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Objective:Studies show that in patients diagnosed with Coronavirus disease-2019 (COVID-19), polymerase chain reaction (PCR) tests can give false negative results depending on sampling techniques/regions. In this study; the positivity of virus RNA was studied consecutive lung tru-cut needle biopsy taken at 6-hour intervals in cases who died during treatment due to COVID-19 infection, it was aimed to determine the postmortem safe working range.Methods:In May 2020-April 2021, 21 patients who died during treatment due to COVID-19 infection diagnosed with clinical and/or RNA detection in Muğla Training Research Hospital, Anesthesia Intensive Care Unit were included. Antemortem, postmortem swabs results, and virus RNA detection by PCR made from postmortem lung tissue samples were compared with their clinics. Statistical analysis was performed.Results:Fifteen (71.4%) of 21 cases were male and 6 (28.6%) were female. The mean age is 71.9 (standard deviation=12.079). All of the toracic CT findings at hospitalization had a ground-glass opacity. The mean hospitalization time was 11.7 days. Antemortem nasopharyngeal virus positivity was shown in 13 cases (61.9%), postmortem nasopharyngeal virus positivity in 5 cases (23.8%), and virus positivity in lung tissue samples in 7 cases (33.3%). No significant correlation was found virus positivity in nasopharyngeal swab and lung tissue sample, the incompatibility rate was 19.1%, which was statistically significant.Conclusion:Although the targeted sample size could not be reached due to study limitations, the inconsistency in virus positivity in nasopharyngeal swabs and lung tissue samples is significant. It is certain that studies with a large comparative sample are needed in terms of postmortem survival time, clinical and organ damage caused by the virus.

Background and Objectives: The primary purpose of the article was to examine the relationship between dark and light personality traits in university students enrolled in the Faculty of Sport Sciences. Materials and Methods: Data were collected from 518 students (208 female, 310 male) with an average age of 20.89 (±2.25). The Short Dark Triad and the Light Triad Scales were used. Harman’s single-factor analysis minimized measurement error, and various statistical methods assessed the effect of gender and age on personality traits. Results: Results indicated a positive correlation among dark personality traits, while light personality traits exhibited more complex relationships. Gender and age were found to significantly influence certain personality traits. Conclusions: This study contributes to the sports literature by exploring the role of demographic variables in personality formation.

Background and Objectives: Extubation success in ICU patients is crucial for reducing ventilator-associated complications, morbidity, and mortality. The Rapid Shallow Breathing Index (RSBI) is a widely used predictor for weaning from mechanical ventilation. This study aims to determine the predictive value of serial RSBI measurements on extubation success in ICU patients on mechanical ventilation. Materials and Methods: This prospective observational study was conducted on 86 ICU patients at Hitit University between February 2024 and July 2024. Patients were divided into successful and unsuccessful extubation groups. RSBI values were compared between these groups. Results: This study included 86 patients (32 females, 54 males) with a mean age of 54.51 ± 12.1 years. Extubation was successful in 53 patients and unsuccessful in 33. There was no significant difference in age and intubation duration between the groups (p = 0.246, p = 0.210). Significant differences were found in RSBI-1a and RSBI-2 values (p = 0.013, p = 0.011). The median RSBI-2a was 80 in the successful group and 92 in the unsuccessful group (p = 0.001). The ΔRSBI was higher in the unsuccessful group (p = 0.022). ROC analysis identified optimal cut-off values: RSBI-2a ≤ 72 (AUC 0.715) and ΔRSBI ≤ −3 (AUC 0.648). RSBI-2a ≤ 72 increased the likelihood of successful extubation by 10.8 times, while ΔRSBI ≤ −3 increased it by 3.4 times. Using both criteria together increased the likelihood by 28.48 times. Conclusions: Serial RSBI measurement can be an effective tool for predicting extubation success in patients on IMV. These findings suggest that serially measured RSBI may serve as a potential indicator for extubation readiness.

Background: To compare distinctive features of hyperreflective particles observed on spectral-domain optical coherence tomography (OCT) sections in eyes with acute toxoplasma chorioretinitis (TC) and non-infectious uveitis (NIU). Methods: Medical records and the spectral-domain OCT images of the patients with TC and NIU were retrospectively reviewed. The TC and NIU groups were compared in terms of age, sex, mean OCT image quality, mean central macular thickness (CMT), presence of intraretinal fluid (IRF), presence of subretinal fluid (SRF), number of hyperreflective particles in the posterior vitreous area and mean particle measurement in the posterior vitreous area. Results: Non-infectious uveitis group included nine patients (60 %) with Behcet's uveitis, five patients (33.3 %) with idiopathic posterior uveitis or panuveitis, and the remaining patient (6.7 %) with HLA-B27 associated uveitis. Comparison of the mean age, sex distribution, mean OCT image quality, mean CMT, presence of IRF, presence of SRF and the mean number of hyperreflective particles in the posterior vitreous area between the two groups showed no statistically significant differences (p = 0.085, p = 0.051, p = 0.748, p = 0.431, p = 0.109, p = 0.080 and p = 0.152, respectively). However, the mean length of the hyperreflective particles in the posterior vitreous area was 27.22 ± 8.60 μm in the TC group, and 21.91 ± 3.58 μm in the NIU group, with a significant difference between the two groups (p = 0.036). Conclusion: This pilot study aimed to assess the hyperreflective particles in the posterior vitreous area using spectral-domain OCT images and image processing software. Despite its limitations, such as the small sample size, limited understanding of the nature of hyperreflective particles, and the absence of differentiation between acute and chronic uveitis, our study points out the potential role of the measurement of the hyperreflective particle length located in the posterior vitreous in differentiating the acute infectious versus non-infectious uveitis as the hyperreflective particles tend to be larger in infectious cases.

BackgroundThe study of physiotherapy is challenging and can affect the students’ well-being and quality of life. The aim of this study was to describe and compare factors that could affect well-being among students across Europe.MethodsIn this descriptive cross-sectional study using an online questionnaire survey, students of bachelor’s physiotherapy programs from 23 European faculties, from 8 countries, were interviewed on mental health and stress burden, sleep quality, dietary habits, and physical activity.ResultsAlthough 75% of students rated their quality of life positively and 47% were satisfied with their mental health, 65% showed higher levels of stress and 51% described impaired sleep quality. The minimum physical activity of 150 min weekly was described by 79% of students, within which 67% engaged in strengthening twice a week. Students with a higher stress load/worse psychological health also showed worse sleep quality and lower amount of physical activity, women were significantly worse off. In terms of physical activity and sleep quality, students from Finland and Kosovo achieved the best results, while students from Italy, Greece, and Portugal achieved the worst. Students from Italy indicated the greatest dissatisfaction with the organisation of the study system and communication with teachers, while in Kosovo students rated the communication and study organisation the highest. All students had a problem with adhering to nutritional habits. Students from Italy and Spain, with the lowest body mass indexes and weight averages, were closest to the nutrition recommendations.ConclusionWe demonstrated that physiotherapy students are burdened with stress, suffer from sleep disorders, and do not follow the recommendations regarding nutrition nor physical activity. There are significant differences between universities and countries in some aspects.

The aim of this study was to investigate the effect of patient demographic and anatomical characteristics on abdominal compliance (AC), which represents the slope of the pressure–volume (P–V) curve of the abdominal cavity and is a measure of the ease of abdominal dilatation. The study included 90 patients undergoing laparoscopic abdominal surgery. Subcutaneous adipose tissue and abdominal muscle thickness were measured using ultrasonography. The mean AC was calculated during insufflation using the formula (ΔV/ΔP). The relationship between demographic and anatomical variables and AC was investigated. The results demonstrated that AC was higher in men, the elderly, and women with a history of pregnancy, and lower in patients with a history of abdominal surgery. No significant correlation was found between AC and BMI, abdominal muscle thickness, and subcutaneous adipose tissue thickness. These findings suggest that morbid obesity, a common comorbidity in laparoscopic surgery, and well-developed abdominal muscles are not indicators of low AC. However, gender, age, pregnancy history, and previous abdominal surgery affect AC during laparoscopic surgery. By taking these factors into account during preoperative evaluation, it may be possible to predict patients with low AC, which could improve perioperative outcomes through the application of individualized intra-abdominal pressure (IAP) during pneumoperitoneum.

Objective:Erectile dysfunction (ED) has a significant impact on quality of life, given its high prevalence and association with cardiovascular diseases. In the present study, we aimed to evaluate exercise treadmill parameters in patients with ED.Methods:A total of 178 patients who were admitted to the cardiology clinic was enrolled in the study. Patients were divided into two groups according to their International Index of Erectile Function-5 (IIEF-5) score. Exercise time, maximum heart rate (HR), resting HR, chronotropic index (CI), HR recovery at one minute (HRR1) and two minutes (HRR2) were evaluated for each patient.Results:Subjects with ED were older, had similar rates of diabetes mellitus and hypertension compared to control group. Exercise time was longer and peak HR was higher in patients with ED compared to the healthy counterparts [556.00 (61) sec. vs 575.5 (84) sec. p=0.025, and 156.00 (13) bpm vs 160.50 (11) bpm p=0.001, respectively]. We did not find statistically significant differences with respect to resting HR, HRR1, HRR2, CI, maximum systolic and diastolic blood pressure, or rate pressure product between two groups. IIEF-5 score was negatively correlated with age (r=-0.54, p=

Arthropathy is a serious and common problem in patients with hemophilia impairing the patient’s quality of life seriously. The most commonly affected joints in hemophilic arthropathy are knees, ankles and elbows. Even a single bleeding could cause devastating effects to synovium, cartilage and also subchondral bones. Ultrasound and magnetic resonance imaging have been advocated for the studying of cartilage damage. Prophylaxis has been demonstrated as a standard choice of management to prevent hemophilic arthropathy development. Primary prophylaxis starting at early years of age is very important to prevent hemorrhages but secondary prophylaxis in adolescents has also significant success rates. As the duration of exposure to the blood increases in the joint cavity, degeneration of the cartilage matrix and resultant cartilage loss also increase, so the aspiration of the hematoma from joint plays an important role in prevention of the disease progression. Synovectomy may be required in cases where prophylaxis and aspiration does not prevent the recurrent hemorrhages. The purpose of synovectomy either with medical or surgical methods is to remove the problematic synovium to prevent the progression of hemophilic arthropathy. Medical synovectomy (synoviorthesis) has two basic types; radiosynovectomy and chemical synovectomy and the former one is appearing to be more effective with an about 85% success rates. If all of these measures fail to prevent the progressive cartilage damage, open or arthroscopic synovectomy, arthrodesis of the affected joint or even arthroplasty could be necessary. Here we tried to summarize the pathological mechanism, diagnosis and management of hemophilic arthropathy in children.

Aim:Although there are few studies on the predictive value of C-reactive protein-to-albumin ratio (CAR) in coronavirus disease-2019 (COVID-19) patients, to the best of our knowledge, there are no studies specifically conducted in COVID-19 patients with cardiovascular disease (CVD). This study assessed the use of baseline CAR levels to predict death in hospitalized COVID-19 patients with CVD.Methods:This study was designed as a single-center cross-sectional study. Patients diagnosed with COVID-19 who were admitted to the University of Health Sciences Turkey, Bagcilar Training and Research Hospital between April 16 and May 20, 2020 were analyzed retrospectively. The patients were divided into 2 groups: those who died and those who survived, considering the follow-up period. The CAR values of the study population, as well as patients with CVD, were calculated, and the association of CAR with in-hospital mortality was evaluated.Results:The in-hospital mortality rate was 11.1% (49/442 pts) in all populations. Deceased patients had significantly more frequent CVD (p

The aim of this study is to compare the diameter of the inferior vena cava with mitral annular plane systolic excursion measurement in order to determine the volume loss before and after blood donation in healthy volunteers.

Amaç: Kalpain-10 (CAPN10), Ca+2 bağımlı intrasellüler sistein proteazlar ailesinin atipik bir üyesidir. Birçok dokuda eksprese edilir ve başta insülin sekresyonu ve aktivitesi olmak üzere çok çeşitli hücresel fonksiyonlar için gereklidir. Tanımlanan ilk Tip 2 diyabet (T2D) yatkınlık genidir. Çalışmamızda bir Türk popülasyonunda CAPN10 gen polimorfizmleri (SNP-44, -43 ve -137) ile artmış T2D riski arasındaki ilişkinin analiz edilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 149 T2D’li hasta ve 48 sağlıklı birey dahil edildi. Genotiplendirme PCR-SSCP tekniği kullanılarak yapıldı, dizi analizi ile doğrulandı. CAPN10 genotiopleri ile T2D gelişimi ve klinik özellikler arasındaki ilişki istatistiksel olarak analiz edildi. Bulgular: Hastalıkla genotip arasındaki ilişkiyi belirlemek için yapılan odds analizi sonuçlarına göre; SNP-44 ile hastalık arasında ilişki gözlenmezken (OR: 1.417 CI:0.452-4.436, P=0.740), SNP-43 ile hastalık arasında anlamlı ilişki bulundu (OR: 0.455 CI:0.235-0.881, P=0.028). SNP-137 genotip dağılımı bakımından tüm hasta ve kontrol bireylerde C/C olarak tespit edildi. Taranan SNP’ler ile klinik parametreler arasında herhangi bir ilişki bulunmadı (P>0.05). Sonuç: Sonuçlarımıza göre; CAPN10 genindeki SNP-43, Türk populasyonunda T2D gelişimi açısından bir risk faktörüdür.

Amaç: Otizm spektrum bozukluğu (OSB), erken çocukluk dönemlerinde sosyal etkileşim ve iletişim becerilerinde yetersizlik, kısıtlı ilgi alanı ve stereotipik davranış örüntüleri ile karakterize nörogelişimsel önemli bir bozukluktur. Bu çalışmanın amacı OSB tanısı almış çocuğu olan ebeveynlerin aşılar hakkında genel bilgilerini ölçme, aşıya karşı tutumlarını belirleme, aşı karşıtlığının oranı ve nedenlerini saptamaktır. Gereç ve Yöntem: Çalışma, OSB tanılı çocukları olan ebeveynlerden birisi ile, yüz yüze görüşmek sureti ile, anket yaparak gerçekleştirilmiştir. Bulgular: Elde edilen verilere göre; kontrol grubu ile karşılaştırıldığında, otizmli çocukları olan ebeveynlerin; aşılar hakkındaki bilgi düzeylerinin, ve aşı reddi tercihlerinin daha yüksek olduğu, aşıların içeriklerinden daha çok şüphe duydukları, özellikle canlı virus aşılaması ile otizmin başlaması arasında, zamansal ilişki olduğuna inandıkları belirlenmiştir. Sonuç: OSB tanılı çocukların rutin çocuk-ergen psikiyatristleri tarafından, rutin kontrollerinde; ailelerin aşılar hakkındaki düşünceleri, kaygıları ve kaçınmaları değerlendirilmelidir.

Purpose: Biomarkers are useful measures assisting the diagnosis, treatment, and prognosis of cardiovascular diseases. They can predict the severity of cardiovascular diseases, especially in acute myocardial infarction at the emergency department. We aimed to investigate the severity of cardiovascular disease using three biomarkers, namely cardiac troponins, C-reactive protein (CRP), and procalcitonin in patients with ST-elevation myocardial infarction who presented to the emergency department. Materials and Methods: The study included a total of 166 patients that presented with ST-elevation myocardial infarction (STEMI) in the first three hours of symptom onset and underwent coronary angiography. SYNTAX (SS) scores were calculated, and based on these scores, two groups were formed. High-sensitivity troponin T (Hs-TnT), high-sensitivite CRP (Hs-CRP), and procalcitonin levels were measured at the presentation. Results: Although the high sensitive troponin, Hs-CRP values were higher in the SYNTAX score>20 groups, there was no statistically significant difference between the two groups. There was no significant difference in the PCT measurements between the two groups Conclusion: When Hs-TnT and Hs-CRP are evaluated together in patients with STEMI with a high SS, it may be predictive in early determining the severity of coronary artery disease.

Abstract Background During aging, hematopoietic stem cells (HSC) lose progressively both their self-renewal and differentiation potential. The precise molecular mechanisms of this phenomenon are not well established. To uncover the molecular events underlying this event, we have performed a bioinformatics analysis of 650 single-cell transcriptomes. Methods Single-cell transcriptome analyses of expression heterogeneity, cell cycle, and cell trajectory in human cell compartment enriched in hematopoietic stem cell compartment were investigated in the bone marrow according to the age of the donors. Identification of aging-related nodules was identified by weighted correlation network analysis in this primitive compartment. Results The analysis of single-cell transcriptomes allowed to uncover a major upregulation of EGR1 in human-aged lineage−CD34+CD38− cells which present cell cycle dysregulation with reduction of G2/M phase according to less expression of CCND2 during S phase. EGR1 upregulation in aging hematopoietic stem cells was found to be independent of cell cycle phases and gender. EGR1 expression trajectory in aged HSC highlighted a signature enriched in hematopoietic and immune disorders with the best induction of AP-1 complex and quiescence regulators such as EGR1, BTG2, JUNB, and NR41A. Sonic Hedgehog-related TMEM107 transmembrane molecule followed also EGR1 cell trajectory. EGR1-dependent gene weighted network analysis in human HSC-associated IER2 target protein-specific regulators of PP2A activity, IL1B, TNFSF10 ligands, and CD69, SELP membrane molecules in old HSC module with immune and leukemogenic signature. In contrast, for young HSC which were found with different cell cycle phase progression, its specific module highlighted upregulation of HIF1A hypoxic factor, PDE4B immune marker, DRAK2 (STK17B) T cell apoptosis regulator, and MYADM myeloid-associated marker. Conclusion EGR1 was found to be connected to the aging of human HSC and highlighted a specific cell trajectory contributing to the dysregulation of an inflammatory and leukemia-related transcriptional program in aged human HSCs. EGR1 and its program were found to be connected to the aging of human HSC with dissociation of quiescence property and cell cycle phase progression in this primitive hematopoietic compartment.

Purpose: The aim of this study was to evaluate the lung-protective mechanical ventilation strategy, early enteral nutrition, negative fluid balance, and adequacy of hospital resources in our pediatric intensive care unit. Materials and Methods: This study included 32 patients who developed acute respiratory distress syndrome (ARDS) during their monitoring in the pediatric intensive care unit. Results: According to their oxygenation status, 14 patients (43.8%) had mild ARDS, nine patients (28.1%) had moderate ARDS, and nine patients (28.1%) had severe ARDS. High-frequency oscillatory ventilation was applied to three patients (9.3%), and four patients (12.5%) received extracorporeal membrane oxygenation (ECMO) support. The most common complications were nosocomial infection (31.3%) and pneumothorax (12.5%). The mortality rate was 6.3%. The survival rate was 75.0% in patients with ECMO support. The patients with a higher Pediatric Index of Mortality (PIM-2) score confronted more severe ARDS, and non-pulmonary ARDS also progressed in advanced stages. Conclusion: In patients with high PIM-2 and PELOD scores, attention must be given to the development of severe ARDS. The lung-protective mechanical ventilation support, early enteral nutrition, negative fluid balance practices, and the adequacy of hospital resources led to a successful survival rate in our study. However, multicenter randomized controlled trials are needed on this subject.

Abstract The use of mesenchymal stem cells (MSC) derived from several sources has been suggested as a major anti‐inflammation strategy during the recent outbreak of coronavirus‐19 (COVID‐19). As the virus enters the target cells through the receptor ACE2, it is important to determine if the MSC population transfused to patients could also be a target for the virus entry. We report here that ACE2 is highly expressed in adult bone marrow, adipose tissue, or umbilical cord‐derived MSC. On the other hand, placenta‐derived MSC express low levels of ACE2 but only in early passages of cultures. MSC derived from human embryonic stem cell or human induced pluripotent stem cells express also very low levels of ACE2. The transcriptome analysis of the MSCs with lowest expression of ACE2 in fetal‐like MSCs is found to be associated in particularly with an anti‐inflammatory signature. These results are of major interest for designing future clinical MSC‐based stem cell therapies for severe COVID‐19 infections.

Objective:Hand dominancy can be observed as right, left, or the usage of bilateral hands. Majority of the Turkish population are right-hand dominant. This study aimed to examine and interpret the motion perception and motor learning of the dominant and non-dominant upper extremity.Methods:A total of 146 right-hand dominant university students participated in this study. The mean age of participants was 23.0±1.99, wherein 80 were female (54.79%) and 66 were male (45.21%). Hand preference was evaluated by the Edinburgh Hand Preference Questionnaire. Participants were positioned at the table edge with the hip, knee, and elbows at 90 degrees flexion. Measurements were made on a special platform. Participants were asked to place the glass at the center point, with a 25 cm distance from the rangefinder, and their eyes closed. Measurements were repeated 3 times on both dominant and non-dominant sides. The distance and deviation rate from the center point were recorded in cm with the laser rangefinder. Statistical Package for the Social Sciences 21.0 program was used in the analysis.Results:According to the Edinburg Hand Preference Questionnaire, 42 of participants (28.76%) were strong right dominant, 95 (65.06%) were weak right dominant, and 9 (6.18%) were weak left dominant. The mean of distance from the central point for three measurements during the activity of glass placing were 2.56±1.91 cm on the dominant side and 2.57±1.86 cm on the non-dominant side. No significant difference was observed in terms of distance from the center point in dominant and non-dominant hand (p>0.05). However, when results of the deviation from the center of three measurements were examined in the dominant side, according to the deviation distance, the first measurement was found closer to the center point than the second and third measurement results (p

Aim:The aim of this study is to determine the relationship between hyperemesis gravidarum and maternal serum pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG) levels. This study was designed as a case-control study.Methods:The study group consists of 54 pregnant women of 10-14 weeks who were diagnosed with hyperemesis gravidarum in the İstanbul Training and Research Hospital Hospital while the control group consists of 54 pregnant women of 10-14 weeks who did not have any complaints. Thyroid stimulating hormone, free T3, free T4, aspartate aminotransferase, alanine aminotransferase, PAPP-A, and hCG values and age were retrospectively scanned from files.Results:We have observed that the hyperemesis gravidarum group has higher hCG levels as compared with the control group. The mean hCG level in control group and hyperemesis group was 1.10±0.569 and 1.55±1.140, respectively (p

Objective: This study aims to investigate the validity and reliability of the FS-ICU 24 survey in the Turkish language, to evaluate the satisfaction of ICU patients' relatives, and to determine the factors affecting satisfaction. Materials and Methods: In this study, the Turkish version was prepared based on the FS-ICU 24 survey applied to the relatives of ICU patients (Anesthesiology, Internal Medicine, General Surgery and Neurosurgery) at the Erciyes University in the Faculty of Medicine between April 2015 and June 2015. The Turkish version was tested and proven to be reliable and valid. Relatives of patients that were hospitalized for at least 48 hours, who had visited the patient at least once, were included. In this study, 369 surveys were completed. Results: FS-ICU 24 survey was found reliable and valid in Turkish. Patients' relatives were unsatisfied with physical conditions, waiting room setting and frequency of communication with nurses the most. The relatives were highly satisfied with the skills and competency of ICU doctors/nurses, setting of the ICU, completeness of treatment provided. Among the intensive care unit departments, there were not any statistically significantly different satisfaction results (p>0.05). The satisfaction level was found to decrease with increasing education levels and increasing duration of hospitalization (p

Amaç: Preterm erken membran rüptüründe (PPROM) ve preterm doğumda (PD) idrar yolu enfeksiyonunun olumsuz neonatal sonuçları ve doğum süresine ile arasındaki ilişkinin araştırılmasını amaçladık.Gereç ve Yöntem: 2008-2014 yılları arasında merkezimize başvuran 1033 gebe hastayı retrospektif olarak değerlendirdik. Çalışma grupları 446 PPROM ve 587 PD hastasından oluşuyordu. Bulgular: İdrar kültürü pozitif PPROM hastalarında transvajinal ultrasonografi ile ölçülen servikal uzunluk(OR = 0.806,) ve amniyon sıvısı indeksi (AFI), (OR = 0.961) ve idrar kültürü pozitif PD hastalarında sadece servikal uzunluk OR = 0.862 doğum süresinin yedi günden daha kısa olacağı ile ilişkili idi. Ayrıca idrar kültürü pozitif olan PPROM grubunda AFI’ nin (OR = 0.982) olumsuz neonatal sonuçlarla ilişkilendirileceğini belirledik.Sonuç: İdrar kültürü pozitif PPROM ve PD hastalarında olumsuz neonatal sonuçları ve doğum zamanını öngörmede AFI ve servikal uzunluk da kullanılabilir.

Cancer is maintained by the activity of a rare population of self-renewing “cancer stem cells” (CSCs), which are resistant to conventional therapies. CSCs over-express several proteins shared with induced pluripotent stem cells (iPSCs). We show here that allogenic or autologous murine iPSCs, combined with a histone deacetylase inhibitor (HDACi), are able to elicit major anti-tumor responses in a highly aggressive triple-negative breast cancer, as a relevant cancer stemness model. This immunotherapy strategy was effective in preventing tumor establishment and efficiently targeted CSCs by inducing extensive modifications of the tumor microenvironment. The anti-tumoral effect was correlated with the generation of CD4+, CD8+ T cells, and CD44+ CD62L- CCR7low CD127low T-effector memory cells, and the reduction of CD4+ CD25+FoxP3+ Tregs, Arg1+ CD11b+ Gr1+, and Arg1+ and CD11b+ Ly6+ myeloid-derived suppressor cell populations within the tumor. The anti-tumoral effect was associated with a reduction in metastatic dissemination and an improvement in the survival rate. These results demonstrate for the first time the clinical relevance of using an off-the-shelf allogeneic iPSC-based vaccine combined with an HDACi as a novel pan-cancer anti-cancer immunotherapy strategy against aggressive tumors harboring stemness features with high metastatic potential.

Progress made during the last decade in stem cell biology allows currently an unprecedented potential to translate these advances into the clinical applications and to shape the future of regenerative medicine. Organoid technology is amongst these major developments, derived from primary tissues or more recently, from induced pluripotent stem cells (iPSC). The use of iPSC technology offers the possibility of cancer modeling especially in hereditary cancers with germline oncogenic mutations. Similarly, it has the advantage to be amenable to genome editing with introduction of specific oncogenic alterations using CRISPR-mediated gene editing. In the field of regenerative medicine, iPSC-derived organoids hold promise for the generation of future advanced therapeutic medicinal products (ATMP) for organ repair. Finally, it appears that they can be of highly useful experimental tools to determine cell targets of SARS-Cov-2 infections allowing to test anti-Covid drugs. Thus, with the possibilities of genomic editing and the development of new protocols for differentiation toward functional tissues, it is expected that iPSC-derived organoid technology will represent also a therapeutic tool in all areas of medicine.

Amaç: Bu çalışmada, ön çapraz bağ tamirinde kullanılan transtibial (TT) ile anteromedial portal (AMP) teknik arasındaki farklılıkların, ön çapraz bağ rekonstrüksiyonu sonrası hastaların diz eklemi fonksiyonları üzerine etkilerinin araştırılması amaçlanmıştır.Gereç ve Yöntemler: Çalışmamıza kliniğimizde ön çapraz bağ yırtığı nedeniyle cerrahi olarak tedavi edilen 60 hasta dahil edildi. Otuz hastaya TT teknik, 30 hastaya AMP teknik uygulandı. Fonksiyonel değerlendirmelerde Lysholm, Uluslararası Diz Belgelendirme Komitesi (International Knee Documentation Committee, IKDC) ve Tegner skoru preop ve postop olarak bakıldı. Postoperatif anteroposterior ve lateral diz grafilerinde femur tüneli ile distal eklem yüzü arasındaki açı ölçüldü ve diz eklemi fonksiyonel sonucu üzerine etkisi incelendi.Bulgular: Çalışmaya dahil edilen hastaların %80’i erkek (n=47) ve %20’si kadındır (n=13). Gruplara göre cinsiyet dağılımı homojendir (p=0.476). Bireylerin ortalama yaşı 32.75±8.81 (16-53) olarak tespit edildi. AMP uygulanan grupta ölçülen operasyon sonrası Lysholm skor değeri, TT teknik uygulanan grupta ölçülen değerinden anlamlı düzeyde daha yüksek bulunmuştur (p

Objective: Retrograde intrarenal surgery (RIRS) is a minimally invasive and relatively new method of treatment for kidney stones. We aimed to identify the factors that cause stent migration in patients who have undergone RIRS to treat kidney stones. Materials and Methods: Four hundred and twenty-eight patients who underwent RIRS to treat kidney stones that were less than 2 cm in size and had JJ stents inserted intraoperatively between December 2013 and December 2017 were included in this study. For each patient, demographic data and, if present, JJ stent migration direction and postoperative complications were recorded. Twenty-eight patients who experienced JJ stent migration (group 1) and 400 patients who did not experience the migration (group 2) were compared. Results: Postoperative complications developed in a total of 39 (9.1%) patients. Seventeen complications were evaluated as minor (Clavien 1–2) and 22 (5.1%) were evaluated as major. Almost all of the major complications (n=21) were found to be associated with JJ stent migration. Urosepsis was detected in only one patient (Clavien 4). The mean ages in groups 1 and 2 were 45.4+-17.3 years and 44.3+-15.1 years, respectively. The mean stone size in group 1 was 16.9+-3.0 mm, whereas it was 14.2+-5.3 mm in group 2 (p=0.031). A comparison of both the groups showed that the likelihood of an occurrence of JJ stent migration increased significantly with the degree of hydronephrosis (p

Amaç: Bu çalışmada kronik plantar fasiit (PF) tedavisinde kullanılan üç farklı popüler konservatif tedavi yöntemi olan kortikosteroid enjeksiyonu (KSE), ekstrakorporeal şok dalga tedavisi (ESWT) ve radyofrekans sinir ablasyonu (RFSA) tedavi yöntemlerinin klinik ve fonksiyonel sonuçlarının karşılaştırması amaçlanmıştır.Gereç ve Yöntemler: Bu retrospektif çalışmaya diğer konservatif tedavi yöntemlerine dirençli olan kronik PF'li hastalar dahil edildi. Ocak 2017 ile Şubat 2019 arasında konservatif tedavi yöntemleriyle tedavi edilmiş olan kronik PF tanılı tüm hastalar incelendi. Uygunluk kriterleri ile uyumlu olan ve KSE, ESWT veya RFSA yöntemlerinden biri ile tedavi edilen kırk sekiz hasta çalışmaya dahil edildi. Hastaların klinik ve fonksiyonel değerlendirmeleri tedaviden hemen önce ve son seansın 6. ve 12. haftalarında, Amerikan Ortopedik Ayak ve Ayak Bileği Birliği (AOFAS) skorlama sistemi ve görsel analog skala (VAS) ile yapıldı.Bulgular: Gruplar arasında hem tedavi öncesi hem de 6. Hafta için VAS skorları bakımından istatistiksel olarak anlamlı düzeyde bir farklılık vardı (her iki p

Objectives: In recent years, a significant increase has been observed in the prevalence of caesarean sections (CS). Although as in many other countries, CS rates in Turkey are higher than the targeted rate. This increase in the prevalence of CS also affects obstetric anaesthesia. In this study, we investigate the choice of anaesthesia among pregnant women who are scheduled for CS, as well as general anaesthesia and regional anaesthesia rates, the reasons for choosing general anaesthesia or regional anaesthesia, and the factors that affect their choices. Methods: A questionnaire consisting of 20 questions were applied to pregnant women applying for delivery by elective caesarean operation, between November 2011 to November 2012, in order to study the anaesthesia technique they prefer and the reason behind their preferences. The questionnaire was applied to pregnant women during the visit, on the day before the operation or while they were waiting in the waiting room before the CS procedure. Results: Our study revealed that age, gravida, previous type of delivery, previous anaesthesia experience, employment status, monthly income level, educational status, being given information about anaesthesia in advance, the source of information, and being diagnosed with panic disorder were all found to be influential in the decision of which type of anaesthesia to opt for. Conclusion: We have found out that the reason why pregnant women who have higher educational status, who work and have high level of monthly-income prefer regional anaesthesia method more depends on the fact that they have more information on anaesthesia method, they have more common use of the internet and the information they obtain from the people around them is not prejudiced against regional anaesthesia method. We believe that as the education levels rise in the future and the patient population becomes more aware, which will direct them to do more research, their preference rates will change.

Objective: We aimed to compare the performances of HYPERsensitive and Fast thyroid-stimulating hormone (TSH) methods in euthyroid subjects. Materials and Methods: The study included 500 euthyroid subjects. We measured the TSH levels of study subjects using HYPERsensitive and Fast TSH methods. We compared the performances of the two methods. Moreover, free triiodothyronine and thyroxine, anti-thyroglobulin, and anti-thyroperoxidase levels were determined in study subjects. Results: Mean serum TSH levels were determined as 1.76+-1.06 and 1.85+-1.12 µIU/mL using Fast and HYPERsensitive TSH methods, respectively. Differences were statistically significant (p

INTRODUCTION[|]The granulocyte colony-stimulating factor (G-CSF) is the most commonly used hematopoietic growth factor recombinant DNA technology. It affects bone metabolism by modulating both osteoclast and osteoblast functions. The aim of the present study was to investigate the effects of short-term use of G-CSF on bone metabolism in children with leukemia and solid tumors.[¤]METHODS[|]Thirty-six patients with a malignancy who received G-CSF therapy according to chemotherapy protocols and another 20 growth factor-free cancer patients who were enrolled as controls were included in the study. The serum osteocalcin and urinary free deoxypyridinoline levels were measured before the start of G-CSF therapy, on day 3 after treatment, and 7 days after G-CSF therapy was discontinued. In the control group, the measurements were made during corticosteroid and methotrexate-free chemotherapy.[¤]RESULTS[|]The mean osteocalcin level (8.6+-2.3 ng/mL) from before the onset of treatment decreased significantly (7.7+-2.3 ng/mL) on day 3 of G-CSF therapy and significantly increased after 7 days of G-CSF therapy (7.9+-2.2 ng/mL) (p

Piyodermagangrenozum PG , nedeni tam olarak aydınlatılamamış, nötrofilikdermatozlar grubundan bir hastalıktır. Primer olarak anormal nötrofilkemotaksisininpatogenezde sorumlu olduğu düşünülmektedir. Lezyonlar ağrılı, deriden kabarık, hassas ve ülsere nodüller şeklindedir. PG, birçok hastalıkla birlikte görülebilir. Ancak, PG idiyopatik olarak da görülebilir.Burada atipik yerleşimli olarak sol lateralgluteal bölgede ortaya çıkan büyük, ülsere, etrafı endüre ve eritemli olan, lezyonun yara kenarından alınan biyopside piyodermagangrenosum olarak değerlendirilen vakamızı sunuyoruz

Amaç: Ürik asit, pürin metabolizmasının son ürünü ve gut için iyi bilinen bir risk faktörüdür. Bununla birlikte, yüksek serum ürik asit düzeyleri insülin rezistansı, obezite, hipertansiyon, renal disfonksiyon, hipotiroidi gibi birçok hastalıkla ilişkili bulunmuştur. Öte yandan, ürik asidin kardiyovasküler morbiditede nedensel bir rol oynayıp oynamadığı tartışılmaktadır. Çalışmamızda serum ürik asit (ÜA) ve kalp yetmezliği prognostik belirteci olan N terminal pro B-tipi Natriüretik Peptit (NT-proBNP) düzeyleri ile sol ventrikül fonksiyon bozukluğu arasında ilişki olup olmadığını araştırmayı amaçladık.Materyal ve Metot: Çalışma retrospektif olarak planlandı. Mart 2016 ile Şubat 2017 tarihleri arasında Ankara Numune Eğitim ve Araştırma Hastanesi Kardiyoloji Servisi ve Koroner Yoğun Bakımda yatan 326 hasta çalışmaya dahil edildi. Bu hastaların serum ÜA, NT-proBNP düzeyleri ile ejeksiyon fraksiyonu (EF) bulguları hastane enformasyon sisteminden alındı. Hastalar serum ÜA düzeylerine göre 4 gruba ayrıldı (1. grup ÜA; 2,7-4,9 mg/dL, 2. grup ÜA; 5-6 mg/dL, 3. grup ÜA; 6,1-7,4 mg/dL, 4. grup ÜA; 7,5-15,6 mg/dL). Gruplar arasında parametreler ANOVA testi kullanılarak karşılaştırıldı. Ayrıca, sol ventrikül disfonksiyon bulgularında ürat düzeylerine göre değişimler incelenirken, cinsiyet, yaş ve eGFR ‘nin bu parametreler üzerindeki etkileri değerlendirildi. Değişkenler arasında ilişki için Pearson korelasyon testi kullanıldı.Bulgular: 4. grup; yaş, NT-proBNP, eGFR diğer gruplardan anlamlı düzeyde farklıydı (p

Background Coasting can reduce the ovarian hyperstimulation syndrome (OHSS) risk in ovulation induction cycles before intracytoplasmic sperm injection (ICSI). This study aimed to investigate the effect of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation (COH) cycles with coasting on the parameters of ICSI cycles and the outcome. Materials and Methods In a retrospective cohort study, 117 ICSI cycles were per- formed and coasting was applied due to hyperresponse, between 2006 and 2011. The ICSI outcomes after coasting were then compared between the GnRH agonist group (n=91) and the GnRH antagonist group (n=26). Results The duration of induction and the total consumption of gonadotropins were found to be similar. Estradiol (E2) levels on human chorionic gonadotropin (hCG) day were found higher in the agonist group. Coasting days were similar when the two groups were compared. The number of mature oocytes and the fertilization rates were similar in both groups; however, the number of grade 1 (G1) embryos and the number of transferred embryos were higher in the agonist group. Implantation rates were significantly higher in the antagonist group compared to the agonist group. Pregnancy rates/embryo transfer rates were higher in the antagonist group; however, this difference was not statistically significant (32.8% for agonist group vs. 39.1% for antagonist group, P > 0.05). Conclusion The present study showed that applying GnRH-agonist and GnRH-antago- nist protocols to coasted cycles did not result in any differences in cycle parameters and clinical pregnancy rates.

Aim: Ultrasound scanning has become universally accepted tool in prenatal care. We sought to evaluate the knowledge and expectations of pregnant women in Turkey towards ultrasound use during pregnancy. Methods: We performed a cross-sectional study of 108 pregnant women in Muğla Sıtkı Koçman University. The subjects completed a questionnaire consisting of three sections: Sociodemographic characteristics, 13-question assessment of knowledge regarding the use of ultrasound during pregnancy, and assessment of expectations. The patients were awarded one point for every correct answer, with total scores categorized into three groups: 0-4 points insufficient, 5-8 points moderately sufficient, and 9-13 points sufficient. Comparisons were performed using the chi-square test. Results: The mean age of the respondents was 28.6±4.9 years (18-39). Patient knowledge was insufficient in 34 participants (31.4%), moderately sufficient in 56 participants (51.9%), and sufficient in 18 participants (16.7%). Among respondents, 31.5% believed that structural abnormalities would be detected in at least 40%, while 99% expected to learn the gender of baby. Conclusion: The majority of our study population had insufficient to moderately sufficient knowledge regarding the use of ultrasound during pregnancy, with a high degree of misinformation regarding patient expectations. These results suggest a greater need for national education in terms of the diagnostic capabilities and limitations of pregnancy ultrasound.

Necrotising fasciitis is a devastating soft tissue infection which characterised by rapidly progressing necrosis involving mainly fascia and subcutaneous tissues. A 66-year old male patient with chronic obstructive pulmonary disease admitted to our hospital with fever, pain and swelling in the right thigh and right leg, difficulty in walking, dry mouth and weakness. There was a single dose intramuscular steroid injection story in his anamnesis. Physical examination revealed swelling, hyperemia and pain in the right gluteal region spreading through the right femur and popliteal fossa. He was diagnosed necrotizing fasciitis complicated with sepsis. We administered the supportive therapy and broad-spectrum antibiotic therapy in addition to the surgical debridement, vacuum assisted closure and hyperbaric oxygen therapy. The patient was discharged after six months of the follow-up period in hospital. In conclusion, Health-care personnel should be careful when the intramuscular injections planned for patients at the risk of development of necrotizing fasciitis reason of their chronic illnesses or immunosuppressive conditions. In patients who developed necrotizing fasciitis despite everything, we want to strongly emphasise the advantageous hyperbaric oxygen therapy as an additional therapy to the broad spectrum antibiotherapy and surgical debridement [Cukurova Med J 2016; 41(4.000): 787-791]

Morbidly adherent placenta (MAP) is a growing concern currently and is still a diagnostic challenge for obstetricians. As emergency hysterectomy due to unscheduled delivery in MAP carries significant risks, we aimed to evaluate whether first and second trimester serum analytes may be used in the prediction of MAP requiring hysterectomy. A retrospective chart review of all identified cases of placenta previa totalis with and without MAP was performed. A total of 316 pregnant women diagnosed as placenta previa totalis were identified and included in the analysis. Cases were examined in three groups (Group 1: 204 nonadherent placenta previa patients; Group 2: 61 MAP patients managed with endouterine hemostatic square sutures and/or Bakri balloon tamponade; and Group 3: 51 patients with MAP requiring hysterectomy). Among all first and second trimester screening analytes only maternal serum alphafetoprotein (MS-AFP) levels were significantly higher in patients with MAP requiring hysterectomy (p

Introduction: Tobacco use is an important public health problem around the world. Aim of this study is to assess attitudes,belief and observation of the students on smoking cessation and medical education. Methods: This study is part of a multi-country study called “Global Health Profession Student Survey”. The study population consisted of third year medical students in Turkey. The sample consisted of a total of 1834 medical students from randomly selected 12 medical schools. Results: Of the students, 1209 (92.1%)thought that health professionals should get specific training on cessation techniques, and that health professionals should serve as "role models" for their patients and the public. The percentage of the students who answered “Health professionals should routinely advise their patients who smoke to quit smoking” was 1211 (93.3%). Of the students, 1204 (60.8%) responded that health professionals who use other tobacco products were less likely to advise patients to stop smoking. The percentage of the students who had received a formal training on smoking cessation approaches was 48.2% (1196). Of the students, 91.5% (1203) had heard of nicotine replacement therapies in tobacco cessation programs. More than half of smokers tried to quit smoking last year, and majority of them did not take professional help or advice. Conclusions: Majority of students are aware of health professionals’ role on smoking cessation. Most of the students are willingness to take specific formal training on tobacco. Student’s behaviours and attitudes were different by gender and smoking status. Improvement of tobacco cessation issues in medical curricula will be beneficial. Keywords: Attitudes; Beliefs; Medical education; Medical students; Smoking cessation. | PubMed

Depresyon ve anksiyete bozukluklarında sıklıkla reçete edilen antidepresanların kanama riskini artırdığı bilinmektedir. Yine de seçici serotonin geri alım engelleyicisi (SSGE) tedavisinin hemostaz üzerine olan istenmeyen etkileri nadiren araştırılmıştır. SSGE’lerin hematolojik sistem üzerindeki en sık yan etkileri kanama zamanında uzama, trombosit agregasyonu ve aktivitesinde bozulmadır. Bu yazıda essitalopram ve fluoksetin ile ekimotik lezyonlar ortaya çıkıp reboksetin ile gerileyen bir olgu sunulacaktır

Amaç: Çalışmamızda sağlık bakımı ilişkili infektif endokardit ile toplumdan edinilmiş infektif endokardit olgularımızın karşılaştırılmalı olarak değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Olgularımızın 21 (% 40)’inin sağlık bakımı ilişkili infektif endokardit ve 31 (% 60)’inin de toplumdan edinilmiş infektif endokardit olduğu belirlendi Araştırma Makalesi / Research Article 91 Kurşun et al. Cukurova Medical Journal Bulgular: Çalışmamızda sağlık bakımı ilişkili infektif endokardit ile toplumdan edinilmiş infektif endokardit olgularımızın karşılaştırılmalı olarak değerlendirilmesi amaçlanmıştır. Toplumdan edinilmiş infektif endokardit ile sağlık bakımı ilişkili infektif endokardit olguları karşılaştırıldığında; ileri yaşın (58.0 ± 15.1 yıl ve 41.3 ± 14.4 yıl, P= 0.000), eşlik eden hastalıklar açısından kronik böbrek yetmezliğinin (P= 0.001), ve diyabetes mellitus varlığının (P= 0.016), önceden hastanede yatmış olmanın (P= 0.0001), tanı ve tedavi amaçlı uygulanan girişimler açısından özellikle hemodiyaliz uygulamalarının (P= 0.022), santral kateter varlığı (P= 0.022), ile gastrointestinal sisteme girişim yapılmasının (P= 0.060), laboratuvar bulguları açısından kan kültüründe S.aureus ve Enterokok üremesinin (P= 0.037), ve son olarak komplikasyonlar açısından ise embolik olay (P= 0.008), spondilodiskit (P= 0.034) ve stroke gelişiminin (P= 0.007) sağlık bakımı ilişkili infektif endokardit olgularında istatiksel olarak da anlamlı olacak şekilde daha yüksek olduğu saptandı. Sonuç: Mortalite sağlık bakımı ilişkili infektif endokardit olgularında (% 28.6 ) daha yüksek bulunurken iki grup arasında bu yönde istatistiksel olarak fark olmadığı tespit edildi. Sonuç olarak, sağlık bakımı ilişkili infektif endokardit, ileri yaşta ve eşlik eden hastalığa sahip, öykülerinde tanı ve tedavi amaçlı invaziv girişim uygulanan ciddi komplikasyonlar ile seyreden ve yüksek mortalite oranına sahip bir hastalıktır

Pseudomonas luteola nadir olarak rapor edilen bir patojendir. Daha önceki çalışmalarda P. luteola’nın altta yatan hastalığı olan olgularda veya kateterli olgularda septisemi, bakteremi, peritonit ve endokardite sebep olabileceği gösterilmiştir. Biz bu yazıda herhangi bir kaynak tespit edemediğimiz P. luteola bakteremili olguyu sunduk. Hastamızı seftriakson ve siprofloksasin kombinasyonuyla başarılı bir şekilde tedavi ettik

Giriş: Bruselloz birçok organ ve dokuyu tutabilen sistemik bir infeksiyondur. En sık etkilenen sistemlerden biri kasiskelet sistemidir. Hastalık sakroiliit, periferik artrit, spondilit, paraspinal apse, bursit, osteomyelit gibi tablolarla ortaya çıkabilmektedir. Çalışmamızın amacı Konya ilinde brusellozlu olgularda osteoartiküler tutulumun oranlarını, tiplerini, klinik özelliklerini değerlendirmek ve osteoartiküler tutulumu olmayan grupla aradaki farkları belirlemektir. Materyal ve Metod: Çalışmamıza Haziran 2003–Haziran 2014 tarihleri arasında bruselloz tanısı ile başvuran 316 hasta alındı. Bruselloz tanısı uygun klinik belirti ve bulguların varlığında, pozitif Brucella Standart Tüp Aglutinasyon testi (1/160 titre) ve/veya kan kültüründe Brucella spp. bakterisinin üremiş olması ile konuldu. Osteoartiküler sistem komplikasyonlarının tanısı uygun fizik muayene bulguları varlığında radyolojik tanı yöntemleri ile saptanan bulgulara göre konuldu. Bel ağrısı, sakroiliak eklem ağrısı ve sırt ağrısı olan olgularda lomber vertebra, sakral vertebra veya torakal vertebra magnetik rezonans inceleme tetkikleri yapıldı. Bulgular: 129 hastada (%40,8) osteoartiküler tutulum gözlendi. (%52 kadın, %48 erkek). En sık bulaş yolu olarak, 97 (%75) olguda hayvancılıkla uğraşma ve/veya pastörize edilmemiş süt ve süt ürünleri tüketimi öyküsü- özellikle taze peynir- mevcuttu. Ortalama yaş 4618 yıldı. En sık osteoartiküler tutulum olarak sakroiliit saptandı. (n: 68, %52,7). Sakroiliitlerin %70,5’i bilateraldi. Sakroiliiti takiben, spondilodiskit 50 (%38,7), periferik artrit 20 (%15,5), bursit 1 (%0,8) olguda saptandı. Osteoartiküler tutulumu olan olgulara en az üç ay medikal tedavi verildi. Sonuç: Brusellozda osteoartiküler tutulum oranları ve tutulum yerleri bölgeden bölgeye farklılık gösterebilmektedir. Çalışmamızda Konya ilinde en sık tutulumun sakroiliit olduğunu gösterdik. Bu hastalık sakroiliit ve spondilodiskit semptomları ya da eklem ağrıları olan olgularda ayırıcı tanıda mutlaka yer almalıdır.

Purpose: Brucellosis is a systemic disease that can affect many organs and tissues. Musculoskeletal system is one of the most commonly affected systems. Disease may present itself with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis or osteomyelitis. The objective of the present study was to determine the frequency, types and clinical features of osteoarticular involvement among cases with brucellosis in Konya city and to establish the differences between patients with and without osteoarticular involvement. Material and Methods: Three hundred and sixteen patients with Brucellosis who presented between June 2003 and June 2014 were included in the study. Brucellosis was diagnosed by positive Brucella Standard Agglutination Test ( and #61619;1/160 titer) and/or growth of Brucella spp. in blood culture in addition to the presence of clinical signs and findings. Diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of the thoracic, lumbar or sacral vertebrae were acquired in patients with back pain, low back pain and sacro-iliac joint pain. Results: Osteoarticular involvement was noted in 129 patients (40.8%) (females: 52% and males: 48%). The most common route of transmission was employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese, in 97 (75%) cases. Mean age was 46 and #61617;18 years. Sacroiliitis was the most frequent osteoarticular involvement (n: 68, 52.7%), 70.5% of which were bilateral. Sacroiliitis was followed by spondylodiscitis in 35 (38.7%), peripheral arthritis in 20 (15.5%), bursitis in 1 (0.8%) cases. Patients with osteoarticular involvement received medical treatment for at least three months. Discussion: Ratio and anatomical region of osteoarticular involvement in brucellosis shows variability among areas. In the present study, we demonstrated that sacroiliitis was the most common form in Konya city. This disease should be included in differential diagnosis in patients with symptoms of sacroiliitis, spondylodiscitis or those with articular pain. [Cukurova Med J 2015; 40(3.000): 483-494]

Cutaneous infections caused by non-tuberculous mycobacteria are uncommon and are so difficult to diagnose. Rapidly growing mycobacteria can cause skin and soft tissue infections in immunocompromised patients. Mycobacterium fortuitum is one of the rapidly growing mycobacterium. In this article, in an immuncompetent patient, we present a case of cutaneous infection in which M. fortuitum is isolated. Our patient recovered completely by clarithromycin and ciprofloxacin treatment given perorally for 12 weeks. [Cukurova Med J 2015; 40(3.000): 584-587]

Non tüberküloz mikobakterilerin yol açtığı kutanöz infeksiyonlar nadirdir ve tanı koymak oldukça güçtür. Hızlı üreyen mikobakteriler immunkompromize hastalarda deri ve yumuşak doku infeksiyonuna neden olabilirler. Mycobacterium fortuitum hızlı üreyen mikobakterilerdendir. Bu makalede immunkompetan bir hastada M. fortuitum’un etken olarak izole edildiği bir deri infeksiyon olgusu sunulmuştur. Hastamız 12 hafta peroral yolla verilen klaritromisin ve siprofloksasin tedavisiyle tam olarak iyileşmiştir.

Pseudomonas luteola has rarely been reported as a human pathogen. It was showed in previous studies showed that P. luteola may cause septicemia, bacteremia, peritonitis, and endocarditis in patients with underlying disease or with indwelling devices. In this article we report a case of P. luteola bacteremia without any source. We successfully treated our patient with ceftriaxone and ciprofloxacin combination. [Cukurova Med J 2015; 40(2.000): 364-367]

Purpose: The present study aimed to comparatively evaluate the cases with health care-associated infective endocarditis and the cases with community-acquired infective endocarditis. Material and Methods: Of the cases followed for infective endocarditis (IE), 21 (40 %) had health care-associated infective endocarditis and 31 (60 %) community-acquired infective endocarditis. Results: Comparing the cases with community acquired infective endocarditis and the cases with health care-associated infective endocarditis, it was determined that advanced age (58.0 +/- 15.1 years vs. 41.3+/- 14.4 years, P= 0.000), presence of chronic renal insufficiency (P= 0.001) and diabetes mellitus (P= 0.016) as concomitant diseases, being previously hospitalized (P= 0.0001), hemodialysis in terms of diagnostic and therapeutic interventions (P= 0.022), presence of central venous catheter (P= 0.022), and undergone intervention for gastrointestinal system (P= 0.060),as well as laboratory results including positive blood culture growth for S. aureus and Enterococcus (P= 0.037), and complications such as development of embolic event (P= 0.008), spondylodiscitis (P= 0.034) and stroke (P= 0.007) were statistically significantly more common in health care-associated infective endocarditis cases. Whilst mortality was higher in health care-associated infective endocarditis cases (28.6 %), it was determined that there was no statistically significant difference between the groups. Conclusion: Health care-associated infective endocarditis is a disease that is more common in the patients at advanced age, with concomitant disease and the history of exposing invasive procedures in the past for diagnostic and therapeutic purpose, and it is a disease with high morbidity and mortality that courses with serious complications [Cukurova Med J 2015; 40(1.000): 91-97]

Antidepressants, frequently prescribed in depression and anxiety disorders, are known to be responsible for an increase in bleeding. Yet, it has rarely been reported that SSRI treatment has unfavorable effects on hemostasis. The most frequently reported side effects of SSRIs on the hematologic system are prolonged bleeding time, impaired thrombocyte aggregation and activity. Here we present a case in whom ecchymotic lesions occurred with esscitalopram and fluoxetine, which disappeared with reboxetine. [Cukurova Med J 2015; 40(Suppl 1): 90-93]

Erectile dysfunction (ED) and urinary incontinence after bilateral nerve-sparing radical prostatectomy (BNSRP) still remain major causes of morbidity. Phosphodiesterase type 5 inhibitors (PDE5-Is) have a role in the treatment of ED after BNSRP. Several studies in patients with ED and lower urinary tract symptoms demonstrated that PDE5-Is could improve both erectile function and urinary symptoms. The aim of this study was to compare the efficacies of two dosing regimens of 20 mg tadalafil (on-demand and 3 times per week) and to assess the role of tadalafil in recovery of erectile function and continence after BNSRP. We conducted a single-center, prospective, randomized controlled trial of three times per week versus on-demand tadalafil 20 mg and a control group after BNSRP. A total of 129 preoperatively potent and continent patients were included in the study. The patients were evaluated at 6 weeks and 12 months postoperatively for erectile function and continence status. There was no significant difference between all three groups with respect to erectile function at 6 weeks after the surgery. Twelve months after the surgery, the International Index of Erectile Function score was significantly higher in the group using tadalafil 20 mg three times per week. However, there was no significant difference between the treated groups and the control group with respect to the continence status at 12 months after the surgery. There was no correlation between incontinence and ED after the surgery in all groups. Tadalafil 20 mg three times per week is an efficacious and well-tolerated treatment option for ED after BNSRP. Treatment with 20 mg tadalafil either three times per week or on demand cannot improve continence recovery after BNSRP compared with the control group.

Mesane içi Bacillus Calmette-Guerin (BCG) ile immünterapi mesane kanserlerinde, nüksü ve progresyonu önlemek için profilaktik olarak uygulanmaktadır. Uygulama sonrasında lokal ve sistemik yan etkiler ortaya çıkabilir. Lokal yan etkilere sıklıkla rastlanmasına rağmen genel olarak bu tedavi şekli hastalar tarafından iyi tolere edilir. Sistemik yan etkilere daha az rastlanırken fatalite çok nadirdir. Bu yazıda; mesane karsinomu nedeniyle idame mesane içi BCG uygulanmasından sonra ateş, sepsis, pnömoni, akut böbrek yetmezliği, granülamatöz hepatit gelişen ve yoğun bakım ünitesinde exitus ile sonuçlanan olguyu sunduk.

Intravesical Bacillus Calmette-Guerin (BCG) instillation is a prophylactic therapy using for treating bladder cancer to prevent tumour progression and recurrence. Both local and systemic complications can arise after the installation. Although local complications are common , this therapy is generally well tolerated. Systemic complications are rarely than local complications but can be fatal. We report a case who died from severe complications such as sepsis, pneumonia, renal failure and granulomatous hepatitis after receiving the first maintanence installation of intravesical BCG immunotherapy for bladder transitional cell carcinoma.