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CONTEXT: Although, many studies have been made on the clinical course of autoimmune thyroiditis, this study focused on women and the factors effecting the natural course such as Selenium. OBJECTIVE: The study aimed to determine Hashimoto’s thyroiditis (HT) clinical course in adults and the factors that could affect it. DESIGN: The study was in a retrospective manner between 2010-2018. SUBJECTS AND METHODS: 101 patients with HT were followed for 60.7±32.7 months. Biochemical and ultrasonographic data were collected. We investigated whether the age at diagnosis, family history, smoking habits, levothyroxine replacement therapy, and serum selenium (Se) levels influenced the disease course. RESULTS: No relationship was observed between age and thyroid functions, thyroid volumes (TV), and autoantibody (Ab) levels at diagnosis. Ab levels were irrelevant with TV, echogenicity, and nodularity at diagnosis. However, initial TSH levels were significantly associated with anti-TPO levels (p=0.028, r=0.218). In the untreated group, thyroid functions seemed to be stable. TV decreased significantly in both treated and untreated patients (p

PURPOSE: To determine the proportion of patients with undetected symptoms of overactive bladder by using the overactive bladder-validated 8 (OAB-V8) screening questionnaire and investigate these symptoms were undetected in female patients who were hospitalized. METHODS: We invited 2,250 female patients hospitalized in the Aegean region of Turkey to answer a self-administered questionnaire. The questionnaire included questions on evidence of lower urinary tract symptoms (OAB-V8), relevant medical history, and demographic data. Patients with a total OAB-V8 score≥8 were defined as having OAB symptoms. RESULTS: The proportion of patients with OAB symptoms in this study was 40.6%. Nearly 57% of the patients with OAB symptoms had not been previously admitted to any hospital for lower urinary tract symptoms (LUTS). The two most common reasons why women with OAB symptoms did not admit themselves to a hospital because of LUTS were as follows: "I did not think I had a disease" and "The symptoms did not bother me," with a response rate of 74.7%. The mean OAB-V8 scores of the patients with these two responses were significantly lower than those of the other patients (P

Aksu, Buket/0000-0001-7555-0603 WOS:000379543300024 Dexketoprofen trometamol is a sensitive molecule and consists of a fine, poor flowing, extremely adhesive powder that leaves behind gummed residue on the punch surface of the tablet press machine. The purpose of this study is to determine the optimum formulation utilizing different modeling techniques and the Quality by Design (QbD) approach without sticking problem during production. General full factorial design of experiments (DoE) was formed and the raw experimental data were evaluated using Minitab, artificial neural network (ANN) and gene expression programming (GEP) modules of the INForm. The Minitab, ANN and GEP modeling programs suggested the optimum formulations that should contain 2.03% and 2.50% glyceryl dibehenate by applying slug compression. However, in trial studies, the only lubricant that resolves the sticking problem was sodium stearyl fumarate. Therefore, new optimum formula trials have been performed by employing sodium stearyl fumarate at the same percentages instead of glyceryl dibehenate. All of the optimum formula analysis indicates that quality target product profile (QTPP) was met and the sticking problem was resolved.

Zorlamaya bağlı spontan sol varikosel rüptürü olgusu sunulmuştur. Zorlu dışkılama sonrası sol skrotumda şişlik ve ağrı yakınmasıyla gelen 21 yaşındaki erkek hastada varikosel rüptürü tanısı konuldu. Doppler ultrasonografi ile sol testiste hematom, sol testisi saran alanda kan akımı ve sol spermatik vende reflü akım izlendi. Hasta konservatif takip sonrası ameliyat edildi

Objective: Although urinary incontinence is not a life threatening disorder, it has beenshown to have detrimental effects on quality of life in terms of psychological, social andsexual problems. The aim of this study was to evaluate the effects of suburethral slingoperation on sexual function, incontinence and quality of life.Material and method: Twenty nine women were evaluated who underwent suburethral sling operation for stress and mixed incontinence from October 2005 to March2007. All women and their partners were sexually active. We evaluated all the women tion, McNeamer, chi square and t tests were used for the data analysis.Results: Mean age and FSFI scores of women were 50.4±8.8 years and 19.3 ± 10.7,respectively. According to total FSFI score (, Amaç:İdrar kaçırma yaşamı tehdit * 7. Ulusal Androloji Kongresi’nde (6-9 Haziran 2007) poster bildiri olarak sunulmuştur

Amaç: Çalışmamızın amacı, hastanemiz Acil Servisi’ne başvuran Karbonmonoksit (CO) maruz kalımlarının değerlendirilmesiydi. Gereç ve yöntem: Çalışmamızda 1993-2006 yılları arasında Acil Servisimize CO gazı maruziyeti nedeniyle başvuran hastaların dosyaları değerlendirildi. Hastaların yaşları, cinsiyetleri, maruz kalım nedenleri, mevsimlere gore CO gazı kaynakları, klinik bulguları, uygulanan tedavi yöntemleri, hastanede kalış süresi ve zehirlenmelerin sonuçları değerlendirildi. Bulgular: Soba kaynaklı CO maruz kalımları kış aylarında anlamlı oranda yüksekti (p=0,0017, χ2=9,826). Klinik bulgular çocuklarda (%53,6) ve erişkinlerde (%61,4) çoğunlukla hafifti. Orta şiddetli ve ciddi CO maruz kalım olguları, hafif CO maruz kalımlarına göre hastanede daha uzun süre izlendi (p=0,01). İlaç ve Zehir Danışma Merkezimizin Hiperbarik Oksijen Tedavisi (HBO) önerdiği ve HBO tedavisi alan hastalarda, hastanede kalış süresi, HBO tedavisi uygulanamayanlara göre daha kısaydı (p=0,01). Sonuç: Çalışmamızda CO maruz kalımlarında HBO alanlarda, Normobarik oksijen tedavisi (NBO) alanlara gore hastanede yatış süresi kısa bulunmasına karşın hasta sayısının az olması nedeniyle, HBO tedavisinin üstünlüğünü söylemek olanaklı değildir. CO zehirlenmesinde HBO tedavisinin NBO’e göre daha etkili olduğunun araştırılması için daha fazla hastanın dahil edildiği çok merkezli çalışmalara gereksinim vardır

Amaç: Çalışmamızda Prematür Ejakülasyon (PE) tanısı konulan hastaların klinik ve demografik özelliklerinin incelenmesi amaçlandı. Gereç ve yöntem: Kliniğimize erken boşalma nedeniyle Ocak-Haziran 2004 tarihleri arasında başvuran 53 hasta çalışmaya alındı. Hasta bilgilerine, cinsel işlev bozuklukları için oluşturulmuş Microsoft Access veri tabanından ulaşıldı. İlk cinsel ilişkiden itibaren PE yakınması olanlar Primer (PPE), yakınması daha sonra başlayan hastalar Akkiz PE (APE) olarak kabul edildi. Her iki grup yaş, eş yaşı, evlilik süresi, sünnet yaşı, nokturnal kontinans yaşı, PE süreleri, ilk koitus yaşı, ejakülasyon latans zamanı, ön sevişme süreleri, sistemik hastalıkları, uluslar arası prostat semptom skoru (IPSS), uluslar arası erektil fonksiyon indeksi (IIEF) ve Amerikan Ulusal Sağlık Örgütüprostatit (NIH-prostatit) skorları açısından karşılaştırıldı. Bulgular: Primer PE’li 27, APE’li 26 hastanın ortalama yaşları, sırasıyla 50,6 ± 12,3 (27–70 yıl) yıl ve 53,5 ± 10,4 (32–68 yıl) yıl olarak saptandı. Çalışmaya alınan hastaların 39’unda (%74) erektil disfonksiyon varlığı saptandı. Çalışmaya alınan hastaların ortalama sünnet yaşı 5,7 ± 2,6 (1–14) yıl, ilk koitus yaşı 19,0 ± 2,7 (13–29) yıl idi. Her iki grup arasında yaş, eş yaşı, evlilik süresi, sünnet yaşı, nokturnal kontinans yaşı, PE süreleri, ilk koitus yaşı, ejakülasyon latans zamanı, ön sevişme süreleri, IPSS, IIEF alt grupları ve NIH-prostatit skorları açısından anlamlı fark saptanmadı (p>0,05). Sistemik hastalık varlığı primer PE grubunda 9 hastada (%32) APE grubunda ise 19 hastada (%68) saptandı (p

ET ÖZET ÖZET Koroner arter hastalığı ile erektil disfonksiyon arasındaki ilişki belirgindir. Bu yazıda kavernozal arter darlığının sessiz fakat ciddi koroner arter hastalığını gösterebileceğinin ortaya konulması amaçlandı. Orta şiddette erektil disfonksiyon yakınması olan 56 yaşındaki hasta risk faktörleri açısından değerlendirildi. Hastanın yaş, sigara, hipertansiyon, hiperhomosisteinemi ve hiperlipidemi olmak üzere çok sayıda vasküler risk faktörü vardı. Penil Doppler ultrasonografide sağ kavernozal arterde çok sayıda darlık saptandı. Treadmill egzersiz testinde belirgin değişiklikleri olan hastanın yapılan koroner anjiografisinde iki damarda stenoz saptandı. Erektil disfonksiyonlu hastalarda penil Doppler ultrasonografi ile kavernozal arterlerde saptanan aterosklerotik plaklar subklinik koroner arter hastalığı habercisi olabilir

Amaç: Ağustos 2009-Mart 2010 tarihleri arasında kliniğimizde gerçekleştirilen laparoskopik ameliyatların sonuçları ve komplikasyonları geriye dönük olarak değerlendirildi. Gereç ve yöntem: Kliniğimizde Ağustos 2009-Mart 2010 tarihleri arasında 32 hastaya (17 erkek, 15 kadın) laparoskopik ameliyat uygulandı. Ortalama yaşları 51,7 ± 14,3 (1972) yıl olan hastaların 15’i renal kitle, 5’i nonfonksiyone böbrek, 4’ü üreter taşı, 3’ü sürrenal kitle, 3’ü üreteropelvik bileşke darlığı, 2’si böbrek kisti nedeniyle ameliyat edildi. Laparoskopik girişimlerin 19’u transabdominal, 13’ü ise retroperitoneal yöntemle gerçekleştirildi. Her iki yöntemde de ortalama trokar yerleştirme süresi 16,6 ± 3,0 dakikaydı. Bulgular: Transabdominal ve retroperitoneal tüm girişimlerin ortalama ameliyat süresi 173,3 ± 51,8 dakikaydı. Perop ve postop dönemde ortalama 0,8 ± 1,5 ünite eritrosit süspansiyonu kullanıldı. Hastalar ortalama 1,1 ± 0,3 günde mobilize edildiler. Ameliyat sonrası dönemde ağrı kesici olarak 2,3 ± 0,6 gün nonsteroid antiinflamatuar ilaç kullanıldı. Hastaların sondası ortalama 2,8 ± 2,8 günde, dreni ise 4,9 ± 3,0 günde çekildi. Hastanede ortalama kalış süresi 6,0 ± 3,1 gündü. Dört (%12,5) hastada (3 renal kitle, 1 sürrenal kitle) renal ven yaralanmasına bağlı kanama nedeniyle açık operasyona geçildi. Bu hastalara perop dönemde 2 ünite eritrosit süspansiyonu verildi. Sonuç: Laparoskopi öğrenme eğrisi uzun olan cerrahi bir tekniktir. Transabdominal ve retroperitoneal laparoskopik girişimler düşük morbidite ve komplikasyon oranları, yüksek hasta memnuniyeti ve kısa hastanede kalış süresi ile tercih sebebidir. Bu minimal invaziv yöntemin sunduğu avantajlardan, değişik patolojileri olan hastalar yararlanabilmektedir

İki Olgu Eşliğinde Peyronie Hastalığının CerrahiTedavisinde Penil Plikasyon YöntemlerininDeğerlendirilmesi

Educational research has shown that many secondary school students consider the subject of trigo-nometric functions as difficult and only develop shallow and fragmented understanding. It is un-clear which of the two popular approaches to introducing trigonometry, namely the ratio method and the unit circle method, works best. In this study we propose a new framework for trigonometric understanding and a new, dynamic geometry supported trajectory for learning trigonometric func-tions. We also report on the results of a classroom case study in which the new approach has been implemented and researched. We discuss the task-related difficulties that students faced in their concept development and we describe their trigonometric understanding in terms of our framework.

Masif plevral efüzyon toraks duvarı, diyafram ve akciğerin kompliyansına bağlı olarak toraks içi basıncı artırır bu da kardiyopulmoner fonksiyonlarda kısıtlanmaya neden olabilir. Biz bu çalışmada masif plevral mayi drenajı ile kardiyopulmoner fonksiyonlarda ne gibi değişiklikler olduğunu göstermeyi planladık.Çalışmaya kliniğimize 13.09.2012 ile 26.02.2013 tarihleri arasında başvuran torokoskopi endikasyonu konan toplam 20 masif plevral efüzyonlu hasta alındı. Hastaların 12'si Erkek, 8'i kadındı. Hastaların yaş ortalamaları 61,8 ± 10,9 du. Çalışmaya alınan 20 hastadan 11 hasta AC CA, 2 hasta Meme CA, 2 hasta Mide CA, 1 hasta HCC,1 hasta KKY, 1 hasta Kolon CA, 1 hasta Pankreas CA, 1 hasta Parapnömonik efüzyon idi. Hastaların torokoskop ile plevral mayi drenajından bir gün önce ve bir gün sonra solunum sayıları, nabız sayıları, sistolik ve diyastolik kanbasınçları ve kangazı ölçümleri yapıldı. Hastalara amelitayathane şartlarında video torokoskopiden hemen önce swan ganz kateter takılarak hastaların CVP, PCWB ve PAB değerleri torokoskopi öncesi ve sonrasında ölçüldü.Masif plevral mayi drenajı öncesi ve sonrası kıyaslandığında solunum sayısı, sistolik kan basıncında, solunum sayısında ,PO2, PAB, CVP ve PCWB da istatistiksel olarak anlamlı bir düşme görülmüştür (p < 0,05). Diyastolik kan basıncında, PCO2 ve nabız sayısın da ise anlamlı bir değişim görülmemiştir. (p >0,05).Sonuç olarak masif plevral kardiyopulmoner kısıtlamalara yol açmaktadır. Mayi drenajı ile pek çok kardiyopulmoner parametrelerde düzelme görülmektedir. Ancak plevral mayinin kardiyopulmoner fonksiyonlar üzerine asıl etkisini belirleyen durumunun plevral mayi miktarından çok plevral mayinin toraks içine yol açtığı basınç değişikliği olabilir.Anahtar kelimeler: masif plevral mayi, kardiyopulmoner fonksiyonlar, drenaj Massive pleural effusion ,depends on chest wall,diaphragm and lung compliance increase the intrathoracic pressure and this can cause cardiopulmonary functions restriction.In this study,we plan to show what kind of changes in cardiopulmonary functions with the massive pleural fluid drainage.This study,included a total of 20 patients who have massive pleural effusion with thorocoscopy indications between the period of 13.09.2012 - 26.02.2013 times in our clinic.12 patients were male and 8 were female.The mean age of patients were 61.8-10.9.The study of 20 patients;11 patients have lung ca,2 patients have breast ca,2 patients have gastric ca,1 patient have hcc,1 patient have congestive heart failure,1 patient have pancreas ca,1 patient have parapneumonic effusion.One day before and one day after the drainage of pleural fluid with thoracoscop, respiratory rates ,pulse rates ,systolic and diastolic blood pressures ,blood gas were measured.In the operating room conditions before the thoracoscopy, by the swan ganz catheter placement, patients CVP, PCWB and PAB were measured.Massive pleural fluid drainage, compared with pre and post, respiratory rate, systolic blood pressure, PO2, PAB, CVP and PCWB have a statistically significant decrease(p0.05).As a result, cardiopulmonary restrictions lead to massive pleural effusions. With the fluid drainage, improvements have seen in many cardiopulmonary parameters.However, the main effect of pleural fluid on cardiopulmonary function status than the amunt of pleural effusion, pleural fluid into the thorax maybe caused by the change in pressure.Anahtar kelimeler: Massive pleural effusion, cardiopulmonary functions, drainage 70

WOS: 000269782800005, PubMed: 19541303, Objective: To evaluate retrospectively the prevalence of cervical cytological abnormalities in patient records obtained from healthcare centers in Turkey. Method: Demographic characteristics and data on cervical cytological abnormalities were evaluated from patients who underwent flap tests in healthcare centers in 2007. Results: Data were collected from 33 healthcare centers totaling 140 334 patients. Overall, the prevalence of cervical cytological abnormalities was 1.8%; the prevalence of ASCUS, ASC-H, LSIL, HSIL, and AGC was 1.07%, 0.07%, 0.3%, 0.17%, and 0.08%, respectively. The prevalence of preinvasive cervical neoplasia was 1.7% and the prevalence of cytologically diagnosed invasive neoplasia was 0.06%. Conclusion: The abnormal cervical cytological prevalence rate in Turkey is lower than in Europe and North America. This might be due to sociocultural differences, lack of population-based screening programs, or a lower HPV prevalence rate in Turkey. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

WOS: 000264684800018, PubMed ID: 19198719, Objectives: To investigate the frequencies of risk factors and the prevalence of coronary heart disease (CAD) in heavy vehicle drivers. Methods: This cross-sectional type study was conducted between November 2004 and September 2006 in heavy vehicle male drivers registered with the Sivas Professional Drivers Association, Sivas, Turkey. From 400 individuals, 200 heavy vehicle male drivers, and 200 control subjects, 90% were reached for the sample. A questionnaire including sociodemographic specifications, body mass index (BMI), and risk factors for CHD was performed and some blood and physiologic parameters such as lipid profiles, fasting glucose level, resting ECG, were checked in all individuals; if required exercise ECG and angiography was performed. Results: The drivers' weight, body fat mass, triglycerides, very low-density lipoprotein, and BMI means were higher than the control group at a statistically significant level, and their mean high-density lipoprotein level, which is a protective factor for CAD, was lower than the control group at a statistically significant level. In the drivers' group, 9 of the 109 exercise ECGs (8.3%), and in the control group 3 of 61 (4.9%) were evaluated as abnormal. In 5% of the drivers, the exercise test was evaluated as positive and this prevalence was 1.7% in the control group (p=0.081). A total of 3.3% of the participants had a positive exercise ECG. Conclusions: Periodic health check-ups for heavy vehicle drivers would allow for the diagnosis of heart disease at an early stage and the initiation of necessary treatment. Health education for this group could also have a part in the decrease and elimination of some risk factors for CAD., The Scientific Research Committee Of Cumhuriyet University, Turkey (CUBAP), This study was financially supported by The Scientific Research Committee Of Cumhuriyet University, Turkey (CUBAP).

Purpose: The aim of this study was to evaluate treatment outcome, survival data and prognostic factors in patients with uterine sarcoma treated by postoperative radiotherapy. Materials and Methods: The records of 46 patients treated between 1993 and 2003 were reviewed. Median age was 55 (range 31-75). There were 21 mixed mullerian tumors, 12 leiomyosarcomas, 11 endometrial stromal sarcomas and two adenosarcomas. According to FIGO classification 65.2% were Stage I, 17.4% Stage II, 13% Stage III and 4.3% Stage IV. All patients received external radiotherapy with 1.8 Gy daily fractions up to 50.4-64 Gy (median 50.4 Gy). Intracavitary brachytherapy was applied to 39 patients. Twelve patients received adjuvant chemotherapy. Results: Median follow-up time was 48 months (6-144 months). Seventeen patients (37%) developed distant metastases and one patient had local failure. Five-year overall, disease-free and local recurrence-free survival rates were 57.8%, 60.5% and 97.8%, respectively. Univariate analysis demonstrated that stage (p = 0.011), histologic subtype (p = 0.010), tumor size (p = 0.044), positive peritoneal cytology (p = 0.006) and the use of chemotherapy (p = 0.005) had a significant effect on overall survival. Prognostic factors influencing disease-free survival were stage (p = 0.009), positive peritoneal cytology (p = 0.000) and the use of chemotherapy (p = 0.002). The only prognostic factor affecting local control was stage (p = 0.000). Conclusion: Postoperative radiotherapy seems to be an effective adjuvant treatment providing high local control rates in uterine sarcomas. However its efficacy should be clarified by randomized trials. The important prognostic factors influencing the treatment results were stage, histologic subtype, tumor size and positive peritoneal cytology.

Recently, different results have been reported that epidural analgesia prolongs labor, increases instrumental vaginal delivery and operative delivery. The purpose of the present study was to determine the effects of the epidural analgesia on the progress of labor and labor outcome at different degrees of cervical dilatation. After approval by the ethical committee, a total of 136 patients scheduled for vaginal delivery were divided into 2 groups. Each group divided into 3 subgroups according to the degree of cervical dilatation. In these subgroups; the degree of cervical dilatation was < 4 cm in group Ia and IIa, 4-5 cm in group Ib and IIb and >5 cm in group Ic and IIc. Epidural catheters were placed for analgesia in group I. Group II was not given any analgesic therapy during labor. Group I parturient received an epidural injection of 12.5 mg (0.125 %) bupivacaine + 50 µg fentanyl. Then they received 0.125 % bupivacaine with 2.5 µg ml-1 fentanyl via patient controlled analgesia (PCA). Patient controlled epidural analgesia (PCEA) background infusion was launched at a rate of 10 mL hour-1. Patients receiving PCEA were allowed to administer themselves a bolus dose of 5 mLevery 30 min as needed. Demographic data, number of pregnancy, degree of cervical dilatation, latent and active phases of the-labor (in the first and in the second stage), and duration of total stage of the labor was recorded. Additionally, systolic- diastolic blood pressure (SBP-DBP), fetal (FHR) and maternal (HR) heart rates and peripheral oxygen saturation (SpO2) were also assessed. However, duration of the first and total stage of the labor was found significantly shorter in epidural subgroups duration of latent phase of the labor was similar between two groups. (p < 0.05). Although duration of the second stage of the labor was found shorter in all epidural subgroups, it was statistically not significant. It was found that the incidence of instrumental vaginal delivery and frequency of Caesarean section was not significant between two groups. In conclusion; epidural analgesia applied at different cervical dilatations, shortened the duration of the first stage and total duration of the labor, but it did not change the duration of the second stage of the labor. Epidural analgesia did not cause an increase in the incidence of instrumental vaginal delivery and the frequency of Caesarean section.