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Prostate cancer is the most common cancer in men. Although the prostate-specific antigen (PSA) is still used as a diagnostic and screening test, there are some controversies about its performance for the differentiation of high-risk cancer from low-risk cancer at an early stage. The Gleason grading system for the pathological grading of prostatic adenocarcinoma is based on the architectural patterns of prostatic glands and it is one of the major predictors of prostate cancer prognosis and clinical management. This study aimed to investigate the concordance between histopathological prognostic findings from prostate needle biopsy samples and serum PSA levels. This retrospective study included data from 150 patients with histopathologically diagnosed as prostatic adenocarcinoma. All patients underwent multi-core transrectal ultrasound-guided prostate needle biopsy because of elevated PSA. Pathological data were classified as high-grade (≥7, 4+3) and low-grade (≤7, 3+4) based on the Gleason score values. Laboratory data were classified as high-risk (>10 ng/mL) and low-risk (≤10 ng/mL) based on the PSA levels. Ninety three (62%) patients had PSA >10 ng/mL. Seventy patients (46.7%) had Gleason score ≥7 (4+3). Age, tumor volume, PSA levels, and the number of tumor-positive cores were significantly higher in the tumors with Gleason score ≥7 (4+3). Tumor volume, Gleason score, and the number of tumor-positive cores were significantly higher in the tumors with PSA >10 ng/mL. Lymphovascular invasion (LVI) and perineural invasion (PNI) positivity were more often in the high-grade and high-risk tumors. Age, tumor volume, PSA, and the number of tumor-positive cores showed a significant positive correlation with the Gleason score and tumor volume. The cut-off values of PSA (Gleason score ≤7 vs ≥7) was 15.45 ng/mL with AUC=0.882 (95% confidence interval, CI: 0.82 to 0.94), sensitivity was 87% (95% CI: 0.76 to 0.94), specificity was 81% (95% CI: 0.69 to 0.88), and likelihood ratio was 4.4. [Med-Science 2019; 8(1.000): 211-7]

Aim: Duchenne Muscular Dystrophy (DMD) is an X-linked, progressive, lethal neuromuscular disorder affecting 1/3500 live-born males. Mutations occur in the dystrophin gene, which is located at Xp21.2. Partial gene deletions occur in two “hot-spot” regions, and can be responsible for up to 60-65% DMD cases, while 5-10% of the cases are caused from clustered gene duplications. Mutations can be inherited from female carriers (2/3) or be de-novo mutations (1/3). Deletions can be easily detected in affected males via multiplex PCR or MLPA. On the contrary, determining the status of female carriers is difficult. The aim of this study is to optimize the gene-dosage method using quantitative fluorescent PCR. Material and Methods: Fluorescently labeled primers are used for amplification and automated detection of amplicons and are designed in multiplex format. The primers contain eighteen exons located within “hot-spot” regions. A promoter region and STR markers are also included in the test as internal controls and for linkage analysis. This is followed by a PCR automated genetic analyzer for the detection of PCR products. This study includes twenty-four families, each with a previously diagnosed member. Results: Results showed the same correlation as was previously reported in nineteen patients, whereas three patients had an extra exon deletion and one patient had one less exon deletion than previously reported. In nineteen families, the mothers were carriers, and in five families, the mothers were not carriers. Conclusion: As a conclusion for carrier screening in DMD patients, quantitative fluorescent PCR is a fast, reproducible and robust method can be used for detection of deletions.

Aim: In this study, we aimed to find out the positive and negative effects of the pregraduation anatomy education received by academic staff working in the Faculty of Dentistry on their professions both as an educator and as a dentist. Material and Methods: The study was conducted through a questionnaire given to 19 academic staff at Uþak University Faculty of Dentistry. A 5-Likert type scale was used for the reliability of feedback. Results: Of the academic staff who participated in the study, 3 were research assistants, 13 were assistant professors, 1 was associate professor and 2 were professors. 84% of the academic staff who participated in the study stated that they “liked the anatomy course during their undergraduate education” and 95% stated that “the content of anatomy course was useful in professional sense”. 90% of the participants stated that “there should be an anatomy department in dentistry faculties”. Conclusion: We believe that these feedbacks we get from the academic staff participants will contribute to anatomy education given during undergraduate period in dentistry education.

Aim: In elderly individuals, infection control is, essential, especially in the presence of severe bacteria such as oral environment. Prevention of biofilm formation in removable dental prosthesis, which is often used in elderly patients might help infection control. This study aimed to evaluate the time-dependent effect of an enzymatic tablet on six microorganisms cultured in two different denture base resins.Material and Methods: Polymethylmethacrylate (PMMA) and polyamide-resin were used in this study. 480 samples were prepared for each resin, and denture cleanser tablet was tested against C.albicans, S.mutans, S.gordonii, A.actinomycetemcomitans, S.aureus, and E.coli for 3rd, 5th, 10th, 20th, 40th, 80th, 160th, and 200th minutes. Cell viability (CV) was evaluated by MTT. ANOVA was used for statistics. Results: C.albicans exhibited higher CV in polyamide-resin compared to PMMA-resin in all tested durations. S.gordonii and A.actinomycetemcomitans exhibited higher CV in PMMA-resin except for 80th minute-S.gordonii, which had similar values. S.mutans had a higher CV in PMMA-resin than polyamide-resin at 3rd, 5th, 10th, 160th, and 200th minutes, and other values were similar to polyamide-resin. The tested concentration killed more than 75% of microorganisms except for 3rd and 5th minute-C.albicans on resins. S.aureus and E.coli had similar. CV of microorganisms on PMMA-resin was higher than on polyamide-resin. All microorganisms exhibited different adherence on the resins.Conclusions: Tablet cleanser was effective in all microorganisms and durations and over 10-minute durations provided over 76% cell death. Patients with a compromised immune system can safely use restorations composed of polyamide-resin or PMMA-resin with 40 min-treatment of tablet cleanser.Keywords: Bacteria; candida albicans; cell survival; denture bases; denture cleansers.

Aim: Patients with head trauma are routinely, and commonly treated with prophylactic antibiotics, which may also be used for the treatment of infection that may be developed during hospital stay. The relevant antibiotic may, however, some side effects and adverse event. The present study aimed to investigate whether the side effects and adverse events of the prophylactic antibiotics were considered as a complication or medical negligence.Material and Methods: Descriptive statistics were used for the evaluation of the data.Results: No studies were found in the literature. Ceftriaxone, ampicillin-sulbactam, and cefazolin sodium were preferred for antibiotherapy. Meropenem or vancomycin was solely administered to patients when observed active pathogens in culture-antibiogram. Clinicians should be cautioned the potential side effects and adverse events of some drugs frequently used in clinics. Conclusion: Otherwise, they may legally be held liable for medical negligence.Keywords: Adverse effect; head trauma; human rights; malpractice; negligence; rational antibiotic use; right to health; side effect; professional liability.

Aim: To date, the main diagnostic tool for assessing the liver fibrosis stage has been liver biopsy. Despite the advantages in patient prognosis prediction and disease management, the application of liver biopsy is hampered by its limitations. The limitations of liver biopsy have led to a need for the development of a non- invasive scoring system that is simple to use, reliable, and cheap. The aim of this study was to evaluate the accuracy of APRI (AST to Platelet Ratio Index) and FIB-4 (Fibrosis-4) scores in the prediction of liver fibrosis in Chronic Hepatitis B patients.Material and Methods: A retrospective assessment was made of the electronic medical records to identify patients who underwent liver biopsy for evaluation of fibrosis related to CHB (Chronic Hepatitis B). A total of 352 patients were included in the study. Laboratory parameters that were measured within 7 days of the liver biopsy day were considered suitable for the calculation of the formulae. The APRI and FIB-4 scores was calculated. Liver biopsy reports, which were eligible for inclusion in the study, were assessed retrospectively. The fibrosis stage and histological acitvity index were used as previously described by Ishak. Analyses were performed using SPSS 22 (IBM SPSS Statistics 22, SPSS inc., an IBM Co., Somers, NY).Results: APRI was well correlated with fibrosis and HAI score (r=0.280, p0.05; r=0.22, p0.05) respectively. The FIB-4 correlation between fibrosis and HAI was significant (r=0.433, p0.05; r=0.34, p0.05) respectively.Conclusion: Inexpensive, non-invasive, and reliable fibrosis assessement models for CHC should be applied in clinical practice.Keywords: Chronic hepatitis B; liver fibrosis; APRI, FIB-4.

Aim: To investigate microalbuminuria in patients with Parkinson’s disease (PD) and to determine its relationship with the stages of the disease. Parkinson’s disease (PD) is a chronic neurodegeneration of dopaminergic neurons in the substantia nigra. The reason for the death of these neurons is still unclear; however, studies have demonstrated the potential involvement of mitochondria, endoplasmic reticulum in contributing to cellular oxidative stress.Material and Methods: Thirty-two PD patients who admitted to Neurology Clinic of Kirikkale University’s Medical Faculty and 30 healthy volunteers whose age and sex-matched were included in the study. Urine creatinine and urine albumin levels were determined in patient and healthy groups. The disease duration and Hoehn and Yahr stages were recorded.Results: There was no statistically significant difference between urine creatinine, microalbumin, and urine creatinine/albumin ratios when PD patient results compared with the healthy volunteers’. There was no significant correlation among urine creatinine, microalbumin, and urine creatinine/albumin ratio between the disease duration and Hoehn and Yahr staging in patients with PD.Conclusion: Microalbuminuria is an indirect finding of oxidative stress in urine. In the current study, microalbuminuria was not detected in PD patients at various stages of the disease. It is an important finding that microalbuminuria, a marker of oxidative stress in the urine in PD, a disease in which oxidative stress plays a significant role in etiopathogenesis, is not found.Keywords: Hoehn and Yahr Scale;microalbumin; oxidative stress; Parkinson’s disease; Urine creatinine.

Aim: This study aimed to reveal the relationship between changes in Claudin-5 expression and the duration of healing in Achillestendon injury.Material and Methods: 18 Achilles tendons of Wistar-Albino rats were used in the study. Rats were divided into 3 groups as 6 ratsin each group, group 1; sham group, group 2; tendon repair group (sacrificed after 3 weeks), group 3; tendon repair group (sacrificedafter 6 weeks). Immunohistochemically, the tendons were stained with Claudin-5 and the degree of staining with light microscopewas rated between 0 and 3. The obtained scores were compared with Kruskal Wallis test and Posthoc analysis.Results: The scores were 0.5 1 (0-1) in group 1.1 1 (1-2) in group 2 and 1.5 1 (1-2) in group 3. A statistically significantdifference was found between the groups (p 0.026). In the posthoc analyzes, there was a significant difference between group 1and 3, but there was no significant difference between groups 1 and 2 and between groups 2 and 3.Conclusion: The expression of claudins is regulated by many factors, including hormones, various cytokines, and epithelialmesenchymaltransition-related transcription factors. In this study, the increase in the expression of Claudin-5 was noticed inproportion to the progress of primary wound healing. This relationship may be a part of the repair mechanism. The role of claudinlevels in intercellular passage is crucial for function as it is important for cell signaling. Achilles tendon healing can be attributed toa laboratory parameter such as claudin. This can help to understand the recovery rate and can help early return to work or sport.We believe that as a laboratory parameter Claudin-5 may be useful in the evaluation of tendon healing.

Aim: To compare the cyclic fatigue resistance at distilled water and %5.25 NaOCl of immersed ProTaper Gold (Dentsply Sirona, Ballaigues, Switzerland) and ProTaper Universal (Dentsply Sirona, Ballaigues, Switzerland) file systems.Material and Methods: The ProTaper Gold F2 (25.06v taper) and ProTaper Universal F2 (25.06v taper) file systems were immersed in distilled water andNaOCl for 5 minutes. After immersion process files were rotated at artificial canal with 60O curvature and a 5-mm radius until fracture occurred. Time to fracture and fractured lengths were recorded. Data were analyzed statistically using independent t-tests. Statistical significance was set at P .05. Results: ProTaper Gold files had a significantly higher resistance to cyclic fatigue than ProTaper Universal files (P .05). When ProTaper Universal immersed in distilled water showed higher resistance to cyclic fatigue than immersed in NaOCl solution (P .05).Conclusion: ProTaper Gold system more resistant than ProTaper Universal system to cyclic failure. The effect of NaOCl were higher on the ProTaper Universal system.Keywords: Corrosion, cyclic fatigue; NaOCl; ProTaper Gold; ProTaper Universal.

Aim: the aim of this study was to describe musculoskeletel disorder (MSD) symptoms in nurses and etiological factors. Material and Methods: This cross-sectional study was conducted in a government hospital in the West of Turkey between March and June 2018. the population was composed of the 608 nurses working in the hospital. All of the population were invited to participate, and the research sample was formed from the 498 nurses who met the research inclusion criteria (participation rate 82%). Data were collected by researchers with technique of face-to-face interviews, using a nurse descriptive form and the Nordic Musculoskeletal Questionnaire. the data were analyzed using SPSS (Statistical Package for Social Sciences for Windows 16.0). Numbers, percentages, means and chi-squared tests were used in data analysis. the level of significance was set at 0.05. Result: the nurses’ mean age was 34.78±8.60 years (min: 18, max: 58) and most of them (75.5%) were females. the results showed that 87.3% of the nurses had reported MSDs symptoms in at least one body region during the past 12 months. the greatest prevalence of MSDs symptoms by body regions were in the lower back (78.5%), the back (74.9%), the knees (63.1%), the neck (61.2%) and the shoulders (59.6%). the study was found that MSDs symptoms were more frequently seen in those aged over 40, those who stated that their health was poor or very poor, those who had been working as nurses for more than 20 years, those with chronic illnesses, those who slept little, and those who worked more than eight hours a day or 40 hours a week (p

Aim: The purpose of the study was to investigate the effective prognostic factors on recurrence and mortality in patients with differential thyroid cancer. Material and Methods: The effects of various parameters of demographic characteristics, the admission symptoms, physical examination, laboratory findings, pathological examination, and surgical method of 184 patients, who underwent surgery due to differential thyroid cancer between January 1986 and December 2009 in 4th General Surgical Clinic of Ankara Numune Training and Research Hospital, on prognosis were examined. The information of the patients was obtained from automation system of the hospital and Thyroid Cancer Information and Follow-Up Form of 4th General Surgical Clinic of Ankara Numune Training and Research Hospital.Results: The sample group consisted of 172 papillary cancer patients and 12 follicular cancer patients. The mean age of the patients was 45.4 years (15-78). There were 159 (86.4%) female patients and 25 (13.6%) male patients. The mean follow-up period of 161 (87.5%) patients, who were followed up regularly, was 73.26 months (1-231). The mean recurrence period was 77.66 months (1-150). Mortality was observed in eight (4.3%) patients during their follow-up period. The mean life expectancy of those who died was 66.87 months (1-150 months).* Single variable analysis revealed that the T stage and pathologic final stage were effective on recurrence. Painful nodules and palpable lymph nodes in the neck and the papillary histological malignant subtype variant, as well as the presence of vascular and adjacent organ invasion, multicentricity, T stage, the lymph nodes, distant metastasis, and the clinical stage during the admission were identified to be effective on mortality.Conclusion: The risk of recurrence is high in DTC patients with high T stage and advanced pathologic stage. The rate of survival of those with multicentric tumors and advanced pathologic stage is low. Therefore, it is important for patients to be followed up closely within a postoperative multidisciplinary context.Keywords: Differential; thyroid; cancer; recurrence; mortality.

Aim: In the present study, our aim is to assess cancer patients receiving treatment in Outpatient Chemotherapy Unit in terms ofdemographic characteristics and life quality and to investigate the use of CAM methods and the factors affecting the use of suchmethods.Material and Methods: The sample of this descriptive study consists of 100 cancer patients treated in Outpatient ChemotherapyUnit. A questionnaire form was used in the study as a data collection tool. The questionnaire form prepared following the approvalof local ethical committee was applied to the patients admitted to oncology unit for outpatient chemotherapy.Results: 56% of patients were males and 44% of them were females. They were aged minimum 40 and maximum 89. 39% of patientshad breast cancer, 22% of them had colorectal cancer, 20% of them had lung cancer, 15% of them had prostate cancer, %2 of them haduterine (endometrium) cancer, and 2% of them had bladder cancer. 23 out of 100 patients in the sample used alternative treatmentmethods. 20 of them preferred herbal therapy while 3 of them used acupuncture. A great majority of patients resorting to alternativetreatment methods were housewives and had lung, breast or colorectal cancer. It was observed that less patients with urogenitalcancer resorted to CAM methods.Conclusion: As a result of this study, it was detected that 23% of cancer patients used one of the CAM methods, the most commonone being the herbal therapy. Physicians and other healthcare professionals must be knowledgeable about the effects and sideeffects of these treatment methods and must warn the cancer patients about their probable complications. Moreover, an interestingresult is that, in Turkey, cancer patients are not informed on their diagnosis by relatives and healthcare professionals.

Aim: This study aimed to evaluate the alterations in the nasal flora in patients who underwent endoscopic endonasal surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Material and Methods: This prospective study included 30 patients diagnosed with CRSwNP who were resistant to medical treatment and recommended for surgery. The nasal cavity was sampled two times, first preoperatively on the day of operation and postoperatively in the 4th week. Patients were divided into two groups according to their culture results, including normal flora bacteria and potential pathogen production. Results: In the preoperative swab samples, 3 (11.1%) patients had no bacterial growth, 16 (59.3%) patients had a normal flora, and potential pathogens were detected in 8 (29.6%) patients. However, postoperatively, 3 (11.1%) patients had no bacterial growth, 13 (48.1%) patients had a normal flora, and potential pathogens were detected in 11 (40.7%) patients during the postoperative period. No significant difference was found between preoperative and postoperative culture results in terms of the number of patients with normal flora, potential pathogens, and no bacterial growth (p=0.676). The most common microorganism in the normal flora group preoperative and postoperative period was coagulase-negative Staphylococcus (77.8%, 51.9%, respectively), and the most common microorganism in the potential pathogen group was Staphylococcus aureus (18.5% and 25.9%, respectively). Comparing preoperative and postoperative culture results according to isolated potential pathogen microorganism types, no statistically significant difference was observed for any microorganism in the potential pathogen group (p>0.05).Conclusion: As a result, no correlation between nasal polyps’ surgery and potential pathogens was detected. Keywords: Chronic rhinosinusitis; culture; nasal polyps; flora; potential pathogens; bacteria; Staphylococcus aureus; coagulase; transnasal endoscopic surgery; pseodomanas.

Herein, we describe primary appendiceal adenocarcinoma (AACa) mimicking the manifestations of ovarian malignancies. A 55-year-old woman with clinical findings of ovarian cancer underwent laparatomy in which an appendiceal tumor was encountered. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, appendectomy, right hemicolectomy and omentectomy were performed. The final histopathological result demonstrated mucinous adenocarcinoma with signet ring epithelial cells. Therefore, AACa should be kept in mind by gynecological surgeons in the differential diagnosis of ovarian malignancies, since the therapeutic approaches differ from each other.Key Words: Primary appendiceal cancer, appendiceal adenocarcinoma, ovarian cancer, Bu yazıda ovaryan malignansi bulgularını taklit eden bir primer appendisiyal adenokarsinoma olgusu sulunmaktadır. Over kanseri klinik bulgularına sahip 55 yaşındaki bir kadın hastaya yapılan laparatomide appendisiyal tümör ile karşılaşıldı. Total abdominal histerektomi, bilateral salpingo-ooferektomi, appendektomi, sağ hemikolektomi ve omentektomi uygulandı. Histopatolojik sonç taşlı yüzük epitelyal hücreli musinöz adenokarsinom olarak rapor edildi. Appendisiyal adenokarsinom, farklı terapötik yaklaşım içermesi nedeniyle ovaryan malignansilerin ayırıcı tanısında akılda tutulmalıdır.Anahtar Kelimeler: Primer appendisiyal kanser, appendisiyal adenokarsinom, over kanseri

Meniere’s disease also known as idiopathic symptomatic endolymphatic hydrops, is an inner ear disease characterized by spontaneous vertigo attacks, fluctuating hearing loss, ear fullness/pressure sensation and tinnitus. Age of onset is often 50-60 years. History and specific audiometric investigation are used in the diagnosis. Definitive diagnosis is only possible with the histopathological examination, nowadays Meniere's disease is currently placed among the diseases difficult to diagnose with. In the majority of patients, treatment is medical and additional psychological support is recommended. Surgical treatment may be considered in patients who do not respond to medical therapy. In this section, pathogenesis, physiology, symptomatology, diagnosis and treatment of Meniere’s disease will be discussed. Key words: Meniere’s disease, vertigo, pathophysiology, diagnosis, treatment., Meniere hastalığı idiyopatik semptomatik endolenfatik hidrops olarak da bilinen, epizodik spontan vertigo atakları, fluktuasyon gösteren işitme kaybı, kulakta dolgunluk/basınç hissi ve tinnitus ile karakterize bir iç kulak hastalığıdır. Hastalığın başlama yaşları sıklıkla 50-60 yaşlarıdır.Hastalığın teşhisinde anamnez ve spesifik odyometrik testlerden yararlanılır. Kesin tanısının konulması ancak histopatolojik inceleme ile mümkün olduğundan günümüzde halen tanısı zor koyulan hastalıklar arasındadır. Tedavi hastaların büyük kısmında medikaldir ve hastalara psikolojik desteğin eklenmesi önerilir. Medikal tedaviye cevap vermeyen hastalarda cerrahi tedavi gündeme gelebilir. Bu bölümde Meniere hastalığının patogenezi, fizyolojisi, semptomatolojisi, tanı ve tedavi şekilleri ele alınacaktır. Anahtar Kelimeler: Meniere hastalığı, vertigo, patofizyoloji, tanı, tedavi.

Purpose: To evaluate choroidal thickness (CT) changes in connective tissue disease (CTD) using spectral domain optical coherence tomography (SD OCT) with enhanced depth imaging (EDI).Methods: In this prospective clinical study, we included 34 subjects who were diagnosed as CTD in remission for at least 3 month and 30 age- and gender-matched healthy controls. Central macular thickness (CMT), subfoveal CT, and CT at nasal (N) and temporal (T) distances of 500 μm (N500 and T500, respectively) and 1500 μm (N500 and T1500, respectively) from the central fovea were measured by EDI OCT .Results: The mean CMT of the patient group (219.2 μm) was thinner compared to the control group (225.5 μm), but the difference was not statistically significant (p = 0.2). At the same time Mean CT values were thinner at all measure points in the CTD subjects. The mean subfoveal CT,N500, N1500, T500and T1500 were not significantly different in comparison to controls (all p>0.05). Conclusions: Although our results did not reach statistical significance, we found thinner choroidal tissue in patients with CTD .Keywords:Choroidal thickness, connective tissue diseases, Amaç: Çalışmanın amacı bağ dokusu hastalıklarında (BDH) koroid kalınlığı (KK) değişikliklerinin Spektral Domein optik koherens tomografi (SD OKT) kullanılarak değerlendirilmesidir.Gereç ve Yöntemler: Bu prospektif klinik çalışmada, en az 3 aydır remisyonda olan ve bağ dokusu hastalığı tanısı almış 34 hasta ve yaş ve cinsiyet uyumu olan 30 sağlam kişi kontrol grubu olarak değerlendirilmiştir. Santral makula kalınlığı (SMK) subfoveal, nazal ve temporal 500, 1500 mikron mesafelerdeki KK, SD OKT ile ölçülmüştür.Bulgular: Hasta grubunda ortalama SMK (219,2 μm) kontrol grubuna göre (225,5 μm) daha ince bulunmuştur. Ancak aradaki fark istatistiksel olarak anlamlı değildi (P = 0,2). Aynı zamanda ortalama KK her ölçüm noktası için hasta grubunda incelmiş olarak bulunmuştur fakat aradaki fark yine istatistiksel olarak anlamlı değildi (P > 0,05). Sonuçlar: İstatistiksel olarak anlamlı olmamasına rağmen BDH’larında koroid dokusu kalınlığı incelmiş olarak bulunmuştur

Objectives. To determine the diagnostic value of fine needle aspiration biopsy (FNAB) and computedtomography (CT) in parotid masses in the basis of postoperative histopathological results. Methods. The recordsof 68 patients diagnosed with a parotid mass and undergone parotis surgery between November 2004 andFebruary 2011 were evaluated retrospectively. Preoperative FNAB and the CT findings were compared withpostoperative histopathological findings. Results. The study included 36 (58%) female and 26 (42%) malepatients. The mean age of the patients was 43.9 years. No statistically significant difference was detected withregards to the performances of both FNAB and the CT (p0.797). When it was evaluated in a detail, theperformance of parotid CT(81.82%) to diagnose a mass in parotid gland was relatively better than FNAB(72.73%). The performance of FNAB (94.12%) to detect healthy ones was also greater than parotid CT (90.2%).Conclusion. We emphasize that preoperative FNAB and parotid CT should be performed to the patients witha parotid mass. The use of these two tests together can minimize the risk rate have been proved.

Amaç: Diyabetik makula ödemi olan hastalarda katarakt cerrahisi sonrası makula ödemindeki değişikliklerin ve hemoglobin A1C ile ilişkisinin incelenmesi.Gereç ve Yöntemler: Bu retrospektif klinik çalışma diyabetik makula ödemi olan ve komplikasyonsuz fakoemülsifikasyon ameliyatı uygulanan 30 hastanın 30 gözünü kapsamaktadır. Olgulara operasyon öncesi ve sonrası birinci hafta birinci ay ve üçüncü aylarda oftalmolojik muayene yapıldı ve optik koherens tomografi yardımıyla santral foveal kalınlık ölçümü yapıldı.Bulgular: Başlangıç değerlerine göre en iyi düzeltilmiş görme keskinliği bakımından birinci ay ve üçüncü ay değerleri artma gösterdi ve bu farklılık istatistiksel olarak anlamlıydı (P 0,05). Foveal kalınlık bakımından da birinci ay ve üçüncü ay değerleri başlangıca göre istatistiksel olarak anlamlı derecede yüksek bulundu. Ancak bir aydan sonra artma eğilimi azaldı. Hemoglobin A1C ile ilk ay foveal kalınlık arasında anlamlı pozitif bir korelasyon bulundu (P 0,030, r 0,38). Sonuçlar: Diyabetik makula ödemi ve kataraktı olan hastalar fakoemülsifikasyonla katarakt cerrahisinden fayda görmektedir. Katarakt cerrahisi sonrası makula ödemi açısından özellikle ilk altı ay optik koherens tomografi ile düzenli takip yapılmalıdır Aim: The aim of this study is to investigate the changes and effect of hemoglobin A1c in patients with diabetic macular edema following cataract surgery.Material and Methods: This retrospective clinical study included 30 eyes of 30 patients with diabetic macular edema who underwent phacoemulsification cataract surgery. Ophthalmological examination and optical coherence tomography evaluation of macula were performed at first week and first and third months.Results: Compared to baseline, best corrected visual acuity improved significantly at first and third month’s visits (P 0.05). In terms of foveal thickness, it was increased significantly at first and third months (P 0.05) and decreased by the end of first month. There was a positive correlation between hemoglobin A1c levels and foveal thickness (P 0.030, r 0.38).Conclusion: Patients with diabetic macular edema and cataract seem to benefit from phacoemulsification surgery. They should be followed for postoperative macular edema with optical coherence tomography, particularly during the first six month

Pleomorfik adenoma (PA) epitelyal ve mezenşimal kaynaklı benign bir tükürük bezi tümörüdür. Sıklıkla parotis ve submandibular tükürük bezlerinde görülür. Daha nadir olarak ise sert damak ve oral mukozada yerleşimli minör tükürük bezlerinde gelişir. Vakaların %25'inin malign dönüşüm gösterdiği rapor edilmiştir. PA'nın tedavisinde minör tükürük bezinin geniş eksizyonu yapılır. Kemik tutulumu olan vakalarda ise periost ve ilgili kemik doku da rezeke edilmelidir. Tedavide yetersiz rezeksiyon lokal nükse yol açar. Yeterli rezeksiyon sağlanamayan vakalarda cerrahi sonrası radyoterapi gerekli olabilir. Bu vaka raporunda, sert damakta minör tükürük bezinden gelişen bir PA vakasının klinik tanısı ve cerrahi tedavisinden bahsedilecektir Pleomorphic adenoma (PA) is a benign tumor of the salivary glands that has elements of both epithelial and mesenchymal tissues. The tumor most commonly arises in the parotid or submandibular glands. Infrequently, it may arise from the minor salivary glands localized in the hard palate and other parts of oral mucosa. Approximately 25% of cases undergo malignant transformation. Treatment for PA is surgical resection with a surrounding cuff of normal tissue. The excision should include periosteum or bone if these are included. If complete resection cannot be achieved, adjuvant radiotherapy should be added. In this case report, we will discuss the clinical diagnosis and surgical treatment of a PA arising from minor salivary glands localized in the hard palate

Cateter and talc pleurodesis is strongly recomended for patients with symptomatic malignant pleural effusion. Large grade talc and thoracoscopic insufflation is recommended.

Amaç: Adrenal insidentalomalar rutin görüntüleme tekniklerinde yaklaşık %4-7 oranında tespit edilirler. Çoğunlukla benign olmakla birlikte dikkatli klinik ve laboratuvar incelemeleri sonrasında karsinom veya fonksiyonel adenomlar belirlenebilir.Gereç ve Yöntemler: Ocak 2010-Haziran 2014 tarihleri arasında adrenal kitle tespit edilerek cerrahi tedavi uygulanan 13 hastanın bulguları retrospektif olarak incelendi.Bulgular: Olgulardan 7'si (%54) erkek, 6'sı (%46) kadın, ortalama yaş 38,2 idi. Klinik tanılarda 5 hastada (%38,4) feokromasitoma, 5 hastada (%38,4) nonfonksiyone adenom, 1 hastada (%7,6) metastatik lezyon, 1 hastada (%7,6) Cushing sendromu, 1 hastada (%7,6) sürrenal karsinom tespit edilmiştir. Cerrahi tedavi uygulanan hastaların 8'ine laparotomi ile, 52'sine de laparoskopik adrenalektomi uygulanmıştır.Sonuç: Adrenal insidentaloma saptanan olgular asemptomatik olsa dahi hormonal yönden detaylı olarak incelenmeli, non-fonksiyone kitlelere ise malignite kuşkulu lezyonlar olarak bakılmalıdır. Kitle boyutu 6 cm'den küçük ve komşu organ infiltrasyonu bulunmayan hastalarda laparoskopik adrenalektomi altın standart haline gelmektedir. Objective: The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation.Material and Methods: Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively.Results: Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38.2. The clinical diagnosis was pheochromacytoma in 5 patients (38.4%), non-functional adenoma in 5 (38.4), and metastatic lesion, Cushing syndrome, and adrenal carcinoma each in one patient (7.6%). Conventional open adrenalectomy was performed in 8 patients, while 5 patients underwent laparoscopic adrenalectomy.Conclusion: Adrenal incidentalomas should be carefully evaluated for hormonal activity even if asymptomatic, and non-functional lesions should be considered as suspicious-for-malignancy. Laparoscopic adrenalectomy has become the gold standard for patients with a mass less than 6 cm, and without infiltration to adjacent organs.

Aim: Recently, catheters with small diameter are getting popularity in the treatment of pleural effusions. In this study, patients with cystofix catheter mounted for pleural effusion drainage were evaluated in terms of age, gender, underlying pathology, efficacy of treatment and complications.Material and Methods: Data of the 59 patients treated with cystofix catheter due to pleural effusion were evaluated retrospectively. 14 F catheter was applied under local anesthesia from the 7th or the 8th intercostal space dorsal axillary line to patients with massive pleural effusion. Results: The average age was 65.9 ± 13.9 and 37 (62.7%) of patients were male. 11 (18.6%) of the cases were having malign and 48 (81.4%) were having benign etiologies. Etiologic reasons were congestive right heart failure in 30 (50.8%) cases, parapneumonic effusion in 14 (23.7%) cases and primary bronchial carcinoma in 6 (10.2%) cases. Conclusion: The results obtained from this study suggested that cystofix catheter can be used as an alternative minimal invasive technique in benign and malign effusion drainage, because of its small diameter, being easily available and applicable, avoiding clogging and being appropriate for pleurodesis. Key Words: Pleural effusion, catheters, minimally invasive surgical procedures, heart failure, Amaç: Günümüzde plevral effüzyon tedavisinde küçük çaplı katater kullanımı daha popüler bir uygulama haline gelmiştir. Bu çalışmada plevral effüzyon drenajı için sistofix katater takılmış hastalar yaş, cinsiyet, altta yatan patoloji, tedavi etkinliği ve komplikasyonlar açısından değerlendirildi.Gereç ve Yöntemler: Plevral effüzyon nedeniyle sistofix kataterle tedavi edilen 59 hastanın verileri retrospektif olarak değerlendirildi. Masif plevral effüzyonlu hastalara lokal anestezi altında arka axiller hat 7. veya 8. interkostal aralıktan 14 F katater uygulandı.Bulgular: Hastaların ortalama yaşı 65,9 ± 13,9 ve 37’si (%62,7) erkek idi. Vakaların etiyolojilerinin 11’i (%86) malign ve 48’i (%81,4) benign idi. Etiyolojik nedenler 30’unda (%50,8) konjestif sağ kalp yetmezliği, 14’ünde (%23,7) parapnömonik effüzyon ve 6’sında (%10,2) primer bronş kanseri idi. Sonuçlar: Elde edilen bulgular, sistofix kataterin, küçük çaplı olması, kolay elde edilebilir ve uygulanabilir olması, tıkanmaması ve plöredez için uygun olmasından dolayı, benign ve malign effüzyon drenajında alternatif minimal invaziv bir teknik olduğunu desteklemektedir. Anahtar Kelimeler: Plevral effüzyon, kataterler, minimal invazif cerrahi yöntemler, kalp yetmezliği

Amaç: Polikistikover sendromu (PKOS) üreme çağındaki kadınları etkileyen en sık endokrin bozukluktur. Klinik ve biyokimyasal özellikleri metabolik sendrom ile benzerlik göstermektedir. Metabolik sendromlu hastalarda insülin direnci, serum ürik asit düzeyi ile ilişkilidir. Çalışmamızda PKOS hastalarında serum ürik asit düzeylerinin laboratuar ve klinik ile ilişkisini incelemeyi amaçladık. Gereç ve Yöntemler: Hastanemiz Endokrin Kliniğin'de takip edilen 172 PKOS hastası, 34 yaş ve vücut kitle indeksi (VKİ) uyumlu kontrol grubu toplam 206 olgu katılmıştır. Erken folliküler fazda, 12 saat açlık sonrası kan örnekleri alınmıştır. Bazal serum hormon düzeyleri immunoassay ile değerlendirildi.Bulgular: Ürik asid düzeylerinin PKOS grubunda kontrol grubuna göre istatistiksel olarak anlamlı bir şekilde daha yüksek saptanmıştır (4,25 1,07 PKOS, 3,7 0,79 kontrol, P 0,048). Ürik asit ile VKİ, total kolesterol, insülin, siklus süresi, Ferriman Gallwey skoru arasında pozitif anlamlı korelasyon, HDL kolesterol ile anlamlı negatif korelasyon bulunmuştur. Çok değişkenli logistik regresyon yapıldığında ürik asit düzeylerinin PKOS grubunda yaş ve VKİ'den bağımsız olarak iki kat daha yüksek olduğu saptanmıştır.Sonuçlar: Çalışmamızda PKOS grubunda ürik asit düzeyleri anlamlı bir şekilde yüksek bulunmuş ve bu yüksekliğin yaş ve VKİ'den bağımsız olduğu görülmüştür. Ürik asit ile kardiyovasküler risk faktörü olan kolesterol, Trigliserit, VKİ, insülin arasında pozitif korelasyon görülmüştür. Klinik gösterge olan Ferriman Gallwey, siklus süresi açısından da pozitif korelasyon saptanmıştır. Artmış ürik asit düzeyleri PKOS hastalarında kardiyovasküler hastalık oluşumu için bağımsız bir risk faktörü olabilir, klinikte olumsuz sonuçları gösterebilir Aim: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder that affects women of reproductive age. Clinical and biochemical characteristics are similar to metabolic syndrome. Insulin resistance in patients with metabolic syndrome is associated with serum uric acid levels. In our study, we aimed to investigate the relationship between serum uric acid levels and clinical and laboratory in PCOS patients. Material and Methods: 172 PCOS patients and, 34 years old, body mass index (BMI) matching control group of a total 206 cases attended to endocrinology outpatient clinic were included in the study. At early follicular phase, blood samples were taken after a 12-hour fasting period. Basal serum hormone levels were measured by immunoassay. Results: Uric acid levels was significantly higher in PCOS than control group (4.25 1.07 PCOS, 3.7 0.79 control, P 0.048). Uric acid levels were positively correlated with BMI, total cholesterol, insulin, cycle time, Feriman Gallwey score and negatively correlated with HDL cholesterol levels. Uric acid levels were 2 times higher than in PCOS group independent to age and BMI with multivariate logistic regression.Conclusion: Uric acid levels in study group was significantly higher independent to age and BMI. Cardiovascular risk factors; LDL, insulin, triglycerides, BMI was positively correlated with uric acid in PCOS group. Clinical indicators; Feriman Gallwey score and cycle time was also positively correlated. Elevated uric acid levels in PCOS patients may be an independent risk factor for cardiovascular disease, may show negative results in the clinic

Amaç: Bu çalışmanın amacı, mide karsinomları ile bunların lenf nodu metastazlarında siklooksijenaz-2 (COX-2) ve vasküler endotelyal büyüme (growth) faktörü (VEGF) immün reaktivitelerini belirlemek, bunların anjiyogenezle ve histopatolojik prognostik parametrelerle olan ilişkisini araştırmaktır.Gereç ve Yöntemler: Otuz üç gastrik karsinom olgusunda immünhistokimyasal yöntemlerle COX-2, VEGF ekspresyonu ve CD34 ile belirlenen mikrodamar dansitesi (MVD) derecesi incelendi.Bulgular: COX-2 ile normal mukoza %96,9, karsinom grubu %87,8 oranında pozitif boyandı. Tümördeki COX-2 boyanma derecesi ile mukozadaki COX-2 boyanma derecesi arasında istatistiksel olarak anlamlı bir fark izlenmedi. Damar invazyonu pozitif olguların COX-2 ile lenf nodu boyanma derecesi anlamlı olarak daha yüksek idi (p, Objective: The aim of this study was to investigate the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in gastric carcinomas and lymph node metastasis and their relationship with angiogenesis and prognostic histopathological parameters. Materials and Methods: COX-2 and VEGF expression and microvessel density (MVD) grade identified by antibodies against CD34 were investigated immunohistochemically in 33 patients with gastric carcinoma. Results: The expression of COX-2 was 96.9% in normal mucosa and 87.8% in gastric carcinoma. Although COX-2 expression in mucosa was higher than in carcinoma, the difference was not statistically significant. The COX-2 positivity rates in lymph nodes were significantly higher in patients with vascular invasion (p

Küçük hücre dışı akciğer kanseri için önerilen 8. TNM sınıflandırmasında tümör boyutunda, 5cm’ye kadar her santiminin yeniden tanımlandığı (T1a-c ve T2a,b) ve bu şekilde tümör boyutunun prognoz açısından öneminin vurgulandığı göze çarpmaktadır. Minimal invazif adenokarsinomun T1a(mi) olarak eklendiği, akciğerin parsiyel veya total atelektazisi durumunda fark gözetilmeden aynı grupta (T2) yer aldığı, diafragma invazyonunun kötü prognoz göstermesi nedeniyle bir üst kategoriye (T4) çıkarıldığı görülmektedir. Tümörün karinadan uzaklığın prognozu etkilemediği saptandığından proksimal tümörler bir alt katagoriye (T2) alınmıştır. N tanımlayıcılarında değişiklik önerilmemiştir. Metastazlarda ise organ sayısı ve metastaz sayısının yeniden tanımlanması (M1a-c) yapılan TNM değişiklikleri olarak özetlenebilir., The tumor size, recommended for 8th TNM classification for non-small cell lung cancer is defined for each centimeters upto 5 cm (T1-c and T2, b) and hence the importance of the prognosis of tumor size is being highlighted. Minimally invasive adenocarcinoma T1 (mi) is added. Without considering the difference of partial or total atelectasis of the lung both of them is placed in the same group (T2). As diaphragmatic invasion shows poor prognosis it is removed to upper category (T4) . As the distance of the tumor to carina does not influence the outcome, proximal tumors are removed to a sub-category (T2). No changes in N identifier is recommended. Finally the number of metastatic organs and number of metastases are also redefined (M1-c).

Psikolojik travma bireyin savaş, tecavüz, doğal afet, ani gelişen hastalık gibi olaylar ya da durumlarla yüz yüze geldiğinde verdiği duygusal (emosyonel) ve bilişsel (kognitif) tepkilerin bütünü olarak tanımlanmaktadır. Travma sonrası büyüme (TSB) ise, travmaya ya da ağır bir hayat krizine bağlı, bireyin kendine bakışında, kişiler arasında ilişkilerinde, hayat felsefesinde olumlu yönde değişiklik olmasıdır. Hasta için yaşadığı süreçleri anlamaya yönelik olması ve TSB'yi etkileyebilecek bilişsel, dinamik, varoluşsal etmenleri inceleyen niteliksel araştırma yöntemlerinin kullanılması faydalı olacaktır Psychological trauma is described as forening of cognitive and emotional response which is reacted when a person confronts with events that occurs suddenly such as war, rape, natural disaster, acute disease. Posttraumatic growth (PTG) refers to positive psychological change in his or her view of his or her self-concept and perception of life experienced as a result of the struggle with highly challenging life circumstances. While using qualitative research methods evaluating cognitive, dynamic, ontological factors that influence PTG, future studies that will be achieved to understand every each patients’ experiences and PTG will be beneficial

A case of hypersensitivity pneumonitis with symptoms of dyspnea and cough, with normal PA chest radiography and with the anamnesis of pigeon exposure was presented here. 66 years old male patient had complaints of dyspnea and cough since 3 months. His respiratory sounds were normal. He did not have other environmental, occupational or drug exposure history. In thorax high resolution computed tomography (HRCT), there were centriacinar nodules in the middle and lower lobes. When his anamnesis was reevaluated, we learned that he was cleaning up pigeon droppings from roof every week. The patient was instructed to stop having direct and indirect contact with pigeons. One month after, the patient was reevaluated. His cough and dyspnea were improved. In his followup thorax HRCT, centriacinar nodules were disappeared. We should always consider hypersensitivity pneumonitis in the patients with the complaints of dyspnea, cough, even if the PA radiography is normal; we should take the exposure history comprehensively. Key words: Hypersensitivity pneumonia, centriacinar nodules, tomography, Nefes darlığı, öksürük semptomları ile gelen PA akciğer grafisi doğal olan ancak detaylı anamnezle güvercin maruziyeti öyküsü tarifleyen ve hipersensitivite pnömonisi tanısı alan olguyu sunduk. 66 yaşında erkek hasta üç aydır olan nefes darlığı, öksürük şikayetleri ile polikliniğine başvurdu. Fizik muayenesinde solunum sesleri doğaldı. Çevresel, mesleksel maruziyet ve özellikli bir ilaç kullanım öyküsü yoktu. PA akciğer grafisi normaldi. Toraks yüksek çözünürlüklü bilgisayarlı tomografi (YÇBT)’de orta ve alt loblarda daha belirgin olan yaygın buzlu cam dansitesinde sentriasiner nodüller izlendi. Hastanın evin çatısındaki güvercinlere ait atık ürünlerini haftalık temizlediği öğrenilmesi üzerine güvercinlerle direk ve dolaylı maruziyetinin kesilmesi önerildi. Bir ay sonraki kontrolünde öksürük ve nefes darlığı semptomlarında gerileme olduğu öğrenildi. Kontrol toraks YÇBT’de her iki akciğerde izlenen yaygın sentriasiner nodüllerin kaybolduğu görüldü. Nefes darlığı, öksürük gibi semptomlarla başvuran hastalarda akciğer grafisi normal bile olsa hipersensitivite pnömonisinin de olabileceği göz önünde bulundurulmalı ve hastaların maruziyet öyküsü detaylı olarak sorgulanmalıdır.Anahtar kelimeler: Hipersensitivite pnömonisi, sentriasiner nodüller, tomografi

Amaç: Akciğer kanseri tüm dünyada kansere bağlı ölümlerde kadınlarda ve erkeklerde birinci sırada yer almaktadır. Cerrahi rezeksiyon küçük hücreli dışı akciğer kanserli (KHDAK) hastalarda en önemli tedavi şeklidir. Ancak rezeksiyon uygulanan erken evre hastalarda bile sağkalım istenilen seviyelere ulaşamamaktadır. Bu çalışmanın amacı cerrahi rezeksiyon uygulanan KHDAK hastalarında sağ kalım üzerinde etkili olabilecek faktörlerin araştırılmasıdır.Gereç ve Yöntemler: 2003 ile 2006 yılları arasında KHDAK nedeniyle cerrahi rezeksiyon uygulanan 71 hastada çalışmaya dahil edildi. Hastalar, bir yıllık takip sonunda hayatta olanlar (Grup I, n 37) ile bir yıllık takip sonunda exitus olanlar veya nüks gelişenler (Grup II, n 34) olmak üzere iki gruba ayrıldı. Bu gruplar arasında hastaların, şikayet, laboratuar bulguları, tümör yerleşim yeri, çapı, lenf nodu durumu, evre ve tedavi şekli açısından farklılıklar araştırıldı.Bulgular: En büyük tümör çapı grup I'de ortalama 40,2 mm, grup II'de ise 51,0 mm idi (P 0,05). Otuzdört hastada N0, 17 hastada N1, 20 hastada da N2 vardı ve lenf nodu evresi grup I'de anlamlı olarak düşük saptandı (P 0,05). Her iki grup evre yönünden evre I, II ve III olarak karşılaştırıldı ve evre grup I'de anlamlı olarak düşük saptandı (P 0,05). Grup I ve grup II için ortalama CEA değerleri sırasıyla 3,26 ile 7,67 ng/mL'ydi (P 0,05). Grup I ve grup II için ortalama CA 19-9 değerleri sırasıyla 13,35 ve 30,04 ng/mL'ydi (P 0,05). Her iki grup arasında balgam çıkarma dışında anlamlı fark saptanmadı (P 0,05).Sonuçlar: Akciğer kanseri için tanımlanan prognostik faktörler farklılıklar göstermektedir. TNM evreleme sistemi KHDAK'li hastalarda prognozu en doğru yansıtan faktör olarak görünmekle birlikte aynı grup içinde serum CEA seviyesi benzeri faktörler de prognoza etki edebilmektedir. Ancak klinik heterojeniteden dolayı KHDAK'li tek bir hastanın prognozunu belirlemek zordur Aim: Lung cancer is the leading cause of cancer related deaths among women and men worldwide. Surgical resection is the treatment of choice in patients with non-small cell lung cancer (NSCLC). However, survival does not reach to desired levels even in patients with resection in an early stage. The aim of this study is to investigate the factors that may affect on survival in patients with NSCLC.Material and Methods: Seventy-one lung cancer patients who treated with surgical resection between 2003 and 2006 were included in this study. The patients were divided into two groups as, group I the surviving patients (n 37) and group II the patients died or with recurrent cancer (n 34), after a follow-up period of one year. These two groups were compared for symptoms, laboratory findings, tumor localization, tumor size, lymph node status, stage and treatment modality.Results: The mean longest dimension of the tumor was 40.2 mm in group I and 51.0 mm in group II (P 0.05). N status was significiantly lower in group I (P 0.05) as 34 patients have N0, 17 patients have N1 and 20 patients have N2 disease. Stage comparison was done according to stage I, II and III and stage was significantly lower in group I (P 0.05). The mean level of CEA was 3.26 and 7.67 ng/mL in group I and II, respectively (P 0.05). The mean level of CA 19-9 was 13.35 and 30.04 ng/mL in group I and II, respectively (P 0.05). There was no significant difference for symptoms except for sputum complaint (P 0.05).Conclusion: Prognostic factors identified for lung cancer show variations. TNM staging system seems to be the most accurate factor reflecting the prognosis in patients with NSCLC, while different factors such as CEA may influence on prognosis in the same patients. However, it is difficult to determine the prognosis of an individual, because of the clinical heterogenity of NSCLC

Bir yaş altındaki bebeklerin beklenmedik ve açıklanamayan ani ölümü olarak tanımlanan "Ani Bebek Ölümü", postmortem araştırma, ölüm yerinin araştırılması ve öykünün gözden geçirilmesi ile bir dışlanma tanısıdır. Kesin nedeni bilinmemektedir. Ölüme katkıda bulunabilecek bazı durumlar risk olarak tanımlanmıştır. İncinebilir gelişim döneminde olma, genetik yatkınlık ve aşırı immün yanıt ölümcül üçgeni oluşturur. Kritik periyotta bulunan bebeğin çevresel risk faktörlerinin etkisine maruz kalması sonucunda gelişir. Bu nedenle koruyucu önlemler risklerin ortadan kaldırılmasına dayanır Unexpected and unexplained death of an infant less than one year of age is defined as the Sudden Infant Death, is a diagnosis of exclusion with postmortem research, revising the story, and to investigate the place of death. The certain reason is unknown, however some conditions which may contribute to death is defined as a risk. Vulnerable developmental period, genetic predisposition and excessive immune response creates lethal triangle. Therefore, protective measures are based on the elimination of risk

Amaç: Subklinik hipotiroidi hafif orta tiroid yetmezlik durumudur. Kardiyovasküler risk artışı ile ilişkili bir durumdur. Dislipidemi ve koagülasyonla ilgili parametrelerdeki değişiklikler subklinik hipotiroidide potansiyel olarak ateroskleroz gelişiminden sorumlu olabilir. Bu çalışmada, subklinik hipotiroidili hastalar ile kontrol grubu arasında kardiyovasküler risk faktörü olarak fibrinojen, yüksek duyarlılıklı C-reaktif Protein ve lipid parametreleri bakımından fark olup olmadığını araştırmayı amaçladık.Gereç ve Yöntemler: Yeni tanı almış 44 subklinik hipotiroidili hasta ve kontrol grubu olarak ise bilinen herhangi bir hastalığı olmayan sağlıklı 44 kişi çalışmaya alındı. Sigara ve alkol kullananlar çalışmaya dahil edilmedi. Serbest tiroid hormonları normal sınırlarda iken serum TSH değerinin 4 mIU/L'den büyük olması subklinik hipotiroidi olarak tanımlandı. Vaka ve kontrol grubu fibrinojen, yüksek duyarlılıklı C-reaktif Protein ve lipid parametreleri bakımından birbiriyle karşılaştırıldı.Bulgular: Vaka grubunda fibrinojen, yüksek duyarlılıklı C-reaktif Protein ve total kolesterol düzeyi kontrol grubuna göre istatistiksel anlamlı olarak daha yüksek saptandı (p

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Amaç: Bu çalışmada, kronik böbrek yetmezliği nedeniyle ayaktan hemodiyaliz tedavisi alan hastalarda Staphylococcus aureus (S. aureus) ve MRSA nazal taşıyıcılık oranlarının ve taşıyıcılıkla ilişkili risk faktörlerinin belirlenmesi amaçlandı. Gereç ve Yöntemler: Kırıkkale ilindeki diyaliz merkezlerinde düzenli hemodiyaliz tedavisi gören 61 kadın (yaş ortalaması: 54,20 ± 15,9), 57 erkek (yaş ortalaması: 60,33 ± 15,8) olmak üzere toplam 118 hasta dahil edildi. Hastalar burun kültürü sonuçlarına gore grup-1 MRSA nazal taşıyıcısı olanlar, grup-2 metisiline duyarlı S.aureus (MSSA) nazal taşıyıcısı olanlar ve grup-3 S.aureus burun taşıyıcısı olmayanlar olmak üzere 3 gruba ayrıldı. Hastalarda eşlik eden hastalıklar (hypertension, diabetes mellitus, akciğer hastalıkları, gastrointestinal sistem hastalığı), diyaliz süresi, son bir yılda hastanede yatış, son 6 ayda antibiyotik kullanımı, ailede hastane personeli varlığı, son bir yılda kateter enfeksiyonu geçirme, sigara alışkanlığı, serum albümin düzeyi ile MRSA burun taşıyıcılığı arasındaki ilişki araştırıldı. Hastalardan alınan burun sürüntü örnekleri sırasıyla; mannitol salt agar ve kromojenik MRSA agar besiyerlerine (BBL Chromagar MRSA II) ekildi, izolatlar konvansiyonel bakteriyolojik yöntemlerle tanımlandı. İzole edilen suşlarda metisilin direnci sefoksitin disk difüzyon yöntemiyle doğrulandı. Verilerin analizi SPSS for Windows 15 paket programında yapıldı. MRSA taşıyıcılığı için tek değişkenli analiz sonucunda anlamlı çıkan değişkenler çok değişkenli logistik regresyon analizi yöntemiyle değerlendirilerek bağımsız risk faktörleri belirlendi. P

Amaç: Serum omentin, osteoprotegerin ve malondialdehit düzeylerinin polikistik over sendromu (PKOS) hastalarındaki serum seviyelerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu prospektif vaka kontrol çalışmasına PKOS tanısı almış 31 hasta ile sağlıklı kontrol grubu olarak değerlendirilen 33 olgu dahil edildi. Her iki grup demografik biyokimyasal parametrelerin seviyeleri ve serum omentin, osteoprotegerin ve malondialdehit düzeyleri açısından karşılaştırıldı. Bulgular: Kontrol grubu ile karşılaştırıldığında, PKOS grubundaki hastaların yaşları istatistiksel olarak anlamlı derecede daha düşük; hirsutism skoru, açlık glukoz seviyesi) total testosteron seviyesi, serbest androjen indeksi, LH seviyesi ve LH/FSH oranı ise anlamlı derecede daha yüksek bulundu. PKOS ve kontrol grubu arasında malondialdehit düzeyleri açısından istatistiksel olarak anlamlı fark saptanmadı. Sonuç: Serum omentin, osteoprotegerin ve malondialdehit seviyeleri obez olmayan PKOS'lu kadınlarda anlamlı bir değişim göstermemektedir.

Aim: The aim of this study is to evaluate the factors affecting pain perception of the patients, before and after vaginal and cesarean delivery by using visual analogue scale (VAS).Material and Methods: The study enrolled 50 vaginal and 50 cesarean delivered patients applied to Dumlupinar University Obstetrics and Gynecology Clinic between January and March 2015. VAS scores were evaluated and variables were compared via demographic features within groups before and after delivery.Results: In vaginal delivery group, before and after delivery VAS scores were 7.8 ± 2.2 and 7.2 ± 2.4 respectively (P > 0.05). Negative correlation was determined between number of follow-up during pregnancy and after delivery VAS scores (P = 0.007 and r = -0.37). In cesarean group, before and after delivery VAS scores were 6.4 ± 2.0 and 5.3 ± 2.6 respectively (P = 0.03). Unlike vaginal delivery, no correlation was determined between number of follow-up during pregnancy and VAS scores (P > 0.05). Income level, educational status, follow-up center, episiotomy or implementation of labor induction had no effect on VAS scores before and after delivery(P > 0.05) in both groups.Conclusion: Providing psychological support and childbirth education during pregnancy, can reduce the anxiety about the delivery, and can cause less pain perception during the delivery. Childbirth education given by supervised centers, will help to reduce the cesarean section rates due to patient request.Key words: Pregnancy, Pain, Labor, Amaç: Bu çalışmanın amacı, doğum öncesi ve doğum sonrası, vizüel analog skala (VAS) skorlarının değerlendirilmesi ile sezaryen ve normal doğum yapan hastalarda ağrı algısına etki eden faktörlerin araştırılmasıdır.Gereç ve Yöntemler: Dumlupınar Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniğinde Ocak-Mart 2015 tarihleri arasında toplam 50 sezaryen ile doğum yapmış ve 50 normal doğum yapmış hasta çalışmaya alındı. Doğum öncesi ve sonrası VAS skorları değerlendirildi ve hastaların demografik özellikleri göz önüne alınarak veriler grup içi karşılaştırıldı.Bulgular: Normal doğum grubunda doğum öncesi ve sonrası VAS değerleri ortalaması sırasıyla 7,8 ± 2,2 ve 7,2 ± 2,4 olarak saptandı (P > 0,05). Gebelikteki izlem sayısı ile doğum sonrası VAS değerleri arasında negatif ilgileşim olduğu görüldü (P = 0,007 ve r = -0,37). Sezaryen grubunda doğum öncesi ve sonrası VAS ortalamaları sırasıyla 6,4 ± 2,0 ve 5,3 ± 2,6 olarak saptandı (P = 0,03). Vajinal doğumdan farklı olarak izlem sayısı VAS skorları arasında ilişki olmadığı saptandı (P > 0,05). Her iki grupta gelir düzeyinin, eğitim durumunun, izlem yerinin, epizyotomi açılmış olmasının veya eylem indüksiyon uygulanmasının doğum öncesi ve sonrası VAS değerlerine etki etmediği izlendi (P > 0,05).Sonuçlar: Gebelik süresince doğumla ilgili eğitim ve psikolojik destek vermek hastanın doğum ve ağrısına dair endişesini azaltarak, doğum esnasında daha az ağrı hissetmesini sağlayabilir. Denetimli gebelik okullarında verilecek eğitim, hastanın vajinal doğuma yönelmesini sağlayarak, hasta isteğine bağlı olan sezaryen sayılarının düşmesi ve sezaryen oranlarının azalmasına yardımcı olabilir.Anahtar kelimeler: Gebelik, Ağrı, Doğum ağrısı

Familial adenomatous polyposis is an autosomal dominant inherited disease inducing numerous polyps in colon and rectum and characterized by cancer formation. Unless polyps are removed at an early age, development of colon cancer from these polyps is unevitable. A-24 year old male patient admitted to the emergency service with bloody diarrhea. He lost nearly 10 kg weight in the last two months. Family history showed that his mother died due to colon cancer 15 days ago, and his 6 close relatives also died due to colon cancer. In rectal examination, polypoid mass was palpated manually. Colonoscopy demonstrated numerous polyps and rectal masses in rectum and colon, a biopsy was conducted. The pathology reveiled adenocarcinoma and the patient was refered to general surgery department. In this case report we aimed to emphasize the importance of rectal digital examination and investigation of the family history to diagnose the underlying malignity in young male patient applied to the emergency service with the complaint of bloody diarrhea.Key words: Familial adenomatous polyposis, bloody diarrhea, anemia, colon cancer, Familyal adenomatöz polipozis kolon ve rektumda sayılamayacak kadar çok sayıda polipin bulunduğu ve bu poliplerden kanser gelişimi ile karakterize otozomal dominant geçişli kalıtımsal bir rahatsızlıktır. Genç yaşlarda polipler ortadan kaldırılmazsa bu poliplerden mutlaka malign kanserler gelişir. Acil servise kanlı ishal şikayeti ile gelen 24 yaşındaki erkek hasta ileri tetkik ve tedavi için yatırıldı. Hasta zayıf ve kaşektik görünümde idi ve son 2 ayda yaklaşık 10 kg kilo kaybettiği öğrenildi. Annesi ve altı birinci dereceden yakın akrabasının da kolon kanserinden vefat ettiği öğrenildi. Rektal muayenede ele kitle geliyordu. Hastaya kolonoskopi yapıldı, rektum ve kolonda sayılamayacak kadar çok polip ve rektal kitle mevcuttu, biyopsi alındı. Patoloji sonucu kolon adeno ca olarak gelen ve operasyon planlanan hasta genel cerrahiye sevk edildi. Acil servise kanlı ishal yakınması ile gelen genç bir erkek hastada altta yatan bir malignite olabileceğinin düşünülmesi rektal tuşenin muayenenin bir parçası olduğunun unutulmaması ve özellikle aile hikayesi yönünden sorgulanmasının önemi vurgulanmak için olgu sunumu yapılmaya değer görülmüştür.Anahtar kelimeler: Familyal adenomatöz polipozis, kanlı ishal, anemi, kolon kanseri

Aim: Thrombocytopenia is a common hematologic problem in the neonatal period. The aim of the study is determine of prevalence and reasons of thrombocytopenia in patients in our newborn intensive care unit (NICU).Material and Methods: Medical records of patients who were hospitalized in NICU between January 2011 and May 2014 were inspected retrospectively. Early thrombocytopenia was identified as thrombocytopenia developing within first 72h’s of life and late thrombocytopenia was identified as thrombocytopenia developing after the first 72h’s of life. Demographic characteristics, clinical and laboratory parameters of the patients’ were recorded.Results: The prevalence of thrombocytopenia was 11% in the study period. The reasons of early thrombocytopenia were placental insufficiency (n=14), with one patient having accompanying chromosomal anomaly, sepsis (n=14), maternal thrombocytopenia (n=7), perinatal asphyxia (n=6), and hemophagocytic syndrome (n=1). Pseudothrombocytopenia and neonatal alloimmune thrombocytopenia was considered in two and four patients respectively. The reasons of late thrombocytopenia were culture proven sepsis (n=15), clinical sepsis (n=10), necrotizing enterocolitis (n=7), TAR Syndrome (n=1), CMV infection (n=1), and pseudothrombocytopenia (n=5).Conclusion: In our study we showed that early thrombocytopenia is related to prenatal or natal complications, however late thrombocytopenia is related to late onset infection or necrotizing enterocolitis. In conclusion, the time of onset of thrombocytopenia is important to determine the etiology of thrombocytopenia.Key Words: Thrombocytopenia, newborn, sepsis, Amaç: Trombositopeni yenidoğan döneminde sık görülen hematolojik sorunlardan biridir. Bu çalışmanın amacı yenidoğan yoğun bakım ünitemizde (YYBÜ) yatan hastalarda trombositopeni sıklığı ve nedenlerini belirlemektir.Yöntem: Ocak 2011- Mayıs 2014 tarihleri arasında YYBÜ’de yatan hastalar dosya kayıtlarından geriye yönelik olarak incelendi. Postnatal ilk 72 saatte gözlenen trombositopeni erken, 72 saatten sonra görülenler ise geç trombositopeni olarak tanımlandı. Hastaların demografik ve klinik özellikleri ve laboratuar bulguları kaydedildi.Bulgular: Çalışma süresince YYBÜ’ de trombositopeni sıklığı %11 idi. Erken trombositopeni gözlenen hastaların trombositopeni nedenleri plasental yetmezlik (n=14), 1 hastada aynı zamanda kromozom anomalisi, sepsis (n=14), maternal trombositopeni (n=7), perinatal asfiksi (n=6), hemofagositoz (n=1) idi. İki hastada yalancı trombositopeni, 4 hastada tanısal değerlendirme yapılamamakla birlikte, neonatal alloimmün trombositopeni düşünüldü. Geç trombositopeni gözlenen hastaların trombositopeni nedenleri kültür pozitif sepsis (n=15), klinik sepsis (n=10), NEK (n=7), TAR Sendromu (n=1), CMV enfeksiyonu (n=1) ve yalancı trombositopeni (n=5) idi.Sonuç: Çalışmamızda ilk 72 saat içinde tanı alan hastalarda trombositopeni genellikle gebelik veya doğum komplikasyonlarına bağlı iken, 72 saatten sonra tanı alan hastalar sıklıkla edinilmiş enfeksiyon veya nekrotizan enterokolitle ilişkilidir. Sonuç olarak, trombositopeninin erken veya geç olması etiyolojik açıdan önemlidir.

Tedavi alanındaki tüm gelişmelere rağmen, akciğer kanseri halatüm dünyada kanserle ilişkili ölüm nedenlerinin başında gelmektedir.Etyolojisinde sigaranın yanı sıra çevresel, mesleksel ve genetikfaktörler rol oynamaktadır. Akciğer kanserleri genellikle kü-çük hücreli akciğer kanseri (KHAK) ve küçük hücreli dışı akciğerkanseri (KHDAK) olmak üzere iki ana histolojik tipe ayrılır. Tümakciğer kanserlerinin yaklaşık %85’ini oluşturan KHDAK’inde bir-çok gen anomalisi saptanır. Anaplastik lenfoma kinaz (ALK) geniinsülin reseptör tirozin kinaz süper ailesinin bir üyesidir. ALK geniakciğer kanseri, lenfoma gibi çeşitli malignitelerde füsyon proteinoluşumuna yol açan translokasyonlara dahil olur. Bu derlemedeKHDAK’inde görülen ALK yeniden düzenlenmelerine ait son literatürgözden geçirilecektir., Despite all improvements in treatment modalities, lung canceris the leading cause of death related to cancers worldwide.Environmental, occupational and genetic factors, as well as smokingplay role in the etiology. Lung cancers are generally dividedinto two main histologic categories: small cell lung cancer (SCLC)and non-small cell lung cancer (NSCLC). Several gene aberrationsare detected in NSCLC, which constitute approximately 85% ofall lung cancers. The Anaplastic lymphoma kinase (ALK) gene is amember of insulin receptor tyrosine kinase super family. ALK geneinvolves with translocation those results in formation of fusion proteinin various malignancies such as lung cancer and lymphoma. Inthis article, latest literature regarding re-arrangement of ALK seenin NSCLC will be reviewed.

Objectives. Nora’s disease is a mesenchymal bone tumor with controversial diagnosis and treatment due to the benign but locally aggressive course and high recurrence rates. Methods. A retrospective analysis was made of patients diagnosed with Nora’s Disease at Ankara University Orthopedics and Traumatology Clinic. The evaluation was made of the age of the patient, gender, symptoms, lesion location, trauma history, treatment choice and recurrence rates during follow-up. Results. Excision was applied to 6 patients diagnosed with Nora’s disease, and in 1 patient an additional autograft and internal fixation were required. Recurrence was observed in 3 patients, 2 of whom underwent revision surgery and one who did not as there no patient complaints. Conclusions . Nora’s disease is problematic for orthopedic surgeons as there are difficulties in diagnosis, there is no absolute treatment algorithm, recurrence potential is high, and there are limited additional treatment choices. Therefore, treatment and follow-up at clinical center’s dealing with orthopedic tumor surgery can be considered appropriate.

Objective: Health care workers are at risk for infections caused by hepatitis B HBV , hepatitis C HCV and human immunodeficiency HIV viruses that transmit via blood and body fluids. In the present study, it was aimed to investigate the seroprevalences of HBsAg, anti-HCV and anti-HIV in patients who admitted in cardiology clinics and who underwent angiography. Method: HBsAg, anti-HCV and anti-HIV test results and demographical data of the patients who underwent angiography in cardiology clinics between May 2008-2011 were evaluated retrospectively. HBsAg, anti-HCV and anti-HIV tests were assayed with macro-ELISA method AxsymAbbott; Architect i2000-Abbott, USA . Statistical analysis was performed Chi-square test Results: Among 415 patients, 177 42.6% were female and 238 57.3% were male. The mean age was 61.5±5.4. HBsAg was positive in nine 2.2% patients; among these eight 2.0% were male and one 0.2% was female. Anti-HCV was positive in only one 0.2% female patient. No patients were positive for anti-HIV. No significant associations were found between sexuality and positivity rates of HBsAg and antiHCV. Conclusion: In the present study, it was observed that the seroprevalences of HBsAg, anti-HCV and anti-HIV were not higher than the population. Taking the safety precautions of the health care workers during surgical or invasive procedures such as angiography without any information about the serological test results of the patients will reduce the contamination of these agents., Amaç: Sağlık çalışanları kan ve vücut sıvılarıyla bulaşan hepatit B HBV , hepatit C HCV ve insan immun yetmezlik virüslerinin HIV neden olduğu infeksiyonlar açısından risk altındadırlar. Bu çalışmada kardiyoloji kliniğine başvuran ve anjiyografi uygulanan hastalarda HBsAg, anti-HCV ve antiHIV seroprevalansının araştırılması amaçlanmıştır. Yöntem: Kardiyoloji kliniğinde Mayıs 2008-2011 tarihleri arasında anjiyografi yapılan hastaların HBsAg, anti-HCV ve anti-HIV test sonuçları ile demografik verileri retrospektif olarak incelendi. HBsAg, anti-HCV ve anti-HIV testleri makroELISA yöntemiyle Axsym-Abbott; Architect i2000-Abbott, ABD çalışıldı. İstatistiksel değerlendirme Ki-kare testi ile yapılmıştır Bulgular: Toplam 415 hastanın 177 %42.6 ’si bayan, 238 %57.3 ’i erkek idi. Tüm hastaların yaş ortalaması 61.5±5.4 dir. Hastaların dokuzunda %2.2 HBsAg pozitif olup sekizi %2.0 erkek, biri %0.2 bayandı. Anti-HCV pozitifliği sadece bir %0.2 bayan hastada rastlandı. Anti-HIV pozitifliğine rastlanmadı. HBsAg ve anti-HCV pozitiflik oranları ile cinsiyet arasında anlamlı ilişki bulunamadı. Sonuç: Çalışmamızda HBsAg, anti-HCV ve anti-HIV seroprevalansının toplumdakinden yüksek olmadığı görülmektedir. Anjiyografi gibi girişimsel işlemler ve cerrahi müdahaleler sırasında tüm sağlık personelinin hastaların serolojik tetkiklerine bakılmaksızın virüs bulaşabilme ihtimalini düşünerek güvenlik önlemlerini alması bu etkenlerin bulaşmasını azaltacaktır

Peptides selected from artificial peptide libraries have special interest in cell targeting, drug discovery, molecular diagnosis and multidrug reversal. Peptides selected from artificial peptide libraries against doxorubicin resistant K562 cells have the capacity in the reversal of the doxorubicin resistance. Our aim is to determine the characteristics of these peptides on recombinant human P-glycoprotein membrane fractions to be able to understand their interactions. Peptides were selected against doxorubicin resistant K562 cells. The effects of synthesized peptides on these cells viability was done by XTT viability assay. The interactions of peptides with P-glycoprotein were done by Pgp-GloTM Assay System by measuring the ATPase activity of P-glycoprotein. According to our results; four selected peptides effected on doxorubicin resistant K562 cells viability and stimulated the P-glycoprotein activity in the presence of doxorubicin at different levels. If the P-glycoprotein stimulation occurs on living doxorubicin resistant K562 cells, cell viability will not be affected due to multidrug resistance effect of P-glycoprotein. Peptides selected from artificial peptide libraries are useful tools in the reversal of multidrug resistance and for understanding the membrane structure-function relationships. [Med-Science 2018; 7(1.000): 158-161]

Intensity modulated radiotherapy is the developed technique of 3 dimensional conformal radiation therapy. In this method, irradiated fields can be seperated into many subfields that are called segments. Each segments radiation dose can be adjusted. Intensity modulated radiotherapy plans have complex segments and high gradient dose regions. Therefore, quality assurance of intensity modulated radiotherapy plans are very important. The aim of this study is to perform quality assurance tests of intensity modulated radiotherapy plans by using different dosimetric systems and compare of results. Intensity modulated radiotherapy treatment plans of thirty patients quality assurance were tested using Matrixx and Delta4. Then, gamma pass rates that were determined as a result of the gamma analysis done using gamma pass-fail criteria that had values of different dose difference and distance to agreement. In our study, the difference between the mean values of gamma pass rates determined before were statistically examined and there was significant difference between two dosimetric systems. [Med-Science 2019; 8(1.000): 63-6]

Aim: Aim of the study was to examine the relationship between pain and quality of life in adult patients with sickle cell disease (SCD) and to examine complications of SCD on pulmonary system. Material and Methods: A total of 25 individuals (19 male, 6 female) diagnosed with SCD were included in the study. Pulmonary system, quality of life and pain was measured. Pain in rest and activity was questioned with Visual Analog Scale. The quality of life was assessed by the Short Form-36 (SF-36) Scale. Results: It was determined that the individuals experienced an important level of pain in rest and activity levels, however it was seen that the pain level in activity was higher. It was determined that the oxygen saturation average was 91% and incidence of secretion and the number of coughing individuals was 6 and that 2 individuals used accessory respiration muscles. It was also found out that the SF-36 Scale’s parameters’ scores were low and that the quality of life of individuals were negatively affected. There was a moderate, negative and significant correlation between pain in rest and SF-36 Scale’s physical function, pain, general health, mental health parameters. Conclusion: It has been concluded that in the treatment of patients with SCD, although it is not mentioned in patient history, pain related problems should be taken into consideration. We believe that pulmonary and pain rehabilitation to patients with SCD will support their wellbeing.

Aim: This study investigates the total sternum length and the lengths of each part of the sternum using computed tomography (CT) images oriented orthogonally to reveal whether there are any significant gender differences with respect to these values.Material and Methods: Thin-section thorax CT images from 60 subjects (30F, 30M) between 20 and 40 years of age were used, oriented to the orthogonal plane using an image-processing program.The sternal angle (SA), manubrium length (ML), corpus length (CL), xiphoid processlength (XPL), total sternum length (TSL), manubrium-corpus length proportion (sternal index; SI), and the proportion of the three parts separate from the TSL were compared by gender.Results: The values of the ML (M: 5.36 cm, F: 4.76 cm), CL (M: 10.11 cm, F: 8.75 cm), and TSL (M: 19.18 cm, F: 16.28 cm) were longer in males (p0.05) than in females. No statistically significant difference was determined in the ratios of the XPL, SI, and sternum parts to the TSL (p0.05). The mean values of the SA in males and females were 161.4 and 160.51, respectively (p0.05). In an ROC analysis, the most significant measurement for gender determination was found to be the CL, and the linear discriminant analysis yielded a correct determination rate of 86% for males and 93% for females.Conclusions: Although metric measurements of the sternum could provide high accuracy rates in gender determination, to increase reliability, image analyses should be conducted in the orthogonal plane to remove errors that could be caused by the differences in orientation.

Aim: In this study we investigated the demographics and medical characteristics of acute stroke patients who applied to emergency department (ED) and were admitted to neurology department (ND). Material and Methods: This study was conducted in a tertiary hospital. The patientsÂ’ medical records were reviewed; age, gender, diagnosis, comorbid diseases, previously anticoagulant treatment, brain computerized tomography reports, brain magnetic resonance imaging reports, hospitalized unit, length of hospital stay, vitamin B12 levels, electrocardiography recordings, and the outcome of patients. Results: In the including time of the study, 523 patients were hospitalized to the ND from ED. The patients with cerebrovascular diseases (CVD) were 68.7% (n=357) of the hospitalized patients. The patients with acute ischemic stroke (AIS) were 74.8 % (n=267) of the patients with CVD. In AIS, the most common comorbid disease was hypertension, followed by atrial fibrillation (AF). The rate of AF was 31% in AIS. AF was newly diagnosed in 46% (38 patients) of patients with AIS, and these patients had no anticoagulation therapy. Vitamin B12 levels were found to be low in 58 (21.7%) of AIS patients. Conclusion: A large number of patients with undiagnosed AF are diagnosed following AIS. Therefore, it is important that these patients should be followed closely for AF and its management, and it is also important to treat vitamin B12 deficiency to prevent stroke development.

Aim: Lumbar spine surgeries can be performed under general anesthesia or spinal anesthesia. We aimed to compare the effects of spinal and general anesthesia on intraoperative bleeding in patients undergoing lumbar disc surgery.Material and Methods: Fifty patients scheduled to undergo elective single-level lumbar discectomy under spinal or general anesthesia were studied. The amount of blood loss was calculated by subtracting the wash solutions from the amount in the aspirator reservoir and evaluating bleeding in the gauze used throughout the operation. The time between the first incision and the final suture was evaluated as the surgical time.Patients’demographic data, duration of surgery, amount of fluid given intraoperatively, intraoperative hemodynamic data, intraoperative blood loss, intraoperative/postoperative ephedrine requirements , postoperative nausea and vomiting and the duration of stay in PACU were evaluated.Results: In group S, intraoperative blood loss was 203.00108.73 ml, while in group G it was 198.00106.40. There were no statistically difference between the groups (p0.884). Inthe duration of surgery, amount of fluid given intraoperatively, intraoperative ephedrine requirements was compared, there wereno difference between the groups too (p0.085, p0.056 and 0.448, respectively).Conclusion: In this study, it was shown that general and spinal anesthesia did not affect major parameters such as intraoperative bleeding in patients undergoing.

Aim: Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. Urticaria is a disease with papules and plaques accompanied by pruritus and edema. In this study, the relationship between these two diseases, which have many common features, was evaluated.Material and Methods: Patients with urticaria and volunteers who did not have any dermatologic disease were included in the study. Participants were assessed for diagnosis of IBS according to Rome III diagnostic criteria. In addition, findings supporting IBS diagnosis, and fecal shape and consistency were evaluated.Results: Fifty urticaria patients (18 males - 36% and 32 females - 64%) and 70 volunteers (38 males - 54.3% and 32 females - 45.7%) were evaluated. The mean age of the urticaria group was 34.8 15.0; the mean age of the control group was 25.8 10.9. IBS was detected in 34 (68%) patients in the urticaria group; and in 22 (31.4%) controls (p 0.001). Diagnosis-supporting findings were more frequently detected in the group of urticaria (p values respectively: 0.037; 0.001; 0.036; 0.050). It was observed that the higher the serum IgE level, the higher the incidence of IBS in chronic urticaria patients ( p: 0.02; eta: 0.206).Conclusion: IBS was observed more frequently in urticaria patients. Diagnosis-supporting findings for IBS were found more frequently in urticaria patients. Serum IgE values also seem to be associated with IBS. These results indicate an association between chronic urticaria and IBS. For this reason, the presence of IBS in patients with chronic urticaria diagnosis should be questioned.

Skin diseases are quite common in childhood and affected by geographic, cultural, and socio-economic conditions. There is no reported study about the prevalence of skin diseases of the pediatric population in the Southeastern Anatolia, Turkey. We sought to investigate the skin diseases of the pediatric population in this region. A cross-sectional study was conducted on 3957 patients, age range 0-17 years, in the Dermatology Outpatient Clinic. The patients were classified according to the age groups: infancy (0-2 years), preschool period (3-5 years), school period (6-11 years), and adolescent period (12-17 years). Skin diseases were evaluated under 17 disease subgroups. Of 3957 pediatric patients (2109 female and 1848 male), 695 (17.56%) were in infancy, 465 (11.75%) were in preschool period, 823 (20.8%) were in school period, and 1974 (49.89%) were in adolescent period. Eczematous diseases (30.12%) were the most common skin disease group, followed by acne (26.35%), infectious diseases (19.03%), pigmentation disorders (4.06%), other-unclassified diseases (3.58%), xerosis cutis (2.8%), urticaria (2.68%), hair diseases (2.72%), papulosquamous diseases (1.74%), photodermatoses (1.41%), melanocytic lesions (1.28%), sweat gland diseases (1.23%), tumors-cysts (1.03%), vascular malformations (0.68%), nail diseases (0.58%), genodermatoses (0.48%), and vasculitis (0.15%), respectively. The high prevalence of eczematous and infectious dermatoses were attributed to the crowded family structure, low socio-economic status, play and cleaning materials, and poor hygiene. The relatively low prevalence of atopic dermatitis in our study has been associated with increased breastfeeding in infancy and feeding with natural products in the region. [Med-Science 2018; 7(3.000): 664-7]

Aim: This study aims to evaluate whether there is a possible relationship between the preoperative and early postoperative period neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and post-dural-puncture headache in patients undergoing cesarean section.Material and Methods: Two hundred twenty pregnant women scheduled to undergo elective cesarean section under spinal anesthesia, were studied. Patiens demografic data and blood count parameters were noted. Blood was sampled from a peripheral vein for neutrophil/lymphocyte ratio ve platelet/lymphocyte ratio. The time points for sampling blood were as follows: Preoperative; 1 day before and postoperative; within 6-12 hours after cesarean section. The patients were questioned for possible occurrence of spinal anesthesia induced headache on the first and seventh postoperative days. Post-dural puncture headache was evaluated according to the International Classification of Headache Disorders (ICHD-II) diagnostic criteria.Results: A total of 220 patients were enrolled in the study and 217 patients completed the investigation. Post-dural puncture headache was detected in 78 patients and the incidence was 35.9%. The measurements of laboratory parameters were statistically similar between two groups (P > 0.05).Conclusion: Our study results showed no relationship between the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, and post-dural-puncture headache in the preoperative and also, early postoperative period in patients who undergoing cesarean section.Keywords: Post-Dural-Puncture Headache; Neutrophil-Lymphocyte Ratio; Platelet-Lymphocyte Ratio; Cesarean Section.

In this study, we aimed to investigate the correlation of Alvarado scoring with C-reactive protein and leukocytes and the reliability of Alvarado scoring, and to guide clinicians for patient management. This study was planned as a prospective study. Data of the patients who presented to the emergency department with abdominal pain and diagnosed with acute appendicitis, and the control group were examined by the researchers. After a detailed physical examination, patients Alvarado scoring parameters and laboratory outcomes were recorded. Pathologic outcomes of the patients who were considered to have acute appendicitis and operated were studied. A different pathology other than appendicitis was found in 13 (15.1%) of 86 patients who were considered to have acute appendicitis and operated (negative appendectomy). According to the pathologic outcomes of the patient group, the most common cause of acute appendicitis was found to be fecalloids by 84.9%. Whereas simple appendicitis was observed in 85% of the patients, perforation was found in 8.2%. The most common finding of physical examination was right iliac fossa (95.8%), while the most common symptom was nausea / vomiting (67.1%) the in the cases of acute appendicitis. Among the Alvarado scoring parameters, fever was the least common symptom by 12.4%. In our study, we found a significant correlation between Alvarado scoring and leukocytes both in patients and control groups. Whereas there was no correlation between Alvarado scoring and C-reactive protein in the patient group, there was a correlation between these two parameters in the control group. There was a weak negative correlation between Alvarado scoring and acute appendicitis. Although Alvarado scoring has been reported to be a guiding scoring system in management of patients considered to have acute appendicitis, in our study this scoring was found to be statistically insignificant. Alvarado scoring alone is not sufficient in establishing a diagnosis, and the diagnosis should be supported by laboratory tests or imaging methods. [Med-Science 2019; 8(1.000): 132-7]

Aim: The aim of this study is to evaluate the predictive value of fragmented QRS (fQRS) wave to detect non-ST elevation myocardial infarction (Non-STEMI).Material and Methods: The study included patients who were diagnosed with Non-STEMI in emergency department and underwent percutaneous coronary intervention in the cardiology clinic. Coronary artery circulation is anatomically divided as the left anterior descending coronary artery (LAD) (V1-V5), the left Circumflex (LCx) (I, aVL and V5,V6) and the right coronary artery (RCA) (II, III and aVF).Results: Our study included 191 patients. Significant fQRS was detected in 139 (%73) patients and ST/T was detected in 79 (%41) patients. The sensitivity, specificity, of fQRS in the inferior leads to predict RCA lesionwas 76%, 46%, respectively. The sensitivity, specificity, of ST/T in the inferior leads to “predict RCA lesion was 12%, 93%, respectively. The sensitivity, specificity of fQRS in the lateral leads to predict LCx lesion were 44% and 83%, respectively. The sensitivity, specificity of ST/T in the lateral leads to predict LCx lesion were 34%, 74%, respectively. The sensitivity, specificity of fQRS in the anterior leads to predict left LAD lesion were 34% and 82%, respectively. The sensitivity, specificity of ST/T in the anterior leads to predict LAD lesion were 38%, and 81%, respectively.Conclusion: We have compared to fQRS and ST/T on ECG; fQRS has higher sensitivity than ST/T to predict culprit coronary artery lesion. Therefore, evaluation of fQRS in addition to ST/T on ECG may be more valuable in pre-diagnosis of Non-STEMI.