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Ocular hypertension (OHT) is a clinical entity characterized by elevated intraocular pressure (IOP) without optic nerve damage. In the presence of other risk factors, OHT may progress to glaucoma. This study aimed to evaluate ocular blood flow (OBF) and choroidal thickness (CT), which may be markers and/or risk factors that could assess the progression of OHT to glaucoma. Age and gender matched 60 eyes of 32 patients with OHT and 61 eyes of 31 control patients were included for this study. All participants underwent a detailed ophthalmological examination including best-corrected visual acuity, IOP measurement with Goldmann applanation tonometry, gonioscopy, optic nerve evaluation with 78 D lens, and visual field test with Humphrey visual field analyzer. Retinal nerve fiber layer, ganglion cell complex, and central corneal thickness measurements were performed by optical coherence tomography (OCT). CT was measured with OCT in the fovea, 1.5 mm, 2 mm, 2.5 mm nasal and temporal to the fovea and from nasal and temporal to the optic disk. OBF data including peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI) and pulsatility index (PI) were measured with color Doppler imaging (CDI) from the ophthalmic artery (OA), central retinal artery (CRA), medial and lateral branches of short posterior ciliary arteries (MPCA, LPCA). Systolic (SBP) and diastolic arterial blood pressure were also noted. CT measurement at each point in the OHT group compared to the control group were found to be significantly thinner (p = 0.001). There was a decrement in CT from the fovea to the nasal and temporal retina in both groups. In the OHT group, there was a significant decrease in PSV and EDV of OA, CRA, MPCA, and LPCA, and a significant increase in PI and RI of measured arteries. (EDV p = 0.036, PI p = 0.006, RI p = 0.006 for OA and p = 0.001 for other arteries and all OBF measurements). There was a negative correlation between CT and age, IOP and axial length (AL) in OHT group (r = − 0.529, p = 0.001; r = − 0.258, p = 0.047; r = − 0.345, p = 0.007, respectively, for fovea). But there was no statistically significant correlation between CT and other measurements in the control group, except age (r = − 0.860 p = 0.001 for fovea). We found that OBF decrement and choroidal thinning in OHT group compared with controls. Interpretation both of CT measurements with OCT and OBF parameters with CDI and new imaging technologies may help to prevent and reduce the possible optic nerve damage.

Gastic cancer is a life-threatening malignancy in the world. The aim of this study was to investigate the clinical significance of the prognostic nutritional index (PNI) as a guiding marker for gastric cancer patients with laparoscopic gastrectomy. We retrospectively examined the medical records of 138 gastric cancer patients who had adenocarcinoma pathological diagnosis and operated laparoscopically. Patients were divided into two groups (survived and death) and these groups were compared with clinical and laboratory parameters results. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm

We planned this experimental study to investigate the effect of carbamazepine (CMZ) on the endometriotic implants. Rats were randomised into four groups after endometriosis surgery. Drinking water was given to the sham group, 0.2 mg/kg oestradiol valerate (EV) to the EV group, 100 mg/kg/day CMZ to the CMZ group, and 0.2 mg/kg EV and 100 mg/kg/day CMZ to the EV-CMZ group. The endometrium of the rats using CMZ stained more intensely with cytochrome P450-3A4 (CYP3A4) enzyme. No endometrial hyperplasia was found in these rats. Endometriotic implants weight was found to be higher in these rats. There was no difference between the groups in terms of staining of the endometriotic implants with CYP3A4 enzyme. Endometriotic implants were less stained with the CYP3A4 enzyme than the endometrium. According to our results, CMZ does not increase the destruction of oestrogen in the endometriotic implants, unlike the endometrium. It may even cause the lesion to enlarge.Impact statementWhat is already known on this subject? Endometriosis is an oestrogen-dependent, progressive disease. Carbamazepine (CMZ) is known to increase oestrogen degradation by activating the cytochrome P450-3A4 (CYP3A4) enzyme. CMZ can be used in the treatment of endometriosis because it increases oestrogen breakdown in tissues.What do the results of this study add? CMZ can protect the endometrium against hyperplasia by increasing the amount of CYP3A4 enzyme in the endometrium. This effect could not be demonstrated in the endometriotic implants. The presence of CYP3A4 enzyme less in the endometriotic implants than in the endometrium may explain this situation. In addition, the fact that CMZ does not increase the enzyme in the endometriotic implants may contribute to this situation.What are the implications of these findings for clinical practice and/or further research? CMZ may not be a suitable alternative in the treatment of endometriosis. However, it may protect against endometrial hyperplasia. Clinical studies are needed for this effect.

Background: It is a challenging question, especially in bariatric surgery (BS), whether antibiotic prophylaxis is necessary in all cases; considering the serious consequences of surgical site infec...

Carbamazepine (CMZ) increases estrogen metabolism by inducing cytochrome P450 (CYP3A4). We investigated whether CMZ is protective against endometrial hyperplasia (EH). We used 32 female Wistar albino rats divided into four equal groups: the control group received drinking water, the estradiol valerate (EV) group was given EV, the CMZ group was given CMZ, and the EV + CMZ group was given both EV and CMZ. After 30 days the uteri of the rats were removed and serum estrogen and progesterone levels were measured, and endometrial tissue characteristics were evaluated. CYP3A4 expression was assessed using immunohistochemistry. Serum estrogen levels were lowest in the EV group and highest in the CMZ group. Serum progesterone levels were similar among all groups. Glandular density, a proxy measure of EH, was highest in the EV group and lowest in the EV + CMZ group. EH was detected in six of eight rats (75%) in the EV group and two of eight rats (25%) in the EV + CMZ group. Immunohistochemical staining revealed no significant difference in CYP3A4 expression among the four groups. CMZ reduced the negative effect of high dose estrogen that is not balanced by progesterone on the endometrium in rats. The effect likely is probably due to the CYP3A4 enzyme activator effect. CMZ may be protective against EH in high risk women, although confirmation is required.

The aim was to investigate the association of the delivery mode and vertical transmission of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) through the samples of vaginal secretions, placenta, cord blood, or amniotic fluid as well as the neonatal outcomes. This cross‐sectional study presents an analysis of prospectively gathered data collected at a single tertiary hospital. Sixty‐three pregnant women with confirmed coronavirus disease 2019 (COVID‐19) participated in the study. Vertical transmission of SARS‐CoV‐2 was analyzed with reverse transcriptase‐polymerase chain reaction (RT‐PCR) tests and blood tests for immunoglobulin G (IgG)–immunoglobulin M (IgM) antibodies. All patients were in the mild or moderate category for COVID‐19. Only one placental sample and two of the vaginal secretion samples were positive for SARS‐CoV‐2. Except for one, all positive samples were obtained from patients who gave birth by cesarean. All cord blood and amniotic fluid samples were negative for SARS‐CoV‐2. Two newborns were screened positive for COVID‐19 IgG–IgM within 24 h after delivery, but the RT‐PCR tests were negative. A positive RT‐PCR result was detected in a neof a mother whose placenta, cord blood, amniotic fluid, and vaginal secretions samples were negative. He died due to pulmonary hemorrhage on the 11th day of life. In conclusion, we demonstrated that SARS‐CoV‐2 can be detectable in the placenta or vaginal secretions of pregnant women. Detection of the virus in the placenta or vaginal secretions may not be associated with neonatal infection. Vaginal delivery may not increase the incidence of neonatal infection, and cesarean may not prevent vertical transmission. The decision regarding the mode of delivery should be based on obstetric indications and COVID‐19 severity.

Background/Aim: Physical activity during pregnancy assumes an important role in the health of both the pregnant and newborn. Our study aims to evaluate the effects of Pilates workouts on labor and newborn outcomes.Methods: This retrospective case control study was conducted with the nulliparous pregnant women admitted to our obstetrics clinic. We evaluated the effects of a Pilates workout program for 70-80 minutes per day, once a week for eight weeks, on the labor and newborn outcomes. We defined the labor outcomes as the type of delivery and the gestational age at delivery and the newborn outcomes as one-minute (APGAR-1) and five-minute Apgar scores (APGAR-5).Results: The incidences of episiotomy, vacuum-assisted vaginal delivery, and cesarean section (CS) were significantly lower in pregnant women who participated in Pilates workouts (P

Natural orifice specimen extraction (NOSE) is an emerging technique usually preferred for colorectal resections or cholecystectomy. NOSE following laparoscopic liver resections is limited to case reports, and there is no previous study comparing the outcomes of NOSE and transabdominal (TA) specimen extraction. Our aim was to compare NOSE and TA specimen extraction methods following laparoscopic minor hepatectomy. Thirty-one patients undergoing laparoscopic minor hepatectomy between 2014 and 2020 were evaluated. The patients were divided into two groups as NOSE (n: 12) and TA (n: 19). The patients’ demographics, preoperative and postoperative findings, pain, and cosmetic scores were compared. Female ratio was higher in the NOSE group (83.3% vs 31.6%, p=0.005); other demographics were similar. The median length of incision was 6 cm in the TA group but only trocar incisions in the NOSE group. There was no difference between intraoperative and postoperative findings except pain and cosmetic scores. Pain scores on postoperative days 1, 2, and 3 and in total were lower in the NOSE group (4.1±0.6 vs. 5.6±1.1, p=0.001; 2.2±04 vs. 4.1±0.9, p

Granulomatous skin disorders are a heterogeneous group of disorders characterized by granuloma formation on histopathology. They may be triggered by various stimuli, including infectious and non-infectious stimuli (foreign bodies, malignancy, metabolites, and chemicals), of different etiological origins. Although pathophysiological mechanisms are still poorly understood, infectious granuloma formation may occur if the patient’s immune system could not eliminate an agent. Clinically, localized or disseminated infectious granuloma formation can be related to the infectious agent’s pathogenicity or the patient’s immunity. Typical infectious agents causing infectious granulomatous reactions are mycobacteria, fungal infections, or parasites, such as leishmaniasis. This review aims to summarize granulomatous skin diseases encountered more frequently in our clinical experience because of infectious causes.

Ziel des im Rahmen der Initiative GBA-Forschungspartnerschaften Mineralrohstoffe durchgefuhrten Projektes „MRI_LossLehm“ war die Einteilung und Beschreibung von Loss- und Losslehmvorkommen der klassischen Lossgebiete im osterreichischen Alpenvorland und im Wiener Becken nach rohstoffgeologischen Gesichtspunkten. Den Ausgangspunkt dafur bildeten granulometrische, gesamtmineralogische, tonmineralogische und chemische Analysen von uber 770 an der Geologischen Bundesanstalt vorliegenden Proben, die in einem interdisziplinaren Ansatz ausgewertet wurden. Neben der Erfassung der Analysen in einer Geodatenbank lag der Arbeitsschwerpunkt auf der Anwendung unterschiedlicher statistischer Methoden fur Kompositionsdaten sowie der Bewertung deren Aussagekraft hinsichtlich Qualitatssicherung, Gliederungs- und Prognosemoglichkeiten. Die Einflusse von Faktoren wie klimatische, geomorphologische und stratigraphische Position auf die Rohstoffqualitat wurden aufgezeigt, ebenso wurden 24 raumlich bzw. genetisch-stratigraphisch zusammengehorende Loss- bzw. Losslehm-Rohstoffbezirke abgegrenzt und in das Interaktive Rohstoffinformationssystem IRIS-Online implementiert.

Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by skin and joint involvement. The disease may present with various joint pattern involvement, which sometimes may lead to joint destruction and deformity. Early diagnosis and treatment with disease-modifying anti-rheumatic drugs may prevent joint deformity. Recently there are many new treatment options including biologic drugs. Ustekinumab, an interleukin 12/23 inhibitor, has proven efficacy in the treatment of psoriatic arthritis. Like other biologic drugs (anti-TNF-), there are contradictory data about the safety of ustekinumab and possible relationship with cancer development. Herein we report the development of chronic lymphocytic leukemia in a patient with PsA treated with ustekinumab.

To investigate the effect of surgical procedure on the operation's results in patients undergoing emergency peripartum hysterectomy (EPH).The records of patients who underwent EPH due to postpartum hemorrhage between 2010 and 2020 in two tertiary centers with a high crude delivery rate were retrospectively analyzed. Surgical data were compared according to the EPH type.During the study period, 115,709 births occurred in these two centers. EPH was administered for 181 (1.6%) of these patients. Sixty-seven (37%) of the EPH cases involved subtotal EPH (SEPH), and 114 (63%) were total EPH (TEPH). Surgical time (107.3 ± 17.6 vs. 134.2 ± 32.3 min,According to the results, if the bleeding in peripartum hemorrhage requiring EPH can be controlled with SEPH, attempting to remove the cervix completely may be associated with increased surgical time, blood transfusion need, and surgical complications.

Objective: Hemophilia is classified according to the factor VIII or IX level as severe, moderate and mild. The Hemophilia Joint Health Score (HJHS) and Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) score used in recent years contribute significantly to the early diagnosis of arthropathy, which continues to be an important problem in severe hemophilia. It was aimed to investigate the compatibility between HJHS and HEAD-US scores. Material and Methods: The demographic and disease-related data, HJHS 2.1 and HEAD-US scores of the participants who participated in the Workshop of the Hemophilia Federation in 2020 were recorded. Results: The mean age of 32 participants was 20.6 (minimum: 15-maximum: 31). Twenty three were diagnosed as Hemophilia A, 8 were Hemophilia B, 1 was Von Willebrand disease. HJHS score of 30 patients was 6.7±6.2 (minimum: 0-maximum: 22). The mean of HEAD-US was 14.3±11.5 (minimum: 0-maximum: 34). HJHS and HEAD-US scores were compatible with each other (p=0.002). Arthropathy was present in 33 joints of 21 patients. There was a statistical significance between patients with and without arthropathy with both the HJHS and the HEAD-US scores (0.006 and 0.005 respectively). The most common arthropathy is in the right knee. HJHS and HEAD-US scores are compatible in both knee and elbow joints. Nonetheless, it is incompatible in both ankles. HJHS and HEAD-US scores were discordant in 21 joints of 7 patients. These joints were right ankle (n=7), left ankle (n=6), left elbow (n=4), right elbow (n=2) and right knee (n=2). Conclusion: A correlation was found between the HJHS and HEAD-US scores. HEAD-US is more sensitive than HJHS in detecting the early stage of arthropathy in the ankle joint. These scores should be done routinely to all patients for manifesting treatment deficiencies and incompatibilities.

Purpose Febrile neutropenia (FN) is a hematological emergency. It is challenging and confusing for the clinicians to make the decision of the febrile neutropenic patients under chemotherapy to be monitored at intensive care unit (ICU). The aim of this study was to define the factors supporting decision-making for the critical patients with febrile neutropenia. Methods The data of 60 patients, who were taken to the ICU while they were under treatment in the Hematology Clinic with a diagnosis of febrile neutropenia, were analyzed retrospectively, in order to identify clinically useful prognostic parameters. Results The ICU mortality rate was 80%. Mortality was significantly associated with higher sequential organ failure assessment score (SOFA), quick sequential organ failure assessment score (qSOFA), and hematological SOFA (SOFAhem) scores on admission. All cases having SOFA score 10 and above and qSOFA score 2 and above died. In multivariate analysis, qSOFA score was found to be statistically significant in predicting mortality in regard to ICU admission (p = 0.004). Conclusion Mortality of febrile neutropenic patients admitted to ICU is high. It would be appropriate to determine the extent of organ dysfunction instead of underlying disease, for making the decision of ICU admission. It should be noticed that the risk mortality is high for the FN cases with SOFA score 10 or above, qSOFA score 2 or above, and in need of mechanical ventilation and positive inotropic support; hence, early intervention is recommended. In our study, the most significant parameter in predicting ICU mortality was found to be qSOFA.

NK (Natural Killer) cell-mediated adoptive immunotherapy has gained attention in hematology due to the progressing knowledge of NK cell receptor structure, biology and function. Today, challenges related to NK cell expansion and persistence in vivo as well as low cytotoxicity have been mostly overcome by pioneering trials that focused on harnessing NK cell functions. Recent technological advancements in gene delivery, gene editing and chimeric antigen receptors (CARs) have made it possible to generate genetically modified NK cells that enhance the anti-tumor efficacy and represent suitable “off-the-shelf” products with fewer side effects. In this review, we highlight recent advances in NK cell biology along with current approaches for potentiating NK cell proliferation and activity, redirecting NK cells using CARs and optimizing the procedure to manufacture clinical-grade NK and CAR NK cells for adoptive immunotherapy.

We aimed to describe the initial experience of mini-laparoscopic adrenalectomy combined with transgastric specimen extraction and to assess its safety and feasibility. We used only 5-mm trocars, three ports for left adrenalectomy and four for right. Intraoperative gastroscopy was performed for specimen extraction through the mouth via an endoscopic snare. The gastrotomy was closed intracorporeally. Demographic, perioperative and pathological data were analyzed. There were 16 patients (12 females) with the mean age of 46.5 ± 11.3 years and half of them had previous abdominal surgeries. The median operative time was 150 (45-432) min with a median blood loss of 88 (0-350) ml. The median oral intake time was 2 (1-4) days and the median length of hospital stay was 2 (2-5) days. There was no mortality and extraction-related complication. Histopathological median tumor length, width and depth were 3 cm, 2.15 cm, and 1.9 cm, respectively. The median specimen length, width and depth were 6.25 cm, 4 cm, and 2.2 cm, respectively. Mini-laparoscopic adrenalectomy combined with transgastric specimen extraction is a safe and feasible surgical technique. It provides a less invasive surgery and may also have some benefits on wound-related complications and cosmesis.

Amaç: Pigmente cilt lezyonlarının birinci basamak sağlık kuruluşlarında çalışan hekimler tarafından tanınması ve eşlik edebilecek malign hastalıklar yönünden araştırılması büyük önem taşımaktadır. Özellikle baş ve boyun yerleşimli olan pigmente lezyonların kozmetik açıdan başarılı bir şekilde çıkarılması hastaların genel başvuru nedeni olmaktadır. Bu çalışmada kliniğimize estetik amaçlarla lezyonlarını aldırmak isteyen hastaların histopatolojik tanıları retrospektif olarak incelenmiş ve tedavi yönetimi irdelenmiştir. Gereç ve Yöntem: Çalışmaya kliniğimize Kasım 2018- Kasım 2019 tarihleri arasında pigmente lezyonlarını sadece estetik amaçlı aldırmak isteyen toplam 85 hasta dahil edildi. Tüm hastalar aynı cerrah tarafından opere edildi. Eksizyon sonrası tüm lezyonlar histopatolojik incelemeye gönderildi. Bulgular: Toplam 85 hastadan 129 lezyon çıkarıldı. Hastaların 37’si (%43,5) erkek; 48’i (%56,5) kadın idi. Hastaların ortalama yaşı 38,9 (14-94 yaş) idi. Lezyonların ortalama büyüklüğü 1,15 cm² (0,3-5,3 cm²) idi. Histopatolojik inceleme sonrası 11 değişik tipte pigmente lezyon patolojisi ortaya çıktı. İntradermal nevüs çıkarılan lezyonlar arasında görülen en sık patoloji sonucuydu (%38). Bunu sırasıyla Seboreik keratoz (%24) ve bazal hücreli karsinom (%22) izledi. Baş-boyun bölgesi çıkarılan tüm lezyonların en sık yerleşim yeri idi. İlk muayenede konan ön tanıyla lezyonların histopatolojik sonucu arasındaki uyumsuzluk toplam 5 hastada gözlenmiştir. Sonuç: Cilt lezyonları geniş bir yelpazede klinik pratiğimizde karşımıza çıkmaktadır. Hastanın ilk başvurusunda çıplak gözle muayene her zaman doğru sonuç vermese de ABCDE kriterlerinin bilinmesi bu aşamada kritik önemdedir. Çalışmamızda sadece kozmetik amaçlı başvuran hastaların dahil edildiği göz önünde bulundurulduğunda hastaların dörtte birinin malign deri kanseri teşhisi aldığını ve bu bağlamda bir halk sağlığı sorunu olarak deri kanseriyle ile ilgili kişilerin eğitiminin yaygınlaştırılması gerektiğini vurgulamak istiyoruz., Objective: It is very important to recognize the pigmented skin lesions and accompanied malignant skin diseases by physicians working in primary health care facilities. The successful removal of pigmented lesions, especially in the head and neck region, is the general reason for patients admitted to aesthetic surgery clinics. In this study, histopathological diagnoses of the lesions removed for aesthetic purposes are examined retrospectively and treatment management is reviewed. Material and Methods: A total of 85 patients who wanted to remove their pigmented lesions for only aesthetic purposes between November 2018 and November 2019 were included in this study. All patients were operated by the same surgeon. After excisional biopsy, all lesions were examined histopathologically. Results: 129 lesions were removed from 85 patients. 37 (43.5%) of the patients were male; 48 (56.5%) were women. The mean age of the patients was 38.9 (14-94 years). The average size of the lesions was 1.15 cm² (0.3-5.3 cm²). After histopathological examination, 11 different types of pigmented lesion pathology were obtained. Intradermal nevus was the most common pathology result among the lesions (38%). This was followed by Seborrheic keratosis (24%) and basal cell carcinoma (22%), respectively. The head and neck region was the most common location of all lesions that was removed. Incompatibility between the preliminary diagnosis and the histopathological results of the lesions was observed in 5 patients. Conclusion: Patients consult with a wide range of skin lesions in our clinical practice. Although the examination with the naked eye does not always give correct results at the first application of the patient, knowing the ABCDE criteria is critical at this stage. Considering the patients who refers for only cosmetic purposes are included in our study, we want to emphasize that one fourth of patients are diagnosed with malignant skin cancer and the education of people with skin cancer should be expanded as a public health problem.

Aim: This study was conducted to assess the correlation between depression and anxiety and quality of life in ET and PV patients. Methods: The study was conducted in the Hematology Clinic of a training and research hospital in the Aegean region of Turkey between July 2016 and May 2017. A total of 60 patients (30 ET patients, 30 PV patients) were included in the study. Eastern Cooperative Oncology Group (ECOG), Karnofsky scale, EORTC QLQ-C30, and Hospital Anxiety and Depression Scale (HADS) were used to collect the data. The data was analyzed using SPSS 20.0 packaged software. The results were assessed at the confidence interval of 95% and significance level of p

BACKGROUND Ischemic preconditioning (IPC) is defined as raising tolerance to subsequent ischemic stress by exposing tissues to sub-lethal ischemia. Although many candidates have been suggested, recent studies have clearly demonstrated that adenosine-mediated ADORA2B receptor (ADORA2BR) activation is the main mechanism involved in IPC. While the tissue-protective role of this mechanism has been demonstrated in different ischemia/reperfusion (I/R) models, its role in flap surgery-derived I/R damage has not to date been investigated. OBJECTIVE To investigate the role of adenosine and ADORA2BR activation in IPC-mediated tissue protection in an epigastric flap model. METHODS Animals were divided into five main groups, all of which were then divided into two subgroups depending on whether or not they were exposed to IPC before the I/R procedure, which consisted of 6 hours of ischemia and 6 days of reperfusion. No drugs were administered in Group 1 (the control group). Animals in Group 2 were pretreated with CD73-inhibitor before IPC application or the ischemic period. Animals in Group 3 were pretreated with adenosine. Animals in Group 4 were pretreated with an ADORA2BR antagonist, and those in Group 5 with an ADORA2BR agonist. After 6 days of reperfusion, tissue survival was evaluated via histological and macroscopic analysis. RESULTS IPC application significantly enhanced CD73 expressions and adenosine concentrations (p

We investigated the protective effect of iloprost against ischemia/reperfusion (I/R) injury in rat ovary. We used 32 female Sprague-Dawley rats randomly allocated to four experimental groups: sham, ischemia, I/R and I/R + iloprost. Ovarian torsion was established in all rats except the sham group. The torsion group was exposed to ischemia for 3 h. The detorsion group was exposed to 3 h ischemia applied + 3 h reperfusion. The detorsion + iloprost group was exposed to ischemia for 3 h + reperfusion for 3 h + intravenous (IV) iloprost infusion for 60 min starting at the beginning of reperfusion. Ovaries were removed and prepared for histopathological evaluation. Reduced glutathione (GSH) and malondialdehyde (MDA) were measured in the blood. The total histopathological injury score and MDA level of the ischemia group were significantly higher than for the sham group. Ovarian injury score and MDA level following I/R increased compared to the ischemia group. Iloprost administration reduced the total injury score and MDA level. The GSH level was higher in the I/R + iloprost group than in the I/R group. We concluded that IV iloprost administration reduces I/R injury in rat ovarian tissue.

Doppler ultrasonography (D-USG) is a non-invasive technique that has become an increasingly essential tool in veterinary theriogenology. The aim of this study was to evaluate the changes of Doppler indices in the foetal aorta (FA), foetal vena cava (FVC), umbilical artery (UA), and uteroplacental artery (UPA) in pregnant queens, thereby advancing knowledge about Doppler findings in normal feline pregnancy. The study was conducted with 10 pregnant queens with known gestational age. Doppler ultrasonography was performed every three days beginning from the 21st day to the 60th day of pregnancy. The pulsatility index (PI) and resistance index (RI) of FA, FVC, UA and UPA were recorded during the D-USG examinations. Although a declining trend was seen in the mean RI of FA, a comparison with earlier sampling periods revealed that significant decreases (P < 0.05) did not occur until Days 30 and 60. While PI of FVC was relatively constant, RI varied througout pregnancy. The PI and RI of UPA values were significantly lower (P < 0.05) on Day 60 when compared to the first five sampling periods for PI and the first six sampling periods for RI. The study concludes that the decrease in UA indices is a precursor for delivery time in queens. However, there is a need for further comparative studies involving impaired pregnancies. © 2020, University of Veterinary and Pharmaceutical Sciences. All rights reserved. British Association for Psychopharmacology: 37251; Istanbul Üniversitesi This research was presented in V. National Congress of Turkish Society of Veterinary Gynaecology, with the support of the Research Fund of Istanbul University (BAP) (Grant number 37251). The authors are also grateful to Prof. Dr. Bülent Ekiz for statistical analysis and Esra Çalişkan Karaçam, DVM for the assistance of Doppler This research was presented in V. National Congress of Turkish Society of Veterinary Gynaecology, with the support of the Research Fund of Istanbul University (BAP) (Grant number 37251). The authors are also grateful to Prof. Dr. B?lent Ekiz for statistical analysis and Esra ?ali?kan Kara?am, DVM for the assistance of Doppler ultrasonography examinations.

Background The pedicled nasoseptal flap (NSF) constitutes the primary reconstructive option for most skull base defects in endonasal endoscopic approaches. The superior nasal turbinate (ST) has received little attention. We report our preliminary experience with the use of the ST mucosal flap in selected cases. Methods We performed a retrospective review of patients who underwent endonasal endoscopic approaches and identified 9 patients who were reconstructed with vascularized ST mucosal flaps as part of a double-layer or triple-layer reconstruction. When there was no intraoperative cerebrospinal fluid (CSF) leak, we used a double-layer technique. If there was an intraoperative CSF leak, regardless of the quality of leakage, we preferred a triple-layer repair technique. In patients with high-flow leaks, triple-layer repair was performed using only autologous tissue grafts and flaps. Results Intraoperative CSF leaks were noted in 7 of 9 patients. Among them, 4 patients had low-flow CSF leaks (grade 1 and 2) and 3 patients had high-flow CSF leaks (grade 3). All reconstructions had complete defect coverage with the ST flaps and NSFs were preserved. All the flaps were viable at 4 weeks without a CSF leak or complication at the reconstruction site. There was no contraction or partial loss of the flap. After a mean follow-up period of 9 months, none of the patients required a flap revision, developed a mucocele, infection, or other complication. Conclusions An ST flap can be used for the vascularized reconstruction of sellar defects if it is bilaterally available. This option should not be overlooked and wasted.

One of the most important problems of palliative care patients is that patients cannot be fed sufficiently. In our study, we aimed to investigate the effect of nutrition on quality of life in palliative care patients. A total of 216 patients who were hospitalized for palliative care interviewed face-to-face during the period between October 2018 and May 2019 and their nutritional status was determined. Mini Nutritional Assessment test was applied to patients at the same time quality of life questionnaire short form 36 test. A total of 216 patients (132 (61.1%) female, 84 (38.9%) male) were included in the study. The mean age of the patients was 77.01 ± 13.0 years, the mean body mass index was 24.15 ± 5.41 kg/m2, and the mean value of Mini Nutritional Assessment was 14.20 ± 7.01. The patients were divided into 3 groups according to their nutritional status. In groups of patients with palliative care according to their nutritional status, 3 groups were compared with the sub-dimension scores of the quality of life scale short form 36, and the physical function, physical role limitation, energy/vitality, emotional health, and perception of general health. Malnutrition is frequently observed in palliative care patients. Malnutrition affects the quality of life negatively. During palliative care, whose aim is to improve the quality of life, the nutritional status of patients should be evaluated and patients should be given nutritional supplements when necessary.

Objective Acute myeloid leukemia (AML) is the disease of elderly patients. Therefore, a significant number of patients are not suitable for intensive induction chemotherapy. In this study, it was aimed to retrospectively evaluate patients with AML who were treated Venatoclax-based regimens in our center. Methodology The data of the patients who were treated Venatoclax-based regimens with the diagnosis of AML in the Bozyaka Training and Research Hospital Department of Hematology were scanned retrospectively from their files. Results Data of 11 patients in total were reached. The mean age of the patients was 73.9. 8 of 11 patients were follow-up with diagnosis of AML , 3 patients with MDS RAEB II. Average follow-up time was 13.6 months. 5 patients died during follow-up. HMA +venatoclax was given to 6 patients as first-line, 4 patients second-line and 1 patient third-line therapy. Complete response was found in 3 patients, partial response in 1 patient, stable disease in 1 patient, and refractory disease in 1 patient. Conclusion Venatoclax is a promising treatment option because it is an oral agent that can be tolerated by elderly patients and improves response rates and survival.

Objective: Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder that can be especially seen in children and young adults. The clinical presentation of patients with LCH varies according to the sites of involvement. In about half of patients, the disease is limited to a single organ system and bone involvement is very common. In this study, it was aimed to retrospectively evaluation the patients diagnosed with LCH who were followed up and treated in our clinic. Methodology: The data of patients over the age of 18 years who were followed up and treated in Bozyaka Training and Research Hospital Hematology Clinic between 2015-2021 were scanned retrospectively from the hospital system. Results: Data of 6 patients were obtained. The mean age of the patients was 33.6. There was no difference between the genders. Pain was the reason for admission in 4 patients and was the most common symptom. While the most frequently involved system was the skeletal system with 5 patients, lung involvement was seen in 2 patients. Vinblastine and prednisolone combination therapy was given to 1 patient, who developed steroid-related avascular necrosis. One patient who was planned for combination treatment Conclusion: LCH is a rare disease especially seen in children and young adults. It can involve the skeletal system, lungs, and other organs. The prognosis is often good with excision of the lesion or systemic treatment.

Tam Metin / Full Text It is thought that the sensitivity of computed tomography (CT) in detecting peritoneal metas tases (PM) is low. In this study, we aimed to present our experience on gastric cancer (GC) patients with intraoperatively detected PM whose preoperative CT was normal in terms of distant metastasis. Materials and Methods: We retrospectively analyzed the demographics and perioperative data of ten pa tients with gastric adenocarcinoma whose preoperative CT was normal in terms of PM, but intraoperatively PM was detected. Results: The mean age of the patients was 68.30±9.44 years. Six patients (60%) were male. Tumors were mostly localized in the distal 1/3 of the stomach (n=5, 50%). The median carcinoembryonic antigen and carbohydrate antigen 19.9 levels were 2.00 ng/ml (0.60–37.50) and 30.76 IU/ml (3.28–449.30), respectively. There were PM on the visceral peritoneum (small bowel mesentery) in two patients (20%) and on the parietal peritoneum in eight patients (80%). The operations were terminated in five patients (50%) when the PM de tected as they did not have any complications due to cancer. Laparoscopic feeding jejunostomy (n=2, 20%), laparoscopic tube gastrostomy (n=1, 10%), and laparoscopic gastroenterostomy (n=2, 20%) were performed on the patients with oral intake deficiency due to GC. Conclusion: Preoperative staging with CT before GC surgery is still valid. Multidetector CT scan should be preferred. However, it is still not enough for detecting all PM before surgery. Staging laparoscopy should be in mind, especially for patients with a high risk of PM.

Primary carcinoma of the sigmoid colon in an inguinal hernia is a rare condition. We present a 79-year-old man diagnosed with sigmoid colon carcinoma referred to 18F-FDG PET/CT for staging. PET/CT showed the primary lesion in the inguinal hernia into scrotum.

Chylothorax occurs by accumulation of lymphatic fluid from the ductus thoracicus into the pleural cavity. Chylous fluid typically contains high levels of triglycerides, generally displaying a cloudy and milky appearance. Chylothorax is caused by a trauma or obstruction of ductus thoracicus. Nontraumatic etiologies include malignancies, sarcoidosis, retrosternal goiter, amyloidosis, superior vena cava thrombosis, benign tumors, congenital abnormalities such as lymphangioleiomyomatosis and hemangiomatosis Here we aimed to present a rare case who presented with shortness of breath due to chylothorax and diagnosed with acute lymphoblastic leukemia. Also, chylothorax cases diagnosed with ALL in the literature are shown in this report.

Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease characterized by isolated thrombocytopenia. While first-line treatments focus on inhibiting autoantibodies and platelet destruction, second- and third-line treatments include splenectomy and thrombopoietin receptor agonists. In this study, we aimed to compare the efficiency and toxicities of splenectomy and eltrombopag as second-line treatments in ITP.We retrospectively analyzed patients who were diagnosed with ITP and followed between 2015 and 2020. Patients who underwent splenectomy or received eltrombopag treatment as second-line or further therapy were included. For subgroup analyses, patients were further stratified according to whether they received eltrombopag in the second or third line of treatment.There were 38 patients in the splenectomy group and 47 patients in the eltrombopag group. The mean age of patients in the splenectomy and eltrombopag groups was 43.2 and 50.5 years, respectively. Time to response was significantly shorter in the splenectomy arm (p=0.001). However, response rates at the 3Comparing the splenectomy and eltrombopag arms, even though time to achieve response was in favor of the splenectomy group, this advantage disappeared when overall response rates and response rate at the 2Primer immün trombositopeni (İTP), izole trombositopeni ile karakterize, edinsel bir otoimmün hastalıktır. Birinci basamak tedaviler otoantikorları ve trombosit yıkımını inhibe etmeye odaklanırken, ikinci ve üçüncü basamak tedaviler arasında splenektomi ve trombopoietin reseptör agonistleri bulunur. Bu çalışmada, İTP’de ikinci basamak tedaviler olarak splenektomi ve eltrombopagın etkinlik ve toksisitelerinin karşılaştırılması amaçlanmıştır.2015-2020 yılları arasında İTP tanısı alan ve takip edilen hastaları retrospektif olarak analiz ettik. Splenektomi yapılan ve 2. veya daha ileri basamaklarda eltrombopag tedavisi alan hastalar çalışmaya dahil edildi. Alt grup analizleri için, hastalar ikinci veya üçüncü tedavi hattında eltrombopag alıp almadıklarına göre gruplandırıldı.Splenektomi grubunda 38 hasta, eltrombopag grubunda 47 hasta vardı. Splenektomi ve eltrombopag gruplarındaki hastaların ortalama yaşı sırasıyla 43,2 ve 50,5’di. Splenektomi kolunda yanıt süresi anlamlı olarak daha kısaydı (p=0,001). Bununla birlikte, 3., 6., 12. ve 24. aylardaki yanıt oranları, toplam yanıt süresi ve yan etkiler açısından gruplar arasında istatistiksel olarak anlamlı fark bulunmadı. Birinci, 3., 6., 12. ve 24. aylardaki yanıt oranları ve toplam yanıt süresi, eltrombopag alt grupları arasında istatistiksel olarak anlamlı değildi. Eltrombopag tedavisi medyan 54,1 ay (1-151) sonra 20 hastada kesildi. Bunlardan 12 hastada (%60) yanıt kaybı yaşanmadı.Splenektomi ve eltrombopag kolları karşılaştırıldığında yanıt alma süresi splenektomi lehine olsa da, genel yanıt oranları ve 2. yıldaki yanıt oranları dikkate alındığında bu avantaj ortadan kalkmaktadır. İkinci veya 3. basamak tedavide eltrombopag kullanılması, yanıt alma süresi açısından herhangi bir fark oluşturmamaktadır.

Hypomethylating agents, 5-azacytidine and 5-aza-2'-deoxycytidine (decitabine) , which have an effect by inhibiting DNA methyltransferase have been approved in Myelodysplastic syndrome (MDS). The most common side effects of hypomethylating agents are cytopenias, nausea, pain, and local reactions in injection zones. The toxicity associated with other organ functions is very rare. Our paper reported a case which a decrease was observed in left ventricular ejection fraction (EF) due to Decitabine treatment because of no response to Azacitidine as the fourth case in the literature. Three cases with cardiac toxicity and function loss have been reported in the literature. our case did not undergo ECHO check before starting Decitabine treatment after Azacitidine, it cannot be clearly understood whether cardiac toxicity occurred with 10 cycles of Azacitidine or 1 cycle of Decitabine treatment. Randomized controlled trials with large patient series are needed to clarify the etiology and pathophysiology of this side effect.

Background The requirement of brain retraction and difficulty in distinguishing the tumor demarcation are challenging in conventional approaches to intra- and paraventricular malignant tumors (IV-PVMTs). Tubular retractors can minimize the retraction injury, and fluorescein-guided (FG) surgery may promote the resection of tumors. Our aim is to evaluate the feasibility, safety, and effectiveness of fluorescein-guided endoscopic transtubular surgery for the resection of IV-PVMTs. Methods Twenty patients with IV-PVMTs underwent FG endoscopic transtubular tumor resection. Fluorescein sodium was administered before the dural opening. The intraoperative fluorescence staining was classified as “helpful” and “unhelpful” based on surgical observation. Extent of resection was assessed using postoperative magnetic resonance imaging. Karnofsky Performance Status (KPS) score was used to evaluate the general physical condition of patients. Results There were 9 glioblastomas, 4 anaplastic astrocytomas and 7 metastatic tumors. “Helpful” fluorescence staining was observed in 16(80%) of 20 patients. Gross total resection was achieved in 16(80%) cases, near-total in 3(15%) cases, and subtotal in 1 (5%) case. No intra- or postoperative complications related to the fluorescein sodium occurred. The median preoperative KPS score was 83, and the median KPS score 3-month after surgery was 88. Conclusion FG endoscopic transtubular surgery is a feasible technique for the resection of IV-PVMTs. It may be a safe and effective option for patients with these tumors. Future prospective randomized studies with larger samples are needed to confirm these preliminary data.

To investigate the effect of thymic stromal lymphopoietin on the development of chronic otitis media with effusion MATERIALS AND METHODS: This study was conducted on 40 patients who had adenoidectomy operation. The objects were divided into two groups. Group 1; adenoidectomy with chronic serous otitis media, group 2; adenoidectomy without chronic serous otitis media. Serum and tissue thymic stromal lymphopoietin levels were measured by ELISA. Serum and tissue TLSP levels, mast cell count, adenoid size were compared between the groups.Twenty-four (60%) of patients were female and 16 (40%) were male. Twenty patients (55%) had adenoid hypertrophy with chronic serous otitis media, and 18 (45%) had adenoid hypertrophy without chronic serous otitis media. The mean age of the patients was 6.21 ± 2.31 years. The mean mast cell count was significantly higher in group 1 compared with group 2 (p = 0.017). The mean tissue thymic stromal lymphopoietin measurement was also significantly higher in group 1 than group 2 (p = 0.023). However, there was no significant difference in regards to serum levels between the groups (p = 0.480).The number of mast cells as well as thymic stromal lymphopoietin levels in the adenoids of children was significantly high in the chronic serous otitis media patients. The release of thymic stromal lymphopoietin from the adenoid tissue plays a role in initiating and maintaining a local inflammatory reaction in the eustachian tube that may lead eventually to middle ear effusion in non-atopic patients.

Objective: Choledochal cyst is a congenital disease in which surgical treatment is preliminary because of the potential for malignancy. In recent years, increase in technological developments and laparoscopic experience have popularised the use of laparoscopy in adult choledochal cyst surgery. This study aimed to present the results of eight adult patients undergoing laparoscopic choledochal excision surgery. Material and Methods: Patients who underwent laparoscopic choledochal cyst excision and hepatico-jejunostomy anastomoses between the years 2013 and 2018 were evaluated retrospectively. Demographic characteristics, preoperative and postoperative findings, pathological results and final condition of the patients were examined. Results: Of the eight patients, three were males and five were females. Median age was 41.5 years (22-49). One of the patients had Type IVa and the rest had Type I choledochal cysts. Laparoscopic choledochal cyst excision, cholecystectomy, and hepatico-jejunostomy anastomoses were performed on all of the patients. One patient was converted to open surgery. Three patients had postoperative biliary leakage. Duration of the operations was determined as median 330 (240-480) minutes and blood loss was 50 (10-100) mL. Hospitalization of the patients was median 6 (4-23) days and follow-up time was median 20 (2-65) months. In the late period, cholangitis occured in a patient who was treated with medical therapy and there was no mortality in the follow-up period. Conclusion: We suggest that laparoscopic choledochal cyst excision in adults may be an alternative to open surgery due to the satisfactory results in the late period in spite of early problems like self-limiting bile leakage. Giriş ve Amaç: Koledok kistleri malignite potansiyeli nedeniyle cerrahi tedavinin ön planda olduğu konjenital bir hastalıktır. Son yıllarda teknolo-jik gelişmeler ve laparoskopik tecrübede artış erişkin koledok kist cerrahisinde laparoskopinin kullanımını yaygınlaştırmaktadır. Bu çalışmada amacımız laparoskopik koledok eksizyonu yapılan sekiz erişkin hastanın sonuçlarını sunmaktır. Gereç ve Yöntem: Kliniğimizde 2013-2018 yılları arasında laparoskopik koledok kist eksizyonu ve hepatiko-jejunostomi uygulanan hastalar retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, peroperatif ve postoperatif bulguları, patolojik sonuçları ve son durumları irdelendi. Bulgular: Çalışmaya dahil edilen sekiz hastanın üçü erkek, beşi kadın idi. Yaşların median değeri 41.5 (22-49) idi. Hastaların bir tanesinde tip IVa, diğerlerinde ise tip 1 koledok kisti saptandı. Hastaların tamamına laparoskopik koledok eksizyonu, kolesistektomi ve heptiko-jejunostomi yapıldı. Bir hastada açık cerrahiye geçildi. Üç hastada postoperatif safra kaçağı oldu. Operasyon süreleri median 330 (240-480) dakika ve kan kaybı 50 (10- 100) mL olarak saptandı. Hastaların yatış süreleri median 6 (4-23) gün ve takip süreleri median 20 (2-65) ay olduğu tespit edildi. Geç dönemde; bir hastada medikal tedavi ile düzelen kolanjit atağı gözlendi, mortalite ise görülmedi. Sonuç: Kendini sınırlayan safra kaçakları dışında erken dönemde önemli sorun yaşamamamız ve geç dönemdeki tatminkar sonuçlar nedeniyle laparoskopik koledok kist eksizyonunun erişkinlerde açık cerrahiye bir alternatif olabileceğini söyleyebiliriz.

Retroperitoneal hematomas (RPH), which are less common than puerperal hematomas, are an important cause of maternal morbidity and mortality due to difficulty in diagnosis and underlying cause. Although different vessel damage is reported in the literature as a cause of RPH, iliac vascular injury after vaginal delivery has not been defined at all. We presented a case who presented with general condition disturbance and developed RPH due to right iliac artery and vein damage in the third day after vaginal delivery. The patient who was diagnosed with computed tomography and who underwent surgery following his admission to the hospital was accepted to the exitus after the third cardiac arrest failed. Although, it is often difficult to diagnose, even with rapid diagnosis and effective treatment, maternal mortality may develop in RPHs.

Objective: This study aimed to evaluate the parameters affecting the treatment success of conservative surgery in cases with placental invasion anomaly. Methods: Archive files and digital image records of 67 patients with placental invasion anomaly were studied. The patients were divided into two groups, a conservative surgery group and a cesarean hysterectomy group. Demographic data, cervical length, placental localization, placental surface area adhering to previous cesarean section line, preoperative and postoperative hematocrit values, transfused blood products, and surgical complications were compared between the two groups. Results: In the conservative surgery group, the cervical length was longer (p < .001) and the surface area of the placenta in the previous cesarean scar line was smaller (p < .001). For cervical length, the sensitivity and specificity values were 97 and 81%, respectively, when the cut-off value was 35.5 mm. When the cut-off value for the placental surface area in the previous cesarean scar line was 85.5 cm2, the sensitivity and specificity values were 68 and 72%, respectively. In the caesarean hysterectomy group, the preoperative and postoperative hematocrit values were lower (p < .001, p = .003, respectively), and the amount of transfused erythrocyte suspension and fresh frozen plasma were higher (p < .001, p = .001, respectively). Conclusion: In this study, it was concluded that the presence of the nondestructive intact cervical tissue, in the cases with placental invasion anomaly and/or the small size of the placental surface area adhering to the previous cesarean scar line, increase the feasibility of conservative surgery.

Hydrocephalus is a rare complication of brain involving acute lymphoblastic leukemia (ALL). The standard treatment is ventriculoperitoneal (VP) shunting, while ventriculoatrial (VA) shunting is the second option in a case of VP shunt failure in young children. But the presence of port catheter at the right atrium restricts and makes a VA shunt difficult to place in the same atrium. We presented a 4-year-old boy who had the diagnoses of ALL and underwent chemotherapy through a port-a-cath. He also had hydrocephalus due to the brain invasion of the ALL. He firstly underwent VP shunting for the treatment of hydrocephalus, but it failed due to an intraabdominal cyst. Then, he underwent VA shunting through the left internal jugular vein. This is the first case in the literature showing both catheters in the right atrium.

In this article, we present a case of anastomosing hemangioma that shows cystic change. The tumor was a unilocular cystic lesion consisting of 2 distinct layers. The inner layer was composed of a proliferation of capillary-sized blood vessels resembling red pulp of the spleen. The outer layer was composed of stromal cells that resembled Leydig or steroid cell tumor of the ovary. An immunohistochemical examination confirmed endothelial and stromal characteristics of the layers, respectively. An ultrastructural analysis revealed absence of Reinke crystalloids in the stromal cells. We conclude that anastomosing hemangioma may rarely arise from the ovary as a cystic tumor and may be accompanied with luteinization of stromal cells.

Background Etiology of the varicose veins is still partly known. It has been proposed that varicose veins formation might be a cause of the oxidative stress and/or cause from genetical reasons. Method The levels of antioxidant defense system enzymes, superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, and an oxidative stress indicator, malondialdehyde, were measured in saphenous vein samples of varicose veins patients. Additionally, genetical polymorphism of glutathione S-transferase theta-1 has been studied. Result In this study, measurements revealed significant increase in catalase and malondialdehyde levels in the patient group, whereas superoxide dismutase and glutathione peroxidase and glutathione S-transferase enzyme activity and comparison of the null mutation frequency in the glutathione S-transferase theta-1 gene did not show a statistically significant difference. Conclusion We propose that the increase in catalase and malondialdehyde activities in our patient group may be related to each other. Increase in catalase levels, an antioxidant enzyme might be a compensatory response to the increase in malondialdehyde levels, an oxidative molecule.

We aimed to evaluate the effectiveness of changes over time in complete blood count (CBC) parameters to estimate the diagnosis of preeclampsia. Data on 161 severe preeclampsia patients and 161 healthy pregnant patients who met the study criteria of pregnant women whose CBC had been measured at 10-12, 22-24 and 28-30 weeks of pregnancy were compared. In the preeclampsia group, an increase in the mean platelet volume (MPV) value and a decrease in the number of platelets were statistically significant in the transition from the second to the third trimester. MPV and lymphocyte counts were more significant in the third trimester and neutrophil lymphocyte ratio (NLR) were more significant in the second trimester. We found that evaluation of the changes in lymphocyte, MPV and NLR values in three different trimesters of pregnancy rather than a single trimester was more meaningful to predict severe preeclampsia.Impact Statement

İş Sağlığı ve Güvenliği terimlerinin risk faktörü ölçümleri ile tanımlanması şirketler için daha önemli hale gelmektedir. İş kazaları ve meslek hastalıkları ile ilgili verilerinin toplanması, bazı sektörlerdeki koşulları değerlendirmek için ilk adımdır. 6331 sayılı İş Sağlığı ve Güvenliği Kanunu’na göre iş güvenliği açısından işverenin risk değerlendirmesi yapma zorunluluğu bulunmaktadır. Bu kapsamda özellikle fiziksel ve kimyasal risk etmenlerinin ölçümü yapılmadan riskin değerlendirilmesini yapmak mümkün değildir. Dolayısı ile bir firmada öncelikli olarak ortam ölçüm çalışmaları yapılması gerekmektedir. Bu çalışmada tekstil sektörleri seçilmiştir. Fiziksel risk etmenlerinin ölçümleri İstanbul’da bulunan iki adet tekstil firmasında yapılmıştır. Bu ölçümlerin sonuçları şirket bazında karşılaştırılmıştır. Sonuçlara dayanarak, şirketlere işyeri ortamı için iyileştirme önerileri sunulmuştur. İki tekstil firmasında toplam 14 aydınlatma ölçümü, 6 termal konfor ölçümü ve 6 kişisel gürültü ölçümü gerçekleştirilmiştir. Tekstil şirketlerindeki ölçümler, bu firmaların çalışma ortamlarının yönetmeliklere ve standartlara uygun olduğunu göstermiştir. Fakat bazı değerler standartlarda istenen değerlere çok yakın çıkmıştır. Bu nedenle, bu sorunların giderilmesine yönelik önlemler ile ilgili öneriler sorumlu taraflara belirtilmiştir. According to the Occupational Health and Safety Law No. 6331, the employer has to make a risk assessment in terms of occupational safety. In this context, it is not possible to evaluate the risk without measuring physical and chemical risk factors. Therefore, environment measurement studies should be carried out primarily in a company. Textile sector is selected in this study. Measurements of physical risk factors were made in two textile companies in Istanbul. The results of these measurements were compared on company basis. Based on the results, companies were presented with recommendations for improvement in the workplace environment.A total of 14 lighting measurements, 6 thermal comfort measurements and 6 personal noise measurements werecarried out in two textile companies. Measurements in textile companies have shown that the working environments of these companies comply with regulations and standards. However, some values are very close to the desired values in standards. For this reason, recommendations regarding the measures to eliminate these problems have been given to the responsible parties.

Objective: Although Covid-19 which has been identified as the disease caused by SARS COV-2 virus mainly affects the respiratory tract, it was observed that many systems were affected. The gastrointestinal system is one of the main systems involved. The aim of this manuscript was to perform epidemiological, virological, and clinical analysis of 59 Covid 19-positive patients with gastrointestinal symptoms. Method: Covid-19 diagnosed patients have been started to be admitted since March, 20, 2020. Epidemiological, demographical, clinical findings, laboratory analyses as well as hospitalization periods and disease progression of the patients presenting gastrointestinal system (GIS) symptoms admitted between March, 31, 2020 and August, 1, 2020. Results: Totally 710 Covid 19-positive patients hospitalized were screened. Among these patients, those with incomplete medical history and deficient data were excluded. The analysis of 281 patients admitted due to Covid-19 diagnosis with complete data since admission revealed that 59 patients presented GIS symptoms at admission. The aforesaid patients were compared with 222 patients admitted due to Covid-19 without GIS symptoms within the same period. GIS symptoms were detected on 59 (59/281) (20.99%) patients admitted due to Covid-19. Detailed review of these patients revealed that 18 (18/59) (30.50%) patients had nausea-vomiting, 10 (10/59) (16.95%) patients had abdominal pain, and 31 (31/59) (52.55%) patients had GIS bleeding. It was observed that vomiting was added into the clinical presentation in 7 of 18 patients. Although there is not any diarrhea symptom alone, total number of cases with diarrhea+abdominal pain, diarrhea+nausea-vomiting, diarrhea+nausea-vomiting+abdominal pain was 17 (17/59) (28.81%) of 59 patients. Conclusion: According to the results of this study, we have found 20.99% gi symptoms in the hospitalizated patients due to Covid 19. Although GIS symptoms are not associated with disease severity, they are important for the identification and spread of the disease, along with respiratory symptoms.

Technological innovations in spinal intradural tumor surgery simplify treatment. Surgical treatment of cranial benign and malignant pathologies under microscope with sodium (Na)-fluorescein guidance has often been reported, but few studies have focused on spinal intradural tumors. We aimed to investigate the usefulness of Na-fluorescein under yellow filter in intradural spinal tumor surgery by retrospectively reviewing cases involving intramedullary and extramedullary tumors operated under the guidance of Na-fluorescein. Forty-nine adult patients with a diagnosis of spinal intradural tumor operated under a yellow filter (560 nm) microscope using Na-fluorescein dye were included in the study. Demographic data, such as age and sex, neurological status, extent of tumor resection, histopathological diagnosis, Na-fluorescein staining pattern, and its usefulness during surgery were noted and statistically analyzed. Of all recruited patients, 26 women (53.1%) and 23 men (46.9%), were included for analysis. The age range of the patients was 18–64 years, with a mean age of 41.6 ± 13.9. An intradural intramedullary mass was found in 30.6% (n = 15) of the patients, and an intradural extramedullary mass in 69.4% (n: 34). While Na-fluorescein staining was homogeneous in all intradural extramedullary tumors, 73.3% (n: 11) of intradural intramedullary tumors were homogeneous, and 13.3% (n: 2) moderately heterogeneous. In the whole study group, the Na-fluorescein staining pattern was helpful in surgical resection in 47 cases (95.9%). While 34/34 (100%) found it helpful for extramedullary tumors, 13/15 (86.7%) did in intramedullary tumors, and for 2/15 (13.3%) it was not. In conclusion, Na-fluorescein helps in distinguishing tumor from healthy tissue in intradural extramedullary and intramedullary tumor surgery under a yellow filter microscope in most cases, thus providing convenient assistance to surgeons.

AIMS JAK2V617F (JAK2), calreticulin (CALR) and MPL515L/K (MPL) mutations are important in essential thrombocythemia (ET) and may be associated with various clinical consequences of the disease. This study aimed to compare the clinical and haematological parameters of ET patients regarding the mentioned mutations and the role of plateletcrit (PCT). METHODS Seventy patients who were diagnosed with ET between 2005 and 2017 in a single centre were included in this descriptive study. The initial symptoms and clinical findings were retrieved from the electronic database. JAK2 gene V617F mutations, MPL gene exon 10 mutations and CALR gene exon 9 DNA sequence analyses were performed. Forty-one healthy volunteers were included to perform ROC curve analysis for interpreting PCT value. RESULTS The distributions of patients according to the mutations were as follows: Thirty-seven (52.9%) patients were JAK2-positive, 15 (21.4%) were CALR-positive, 2 (2.8%) patients were positive for both CALR and JAK2, and 1 (1.4%) was only MPL-positive. Fifteen (21.4%) patients were triple-negative. The ET patients with JAK2 mutation showed a higher level of haemoglobin at the time of diagnosis. The ET patients with CALR mutation presented with higher platelet and LDH levels (P = .002 and P = .001, respectively). The PCT level was higher in the CALR-positive group when compared to the others (P = .026). A sensitivity value of 97.6% and specificity value of 98.6% were determined regarding PCT% at a cut-off value of 0.37 in ET patients. In CALR-positive patients, the sensitivity and specificity values were 100% for the PCT at a cut-off value of 0.42%. CONCLUSION We determined that the platelet count and blood LDH level was high in the ET patient group with CALR mutation. Besides, we found that the blood haemoglobin level was higher in the ET patient group with JAK2 mutation. Additionally, the PCT level was higher in the CALR group when compared to the other patient groups.

Introduction: We aimed to establish a standardized, routine-use pre-analytical protocol for measuring Alzheimer's disease (AD) biomarkers in cerebrospinal fluid (CSF). Methods: The effect of pre-analytical factors (sample collection/handling/storage/transportation) on biomarker levels was assessed using freshly collected CSF. Tube type/sterilization was assessed using previously frozen samples. A low-bind false-bottom tube (FBT, Sarstedt) was used for all experiments, except tube types/sterilization experiments. Biomarkers were measured using Elecsys CSF assays. Results: Amyloid beta (Aβ)1-42 levels varied by tube type, using a low-bind FBT reduced variation. Aβ1-42 levels were higher with no mixing versus roller/inversion mixing. Aβ1-42 levels were lower with horizontal versus upright transportation; this was resolved by maximal tube filling and storage at 2°C to 8°C. Aβ1-40 levels were less strongly affected. Phospho-tau and total-tau levels were largely unaffected. Discussion: We propose an easy-to-use, standardized, routine-use pre-analytical protocol, using low-bind FBTs, for measuring AD CSF biomarkers in clinical practice. (Less)