Fifty-one patients with lesions >5 cm in diameter were included into the study. The diagnosis, age, sex, history of prematurity, lesion type and location, imaging and biopsy findings, complications, details of treatment, and follow-up were evaluated. Results Twenty-nine (57%) of patients were female and 22 (43%) were male. The female to male ratio was 1.3:1. The median age at admission was 15 months (10 days-180 months). Eight patients (16%) had a history of premature birth. Thirty-one patients (61%) had lesions since birth, eight lesions (8%) appeared in the first month of life and 6 (12%) occurred after 1 year of age. Sixteen of the patients (31%) had hemangioma, 11 (22%) had lymphangioma, 19 (37%) had venous malformation and 5 (10%) were diagnosed as Klippel Trenaunay Syndrome. The lesions were in the upper extremity in 21 patients (41%), in the lower extremity in 27 patients (53%), and both lower and upper extremities were affected in 3 patients (6%). Of all patients, six had intramuscular and two had intraarticular lesions. The diagnosis was made on clinical grounds in most of the cases. In 22 children Magnetic Resonance Imaging was performed for differential diagnosis and to demonstrate the infrastructure of the lesion and the extent of local infiltration. Histopathologic examination by biopsy was done in four patients. Complications developed in 19 patients as follows: Disseminated intravascular coagulation in 6, bleeding in 4, thrombosis in 3, and soft tissue infection in 6. Twenty-one patients were not given any treatment. Medical treatments were propranolol in 14 patients, sirolimus in 4 patients, propranolol and sirolimus in 5 patients. Intralesional bleomycin injection was performed in 3 children. Conclusion The diagnosis, classification and treatment of extremity located vascular malformations in children are complex. Treatment strategy should be defined as in accordance with a combination of the type of the vascular malformation, the age of the patient and the clinical picture.

OBJECTIVE Our objective was to determine if there is a difference in anxiety during urodynamics in women given lavender aromatherapy (lavender) versus placebo. METHODS This was a randomized, controlled trial of women scheduled for urodynamic testing with baseline anxiety. Participants rated their anxiety and pain immediately before the examination and then were randomized to lavender or placebo. Anxiety and pain were assessed immediately after catheter placement and 15 minutes after termination of the study. RESULTS Data for 40 women who received lavender and 38 women who received placebo were available for analysis. Decrease in anxiety from baseline to catheter placement (-2 vs -0.5, P = 0.01) and 15 minutes post procedure was significantly greater in the lavender group. Postprocedure anxiety was lower in the lavender group compared with controls (0 vs 0.5, P = 0.001). No differences were seen in pain. CONCLUSIONS Lavender aromatherapy reduces anxiety during urodynamics.

Purpose The increasing tendency of chest CT usage throughout the COVID-19 epidemic requires new tools and a systematic scheme for diagnosing and assessing the lung involvement in Coronavirus Disease 2019 (COVID-19). To investigate the use of the COVID-19 Reporting and Data System (CO-RADS) classification and chest CT Involvement Score (CT-IS) in COVID-19 pneumonia. Material and methods This retrospective study enrolled 280 hospitalized patients diagnosed with COVID-19 pneumonia in a tertiary hospital in Turkey. All patients underwent non-contrast CT chest imaging. Two radiologists interpreted all CT images according to CO-RADS classification without knowing the clinical features, laboratory findings. We used CT involvement score (CT-IS) for assessing chest CT images of COVID-19 patients. Also, we examined the relationship between CT-IS and clinical outcomes in COVID-19 patients. Results Of the patients, 111(39.6%) had positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results. CO-RADS 5 group patients had statistically significant positive RT-PCR results than the other groups (P

Background: The purpose of the current study was to investigate the presence of polycystic ovarian morphology (PCOM) in patients with ectopic pregnancy (EP) and to find out the value of sonographic appearance of ovaries on the earlier diagnosis of EP. Methods: In the current case-control study, thirty five patients with EP were re-cruited to evaluate ovarian sonographic morphology whereas 35 gestational age-matched women with healthy intrauterine pregnancy (IUP) were the controls. After ovarian sonography, ultrasound images were analyzed offline for ovarian area, ovarian volume, follicle number per cross section, and follicle distribution pattern. A questionnaire about the presence of hirsutism and menstrual irregularity prepared as well. Student's t-test or Mann-Whitney U test were used to compare continuous variables between 2 groups and categorical data were evaluated by using Chi-square or Fisher’s exact test, where appropriate. Multiple logistic regression was used to find out the risk factors for EP. Results: Mean gravidity and parity were significantly higher in the EP group com-pared to IUP group (p

Vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been rapidly developed to prevent coronavirus disease 2019 (COVID-19) pandemic. There is increasing safety concerns regarding COVID-19 vaccines. We report a 78-year old woman who was presented with tetraparesis, paresthesias of bilateral upper extremities, and urinary retention of one-day duration. Three weeks before these symptoms, she was vaccinated with CoronaVAC vaccine (Sinovac Life Sciences, China). Spine magnetic resonance imaging showed longitudinally extensive transverse myelitis (TM) from the C1 to the T3 spinal cord segment. An extensive diagnostic workup was performed to exclude other possible causes of TM. We suggest that longitudinally extensive TM may be associated with COVID-19 vaccination in this case. To the best of our knowledge, this is the first report of longitudinally extensive TM developing after CoronaVac vaccination. Clinicians should be aware of neurological symptoms after vaccination of COVID-19.

Objective: Frontline healthcare workers (HCW) exposed to coronavirus disease-2019 (COVID-19) patients at their work environment are at a higher risk of acquiring the disease. The aim of this study was to research the COVID-19 risks due to the occupational exposure of HCW and the clinical characteristics of the affected. Material and Methods: In this retrospective study, HCW, employed by The Umraniye Research and Training Hospital, who were diagnosed with COVID-19 between 20th March 2020 to 20th May 2020 were analysed. Results: A total of 128 (3.8%) HCW were diagnosed with COVID-19. Most of the infected HCW were medical staff (34%), nurses (24%), physicians (22%) and staff with no patient contact (20%). Fifty-six percent of the infected HCW were working in COVID-19 wards and out-patient clinics. Twenty-nine percent acquired the infection in hospital from an index patient and 32% of them from an infected HCW. The highest transmission was during the sharing of the same environment (53%) like offices. Thirteen per cent of the HCW took the virus during examination or treatment, 31% of the individuals were unaware of the transmission. The number of the infected HCW was higher during the beginning of the outbreak in Turkey. The symptomatic cases were more (88%) than the asymptomatic cases (12%). A total of 28 (22%) HCW were hospitalised and only 4% of the cases were severe. Conclusion: The asymptomatic COVID-19 carrying HCW are to be considered as the source of the spread of the disease among their colleagues. Stricter measures should be implemented to prevent in-hospital transmission. © 2021 by Turkiye Klinikleri.

Objective:The investigation of the epidemiological status of patients who underwent partial hip replacement is necessary by evaluating their postoperative status based on the hip score so as to examine the effect of additional diseases on postoperative recovery and survival.Methods:A total of 99 patients who underwent partial hip replacement between September 2013 and 2017 for femoral neck fracture were included in the study. Preoperative diabetes status and presence of additional diseases were examined. Harris scoring form was filled up by all patients. Osteoporosis treatment and additional fracture were evaluated at the final follow-up examination.Results:The mean age of the 99 study subjects [36 (36.4%) men, 63 (63.6%) women] of all, 18 (18.2%) patients had diabetes and 12 (12.1%) had postoperative fractures. In addition, 17 (17.2%) patients received regular osteoporosis treatment and 4 patients (4.1%) were diagnosed with malignancy from the femoral head. Additional diseases were recorded in 21 (21.2%) patients. The mean Hip Harris score of the patients was 53.62±12.71. A total of 22 (22.2%) patients died during the follow-up. Exitus was significantly lower in patients with high postoperative Harris score (p

Objective: Isolated tubal torsion in pregnancy is a rare condition we want to present this case. Case(s): In our study, we present a 23-year-old woman primigravida at 37 weeks of gestation with acute right lower abdominal pain. The clinical and Magnetic resonance imaging (MRI) findings led to diagnosis of acute appendicitis. Emergency exploratory laparotomy and cesarean section were performed. A twisted right Fallopian tube and Morgagni’s cyst was noted and right salpingectomy was performed. Conclusion: Although isolated tubal torsion during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity.

Üniversite öğrencilerinin mevcut ruhsal bozukluk semptomlarının ve bunların sosyodemografik faktörler ile olası ilişkilerinin belirlenmesi amaçlanmıştır. Kesitsel tipteki araştırmanın evrenini 2018-2019 eğitim-öğretim yılında üniversitede öğrenim görmekte olan lisans öğrencileri oluşturmaktır. Sınıf seviyesine göre tabakalandırılarak her fakülteden öğrenci sayısıyla orantılı olacak şekilde tabakalı rastgele örneklem yöntemi ile 814 katılımcı ile çalışmamız yürütülmüştür. Veriler gözlem altında katılımcılar tarafından doldurulan sosyodemografik özelliklere yönelik soru formu ve Kısa Semptom Envanteri (KSE) ile toplanmıştır. Veri analizinde Ki kare, Mann-Whitney U ve Kruskal Wallis testleri kullanılmıştır. Çok değişkenli analizde çoklu lineer regresyon kullanılmıştır. İstatiksel olarak, p

OBJECTIVES Our goal was to evaluate the prevalence of and risk factors for pneumothorax in patients with invasive mechanical ventilation in the intensive care unit (ICU) diagnosed with coronavirus disease 2019 pneumonia. METHODS The prevalence of pneumothorax was retrospectively reviewed in 107 patients diagnosed with coronavirus disease 2019 pneumonia and treated in an ICU in Turkey between 11 March 2020 and 30 April 2020. RESULTS The patients were aged 19–92 years; 37 (34.6%) were women. Pneumothorax developed in 8 (7.5%) of the intubated patients. Four (50%) of the patients with pneumothorax and 68 (68.7%) of those without it died. In the univariable logistic regression analysis of the presence of comorbid diseases (P = 0.91), positive end-expiratory pressure (P = 0.18), compliance (P = 0.93), peak pressure (P = 0.41) and the Horowitz index (P = 0.13) did not show statistically significant effects in increasing the risk of pneumothorax. CONCLUSIONS There was no significant increase or decrease in the risk of pneumothorax in patients treated with invasive mechanical ventilation after the diagnosis of coronavirus disease 2019-related pneumonia/acute respiratory distress syndrome. However, consideration of the risk of pneumothorax in these individuals may have the potential to improve the prognoses in such settings., Severe acute respiratory syndrome coronavirus 2 is associated with high rates of transmission and death [1].

Her birey yaşamı boyunca baş etmesi gereken sayısız olay ve sorunla karşı¬laşmakta ve bu sorunların çoğunun üstesinden gelmektedir. Ancak bu olaylardan bazıları, yaşamı, belirgin bir biçimde etkilemektedir. Yaşamın doğal akışı içinde kayıp ya da kayıp oluşturacak bir tehditle zaman zaman karşı karşıya kalmak ve sevilen birinin beklenmedik ölümü bu tip olaylardandır. Kayıp karşısında verilen ilk tepkiler doğal bir tepki olduğu için hastalık olarak nitelendirilmemektedir. Yas ise, değer verilen ve sevilen bir kişinin ölümünün ardından kayıp yaşayan bireylerin verdiği duygusal, bilişsel ve davranışsal tepkiler olarak nitelendirilebilmektedir. Kayıp sonucu oluşan yas süreci, yaşam döngüsü içinde karşılaşılan farklı bir durum olup yaş, cinsiyet, kültür ve daha önceki yas deneyimine bağlı olarak özgün bir biçimde deneyimlenir. Çünkü her birey benzersizdir ve bu nedenle yas bireyden bireye değişiklik gösterebilir. Yas sürecinde bulunan bireye bu faktörler göz önünde bulundurularak yaklaşım sergilenmesi önemlidir. Yaşanan kayıplar sonrası veya yas sürecinde ihtiyaç olması halinde sağlık profesyonellerince (hemşireler, doktorlar, psikologlar gibi) yardım sağlanabilmektedir. Kayıp sonrası sağlık profesyonelleri tarafından profesyonel destek sağlanmaktadır. Bu destekleyici hizmetler, problem çözmeyi, rol model olmayı, cesaretlendirmeyi, öğretmeyi ve danışmanlığı içermektedir. Yapılan çalışmalar, sağlık profesyonellerinin yas sürecini yaşayan birey ile iletişim, yas süreci ile baş etme ve kayıp yas sürecindeki bireye psikososyal yaklaşım konusunda bilgi eksikliği olduğunu göstermektedir. Bu derlemede kayıp yas yaşayan bireylerde psikososyal yaklaşımın önemini vurgulanması amaçlanmıştır.

Hastaneye başvuru sırasında herhangi bir inkübasyon bulunmayan hastada, hastaneyebaşvurusundan en az 48 saat sonra gelişen enfeksiyonlar hastane enfeksiyonu olarakadlandırılmaktadır. Hastane enfeksiyonları, hastaların hastanede yatış sürelerinin uzamasınave sağlık bakım maliyetlerinin artmasına neden olmaktadır. Ayrıca hastane enfeksiyonlarıgünümüzde önemli bir morbidite ve mortalite sebebi olarak değerlendirilmektedir. Hastaneenfeksiyonlarının oranı, yataklı hizmet kurumlarının hizmet kalitesinin bir göstergesi olarakgörülmesi nedeniyle önemlidir. Hastane enfeksiyonlarının diğer kliniklere oranla yoğun bakımünitelerinde daha fazla meydana geldiği bilinmektedir. En sık görülen hastaneenfeksiyonlarına bakıldığında ise üriner sistem enfeksiyonları, pnömoniler, bakteriyemi,kateter enfeksiyonları ve cerrahi yara enfeksiyonları görülmektedir. Literatüre bakıldığındayoğun bakım ve hastane enfeksiyonları üzerine birçok çalışma bulunmaktadır. Bu makaledeliteratürde ulaşılan yoğun bakım ünitelerinde oluşan hastane enfeksiyonları gelişmeoranlarının karşılaştırılması amaçlanmıştır. Bu amaçla hastane enfeksiyonu, üriner sistemenfeksiyonları, pnömoniler, bakteriyemi, kateter enfeksiyonları ve cerrahi yaraenfeksiyonlarına yönelik literatür taranmış ve ulaşılabilen makaleler incelenmiştir.Değerlendirilen çalışmalarda, hastanelerin yoğun bakım ünitelerinde meydana gelen hastaneenfeksiyonlarının sıklığı ve çeşitleri değerlendirilmiştir. En sık görülen hastane enfeksiyonlarısıralamasında genellikle kan dolaşımı enfeksiyonları, pnömoni, üriner sistem enfeksiyonları vecerrahi alan enfeksiyonları izlemektedir. Bunlardan yola çıkılarak, hastane enfeksiyonlarınınönlenmesinde hastane personelinin bilinçlendirilmesi, hastanelerin yoğun bakım ünitelerindeenfeksiyon kontrolü üzerinde çalışılması ve buna yönelik politikaların geliştirilmesi önerilebilir., Hospital infections are infections that develop at least 48 hours after hospital admission inpatients who do not have any incubation during the time of hospital admission. Hospitalinfections cause prolonged hospital stay and health care costs. Additionally, hospitalinfections nowadays are considered as a major cause of morbidity and mortality. The rate ofhospital infections are important as it is seen as an indicator of service quality of inpatientinstitutions. It is known that nosoinfections occur more in intensive care units than otherclinics. When looking at the most common hospital infections; urinary system infections,pneumonias, bacteremia, catheter infections and surgical wound infections are seen. Thereare many studies on intensive care and hospital infections in literature. In this article, it is aimed to compare the rates of development of hospital infections occurring in the intensive care unitsreached in the literature. For this purpose, the literature on hospital infections, urinaryinfections, pneumonia, bacteremia, catheter infections and surgical wound infections werescanned and available articles were examined. In the studies, the frequency and types ofhospital infections occurring in the intensive care units of the hospitals were evaluated. Themost common hospital infections are usually followed by bloodstream infections, pneumonia,urinary system infections and surgical site infections. Based on these, it can be recommendedto raise the awareness of hospital personnel in the prevention of hospital infections, to workon infection control in the intensive care units of the hospitals and to develop policies for this.

Objective: The purpose of this study is to evaluate the impact of loop electrosurgical excision procedure (LEEP) and cold-knife conization (CKC) active training model on the surgical education and confidence levels of gynecologists. Materials and Methods: The LEEP and CKC hands-on training model consists of sausage, which is 2.5 cm in diameter, as cervix; plastic cup as vagina; foam rubber as posterior and anterior fornices; and cotton plate as the leukoplakia area. In total, 34 participants performed LEEP and CKC procedures on the training model under the guidance of mentors after theoretical lessons about the transformation zone, indications, and surgical techniques of LEEP and CKC. Afterward, a web-based survey was conducted to measure the effectiveness of this surgical model, and participants graded their learning and confidence levels on the same. Results: We evaluated the educational levels of the course, which were based on the basic surgical steps of LEEP and CKC procedures, and the confidence levels of the participants with regard to the previous practice or expertise of LEEP and CKC. Importantly, participants in each group had similar learning gains irrespective of previous practice or expertise. Despite a significantly higher pre-course confidence level of participants who had previously performed LEEP (p

Body awareness and chronic low back pain: validity and reliability study of Turkish version of Body Awareness Rating Scale Background/aim: Previous studies reported that patients with chronic low back pain (CLBP) had trouble describing senses or body functions. A questionnaire, the Body Awareness Rating Questionnaire (BARQ), was recently developed for assessing body awareness. The aim of the study was to develop a Turkish version of the BARQ and investigate the validity and reliability in patients with CLBP. Materials and methods BARQ translated to Turkish with forward-backward method. Ninety-nine patients with CLBP and 101 healthy controls (HC) completed the BARQ-T. Fifty-one of patients with CLBP and HC repeated BARQ-T three days later. In addition to BARQ-T, Oswestry Disability Index (ODI), pain severity, Short Form 36 (SF-36) and Toronto Alexithymia Scale (TAS) were administered. Results The current study found good-excellent Cronbach's alpha values for patients with CLBP (?: between 0.883-0.967) and acceptable-good Cronbach's alpha values for HC (?: between 0.649-0.825) in factors of BARQ-T. ICC values for test-retest validity were found to be good-excellent for patients with CLBP in all factors. BARQ-T was positively correlated with SF-36 and negatively correlated with ODI and TAS (p Conclusion The study confirmed that the BARQ-T has acceptable validation and reliability in terms of pain perception and pain assessment in the Turkish CLBP community.

Amaç: Kolorektal tümörlere bağlı akut sol kolon tıkanıklığı bulguları gösteren olgularda acil koşullarda uygulanan rezeksiyon primer anastomoz sonuçlarının değerlendirilmesi ve bu sonuçların Hartmann Prosedür uygulanan hastaların sonuçlarıyla karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Ağustos 2005-Mart 2011 tarihleri arasında Ankara Numune Eğitim ve Araştırma Hastanesi Acil Cerrahi Servisi’ne yatış yapılan kolorektal kansere bağlı akut sol kolon obstrüksiyonu nedeniyle ameliyat edilen 84 hasta çalışmaya alındı ve retrospektif olarak incelendi. Hastaların tümü acil serviste değerlendirilip acil ameliyathanede opere edilmiştir. Hastaların tedavisinde Hartmann kolostomi ve rezeksiyon primer anastomoz cerrahi prosürleri kullanıldı. Barsak temizliği yapılmadan operasyona alındı ve intraoperatif rezeksiyon sonrası tüm hastalara manuel dekompresyon yapıldıktan sonra ya rezeksiyon primer anastomoz ya da Hartmann Prosedür yapıldı. Bulgular: Stoma açılan grupta postoperatif yoğun bakım ihtiyacı olan hasta sayısı 25, ventilatör ihtiyacı olanların sayısı 16, stoma revizyonu yapılan hasta sayısı 3 idi. Kardiyopulmoner morbidite sayısı 10, reoperasyon 9, mortalite sayısı 13 olarak saptandı. Anastomoz yapılan grupta ise postoperatif yoğun bakım ihtiyacı olan hasta sayısı 13, ventilatör ihtiyacı olanların sayısı 4’tü ve anastomoz yapılanların 2’sinde anastomoz kaçağı olduğu görüldü. Yeniden operasyona giren hasta sayısı 2 idi, mortalite sayısı 5 olarak saptandı. Her iki grup arasında postoperatif yoğun bakım ihtiyacı, ventilatör ihtiyacı, reoperasyon ve mortalite açısından p değerleri

The aim of this analysis was to study the postnatal short-term outcome of cases with aneurysmal septum primum (ASP) and non-restrictive foramen ovale in otherwise structurally normal hearts. This is a retrospective review of fetuses with ASP referred between 2016 and 2018 to the University Hospital of Cerrahpasa, Department of Fetal Cardiology for cardiac scanning. Prenatal and postnatal clinical features and outcomes for each case were ascertained from the departmental database and from individual clinical hospital records. We presented twenty-four cases which also had postnatal echocardiographic examination in our hospital. At the time of diagnosis of ASP, the mean maternal age was 31.1 ± 5.7 years, the mean gestational age was 28.9 ± 5.9 weeks, the mean birth week was 37.4 ± 3.1 weeks, and the mean birth weight was 2940.8 ± 736.6 g. The postnatal first 3 months prevalences of atrial septal aneurysm, patent foramen ovale and, secundum atrial septal defect (ASD) were 12.5%, 12.5%, 20.8% among fetuses with ASP, respectively. ASP may persist after birth and may increase the frequency of secundum ASD. These data suggest that fetuses with ASP should be followed by a pediatric cardiologist in postnatal life.

AASLD - TASL Connect Regional Meeting -- MAR 15-16, 2019 -- Istanbul, TURKEY WOS:000535263200004 PubMed: 32412901 Background/Aims: mbitasvir/paritaprevir/ritonavir (OMV/PTV/r) +/- dasabuvir (DSV) +/- ribavirin (RBV) combination has demonstrated excellent rates of sustained virologic response (SVR) and a very good safety profile in patients with the chronic hepatitis C virus (HCV) genotype 1 or 4 infections. We aimed to investigate the effectiveness and safety of OMV/PTV/r +/- DSV +/- RBV combination regimen in a real-world clinical practice. Materials and Methods: Data from HCV genotype 1 and 4 patients treated with OMV/PTV/r +/- DSV +/- RBV (n=862) in 34 centers across Turkey between April 1, 2017 and August 31, 2018 were recorded in a large national database. Demographic, clinical, and virologic data were analyzed. Results: The mean age of the patients was 55.63, and 430 patients (49.9%) were male. The majority had HCV genotype 1b infection (77.3%), and 66.2% were treatment-naive. Non-cirrhosis was present at baseline in 789 patients (91.5%). SVR12 rate was 99.1% in all patients. Seven patients had virologic failure. No significant differences were observed in SVR12 according to HCV genotypes. HCV RNA was undetectable at treatment week 4 in 90.9%, at treatment week 8 in 98.5%, and at the end of treatment (EOT) in 98.9%. SVR12 ratio was significantly higher in the non-cirrhotic patients compared to that in the compensated cirrhotic patients. Rates of adverse events (AEs) in the patients was 59.7%. Conclusion: The present real-life data of Turkey for the OBV/PTV/r +/- DSV +/- RBV treatment of patients with HCV genotype 1b, 1a, or 4 infection from 862 patients demonstrated high efficacy and a safety profile. AASLD, TASL

Background/aims An anal fissure (AF) is a linear tear in the distal anal canal and is one of the most common causes of anal pain. Hemorrhoidal disease (HD) is a symptomatic growth and distal displacement of normal anal cushions. Numerous studies have addressed the contributing factors of these conditions, yet the results remain controversial. In this study, we hypothesize that increasing patients' awareness of hidden risk factors could reduce the rate of HD and AF. Materials and methods A questionnaire-based controlled study was planned. After power analysis, patients with HD (n=60) and AF (n=60) were enrolled consecutively into the study group and compared with the control group (n=60) of healthy individuals. The survey was designed to assess the participants' toilet and dietary habits and anxiety risk. Odds ratios were calculated and a binary logistic regression model was constructed to identify associated factors. Results Hard stools, spending more than 5 minutes in the toilet, frequent straining during defecation, and increased spice intake were more frequent in the patients with HD; and hard fecal consistency, time elapsed in toilet greater than 5 min, straining during defecation, and high anxiety risk were more frequent in the patients with AF as compared to the control group (p Conclusion Possible associations were identified between habitual factors or conditions (i.e., fecal consistency, the time elapsed in the toilet, straining during defecation) and anxiety and benign anorectal diseases (i.e., HD and AF). Patients should be advised about these hidden threats.

IntroductionPrevious studies have suggested that metformin use may enhance the therapeutic effect of progestin therapy for endometrial hyperplasia or malignancy. However, it is not known how the impact of concurrent metformin may be altered by route of progestin therapy, either locally via an intrauterine device or systemically. This study examined the effectiveness of concurrent metformin use and progestin therapy for women with complex atypical hyperplasia stratified by progestin route (systemic vs local).MethodsThis single-institution retrospective study examined consecutive women with complex atypical hyperplasia who received progestin therapy from 2003 to 2018. Time-dependent analyses for complete response rate were performed comparing concurrent metformin users versus non-users in the oral progestin group and in the levonorgestrel-releasing intrauterine device group.ResultsAcross the study cohort (n=245), there were 137 (55.9%) women who responded to progestin therapy. In the oral progestin group (n=176), the median age and body mass index were 36 years and 37.7 kg/m2, respectively. 36 (20.5%) of women on oral progestins also took metformin. After controlling for diabetes status, women taking both oral progestins and metformin had a complete response rate similar to those not taking metformin (6 month cumulative rates, 23.1% vs 27.8%, adjusted hazard ratio (aHR) 0.71, 95% confidence interval (95% CI) 0.36 to 1.41). In the levonorgestrel-releasing intrauterine device group (n=69), the median age and body mass index were 35 years and 39.9 kg/m2, respectively. There were 15 (21.7%) women who took metformin in addition to the levonorgestrel-releasing intrauterine device. After controlling for diabetes status, women who had the levonorgestrel-releasing intrauterine device and took metformin had a significantly higher complete response rate compared with those not taking metformin (6 month cumulative rates, 86.7% vs 58.9%, aHR 2.31, 95% CI 1.09 to 4.89).ConclusionIn a predominantly obese population, concurrent metformin may possibly offer treatment benefit when used with the levonorgestrel-releasing intrauterine device.

The aim of this study was to investigate whether receiving a clinical diagnosis of interstitial cystitis (IC) or bladder pain syndrome (BPS) improves patients' symptoms, health-related quality of life (HRQOL), or ability to cope with their symptoms.In this cross-sectional study, participants with self-reported IC/BPS completed an online questionnaire recalling their perceived change in symptoms after diagnosis and treatment. The questionnaire included demographic information, overall HRQOL measured on a visual analog scale (VAS), O'Leary-Sant Interstitial Cystitis Problem Index, the Urinary Impact Questionnaire, and questions regarding patient beliefs about diagnosis. HRQOL and symptom impact scales were compared before and after diagnosis and treatment. Demographic data, symptom data, and beliefs were examined for correlation with improvement in quality of life after diagnosis.A total of 1052 participants initiated the survey and were included in the analysis; most of them identified as female, non-Hispanic, and white (90%). Before symptom onset, median VAS HRQOL score was 87 (interquartile range [IQR], 77-95). Median scores nadired at 34 (IQR, 20-59) after symptom onset before diagnosis, but improved to 61 after diagnosis and treatment (IQR, 38-74; all P0.001). Scores remained stable after diagnosis and initiation of treatment with a median score of 65 at the time of survey (IQR, 37-80; P0.05). Age, insurance type, and improvement in scores on the symptom impact scale predicted improvement in HRQOL after diagnosis and treatment in the multivariable model.Participants reported improvements on global and symptom-specific quality of life measures after diagnosis and treatment for IC/BPS.

This study aimed to examine complementary and alternative medicine (CAM) use among patients with ankylosing spondylitis (AS) who had or who had not received treatment with biological agents; the study also aimed to determine the types of CAM methods used by these patients. This is a comparative and cross-sectional study. This research was conducted at a rheumatology outpatient clinic of a university hospital in Turkey. A total of 120 patients who had (n = 60) and had not (n = 60) received therapy with biological agents participated in this study. A patient identification form and a questionnaire prepared by the researchers were used to collate the study data. This study found that the most commonly used method among patients who did not receive biological therapy was thermal facilities, at a rate of 28.3%; and that the most commonly used method among patients who did receive biological therapy was the use of thermal facilities, at a rate of 25%. No significant difference was found between patients who had received and patients who had not received biological therapy in terms of age and disease duration. Information was provided by health professionals to the patients concerning frequently used CAM modalities.

Purpose: The aim of this study was to investigate the relationship between serum dynamic thiol-disulfide homeostasis (TDH) and sepsis, in adult patients.Materials and Methods: In this observational, prospective, case-control study patients (n=44) diagnosed with sepsis compared with ages and gender-matched healthy controls (n=44). Patients were divided into two subgroups (survivors and non-survivors) dependent variable being remaining alive on the 28th day after ICU admission at the follow-up period. TDH parameters measured using a novel automatic and spectrophotometric method and compared statistically.Results: In patients with sepsis, native thiol, total thiol, and disulfide levels were lower than the control group, and this difference was statistically significant. TDH parameters between surviving and non-surviving patients were similar at the sepsis diagnosis. However, significant differences found in native and total thiol levels at follow-up via repeated measurement analyses on days 3 and 7 in surviving and non-surviving sub-groups. Conclusion: This study showed that impairment in dynamic TDH in adults with sepsis may be related to negative outcomes.

Objective: The effects of alpha lipoic acid (ALA) and its possible mechanisms in treating Primary ovarian failure (POF) model was studied with 4 vinylcyclohexene diepoxide (VCD). Material and methods: Rats were divided into 4 groups (n = 7) as Control, VCD, VCD + ALA and ALA. POF model was induced by applying VCD intraperitoneally and ALA was administered by oral gavage as 100 mg/day to the VCD + ALA and ALA groups. Results: At the end of 42 days, ovarian and uterine tissues were received. The number of primordial and primary follicles were increased and corpus luteum and cystic follicles were decreased in ovarian tissues in VCD + ALA group compared to VCD group. Caspase-3 immunoreactivity in follicular cells was decreased in VCD + ALA group compared to VCD group. eNOS immunoreactivity and eNOS levels were decreased in VCD group and increased in VCD + ALA group while iNOS immunoreactivity and iNOS levels were increased in VCD group, decreased in VCD + ALA group in ovary and uterine tissue. Plasma FSH and LH hormone levels were increased in the VCD but decreased in VCD + ALA group. Estradiol level decreased in the VCD group compared to the other groups. The MDA values were significantly increased in the VCD + ALA group compared to VCD group. In addition, the levels of GSH values were decreased in VCD + ALA group compared to VCD group. Conclusion: Alpha lipoic acid treatment of rats with VCD-induced POF had a beneficial effect on reducing ovarian damage by improving histological, immunohistochemical, hormone level and oxidative stress markers. Our results show that ALA is an effective treatment of VCD-induced POF rats. Keywords: Alpha lipoic acid, Infertility, Ovarium, Primary ovarian failure, Uterus

Introduction: Although childhood trauma is a major cause of morbidity and mortality, the incidence of spinal trauma is significantly lower in children than in adults. Existing studies on pediatric spinal trauma (PST) largely concern cervical trauma because of its frequency of incidence. We aimed to obtain more information by examining all types of spinal trauma, and evaluating factors such as age, trauma type, injury type, and American Spinal Injury Association score and comparing them with data from the literature. Methods: We retrospectively reviewed 30 pediatric trauma patients with spinal pathology confirmed by spinal imaging. Results: The mean age was 166.4 months. Mean age for each mechanism of injury was: 142.7 months for a simple fall, 149.0 months for injury involving a foreign object, 163.5 months for a fall from a height, and 181.6 months for traffic accidents. There was no statistically significant difference in mean age for different mechanisms of injury (p = 0.372). The levels of the spinal injuries were: lumbar 53.3% (16), thoracic 26.6% (8), and cervical 20.0% (6). Mean age for each level of spinal injury was 113.3 months for the cervical area, 172.2 months for the thoracic area, and 183.3 months for the lumbar area. Mean age was found to be statistically significant (p = 0.000). Discussion: PST is uncommon and the type of trauma and the spinal level affected varies with age. Cervical trauma predominates at younger ages, but adult-like traumas begin to occur with increasing age. It should be considered that the risk of developing neurological deficits is higher in pediatric patients than in adults, and the risk of multisystem injury is also high.

Tıbbi beslenme tedavisine uyum çoğu hastanın uyumluluk, kısmen uyumluluk ve uyumsuzluk arasında yer değiştirdiği dinamik bir süreçtir. Sağlık çalışanları çoğu zaman uyum sözcüğünü kullansalar da, doğru terminoloji hakkında çeşitli tartışmalar mevcuttur. Beslenme tedavisine uyumu tanımlamada üç terim kullanılmaktadır. Beslenme tedavisine uyum (compliance) diyetisyenlerin önerilerine hasta davranışlarının ne ölçüde uyduğudur. Diyetisyenlerin talimatlarına riayet etme veya itaat anlamına gelir. Bu terim içerisinde negatif anlamı barındırmaktadır. Zorlama ve utancı kapsar. Beslenme tedavisine bağlı kalma (adherence), diyeisyenlerin hasta veya ailesi tarafından kabul edilmiş önerilerine hasta davranışlarının ne ölçüde uyduğudur. Beslenme tedavisine bağlılık ve sadakati içerir. Yargısal olmayandır. Beslenme tedavisinde ahenkli çalışma ise (concordance) hastanın inançlarına ve alışkanlıklarına saygı gösterecek şekilde, hasta ve diyetisyen arasındaki uzlaşmadan sonra ulaşılan anlaşma olarak tanımlanmıştır. Diyabette beslenme tedavisine uyumu ölçen tek parametre bulunmamaktadır. Diyabetle yaşayan bireylerin öneri ve tedavilerine ölçümü gösteren tanımlamalara gerek vardır. Beslenme tedavisine uyum konusunda hastalar desteklenmeli suçlanmamalı, sağlık çalışanları da uyumu arttırma konusunda eğitilmelidir.

The aim of the study was to investigate whether serum hypoxia-inducible factor-1alpha (HIF-1α), hepcidin and interleukin-6 (IL-6) concentrations differed between threatened preterm labour (TPL) and uncomplicated pregnancies. This study was conducted on 54 women with TDL pregnancies and 26 healthy pregnant women. The TPL group was further divided into two subgroups according to the gestational age at delivery. Patients who gave birth within 48-72 h after the hospitalisation were referred to as preterm delivery (PD) and who gave birth at ≥37 weeks were referred to as term delivery (TD). Maternal levels of serum HIF-1α, hepcidin and IL-6 were measured with the use of enzyme-linked immunosorbent assay kits. The mean maternal serum HIF-1α, hepcidin and IL-6 levels of PD were significantly higher than TD (

The aim of this study is to evaluate the variability of selecting the ultrasound features used in American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and in assigning the ACR-TIRADS level in a single center among radiologists and radiology residents. The study cohort consisted of 108 thyroid nodules in 102 patients who had definite cytology results after thyroid fine needle aspiration biopsy (Bethesda category II, VI) or surgery. Seven observers including 3 radiologists and 4 radiology residents evaluated the nodules according to 5 ultrasound feature categories. The evaluation process was performed after a joint meeting session, in which the "white papers" of the ACR-TIRADS committee were discussed regarding the thyroid ultrasound reporting lexicon, and final TIRADS system. Variability of ultrasound features and assigning ACR-TIRADS level was measured using Fleiss kappa statistics. Agreement for ultrasound features was "substantial" to "almost perfect" among all observers, with composition (κ = 0.86), macrocalcification (κ = 0.89) and peripheral calcification (κ = 0.92) at the highest level of agreement. The level of agreement for large comet tail artifacts and punctate echogenic foci was "moderate" in residents, whereas in radiologists, that level was "substantial." The agreement for assigning ACR-TIRADS level was moderate in resident as well as in radiologist subgroup. Agreement of thyroid ultrasound features was "substantial to almost perfect" among all observers. Although the level of agreement among resident group decreased to "moderate" level, ACR-TIRADS is a useful system in thyroid nodule management.

Background Shift workers have risks associated with metabolic syndrome and low sleep quality. Aims This study aimed to examine metabolic syndrome and sleep quality in firefighters and mine workers working shifts and daytime hours. Methods A comparative descriptive study was conducted in two institutions on firefighters and mine workers (n = 120) who were working shifts (n = 84) and working daytime hours (n = 36). The data were obtained using a questionnaire including socio-demographic information, anthropometric measurements and the Pittsburgh Sleep Quality Index. Results When risk of metabolic syndrome was compared with sleep quality, it was found that according to International Diabetes Federation criteria, 11% of those diagnosed with metabolic syndrome among shift-working firefighters and 5% of those diagnosed with metabolic syndrome among shift-working miners had low sleep quality. It was found that according to the National Cholesterol Education Program-Adult Treatment Panel III criteria, 9% of those diagnosed with metabolic syndrome among shift firefighters and 2% of those diagnosed with metabolic syndrome among shift miners had low sleep quality. Conclusions Preventive measures should be taken to reduce the risk of metabolic syndrome in shift workers.

The purpose of this study was to investigate the rate of concordance between indirect- and direct laryngoscopy and final pathology in patients undergoing laryngeal microsurgery.Retrospective case study.This study was conducted in the Otolaryngology clinic of a tertiary center between January 2017 and June 2020. Archives records of 432 patients, who underwent laryngeal microsurgery because of benign and premalignant lesions or malignancy, were examined. The patients were divided into three subgroups according to pathology results: benign lesions, premalignant lesions, and malignancies.There were 400 laryngeal lesions from 385 patients, that met the inclusion and exclusion criteria, 307 (79.7%) were male and 78 were (20.3%) female. The average age of patients was 52.88 ± 13.21 years. The most common diagnosis was polyp (34.25%) followed by squamous cell carcinoma (27.75%) and Reinke's edema (8.25%) according to final pathology. For the benign laryngeal lesions, a high correlation level was observed regarding the compatibility of the indirect- and direct laryngoscopy diagnosis, and final pathology (P0.001). The laryngeal premalignant lesions and malignancies were significantly more common in older age and male gender (P0.001). Similarly, smoking usage was more frequent in patients with premalignant lesions and malignancy (P0.001). The neutrophil count, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, neutrophil to platelet ratio as well as CRP value were significantly higher in malignancy group (P0.05). On the other hand, lymphocyte ratio was smaller in the malignancy group compared with the benign and premalignant lesions, and this difference was significant (P = 0.016).Our study demonstrated a high rate of agreement between the clinical diagnosis and pathology results in patients with benign laryngeal lesions, in contrast to premalignant lesions and malignancies. Also, the neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, neutrophil to platelet ratio as well as CRP were shown to be increased in patients with laryngeal malignancies.

Amaç: Kronik obstrüktif akciğer hastalığı olan yaşlı kadın ve erkek bireylerde kuadriseps kas kuvveti ve kinezyofobinin sağlıkla ilgili yaşam kalitesi üzerine etkilerinin incelenmesi amaçlanmıştır.Gereç ve Yöntem: Bireylerin sosyodemografik bilgileri kaydedildikten sonra, ağrı durumu için Vizüel Analog Skalası (VAS), dispne için modifiye Medical Research Council Skalası (mMRCS), kinezyofobi için TAMPA ölçeği (TKÖ), sağlıkla ilgili yaşam kalitesi için Saint George Solunum Anketi (SGSA) ve quadriceps kas kuvvetini ölçmek için manuel dinamometre kullanıldı.Bulgular: Kırk beş katılımcının 17’si (37.8%) kadındı. Kadınların yaş ve vücut kütle indeks ortalaması sırasıyla 71.59±4.84 yıl, 28.75±6.71 kg/m2, erkeklerin yaş ve vücut kütle indeks ortalaması sırasıyla 72.14±5.66 yıl, 26.53±3.91 kg/m2 idi. Kinezyofobi ortalamaları kadın ve erkelerde sırasıyla 47.47±7.40 ve 41.89±7.65, SGSA(Semptom) skorları kadın ve erkeklerde sırasıyla 75.97±15.87 ve 63.89±18.54 idi. Yapılan istatistik analizde kadın ve erkeklerde, kinezyofobi ve SGSA(Semptom) arasında anlamlı fark olduğu gözlendi (p0.05). Sonuç: KOAH’lı yaşlı bireylerde kinezyofobi yaşam kalitesini etkileyen önemli bir faktör olup, yaşam kalitesini arttırabilmek amacıyla fiziksel aktivitenin arttırılması, fizyolojik, emosyonel iyilik halinin takibi tavsiye edilmektedir., Objective: The aim of this study was to investigate the effects of quadriceps muscle strength and kinesiophobia on health-related quality of life in elderly women and men with chronic obstructive pulmonary disease.Methods: After recording the socio-demographic information of individuals, the Visual Analogue Scale (VAS) for pain status, the modified Medical Research Council Scale (mMRCS) for dyspnea, TAMPA Scale for Kinesiophobia (TSK), Saint George Respiratory Questionnaire (SGRQ) for health-related quality of life, and manual dynamometer were used to measure for muscle strength of quadriceps.Results: Seventeen (37.8%) of the 45 participants were female. The mean age and body mass index of females were 71.59±4.84 years and 28.75±6.71 kg/m2, respectively. Kinesiophobia averages were 47.47±7.40 and 41.89±7.65 in women and men, respectively, and SGRQ(Symptom) scores were 75.97±15.87 and 63.89±18.54 in women and men, respectively. Statistical analysis showed that there was a significant difference between men and women between kinesiophobia and SGRQ(Symptom) (p0.05). Conclusion: In elderly individuals with COPD, kinesiophobia is an important factor affecting the quality of life and is recommended to increase physical activity, and monitor the physiological, emotional well-being in order to improve quality of life.