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Aim:This study investigated the potential role of serum copeptin, a mediator of acute pain via sympathetic stress stimulation, as a biomarker of varying degrees of migraine-related disability. Specifically, we aimed to analyze whether the serum copeptin level can be used to differentiate migraine types (e.g., with and without aura).Methods:The study population included 80 consecutively consenting adult patients who had migraine attacks and attended the emergency department from June 2020 through November 2020, as well as 80 age- and sex-matched healthy controls. Using the Migraine Disability Assessment Scale (MIDAS), the same medical professional assessed each patient’s level of headache-related disability. Based on their MIDAS scores, the patients were separated into four groups: no disability (score 0-5; group MIDAS-I); mild disability (score 6-10; group MIDAS-II); moderate impairment (score 11-20; group MIDAS-III); and severe disability (score >20; group MIDAS-IV). There were also two categories of migraineurs: those with auras and those without auras. Upon admission, comparisons were made between the groups’ serum copeptin values.Results:In comparison to the control group, the patient group’s serum copeptin levels were noticeably higher (2113.30±206.20 vs. 1383.40±488.40; p

Aim:We emphasize the importance of serum native thiol (SH), lipid peroxidation (LOOH), and ceruloplasmin (CP) levels in the management of patients with a migraine attack and clarify the possible relationships among these parameters in the emergency department (ED).Methods:The study was designed as a case-control study which is a type of observational study by including the patients who applied to the University of Health Sciences Turkey, University Diyarbakır Gazi Yasargil Training and Research Hospital between December 2018 and July 2019. A total of 88 participants (study group, n=46 and healthy control group, n=42) consecutively admitted to the ED. with similar demographic characteristics were included in the study. SH, LOOH, and CP levels in both groups were recorded and studied.Results:The serum SH level was significantly lower in the patient than in the control group (p=0.002). However, the LOOH and CP levels were significantly higher in the patient group than in the control group (p

OBJECTIVE: Many criteria have been developed to predict left ventricular hypertrophy using an electrocardiogram (ECG). However, one major common limitation of all has been their low sensitivity. Based on that, recently, a novel criterion has been proposed, which is believed to have higher sensitivity without a compromise in specificity. Therefore, in our study, we aimed to test this novel ECG criterion prospectively in large, unselected cardiac patients. METHODS: Patients who were referred to our echocardiography laboratory due to various etiologies were prospectively enrolled. The novel Peguero-Lo Presti criterion was assessed along with other established ECG criteria. The left ventricular mass index was calculated using echocardiography. The performance of each index was evaluated. RESULTS: Overall, 767 patients were enrolled in this study. The sensitivity and specificity of the Peguero-Lo Presti criterion were 17.5% and 94.5%, respectively. Although the highest sensitivity belonged to the Peguero-Lo Presti criterion, in ROC analysis, it showed modest predictive capability, which was similar to the established Cornell voltage criterion (AUC=0.64 [0.56–0.68 95% CI], p

INTRODUCTION[|]Stage III disease accounts for approximately one-fourth of all non-metastatic non-small cell lung cancer (NSCLC). The patients who are not candidates for curative resection are offered concomitant chemoradiotherapy. In this subgroup, which is difficult to manage, studies that address the role of PET-CT to predict outcome measures specifically for stage III NSCLC receiving concurrent chemoradiotherapy may help better risk stratification. This study aimed to assess whether baseline PET maximum standardized uptake value (SUVmax) value in stage III NSCLC treated with concurrent chemoradiotherapy would independently identify patients with high risk of progression and death.[¤]METHODS[|]The study population consisted of patients aged 18 years or more with unresectable stage III histologically or cytologically proven NSCLC who received concurrent chemoradiotherapy. From 2007 to 2014, medical records of patients admitted to our institution were retrospectively analyzed. Pretreatment PET-CT SUVmax values were recorded for each patient. These values were categorized as low or high according to the median SUVmax measure of the study population.[¤]RESULTS[|]A total of 175 patients were analyzed. The median follow-up time was 23 months (range 6–109). The PET-CT SUVmax values ranged from 3.5 to 46 with a median value of 14. The median overall survival was 25 months in SUVmax

Aim: Thyroid gland surgery has a risk of serious complications. Advancements in technology have led to improvements in complications but significant challenges to preserving voice and airway function still remain. The purpose of this study was to evaluate voice quality following total thyroidectomy under neuromonitoring and effect of intraoperative neuromonitoring (IONM) on identification of the recurrent laryngeal nerve (RLN) and external branch of the superior laryngeal nerve (EBSLN). Methods: A total of 80 patients scheduled for total thyroidectomy between May 2015 and March 2016 were included in the study. All the RLNs and EBSLNs were identified. Voice assessment included preoperative and postoperative fiberoptic laryngoscopy, analysis of Jitter, Shimmer, and fundamental frequency and the Voice Handicap index-10. Results: Eighty patients were included in this study (71 females, nine males). There was no significant difference between mean initial and post-dissection electromyographic amplitudes with RLN and EBSLN stimulation. The rate of postoperative transient RLN palsy per nerve at risk was 4.375% (7/160) and null for permanent RLN palsy (0%, 0/160). Conclusion: Both subjective and objective assessments revealed preservation of voice quality in patients after total thyroidectomy under neuromonitoring. IONM may be used effectively and safely in order to identify the EBSLN during thyroid surgery.

INTRODUCTION[|]Analgesic therapies have an immense role in early rehabilitation period after Total knee arthroplasty (TKA) and multimodal approaches should be considered as the first choice. In this retrospective study, we aimed to evaluate the effectiveness of multimodal analgesic therapies for TKA, including FNB and patient controlled analgesia (PCA).[¤]METHODS[|]We retrospectively evaluated 79 patients who underwent TKA between January and December 2016. Sixty-three patients met inclusion criteria. Hemodynamic records and VAS scores for 0-2-4-6-9-12 hours were evaluated and patients were separated into three groups. Group 1: FNB with %0.25 bupivacaine, Group 2: FNB with %0.166 Bupivacaine, Group 3: No FNB.[¤]RESULTS[|]Average age of patients was 64.3+-14.9 years and average BMI was 32.5+-5.3 kg/m2. There was not statistical difference between the age, gender, ASA scores, BMI and anaesthesia types for all groups (p0.05). When difference between groups 1-3 and groups 2-3 were compared, the difference was statistically significantly for VAS 0 (p>0.05). Additional analgesic use was highest in group 3.[¤]DISCUSSION AND CONCLUSION[|]This study has shown that FNB significantly decreases postoperative pain intensity and additional analgesia requirements in patients undergoing TKA. A concentration of 0.166% bupivacaine is as effective as a concentration of 0.25% when used as part of multimodal analgesia regimen in TKA.[¤]

Amyloidosis is a disease which can affect any tissue in the body with extracellular deposition of low molecular weight protein fibrils. Amyloid deposition can appear in many organs and tissues. Amyloidosis of tongue occurs most commonly in systemic form as rubbery macroglossia due to extra-deposition of amyloid within the suprahyoid muscle. Anesthesiologist can experience the negative consequences of amyloidosis in many conditions. Difficult airway due to amyloid deposition in tongue is an unexpected condition. We aimed to report a case that had respiratory distress with extremely big tongue due to amyloidosis. We performed a fiberoptic intubation for emergent tracheostomy without any complication [Cukurova Med J 2016; 41(4.000): 804-807]

Purpose: The aim of this study is to determine the epidemiology of the Eagles syndrome among patients presenting with a long-term complaint of pain in the ear. Material and Methods: In this prospective study, 48 patients with a complaint of otalgia lasting for 6 months, admitted to our clinic between June 2012 and December 2012 were included. All patients underwent to a maxillofacial CT scan, to detect the length of the styloid process. Patients with a length of more than 30 mm of styloid process were interpreted as Eagle's syndrome. Results: Ten patients(20.8%) with more than 30 mm length of styloid process were diagnosed as Eagle's syndrome. Conclusion: In patients with inconsistency in complaints and physical examination, Eagle syndrome as one of the causes of secondary otalgia, must be considered beside the primer otalgia.. [Cukurova Med J 2015; 40(4.000): 654-660]

Fibröz displazi fibroplastik proliferasyon ve normal kemiğin progresif fibröz doku ile yerdeğiştirmesi ile karakterize nonneoplastik fibroosseöz bir lezyondur. Fibröz displazi sıklıkla sinonazal bölgede olmak ile birlikte orta konka kemiğinde oluşumu oldukça nadirdir. Genellikle asemptomatiktir ancak ileri olgularda hastalığın yayılımı ile burun tıkanıklığı, sinir basısından ötürü ağrı veya patolojik kırıklar olabilir. Genellikle bağlı kemiklerden hastalığın uzanıma seconder olarak gelişir. Bu olgu sunumunda tek taraflı burun tıkanıklığı olan 54 yaşında bayan hasta literature bilgileri gözden geçirilerek sunuldu.

Amaç: Bu çalışmanın amacı uzun süreli kulak ağrısı şikayeti ile gelen hastalarda Eagle sendromunun epidemiyolojisini araştırılmasıdır. Materyal ve Metod: Bu çalışma prospektif bir çalışma olup, haziran 2012 ile aralık 2012 tarihler arasında ez az 6 aydır devam eden kulak ağrısı şikayeti ile kliniğimize başvuran 48 hasta incelenmiştir. Tüm hastaların aksiyel planda maksillofasiyal BT tetkiki istenerek uzun stiloid proçesi olan olguların stiloid proçesleri ölçüldü. Stiloid çıkıntısı 30 mm’den uzun olan olgular Eagle sendromu olarak yorumlandı. Bulgular: Stiloid proçes uzunluğu 30 mm ve daha fazla olan 10 olgu (%20.8) Eagle sendromu olarak yorumlandı. Sonuç: Otalji yapabilecek primer nedenler dışlandıktan sonra Eagle sendromu, özellikle şikayetleri ile fizik muayenesi arasında uyumsuzluk gözlenen hastalarda araştırılması gereken sekonder otalji nedenlerinden biridir. .

Fibrous dysplasia is a nonneoplastic fibro-osseous lesion characterized by fibroblastic proliferation and progressive replacement of normal bone with fibrotic tissue and disorganised bony trabeculae.Fibrous dysplasia infrequently occurs in the sinonasal tract. Location in the middle turbinate is extremely rare. It is usually asymptomatic but, in the advanced stage, nasal obstruction due to extension of disease and pain due to neural compression, or pathological fractures may occur. It is usually secondary to extension of disease from adjacent bones. In this case report we presented a 54 year old woman with unilateral chronic nasal obstruction [Cukurova Med J 2015; 40(Suppl 1): 106-111]

Amaç: Malign eksternal otit temporal kemiğin ve çevre dokuların ender görülen ciddi enfeksiyonudur. Bu çalışmada hastalığın prognozunu olumsuz etkileyen faktörlerin saptanması ve tedavi etkinliğinin değerlendirilmesi ve literatürle karşılaştırılması amaçlandı. Materyal ve Metod: Cukurova University Tıp Fakültesi Kulak Burun Boğaz Anabilim Dalı"nda Ocak 2002 ile Temmuz 2011 tarihleri arasında Malign External Otit tanısıyla yatırılıp tetkik ve tedavi edilen 41 hastanın dosyaları incelendi. Hastaların dosyaları, eşlik eden hastalıkları, radyolojik incelemeleri, mikrobiyolojik kültür sonuçları, tedavi protokolleri, tedaviye verdikleri cevaplar ve takipleri incelendi. Bulgular: Hastaların yaşları 38 ile 90 arasında değişmekte olup ortalama 63,24 olarak hesaplandı. Çalışmaya dahil edilen 41 hastadan 40"ında diabet mevcuttu. İnsulin kullanan 19 hastadan 9"u (%47,4) oral antidiyabetik kullanan hastaların ise 5"i (%23,8) kötü prognozlu hastalar grubuna dahildi. Bu çalışmada fasial paralizi bulunan 7 hastanın 3"ü kaybedilmiş olup mortalite oranı %42,9"dur. Bilateral tutulum olan 5 hastanın 4"ünde (%80) tedavi sonrası rekürrens gelişmesi üzerine tekrar kliniğimize yatırılarak tedavi uygulanmıştır. Yaygın radyolojik tutulum gösteren toplam 8 hastamızın 1 tanesi kaybedilmiş olup mortalite oranı %12,5 olarak bulunmuştur. Temporal kemikte yaygın enfeksiyon bulguları olan 8 hastadan 6"sı (%75) kötü prognozlu hastalar grubuna dahil olmuştur. Sonuç: İnsuline bağlı diabet, bilateral kulak tutulumu, yaygın enfeksiyon, fasial paralizinin prognozu olumsuz etkileyen faktörler olduğu düşünülmüştür. Tedavinin başarısı diabetin kontrolüne, günlük kulak pansumanına ve uzun süreli kombine antibiyoterapiye bağlıdır. Erken tanı ve tedavi şarttır.

Purpose: Malignant external otitis is a very rare and serious infection of temporal bone and surrounding tissues. This report aimed to determine negative prognostic factors, effectiveness of treatment and companing with literature. Material and Methods: Fourty-one patient's files who were hospitalized in Cukurova University Medical Faculty Ear Nose and Throat department were examined retrospectively. Patient's files, comorbidities, radiographic examination, microbiological culture results, treatment protocols, treatment and their responses were analyzed. Results: Patients were between 38 and 90 years old and median age was 63,24. Fourty of them were diabetic. Nine of 19 insulin users (47,4%) and 5 of oral antidiabetic users (23,8%) were found to be in negative prognostic group. There were 7 patients with facial paralysis and 3 of them died. There were bilateral diseases in 5 patients and 4 of them had recurrence after treatment. Eight patients had advenced radiological findings and 1 of them died (12,5%). And 6 of 8 patients who had serious infection of temporal bone assesed in negative prognostic group. Conclusion: Insulin dependent diabetes, bilateral disease, advenced infection and facial paralysis were considered to be negative prognostic factors. The success of treatment was considered to be dependent on control of diabetes, daily ear aspirations, and long term combined antibiotherapy. Early diagnosis and treatment is essential. [Cukurova Med J 2014; 39(3.000): 525-531]

Rinolitler genellikle nazal kaviteye yerleşmiş bir cisime sekonder yerleşen mineralize kitlelerdir. Nadir görülürler ve uzun süre boyunca tanı konulmazsa nazal obstrüksiyona yol açacak kadar büyüyebilirler. Tek taraflı burun akıntısı, burun tıkanıklığı ve kötü koku en sık görülen semptomlardır.. Bu çalışmada, rinolithiasis nedeni ile opere edilen 39 yaşında bayan hasta literatür bilgileri gözden geçirilerek sunuldu.

Rhinolith is mineralized masses which is usually consisting secondary to an object located in the nasal cavity. they are rarely seen and if diagnosis prolonged they can cause nasal obstruction. A unilateral rhinorrhea, nasal congestion and a bad smell is the most common symptoms. In this study, the 39-year-old female patient was operated on for rhinolithiasis with the review of the literature is presented. [Cukurova Med J 2013; 38(2.000): 290-294]

Ektima gangrenozum sıklıkla P. aeruginosa tarafından oluşturulan deri lezyonudur. Periferik fasiyal paralizi ve mastoidit, P.aeruginosa"nın etken olduğu otitis medianın nadir görülen komplikasyonlarıdır. Bu çalışmada, ektima gangrenosum ve fasial paralizisi olan 4 aylık çocuk sunulmuştur.

Ecthyma gangrenosum is a skin lesion which is created by pseudomonas auriginosa. Peripheral facial paralysis and mastoiditis as a rare complication of otitis media induced by pseudomonas auriginosa.In this study, 4 months child who has ecthyma gangrenosum and facial nerve paralysis was reported. [Cukurova Med J 2013; 38(1.000): 126-130]

Purpose: We aimed to investigate the effects of intravenous and peritonsillar dexamethasone plus levopubivacaine on postoperative pain, bleeding, nausea and vomiting in children undergoing tonsillectomy or adenotonsillectomy. Methods: After obtaining the approval of Ethics Committee of Cukurova University Medical Faculty Hospital and the patients were given informed consent, 60 patients of ASA (American Society of Anesthesiologist) class I- II between ages 3-12 which were planned to be undergone elective tonsillectomy or adenotonsillectomy were included. All patients were randomised and divided into 3 groups. After anesthesia induction, Group I (n=20) patients received 0.4 mg/kg %0.5 levobupivacaine for each tonsil at the dose of max. 4 ml with peritonsillar infiltration after before tonsillectomy. While Group II (n=20) and Group III (n=20) received levobupivacaine via the same route, Group II received i.v. (intravenous) dexamethasone 0.25 mg/kg and Group III 4 mg dexamethasone with peritonsillar infiltration additionally. All groups were administrated 1mg/kg tramadol iv as postoperative analgesic. Hemodynamic parameters were recorded after drug injections. Frequency of nausea and vomiting and analgesic requirements determined with Visual Analog Scale (VAS) and CHEOPS (Children’s Hospital of Eastern Ontario Pain Scale) at first, 10th, 20th, 30th, 45th minutes and first, 2nd, 4th, 6th and 24th hours were recorded. Postoperative bleeding were recorded at early and late periods. Results: The hemodynamic parameters and demographic data of groups were similar. The insidance of nausea and vomiting was statistically higher in Group I compared to Group II and III. First analgesic administered time was 3.15±0.88 in Group I, 4.85±1.09 in Group II and 5±1.21 in Group III and the difference was found significant. At postoperative period, VAS and CHEOPS scores were lower in group II than the other groups. Bleeding or other complications did not recorded. Conclusion: In concluded that, intravenous and peritonsillary dexamethasone prolonged the first analgesic administered time and decreased pain, nausea and vomiting compared to peritonsillar levobupivacaine alone in children undergoing tonsillectomy or adenotonsillectomy. However, dexamethasone did not increase postoperative bleeding after tonsillectomy. [Cukurova Med J 2012; 37(4.000): 203-210]

Abstract The EGFR‐driven cell‐cycle pathway has been extensively studied due to its pivotal role in breast cancer proliferation and pathogenesis. Although several studies reported regulation of individual pathway components by microRNAs (miRNAs), little is known about how miRNAs coordinate the EGFR protein network on a global miRNA (miRNome) level. Here, we combined a large‐scale miRNA screening approach with a high‐throughput proteomic readout and network‐based data analysis to identify which miRNAs are involved, and to uncover potential regulatory patterns. Our results indicated that the regulation of proteins by miRNAs is dominated by the nucleotide matching mechanism between seed sequences of the miRNAs and 3′‐UTR of target genes. Furthermore, the novel network‐analysis methodology we developed implied the existence of consistent intrinsic regulatory patterns where miRNAs simultaneously co‐regulate several proteins acting in the same functional module. Finally, our approach led us to identify and validate three miRNAs (miR‐124, miR‐147 and miR‐193a‐3p) as novel tumor suppressors that co‐target EGFR‐driven cell‐cycle network proteins and inhibit cell‐cycle progression and proliferation in breast cancer.

The appearance of a solitary lateral cervical cystic mass as the only initial presenting symptom of occult thyroid carcinoma is uncommon. Its presence is often related with the more frequently branchial cyst in young adults, but also rarely related with thyroid carcinomas. In most of these cases all such lesions may initially be considered as metastatic foci from a primary thyroid lesion. However, an alternative explanation by means of which ectopic thyroid tissue is associated with a branchial cyst has to be considered, especially if no primary tumour is observed in the histological examination of the thyroid gland. We present two case of solitary cystic lymph node metastasis of occult papillary carcinoma of the thyroid. [Cukurova Med J 2011; 36(1): 29-33]

The appearance of a solitary lateral cervical cystic mass as the only initial presenting symptom of occult thyroid carcinoma is uncommon. Its presence is often related with the more frequently branchial cyst in young adults, but also rarely related with thyroid carcinomas. In most of these cases all such lesions may initially be considered as metastatic foci from a primary thyroid lesion. However, an alternative explanation by means of which ectopic thyroid tissue is associated with a branchial cyst has to be considered, especially if no primary tumour is observed in the histological examination of the thyroid gland. We present two case of solitary cystic lymph node metastasis of occult papillary carcinoma of the thyroid. [Cukurova Med J 2011; 36(1.000): 29-33]

Nasal gliomas are rare, benign, congenital tumors that are thought to be result of abnormality in embryonic development. Three types of clinical presentations have been recognized; extranasal, intranasal and combined. Clinically, these masses are non-pulsatile, gray or purple lesions that obstruct the nasal cavity and cause deformity extranasaly. Histologically, they are made up of astrocytic cells, fibrous and vascular connective tissue that is covered with nasal respiratory mucosa. Treatment of the nasal glioma requires a multidisciplinary approach including an radiologist, neurosurgeon and otorhinolaryngologist. Radiological investigation should be performed to describe intracranial extension. In this case, a 2 years old boy with nasal mass that was diagnosed as nasal glioma is reported. . [Cukurova Med J 2011; 36(1): 34-36]

Nasal gliomas are rare, benign, congenital tumors that are thought to be result of abnormality in embryonic development. Three types of clinical presentations have been recognized; extranasal, intranasal and combined. Clinically, these masses are non-pulsatile, gray or purple lesions that obstruct the nasal cavity and cause deformity extranasaly. Histologically, they are made up of astrocytic cells, fibrous and vascular connective tissue that is covered with nasal respiratory mucosa. Treatment of the nasal glioma requires a multidisciplinary approach including an radiologist, neurosurgeon and otorhinolaryngologist. Radiological investigation should be performed to describe intracranial extension. In this case, a 2 years old boy with nasal mass that was diagnosed as nasal glioma is reported. . [Cukurova Med J 2011; 36(1.000): 34-36]

Amaç: Çalışmamızda, çocuklarda tonsillektomilerde, peritonsiller levobupivakaine eklenen i.v. (intravenöz) deksametazon ve peritonsiller deksametazonun postoperatif ağrı, kanama, bulantı ve kusma üzerine etkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya Cukurova University Tıp Fakültesi Hastanesi Etik Kurul Onayı ve ailelerin yazılı onamı alındıktan sonra, elektif tonsillektomi veya adenotonsillektomi operasyonu yapılması planlanan 3-12 yaş arası ASA (American Society of Anesthesiologist) I- II toplam 60 hasta dahil edildi. Operasyona alınan tüm hastalar randomize olarak 3 gruba ayrıldı. Anestezi indüksiyonu sonrası cerrahi başlamadan önce Grup Ι"de (n=20) olgulara, her bir tonsile % 0,5 levobupivakain 0,4 mg/kg (maximum 4"er ml) ile peritonsiller infiltrasyon yapıldı. Grup II"de levobupivakaine ek olarak (n=20) 0.25 mg/kg i.v. deksametazon, Grup III"deki olgulara ise levobupivakaine ek olarak peritonsiller 4 mg deksametazon uygulandı. Her üç gruba da postoperatif analjezik olarak 1 mg/kg i.v. tramadol uygulandı. Preoperatif ve ilaçların enjeksiyonunu takiben hemodinamik parametreler kaydedildi. Postoperatif dönemde, uyanma odasında 1 saat (erken dönem) ve sonraki 24 saat (geç dönem) veya taburcu olana kadar bulantı ve kusma sıklığı, analjezi düzeyleri, ilk analjeziğe gereksinim zamanı, ağrı düzeyi (VAS;Vizüel Analog Skala ve CHEOPS;Children"s Hospital of Eastern Ontorio Pain Scale) 10, 20, 30 ve 45. dakikalar ile 1, 2, 4, 6 ve 24. saatlerde kaydedildi. Postoperatif erken ve geç dönemde kanama olup olmadığı kaydedildi. Bulgular: Grupların demografik verileri ve hemodinamik parametrelerinin benzer olduğu ve aralarında istatistiksel olarak anlamlı bir fark bulunmadığı belirlendi. Grup I"de bulantı, kusma yüzdesinin daha yüksek olduğu saptandı. Ek analjezik başlama süresi Grup I"de 3,15±0,88 saat, Grup II"de 4,85±1,09 saat ve Grup III"de 5±1,21 saat olup istatistiksel olarak anlamlı bulundu (p