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Background/Aim: Heart failure is an important health problem with an increasing incidence in the world and poor prognosis. Galectin-3 is associated with progressive fibrosis, an underlying pathology of heart failure, just as vitamin D deficiency. We examined the relationship between the stage of heart failure and galectin-3 and 25-OH vitamin D levels.Methods: Sixty patients with heart failure and 30 healthy volunteers were included in this prospective case-control study. Demographic data, comorbid diseases and laboratory data were examined, and 25-OH vitamin D and galectin-3 levels were compared between the patients with CHF and the control group.Results: Galectin-3 levels were high in patients with heart failure (P

Background/aim: with the increased experience in living donor liver transplantation (LDLT), it has been adopted for the treatment of hepatocellular carcinoma (HCC), with emerging discussions of criteria beyond tumor size and number. In contrast to deceased donor liver transplantation (DDLT), recipient selection for LDLT is not limited by organ allocation systems. We discuss herein the assessment, criteria, and experience with liver transplantation (LT) in HCC cases at a high-volume LDLT center. Material and methods: between August 2006 and December 2017, 191 adult LT HCC recipients with at least one-year follow-up were retrospectively analyzed. Results: in 191 patients, one-, three-and five-year survival rates were 87.2%, 81.6%, and 76.2%, respectively, including early postoperative mortality. In 174 patients with long-term follow-up, one-, three-and five-year disease-free survival rates were 91.6%, 87.7%, and 84.4%, respectively. When multivariate analysis was utilized, tumor differentiation was the only factor which statistically affected survival (p = 0.025). Conclusion: LDLT allows us to push the limits forward and the question ""Are the criteria always right?"" is always on the table. We can conclude that, with the advantage of LDLT, every HCC patient deserves a case-by-case basis discussion for LT under scientific literature support. In borderline cases, tumor biopsy might help determine the decision for LT., NA

Bruselloz pastörize edilmemiş süt ve süt ürünlerinin ağız yoluyla alınmasıyla veya enfekte hayvan salgılarıyla yakın temas yoluyla bulaşan, gram negatif bir kokobasil olan Brucella türlerinin neden olduğu ülkemizde de yaygın olarak görülen zoonotik bir hastalıktır. Bruselloz özgül olmayan semptom ve bulgulara sahip olması nedeniyle diğer birçok hastalığı taklit edebilir. Kırım Kongo Kanamalı Ateşi (KKKA) brusellozun ayırıcı tanısında yer alan zoonotik bir hastalıktır. Bu yazıda KKKA ön tanısı ile hastanemize sevk edilen ve bruselloz tanısı konulan iki pediatrik olgu sunulmuştur., Brucellosis is a common zoonotic disease in our country caused by Brucella species, a gram negative coccobacillus that is transmitted by oral ingestion of unpasteurized milk and dairy products or by close contact with infected animal secretions. Because brucellosis has nonspecific symptoms and findings, it can mimic many other diseases. Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease included in the differential diagnosis of brucellosis. In this article, two pediatric cases referred with a pre-diagnosis of CCHF and diagnosed with brucellosis were presented.

Chronic granulomatous disease (CGD) is a genetically heterogeneous primary immune deficiency of phagocyte function characterized by recurrent, life-threatening bacterial and fungal infections that lead to granuloma formation. Early diagnosis is possible by the awareness of the clinician about early infectious clues of the disease. Aggressive treatment of infectious complications is very important in CGD patients and subsequently antimicrobial (antibiotic and antifungal) and immunomodulatory (interferon-gamma) prophylaxis until hematopoietic stem cell transplantation. Despite improved mortality, morbidities due to complications associated with CGD remain significant. One of these is a hepatic abscess in CGD patients which is seen in more than one-quarter of patients and also very refractory and frequently requires multiple surgeries with frequent morbidities. Therefore, the most optimal and beneficial treatments are still being investigated in the world. We present a 3 y old CGD patient with multiple liver abscesses due to S.aureus and Aspergillus spp who treated by several percutaneous liver-directed interventional radiological treatment along with granulocyte transfusions, Kronik granülomatöz hastalık (CGD), tekrarlayan, yaşamı tehdit eden bakteri ve mantar enfeksiyonları ile karakterize olan, granülom oluşumuna yol açan genetik olarak heterojen bir primer immün yetmezlik olan fagosit fonksiyon yetersizliğidir. Erken teşhis, klinisyenin hastalığın erken enfeksiyon ipuçları konusunda bilinçlenmesi ile mümkündür. CGD hastalarında Enfeksiyöz komplikasyonların agresif tedavisi çok önemlidir ve hematopoietik kök hücre nakline kadar antimikrobiyal (antibiyotik ve antifungal) ve immünomodülatör (interferon-gama) profilaksileri de çok önemlidir. Mortalitenin azalmasına rağmen, CGD ile ilişkili komplikasyonlara bağlı morbiditeler önemini korumaktadır. Bunlardan biri, CGD hastasında, hastaların dörtte birinden fazlasında görülen ve aynı zamanda çok dirençli ve sıklıkla sık morbiditeli birden fazla ameliyat gerektiren karaciğer apsesidir. Bu nedenle dünyada halen en uygun ve faydalı tedaviler araştırılmaktadır. Granülosit transfüzyonları ile birlikte perkütan karaciğere yönelik girişimsel radyolojik tedavi ile tedavi edilen S.aureus ve Aspergillus spp’ye bağlı çoklu karaciğer apsesi olan 3 yaşında bir CGD hastasını sunuyoruz.

Introduction:: Anemia is one of the important public health problems plaguing the world today. Iron deficiency anemia (IDA) constitutes the majority of this anemia population. This study aims to explore the relationship of IDA and socio-demographic, lifestyle, dietary, physical activity, and different body size phenotypes in the adult Turkish populationMethods: The case-control study was carried out between August and October 2019 at the internal medicine outpatient clinic of the tertiary hospital. A total of 101 anemic and 111 age and gender matched non-anemic healthy controls were included. Iron-deficiency anemia was defined as the presence of both anemia and inflammation-adjusted ferritin concentration less than 15 ng/ml. Sociodemographic, lifestyle and nutritional characteristics of the participants were questioned with a questionnaire form. The physical activity level of the participants was evaluated with the International Physical Activity Questionnaire (IPAQ).Results: Non-anemic 111 (90 female, 21 male) and anemic 101 (90 female, 11 male) participants were included in the study. Unemployment (p=0.02), tea consumption (p=0.001), chronic disease (p=0.036), physical activity (p, Giriş: Anemi, günümüzde dünyayı etkileyen önemli halk sağlığı sorunlarından biridir. Demir eksikliği anemisi (DEA) bu anemi popülasyonunun çoğunu oluşturur. Bu çalışma, yetişkin Türk popülasyonunda DEA ile sosyo-demografik, yaşam tarzı, diyet, fiziksel aktivite ve farklı beden boyutları arasındaki ilişkiyi araştırmayı amaçlamaktadır.Yöntem: Bu vaka kontrol çalışması Ağustos ve Ekim 2019 tarihleri arasında üçüncü basamak hastanenin iç hastalıkları polikliniğinde gerçekleştirildi. Toplam 101 anemik ve yaş ve cinsiyetleri benzer 111 anemik olmayan sağlıklı kontroller çalışmaya dahil edildi. Demir eksikliği anemisi hem anemi hem de inflamasyona göre ayarlanmış ferritin konsantrasyonunun 15 ng/ml'den az olması olarak tanımlandı. Katılımcıların sosyodemografik, yaşam tarzı ve beslenme özellikleri bir anket formu ile sorgulanmıştır. Katılımcıların fiziksel aktivite düzeyleri Uluslararası Fiziksel Aktivite Anketi (IPAQ) ile değerlendirildi.Bulgular: Anemik olmayan 111 (90 kadın, 21 erkek) ve anemik 101 (90 kadın, 11 erkek) katılımcı çalışmaya dahil edildi. İşsizlik (p = 0,02), çay tüketimi (p = 0,001), kronik hastalık (p = 0,036), fiziksel aktivite (p

Ağır konjenital nötropeniler (AKN), nadir görülen olgun nötrofillerin eksikliği ile karakterize primer bir immün yetersizlik hastalığıdır. Klinik özellikler arasında doğumdan itibaren azalmış mutlak nötrofil sayısı, tekrarlayan ve yaşamı tehdit eden enfeksiyonlar vardır. Ayıca miyelodisplastik sendrom, akut miyeloblastik lösemi riskinde artış vardır. Dört yaş kız çocuğu sık tekrarlayan ağız içi yaraları, tonsillofarenjit, yumuşak doku ve akciğer enfeksiyonları ile başvurdu. Hastanın şikâyetleri nedeniyle bir kez yoğun bakımda olmak üzere birçok kez hastaneye yatışları olmuş. Tekrarlayan enfeksiyonlar nedeniyle bir yılda yaklaşık 15 kez intravenöz veya oral antibiyotik ihtiyacı olduğu öğrenildi. Hasta ateş, halsizlik ve frontal bölgede şişlik, kızarıklık şikâyetleri ile kliniğimize başvurdu. Öyküsünde, bir yıl önce de frontal bölgede apse gelişen hastaya drenaj ve antibiyotik tedavisi uygulandığı öğrenildi. Anne baba arasında akrabalık mevcuttu. Ailede benzer şikâyetleri olan bireyler yoktu. Hastamızın genetik analizinde HAX1 (HCLS1 ilişkili protein X-1) geninde homozigot mutasyon saptandı ve AKN tip 3 tanısı konuldu. Anne ve baba da aynı heterozigot mutasyon vardı. Özellikle tekrarlayan enfeksiyonlar ve nötropeni tespit edilen hastalarda nadir görülen bir hastalık olan Kostmann sendromunun ayırıcı tanıda düşünülmesi gerektiğini vurgulamak amacıyla bu vakayı sunduk, Severe congenital neutropenia (SCN) is a primary immune deficiency disease characterized by a rare deficiency of mature neutrophils. Clinical features include recurrent and life-threatening infections and a reduced absolute neutrophil count from birth. There is also an increased risk of myelodysplastic syndrome and acute myeloblastic leukemia. A four-year-old girl has recurrent oral aft, tonsillopharyngitis, soft tissue, and lung infections. Due to the complaints of the patient, she was hospitalized several times, once in intensive care. She needed intravenous or oral antibiotics about 15 times a year due to recurrent infections. The patient applied to our clinic with fever, fatigue, swelling, and redness in the frontal region. In her history has the patient was administered drainage and antibiotic therapy one year ago due to an abscess in the frontal region. There was a kinship between the parents. There were no individuals with similar complaints in the family. In our patient’s genetic analysis, there was a homozygous mutation in the HAX1 (HCLS1-associated protein X-1) gene, and SCN type 3 was diagnosed. The heterozygous same mutation was present in the mother and father.We reported this case to emphasize that Kostmann Syndrome as a rare disease in children with recurrent infections and neutropenia.

Giriş: Çocuklukta akut zehirlenmelerin özellikleri aynı toplumlarda zaman içinde değişebilmektedir. Bu çalışmanın amacı aynı merkeze farklı zamanlarda başvuran zehirlenme olgularının demografik özelliklerini karşılaştırmaktır.Yöntemler: Bu çalışma merkezimize 2010 ve 2016 yıllarında zehirlenme şikayetiyle başvuran 0-16 yaş arasındaki çocuklar arasında yapıldı. Zehirlenme olgularının demografik özellikleri acil kayıtlarından değerlendirildi ve her iki yılın bulguları birbiriyle karşılaştırıldı.Bulgular: Grup 2010’da 404, Grup 2016’da ise 398 olgunun yaş ortalaması sırasıyla 6,5±5.1yaş ve 4,7±4.6 yaş idi (p=0.001). İlaç zehirlenmeleri her iki grupta ilk sıradaydı, Grup 2010’da %61.6 ve Grup 2016’da %49.7 sıklığında idi (p=0.001). Gazlarla olan zehirlenmeler Grup 2010’da %19.2 ve Grup 2016’da %10.1 oranında gözlendi (p=0.0001). Grup 2010 ile Grup 2016 karşılaştırıldığında Grup 2010'da %13.8 Grup 2016’da ise %29.4 sıklığında korroziv maddelerle zehirlenme gözlendi. Kaza sonucu zehirlenme olguları ise Grup 2010'da % 77.3 iken Grup 2016'da % 81.9 idi (p = 0,001). Sonuçlar: İlaç ve gaz ile olan zehirlenmelerde azalma, ancak kostik maddelerle olan zehirlenmelerde artış görülmüştür. Kaza ile olan zehirlenmelerdeki artışın toplumun bu konuda farkındalığının artması ve eğitilmesi ile önlenebileceği düşünülmektedir., Introduction: Characteristics of acute childhood poisonings may change over time in the same populations. The aim of this study is to compare the demographic characteristics of poisoning children presenting to the same center at different times.Methods: This study was conducted among children aged 0-16 years who presented with the complaint of poisoning to our center in 2010 and 2016.The demographic characteristics of the poisoning cases were evaluated from the emergency records and the findings of both years were compared with each other. Results: The mean age of 404 cases in Group 2010 and 398 cases in Group 2016 were 6.5 ± 5.1 years and 4.7 ± 4.6 years, respectively (p = 0.001). Drug poisonings were in the first place in both groups, the group was 61.6% in 2010 and 49.7% in 2016 (p = 0.001). Gas poisoning was observed at a rate of 19.2% in the Group 2010 and 10.1% in the Group 2016 (p = 0.0001). When Group 2010 and Group 2016 were compared, poisoning with corrosive substances was observed with a frequency of 13.8% in Group 2010 and 29.4% in Group 2016. The rate of accidental poisoning cases was 77.3 % in Group 2010 and 81.9 % in Group 2016 (p = 0.001). Conclusions: There was a decrease in drug and gas intoxications, but an increase in intoxications with caustic substances. It is thought that the increase in accidental poisoning can be prevented by increasing the awareness and education of the society on this issue.

Objective: We aimed to evaluate asthma control status, drug compliance and anxiety levels of children and their parents who were followed up with the diagnosis of asthma during the COVID-19 pandemic.Material and Methods: Sixty-seven children aged between 8-12 years diagnosed with asthma and their parents were prospectively recruited to the study. A questionnaire including demographic features such as age, gender, asthma medications and questions about COVID-19 prepared according to a 5-point Likert scale was conducted to the parents. Children completed the State-Trait Anxiety Inventories for Children (STAI-C) scales, and childhood asthma control test(c-ACT). Parents also fulfilled STAI scales. Results: The mean age of the patients was 9.5±1.2 years, the median follow-up period for asthma (C-ACT) was 36 (21-66) months, and 45 (67.2%) were male. Most of the children were using their asthma medication regularly. Children’s STAI-C state and trait anxiety scores showed a statistically significant positive correlation with parents’ STAI state and trait anxiety scores. The anxiety levels of parents who thought that they would get the disease and that there would be no effective treatment and vaccine against COVID-19 were found to be higher.Conclusion: During the pandemic period, regular asthma follow-up and drug compliance are very important controlling asthma symptoms in children. Considering the effects of the pandemic in children with asthma, psychosocial evaluations during outpatient controls may have positive effects on children’s mental health and disease control., Amaç: Çalışmamızda astımlı çocuklarda ve ailelerinde yeni tip coronavirüs hastalığı (COVID-19) döneminde astım kontrol durumları, ilaç uyumları ve kaygı düzeylerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya en az altı aydır astım tanısıyla izlenen 8-12 yaş arası 67 çocuk ve ebeveynleri dahil edilmiştir. Ebeveynlere yaş, cinsiyet, astım ilaçları gibi demografik özellikleri ve 5’li Likert ölçeğine göre hazırlanmış COVID-19 ile ilgili soruları içeren anket yapılmıştır. Ayrıca çocukluk çağı astım kontrol anketi (AKT) ve kaygı düzeyini değerlendirmek için çocuklara Çocuklar İçin Durumluk-Sürekli Kaygı Envanteri (Ç-DSKE), ebeveynlere de Erişkinler için Durumluk-Sürekli Kaygı Envanteri (DSKE) uygulanmıştır.Bulgular: Hastaların ortalama yaşı 9.5±1.2 yıl, astım takip süresi ortancası (çeyrekler arası aralık) 36 (21-66) aydı ve 45’i (%67.2) erkekti. Çocukların çoğu astım ilaçlarını düzenli kullanıyordu. Çocukların Ç-DSKE durumluk ve sürekli kaygı puanları, ebeveynlerin DSKE durumluk ve süreklik kaygı puanlarıyla istatistiksel olarak anlamlı pozitif yönde korelasyon gösteriyordu. Hastalığı geçireceğini, COVID-19’a karşı etkili tedavi ve aşı bulunamayacağını düşünen ebeveynlerin kaygı düzeyleri daha yüksek bulundu. Çocukların cinsiyeti, astım takip süreleri, astım kontrol durumları, düzenli takibe gelme ve astım ilacını düzenli kullanmasına göre gruplandırılarak karşılaştırıldığında yine çocuk Ç-DSKE ve ebeveynlerin DSKE skorları arasında fark yoktu.Sonuç: Pandemi döneminde düzenli kontrol ve ilaç uyumu çocuklarda astım semptomlarının kontrol altına alınmasında son derece önemlidir. Astımlı çocuklarda pandeminin etkileri de göz önünde bulundurularak poliklinik kontrolleri sırasında psikososyal değerlendirilmelerinin yapılması çocukların ruh sağlığı ve hastalık kontrolü üzerinde olumlu etkileri olabilir.

Accumulating evidence shows that secondary infection increases the risk of disease severity in respiratory diseases. There have been few studies about secondary infections among COVID-19 patients. Therefore we aimed to investigate prevalence, predisposing factors and causative organisms associated with COVID-19 secondary infection. This study was conducted at Training and Research Hospital in Samsun Turkey between March 15, 2020 and June 15, 2020. Hospitalized COVID-19 patients confirmed with Reverse Transcription Polymerase Chain Reaction (RT-PCR) were included in this study. Various clinical specimens (urine, sputum, endotracheal aspirate, blood etc.) of these patients have been sent to the microbiology laboratory were evaluated retrospectively. During the study period, 270 patients have been diagnosed COVID‐19 confirmed with PCR. The bacterial secondary infection rate among COVID-19 patients was 4% (11 of 270). The mortality rate among intensive care unit (ICU) patients with secondary infections was 80%. The most common secondary infection was urinary tract infection followed by bacteremia, and pneumonia. The most common isolated bacteria is Escherichia coli (E. coli) followed by coagulase-negative staphylococci (CoNS). Among COVID-19 patients, secondary infection may significantly inhibit the immune system of host and leads to significant morbidity and mortality. This is problematic and especially impacts patient clinical management, infection control, and antimicrobial stewardship programs. Therefore, further studies are needed to identify the possible pathogens and to evaluate the influence of secondary infections on the severity of SARS-CoV-2 infection.

Amaç: Amaç: Bu çalışmada Yoğun Bakım Ünitesinde (YBÜ) bir yıl içinde mortalite gözlenen hastaların klinik özelliklerinin saptanması ve YBÜ’ye kabul esnasında albümin, laktat seviyelerinin ve Acute Physiology and Chronic Health Evaluation II (APACHE II) skorlarının YBÜ yatış süresi ile ilişkisinin belirlenmesi amaçlandı.Materyal ve Metot: Çalışmada Ocak 2018 ve Aralık 2018 tarihleri arasında YBÜ’de mortalite gözlenen (n:350) hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik verileriyle birlikte klinik özellikleri, YBÜ’ye kabul tipi (cerrahi veya dahili), kabul edildiği üniteleri, kabul nedenleri, komorbiditeleri, kabul albümin ve laktat seviyeleri, APACHE II skorları ve YBÜ yatış süreleri kayıt edildi. Hastaların klinik özelliklerinin YBÜ yatış süresi ve laboratuvar değerleri ile ilişkisi değerlendirildi.Bulgular: Hastaların yaş ortalaması 72.68±12.98 yıl, ortalama APACHE II skoru 27.0±10.0, albümin değeri 3.1±0.7 g/dL ve laktat değeri 4.1±3.3 mmol/L olarak belirlendi. Mekanik ventilatör (MV) ihtiyacı nedeniyle YBÜ’ye kabul edilen hastalarda albümin değerinin daha düşük olduğu (p, Aim: The aim of this study was to find out the clinical characteristics of patients who died within a year in the intensive care unit (ICU) and to find out the association of ICU admission albumin, lactate levels and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of these patients who died with ICU length of stay.Material and Method: The files of patients who died in the ICU (n:350) between January 2018 and December 2018 were examined retrospectively. The patients’ demographic data and their clinical characteristics, ICU admission types (surgery or medical medicine), the units they were admitted in, reasons for admission, comorbidities, admission albumin and lactate levels, APACHE II scores and ICU length of stay were recorded. The association of patients’ clinical characteristics with ICU length of stay and laboratory values was evaluated. Result: The patients’ mean age was 72.68±12.98 years, mean APACHE II score was 27.0±10.0, mean albumin value was 3.1±0.7 g/dL and mean lactate value was 4.1±3.3 mmol/L. It was found that albumin value was lower in patients admitted to ICU with mechanical ventilator (MV) need (p

Amaç: Bu çalışmada pandemi sürecinde Ankara Şehir Hastanesi Çocuk ve Ergen Psikiyatri Servisinde yatarak tedavi gören hastaların klinik ve sosyodemografik özelliklerinin incelenmesi amaçlanmıştır.Gereç ve Yöntemler: Mart 2021-Mart 2022 tarihleri arasında Ankara Şehir Hastanesi Çocuk ve Ergen Psikiyatri Servisinde yatarak tedavi gören hastaların yatış dosyaları geriye dönük olarak incelenmiştir. Hastalar sosyodemografik veriler, yatış sırasında aldıkları tanı ve tedaviler, yatış süresi, yatış ve taburculuk sırasındaki Klinik Global İzlenim Ölçeği (KGİÖ) puanları açısından değerlendirilmiştir.Bulgular: Çalışmamızda toplam 132 olgunun (86 kız, 46 erkek) yaş ortalaması 15.1±1.8 yıl olarak bulunmuştur. Olguların %30.3’ü (n=40) major depresif bozukluk (MDB), %25’i (n=33) psikotik bozukluk, %14.4’ü yeme bozuklukları (n=19) ve %30.3’ü (n=40) diğer bozukluklar idi. Olguların %63.6’sında (n=84) klinik bozukluk tanısına eşlik eden komorbid başka bir bozukluğun varlığı saptanmıştır. Kız cinsiyetinde yeme bozukluğu, komorbidite varlığı ve antidepresan kullanımı anlamlı yüksek bulunmuştur. Hastaların almış olduğu tanılara göre yatış-çıkış Klinik Global İzlenim Ölçeği hastalık şiddeti (KGİÖ-HŞ) skorları karşılaştırıldığında, MDB, bipolar bozukluk (BPB), psikotik bozukluk, yeme bozukluğu, davranım bozukluğu ve travma sonrası stres bozukluğu (TSSB)’nun anlamlı düzeyde farklılık gösteren bozukluklar olduğu saptanmıştır. Yatış-çıkış KGİÖ yan etki skorları arasında ise yalnızca BPB için anlamlı düzeyde farklılık saptanmıştır.Sonuç: Çalışmamızda serviste yatarak tedavi gören hastaların en sık major depresif bozuk, psikotik bozukluk ve yeme bozukluğu tanılarının olduğu ve her 3 olgudan ikisine eşlik eden bir komorbidite varlığı saptanmıştır. Ülkemizde çocuk ve ergen psikiyatri servisleri az sayıda olup bu konuda yapılan çalışmalara az rastlanmakta, çalışmamızın çocuk ruh sağlığı yataklı servisleri hakkındaki alan yazına katkı sağlayacağı düşünülmektedir., Objective: In this study, it was aimed to examine the clinical and sociodemographic characteristics of patients hospitalized in Ankara City Hospital Child and Adolescent Psychiatry Inpatient Unit during the pandemic period.Material and Methods: Medical records of children and adolescents who were hospitalized in Ankara City Hospital Child and Adolescent Psychiatry Inpatient Unit between March 2021 and March 2022 were retrospectively analyzed. Patients were evaluated in terms of sociodemographic characteristics, clinical diagnosis and treatment, duration of hospitalization, and Clinical Global Impression Scale (CGI) scores at admission and discharge. Results: In our study, the mean age of 132 cases (86 girls, 46 boys) was found 15.1±1.8 years. The main diagnoses of the subjects were 30.3% (n=40) major depressive disorder, 25% (n=33) psychotic disorder, 14.4% (n=19) eating disorders, and the remaining 30.3% (n=40) were other disorders. Comorbidity was found in 63.6% (n=84) of the cases. The presence of eating disorders, comorbidity and antidepressant use were found significantly higher in females. There was a significant differences in major depressive disorder (MDD), bipolar disorder (BD), psychotic disorder, eating disorder, conduct disorder, and post-traumatic stress disorder (PTSD) between admission and discharge CGI-Severity (CGI-S) scores. In addition, there was a significant difference between admission and discharge CGI side effects scores only for BD.Conclusion: In our study, major depressive disorder, psychotic disorder, and eating disorder were the most common diagnoses of cases hospitalized in inpatient unit. There was a comorbidity accompanying two out of every three cases. There are few child and adolescent psychiatry services in our country, and studies on this subject are scarce. It is thought that our study will contribute to the literature on child and adolescent psychiatry inpatient units.

Background Background The study aims to determine the frequency of restless legs syndrome (RLS) in patients with ankylosing spondylitis (AS) and the relationship between the International Restless Legs Syndrome Study Group Rating Scale (IRLSSG-RS) score and anemia. Material and Methods It was a case-control study that included 106 patients with AS and 106 age- and sex-matched healthy controls in the rheumatology clinic of a training and research hospital. The patients were divided into two groups according to their hemoglobin levels. A hemoglobin level lower than 12 g/dL in women and less than 13 g/dL in men was the criterion for anemia. Results Although the frequency of RLS was higher in AS patients than in control groups, there was no significant difference in the IRLSSG-RS score between AS patients and control groups. 23 (57.5%) of the AS patients with anemia had RLS, and the IRLSSG-RS score was 21.3±5.7. Of the AS patients without anemia, 11 (16.7%) had RLS, and the IRLSSG-RS score was 15±6. Statistically significant differences between AS patients with and without anemia regarding RLS frequency and IRLSSG-RS score were found. The IRLSSG-RS scores of AS patients were negatively correlated with serum iron and hemoglobin level. Conclusions Patients with AS had a higher RLS frequency than the control group; AS patients with anemia had a higher RLS and IRLSSG-RS score than AS patients without anemia. Also, a negative and significant correlation was found between the IRLSS-RS score and serum iron and hemoglobin levels in AS patients.

Amaç: İnfluenza aşısının astım kontrolü üzerindeki etkisi tartışmalıdır. Bu çalışmanın amacı astımlı çocuklarda influenza aşısının hastalık kontrolüne etkisini araştırmaktır.Gereç ve Yöntemler: Astım tanısı alan çocuklar prospektif olarak çalışmaya dahil edildi. Hastaların sosyo-demografik özellikleri, bir önceki yılda influenza aşısı olma durumu, bronkodilatatör kullanımı ve sistemik steroid tedavisi, hastaneye yatış sıklığı, aşılam durumunu ve hastalığın kontrol durumunu etkileyecek risk faktörleri araştırıldı.Bulgular: Çalışmaya ortanca yaşı 11 olan toplam 187 astımlı çocuk dahil edildi. Hastaların yaklaşık yarısında (%47,6) astım kontrol altında değildi. Son bir yılda %14,4'ü, %14,4'ü iki, %19,3'ü ≥3 atağı geçirirken, %51,9'u astım atağı geçirmedi. Bir önceki yılda hastaların %52,4'ü grip aşısı olmuştu. İnfluenza aşılaması, kontrollü ve kontrolsüz astımı olan hastalarda eşit oranda yaygındı (%54.1'e karşı %50.6) ve aşılamanın hastalık kontrolü üzerinde etkisi yoktu (p=0.662). Alerjik riniti ve atopisi olan hastalarda, alerjik riniti olmayan hastalara göre anlamlı olarak daha yüksek kontrolsüz astım durumu vardı (sırasıyla p=0.027 ve p=0.041). Kontrolsüz astımı olan çocuklar kontrol grubuna göre daha az profilaktik ilaç kullanmışlardı (p, Objective: The influenza vaccine's effect on the control of asthma is debatable. The purpose of this study is to investigate the effect of the influenza vaccine on disease control in children with asthma.Material and Methods: Children with a diagnosis of asthma were prospectively included in the study. The socio-demographic characteristics of the patients, the status of influenza vaccination in the previous year, the use of bronchodilators and systemic steroid therapy, the frequency of hospitalization, risk factors that will affect the disease's control status, and the effects of vaccination status and risk factors on the control of the disease were investigated.Results: A total of 187 asthmatic children with a median age of 11 years were included in the study. Almost half of the patients (47.6%) did not have asthma under control. In the last year, 14.4% had one asthma attack, 14.4% had two attacks, 19.3% had ≥3 attacks, while 51.9% had no asthma attack. In the previous year, 52.4% of patients received influenza vaccination. Influenza vaccination was equally common in patients with controlled and uncontrolled asthma (54.1% vs 50.6%), and vaccination had no effect on disease control (p=0.662). Patients with allergic rhinitis and atopy had significantly higher uncontrolled asthma status than patients without allergic rhinitis (p=0.027 and p=0.041, respectively). Children with uncontrolled asthma used less prophylactic drugs than those in control (p

Amaç: Çocuklarda dört haftadan uzun süren öksürük kronik öksürük olarak adlandırılmaktadır. Bu çalışmada kronik öksürüğün altta yatan nedenlerinin saptanması amaçlandı.Gereç ve Yöntemler: Bu çalışmaya kronik öksürük nedeniyle 27 Aralık 2021- 30 Haziran 2022 tarihleri arasında Şanlıurfa Eğitim ve Araştırma Hastanesi Çocuk Göğüs Hastalıkları Polikliniğine başvuran 0-18 yaş arası hastalar dahil edildi.Bilinen kistik fibrozis, primer silyer diskinezi, interstisyel akciğer hastalığı, astım, bronkopulmoner displazi tanısı olan hastalar çalışma dışı bırakıldı. Kronik öksürüğe yaklaşımda “CHEST Guideline and Expert Panel Report” kılavuzu örnek alındı.Bulgular: Çalışmaya 153 hasta dahil edildi. Bu çalışmada kronik öksürüğün en sık nedenleri astım (%30.7), uzamış bakteriyel bronşit (%20.3), üst solunum yolu öksürük sendromu (%11.1) olarak sıralandı. Kronik öksürük olan hastaların %60.8’inde ıslak öksürüğün mevcut olduğu, ıslak öksürüğü olan hastalarda ise en sık tanıların uzamış bakteriyelbronşit (%33.3), pnömoni ve diğer akciğer enfeksiyonları (tüberküloz ve kist hidatik) (%17.2) ve bronşektazi (%12.9) olduğu görüldü. Kuru öksürüğü olan hastalarda ise en sık tanılar astım (%68.3), üst solunum yolu öksürük sendromu (%6.7) ve doğal iyileşme (%6.7) olarak sıralandı. Islak öksürük olan hastalarda kilo alamama şikayeti kuru öksürük olan hastalara göre daha belirgin iken (p, Objective: A cough that lasts longer than four weeks in children is called chronic cough. The aim of this study is to determine the underlying causes of chronic cough. Material and Methods: Patients aged 0-18 years who were referred to Şanlıurfa Training and Research Hospital pediatric pulmonology outpatient clinic between 27 December 2021 and 30 June 2022 due to chronic cough were enrolled. Patients with known cystic fibrosis, primary ciliary dyskinesia, interstitial lung disease, asthma, bronchopulmonary dysplasia were excluded from the study. The “CHEST Guideline and Expert Panel Report” guideline was used in the approach to chronic cough. Results: 153 patients were included in this study. The most common causes of chronic cough were asthma (30.7%), protracted bacterial bronchitis (20.3%), and upper respiratory tract cough syndrome (11.1%). Wet cough was present in 60.8% of the patients with chronic cough and the most common diagnosis in patients with wet cough were protracted bacterial bronchitis (33.3%), pneumonia and other lung infections (17.2%) and bronchiectasis (12.9%). The most common diagnoses were asthma (68.3%), upper airway cough syndrome (6.7%), and natural recovery (6.7%) in patients with dry cough. Failure to thrive was more common in patients with wet cough than patients with dry cough (p

Objective: In our study, it was aimed to investigate the effects of disease symptoms at presentation in pediatric systemic lupus erythematosus (SLE) patients on low disease activity and remission success after the 2nd year of the disease.Method: Demographic, clinical, and laboratory data of pediatric SLE patients being followed up at our center were obtained from their electronic medical records and patient files. Disease activity at 2 years after diagnosis was measured based on SLE Disease Activity Index-2000 (SLEDAI-2K) scores. Results: In this study, 29 patients diagnosed with pediatric SLE and followed up regularly for at least 2 years were included. At 2 years following diagnosis, according to their SLE activity measurements, 14 (48.2%) patients had high disease activity status (HDAS), whereas 15 (51.7%) had low disease activity status (LDAS)-remission. There was no statistically significant difference between the initial presenting symptoms of the two groups. At 5 years following diagnosis, among 15 patients, 6 (40%) had LDAS-remission, and 9 (60%) had HDAS. The 5th-year SLEDAI-2K scores of the patients with HDAS at 2 years were significantly higher than the 5th-year scores of those with LDAS-remission at 2 years (p=0.028). It was also found that the HDAS of 8 patients who had active disease at 2 years (80%) continued at 5 years.Discussion: The results of our study showed that pediatric SLE presenting symptoms did not have a significant determining effect on low disease activity and remission at 2 years. On the other hand, low disease activity and remission observed at 2 years may be indicative of LDAS and remission at 5 years., Amaç: Çalışmamızda pediatrik sistemik lupus eritematozus (SLE) hastalarında, hastalık prezentasyon bulgularının, hastalığın 2. yılındaki düşük hastalık aktivitesi ve remisyona ulaşmadaki etkilerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Merkezimizde takipli olan pediatrik SLE hastalarının elektronik tıbbi kayıtları ve hasta dosyalarından demografik, klinik ve laboratuvar verileri kaydedildi. Hastalığın 2. yılındaki aktivite ölçümü SLE Hastalığı Aktivite İndeksi-2000 (SLEDAI-2K) skoru baz alınarak hesaplandı. Prezentasyon bulguları ile düşük hastalık aktivitesi ve remisyon arasında ilişki olup olmadığı istatiksel yöntemlerle incelendi.Sonuçlar: Bu çalışmaya merkezimizde pediatrik SLE tanısı almış ve en az 2 yıl düzenli takibe gelmiş 29 hastayı dahil ettik. Tanıdan sonraki 2. yılda hastalarda SLE aktivite ölçümüne göre 14 hastada (%48.2) HDAS, 15 hastada (%51,7) LDAS-remisyon elde edilmişti. İki grup arasında başlangıçtaki prezentasyon bulguları açısından anlamlı istatiksel farklılık saptanmadı. 5. yılda 15 hastadan 6’sında (%40) LDAS-remisyon, 9’unda (%60) HDAS mevcuttu. 2. yılda HDAS’a sahip hastaların 5. yıl SLEDAI-2K skorları, 2. yılda LDAS-remisyona sahip hastaların 5. yıl SLEDAI-2K skorlarına göre anlamlı olarak yüksekti (p= 0.028). Ayrıca 2. yılda aktif olan 8 hastanın (%80) 5. yılda HDAS’ın devam ettiği gözlendi.Tartışma: Çalışmamızda pediatrik SLE prezentasyon bulgularının hastalığın 2. yılındaki düşük hastalık aktivitesi ve remisyon üzerine belirleyici etkilerinin olmadığını gösterildi. Ayrıca 2. yılda elde edilen düşük hastalık aktivitesi ve remisyon 5. yıldaki düşük hastalık aktivitesi ve remisyonun belirleyicisi olabilir.

Amaç: Transkateter aort kapak replasmanının (TAVR) cerrahiye uygun olmayan, yüksek riskli semptomatik şiddetli aort darlığı (AS) olan hastalar için etkili bir tedavi yöntemidir. TAVR’da cinsiyete bağlı farklılıklar hala tartışılmaktadır. Bu çalışma ile kliniğimizde TAVR uygulanan hastalarda cinsiyetin klinik sonuçlar üzerine etkisini araştırmayı amaçladık.Yöntemler: Ocak 2015 ile Ocak 2022 tarihleri arasında TAVR yapılan ardışık 270 hasta çalışmaya dahil edildi. AS’yi değerlendirmek için hastanın tıbbi öyküsünün yanı sıra transtorasik veya transözofageal ekokardiyografi ve bilgisayarlı toraks tomografisi bulguları incelendi. Semptomatik, yüksek riskli şiddetli aort darlığı tespit edilen hastalara kendiliğinden genişleyebilen Evolute-R cihazlarıyla işlem yapıldı. Hastalar taburculuk sonrası ilk bir yıl takip edildi. Takipler klinik ziyaretler ve telefon görüşmeleriyle gerçekleşti.Bulgular: Hastane içi mortalite (%5.4’e karşı %7.4 ; p=0.507), bir yıllık takipte ölüm (%14.9'e karşı %.13.1, p=0.681) ve bir yıllık takipte majör advers kardiyovasküler ve serebrovasküler olaylar (MACCE) (%26.4'e karşı %23.8, p=0.627) oranları açısından kadın ve erkek cinsiyetleri arasında istatistiksel olarak anlamlı farklılık saptanmadı. Bir yıllık mortalite ve MACCE oranlarını içeren sağkalım analizi Kaplan-Meier eğrileri kullanıldı. Buna göre her iki cinsiyet arasında mortalite ve MACCE açısından istatistiksel olarak anlamlı farklılık saptanmadı ( sırasıyla; p= 0.910; p =0.889).Sonuç: TAVR yapılan hasta grubumuzda her iki cinsiyet arasında klinik sonlanımlar açısından önemli bir farklılık saptayamadık. Son yıllarda cihaz ve prosedürle ilişkili gelişmelerle cinsiyetin klinik sonuçlar üzerine etkisi azaltılmıştır., Aim: Transcatheter aortic valve replacement (TAVR) is an effective treatment modality for patients with high-risk symptomatic severe aortic stenosis (AS) who are not suitable for surgery. Gender-related differences in TAVR are still deliberated, thus in this study we aimed to investigate the effect of gender on clinical outcomes in patients who underwent TAVR in our clinic.Methods: 270 consecutive patients who underwent TAVR between January 2015 and January 2022 were included in the study. In addition to the patient's medical history, transthoracic or transesophageal echocardiography and computed tomography findings were examined to evaluate AS. Patients with symptomatic, high-risk severe aortic stenosis were treated with self-expanding Evolute-R devices. The patients were followed up for the first year after discharge. Follow-up was done by clinical visits and phone calls.Results: In-hospital mortality (5.4% vs. 7.4%; p=0.507), death at one-year follow-up (14.9% vs. 13.1%, p=0.681), and major adverse cardiovascular and cerebrovascular events (MACCE) at one-year follow-up (26.4% versus 23.8%, p =0.627) rates, there was no statistically significant difference between male and female genders. Kaplan Meier curves were used for survival analysis, including one-year mortality and MACCE rates. Accordingly, no statistically significant difference was found between the two genders in terms of mortality and MACCE (respectively; p= 0.910; p=0.889).Conclusion: In our patient group who underwent TAVR, we could not detect a significant difference in clinical outcomes between both genders. In recent years, the effect of gender on clinical outcomes may decrease with device and procedural developments.

Introduction: donor-derived modified immune cells (MIC) induced long-term specific immunosuppression against the allogeneic donor in preclinical models of transplantation. In a phase I clinical trial (TOL-1 Study), MIC treatment resulted in a cellular phenotype that was directly and indirectly suppressive to the recipient's immune system allowing for reduction of conventional immunosuppressive therapy. Here, we describe a protocol for a randomised controlled, multicentre phase-IIb clinical trial of individualised immunosuppression with intravenously administered donor MIC compared with standard-of-care (SoC) in living donor kidney transplantation (TOL-2 Study). Methods and analysis: sixty-three living donor kidney transplant recipients from six German transplant centres are randomised 2:1 to treatment with MIC (MIC group, N=42) or no treatment with MIC (control arm, N=21). MIC are manufactured from donor peripheral blood mononuclear cells under Good Manufacturing Practice conditions. The primary objective of this trial is to determine the efficacy of MIC treatment together with reduced conventional immunosuppressive therapy in terms of achieving an operational tolerance-like phenotype compared with SoC 12 months after MIC administration. Key secondary endpoints are the number of patient-relevant infections as well as a composite of biopsy-proven acute rejection, graft loss, graft dysfunction or death. Immunosuppressive therapy of MIC-treated patients is reduced during follow-up under an extended immunological monitoring including human leucocyte antigen-antibody testing, and determination of lymphocyte subsets, for example, regulatory B lymphocytes (Breg) and antidonor T cell response. A Data Safety Monitoring Board has been established to allow an independent assessment of safety and efficacy. Ethics and dissemination: ethical approval has been provided by the Ethics Committee of the Medical Faculty of the University of Heidelberg, Heidelberg, Germany (AFmu-580/2021, 17 March 2022) and from the Federal Institute for Vaccines and Biomedicines, Paul-Ehrlich-Institute, Langen, Germany (Vorlage-Nr. 4586/02, 21 March 2022). Written informed consent will be obtained from all patients and respective donors prior to enrolment in the study. The results from the TOL-2 Study will be published in peer-reviewed medical journals and will be presented at symposia and scientific meetings. Trial registration number NCT05365672., Preparation of the study was funded by the Federal Ministry of Education and Research, Berlin, Germany (FKZ 161B0560A, 161B0560B, and FKZ 031B0560A, 031B0560B), and TolerogenixX GmbH, Heidelberg, Germany (N/A). Conduct of the study is funded by TolerogenixX GmbH (N/A).

A woman, 51 years old with known hypothyroidism, was admitted to the emergency service because of postoperative complaints of nausea, vomiting, and jaundice. The patient's imaging revealed pleural effusion, compression atelectasis in the right lung, and lesions compatible with type 2 hydatid cysts in the liver; therefore, PAIR (Puncture, Aspiration, Injection, Reaspiration) was planned, and she was admitted to the internal medicine service. After this, the routine COVID PCR, taken before the interventional procedure, was found positive. During the patient's follow-up, there were no indications of respiratory failure brought on by a COVID infection. Although her vitals were steady, it was noted that she had an intense headache, and frequent and severe hair loss from night to morning on the third day of hospitalisation due to a contagious infection. There are few photos about similar cases. This case also important to be recognized as a symptom/complication of COVID-19 to be managed.

Aims: In pneumoconiosis, which is a chronic lung disease, frequent seasonal flu and pneumonia worsen the course of the disease. Therefore, it is important that patients have seasonal flu and pneumococcal vaccines. The study aims to measure the knowledge level of patients with pneumoconiosis about influenza and pneumonia and to determine their vaccination status.Methods: We reached 73 patients with pneumoconiosis and had them fill out a 26-question questionnaire that evaluated their information about influenza and pneumonia and their vaccination status. The study was designed as descriptive, cross-sectional. We also examined the sociodemographic, socio-economic characteristics and working conditions of the patients.Results: The mean age of 73 patients, one of whom was female, was 46.4±7.8 years. They started working life in middle adolescence. Most of them are primary school graduates and they estimated their income was not sufficient. One-third of the patients were hesitant about vaccination in general. Some had not heard of the seasonal flu and pneumonia vaccine. Thirty-four patients (46.6%) said that they heard about the vaccines from the TV or the internet, not from the healthcare professionals. After the diagnosis of pneumoconiosis, influenza and pneumonia vaccination rates were very low (14 patients/19.2% and 16 patients/21.9%, respectively). One-third of the patients were unaware that pneumonia was a lung disease. When we asked, "Why haven't you been vaccinated against pneumonia?" the answer "I just got this information" came to the fore (39 patients/53.5%). Most patients (42/57 patients) who were not vaccinated against pneumonia after being diagnosed with pneumoconiosis were not aware that pneumonia could be prevented by vaccination (p, Amaç: Kronik bir akciğer hastalığı olan pnömokonyozda sık sık influenza ve pnömoniye yakalanmak hastalığın seyrini kötüleştirir. Bu sebepten hastaların influenza ve pnömokok aşılarını olması önem arz eder. Çalışmanın amacı pnömokonyozlu hastaların influenza ve pnömoni hakkında bilgi düzeylerini ölçmek ve aşılı olma durumlarını belirlemektir.Yöntem: Yetmiş üç pnömokonyoz tanılı hastaya ulaşarak mevsimsel grip ve pnömoni hakkında bilgileri ve aşılı olma durumlarını değerlendiren 26 soruluk anket bilgi formu doldurmalarını sağladık. Çalışma tanımlayıcı, kesitsel olarak tasarlandı. Hastaların sosyodemografik, sosyoekonomik özelliklerini, çalışma şartlarını da inceledik.Bulgular: Biri kadın 73 hastanın yaş ortalaması 46,4±7,8 yıl idi. Hastalar çalışmaya orta ergenlik döneminden itibaren başlamış. Çoğu ilkokul mezunu ve gelir durumlarının yeterli olmadığını düşünüyorlardı. Hastaların üçte biri genel olarak aşı konusunda tereddütte idi. Grip ve zatürre aşısını duymayanlar vardı. Otuz dört hasta (%46,6) aşıları bizzat sağlıkçılardan değil, TV veya internetten duyduğunu söyledi. Pnömokonyoz teşhisi sonrası grip ve zatürre aşısı olma oranları çok düşüktü (sırasıyla, 14 hasta/%19,2 ve 16 hasta/%21,9). Hastaların üçte biri zatürrenin akciğer hastalığı olduğu, 41 hasta (%56,2) ise pnömokonyozun zatürre riskini artırdığı bilgisine sahip değildi. ‘‘Neden zatürre aşısı olmadınız?’’ diye sorduğumuzda ise ‘‘Bu bilgiye henüz yeni ulaştım’’ cevabı ön plana çıktı (39 hasta/%53,5). Pnömokonyoz teşhisi aldıktan sonra zatürre aşısı olmayan hastaların büyük çoğunluğu (42/57 hasta) zatürrenin aşıyla önlenebileceği bilgisine sahip değildi. Diğer taraftan aşıyı olanların çoğu önceden bu bilgiye sahip olduklarını söyledi (15/16 hasta) (p

Amaç: Bu çalışmanın amacı, annelerin bebek uyku pozisyonu uygulamalarını ve güvenli uyku ortamı farkındalıklarını belirlemektir.Gereç ve Yöntemler: Tanımlayıcı tipte olan bu araştırma, iki hastanenin çocuk polikliniklerine çalışmaya katılmayı kabul eden 0-6 aylık bebeği olan 418 anne ile yapıldı. Veriler, Ocak-Aralık 2020 tarihleri arasında yapılandırılmış anket yoluyla yüz yüze görüşme yoluyla toplanmıştır. Bulgular: 418 annenin %28’i bebeklerini sırtüstü pozisyonda yatırırken, %59.6’sı yastık ve %76.8’i yumuşak yatak kullanmış, %42.3’ü uykuda iken bebeklerinin yüzünü örtmüşlerdir. İlkokul mezunu anneler, lise ve üniversite mezunlarına göre daha fazla bebeklerinin yüzünü örtmeye eğilimli idiler (p, Objective: The aim of this current study was to determine mothers’ infant sleep position practices and their awareness of a safe sleeping environment.Material and Methods: This descriptive survey was conducted with 418 mothers who had infants aged 0-6 months and who agreed to participate in pediatric outpatient polyclinics of two hospitals. Data were collected between January-December 2020 via-structured questionnaires by face-to-face interview. Results: Of the 418 mothers; 28% placed their babies in the supine sleeping position, 59.6% used a pillow when they put their babies in bed and 76.8% used a soft mattress. 42.3% of mothers covered their babies’ faces during sleep; primary school graduate mothers were more intended on covering their babies’ faces than high school and university graduates (p

Amaç: Epileptik Alzheimer hastalarının klinik özelliklerini ve serebral FDG PET metabolizmalarını araştırmak ve saf Alzheimer demansı hastaları ile arasındaki farkları karşılaştırmaktır.Yöntemler: Bu vaka-kontrol çalışmasına Alzheimer hastalığı olan 7 hastadan oluşan control grubu ve Alzheimer hastalığına eşlik eden epilepsisi olan 7 hastadan oluşan çalışma grubu olmak üzere toplam 14 hasta dahil edildi. Tüm katılımcılara ayrıntılı nörobilişsel bateri ve beyin florodeoksiglukoz pozitron emisyon tomografisi (FDG PET-CT) uygulandı.Bulgular: Nörobilişsel test puanları karşılaştırıldığında, çalışma ve kontrol grupları arasında anlamlı bir fark yoktu. Ancak geriatrik depresyon ölçeği puanları çalışma grubunda kontrollere göre anlamlı derecede düşüktü (p= 0.026). Çalışma grubundaki olguların serebral FDG-PET BT profillerinde sol ve sağ serebellum, sol lentiform nükleus, sağ talamus ve vermiste anlamlı düzeyde daha düşük metabolizma saptadık (p=0,008, p=0,023, p=0,003, p=0,002, p =0,002, sırasıyla). Sağ parietotemporal korteks ve sağ ve sol birleştirici görsel kortekste, çalışma grubunda kontrollere göre daha yüksek metabolizma bulduk (sırasıyla p=0.023, p=0.012, p=0.003).Sonuç: Alzheimer demansı olan epileptik hastalar, saf Alzheimer hastalarından farklı klinik ve metabolik profile sahip olabilir. Hastaların nörokognitif klinik skorlarında fark olmasa bile depresyon ve ilişkili fonksiyonel anormallikler epileptik AD hastaları için bir biyobelirteç olabilir., Aim: To investigate the clinical characteristics and cerebral FDG PET metabolisms of dementia patients who were also diagnosed with epilepsy and compare the differences with pure Alzheimer dementia patients.Methods: In this case-control study, a total of 14 patients, 7 patients with pure Alzheimer disease as a control group and 7 age and gender-matched patients with Alzheimer disease and concomitant epilepsy as a study group, were included. Detailed neurocognitive battery and brain fludeoxyglucose positron emission tomography (FDG PET-CT) were performed for all subjects.Results: In comparison of neurocognitive test scores, there was no significant difference between the study and control groups. However, geriatric depression scale scores were significantly lower in study group than the controls (p= 0.026). In cerebral FDG-PET CT profiles of subjects we detected significantly lower metabolism in left and right cerebellum, left lentiform nucleus, right thalamus and vermis in the study group (p=0.008, p=0.023, p=0.003, p=0.002, p=0.002, respectively). In the right parietotemporal cortex and right and left associative visual cortex, we found higher metabolism in the study group than controls (p=0.023, p=0.012, p=0.003, respectively).Conclusion: Epileptic patients with Alzheimer’s dementia may have distinct clinical and metabolic profiles, than pure Alzheimer’s disease patients. Even if there is no difference in the neurocognitive clinical scores of the patients, depression and related functional abnormalities may be a biomarker of epileptic AD.

Familial hyperlipidemia (FH) is an autosomal dominant inherited disease characterized by genetic disorders with severe high blood cholesterol levels. There are two forms of the disease which are homozygous and heterozygous FH. FH cases are generally caused by hereditorial mutations in the LDL receptor (LDL-R) gene and less commonly in genes encoding apolipoprotein B (Apo B) and pro-protein convertase subtilisin/kexin 9 (PCSK9) proteins. The risk of early-onset coronary artery disease (CAD) in FH patients is 20 times higher than the normal population. Early diagnosis and treatment of FH will greatly reduce the morbidity and mortality associated with CAD.

Dietary supplements, also known as food or nutritional supplements, are intended to compensate for nutrient deficiencies or to maintain the proper nutrient balance in the diet. As dietary supplements are not permitted by law to be marketed as a treatment, prevention, or cure for any disease; only drugs are permitted to make such claims physicians should be aware of the fact that individuals using these supplements could affect their health. A 22-year-old man presented to the emergency department with palpitations and dyspnea of recent onset (>2 hours). His medical history revealed nothing noteworthy. His physical examination revealed tachyarrhythmia. His electrocardiography revealed an AF speed of 130 beats per minute (ECG). In this case, a young man who was using Jack3D and diagnosed with atrial fibrillation has been presented which has been unique. Despite the fact that natural products in food supplements are more expensive than synthetic ones, the majority of people prefer them. This could be because they believe natural products are more beneficial and safe for their health. As a result, this is a significant public health issue that also poses a financial risk.

Background The aim of the present study was the estimation of serum paraoxonase (PON1) activity in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Material and Methods In this cross-sectional study we estimated serum paraoxonase activity in 73 patients with SARS-CoV-2 infection and 73 healthy controls. Results The results showed that PON1 activity was significantly decreased in patients with SARS-CoV-2 (1.30±0.55 kU/L) than in healthy controls (1.913±0.48 kU/L, p

Objectives: Hematological malignancies presenting with febrile neutropenia constitute an important health issue all over the globe. In this study, we aimed to elucidate the prognostic factors of febrile neutropenic patients with hematological malignancies and to investigate the causes of mortality. Method: This research had a retrospective nature. A total of 174 febrile neutropenia patients ≥ 18 years of age hospitalized have been enrolled in the study. Patients enrolled in the analysis were determined according to the American Society for Infectious Diseases 2010 Febrile Neutropenia Diagnosis and Treatment Guidelines. Accordingly, neutropenia was defined as an expected decrease in the absolute neutrophil count (ANS) to < 500 cells/mm³ or < 500 cells/mm³ over the next 48 hours and body temperature over ≥ 38°C. Results: A total of 174 patients have been included in the analysis and 32 (18.5%) died while 142 (81.5%) did not develop mortality. When the statistically significant results are evaluated according to multivariate analysis; Age, Crp, MASCC, acute renal failure, and hypotension were similar in both groups. On the other hand, when univariate statistically highly significant results are evaluated according to multivariate analysis; the Presence of urinary catheter, diagnosis of bacterial pneumonia, and ANS not increasing after 1 week were found to be statistically significant in the mortality group. Conclusion: The results of the study showed that in febrile neutropenic patients, mortality was increased by 6.7 times by a diagnosis of bacterial pneumonia, 245.6 times by the absence of ANS elevation, and 13.9 times by urinary catheterization.

Aim: Diabetes mellitus (DM) is an important health problem with an increasing incidence worldwide and causes many complications. Diabetic retinopathy (DR) is one of the most serious complications of DM. Polymorphisms of the AKR1B1 gene, which encodes an aldose reductase enzyme, have been associated with development of DM and DR in some studies. The current study aims to investigate the relationship of AKR1B1 rs759853 polymorphism with type 2 DM (T2DM), DR and DR severity in the Turkish population. Material and Methods: A total of 437 individuals, including 141 T2DM patients without DR, 125 T2DM patients with DR, and 171 healthy controls, were included in the study. Genotyping was performed using PCR-RFLP method. Results: An association between T allele / TT genotype and increased risk of proliferative diabetic retinopathy (PDR) was detected. In the logistic regression analysis in which other risk factors were included, rs759853 polymorphism and diabetes duration were found to be associated with the PDR development. There was no significant relationship between the AKR1B1 rs759853 variation and the development of T2DM and DR. Conclusion: Obtained data showed that AKR1B1 rs759853 polymorphism is not associated with the development of T2DM and DR in the Turkish patients, but TT genotype and diabetes duration are independent risk factors for the development of PDR.

This study was conducted to investigate internalized stigma and related factors in patients applying to psychiatry outpatient clinics. The descriptive-cross-sectional study was conducted with 187 patients. In the survey included in the study, socio-demographic data, data on previous clinical/disease and Internalized Stigma of Mental Illness (ISMI) Scale were used. It was determined that 16.6% of the patients were hospitalized due to mental illness and 10.7% of them were dismissed due to mental disorders. The total mean score of the participants in ISMI was found to be 56.2±11.3. The scale total score of the patients whose education level was university or higher was found to be lower than the other groups (p=0.012). The mean scores of the patients with children were significantly lower than those without children (p=0.012) and the patients living in the village compared to the patients living in the city center (p=0.002). The total ISMI score was found to be higher in patients who were previously hospitalized due to mental illness and patients who were dismissed due to mental disorders (p=0.016, p=0.006, respectively). It was determined that there was a positive and low-level significant relationship between disease duration and ISMI total score (r= 0.152; p= 0.038). Educational status, place of residence, hospitalization due to mental illness, dismissal status due to mental disorders and duration of illness were determined as variables affecting the level of internalized stigma in individuals with mental disorders.

Aim: The aim of the present study was to investigate the clinical and polysomnographic (PSG) characteristics in patients with PSG-verified obstructive sleep apnea syndrome (OSAS) with or without morning headache (MH) and to evaluate the response to nasal continuous positive airway pressure (n-CPAP) treatment.Methods: Patients who were referred to the sleep laboratory due to suspected OSAS were prospectively evaluated and divided into two groups: with MH (group 1) and without MH (group 2). Age, sex, body mass index (BMI), Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI), Hamilton Depression Scale (HDS), Hamilton Anxiety Scale (HAS), and PSG variables were compared. Patients in group 1 who received n-CPAP treatment were also evaluated for headache persistence.Results: Seventy-eight patients with OSAS were included and 28 (35.9%) patients reported MH. Female gender and mean BMI were significantly higher in group 1 (43% vs. 20%, p=0.03; 33.14.9 vs. 30.64.8 kg/m2, p=0.04, respectively). The ESS was higher in group 1 (10.8±4.4 vs. 8.4±4.1, p=0.02). PSQI score, HDS, and HAS did not differ between the groups. Average SpO2 (903.64 vs. 92.42.88) and minimum SpO2 (78.1±10.7 vs. 83.2±6.8) were significantly lower in the MH group (p=0.02 and p=0.03). In addition, the duration of SpO2, Amaç: Bu çalışmada polisomnografik olarak obstrüktif uyku apne sendromu (OUAS) tanısı konulan hastalarda sabah başağrısı (SBA) olan ve olmayan grupların klinik ve polisonmografi (PSG) sonuçları ile nazal pozitif basınçlı havayolu tedavisinin (n-CPAP) baş ağrısı üzerine etkileri araştırılmıştır.Yöntemler: OUAS şüphesi ile uyku laboratuarına yönlendirilen hastalar prospektif olarak takip edilerek SBA olan (grup 1) ve SBA olmayan (grup 2) olmak üzere iki gruba ayrıldı. Yaş, cinsiyet, vücut kitle indeksi (VKI), Epworth uykululuk skalası (EUS), Pittsburg uyku kalitesi indeksi (PUKI), Hamilton depresyon skalası (HDS), Hamilton anksiyete skalası (HAS), and PSG sonuçları karşılaştırıldı. Grup 1’deki hastalardan n-CPAP tedavisi alanların son takipteki baş ağrıları değerlendirildi. Bulgular: OUAS tanısı alan 78 hastanın dahil edildiği çalışmada hastaların 28’inde (%35.9) SBA vardı. Kadın cinsiyet ve ortalama VKI grup 1’ de istatistiksel olarak fazla idi (sırasıyla %43 ve %20, p=0.03; 33.14.9 ve 30.64.8 kg/m2, p=0.04). EUS sonuçları grup 1’de daha yüksek saptandı (10.8±4.4 vs. 8.4±4.1, p=0.02). PUKI, HDS and HAS iki grup arasında karşılaştırıldığında fark bulunmadı. Ortalama SpO2 (903.64 ve 92.42.88) and minimum SpO2 (78.1±10.7 ve 83.2±6.8) grup 1’de anlamlı düşük saptandı (p=0.02 ve p=0.03). Grup 1’de uyku süresi boyunca SpO2 90’ın altında olduğu süre istatistiksel olarak daha yüksek idi (17.9817.67 ve 11.0712.37, p=0.04). n-CPAP tedavisi olan 22 hastanın 19’unda (86.4%) son takipte baş ağrısı saptanmadı.Sonuç: Minimum SpO2 değerleri ve uyku sırasındaki desatürasyon süresi, kadın cinsiyet ve VKI SBA ile ilişkilidir. n-CPAP tedavisi SBA olan OUAS hastalarında etkili bir yöntemdir.

Aim: Somatic symptom disorder (SSD) is a psychiatric disorder with unknown etiopathogenesis that is still under investigation. The results of neuroimaging studies on SSD have shown that some brain regions may be associated with it. In this connection, this study aims to explore the orbitofrontal cortex (OFC) morphometric changes in patients with SSD to better comprehend the etiopathogenesis.Material and Methods: The study enrolled 20 patients and 20 healthy controls. All study participants were administered a sociodemographic and clinical questionnaire, the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A). The volumes of total brain, OFC, total white matter, and total gray matter were measured by a magnetic resonance imaging (MRI)-based method in studied patients. Results: Orbitofrontal cortex volume was significantly smaller in the patient group than in healthy controls (p0.05).Conclusions: The OFC was markedly smaller in SSD patients than in healthy controls, suggesting that the OFC may be associated with SSD pathophysiology. Future studies examining the functional features of the OFC using imaging and cognitive function tests will likely shed more light on this issue.

Amaç: Bu çalışmanın amacı, 2-10 kg arası bebeklerde çoğunlukla Amplatzer Piccolo Occluder olmak üzere farklı cihazlarla transkateter patent duktus arteriyozus (PDA) kapatma konusundaki deneyimlerimizi sunmaktır.Gereç ve Yöntemler: Bu çalışmada Aralık 2019-Ağustos 2022 tarihleri arasında transkateter PDA kapatılan 31 hastanın dosyaları geriye dönük olarak incelendi.Bulgular: Toplam 31(14 kadın), 2-10 kg ağırlığındaki, bebeğe transkateter PDA kapaması yapıldı. Hastaların yaş ortalaması 10.7±6.7 ay (2-28) ve ortalama ağırlık 6.6±2 kg (3-9.9)’du. Duktusun en dar ortanca çapı 2.2 mm (IQR 2-3) ve ortanca duktus uzunluğu 6 mm (IQR 4.75-8)’di. Tüm girişimsel prosedürlerin prosedürel başarı oranı %88’di (30/34). Bir hastada cihaz implantasyonu başarısızlığı, 2 hastada işlem sonrası cihaz embolizasyonu ve bir hastada önemli rezidüel şant olmak üzere toplam dört hastada komplikasyon meydana geldi. Hiçbir hastada ameliyat gerekmedi. Üçü yeniden müdahale olmak üzere 34 girişimsel işlemde 34 cihaz kullanıldı. Bunların 27’si (%79) Amplatzer Piccolo Occluder’dı. Ortanca floroskopi ve prosedür süreleri sırasıyla 10.5 dakika (IQR 7.25-18.5) ve 40 dakika (IQR 35-57.5)’dı. Hastaların ortalama takip süresi 10.3±8.8 ay (1-32 ay)’dı.Sonuç: Deneyimlerimize göre 2-10 kg arası bebeklerde uygun duktus anatomisi ve boyutu için ilk tercihimiz olan Amplatzer Piccolo Occluder cihazı ile PDA’nın transkateter tedavisi güvenli ve etkilidir., Objective: The aim of this study was to present our experiences on transcatheter patent ductus arteriosus (PDA) closure with different devices, mostly the Amplatzer Piccolo Occluder, in infants weighing between 2-10 kg. Material and Methods: In this study, the files of 31 patients who underwent transcatheter PDA closure between December 2019 and August 2022 were reviewed retrospectively.Results: Transcatheter PDA closure was performed on 31(14 female) infants weighing between 2-10 kg. The mean age of patients was 10.7±6.7 months (2-28), and the mean weight was 6.6±2 kg (3-9.9). The median narrowest diameter of the ductus was 2.2 mm (IQR 2-3) and the median ductus length was 6 mm (IQR 4.75-8). The procedural success rate of all interventional procedures was 88% (30 of 34). Complications occurred in a total of four patients including failure of device implantation in one patient, post-procedural device embolization in 2 patients, and the significant residual shunt in one patient. None of the patients required surgery. In 34 interventional procedures, 3 of which were reintervention, 34 devices were used. Twenty-seven (79%) of them were Amplatzer Piccolo Occluder. The median fluoroscopy and procedural times were 10.5 minutes (IQR 7.25-18.5) and 40 minutes (IQR 35-57.5) respectively. The mean duration of follow-up was 10.3±8.8 months (1-32 months). Conclusion: In our experience, transcatheter treatment of PDA with the Amplatzer Piccolo Occluder device which was our first choice for appropriate duct anatomy and size in infants weighing between 2-10 kg, is safe and effective.

Human metapneumovirus (HMPV) is a virus from the paramyxovirus family identified in 2001. It is the second most common cause of lower respiratory tract infection in children after respiratory syncytial virus. In adults, it is mostly seen in the elderly population, immunosuppressive patients or those with a concomitant chronic disease. Human metapnemovirus can cause various clinical pictures ranging from a simple upper respiratory tract infection to bronchiolitis and asthma attack, from severe pneumonia to encephalitis and acute respiratory distress syndrome. In the case of viral infection in adults, especially during the Covid-19 pandemic, clinical and laboratory findings are similar, so it should be kept in mind in the differential diagnosis. This article is presented to draw attention to the inclusion of HMPV in the differential diagnosis of a 65-year-old female patient who applied to the practice with the complaints of high fever, cough, wheezing and headache during the Covid-19 pandemic. It has become important to detect the causative agent with multiple molecular tests and direct antigen tests in terms of differential diagnosis in respiratory tract infections, which are generally seen in adults during the pandemic. After the viral agent is determined with the diagnosis of the causative agent, the infection can be controlled more easily with the right treatment and the unnecessary use of antibiotics can be prevented.

Amaç: Pandemi, dünyanın geniş bir bölgesine yayılan ve birçok insanı etkileyen bulaşıcı hastalık salgınıdır. Bu çalışmada, Türkiye’nin Ankara ilinde, 2019 koronavirüs hastalığı (COVİD-19) pandemisinin çocuk hastaların ambulans kullanımına etkisinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Bu retrospektif çalışmada 2019 ve 2020 yıllarının bahar-yaz aylarında ambulans ile hastaneye nakledilen çocuk hastaların elektronik tıbbi kayıtları incelendi.Bulgular: Çalışmaya alınan 23201 hastanın %49.6’sının pandemi döneminde nakledildiği belirlendi. Erkek cinsiyet hem pandemi hem de pandemi öncesi dönemlerde daha yüksekti, yaş ortalamaları açısından fark yoktu. Pandemi döneminde adli vaka ve mülteci hasta oranı artarken, acil hasta oranı azaldı. Hem olay yerine gelme süresi hem de müdahale süresi uzadı. Medikal nedenler her iki yılda da en sık acil çağrı nedeniydi, ancak 2020’de önemli ölçüde arttı. Trafik kazası, özkıyım ve diğer kaza vakalarındaki azalma istatistiksel olarak anlamlıydı. Pandemi döneminde toplam kesin ve şüpheli COVİD-19 enfeksiyonu oranı %29.7’di. Hastaların çoğu devlet hastanesine sevk edildi.Sonuç: Pandemi döneminde ambulansların çoğunun acil tıbbi müdahale gerektirmeyen hafif hastalığı olan hastaları taşımak için kullanıldığı tespit edildi., Objective: A pandemic is an epidemic of an infectious disease that has spread across a large region of the world and affects many people. In this study, it was aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on ambulance use by pediatric patients in Ankara Province, Turkey.Material and Methods: This retrospective study was conducted in the spring-summer of 2019 and 2020. The electronic medical records of pediatric patients who were transported to the hospital by ambulance were analyzed.Results: It was determined that 49.6% of the 23.201 patients included in the study were transported during the pandemic period. Male gender was higher in both the pandemic and pre-pandemic periods, there was no difference in terms of average age. The rate of forensic cases and refugee patients increased, while that of emergency patients decreased. Both the arrival at the scene time and intervention time were prolonged. Medical cause was the most common cause of emergency calls in both years, however, it increased significantly in 2020. The decrease in cases of traffic accidents, suicides, and other accidents was statistically significant. In the pandemic period, total rate of COVID-19 infection and suspicion was 29.7%. Most of the patients had been referred to a public hospital.Conclusion: It was found that most of the ambulances were used for transporting patients with minor illnesses that did not require immediate medical attention in pandemic period.

A person can develop addiction to many kinds of substances. Methamphetamine is the second most widely abused drug worldwide. Long-term methamphetamine usage may cause social, psychological, and physical problems. Long-term effects (such as weight loss, memory loss, tremors, convulsion, psychosis, paranoia, hallucinations, Parkinson's-like symptoms, and cardiovascular collapse) and short-term effects (such as euphoria, dilated pupils, insomnia, reduced appetite, increased blood pressure ) are listed and, brain damage and mental problems due to methamphetamine abuse are briefly mentioned in this text. The severity of withdrawal symptoms varies from person to person. Unfortunately, there is no exact cure for methamphetamine abuse. This is not a systematic review.

Purpose: There is a conflicting result in terms of insulin resistance (IR) in children with Premature Adrenarche (PA). The study aimed to investigate the IR and Trıglycerıde-Glucose (Ty-G) index in patıents wıth PA. Material and Methods: This cross-sectional study was conducted in a tertiary pediatric endocrinology clinic with 160 children aged 6-8 years old. The study group (n=75) were selected cases diagnosed with PA. Seventy-nine age and sex-matched children were also selected as a control group. Ty-G İndex, Homeostasis Model of Insulin Resistance (HOMA-IR), and atherogenic index of plasma (AIP) were calculated. Results: Trıglycerıde-Glucose index, AIP, and HOMA-IR were similar (p>0.05). Ty-G İndex was positively correlated with AIP (r=0.61, p

COVID-19 first emerged in China, spread quickly, and was declared a pandemic by the World Health Organization. Neurological complications have led to important symptoms in patients diagnosed with COVID-19. These symptoms have substantially affected patients' quality of life, caused them to depend on others, and prolonged their recovery processes with anxiety and hopelessness. In this case report, the care process applied to an individual who developed quadriplegia due to neurological involvement after COVID-19, according to the "Nursing Model Based on Activities of Living", is shared. With effective evidence-based nursing care, the patient's quality of life was improved, existing problems were alleviated, and the patient was protected against complications.

Objectives: The number of end-stage renal failure patients undergoing dialysis is increasing in our country and all over the world. Many patients continue with hemodialysis or peritoneal dialysis lifelong though kidney transplantation is the gold standard renal replacement therapy. The purpose of this study is to compare depression, anxiety, self-esteem and social adaptation in hemodialysis and peritoneal dialysis patients. Methods: The research consists of 30 hemodialysis and 30 peritoneal dialysis patients who are undergoing dialysis treatment in Uludag University Medical Faculty Hemodialysis and Peritoneal Dialysis Unit. Demographic Data Form, Beck Depression Inventory, Coopersmith Self-Esteem Scale, Social Adaptation Self-evaluation Scale, and State and Trait Anxiety Scale were administered to patients. Conclusion: The self-esteem score of peritoneal dialysis group is significantly high from the hemodialysis group. Peritoneal dialysis group average point was 21.0, hemodialysis group average point was 17.5 on Coopersmith Self-Esteem Scale. There was no significant difference in depression, anxiety and social adaptation scale scores.

Background This study aimed to analyze patients who apply to emergency services and need palliative care regarding appropriate patient care and effective use of health institutions. Materials and Methods The study was conducted prospectively on patients who applied to the emergency services of Bursa Uludag University Health Application and Research Center, Health Sciences University Bursa Yüksek Ihtisas Training and Research Hospital and Bursa City Hospital between 15.08.2021 and 15.02.2022 and needed palliative care. Results A total of 261 patients, 143 male (54.8%) and 118 female (45.2%), were included in the study. It was determined that 50 (19.1%) of these patients had previously received palliative care services. It was determined that the patients included in the study applied to the emergency services 7.52±6.77 times in the last year. The three most common diseases diagnosed in patients admitted to the emergency department were pneumonia (24.5%), urinary system infection (7.7%), and cerebrovascular disease (5.4%). Of the patients, 39.84% were referred/hospitalized, 25.28% were referred/hospitalized to intensive care units, 2.68% refused treatment, 2.68% died, and 29.5% have been discharged. Conclusion As a result, it is understood that most of the patients in need of palliative care do not receive this service, and patients who can be treated in palliative care units are treated in clinics and intensive care units.

Amaç: Metanol zehirlenmesi (MZ) dünya çapında önemli bir tıbbi sorundur, tanı ve tedavideki gelişmelere rağmen bu vakalarda ölüm oranı yüksektir. Bu çalışmada MZ olan hastalarda hastane içi mortaliteyi öngörmek için klinik ve laboratuvar faktörlerinin değerlendirilmesi amaçlandı.Yöntemler: Bu tek merkezli, retrospektif, gözlemsel çalışma, 01 Ocak 2017 ve 01 Şubat 2022 tarihleri arasında üçüncü basamak bir eğitim ve araştırma hastanesinin acil servisini (AS) ziyaret eden yetişkin 65 MZ vakası ile yürütülmüştür. Veriler hayatta olanlar ve hayatta olmayanlar arasında istatistiksel olarak karşılaştırıldı.Bulgular: Hastane içi ölüm oranı %41,5 idi. Hayatta kalmayanlar grubunda solunum sıkıntısı, düşük GKS (≤8), ve hastaneye geç başvuran (24 saaten sonra) vakalarının oranı, hayatta kalanlar grubuna göre daha yüksekti. Ölen hastaların grubunda yaşayanlara kıyasla daha yüksek anyon açığı (30,5 mEq/L vs. 25,5mEq/L), baz fazlalığı (-25,0 mmol/L vs. -18,6 mmol/L), laktat seviyeleri (10,2 mmol/L vs. 2,2 mmol/L) ve daha düşük pH (6,76 vs. 7,14) ve bikarbonat (6,3 mmol/L vs. 10,3 mmol/L) seviyeleri vardı (p, Aim: Methanol poisoning (MP) is an significant medical problem worldwide, and despite advances in diagnosis and treatment, the mortality rate in these cases remains high. This study aimed to evaluate the clinical and laboratory factors to determine in-hospital mortality in patients with MP.Methods: This single-center, retrospective, observational study was conducted with 65 adult MP cases visiting the emergency department (ED) of a tertiary training and research hospital, between January 01, 2017 and February 01, 2022. Data was statistically compared between survivors and non-survivors.Results: The in-hospital mortality rate was 41.5%. The rate of cases with respiratory distress, low Glasgow coma scale (GCS) (≤8), and delayed arrival to the hospital (>24 hours) was higher in the group of non-survivors compared to the group of survivors. Non-survivors had a higher anion gap (30.5 mEq/L vs. 25.5mEq/L), base excess (-25.0 mmol/L vs. -18.6 mmol/L), lactate (10.2 mmol/L vs. 2.2 mmol/L) levels, and lower pH (6.76 vs. 7.14) and bicarbonate (6.3 mmol/L vs. 10.3 mmol/L) levels than survivors (p

Objectives: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, was identified as the cause of a severe respiratory illness in Wuhan, China three years ago. The COVID-19 infection, which was declared a pandemic in March 2020, caused more than 600 million people to get sick and close to 7 million people to die. Which people have the disease more severely and who have higher mortality are still the subject of research. We investigated whether vitamin D, whose role in immunity has been known for a long time, also affects the prognosis of COVID-19 infection. COVID-19 is currently the leading cause of death worldwide. Vitamin D is an important micronutrient and has been reported to protect against respiratory diseases by improving immunity. In this study, we aimed to reveal whether the 25-hydroxyvitamin D (25 (OH) D) concentration is associated with the risk and severity of COVID-19 by evaluating vitamin D levels in outpatients or hospitalized patients with the diagnosis of COVID-19. Methods: In the study, vitamin D levels in 124 COVID-19 cases and clinical course and laboratory findings were analyzed retrospectively between March 11-May 31 2020. Statistical analysis was done using IBM SPSS 23. Kolmogorov Smirnov, Man Whitney U, Kruskal Wallis Test, Chi-square, and fisher extract and risk analysis tests were used. Categorical variables were expressed as %. P value < 0.05 was considered significant. Results: Vitamin 25 (OH) D level in 32 patients (median 10.2) who were given antiviral treatment and needed oxygen. It was found to be significantly lower than the other 92 patients (median 16.25). When patients who needed oxygen treatment during COVID-19 treatment were examined in terms of vitamin D levels; It was observed that patients with 25 (OH) vitamin D level < 10 needed more O2 (OR: 2,833 CI 95% 1,230-6,528, p = 0.013). In patients with 25 (OH) vitamin D < 10, more patients had pulmonary involvement with thorax CT (OR: 2.225 CI 95% 0.999-4.952 p = 0.048) and these patients had more back pain symptoms (OR: 4,765 CI 95% 1,126-20,163 p = 0.022). Patients with 25 (OH) vitamin D

In our study, it is aimed at examining the effects of nutrition with genetically modified organisms on gender hormones and the changes of these effects with stimulants such as auditory and exercise. In the study, eight weeks of 32 female and 32 male Spraque Dawley rats randomly, control, genetically modified organism, auditory stimulus, exercise, the genetically modified organism + auditory stimulus, genetically modified organism + exercise, genetically modified organism + auditory stimulus + exercise groups are divided into eight groups. Genetically modified organisms (GMOs) groups were given a mix of 40 ml 50% corn syrup a day, while auditory stimulants (AUDI) groups were played at Segâh and Huseyni's voice height 60 minutes a day, while exercise groups (EXC) were treated as a rough swimming swim in a 80X40 cm pool. After the experimental procedure, changes in the subject's body weight and gender hormones have been reported. All GMOs were found to have significant body weight growth (p˂0,05), while the most remarkable increase was found to be female rats. In examining the lactate levels, male rats observed a significant increase in GDO, EXC + AUDI and GDO + EXC group in the control group, but a decrease in GDO + AUDI group compared to the GDO group, while female rats saw significant increases in blood lactate level (p˂0,055). In examining the testosterone levels, male rats were monitored for a reduction in AUDI group by other groups, while female rats were reduced by the control group IN AUDI+ EXC (p˂0,05). In examining estrogen levels, there is no significant difference in male rats, while there are significant reductions in female rats in exercise groups and in the GDO + AUDI group compared to CONT, while an increase in AUDI + EXC group has been detected in GDO group (p˂0,05). In female rats, there was no statistically significant difference. All of these results show that GMOs are very effective in weight growth and cause hormonal changes. Auditory and exercise stimuli have been found to be able to respond to changes. However, detailed work is needed to fully explain the mechanisms.

Patients hospitalized in the intensive care unit (ICU) due to COVID-19 pneumonia require high levels of oxygen. In the light of the developing evidence, non-invasive oxygenation strategies instead of invasive mechanical ventilation (IMV) have become of paramount importance in patients. High flow nasal oxygen (High Flow Nasal Oxygen (HFNO)) therapy is one of these methods. There are studies in the literature showing that HFNO treatment reduces mortality. In our study, we aimed to evaluate the efficacy and results of HFNO treatment in acute respiratory failure due to COVID-19 pneumonia. The study included 23 patients who were admitted to the ICU due to COVID-19 pneumonia, had peripheral oxygen saturation (SpO2), COVID-19 pnömonisi nedeniyle yoğun bakım ünitesine (YBÜ) yatırılan hastalar yüksek oranda oksijene ihtiyaç duyarlar. Gelişen kanıtlar ışığında hastalarda, invaziv mekanik ventilasyon (IMV) yerine non-invaziv oksijenasyon stratejileri çok büyük öneme sahip olmuştur. Yüksek akışlı nazal oksijen (High Flow Nasal Oxygen (HFNO)) tedavisi bu yöntemlerden birisidir. HFNO tedavisinin mortaliteyi azalttığına dair literatürde çalışmalar mevcuttur. Çalışmamızda COVID-19 pnömonisine bağlı akut solunum yetmezliğinde HFNO tedavisinin etkinliğini ve sonuçlarını değerlendirmeyi amaçladık. Çalışmaya COVID-19 pnömonisi nedeniyle YBÜ’ne kabul edilen, periferik oksijen saturasyonu (SpO2)

Amaç: Amasya’da aşı tereddüdü yaşayan veya aşı yaptırmayı reddeden ebeveynler ile yapılan bu çalışmada onlarınkararını etkiyen faktörleri belirlemek amaçlanmıştır.Gereç ve Yöntemler: Bu araştırma, 2019-2020 yılı içinde Amasya ilinde çocuklarına aşı yaptırmayı reddeden ailelerinözellikleri sorgulanarak, aşı yaptıran bir grup aile ile karşılaştırılmıştır.Bulgular: Çalışma grubunda aşının içinde çocuğa zararlı maddelerin olduğunu düşünme, aşının çocuğa zarar vereceğinidüşünme ve bütün çocukluk çağı aşılarının dış ülkelerden geldiği için güven vermemesi aşı yaptırmama nedenleri ileilgili en çok ifade edilen üç neden olarak belirtilmiştir. Aşı yaptırmayı reddeden çalışma grubunda doğum öncesi taramatestleri, şeker yükleme ve tetanos aşısı yaptırmayanların oranı kontrol grubuna göre anlamlı derecede yüksek olaraksaptanmıştır. Aşıyla ilgili olumsuz deneyimlere sahip olma (OR= 6.57) ve bulaşıcı hastalıklara yönelik tedbir almama (OR=32.64) aşıyı yaptırmamayla pozitif yönde ilişkili bulunmuştur.Sonuç: Bu çalışma ebeveynlerin sosyodemografik özellikler ile aşıya tutumlarını değerlendiren sınırlı sayıdaki çalışmalardan biridir. Aşılarıntemini ve finansmanından dolayı ailelerde aşılara karşı güven endişesi mevcuttur. Aşılamanın sadece bireysel değil toplumsal bağışıklık içingerekli olduğu gerçeği toplumdaki tüm bireylere çağdaş bilimsel bilgiler ışığında anlatılmalıdır., Objective: This study conducted with parents who have vaccination hesitation or refused to be vaccinated in Amasyais aimed to determine the factors that affected their decision.Material and Methods: In this study, the characteristics of families who refused to vaccinate their children in Amasyain 2019–2020 were questioned and compared with a group of families who had their children vaccinated.Results: In the study group, thinking that there are harmful substances in the vaccine, thinking that the vaccine willharm the child, and not giving confidence because all childhood vaccines come from abroad were stated as the threemost expressed reasons for not vaccination. The rate of prenatal screening tests, sugar loading and tetanus vaccinewas found to be significantly higher in the study group who refused vaccination compared with the control group.Having negative experiences related to vaccination (OR = 6.57) and not taking measures for communicable diseases(OR = 32.64) were positively associated with not having the vaccine.Conclusion: This study is one of the limited number of studies evaluating parents’ sociodemographic characteristics andattitudes toward vaccination. Due to the provision and financing of vaccines, families have concerns related to confidencein vaccines. The fact that vaccination is necessary not only for individuals but also for social immunity should be explainedto all individuals in society considering modern scientific knowledge.

Amaç: Hiperkalemi, kalp yetmezliğinde (KY) yaygın ve potansiyel olarak yaşamı tehdit eden bir sorundur. Bu çalışmada KY polikliniğinde hiperkalemi sıklığı ve ilişkili faktörlerin gerçek yaşam verileriyle gösterilmesi amaçlanmıştır.Yöntemler: KY polikliniğinde izlenen sol ventrikül ejeksiyon fraksiyonu ≤ %40 ve potasyum düzeyi ≥ 3.5 mmol/L olan 1146 hasta çalışmaya dahil edildi.Bulgular: Hastaların medyan potasyum değeri 4.6 mmol/L [IQR, 4.3-5] idi. Başlangıç potasyum düzeylerine göre 3.5-5 mmol/L (normokalemi), 5.1-5.5 mmol/L (hafif hiperkalemi) ve ≥ 5.5 mmol/L (orta-ciddi hiperkalemi) olmak üzere üç grupta değerlendirildi. %14.5'inde hafif hiperkalemi ve %7.1'inde orta ila şiddetli hiperkalemi mevcuttu. Hastaların %21.6'sında potasyum değeri > 5 mmol/L idi. Tahmini glomerüler filtrasyon hızı (eGFR) (OR: 0.969, 95% CI: 0.961-0.976, p, Aim: Hyperkalemia is a common and potentially life-threatening problem in heart failure (HF). In this study, we aimed to show the frequency of hyperkalemia and related factors in the HF outpatient clinic with real-life data.Methods: 1 146 patients monitored in the HF outpatient clinic with left ventricular ejection fraction ≤ 40% and potassium level ≥ 3.5 mmol/L were included.Results: The potassium value of the patients was median 4.6 mmol/L [IQR, 4.3-5]. It was evaluated in three groups as 3.5-5 mmol/L (normokalemia), 5.1-5.5 mmol/L (mild hyperkalemia) and ≥ 5.5 mmol/L (moderate to severe hyperkalemia), according to baseline potassium levels. Mild hyperkalemia was present in 14.5% and moderate to severe hyperkalemia was present in 7.1%. The potassium value was > 5 mmol/L in 21.6% of the patients. The estimated glomerular filtration rate (eGFR) (OR: 0.969, 95% CI: 0.961-0.976, p

Aim: Obesity is a risk factor for sexual dysfunction. The aim of this study was to determine the frequency of sexual dysfunction in patients diagnosed with morbid obesity.Methods: The patient group included in the study consisted of 78 morbidly obese patients with BMI≥40 kg/m2 and 68 healthy individuals with normal BMI. The data were obtained by using the sociodemographic information form filled by the participants, Beck anxiety scale, Beck depression scale and Golombok Rust Sexual Satisfaction Inventory.Results: Obese individuals were found to have sexual dysfunction compared to individuals with normal body BMI (p, Amaç: Obezite cinsel işlev bozukluğu için bir risk faktörüdür. Bu çalışmanın amacı morbid obezite tanısı almış hastalarda cinsel işlev bozukluğu sıklığını saptamak amaçlanmıştır.Yöntemler: Çalışmaya dahil edilen hasta grubu için BKI≥40 kg/m2 olan 78 morbid obez hasta birey ve normal BKI değerine sahip 68 sağlıklı birey oluşturmuştur. Veriler, katılımcılar tarafından doldurulan sosyodemografik bilgi formu, Beck kaygı ölçeği, Beck depresyon ölçeği ve Golombok Rust Cinsel Doyum Envanteri kullanılarak elde edilmiştir.Bulgular: Obez bireylerin normal vücut BKI’sına sahip bireylere göre cinsel işlev bozukluğu yaşadığı saptanmıştır (p

Epidermal growth factor receptor (EGFR) monoclonal antibody inhibitors are used to treat metastatic colorectal cancers. Cetuximab, an EGFR inhibitor drug, targets specific molecular pathways and does not cause the severe systemic side effects seen in cytotoxic chemotherapy. Herein, we presented a case who developed acneiform eruptions during cetuximab treatment.

Various autoimmune diseases may accompany type 1 diabetes. Autoimmune thyroid diseases are common in these patients. Herein, we presented a type 1 diabetic female patient with diabetic ketoacidosis accompanied by a thyroid storm.

Colchicine is produced from the essence of the lily plant that has been cured for many sicknesses such as familial Mediterranean fever, recurrent pericarditis, gout since it has anti-inflammatory properties. This anti-inflammatory drug’s acute intoxication has a high mortality rate and is a critical clinic to follow but not very common. The intoxication severity and mortality are directly depending on the ingested dose. However, although its treatment is principally symptomatic, if left untreated, it is a clinical effect that can be fatal depending on the dose taken directly. In our case, we aimed to present the patient hospitalized in the intensive care unit due to 30 tablets of colchicine intaken and finally was discharged in good health.

The Covid-19 pandemic is a big challenge for all of us and has brought us suffering, death, and fear. This issue is an unprecedented situation and requires an unprecedented response. Fortunately, COVID-19 vaccines have been developed rapidly and in a short period, they were demonstrated to be safe and effective. Also, World Health Organization is working to promote fair access to safe and effective COVID-19 vaccines and coordinates key steps in this process. Nowadays, thankfully more than ten different vaccines have been administered. The vaccination programs started in early December 2020 and more than 20% of the world population has received at least one dose of a COVID-19 vaccine by the end of June 2021 (1,2). Some of the COVID-19 vaccines have been the first to be produced using the messenger RNA (mRNA) platform. While high effectivity is an expectation of these vaccines also, they are “reactogenic,” meaning that they’re likely to cause a noticeable immune response. So, according to reports, about side effects following vaccination with the Pfizer and Moderna mRNA vaccines the side effects of the COVID-19 vaccine vary with the type of the vaccine (3,4). While the soreness of the site of injection is the most common side effect, other side effects such as headache, fatigue, muscle aches, joint pain, chills, and fever usually last 24 to 48 hours (3,4). Maybe not as a side effect but, an imbalance was reported in the incidence of facial paralysis following the vaccination. Facial paralysis (FP) was reported during the phase 3 clinical trials of mRNA COVID-19 vaccines (3,4). Seven cases were observed in vaccine groups among the 35611 participants (3,4). Also, facial nerve-related disorders such as facial paresis, facial spasms, and nerve disorders were reported as a drug reaction with mRNA COVID-19 vaccines (5). According to reports, we see symptoms of nerve pathology can vary from one to another and range in severity from mild weakness to total paralysis (5). According to World Health Organization Pharmacovigilance Database, almost half of the patients with FP were reported from the United States of America (USA) and the United Kingdom (UK) (5). According to our current knowledge, there is no case reported from Turkey. In June 2021, we had the opportunity to treat two patients with FP who developed nerve damage following the Pfizer COVID-19 vaccine. The purpose of this letter is to describe the individual situation of two FP patients in detail and to help health professionals make a decision about how to do things in similar features., Covid-19 salgını hepimiz için büyük bir zorluk olmuş ve acı, ölüm ve korku getirmiştir. Günümüz için bu salgın eşi görülmemiş bir durumdur ve farklı bir yöntem gerektirir. Neyse ki, COVID-19 aşıları hızla ve kısa sürede geliştirildi, güvenli ve etkili oldukları gösterildi. Ayrıca, Dünya Sağlık Örgütü tüm ülkelerin, güvenli ve etkili COVID-19 aşılarına hakkaniyetli erişme imkanının sunulabilmesi için önerilerde bulunuyor ve bu süreçteki önemli adımları koordine ediyor. Günümüzde, onun üzerinde farklı Covid aşısı ruhsat aldı. Aşı programları Aralık 2020'nin başlarında başladı ve dünya nüfusunun ~ %20'sinden fazlası Haziran 2021 sonuna kadar en az bir doz COVID-19 aşısı aldı (1,2). COVID-19 aşılarından bazıları messenger RNA (mRNA) teknolojisi kullanılarak üretilen ilk aşılardır. Bu mRNA aşıları oldukça "reaktojenik"tir, yani belirgin bir bağışık yanıta neden olma olasılıkları yüksektir. COVID-19 aşısının yan etkileri aşının türüne göre değişkenlik gösterebilir (3,4). Pfizer ve Moderna mRNA aşısı uygulandıktan sonra, enjeksiyon bölgesinde ağrı (en yaygın yan etki), baş ağrısı, yorgunluk, kas ağrıları, eklem ağrısı, titreme ve ateş gibi yan etkiler genellikle 24 ila 48 saat sürer (3,4). Belki yan etki olarak değil ama aşılamadan sonra yüz felcinin görülme sıklığında bir farlılık olduğu bildirilmiştir. mRNA COVID-19 aşılarının faz 3 klinik çalışmaları sırasında yüz felci (YF) bildirilmiştir (3,4). 35611 katılımcı arasında aşı gruplarında yedi fasiyal paralizi olgusu gözlendiği bildirilmektedir. Ayrıca yüz parezisi, yüz spazmı, sinir bozuklukları gibi yüz siniri ile ilgili rahatsızlıklar mRNA COVID-19 aşıları ile ilaç reaksiyonu olarak bildirilmiştir (5). Sinir patolojisi semptomlarının kişiden kişiye değişebildiğini ve hafif zayıflıktan tam felce kadar değişkenlik gösterdiği bildirilmektedir (5). Dünya Sağlık Örgütü Farmakovijilans Veritabanı'na göre, YF'li hastaların neredeyse yarısı Amerika Birleşik Devletleri (ABD) ve Birleşik Krallık'tan (İngiltere) bildirilmiştir (5). Güncel bilgimize göre Türkiye'den bildirilen bir vaka bulunmamaktadır. Haziran 2021'de Pfizer COVID-19 aşısının ardından sinir hasarı gelişen YF'li iki hastayı tedavi ettik. Bu mektubun amacı, iki YF hastasının klinik özelliklerini ayrıntılı olarak tanımlamak ve sağlık profesyonellerinin benzer durumlarda süreç konusunda karar vermelerine yardımcı olmaktır.

Günümüzde hakkında global olarak çok sayıda araştırmalar devam eden Koronavirüs hastalığı (COVID-19) hastalığının da prognozunun belirlenmesinde, patolofizyolojisinin anlaşılmasında biyobelirteçlerin rol alabileceği düşünülmektedir. Presepsin de bu biyobelirteçlerden olup, kritik COVID-19 vakalarının erken tespitinde ve mortalite riskinin değerlendirmesinde kullanılabileceği iddia edilmiştir. Biz de çalışmamızda Koronavirüs COVID-19 ve presepsin ilişkisini literatür eşliğinde irdelemeyi amaçladık. Sınırlı sayıdaki bilimsel makale mevcut olup, mevcut veriler kısıtlı hasta sayılarını içermektedir. Sonuç olarak presepsinin COVID 19 da kullanılabilecek bir biyomarker olduğu konusunda henüz kesin bilimsel kanıtlar bulunmamaktadır. Daha fazla hastayı içerem ileriye dönük çalışmalara ihtiyaç duyulmaktadır.

Objectives: We aimed to describe our technique and donor selection for donor hepatectomy, review our case series and report our complication rates and outcomes.Materials and Methods: We retrospectively reviewed 41 consecutive donor hepatectomy cases between October 2019 and November 2020 at Yeditepe University, Istanbul, Turkey. Complications were graded according to Clavien-Dindo classification. All cases were performed via laparotomy. Results: Out of 41 donor cases, 38 (92,6%) were right lobe, 2 (4,8%) were left lobe and 1 (2,4%) was left lateral segment donor hepatectomy. Follow up was 9 ±2,2 months (4-16 months). There were 8 (19,5%) complications and all were minor (grade 1 or 2). There were no grade 3 or higher complications. Three (7,3%) of our donors are heterozygous for factor 5 leiden mutation and 4 (9,7%) of our donors had heterozygous prothrombin mutation. Length of stay was average 6.4±1,4 days (range=5-12). Ten donors lost weight with a supervised diet and exercise program. There was one wound complication in this subset of patients. Conclusions: We present our single center donor hepatectomy series with excellent results. We also describe successful weight loss for donors with Body Mass Index (BMI) >30. Donor safety is the most important component of living donor liver transplantation. As donor results continue to improve, living donor liver transplant (LDLT) will continue expand worldwide., Amaç: Donör hepatektomi tekniğimizi ve donör seçimimizi tanımlamayı, vaka serimizi gözden geçirmeyi, komplikasyon oranlarımızı ve sonuçlarımızı bildirmeyi amaçladık. Gereç ve Yöntemler: Yeditepe Üniversite Hastanesi'nde Ekim 2019 - Kasım 2020 tarihleri arasında 41 ardışık donör hepatektomi olgusunu retrospektif olarak inceledik. Komplikasyonlar Clavien-Dindo sınıflamasına göre derecelendirildi. Tüm olgular laparotomi ile yapıldı. Bulgular: 41 donör olgusunun 38'i (% 92,6) sağ lob, 2'si (% 4,8) sol lob ve 1'i (% 2,4) sol lateral segment donör hepatektomisi idi. Takip süresi 9 ± 2,2 aydı (4-16 ay). Sekiz (% 19,5) komplikasyon vardı ve hepsi minördü (derece 1 veya 2). Derece 3 veya daha yüksek komplikasyon görülmedi. Üç donörde heterozigot Faktör 5 Leiden mutasyonu ve 4 tanesinde heterozigot protrombin mutasyonu vardı. Kalış süresi ortalama 6,4±1,4 gündü (aralık = 5-12). Kontrollü diyet ve egzersiz programı ile 10 donör kilo verdi. Bu hasta alt grubunda bir yara komplikasyonu vardı. Sonuç: Tek merkezli donör hepatektomi serimizi çok iyi sonuçlarla sunuyoruz. Ayrıca BMI( Vücut Kitle İndeksi) > 30 olan donörler için başarılı kilo vermeyi de tanımlıyoruz. Donör güvenliği, canlı donör karaciğer naklinin en önemli bileşenidir. Donör sonuçları iyi oldukça, LDLT(Canlı Vericili Karaciğer Nakli) dünya çapında yaygınlaşmaya devam edecektir.