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Background: SARS-CoV-2 associated with severe acute respiratory syndrome is a common, rapidly growing infectious disease with high morbidity and mortality. Mutations in the sequence of the three structural proteins of this virus may have a significant impact on the progression of the pandemic. In this study, it was aimed to reveal possible targets for future drug and vaccine research by modeling and analyzing mutations in five variants of SARS-CoV-2 of concern. Materials and Methods: RNA sequences of five variants identified by WHO as Variants of Concern (VoC) were obtained from NCBI. The translation of these sequences to amino acid sequence, sequence alignment and sequence comparison between variants was performed in RStudio 1.4.1717 with reference to 2020 study. Structural proteins and PDB files of the Wuhan variant were downloaded from studies conducted with the I-TASSER server. 3D representations of structural proteins were performed in LLC, Schrödinger, PyMOL Molecular Graphics System 1.2r3pre. Results: The amino acid sequences of three structural proteins belonging to the VoC and the Wuhan lineage and the mutations are shown. The mutation numbers in Alpha, Beta, Delta and Gamma were as follows; 10, 8, 10 and 12. The envelope and membrane proteins had one mutation each in Beta and Delta, respectively. Conclusions: The results show that several mutations occur the spike proteins of the SARS-CoV-2 variants. Only a small number of mutations are observed in envelope and membrane proteins. It may be beficial to focus on less mutated structural proteins for future vaccine and drug development studies. &nbsp

Serebral palsi kronik nörolojik bir hastalık olup tedavinin temelini fizik tedavi oluşturmaktadır. Hippoterapi bu klasik tedavi yöntemine ek olarak uygulanabilmektedir. Çalışmamızda hippoterapinin serebral palsi hastalarına olan etkisi araştırıldı. Çocuklara tedavi öncesi ve sonrasında Kaba Motor Fonksiyon Ölçeği-88 (KMFÖ-88) ve Berg Denge Ölçeği uygulandı. On iki haftalık terapi sonrasında KMFÖ-88 ve Berg Denge ölçeği puanlarında istatiksel olarak anlamlı artış belirlendi. Bu ön çalışmamız hippoterapi uygulamasının pediatrik serebral palsi hastalarının tedavisinde kullanılabileceğini göstermektedir., Cerebral palsy is a chronic neurological disease and the mainstay of treatment is physical therapy. Hippotherapy can be applied in addition to this classical treatment. Our study investigated the effect of hippotherapy on patients with cerebral palsy. Gross Motor Function Scale-88 (GMFS-88) and Berg Balance Scale were administered to the children before and after the treatment. After 12 weeks of therapy, a statistically significant increase was determined in the GMFS-88 and Berg Balance scale scores. This preliminary study shows that hippotherapy can be used in the treatment of pediatric cerebral palsy patients.

Psoriasis is a chronic inflammatory skin disease that is characterized by well-demarcated erythematous plaques with a silver scale. Although many new and emerging therapeutic agents are often sufficient to control the disease, there is still a need for alternative treatment options in challenging cases. Extracorporeal photopheresis (ECP) has been applied to many T-cell-mediated diseases to restore immune homeostasis and treat psoriasis effectively. In this paper, we present a psoriasis patient who did not respond to methotrexate, narrowband ultraviolet B, or acitretin. Because of a diagnosis of non-Hodgkin lymphoma, the patient had contraindications for cyclosporine, fumaric acid esters, and biologics but achieved remission with a total of 12 sessions of ECP in two and a half months. Although exacerbation was recorded after polymerase chain reaction (PCR) confirmed coronavirus 2019 (COVID-19) disease infection at the end of the first month, scores from the psoriasis area severity index (PASI) and dermatological life quality index (DLQI) were regressed significantly within two and a half months. ECP seems to provide an effective and rapid response for psoriasis and should be considered for psoriasis patients who fail to respond or have contraindications to existing treatments.

Objective The response of elderly patients with acute myeloid leukemia (AML) to standard induction therapy is quite poor due to higher frequency of adverse genomic features, increased resistance to treatments, comorbidities and performance status. BCL-2 overexpression is implicated in survival of AML cells and treatment resistance. Preclinical data demonstrated the anti-leukemic effect of venetoclax, a selective BCL-2 overexpression is implicated in survival of AML cells and treatment resistance. Methodology Venetoclax has received FDA approval for the treatment of AML patients g75 years of age and in combination with hypomethylating agents/low-dose cytarabine in patients not eligible for intensive therapy. Six newly diagnosed AML patients who were followed up in Gulhane Education and Training Hospital, Hematology clinic and treated with azacitidine+venetoclax were evaluated retrospectively. Results F/M:1/5,the mean age was 77.3 (63-87).Two patients were secondary AML.All patients had normal karyotype.Venetoclax+azacytidine treatment was started in all patients as first-line treatment after obtaining off-label consent.The average number of courses of venetoclax + azacitidine administered 3.5 (1-8).Patients received 200 mg/day venetoclax because of fluconazole usage concomittantly.One patient died with a FEN attack at the end of the second cycle, and 5 patients are still being followed up. Conclusion Azacitidine or decitabine monotherapy yields low response rates (10%-50%, including hematologic improvement), require 3.5 to 4.3 months to achieve best response, and are not curative, with a median OS of less than 1 year.Targeted therapies capable of rapidly inducing a high rate of clinical response, with better tolerability and durable responses for elderly patients with AML. The novel combination of venetoclax with decitabine or azacitidine was effective and well tolerated in elderly patients.

Context: There is still no clear information about the incidence and consequences of infections with cyclophosphamide (PTCy) administration as prophylaxis against graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Objectives: Revealing the incidence of pre-vaccination bacterial and viral infections (cytomegalovirus [CMV], herpes virus, and BK-polyomavirus hemorrhagic-cystitis), infection-related mortality, and predictive factors associated with PTCy application after allo-HSCT was the study aim. Design: Patients who underwent allo-HSCT from 9/10–10/10 HLA tissue-matched, unrelated donors and received cyclophosphamide for post-transplant GVHD prophylaxis from 3 centers between 2015 and 2020 were retrospectively reviewed. Infections that developed in the first 100 days after transplantation were recorded. Patients: Forty-one patients, M/F: 25/16, were included in the study. The mean age was 40.8 years (21–67), with 23 AML, 11 ALL, 3 NHL, 2 MDS, one biphenotypic leukemia, and 1 HL diagnosis. HLA tissue compatibility was 9/10 in 32 patients and 10/10 in 9 patients. All patients received one myeloablative priming regimen [TBI (800–1200 cGy)+Flu (30 mg/m2×5), Cy (60 mg/kg×2) + TBI (1200 cGy), treosulfan (10 g/m2×3) + Flu (40 mg/m2×4)]. In GVHD prophylaxis, PTCy was administered 72 and 96 hours following transplantation in combination with calcineurin inhibitors ± methotrexate ± mycophenolate mofetil. Levofloxacin, valacyclovir, fluconazole, and trimethoprim-sulfamethoxazole were empirically given to all patients along with the transplant preparation regimen. Results: At least one episode of febrile neutropenia (FEN) developed in all patients during the transplantation process. More than one episode of FEN developed in 22% of the patients. One patient died due to septic shock on post-transplant day 9. The incidence of CMV infection requiring treatment was 36.6% in the first 100 days and 41.5% at 1 year. All patients except 1 were CMV IgG-positive before transplantation. CMV reactivation was observed in 50% (15/15) of donor/patient CMV IgG (+/+). CMV reactivation was found in 30% (3/7) of the donor/patient CMVIgG (–/+) patients. Only one of these patients received antiviral therapy due to multiple reactivations. In 4 patients, CMV pneumonia developed, and 3 of them died. The rate of polyomavirus-associated cystitis was 7.3% (3/41). In the first year after transplantation, invasive fungal infection occurred in only 4 patients (9.8%), herpes virus infection occurred in 1 patient. Three patients received tenofovir–entecavir treatment because of anti-HBcIg positivity, and HBV reactivation was not detected in any of the patients. Conclusion: GVHD prophylaxis containing PTCy after allo-HSCT from an unrelated donor does not have an increased risk in terms of bacterial, viral, or fungal infections and can be used safely.

Context: Oncogenes, pollution, infections, or the dysregulation of the immune system can be triggering factors for leukemias, but there is not a specific factor for acute promyelocytic leukemia (APL). Objectives: Investigating the impacts of seasonality in the incidence of APL in our center and its characteristics were the aims of the study. Design: Six-year records of 21 APL patients who were diagnosed and treated in Gulhane Education and Training Hospital from 2015 to 2021 were evaluated retrospectively. Patients were categorized on the basis of the seasons in which they were diagnosed: winter (December–February), spring (March–May), summer (June–August), and autumn (September–November). Results: The mean age of the patients was 47.7 years (30–79) M/F: 3/1. Seven patients (33.3%) were diagnosed in winter, 7 patients (33.3%) in autumn, 5 patients in spring (23.8%), and 2 patients (9.5%) in summer. There was a significant difference in terms of APL incidence in winter and autumn versus summer. Conclusion: Seasonal variations in hematologic diseases and leukemias have been largely reported by several epidemiological studies. In contrast to our study, Hassan et al. could not find any seasonal variations in APL. A Brazilian study reported a correlation between rainfall and APL. Timonen hypothesized that viral infections, sunlight deficiency, and cold temperatures could be effective for triggering leukemias. Acute myeloblastic leukemia (AML) showed the highest risk during dark seasons, which can be explained by vitamin D insufficiency. Parallel to this study, we can explain that decreased sun exposure in winter and autumn can trigger vitamin D deficiency and APL occurrence. Similarly, elevated viral infections can trigger leukemogenesis in winter. Supplementation with vitamin D and vaccination against influenza may be beneficial to prevent APL occurrence.

Amaç: Bu çalışmada Mardin ili, Kızıltepe ilçesi makarnalık buğday (Triticum durum Desf.) tarımı yapılan alanların verimlilik durumlarının toprak ve tane mineral analizleriyle belirlemesi amaçlanmıştır.Yöntem ve Bulgular: Bu amaç için buğday tarımı yapılan alanlardan 10 ayrı noktadan ve her noktadan üç adet olmak üzere kök derinliği esasına göre 0-30 cm derinlikten toplam 30 adet arazi büyüklüğü ve topoğrafyası göz önünde bulundurularak toprak örnekleri ile buğday örnekleri alınmıştır. Alınan toprak örneklerinde, bünye, pH, % kireç (CaCO3), % toplam tuz, organik madde (% OM), bitkiye yarayışlı fosfor (P), potasyum (K), çinko (Zn), demir (Fe), mangan (Mn), bakır (Cu), nikel (Ni) ve kadmiyum (Cd) miktarları belirlenirken, buğday tanelerinde, % Protein içeriği, azot (N), P, K, Zn, Fe, Mn, Cu, Ni ve Cd konsantrasyonları belirlenmiştir.Genel Yorum: Elde edilen bulgulara göre topraklar Killi-Tın bünyeli, nötr ve hafif alkalin reaksiyonlu, kireçli, tuzsuz ve genelde organik maddece fakir olduğu belirlenmiştir. Toprakların P içeriklerinin yeterli, K ve Fe içerikleri ise yeterli ve yüksek, Mn ve Cu içeriklerinin yeterli olarak belirlenirken, Zn içeriklerinin ise noksan olduğu belirlenmiştir. Buğday tane örneklerinde yapılan analizlerde protein oranı % 11.00 ile 12.6 arasında ortalama % 11.8 olarak bulunmuştur. Buğday tanesi örneklerinin P, K, Mn ve Fe içeriklerinin yeterli, N ve Zn içeriklerinin ise yetersiz olduğu belirlenmiştir.Çalışmanın Önemi ve Etkisi: Sonuç olarak, Mardin ili Kızıltepe ilçesi makarnalık buğday tarımı yapılan alanların beslenme sorunlarının olduğu, özellikle bütün topraklarada organik madde, N, Zn ve bazı topraklarda Cu noksanlığının bulunduğu ve yörede bilinçli bir bitki beslenme programlarının eksikliği belirlenmiştir., Aims: In this study, it is aimed to determine the fertility status of the areas where durum wheat (Triticum durum Desf.) in Kızıltepe district cultivated Mardin province by soil and grain mineral analysis. Methods and Results: For this purpose, taking into account the size and topography of the land, soil samples and wheat grains samples were taken from 10 different points on the basis of root depth (3 repeats from 0-30 cm depth) where wheat cultivation is carried out. In soil samples taken; texture, pH, lime (CaCO3), total salt, organic matter (OM), plant-available phosphorus (P), potassium (K), zinc (Zn), iron (Fe), manganese (Mn) ), copper (Cu), nickel (Ni) and cadmium (Cd) amounts, Protein content, nitrogen (N), P, K, Zn, Fe, Mn, Cu, Ni and Cd concentrations were determined in wheat grains. Conclusions: According to the findings obtained, it was determined that the soils were clayey-loamy, neutral and slightly with alkaline reaction, calcareous, salt-free and generally poor in organic matter. It was determined that P contents of soils were sufficient; K and Fe contents were sufficient and high; Mn and Cu contents were sufficient; while Zn contents were deficient. In the analyzes done on wheat samples, the protein ratio was found to be 11.8%, between 11.00% and 12.6% on average. It was determined that the P, K, Mn and Fe contents of the wheat grain samples were sufficient, while the N and Zn contents were insufficient. Significance and Impact of the Study: As a result, there are nutritional problems in the areas where durum wheat is cultivated in Mardin province, Kızıltepe district. Especially the organic matter, N, Zn in all soils and Cu in some soils, as well as the lack of a conscious plant nutrition program has been determined in the region.

Otomatik bir rahim ağzı kanseri testinde, 2 boyutlu görüntülerden rahim ağzının yerinin tahmin edilmesi gerekir. Servikal os, dört kadran konumu gösteriminde veya 12 saatlik dilimler halindeki gösterimde her bir konumun yerini belirlemek için referans noktası olarak kullanılmaktadır. Servikal os noktasının hassas tespiti lezyonların doğru adreslenmesini sağlar. Bu çalışmada, 2 boyutlu gri tonlamalı görüntülerde servikal os koordinatının (x, y) merkezini tahmin etmek için 6 katmanlı bir evrişimli sinir ağı kullanılmıştır. Servikal os'un yerini tahmin etmek için herhangi bir görsel unsuru maskelemeden bütünsel bir yaklaşım kullandık. Çalışmada kullanılan iki boyutlu görüntüler, bir telesentrik lens ve 500-550 nanometre ışık dalga boylarına sahip bir CCD kamera kullanılarak elde edildi. Sınırlı sayıda örnek görüntü (145 görüntü) nedeniyle veri, büyütme tekniklerinden faydalanılarak her bir orijinal görüntü, görüntünün merkez noktasına göre -30 dereceden +30 dereceye kadar 1 derecelik artan açılar ile döndürüldü. Bu veriler üzerinden öğrenme yapan 6 katmanlı evrişimli sinir ağı, daha önce görülmeyen 21 serviks görüntüsü üzerinde test edildi. Sonuçlar, kullanılan görüntü merkezi tabanlı büyütme tekniğinin tahmin performansını iyileştirdiğini gösterdi. Servikal os lokasyonunun tahmininde 2.4 RMSE değeri elde edildi., In an automated cervical cancer test, the prediction of the location of the cervical os from 2D images is required. Cervical os is the reference point to determine the lesion's location by either using cervical four-quadrant location or by 12 o’clock locations. Precise detection of the cervical os point ensures correct addressing of the lesions. This study used a 6-layer convolutional neural network to predict the center of the cervical os’ coordinates (x,y) on 2D grayscale images. We used a holistic approach without masking any visual element to predict the location of the cervical os. The 2D images were obtained using a telecentric lens and a CCD camera with light wavelengths of 500 550 nanometers. Because of the limited number of image samples (145 images), we used augmentation techniques to increase the training set size by rotating each original image in 1-degree increments from -30 degrees to +30 degrees relative to the center of the image. The 6-layer convolutional neural network was tested on 21 unseen cervix images using augmentation data. The outcomes showed that the image center-based augmentation technique improves the prediction performance. We obtained 2.4 RMSE in predicting the location of the cervical os.

Invasive meningococcal disease (IMD) is among the leading causes of morbidity and mortality worldwide. Epidemiological studies in Turkey have shown that serogroups B and W are the most prevalent serogroups associated with IMD cases and meningococcal carriage. Many Turkish citizens who live in Europe visit their homeland of Turkey every year. However, no data is available on meningococcal carriage in this population. In addition, the effects of the presence of these citizens on meningococcal epidemiology in Turkey are unknown. This study aimed to examine the presence of Neisseria meningitidis carriage and serogroup distribution in Turkish citizens who live in Germany, Belgium, and the Netherlands and have visited Turkey. The study sample comprised 361 volunteers aged 2–85 who lived in Germany, Belgium, and the Netherlands and arrived at the Eskisehir airport between June 1 and August 22, 2016. A polymerase chain reaction assay for N. meningitidis was performed on the nasopharyngeal samples of these participants. Of the 361 volunteers, the nasopharyngeal meningococcal carriage rate was 0.6% (two subjects from Belgium). Serogroup X was isolated in a 46-year-old man, and non-groupable N. meningitidis was isolated in an 18-year-old girl. Previous studies showed that serogroup W is the one of the predominant strain in Turkey, was associated with having participated in the Hajj and the Umrah, have been controlled with routine immunization before travel. In contrast, the meningococcal carriage rate was low among Turkish citizens arriving each year from European countries; therefore, these visitors had no effect on meningococcal seroepidemiology in Turkey., İnvaziv meningokok enfeksiyonları, tüm dünyada önemli morbidite ve mortalite nedenleri arasında yer almaktadır. Türkiye’de yapılan epidemiyolojik çalışmalarda, invaziv meningokok enfeksiyonu ve taşıyıcılık için en sık görülen serogrupların B ve W olduğu gösterilmiştir. Avrupa’da yaşayan birçok Türk vatandaşı her yıl Türkiye’yi ziyarete gelmektedir. Ancak bu kişilerde meningokok taşıyıcılığı ile ilgili çalışma bulunmamaktadır. Buna ek olarak, bu taşıyıcılığın, Türkiye’de meningokok epidemiyolojisi üzerine etkisi ile ilgili de veri bulunmamaktadır. Bu çalışmada, Almanya, Belçika ve Hollanda’da yaşayan ve Türkiye’ye ziyarete gelenlerde, Neisseria meningitidis taşıyıcılığı ve serogrup dağılımının değerlendirilmesi planlandı. Çalışmaya 1 Haziran- 22 Ağustos 2016 tarihleri arasında Almanya, Belçika ve Hollanda’dan Eskişehir Havalimanı’na gelen 2-85 yaş arasında 361 gönüllü dahil edildi. Nazofaringeal örneklerde N. meningitidis polimeraz zincir reaksiyonu ile değerlendirildi. Çalışmaya dahil edilen 361 gönüllüde, meningokok taşıyıcılığı %0.6 (Belçika’dan gelen iki olguda) olarak saptandı. 46 yaşında bir erkekte serogrup X, 18 yaşında bir kadında da gruplandırılamayan N. meningitidis saptandı. Daha önceki çalışmalarda serogrup W, Türkiye’de en sık saptanan etkenlerden biri olup, Hac ve Umre ile ilişkili olduğu düşünülmüştür ve seyahat öncesi rutin aşılama ile kontrol altına alınmıştır. Bunun aksine Avrupa ülkelerinden her yıl Türkiye’ye çok sayıda Türk vatandaşı gelmesine rağmen, bu çalışmada bu ziyaretçilerin Türkiye’de meningokok seroepidemiyolojisine etkisi saptanmamıştır.

Objective: The study aims to determine the daily workload and to analyze the content of workload, to describe the service profile of FPs working in primary care in Turkey.Methods: The study design is descriptive and cross-sectional. A total of 28 FPs from 17 different cities were enrolled into the study. Two surveys, one inquiring the demographic properties of FPs participated and a second encounter form with 43 items inquiring all aspects of FPs’ workload were filled by the participants. Results: A total of 1,215 visits were reported. The average daily workload of FPs participating was 45.7± 16.8 visits. 92.5% of all patients were family physicians’ own registered patients while 7.5% of them were guests. A total of 1,610 RFEs were reported. We categorized them as prescription requests (451, 28%), clinical complaints (447, 27.8%), preventive medicine services (436, 27%), administrative reasons (161, %10) and other reasons (115, 7.2%). Essential hypertension and diseases of musculoskeletal system were the most common diagnoses in prescription requests. Sore throat and cough were the top two clinical complaints. Conclusions: FPs in Turkey are under severe pressure. Prescription requests account for an important percentage of this workload. Measures should be taken to lessen this burden., Amaç:Bu çalışma, Türkiye'de birinci basamakta çalışan aile hekimlerinin günlük iş yükünü belirlemeyi, iş yükünün içeriğini analiz etmeyi ve hizmet profilinitanımlamayı amaçlamaktadır.Gereç ve Yöntem: Çalışma tasarımı tanımlayıcı ve kesitseldir. Çalışmaya 17 farklı şehirden toplam 28 aile hekimi dahil edilmiştir. Biri aile hekimlerinin demografik özelliklerini, diğeri ise iş yüklerini 43 maddede tüm yönleri ile sorgulayan iki anket katılımcılar tarafından doldurulmuştur.Bulgular: İlgili gün içerisinde toplam 1215 muayene kaydı bildirildi. Katılan aile hekimlerinin günlük ortalama iş yükü 45,7 ± 16,8 muayenedir. Tüm hastaların% 92,5'i aile hekimlerinin kendi kayıtlı hastalarıyken % 7,5'i misafirdir. Toplam 1610 başvuru sebebi rapor edilmiştir. Bunlar reçete talepleri (451, % 28), klinik şikayetler (447, % 27.8), koruyucu hekimlik hizmetleri (436, % 27), idari nedenler (161, % 10) ve diğer nedenler (115, % 7.2)olarak sınıflandırılmıştır. Esansiyel hipertansiyon ve kas-iskelet sistemi hastalıkları reçete taleplerinde en sık görülen tanılardır. Boğaz ağrısı ve öksürük en sık görülen iki klinik şikayettir.Sonuç: Türkiye'deki aile hekimleri iş yükü açısından ciddi baskı altındadır. Reçete talepleri bu iş yükünün önemli bir yüzdesini oluşturmaktadır. Bu yükü azaltmak için önlemler alınmalıdır

Amaç: Yaşlanma; canlının olgunlaşma süreci tamamlandıktan sonra fizyolojik yedek kapasitelerinin giderek azaldığı, yıprandığı ve buna bağlı olarak yaşam fonksiyonlarının aksadığı bir süreci ifade eder. Yaşlanma, geri dönüşü olmayan bir şekilde fonksiyon ve yeterliliklerde kısıtlanmaya neden olur. Yaşlıların sağlık durumlarını değerlendirmenin en kolay yollarından biri, düşkünlüğü gösteren ve objektif veriler sağlayan fonksiyonel değerlendirmenin yapılmasıdır. Kronik hastalıklarda ve yaşlılarda tedavi ve prognozun değerlendirilmesinde kullanmak amacıyla 1963 yılında Katz ve arkadaşları tarafından Günlük Yaşam Aktiviteleri (GYA) İndeksi geliştirilmiştir. Bu çalışmada amacımız; Katz Günlük Yaşam Aktiviteleri Ölçeği’nin Türkçe’ ye uyarlanması ve güvenilirliğinin değerlendirilmesidir.Materyal ve Metot: Çalışma; Eskişehir Osmangazi Üniversitesi Klinik Uygulamalar ve Araştırma Hastanesi Aile Hekimliği Polikliniği ve İç Hastalıkları Polikliniği’nde yürütüldü. Çalışmaya 173 yaşlı hasta dahil edildi. Örneklem hacminin belirlenmesinde, ölçekte yer alan soru sayısının en az 5-10 katı olması gereği dikkate alınarak hareket edildi.Bulgular: Çalışmaya 173 yaşlı dahil edilmiş olup, bunların 109' u kadın (%63,00), 64'ü erkekti (%37,00). Yaş ortalamaları 74,17±6,71 olarak saptandı (Kadınların yaş ortalaması 74,73±7,04 iken erkeklerin yaş ortalaması 73,21±6,05) idi. Çalışmaya dahil edilen tüm yaşlı hastaların ortalama Katz skoru 5,14±1,50 olarak hesaplandı. Yaşlı hastalardan %60,00’ı tamamen bağımsızken, %8,70’si ağır işlev bozukluğuna sahipti. Ölçeğin Cronbach Alpha katsayısı 0,83 olup bu değer ölçeğin güvenilir olduğunu gösterdi.Sonuç: Çalışmamız; Katz Günlük Yaşam Aktiviteleri Ölçeği’nin Türkçe güvenilirliğini göstermektedir. Bu çalışmayla birlikte yaşlıların işlev bozukluklarının değerlendirilmesinde Katz İndeksi’nin kullanılabileceği kanaatindeyiz. ileceği kanaatindeyiz., Objectives: Aging; refers to a process in which the physiological reserve capacities gradually decrease and become worn out after the maturation process of the creature has been completed, and accordingly the function of life is interrupted. Aging is the process of restricting function and competence in a way that is irreversible. In 1963, the Daily Living Activities (DLA) Index was developed by Katz et al. In order to be used in the treatment and prognosis assessment in chronic diseases and in the elderly. In this study, we aimed to evaluate the reliability and validity of the Katz Daily Activities Scale.Materials and Methods: The study was conducted in Eskisehir Osmangazi University Clinical Practice and Research Hospital Family Medicine and General Internal Polyclinics. A total of 173 elderly patients were included in the study. It has been taken into consideration that; the sample size should be at least 5-10 times the number of questions in the scale. Elderly patients were asked to answer the Turkish version of the questionnaire and were asked to report if they encounter confusing expressions.Results: A total of 173 elderly patients were included in the study, 63.00% of them were female, 37.00% were male (109 female, 64 male). The average age was 74.17 ± 6.71. (Mean age of women were 74.73 ± 7.04, mean age of men were 73.21 ± 6.05). The mean Katz score for all elderly patients included in the study was calculated as 5.14 ± 1.50. Of the elderly patients, 60.00% were completely independent and 8.70% had severe dysfunction. The Cronbach Alpha coefficient of scale was 0.83, indicating that the scale was reliable.Conclusion: Our study demonstrates the Turkish reliability of the Katz Daily Life Activities Scale. With this study, we believe that the Katz Index can be used in the evaluation of dysfunctions of the elderly.be used in the evaluation of dysfunctions of the elderly.

Amaç: Diyaliz hastalarında tedavidebaşarı; büyük ölçüde hastaların diyet, sıvı kısıtlaması ve ilaçları düzenlikullanmalarına bağlıdır. Hastaların diyet konusunda daha dikkatli oldukları,ancak ilaç kullanımı ve sıvı kısıtlamasına dikkat etmedikleri görülmektedir.Hemodiyaliz hastalarında mortaliteyi azaltmak için hastaların tedaviye uyumunuartırmak gerekir. Çalışmamızda hemodiyaliz tedavisi uygulanan hastalarıntedaviye uyumunu, hastalıkları hakkındaki bilgi ve motivasyon düzeylerinideğerlendirmeyi amaçladık.Materyal ve Metot: Çalışmaya 1 Mayıs - 30 Haziran 2017 tarihleri arasında hemodiyaliz tedavisi uygulanan 102hasta dâhil edildi. Hastaların bazı sosyodemografik özelliklerini, kliniközelliklerini ve son üç ay içindeki laboratuvar değerleri ile ilgili sorularıiçeren anket formu, yüz yüze görüşme yöntemi ile ilgili araştırmacılartarafından dolduruldu. Çalışmada; tedaviye uyumun değerlendirilmesinde ModifiyeMorisky Ölçeği kullanıldı.Bulgular: Hastaların 58’i (%56,90)erkek, 44’ü (%43,10) ise kadın idi. Hastaların yaşları 30-85 arasındadeğişmekte olup, ortalama 60,90±12,00 yıl idi. Hemodiyaliz hastalarında 88(%86,30) kişide yüksek motivasyon, 93 (%91,20) kişide yüksek bilgi düzeyitespit edildi. Yaş, öğrenim durumu, medeni durum, beden kitle indeksi, diyalizsüresi, böbrek nakli öyküsü ve diabetes mellitus varlığı ile hastaların bilgive motivasyon düzeyleri arasında ilişki saptanmadı. Kadınlarda bilgi düzeyierkeklere göre daha yüksek bulundu (p, Objectives: Success in treatment ofdialysis patients is largely dependent on the patient's diet, fluid restrictionand regular use of medications. Patients are more cautious about diet, but donot pay attention to drug use and fluid restriction. To reduce mortality inhemodialysis patients we need to improve the compliance of the patients. Weaimed to evaluate the level of knowledge and motivation about diseases andtreatment compliance of hemodialysis patients in our study.Materials and Methods: The studyincluded 102 patients who underwent hemodialysis treatment between May 1 - June30, 2017. A Questionnaire form including some sociodemographic characteristics,clinical features and laboratory values for the last 3 months of the individualswas applied with face-to-face interview method by the investigators. ModifiedMorisky Scale was used in the evaluation of treatment compliance in the study.Results: 58 (56.90%) of the patientswere male and 44 (43.10%) were female. The mean age of the patients ranged from30 to 85 years and the mean age was 60.90 ± 12.00 years. In hemodialysispatients, 88 (86.30%) people had high motivation and 93 (91.20%) people hadhigh level of knowledge. There was no correlation between age, educationstatus, marital status, body mass index, duration of dialysis, kidneytransplantation history and diabetes mellitus and the knowledge and motivationlevels of the patients. The level of knowledge in females was higher than males(p

Context Primary plasma cell leukemia (PPCL) is a rare hematological malignancy with an incomprehensible pathogenesis and a very aggressive course. Objectives Determining the risk factors that can cause the development of PPCL and affect its course was aimed. Design Four PPCL patients diagnosed at Gulhane Training and Research Hospital between March 2019 and June 2020 were evaluated in terms of laboratory and clinical course retrospectively. Patients or Other Participants The mean age of the patients at the time of diagnosis was 66 years (44–76), and males/females:1/1. None of the patients had a history of multiple myeloma (MM). Results Two patients presented with leukocytosis. Mean WBC was 59.625x103/mL (3800–197,000), average plasma cell in smear was 54.5% (20–100), mean plasma cell was 55,500x103/mL (600–188,000). Leukapheresis was applied to one patient. Anemia was detected in all, mean Hb was 9.9 g/dL. Thrombocytopenia was detected in 3 patients and mean platelet was 101x103m/L. Immunofixation results were IgG lambda in two, free lambda in one, and free kappa in 1 patient. Genetic results could not be reached. One patient was lost to follow-up and 3 patients were given bortezomib-cyclophosphamide-dexamethasone (VCD) in first-line treatment. Two patients died during follow-up, and mean survival was 77 days. One patient who was given 1 cycle VCD and 1 cycle lenalidomide-dexamethasone was lost to follow-up. ASCT could not be planned due to the short life span of the patients. Conclusion Incidence of PPCL is 0.4–1.2/million, progression from MM is seen in 0.5% cases. There is no difference between MM and PPHL in terms of CD38 and CD138 positivity, but CD56 is more frequently positive in MM and CD20 in PCL. CD27 positivity in PCL indicates increased anti-apoptotic activity. Discussion Approximately 150 multiple myeloma patients were followed up in our clinic between the same dates. Secondary PCL cases were not detected, and the fact that all of the diagnosed cases were PPCL created a picture incompatible with the incidence rates reported in the literature. Lambda monoclonality was shown in three of our patients, so it constitutes a feature for PPCL, unlike myeloma. Absence of genetic results is an important lack of our patients. More patients are needed for determination of risk factors in PPCL. It is necessary to identify poor prognostic indicators and urgently undergo transplantation in eligible patients using bortezomib-based treatment regimens.

Introduction Microbial contamination can be a marker for faulty process and is assumed to play an important role in the collection of hematopoietic progenitor cell (HPC) and infusion procedure. We aimed to determine the microbial contamination rates and evaluate the success of hematopoietic cell transplantation (HCT) in patients who received contaminated products. Patients-methods We analyzed microbial contamination records of HPC grafts between 2012 and 2015, retrospectively. Contamination rates of autologous donors were evaluated for at three steps: at the end of mobilization, following processing with dimethyl sulfoxide, and just before stem cell infusion. Grafts of allogeneic donors were assessed only before HCT. Result A total of 445 mobilization procedures were carried out on 333 (167 autologous and 166 allogeneic) donors. The microbiological contamination of peripheral blood (323/333 donations) and bone marrow (10/333 donations) products were analyzed. Bacterial contamination was detected in 18 of 1552 (1.15 %) culture bottles of 333 donors. During the study period 248 patients underwent HCT and among these patients microbial contamination rate on sample basis was 1.3 % (16/1212). Microbial contamination detected in nine patients (7 autologous; 2 allogeneic). In 8 of 9 patients, a febrile neutropenic attack was observed. The median day for the neutropenic fever was 4 days (0–9). None of the patients died within the post-transplant 30 days who received contaminated products. Conclusion The use of contaminated products with antibiotic prophylaxis may be safe in terms of the first day of fever, duration of fever, neutrophil, platelet engraftment and duration of hospitalization.