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Aim: The late elderly, are the leading group of non-survivors infected with the coronavirus disease 2019 (COVID-19). Computed tomography (CT) imaging has been recognized as an important diagnostic method for COVID-19. This study aimed to determine the prognostic performance of CT imaging in patients above 75 years old.Material and Methods: After meeting the inclusion and exclusion criteria 56 elderly patients, 28 male, and 28 female were included in the study. Two radiologists interpreted CT imaging and a third experienced radiologist was in charge of reviewing the data and imaging findings in the controversial and disagreement cases. The lung score was determined for each patient, and radiologic signs were also examined.Results: The mean age of the patients was 81.4±5.0 years. Thirty-six patients survived, and 20 did not. 28 (50.0%) patients had central involvement, while 25 (44.6%) patients had diffuse involvement. Radiologic signs such as consolidation and air bronchogram were more common among non-survivors than survivors (both p=0.001). The mean lung score for the survivors was 8.75±6.21 and 13.45±6.41 for non-survivors, and the difference between the two groups was statistically significant (p=0.010). The area under the receiver operating characteristic curve for a cut-off score of 12 was 0.714 (95% CI, 0.577 to 0.827, p=0.003).Conclusion: It seems that using lung scores can play a very important role in predicting the condition of hospitalized patients over 75 years old., Amaç: İleri yaşlılar, koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) ile enfekte olan ve hayatta kalamayanların önde gelen grubudur. Bilgisayarlı tomografi (BT) görüntüleme COVID-19 için önemli bir tanı yöntemi olarak kabul edilmiştir. Bu çalışmanın amacı 75 yaş üstü hastalarda BT görüntülemenin prognostik performansını belirlemektir.Gereç ve Yöntemler: Dahil etme ve hariç tutma kriterleri karşılandıktan sonra 28 erkek 28 kadın olmak üzere 56 yaşlı hasta çalışmaya dahil edildi. İki radyolog BT görüntülerini yorumladı ve üçüncü bir deneyimli radyolog, tartışmalı ve anlaşmazlık vakalarında verileri ve görüntüleme bulgularını gözden geçirmekten sorumluydu. Her bir hasta için akciğer skoru belirlendi ve radyolojik bulgular incelendi.Bulgular: Hastaların yaş ortalaması 81,4±5,0 yıl idi. Otuz altı hasta hayatta kaldı ve 20 hasta hayatta kalamadı. 28 (%50,0) hastada merkezi tutulum varken 25 (%44,6) hastada ise yaygın tutulum vardı. Konsolidasyon ve hava bronkogramı gibi radyolojik bulgular hayatta kalamayanlar arasında hayatta kalanlardan daha yaygındı (her iki p=0,001). Hayatta kalanlar için ortalama akciğer skoru 8,75±6,21 ve hayatta kalamayanlar için 13,45±6,41 idi ve iki grup arasındaki farklılık istatistiksel olarak anlamlıydı (p=0.010). Alıcı işlem karakteristiği eğrisi altında kalan alan 12 kesim değeri için 0,714 (%95 GA, 0,577 ile 0,827, p=0,003) idi.Sonuç: Akciğer skorlarının kullanılmasının hastanede yatan 75 yaş üstü hastaların durumunu tahmin etmede çok önemli bir rol oynayabileceği görülmektedir.

OBJECTIVE: The internal auditory canal (IAC) also known as internal acoustic meatus is a bone channel that connects the internal ear to the posterior cranial fossa. The mean length is approximately 1 cm. The edge of the IAC is called internal acoustic pore (IAP), and the edge of this aperture is blunt and rounded. Important formations such as facial nerve, vestibulocochlear nerve, labyrinth artery and labyrinth vein pass through the IAC. In addition, on the precise determination of the morphometry in surgical interventions on the temporal lobe, MAI is vital. Therefore, in this study, it was aimed to determine the morphometry and volume of MAI.MATERIAL AND METHODS: The study was carried out on the CT images of 210 individuals randomly from the normal population between the ages of 10-90. Morphometric measurements of IAC (lateral angle (LA), canal length, anteroposterior (AP), diameter of IAP, distance from IAP to vestibular aqueduct (VA)) were performed. In addition, the shape and volume of IAC was determined in this study. Cases were divided into 7 different subgroups, 10-14, 15-20, 21-30, 31-40, 41-50, 51-60 and 61 years old, depending on their age.RESULTS: In this study, CT images of 210 patients were analyzed. The mean length of the MAI was 9.5±1.6mm, the AP diameter was 6.3±1.5mm, the distance from the entrance part to the VA was 15.1±6.64mm, the volume was 290±120mm3, and the LA was 50±14º.CONCLUSIONS: When the outcome data were compared by gender, it was found statistically significant that the right AP diameter was higher in men, the length of the right MAI and both sides LA were higher in women. In addition, when the volumes of MAI were compared by age groups, it was determined that the 10-14 age group was smaller than the other age groups., AMAÇ: İç kulak yolu olarak da bilinen meatus acusticus internus (MAI), iç kulağı fossa cranii posterior’a bağlayan bir kemik kanaldır. Ortalama uzunluğu yaklaşık 1 cm'dir. MAI'nin kenarına porus acusticus internus (PAI) denir ve bu açıklığın kenarı künt ve yuvarlaktır. Nervus (n) facialis, n. vestibulocohlearis, arteria ve vena labirinti gibi önemli oluşumlar MAI’nin içinden geçer. Ayrıca MAI, temporal lob üzerindeki cerrahi müdahalelerde morfometrinin doğru belirlenmesinde hayati önem taşımaktadır. Bu nedenle bu çalışmada MAI'nin morfometrisinin ve hacminin belirlenmesi amaçlanmıştır.GEREÇ VE YÖNTEM: Çalışma, 10-90 yaş arası normal popülasyondan rastgele 210 kişinin BT görüntüleri üzerinde gerçekleştirildi. MAI'nin morfometrik ölçümleri (lateral açı (LA), anteroposterior (AP) kanal uzunluğu, PAI çapı, PAI'den aquaductus vestibularis’e kadar olan mesafe (AV)) yapıldı. Ayrıca bu çalışmada MAI'nin şekli ve hacmi belirlendi. Olgular yaşlarına göre 10-14, 15-20, 21-30, 31-40, 41-50, 51-60 ve 61 yaş olmak üzere 7 farklı alt gruba ayrıldı.BULGULAR: Bu çalışmada 210 hastanın BT görüntüleri analiz edildi. MAI'nin ortalama uzunluğu 9.5±1.6 mm, AP çapı 6.3±1.5 mm, giriş kısmından AV'ye olan mesafe 15.1±6.64mm, volüm 290±120 mm3 ve LA 50±14º idi.SONUÇ: Sonuç verileri cinsiyete göre karşılaştırıldığında, erkeklerde sağ AP çapının, kadınlarda sağ MAI uzunluğunun ve her iki taraf LA'nın daha yüksek olduğu istatistiksel olarak anlamlı bulundu. Ayrıca MAI hacimleri yaş gruplarına göre karşılaştırıldığında 10-14 yaş grubunun diğer yaş gruplarına göre daha küçük olduğu belirlendi.

The achievement of euthyroid state has been suggested in patients with thyrotoxicosis undergoing surgery to reduce the risk of thyroid storm. However, euthyroid state could not always be achieved by antithyroid drugs. Therefore, therapeutic plasma exchange (TPE) is an option in this condition. A 58-year-old male patient with a history of type-2 diabetes using 200 mg amiodarone per day, admitted for diabetic ketoacidosis (DKA), induced by thyrotoxicosis. with palpitation, sweating, polyuria, and polydipsia. Euthyroid state could not be achieved, despite all apropriate treatments for thyrotoxicosis. Therefore, preparation with TPE followed by total thyroidectomy was planned. A 35% decrease in fT3 (free T3) and fT4 (free T4) levels were achieved, after two sessions of TPE. A 74-year-old male patient, admitted for acute anterior myocardial infarction (AMI) induced by thyrotoxicosis due to Graves disease. Multiple vessel disease was detected on primer percutanous coronary angiography, and an emergency coronary artery bypass grafting (CABG) was planned. Therefore, preperation with TPE was planned before surgery. A substential decrease in fT4 and fT3 levels (45% and 72%, respectively) levels were achieved, after one session of TPE. Most of the studies evaluating the efficacy of TPE in patients with thyrotoxicosis are including patients with Graves disease and toxic multinodular goiter, and TPE was indicated as an effective option for preparation of these patients for surgery. However, as presented in case 1, TPE may not be effective in amiodarone induced thyrotoxicosis (AIT) as in cases with thyrotoxicosis due to Graves disease. [Med-Science 2019; 8(1.000): 233-6]

Chest pain (CP) is the major presenting symptom of coronary artery disease (CAD) wherein history remains to be a fundamental and challenging diagnostic step. Despite the clarity of typical CP characteristics in guidelines; interpretation and description of CP by patients are open to wide variations. The aim of this study was to define the components of CP that most closely associate to presence of obstructive CAD and determine the influence of gender on CP features. Herein, consecutive patients with suspected stable CAD who were scheduled for a coronary angiography(CAG) were prospectively enrolled. The data on demographic and pain characteristics were collected by a questionnaire. Patients were categorized into CAD and Normal groups with respect to presence of obstructive CAD in CAG. Among 402 patients, 86 had chest discomfort or equivalent symptoms but denied CP. Patients with CAD were more commonly male; with older age, lower BMI, more frequent prior revascularization, clopidogrel use, higher creatinine and lower HDL levels. When classical features of CP such as quality; location, duration, relationship to exertion were compared; stabbing/sharp pain, CP related to cold or emotional stress and CP that radiates to back were significant factors against CAD; while absence of precipitating factors was related to CAD. Yet, none of the features of typical angina pectoris were significantly related to presence of CAD. Determinants of CAD were; prior revascularization (OR= 22.7, p=0.021), body mass index (OR=1.4, p=0.007), clopidogrel use(OR=55.5, p=0.018) and blood glucose (OR=1.02, p=0.046) in women; and age (OR=1.2, p=0.029) was the single predictor of CAD in men. This study demonstrated no association between classical features of typical CP and presence of CAD in patients with stable angina pectoris. Clinical factors that influenced presence of CAD in different genders were also different. [Med-Science 2019; 8(1.000): 88-92]

Endometrial cancer is the most common gynecological cancer. Increased postmenopausal endometrial thickness may be an indicator of endometrial cancer. Transvaginal ultrasound (TV-USG) is the primary imaging method for evaluating endometrial thickness in the postmenopausal period. The aim was to employ transvaginal ultrasonography in the evaluation of adnexal masses synchronously seen in postmenopausal women with increased endometrial thickness. The work was designed as a retrospective study. The medical records of 155 patients evaluated for increased postmenopausal endometrial thickness were examined. Ultrasonography had been performed on the women in the study for routine follow-up, postmenopausal hemorrhage, pelvic pain, pelvic mass on examination and family history of gynecological cancer. All patients had undergone endometrial evaluation with fractional dilatation and curettage (D & C) or pipelle endometrial sampling. Histopathological diagnosis was based on endometrial sampling results. Adnexal mass was present simultaneously in 17.4% (n = 27) of the women included in the study, while 82.6% (n = 128) had no gynecological pathology other than increased endometrial thickness. The endometrial thickness in the women with postmenopausal adnexal masses was greater than in those without adnexal mass (11.7 mm vs. 7.8 mm, p = 0.009). Non-atypical and atypical endometrial hyperplasia was more frequent in the group with postmenopausal adnexal mass (11.1% vs. 2.8%, 11.1% vs. 3.79, p = 0.03, p = 0.04, respectively). Final histopathological evaluation of patients operated on for adnexal masses revealed tubo-ovarian abscess in 1.9% (n = 1), benign ovarian tumor in 25.9% (n = 7) and malignant ovarian tumor in 11.1% (n = 3) of the patients. In postmenopausal women, adnexal masses can be seen simultaneously with increased endometrial thickness. In this regard, transvaginal ultrasound offers important opportunities for evaluation of both the endometrium and adnexa. Pre-surgery transvaginal ultrasound as well as multivariate serum markers may be used in evaluation models. [Med-Science 2018; 7(4.000): 848-51]

Objective: Previous studies showed that obstructive sleep apnea syndrome (OSAS) was associated with liver diseases such as elevated liver enzyme levels and hepatic steatosis. The aim of this study was to assess the relationship between serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and OSAS and its severity. Methods: A total of 617 patients who underwent PSG (polysomnography) between January 2016 and May 2017 were evaluated in this study. AST, ALT, total cholesterol, triglyceride levels and body mass index were analyzed. The data were analyzed using the Student t-test, ANOVA, Chi-square test, and Pearson's correlation coefficient. Results: Five hundreds and thirty patients with OSAS and 60 healthy controls were included in the study. Of the patients in the OSAS group, 17.7% had an elevated ALT level and 7.9% had an elevated AST level. There was a statistically significant difference in ALT and AST levels between the OSAS and control groups (p < 0.001 and p < 0.001, respectively). In the OSAS group, there was a statistically significant positive relationship between serum ALT and AST levels and apnea-hypopnea index (AHI), apnea index, oxygen desaturation index. Both AST and ALT levels were statistically significantly higher in obese patients than in non-obese patients (p < 0.001 and p < 0.001, respectively). ALT level was statistically significantly higher in patients without hypertension than in patients with hypertension (p < 0.001). In OSAS patients without hypertension, there was a statistically significant relationship between serum ALT and AST levels and AHI (r = 0.223, p < 0.001 and r = 0.142, p = 0.007; respectively). Conclusion: OSAS is a risk factor for elevated liver enzyme levels. Hypoxia plays an important role on liver enzymes in OSAS patients.

Amaç: Bu çalışmada, Istranca meşesi (Quercus hartwissiana Steven) kabuğu ekstraktlarının bakteriyelve fungal patojenlere karşı antimikrobiyal aktivitesini araştırmak amaçlanmıştır.Gereç ve Yöntemler: Istranca meşesinin, etanol, formaldehit, aseton, etil asetat ve metanol çözücüleriile ekstraksiyonu gerçekleştirilmiştir. Bu ekstraktlardan 50 µl alınarak steril disklere emdirildiktensonra ekstraktlarda bulunan çözücülerin sonucu etkilememesi amacıyla diskler 24 saat steril ortamdakurutulmuştur. Disk difüzyon yöntemiyle Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichiacoli, Klebsiella pneumoniae, Salmonella spp., metisilin dirençli Staphylococcus aureus, metisilinduyarlı Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus spp., Candida albicans,Candida glabrata ve Candida tropicalis türlerine karşı antimikrobiyal aktivite araştırılmıştır.Bulgular: En geniş zon çapının etanolle hazırlanan ekstraktta Enterococcus spp. (8 mm) ve S. epidermidis(8 mm) suşlarına, formaldehit ve etil asetatla hazırlanan ekstraktlarda E. Coli suşuna (16 mm,28 mm), asetonla hazırlanan ekstraktta Enterococcus spp. suşuna (21 mm), metanolle hazırlananekstraktta ise metisilin duyarlı S. aureus suşuna (28 mm) karşı oluştuğu görülmüştür. Mayalarda iseen geniş zon çapının etanolle hazırlanan ekstraktta C. glabrata suşuna (12 mm), formaldehitle hazırlananekstraktta C. albicans (28 mm) ve C. tropicalis (28 mm) suşlarına, aseton, etil asetat ve metanollehazırlanan ekstraktlarda C. albicans suşuna (19 mm, 30 mm, 22 mm) karşı oluştuğu saptanmıştır.Tartışma ve Sonuç: Etil asetat ile hazırlanan ekstraktın diğer çözücülerle hazırlanan ekstraktlara kıyaslaçalışılan suşlara karşı daha geniş zon çapı oluşturduğu saptanmıştır. En geniş zon çapı E. coli, S. aureusve C. albicans türlerinde oluştuğundan, ülkemizde doğal olarak yetişen Istranca meşesinin inhibeedici etkilerine yönelik in vivo antimikrobiyal çalışmalar yapılmasının önemli olduğunu düşünmekteyiz. Aim: This study aimed to investigate the antimicrobial activity of extracts from the Istranca oak (Quercushartwissiana Steven) against bacterial and fungal pathogens.Materials and Methods: Extraction of the Istranca oak was carried out with ethanol, formaldehyde,acetone, ethyl acetate, and methanol solvents. After injecting 50 ?l of these extracts into sterile discs,the discs were dried in a sterile environment for 24 hours in order for the results not to be affected bythe solvents present in the extracts. Antimicrobial activity against the species Pseudomonas aeruginosa,Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Salmonella spp., methicillin-resistantStaphylococcus aureus, methicillin-susceptible Staphylococcus aureus, Staphylococcusepidermidis, Enterococcus spp., Candida albicans, Candida glabrata and Candida tropicalis was investigatedby disc diffusion method.Results: It was observed that the extract prepared with ethanol showed the widest zone diameteragainst Enterococcus spp. (8mm) and S. epidermidis (8mm), the extracts with formaldehyde and ethylacetate against E. coli (16mm, 28mm), the extract with acetone against Enterococcus spp. (21mm),and the extract with methanol against methicillin-susceptible S. aureus (28mm). For the yeasts, theextract prepared with ethanol showed the widest zone diameter against C. glabrata (12mm), the extractwith formaldehyde against C. albicans (28mm) and C. tropicalis (28mm), and the extracts preparedwith acetone, ethyl acetate, and methanol against C. albicans (19mm, 30mm, 22mm).Discussion and Conclusion: It was determined that the extract prepared with ethyl acetate showedwider zone diameter against the strains studied, compared to extracts prepared with the other solvents.Given that the widest zone diameters were observed against the strains E. coli, S. aureus and C.albicans, we think that it is important to conduct in vivo antimicrobial studies on the inhibitory effectsof the Istranca oak indigenous to our country.

Ortodontik tedavinin amacı; bireyin dentofasiyal fonksiyonlarını ve estetiğini geliştirerek yaşam kalitesini artırmaktır. Başarılı bir tedavinin kriterleri; en az histolojik hasar ve ağrı, hızlı diş hareketi, kısa tedavi süresi ve stabil sonuçlardır. Son yıllarda ortodontik tedavi talebi giderek artmaktadır. Ortodontik tedavi sürelerinin uzun olması, hem hastaların psikolojik motivasyonlarını etkilemekte, hem de çürük, dişeti çekilmesi ve kök rezorpsiyonu gibi birçok istenmeyen duruma yol açmaktadır. Bu sebeple son yıllarda araştırıcılar ortodontik diş hareketinin hızlandırılması üzerine çalışmalar yapmaktadır. Ancak daha hızlı diş hareketi elde etmek için laboratuvar ve klinik olarak birçok girişimde bulunulmasına rağmen, bu tekniklerle ilgili belirsizlikler ve cevaplanmamış sorular halen mevcuttur. Literatürde ortodontik diş hareketini hızlandırmak amacıyla çoğu henüz hayvanlar üzerinde denenmiş ve insanlar üzerinde uygulanabilirliği kuşkulu olan cerrahi teknikler, fiziksel ve kimyasal uygulamalar bildirilmiştir. Ancak diş hareketi multifaktöriyel bir olgu olduğu için konu hakkında gelecekte daha fazla araştırma yapılması gerekmektedir. Bu derlemede literatürde şu anda var olan ortodontik diş hareketi hızlandırma yöntemlerinden bahsedilecektir., The purpose of orthodontic treatment is to enhance patients’ life quality by improving their dentofacial functions and aesthetics. Minimal histological damage and pain, rapid tooth movement, short treatment duration, and stability of results are the major criteria for successful treatment. In recent years, the demand for orthodontic treatment has been increasing gradually. Prolonged duration of orthodontic treatment affects the psychological motivation of the patients and leads to several undesirable situations, such as caries, gingival recession, and root resorption. Thus, in recent years, related research has investigated the acceleration of orthodontic tooth movement. However, despite the various laboratory and clinical interventions designed to achieve faster tooth movement, uncertainties and unanswered questions about these techniques persist and warrant further investigation. Several surgical techniques as well as physical and chemical applications have been reported by previous studies to accelerate orthodontic tooth movement, most of which have been conducted on animals, with debatable applicability on humans. However, as tooth movement is a multifactorial phenomenon, further research is needed in the future. In this review, we describe the orthodontic tooth movement acceleration methods reported thus far.

Objectives: Radiological reporting is a relatively new and challenging issue in dentomaxillofacial radiology, whereas it has been performed so many years in medical radiology. The purpose of this study is to compare approaches of dentomaxillofacial and medical radiologists regarding radiology reporting. Materials and Methods: Dentomaxillofacial and medical radiologists were invited by e-mail. The participants filled a survey regarding the features of their own radiology reports. The study was based on two independent groups (dentomaxillofacial and medical radiologists). Mann-Whitney U test was used for two independent groups. Results: 285 radiologists in total (115 dentomaxillofacial and 170 medical radiologists) participated in this survey. Structured radiologic reports were mostly preferred by both dentomaxillofacial (53.9%) and medical radiologists (77%), but statistically significant difference was found between two groups (p

Depression is a major mental health issue worldwide, and university students with heavy burdens of study are at a high risk for depression. The purpose of this study was to determine the prevalence of depressive symptoms among nursing students, and to explore the association between socio-demographic factors, health-related quality of life and depressive symptoms. This study adopted a cross-sectional design. A total of 345 nursing students from a Faculty of Health Sciences were assessed by the questionnaire consisted of demographic information, Beck Depression Inventory (BDI), a 12-item Short Form Health Survey. SPSS software, version 16, was used to analyze the data. Pearson Chi-Square, Fishers Exact Test and Independent-Samples T-Test were used to compare different categorical variables. A total of 345 nursing students participated in the study (282 females and 63 males). Overall, 92 (26.7%) of the participants had depression of various grades based on the BDI diagnostic criteria using a cut point of more than 17. The depressive symptoms were statistically associated with gender and the parental attitudes. BDI score at the cut point of 17 was statistically associated with the Physical and Mental Health Composite Scores. This study seems to indicate an alarming rate of depressive symptoms. Female gender, non-democratic parental attitude have the highest association with depressive symptoms. The findings suggested that in order to prevent depression among undergraduate nursing students, school-and family based strategies should be developed and implemented. [Med-Science 2018; 7(1.000): 154-157]

The incidents of hip fractures rise as the population gets older. Weakness of bones cause fractures easily due to falling, which can occur by balance deficiency, side effects of medications and maneuvering difficulties through environmental hazards. Patients with hip fractures are cared by clinicians in different specialties who should be familiar with the management of these injuries. The fascia iliaca compartment block, an easy to perform and low-cost procedure, provides efficient perioperative analgesia for patients who suffer from hip or femur fractures. Increased success rates are due to the facilitation of the block via ultrasound which is easily accessible in many operation theaters and emergency services. Anterior thigh and knee surgery as well as analgesia following hip and knee procedures are the basic indications for this block. In this case, we performed an ultrasound guided fascia iliaca compartment block for postoperative analgesia after a hip fracture surgery. [Med-Science 2019; 8(1.000): 239-41]

Distant metastasis of breast carcinoma frequently occurs within five years after the diagnosis of the primary tumor. A 58-year-old female sharing a history of mastectomy for invasiveductal carcinoma six years previously admitted to our clinic with dyspnea progressively ongoing forpast two weeks. A right-sided massive pleural effusion was diagnosed and also pleural catheterdrained. Radiologic studies and cytological examination of the fluid did not introduce any evidenceof malignancy while she lately underwent thoracoscopy for the residuary effusion and atelectasis.Pathological study of the punch biopsies through the parietal pleura reported the pleural metastasis of the breast carcinoma but still negative evidence of malignancy for the pleural fluid. After discharge, evaluation with positron emission tomography also did not verify an uptake in any of thepleura, lungs or primary malignancy site. This event is of importance revealing that the patientssharing a past of malignancy should be approached with more caution and suspicion since the routine diagnostic algorithms pending to be reliable may not be applicable for all patients.

In this study; we tried to compile risk scoring systems (Original EuroSCORE, EuroSCORE II and STS) used in robotic surgery, minimally invasive cardiac surgery and open-heart surgery in the context of the literature.As a result, literature study of risk scoring systems in the robotic surgery was not found. In minimally invasive cardiac surgery, few studies are available. The effectiveness of existing risk scoring systems has not been established in these studies. Therefore, further investigations are required for developing risk scoring systems in robotic surgery and minimally invasive cardiac surgery. In open heart surgery, there is still no gold standard scoring system in all populations. Due to the increased case diversity, we believe that the commonly used risk scoring systems must be updated. Widely used risk-scoring systems are not effective in minimally invasive cardiac surgery and this is supporting our idea. Each clinic should choose the appropriate risk scoring system according to their own experience and case diversity. [Med-Science 2018; 7(4.000): 959-61]

In recent years, medication-related diseases have become a major concern in elderly care. Elderly people tend to experience more negative drug events than younger patients due to accompanying diseases, multiple drug use, and age-related changes in pharmacodynamics and pharmacokinetics of drugs. Vancomycin is a nephrotoxic and ototoxic antibiotic commonly used in gram (+) bacterial infections, especially in Methicillin-resistant Staphylococcus aureus (MRSA), which can cause important problems such as flushing, muscle spasm, redman syndrome. It was aimed to report vancomycin drug reaction, which emerges of elevated eosinophilia. [Med-Science 2018; 7(2.000): 453-5]

Amaç: Bu çalışmada Konya ilinde yaşayan 6-18 yaş arası öğrencilerin vücut kitle indeksleri (VKİ) ölçülerek obezite sıklığının belirlenmesi, elde edilen verilerle persentil eğrilerinin oluşturulması amaçlanmıştır.Gereç ve Yöntem: Çalışma Konya il merkezi ilk ve ortaöğretim okullarında öğrenim gören 6-18 yaş arası 3171çocukta gerçekleştirildi. Antropometrik ölçümler sonrası hesaplanan VKİ değerleri 5. persentilin altında olanlardüşük kilolu, 5. ile 85. persentil arası normal kilolu, 85. ile 95. persentil arası fazla kilolu, 95. persentil ve üzeriolanlar ise obez olarak tanımlandı.Bulgular: Öğrencilerin yaş ortalaması 12,683,25 yıl; % 51,2’si (1624) erkek, % 48,8’i (1547) kız idi. Kız çocukların ortalama VKİ’i 20 4 kg/m2, erkek çocukların 20,1 4,2 kg/m2 olarak hesaplandı. Her bir yaş aralığındaki değerlere bakıldığında obezite (% 12,3) ve fazla kilolu olma sıklığı (% 11,9) 15 yaşında anlamlı derecede(sırasıyla; p0,018-p0,02) yüksek bulundu. Elde edilen veriler ışığında Konya ili için 6-18 yaş arası çocuklarınboy, vücut ağırlığı ve VKİ persentil eğrileri çıkarıldı. Buna göre öğrencilerin toplamda % 4,9’si obez, % 9,4’üfazla kilolu, % 79,2’si normal kilolu, % 6,5 düşük kilolu olarak saptanırken; erkeklerin % 5,4’ü obez, % 9,5’i fazlakilolu, kızların % 4,3’ü obez, % 9,4’ü fazla kilolu olarak tespit edildi.Sonuç: Tüm dünyada olduğu gibi ülkemizi de etkileyen obezite sıklığındaki artış Konya ilinde de etkisini göstermekteydi. Bununla birlikte obezitenin doğru teşhisi için hali hazırda kullanılan standart büyüme persentillerinyanısıra il bazlı verilerle oluşturulacak bölgesel eğrilere ihtiyaç duyulmaktadır ki; çalışmamız bu bağlamda yapılacak daha ileri çalışmalara ışık tutacaktır., Objective: In this study, it was aimed to determine the frequency of obesity by measuring the body massindexes (BMI) of 6-18 year old students living in Konya and to ob-tain anthropometric percentile curves.Materials and Methods: The study was carried out in 3171 children aged between 6 and 18 years, whowere going to primary and secondary schools in Konya city center. Children with a BMI value lower than5th percentile were defined as underweight, BMI between 5th and 85th percentile as normal weight, BMIbetween 85th and 95th percen-tile overweight, and BMI above 95th percentile were defined as obese.Results: The average age of the students was 12,683,25 years, 51,2% (1624) were male and 48,8% (1547)of female. The mean BMI of girls and boys were 20 4 kg / m2 and 20.1 4.2 kg / m2, respectively. Whenthe frequencies of obesity (12.3%) and overweight (11.9%) examined for each age, they were both foundto be significantly higher at the age of 15 years (p 0.018-p 0.02, respectively). With the obtained data,the height, body weight and BMI percentile curves of the children aged 6-18 years were achieved for Konyaprovince. According to study results 4.9% of the students were obese, 9.4% were overweight, 79.2% werenormal weight and 6.5% were underweight. While 5.4% of boys were obese and 9.5% were overweight, 4.3%of girls were obese and 9.4% were overweight.Conclusion: The increase of the frequency of obesity, affects our country as in the whole world, also showsits effect in the province of Konya. However, for the correct diag-nosis of obesity, there is a need for regionalanthropometric curves in addition to currently used standard growth percentages. Our work will shed light onfurther works to be done in this context.

Histopathologically, calvarial lesions are congenital, inflammatory, neoplastic and traumatic origin and these are rarely seen. The calvarial lesions most commonly manifest as palpable mass on physical examination or they are diagnosed incidentally during a radiological test. Defect, lysis and sclerosis in the bony structure are evaluated with radiography and computed tomography (CT) and relationships of the lesions with the soft tissue components and surrounding soft tissue are evaluated with CT and magnetic resonance imaging (MRI) and especially with MRI. Based on the radiological findings, benign-malignant discrimination of the calvarial lesions can be made and it may be possible to estimate their histopathological diagnoses., Kalvarial lezyonlar histopatolojik olarak, kongenital, enflamatuar, neoplastik ve travmatik kökenli olup, nadir olarak izlenmektedir. Kalvarial lezyonlar en sık klinik muayenede ele gelen kitle şeklinde ya da radyolojik bir tetkikde insidental olarak tanı konur. Kemik yapıdaki defekt, lizis ve skleroz radyografi ve bilgisayarlı tomografi (BT) ile, lezyonların yumuşak doku komponentleri ve çevre yumuşak doku ile ilişkisi, BT ve manyetik rezonans görüntüleme (MRG) ile ve özelikle MRG ile değerlendirilir. Radyolojik değerlendirme sonucu, radyolojik bulgulara göre kalvarial lezyonların benignmalign ayrımı ve histopatolojik tanısını tahmin etmek mümkün olmaktadır.

Amaç: Tamamlayıcı ve alternatif tıp (TAT) yöntemlerinin kullanımı yaşlılar arasında artmıştır. Bakım kalitesini yükseltmek için sağlık profesyonelleri TAT yöntemlerinin kullanımını değerlendirmelidir. Bu çalışma İstanbul’da iki huzurevinde kalan yaşlılarda TAT yöntemlerini kullanma durumunu saptamak amacıyla yapıldı.Materyal ve Metot: Bu çalışma Aralık 2012 ve Mayıs 2013 tarihleri arasında İstanbul’da iki huzurevinde yapıldı. Çalışmanın örneklemini 230 yaşlı birey oluşturdu. Bulgular: Yaşlıların %59,1’i TAT yöntemlerinden birini kullanıyordu. Bitkiler (%55,2) ve bitkisel olmayan destekler (%53,5) en çok kullanılan TAT yöntemleriydi. Ortaokul mezunu, kronik bir hastalığı olan ve düzenli tıbbi tedavi alan yaşlılar arasında TAT kullanım oranı yüksekti (p, Aim: Complementary and alternative medicine (CAM) usage has increased among the elderly. To promote comprehensive quality care, health professionals should assess for CAM usage. This study was planned to determine the CAM usage among elderly living in nursing homes in Istanbul. Material and Method: This study was made in two nursing homes in Istanbul between December 2012 and May 2013. The study sample consisted of 230 elderly. Results: A percentage of 59.1 of elderly (n=136) used CAM. Herbs (55.2%) and non-herbal supplements (53.5%) were the most frequently used therapies. CAM usage rate was higher among elderly who graduated from secondary school, had chronic disorder, and used medicine regularly (p

Mushroom poisoning has an important place in thepoisonings applied to emergency department (ED).Patients may present with different toxoids according tothe fungus and toxin fecalin. Pantherina syndrome is atablature that can interfere with cerebrovascular diseasesdue to clinical presentation. Three patients from thesame family were admitted to our ED with newlydeveloped symptoms of confusion, aphasia andmydriasis. When the first patient was evaluated, thediagnosis of hypertensive encephalopathy was firstconsidered with the current symptoms. However, afterthe application of the second and third patients withsimilar symptoms, the anamnesis was deepened and thestory of eating a mushroom was questioned. Patients aretreated in the emergency ICU. Two patients recoveredwithin 24 hours, and the symptoms of one patientcontinued for up to 72 hours. Pantherina syndrome is atoxicoma characterized by early onset, confusion,neurological symptoms such as aphasia and mydriasis.Treatment is generally supportive treatment. Stomachlavage and activated charcoal will be useful in the earlyperiod. Benzodiazepines can be used in extremeagitation. Pantherina syndrome is one of the diagnosesthat clinicians should actually have in patients presentingwith an acute confusional condition. Mantar zehirlenmeleri günlük acil servis pratikuygulamasında zehirlenmeler içinde önemli bir yeresahiptir. Hastalar mantara ve toksinin türüne göre farklıklinik tablolar ile hastaneye başvurabilirler. Pantherinasendromu, serebrovasküler hastalıklarla k arışabilen birklinik tablodur. Aynı aileden üç hasta, yeni gelişen bilinçbulanıklığı, afazi ve midriyazis belirtileri ile acil servisebaşvurdu. İlk hasta değerlendirildiğinde, mevcutsemptomlarla birlikte hipertansif ensefalopati tanısıkonuldu. Bununla birlikte, benzer semptomlara sahipikinci ve üçüncü hastada anamnezin derinleştirilmesi ilemantar yemekten kuşkulanıldı. Hastalar acil yoğun bakımünitesinde tedavi edildi. İki hasta 24 saat içinde düzeldive bir hastanın semptomları 72 saate kadar devam etti.Pantherina sendromu erken başlangıçlı, konfüzyon, afazive midriyaz gibi nörolojik semptomlarla karakterize birklinik durumdur. Tedavi genellikle destek tedavisidir.Mide yıkama ve aktif kömür erken dönemde faydalıolacaktır. Benzodiazepinler aşırı ajitasyon durumundakullanılabilir. Pantherina sendromu, akut konfüzyonel birdurumla başvuran hastalarda klinisyenlerin düşünmesigereken tanılardan biridir.

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Objective: Foreign body aspiration is a potentially life-threatening emer-gency in children. Urgent rigid bronchoscopy should be performed when presentation includes severe respiratory failure with suspicion for FBA. To the best of the knowledge, this is the first study that evaluates URB in English literature.Methods: Forty-eight patients who underwent urgent rigid bronchoscopy were included in this study. From the medical records, the patients’ demo-graphic characteristics, hospital arrival time, endotracheal intubation status, peripheral oxygen saturation, bronchoscopy results, type and location of for-eign body , intraoperative and postoperative complications, mortality, X-ray results, length of hospital stay were evaluated. Results: Twenty-four of the 48 patients were non-intubated. Peripheral oxy-gen saturation values were 60±14.40 in the preoperative period. There was not any statistically significant difference between intubated and non-intu-bated patients in terms of intraoperative and postoperative complications. There was not any statistically significant difference between patients with negative and positive results for bronchoscopy in terms of intraoperative and postoperative complications. Conclusions: Bronchoscopy is not without risk; however, it is a life-sav-ing procedure. Despite negative foreign body results, urgent bronchoscopy should be performed in suspicious cases.

Aim: The aim was to analyze the outcome of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vinblastine,and dacarbazine (ABVD) chemotherapy adjuvant radiotherapy according to the risk groups and determine the adverse prognosticfactors affecting survival in Hodgkin lymphoma.Material and Methods: A retrospective study was performed on 52 pediatric patients with Hodgkin lymphoma who were treated withABVD between 1997 and 2018. Patients with early-stage favorable disease received 4 cycles of ABVD radiotherapy. Early-stageunfavorable and advanced-stage patients received 6 cycles of ABVD radiotherapy.Results: Thirty (57.7%) boys and 22 (42.3%) girls were included in the study. The median age of the patients was 9 years and 3months (1 year and 10 month – 17 years and 7 months). Overall survival rate was 94.2% and the mean survival time was 19.50.70(95% CI, 18.1 - 20.9) years. The mean event-free survival time was 9.56.5 years. Overall survival rate was 90%, and the meanevent-free survival time was 8.26.1 years in early-stage favorable disease. Overall survival rate was 100%, and the mean eventfreesurvival time was 1.97.0 years in early-stage unfavorable disease. Overall survival rate was 94.1 %, and the mean event-freesurvival time was 8.96.3 years in advanced-stage disease. Presence of bulky disease, nodular sclerosing histologic subtype andleukocytosis had a negative prognostic effect on relapse and bulky disease had adverse effect on overall survival (p0.05).Conclusion: Four courses of ABVD chemotherapy radiotherapy (IFRT or ISRT) in early-stage favorable patients and 6 courses ofABVD chemotherapy radiotherapy (IFRT or ISRT) in both early-stage unfavorable and advanced-stage Hodgkin lymphoma patientsbenefited from promising outcomes in terms of OS and FFS.Presence of bulky disease, nodular sclerosing histologic subtype and leukocytosis have adverse prognostic effects on relapse andpresence of bulky disease have adverse effect on OS.

Cryptococcus neoformans is an opportunistic fungal agent, which may cause infectiondepending on the state of immunity. The agent is especially prone to be localized in the centralnervous system. Fingolimod is an immunomodulatory drug that is used in the treatment of Multiple Sclerosis (MS). The use of this drug leads to a decrease in lymphocyte count and thus might result in the occurrence of the opportunistic infections like Cryptococcosis. In this article, we presenta MS patient that underwent fingolimod treatment and developed Cryptococcus meningoencephalitis.

Aim: Alopecia areata is an auto-immune skin disease characterized by non-scarring hair loss. Nail changes are strongly associatedwith prognosis. In patients with Alopecia areata, the nail examination should not be neglected for an optimal follow-up.Material and Methods: A retrospective study involving 207 patients with Alopecia areata was undertaken in a tertiary hospitalbetween April 2016 and May 2017. Patients whose nail changes were registered in the database were included in the study. Gender,age, disease severity, sites affected, and nail changes of those patients were noted.Results: 114 patients (55%) had nail involvement. The most common nail finding was leukonychia (n 84). Nail pitting was detectedin 29 patients.11 patients had both leukonychia and nail pitting. The mean age of the patients with leukonychia was 23.3, while themean age of nail pitting patients was 31.7 and the mean age of the patients without nail change was 34.1.Conclusion: Leukonychia is the most common nail change in this study, as a different finding from all previous studies

Objectives: Lung cancer accounts for 20% of cancer-related deaths worldwide. Several studies have shown that Vitamin D levels at the time of diagnosis are prognostic in lung cancer. In this study, we evaluated the relationship between pre-diagnosis Vitamin D replacement levels and platinum-based chemotherapy results. Methods: In this cross-sectional study, we retrospectively analyzed archive records of all 247 patients diagnosed with lung cancer from an oncology center in Turkey, between 2012-2018. The chemotherapy outcomes, Vitamin D levels and replacement doses of these patients up to 6 months ago were recorded. Results: Vitamin D levels of 153 patients were below 15 ng/mL, 65 patients had a level of 15-30 ng/mL, and 29 patients had a vitamin D level higher than 30 ng/mL. In the study population, 215 had a replacement below 300.000 IU whereas 32 had a replacement above 300.000 IU. When the patients were evaluated based on their chemotherapy responses, no difference was observed between the patients with below and above 300.000 IU. In our study, Vitamin D and replacement level at the time of diagnosis did not change the chemotherapy response. Conclusion: Vitamin D replacement levels were not significantly associated with chemotherapy outcomes in our study.

Objectives: Lung cancer has been the leading cause of cancer mortality, and its incidence is growing throughout the world. This study aims to compare the distribution of the six World Health Organization by configural frequency analysis (CFA). Methods: The National data (GLOBOCAN 2012) were included in the analysis. Data were analyzed by CFA which is used for the analysis of multiway contingency tables. Results: In Africa, East Mediterranean, Europe, and Southeast Asia, lung cancer incident cases were observed to be higher than expected. Under the years

Aim: We aimed to determine whether Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), D-dimer, and troponin values were correlated with the simplified Pulmonary Embolism Severity Index (sPESI) in patients diagnosed as having Pulmonary Embolism (PE) in the emergency room. Material and Methods: Forty-three patients diagnosed as having PE in the emergency departmentwere divided into low and high-risk groups according to the sPESI. We investigated whether NLR, MLR, and PLR, d-dimer, troponin-I, and Pulmonary Artery Pressure (PAP) had any effect in determining the severity of PE. Also, patients were divided into groups as those with PAP ≤20 or >20 mm Hg, Systolic Blood Pressure (SBP) ≤100 or >100 mm Hg, and those receiving or not receiving thrombolytic treatment, and compared. Results: There was a statistically significant difference between patients with low sPESI (n=10) and those with high sPESI (n=33) in terms of age (p=0.001), pulse (p=0.016), oxygen saturation (p=0.039), troponin-I (p=0.029) and PAP (p=0.032), but there was no difference between the groups in terms of NLR (p=0.796), MLR (p=0.656), PLR (p=0.863), and d-dimer (p=0.343). There was a statistically significant difference between patients who did (n=6) and did not (n=37) receive thrombolytic treatment in terms of troponin-I (p=0.012), but there was no difference between the groups in terms of NLR (p=0.861), MLR (p=0.335), and PLR (p=0.277). Conclusion: NLR, MLR, PLR and d-dimer levels were found not to be effective in determining the severity of PE. Troponin-I was associated with sPESI and was considered as an effective marker in determining the thrombolytic treatment.

Aim: An increase in the elderly population owing to an extended average life expectancy leads to an increase in the geriatric patient admissions to the emergency departments (EDs). The aim of this study was to investigate the intensity of geriatric patients among all admissions to the emergency department and to determine the importance of these patients in hospitalizations from the EDs.Material and Methods: Geriatric patients aged over 65 years were retrospectively evaluated between 1 January 2017and 31 December 2018. The patients were divided into two groups by the age: 65–79 (group I) and ≥80 years (group II). The number of days of hospitalization and mortality in the intensive care units (ICUs) and clinics were examined.Results: Of 386.670 patients aged over 18 years who were admitted to the ED, 17% (n=65.907) were aged ≥65 years. 64.4% of the patients who were hospitalized in the ICU from the ED were aged ≥65 years. The sex distribution of the patients who were admitted to but died in the ED in both the groups was as follows: Of 62.1% (n=72) in Group II were females, and of 62.1% (n=82) in Group I were males.Conclusion: In parallel with the increase in the number of geriatric patients in ED, there is a crowding in both clinics and ICUs. This article highlights the importance of geriatric patients in emergency department admissions and their importance in hospitalizations. Hospitalization and mortality rates increase with age. Keywords: Emergency department; crowding; geriatric patients.

Aim: Congenital heart disease (CHD) is one of the most common congenital anomalies. It is known that early detection of the criticallesions without symtomatic improves the prognosis of patients in the long term. In our study, we aimed to evaluate the efficacy andcost of pulse oximetry screening for detection of CHD in Konya region.Material and Methods: In our study, we analyzed the results of pulse oximetry screening of infants born between 2016 and 2018in Selcuk University and Saglik Bilimleri University Konya Training and Research Hospital. Positive screening test results and theircosts was evaluated.Results: Pulse oximetry was performed on a total of 3440 infants for screening congenital heart disease at two different centers. 2003(58.2%) of the cases were female and 1437 (41.8%) were male. The mean timing of screening was 24.713.1 (4-100) hours (mean SD (min-max). 292 (8.48%) infants were tested positive. Echocardiographic examination was performed in the positive cases. Theprevalence of CHD was found to be 27.6 ‰. The prevalence of critical CHD was 1.16 per 1000 live births. The false-positive screenrate was found to be 197 (5.7%). Among the cases who were screened, the most common CHD was the secundum ASD. The totalcost of probes was 2622 (497.91). The cost of echocardiography for 292 babies was approximately 13181 (2503).Conclusion: Screening for heart disease can be used effectively in the early diagnosis of serious and life-threatening diseasesin newborn and the cost is unneglectable in the early screening of patients. This study, the total cost of each infant screening isapproximately 4.5 (0.85) which appears to be a quite cheap and effective screening compared to the other countries.

Demodex mite is a compulsory human ecto-parasite situated in or near pilo-sebase units. Demodex folliculorum and Demodex brevis are two species found in humans. In this case; there were long-term complaints of severe pruritus (six months), and common erythematous papules on the body. Other physical examination findings, complete blood count, biochemistry, sedimentation and C-reactive protein levels were normal. However, Demodex spp. was detected in standard superficial skin biopsy taken from the patients skin. Demodex should be considered prediagnosis for unexplained and continued pruritus complaints and maculopapular lesions. [Med-Science 2019; 8(1.000): 242-4]

Amaç: Bu çalışmada, abdominal aortaya açık cerrahi girişim gerçekleştirilen hastalar ile endovasküler girişimgerçekleştirilmiş hastaların postoperatif dönemde ağrılarını ve analjezik ihtiyaçlarını karşılaştırmak amaç-lanmıştır.Gereç ve Yöntem: Araştırma Ocak 2014- Aralık 2015 tarihleri arasında merkezimizde abdominal aortaya açıkcerrahi ve EVAR uygulanan hastalarda retrospektif olarak yapılmıştır. Çalışmaya 68 hasta dahil edilmiştir.Ancak 7 hasta öldüğü için çalışma dışı bırakılmıştır. 22 hastaya açık cerrahi uygulanırken 39 hastaya EVARuygulanmıştır. Ağrı değerlendirilmesinde kliniğimizin protokolü olarak yedi yaş üzeri çocuklarda, erişkin vebilinci açık hastada sayısal/sözlü/vizüel ağrı ölçeği kullanılmaktadır.Bulgular: Araştırma kapsamına alınan hastaların %63.9’una EVAR uygulanırken %36.1’ine açık cerrahi uy-gulandı. EVAR grubunun yaş ortalaması 67.3511.05, açık cerrahi grubunun 64.2213.53 idi. EVAR grubunağrı skoru 1.350.82 iken, açık cerrahi grubunun 4.811.32 idi. EVAR uygulanan hastaların ağrı puanları açıkcerrahi uygulananlara kıyasla daha düşüktü (p0.000). EVAR grubunun %59’u, açık cerrahi grubunun ise%90.9’u ağrı kesici kullanmıştır (p0.009).Sonuç: Ağrı durumları değerlendirildiğinde açık cerrahi işlem uygulanan hastaların EVAR uygulanan has-talara kıyasla ağrılarının daha fazla olduğu görülmüştür. Günümüzde endovasküler girişimler artan sıklıktauygulanmaktadır. Endovasküler girişimlerin hasta konforu ve özellikle cerrahi işlem sonrası hastaların sıklıklayakındıkları postoperatif dönem ağrı üzerinde olumlu etkileri vardır., Objective: In this study, it was aimed to compare the pain and analgesic needs of the patients who under-went open surgery and who underwent endovascular aneurysm repair (EVAR) for abdominal aorta in thepostoperative period.Material and methods: The study was performed retrospectively in patients who underwent open surgeryand EVAR for abdominal aort at our center between January 2014 and December 2015. Sixty-eight patientswere included in the study but seven patients were excluded from the study because of the deaths. EVARwas applied to 39 patients when open surgery was applied to 22 patients. In the evaluation of pain, as aprotocol of our clinic, numerical / verbal / visual pain scale is used in children over seven years, adult andconscious open patient.Results: Of the included patients, EVAR was applied to 63.9%, open surgery was applied to 36.1%. The meanage of the EVAR group was 67.35 11.05, and the open surgical group was 64.22 13.53. The EVAR grouphad a pain score of 1.35 0.82 and the open surgical group was 4.81 1.32. Pain scores of EVAR patientswere lower than open surgery patients (p 0.000). 59% of the EVAR group and 90.9% of the open surgicalgroup used analgesic (p 0.009).Conclusion: When the pain conditions were evaluated, it was seen that patients who underwent open sur-gery had more pain than EVAR patients. Today, endovascular interventions are being applied with increasingfrequency. Endovascular interventions have positive effects on patient comfort and especially after surgerypatients often suffer pain in postoperatively.

Aim: To invastigate the inflammatory process and hormone parameters as a result of underlying cause of unexplained infertility (UI)Metarial and Methods: In total 153 patients with UI who underwent to intracytoplasmic sperm injection (ICSI) were included in the study. The blood hormones levels were obtained on the 2nd or 3rd day of the menstruation. Other blood count examinations were taken on the day of HCG administration. Relationship regarding embryo grade was also investigated.Results: Of those 153 patients, only 42 of them got pregnant. Mean maternal age was 29.08±3.5 and mean duration of the infertility was 8.19±3.1 years, respectively. There was no statistically significant difference between pregnancy rate, embriyo grade, and FSH, progesterone, fT3, fT4, TSH levels (p>0.05). Also no significant difference was found between pregnancy rate, embriyo grade and hemoglobin, hemotocrit, platelet, mean platelet volume, neutrophil, lymphocyte counts, neutrophil lymphocyte ratio and platelet lymphocyte ratio (PLR) (p>0.05). However, a significant difference was found between embriyo grade and estradiol values (p0.05). There was a negative correlation between hematocrit values and the oosit number collected with the number of embryos (p0.05). PLR was found to be 110.9 (63.6 - 313.2) in pregnant women and 110.5 (51.8 - 390) in nonpregnant patients and the correlation between the PRL measured on HCG day and pregnancy rate.was significant (p=0.002). LH median values measured on HCG day were significantly lower in pregnant group (p0.001). Conclusion: We found that inflammation does not affect on IVF result and estradiol levels significantly effects on embriyo quality. Also there was an inverse correlation between hematocrit levels and the number of oocyte- and number of embryos.Keywords: Infertility; blood cell count; inflammation; estrogen.

Objectives: The aim of this study was to investigate the temporomandibular joint mobility, cervical mobility, head position, and kinesiophobia in individuals who were seperated into different groups according to the Research DiagnosticCriteria for Temporomandibular Disorders, and were diagnosed with only one.Methods: Individuals with temporomandibular disorders were divided into 3 groups according to the Research Diagnostic Criteria for Temporomandibular Disorders. After obtaining sociodemographic information of individuals, cervical mobility and head position with a goniometer, temporomandibular joint mobility with a ruler, and kinesiophobiawith a Tampa Scale for Kinesiophobia were assessed.Results: In the statistical analysis among the groups; values for the Tampa Scale for Kinesiophobia of individuals ingroup 3 were higher than the others with temporomandibular disorders (p0.002); while head position, temporomandibular joint mobility and cervical mobility values did not differ (p0.05).Conclusion: It is considered that craniocervical symptoms can different in subgroups of temporomandibular disordersat the beginning. However, these symptoms were same in all groups, except kinesiophobia. On this basis, it is need forfurther study with high level of evidence.

Aim: The frequency of placenta previa (PP) is increasingly rising due to the increase in caesarean ratio. The aim of this study is to investigate the role of the white blood cell (WBC) in the preoperatively taken complete blood specimen in foreseeing whether hysterectomy will be performed or not in patients with placenta previa totalis.Materials and Methods:Two hundred fifty-seven (257) patients who experienced caesarean due to placenta previa totalis (PPT) in Ondokuz Mayis University between 2010 and 2018 had been surveyed retrospectively. The results of the preoperative Complete Blood Count (CBC) of the Placenta PreviaTotalis (PPT) patients in which either hysterectomy was applied or not, demographic characteristics, other follow-up and treatment results were accessed via system records and file surveys. The primary outcome is the role of preoperative White Blood Cell (WBC) levels in predicting hysterectomy, Results: WBC median values in the pre-operative complete blood specimen of the patients with placenta previa totalis demonstrate difference between the patients with hysterectomy and those without hysterectomy. While the median value was as 9.7 109/L in the patients who could be recovered with treatments apart from hysterectomy, this was obtained as 11.3109/L in the patients in which hysterectomy was applied (p=0.007).Conclusion: Increase in WBC in the pre-operative blood specimen of the patients with diagnosis of Placenta Previa Totalis may be guiding whether hysterectomy will be applied or not.Keywords: Placenta previa; hysterectomy; leukocytosis; caesarean.

Aim: In this prospective study, we aimed to compare the patients scheduled for in vitro fertilization (IVF) with poor ovarian reserve to patients with unexplained infertility in the same age group in terms of sexual dysfunction.Material and Methods: In this prospective study, a total of 146 patients admitted to the IVF center of Ondokuz Mayis University between June 2018 and December 2018 were included in the study. Fourty-eight of these patients had poor ovarian reserve and 98 were scheduled for IVF due to unexplained infertility. In these patients, the female sexual function index (FSFI) scores were calculated for the diagnosis of sexual dysfunction prior to treatment. In addition, ovarian reserve tests such as cyclic follicle stimulating hormone (FSH) and anti mullerian hormone (AMH) at the beginning of the menstrual cycle were recorded.Results: The mean age of the female patients in the study was 30.2+-5 years. The mean FSFI score was 22.36 +-3.31 and 22.44+-3.53 in the group with poor ovarian reserve and with unexplained infertility, respectively. The prevalence of sexual dysfunction (FSFI score 26.55) in the poor ovarian reserve group was 89.6% (n=48) compared to the unexplained infertility group, which was 93.9% (n=98). The analysis of domains revealed no statistically significant difference between the two groups (p=0,356).Conclusion: Sexual dysfunction is frequently observed in patients scheduled for IVF. Our study showed that there was no difference in sexual dysfunction between the two groups. Interestingly, it was revealed that there was a correlation between FSH levels and satisfaction and pain.It was also interesting that the rate of sexual dysfunction was extremely high in both groups.Keywords: Decreased ovarian reserve; sexual dysfunction; unexplained infertility; ovarian reserve.

Aim: The large number and different varieties of cysts and cyst-like lesions around the knee joints are commonly encountered on the magnetic resonance scanning. We aimed to evaluate type, frequency, and size of cystic lesions observed around the knee joints and to find out its relationship with osteoarthritis.Material and Methods: 620 knee joints belonging to 545 patients were enrolled in the study. We retrospectively examined magnetic resonance images of the knee joints which were divided into three groups as non-degenerative, mild degenerative, and severe degenerative. The cysts have been classified according to count, type and size and their relationship with knee osteoarthritis was assessed.Results: Out of 620 knees, 248 knees (40%) had no degenerative arthritis, 178 knees (28.7 %) had mild, and 194 knees had severe (31.3 %) degenerative arthritis. Cystic lesions were identified in 411 knees (66.3%). One cyst in 261 knees, two cysts in 102 knees, three cysts in 40 knees, and four cysts in 8 knees were encountered. Increased number and average diameter of the cysts showed statistically significant relation with the degree of osteoarthritis (p0.001 and p0.04, respectively). Moreover, some types of cysts such as synovial cysts, intraarticular ganglion cysts, and intraosseous cysts were significantly increased with osteoarthritis (p0.001).Conclusion: There was significant increase in frequency, number, and average size of knee joint cysts in patients with degenerative arthritis findings. In addition, almost all cyst types except intrameniscal and parameniscal cysts, were found more frequently in the knees with degenerative arthritis.

Aim: The aim of this retrospective study was to evaluate the possible complications and the complication management of cervical anterior discectomies and fusions in light of the literature.Materials and Methods: The study population consisted of patients who presented to the clinic with neck pain and/or arm pain, loss of strength, and sensory disturbances who were operated on after a lack of response to conservative/medical treatment. This study included 200 cervical discopathy and/or cervical spondylosis cases. The literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‑analyses guidelines without language or country restrictions.Results: The most common complication was dysphagia. The complications also included dural tears, cerebrospinal fluid leakage, graft extrusions, neurological deterioration, postoperative hematomas, and recurrent laryngeal nerve injuries. These were found to be consistent with the literature.Conclusion: In order to minimize the incidence of complications, the preoperative clinical examinations and radiological imaging of each patient should be examined carefully, and the appropriate surgical planning should be performed. It is also important to comply with the rules of asepsis and antisepsis, make sure the surgical time is as short as possible, and perform a dissection based on the patient’s anatomy with the appropriate surgical equipment. In addition, it is important to wash the surgical area frequently, drain the system at the end of the operation, close the tissues in accordance with anatomical integrity, and perform close clinical follow-ups.Keywords: Anterior cervical discectomy and fusion; cervical degenerative disc disease; complications; management of complications.

Servikal omurganın yapısal ve işlevsel bütünlüğünü travma, dejenerasyon, tümöral ve infeksiyöz hastalıklar bozabilirler. İnstabilite ayrıca, çeşitli nedenlerle yapılan cerrahi girişimlerden sonra da iyatrojenik olarak da görülebilir. Servikal instabilite hafif nörolojik kusurlardan, ağır nörolojik defisitlere hatta ölüme neden olabilecek ciddi bir durumdur. Tedavisi nöral ve vasküler yapıların dekompresyonunu, normal anatomik dizilimin tekrar sağlanmasını ve rijid bir fiksasyonu gerektirir. Uzun süre immobilizasyon, traksiyon ve eksternal fiksatörler gibi ortez kullanımı şeklindeki konservatif tedaviler, bazı olgularda uygulanıyor olsa da gelişen cerrahi ve enstrumantasyon sistemleri günümüzde cerrahi ile sağlanan internal fiksasyonu öne çıkarmıştır. Pedikül vidaları ile son derece güçlü stabilizasyon sağlanır. Bu nedenle torakolomber omurgada en sık kullanılan enstruman olan pedikül vidalarının son yıllarda servikal bölgede de kullanımına başlanmıştır. İnce pedikül yapısı ve vertebral arterin yakın komşuluğu servikal bölgede pedikül vidalarının kullanımını zorlaştıran faktörlerdir. Komplikasyonsuz bir cerrahi için bölge anatomisinin son derece iyi bilinmesi, vida giriş noktalarının, açılarının, vida genişlik ve derinliklerinin ölçülere uygun şekilde seçilmesi şarttır. Ölçümlerimizde pedikül kalınlıklarının kranio-kaudal yönde arttığını, 3.5 mm vida kalınlığının genel olarak uygun olduğu, pedikül yüksekliklerinin pedikül kalınlıklarından fazla olduğunu gördük. Pedikül transvers açılarını 30-45º arasında ölçtük. Ölçümler hem kişiye hem de ölçülen seviyeye göre farklılıklar göstermektedir. Bu durum, cerrahi öncesi radyolojik yöntemlerle yapılacak bir planlamanın pedikül vidalamasındaki önemini gösterir. Trauma, dejeneration, tumoral and infectional diseases may get demaged to integrity of structural and functional cervical spine. And also, instability may be seen as an iatrogenic after the surgery. Servical instability is a situation that may cause minimal neurologic order to high neurologic deficit and even it may cause to death. Treatment requires vascular and neural structures of decompression, providing again of normal anatomic order and a rigid fixation. Even so conservative treatment which is usage of as an orthesis as a long time immobilization, traction and external fixator, is implemented in some cases, it puts forward internal fixation, which is provided with surgery today, with the help of devoloping surgery and instrumentation systems. With the pedicle screws are provided strong stabilization for that reason, in recent years pedicle screws which are used in thoracolumbar spine, are started to be used cervical region. It’s slim pedicle structure and the nearer of vertebral artery are made difficult to usage of pedicle screws in cervical region. Surgery which is not involved in complication, needs to be well-known the region of anatomy, screw entrance points, angles, wideness and deepness must be choosen as a suitable form. According to our measurements, the pedicle thickness increase towards craniocaudale, 3.5 mm screw thickness is suitable for surgery and pedicle highnesses are more than pedicle thicknesses. We measure that pedicle transverse angles are 30-45º. Measurements may be different for every level and each person. This situation shows the importance of planning in computerized tomography imaging before the surgery.

Objective(s). Interferon alpha therapy is associated with series of adverse effects leading premature discontinuation of treatment. Here we aimed to determine the effects of Tumor necrosis alpha promoter polymorphisms on interferon related side effects during interferon alpha 2b treatment in chronic hepatitis B patients Material and Method(s). This observational study enrolled 50 chronic hepatitis B patients, who were treated with interferon alpha 2b 10 tiw plus lamivudine 100mg/day at Selçuk University Meram Medical Faculty Department of Infectious Diseases and Clinical Bacteriology between 2006-2007. Patients were followed-up with complete blood count, transaminases and amylase monthly at out patient clinics of our department. All patients were asked to fill a questionnaire to evaluate the interferon related side effects at every visit. Tumor necrosis factor alpha -238 and -308 polymorphisms were investigated with PCR-Restriction fragment length polymorphisms. Result(s) and Conclusion Arthralgia was present in 93.8% of patients. Exhaustion, loss of appetite, mount dryness and fever are the leading complaints of the patients. Median complaint scores were 9, 9.5, 11 and 5 at 4th, 12th, 24th and 48th week visits, respectively. Thrombocytopenia and leucopenia were detected in 8 (16%) and 5 (10%) patients, respectively. One-third of the patients reported depressive mood however, depression was diagnosed in 5 (10%) patients. TNF alpha promoter 238GG and 308GG allele was present in 42/50 and 43/50 patients, respectively. No association was found between TNF promoter allele and certain patient-reported side effect, complaint score, hematological and psychological adverse effects. TNF alpha promoter polymorphisms do not contribute to occurrence of IFN alpha treatment related side effects.

Aim: Although tumor grade has no impact on endometrial cancer stage, it carries prognostic and therapeutic importance. Surgical management and adjuvant treatment following surgery in certain patients depends on a number of factors including tumor grade. Although grade 3 tumors are included in the high-intermediate risk group, there are data demonstrating that there is a slight difference in survival between patients with grade 1 and 2 tumors in early-stage disease. In this study, we aimed to investigate the association of grade with clinicopathological characteristics, recurrence-free and disease-specific survival in patients treated at our clinic and diagnosed with endometrioid endometrial cancer. Material and Methods: 279 patients with early FIGO Stage endometrioid endometrial cancer treated between 2009-2018 in a University hospital were included in the study. The associations between tumor grade with stage, lymphovascular space invasion (LVSI), myometrial invasion, tumor size, and survival were analyzed. Results: LVSI, ≥50% myometrial invasion, advanced stage and > 2 cm tumor size were significantly higher in grade 3 tumors compared to patients with grade 1 tumors. Recurrence-free and disease-specific survival were significantly lower in patients with grade 2 and 3 tumors compared to patients with grade 1 tumors. In multivariate analysis of RFS and DSS, tumor grade, LVSI and stage were independent prognostic factors. Conclusion: According to this study, grade 2 tumors may not differ significantly from grade 3 tumors in terms of survival. Therefore, due to the potential adverse prognosis associated with grade 2 and 3 tumors, vigilance for recurrence is warranted.

Aim: The aim of this study was to investigate the relationship between tinnitus and the factors that cause the tendency to thrombosis in terms of gender.Material and Methods: Fifty-five consecutive patients who admitted to our clinic with the complaint of idiopathic subjective tinnitus were included in this study. Routine ENT (ear nose throat) examinations and pure tone audiometry test were performed. Prothrombin time (PT), partial thromboplastin time (PTT), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, Triglycerides, antithrombin III (AT III), protein C, protein S, homocysteine, antiphospholipid and anticardiolipin antibodies were examined in blood samples of patients. Temporal bone magnetic resonance imaging (MRI) was performed all patients. The results of the patients were compared in terms of gender and age groups (40 age).Results: The study was completed with 47 patients. Twenty-four of the patients were female and 23 were male. Both genders groups were similar in terms of age and pure tone average. Antiphospholipid and anticardiyolipin antibodies (IgG and IgM) were found as negative in all patients. Homocysteine levels were found to be statistically significantly higher in males than females (p=0.015; respectively 13.38±5.98 µmol/L and 9.87±3.11 µmol/L). AT III and Protein S levels were lower in males than females although this difference was not statistically significant (respectively p=0.07 and p=0.08)Conclusion: In this study, an association was shown between hyperhomocysteinemia and tinnitus, especially in males. Keywords: Tinnitus; tinnitus of vascular origin; thrombosis; gender role.

Aim: The aim of this study was to compare the important parameters for life, such as sleep, fatigue and quality of life, between the asymptomatic and schizophrenic individuals.Material and Methods: The study included 38 individuals diagnosed with schizophrenia by the psychiatrist and 39 asymptomatic individuals.All participants of our study applied to the outpatient clinic of Kirikkale High Specialization Hospital, Community Mental Health Center. Sociodemographic information of the individuals was questioned by the evaluation form. Sleep qualities of the individuals were evaluated with Pittsburgh Sleep Quality Index (PSQI), fatigue scores were evaluated with Fatigue Severity Scale (FSS), and quality of life scores were evaluated with World Health Organization Quality of Life Scale Brief Turkish Version (WHOQOL-BREF-TR).Results: A total of 77 individuals aged between 20 and 71 were included in the study. The mean age of the individuals with schizophrenia was 40.07 12.14 years, whereas the mean age of the asymptomatic individuals was 43.61 12.19 years.When the quality of sleep and the sleeping medication use were examined between the two groups, it was found that there was a statistically significant difference (p0.05). When the total scores of the sleep quality questionnaires were evaluated between the two groups, it was detected that there was no statistical difference (p0.05).When the quality of life was evaluated between the two groups, it was seen that the physical and social sub-parameters of the patients with schizophrenia were worse (p0.05).It was detected that there was no statistically significant difference in evaluations of fatigue severity between the two groups (p0.05).Conclusion: It was found that individuals with schizophrenia had a lower quality of life than asymptomatic individuals.We think that the physiotherapy and rehabilitation approaches in addition to medical and psychotherapy should be applied to improve sleep quality and quality of life in individuals with schizophrenia.

Objective. We aimed to investigate iron metabolism and laboratory findings of anemia in children undergoing adenotonsillectomy for sleep disordered breathing. Methods. Consecutive children undergoing adenoidectomy/adenotonsillectomy for sleep disordered breathing between January 2013 and January 2015 were investigated. Routine preoperative blood tests including blood count and iron studies were analyzed. Subgroup analyses were performed addressing to the severity of sleep disordered breathing, age and duration of symptoms. Results were compared between subgroups and normal values. Results. The study included 171 children. The mean age was 5.44 ± 2.62 years. The mean hemoglobin level was 11.87 ± 1.125 gr/dL and 24 (14%) out of 171 patients had anemia (< 11 gr/dL). The mean ferritin levels were 23.23 ± 17.27 µg/L and 21.27 ± 15.44 µg/L in patients with anemia and non-anemic patients, respectively ( p = 0.572). Ferritin levels decreased in only 8 (33%) out of 24 patients with anemia. The mean age, body mass index, hematocrit, mean corpuscular volume, unsaturated iron binding capacity and serum iron levels decreased in patients with anemia. The rate of anemia significantly increased in children less than or equal to 3 years of age ( p = 0.020). There was no significant association between hemoglobin levels and sleep disordered breathing clinical score or duration of symptoms. Conclusion. The association between low iron status and sleep disordered breathing has previously published. Unfortunately, the type of anemia is still unclear. Our results supposed that the anemia of chronic disease secondary to chronic inflammatory process might play a role in pathogenesis of anemia in patients with sleep disordered breathing.

Aim: This study was conducted to evaluate the knowledge, use and views of health school nursing students about complementary and alternative medicine (CAM) practices.Materials and Methods: In this descriptive study, the questionnaire was distributed to every student who was studying on the days when the research was applied. The study was conducted with 489 volunteer students who agreed to fill out the questionnaire. The obtained data were recorded in SPSS packaged software and statistical analyzes were done through this software. Results: The CAM methods that are most known by the students who participated in the research are respectively, (82.6%) exercise, (79.6%) vitamins, (74.0%) diet, (73.0%) vegetable products and (71.3%) massage. The frequency of using CAM was found to be 51.3%. CAM usage rate in males is higher than females (p

The association between acromegaly and increased incidence of malignancy has been reported due to high GH and IGF levels. Although the incidence of all malignancies increases in patients with acromegaly, renal cell carcinoma (RCC) has been rarely reported. Herein, we report an acromegaly case with lung, gluteal and scapular metastatic RCC. The risk of cancer and cancer metastasis is high in uncontrolled acromegaly. At this point, treating acromegaly and controlling the disease progress are both important to enhance the life expectancy of a patient. [Med-Science 2018; 7(3.000): 704-6]

Aim: The aim of this study was to evaluate the accompanied cervical injuries of the patients presenting to the emergency department (ED) because of penetrating, perforating or tangential cranial gunshot injuries (CGI). Material and Methods: The retrospective study included 137 patients that presented to the EDs at Mustafa Kemal and Ataturk University due to penetrating, perforating or tangential CGI between 2014 and 2018. Patients younger than 12 years old and had insufficient radiological records were excluded from the study and thus 115 patients were included in the study. Results: 115 patients included 105 (91%) men and 10 (9%) women with a mean age of 27 (range, 12-65) years. Of the 115 injuries, 84 (73%) were high-velocity and 31 (27%) were low-velocity gunshot injuries. The injuries included 92 (80%) penetrating or perforating and 23 (20%) tangential injuries. No cervical dislocation injury was accompanied by CGI in any patient. Unilateral lamina fracture of the cervical vertebra was observed in one patient. Conclusion: Our results support the opinion that isolated penetrating, perforating or tangential CGI did not cause to cervical spinal injuries, the intubation or tracheostomy procedures should not be postponed after radiological evaluation of cervical spinal stability.

Eğitimli insan gücü yetiştirilmesinde etkin rol oynayan üniversitelerde mesleki ve teknik eğitim, dört yıllıkmesleki-teknik eğitim fakülteleri ve iki yıllık meslek yüksekokulları ile gerçekleştirilmektedir. Bunlardan meslekyüksekokulları (MYO), iş piyasasının ihtiyaç duyduğu ara elemanların yetiştirilmesi amacıyla kurulmuşken,anılan fakültelerin amacı mesleki orta öğretim kurumlarının öğretmen ihtiyaçlarını karşılamaktır. Ancak istenilennitelikteki ara insan gücünü yetiştirecek eğitimcilerin, verilmek istenilen bu eğitim sürecinde karşılaşılan bazısıkıntılar, mesleki eğitimi de olumsuz yönde etkileyebilmektedir. Bu derlemenin amacı, insan sağlığınaodaklanan mesleklerde çalışacak ara insan gücünü yetiştiren Sağlık Hizmetleri Meslek Yüksekokullarındakiakademik personelin durumu ve karşılaştıkları sorunlar ile çözüm yollarını irdelemektir. Genel birdeğerlendirmeyle ele alındığında Sağlık Hizmetleri Meslek Yüksekokullarında eğitici/öğrenci oranının diğermeslek yüksekokullarına göre yüksek olduğu, akademik personelin bireysel ve mesleki gelişimi destekleyecekmekanizmaların bulunmadığı, alan dışı görevlendirmelerin yapıldığı ve bazı yönetsel sorunların yaşandığıgörülmüştür. At universities, which constitute the most important source of qualified labor, vocational and technical training iscarried out through four-year vocational and technical education faculties and two-years vocational schools.Vocational schools (VS) are intended to meet the intermediate staff needed by the labor market while vocationalfaculties are aimed at training teachers needed by vocational secondary schools. However, trainers who will trainthe intermediate human power in the desired quality experience some difficulties in this process andconsequently vocational education can be affected negatively. This review explores the current status andproblems, as well as solutions, of academic staff of Vocational Schools of Health Services, which provide theintermediate human power to work in the occupations focused on human health. In general, it was observed thatthe trainer/student ratio in Vocational Schools of Health Services was higher than other vocational schools, therewere no mechanisms to support individual and professional development of academic staff, and there wereirrelevant assignments and some administrative problems.

Aim: Patient education is important for patients with predialysis chronic renal disease (CKD)because it can delay the progression of the disease to end-stage renal failure.Anxiety and depression may also contribute to the progression of the disease in patients with CKD. We evaluated the influences of education on progression ofCKD, the Short Form 36 Health Survey (SF36), and the Beck Depression Inventory (BDI) in predialysis CKD patients. Material and Methods: 121 patients with nondialysis stage 2-5 CKD were involved in this study. At the start of the study, the SF36 and BDI scoring were performed in all patients and their creatinine clearances were calculated. 31 patients were given education on CKD by the dialysis specialist nurse once a month. At the end of the sixth month, SF36 and BDI were rescored, and their creatinine clearances were recalculated. Results: There were no significant differences between the two groups regarding age, gender, creatinine clearance, and duration of chronic kidney disease. At the end of the sixth month, when the educated and uneducated patients were compared, while the increase of the creatinine level was significant in the two groups, the SF36 and BDI scores were found to be improved significantly in the study group. Conclusion: The results of this study suggested that patient education may improve the SF36 and BDI scores, but it does not affect the progression of the disease for at least six months in duration.

Near-infrared ışığın dokulara penetre olabilmesi, oksihemoglobin ve deoksihemoglobin tarafındanabsorbe edilebilmesi rejyonel serebral oksijen satürasyon ölçümünün temel prensibinioluşturur. Bu yöntemle, serebral dokunun oksijen arz-talep dengesi devamlı ve gerçek zamanlıolarak değerlendirilebilmektedir. Ölçümlerde, beyinde venöz, kapiller ve arteriyel kompartmanlardabulunan kan volümünün sabit bir değer olduğu varsayılır. Bu sebeple serebral oksimetrelerbu kompartmanlara ait oksijenizasyonla ilgili ortalama bir değer sunmaktadırlar.Düşük rejyonel serebral oksijen satürasyon değerleri serebral hipoksi ve/veya iskemi ile ilişkilendirilmiştir.Ancak serebral oksimetrelerin postoperatif nörolojik komplikasyonları azalttığıyönündeki veriler çelişkilidir. Bu yüzden genel anestezi uygulamalarında rutin bir monitörizasyonyöntemi olarak kullanılması önerilmemiştir. Yine de özellikle kardiyak cerrahi ve karotisendarterektomi cerrahisinde kullanımı faydalı olabilir. Penetration of near-infrared light into the tissue and its absorption by oxyhemoglobin anddeoxyhemoglobin constitute the basic principle of regional cerebral oxygen saturationmeasurement. With this method, oxygen supply-demand balance of the cerebral tissue canbe evaluated continuously and real-timely. Blood volume present in venous, arterial andcapillary compartments of the brain is assumed to be a constant volume in the measurements.Therefore, cerebral oximeters provide an average value related to the oxygenation of thesecompartments. Low regional cerebral oxygen saturation values were associated with cerebralhypoxia and/or ischemia. However, the data showing that cerebral oximeters decreasepostoperative neurological complications are conflicting. Therefore, it has not been suggestedas a routine monitoring method in general anaesthesia applications. İts use may be helpfulespecially in cardiac surgery and carotid endarterectomy surgery.