Makale Arama

AIM:  In the present study, we aimed to evaluate the effect of blood pressure regulation on sleep quality in the hypertensive subjects and determine blood pressure parameters related with poor sleep quality.

METHOD AND MATERIALS: Our study is a cross-sectional study including 90 hypertensive subjects at age between 35 and 65 years. The patients were performed 24-hour ambulatory blood pressure monitoring and divided into those with regulated blood pressure group and poor blood pressure control group. Sleep quality was checked before the ambulatory blood pressure monitoring by using Pittsburgh sleep quality test. Statistical analyses were performed with SPSS 13.0 packet program.

MAIN FINDINGS: Global Pittsburgh sleep quality index (PSQI) scoring were similar in both groups and when components of the sleep quality were evaluated, daytime dysfunction was significantly higher in patients with poor blood pressure control compared to patienst with regulated blood pressure (1.0±0.9 versus 1.4±1.0, p=0.05; respectively ). Global PSQI score did not show significant correlation with arterial blood pressure leveles, pulse pressure, and systolic blood pressure levels. However, night diastolic pressure levels were weakly correlated with global PSQI scoring (r=0.16, p=0.04). Only diastolic non-dipper status was found as independent predictor of poor sleep quality as a result of logistic regression analysis (Odds: 3.21 (CI: 1.51-7.72), p=0.03).

CONCLUSION: In the present study, sleep quality was markedly impaired in hypertensive patients and diastolic non-dipper was determined as an independent predictor of poor sleep quality. It seems important to assess sleep quality in patient with diastolic non-dipper at ambulatuary blood pressure evaluation, especially for detection of poor sleep status.    

\r\n Aim: The aim of this study is to determine the relationship between pregnancy outcomes and histopathology examination of the intended placenta and umbilical cord specimens.

\r\n Patients and Methods: 112 placenta materials were scanned as retrospective in an archive of Usak University Education and Research Hospital of Pathology Department. Term placentas measurement were based on Kaufmann’s Pathology thus; 37-40 week, size 18 cm, weight 350-750 gr, thickness 2-2,5 cm. Umbilical cord's vessel number, membrane structure, chorioangioma, infarct, hematoma, hemorrhage were recorded. Infarct, chorioamnionitis, subchorionic fibrin deposit, congestion of chorionic vessel, subchorionic hemorrhage, corangiosis, chorioangioma, calcification, perivillous fibrin deposit, an effect of meconium, fibrinoid necrosis, villitis, ectasia of a chorionic vessel were detected as histopathologic findings. Gender, mode of delivery, maternal disease, birth weight, maternal age, parity, birth length, head circumference, APGAR between 0-9 were recorded.

\r\n Results: 112 placentas; 4 of 29 (13,7%) placental infarct, 2 of 19 (10,5 %) placental corangiosis, one of 17 (5,8%) subchorionic haemorrhage, 2 of 29 (6,8%) chorioamnionitis, one of 12 (8,3%) umbilical cord congesione cases were detected with abnormal pregnancy outcomes. Statistically significant results were found between subchorionic haemorrhage and placenta size (P = 0, 004), maternal age and umbilical cord dimension (P = 0, 0001), birth weight and placenta and umbilical cord dimensions (p = 0.000). However, no association was found between these parameters and pregnancy outcomes. Relationship between baby weight and placenta and umbilical cord size was determined in diabetic, preterm, ablatio placenta, and stillbirths and pregnancies. No significant association was found between histopathologic findings and pregnancy outcomes.

\r\n Conclusion: When placenta and umbilical cord specimens are evaluated, the location and size of the lesion should be indicated along with the presence of the lesion in order to explain regular clinical follow-up and adequate anamnesis as well as the effect on the pregnancy outcome.

Introduction: Patients with neurological diseases may require intensive care support as a result of respiratory failure due to various reasons. Some of them benefit from intensive care supportive treatment while others continue to live as caregivers or need rehabilitation programs. It is important for the rational use of intensive care beds that the routing process to the palliative care, rehabilitation centers or discharge of patients with prolonged treatment in the intensive care unit should be managed well

Materials and Methods: We retrospectively evaluated the data of our patients who were hospitalized with the diagnosis of primary neurological diseases in the intensive care unit and terminated with exitus or referred to home / palliative care between January 2017 and May 2018 with the permission (17073117-050.06 decision no) of XXXXXXXXXXXXXXX scientific studies committee. Patients who transferred to other clinics were excluded from the study. APACHE II/SAPS II scores, hospitalization day, mechanical ventilation time, tracheostomy and percutaneous endoscopic gastrostomy requirement, home ventilator supply and the situation of discharge from intensive care unit of patients were recorded

Results: A total of 942 patient files were reviewed retrospectively and 74 (7.8%) of our patients were neurological patients who were died or discharged to directly home\palliative care. Most of the patients in the study had severe dementia (30 patients, 40.5%) and fewer number of patients had ischemic stroke (21 patients, 28.3%). Sixty of the 74 patients (81.1%) died in the intensive care unit. Only 5 patients were transferred to palliative care (6.8%).

Conclusion: Increasing transfer from intensive care to palliative care is important for the effective use of intensive care beds. Therefore, it is suggested that intensive care patients should be evaluated periodically to be directed to palliative care

Aim: Accelerated Ponseti technique is aplication of manipulation and casting the clubfoot patients more frequent than the weekly technique. The aim of this study is to compare two different accelerated ponseti techniques applied to clubfoot patients.

Patients and techniques: Twelve patients (19 feet) treated with the accelerated Ponseti technique for severe clubfoot between September 2018 and April 2020 were included in the study. The patients were divided into 2 groups as group A and group B. Group A had casting twice a week  and Group B had 1st casting in first day of the treatment, with the 2nd, 3rd, 4th, 5th castings in the 4th, 5th, 6th, 7th day post-manipulation

Results: 6 patients ( 9 feet) were in group A, 6 patients ( 10 feet) were in group B. There was no significant difference regarding ages of patients’ between groups (P=0.206). There were no significant difference between groups regarding Pirani score after final cast removal (P=0.856) and after 6 weeks (P=0.930).

Conclusions: Although there is no definite interval determined for the accelerated Ponseti technique, successful results were obtained as a result of the techniques applied in the present study.

Aim: Gastric cancer is one of the leading causes of cancer-related deaths. Tumor budding has been
shown to be a prognostic factor in many cancers. In this study, we aimed to evaluate the prognostic
significance of tumor budding in intestinal-type gastric adenoc arcinoma.
Patients and Methods: A total of 152 cases diagnosed as intestinal type gastric adenocarcinoma in
the Pathology Clinic between 2015 and 2021 were included in the study. Tumor budding was grouped
as low, medium and high. Hematoxylin and eosin-stained slides were re-evaluated in terms of tumor
differentiation, lymphovascular invasion (LVI), perineural invasion (PNI), lymph node involvement, depth
of invasion (pT) and tumor budding.
Results: Tumor budding was low in 30.9% (n=47) of the subjects included in the study, moderate in 37.5%
(n=57) and high in 31.4% (n=48). Statistically, as tumor budding increased, tumor size increased (p<0,05),
follow-up times were shortened, survival time (p<0,05), and tumor differentiation (p<0,05) decreased. A
statistically significant correlation was observed between tumor budding and LVI (p<0,05), PNI (p<0,05),
pT(p<0,05), lymph node involvement(p<0,05), and mortality of the cases (p<0,05). No statistically
significant correlation was observed between tumor budding and gender, age, tumor localization and
operation type (p>0.05).
Conclusions: Tumor budding is associated with poor prognostic factors. As it may be important to guide
the treatment modality and follow-up, tumor budding status may be mentioned in routine pathology reports.

Aim: Objective of this study was to investigate the endoplasmic reticulum (ER) stress and apoptosis mediated anticancer ef fect of boric acid in human pancreatic cancer MIA PaCa-2 and P ANC-1 cells. Materials and Methods: The effect of boric acid on the viability of pancreatic cancer cells and the IC50 value were calculated by XTT test and using CompuSyn version 1.0 software. Apoptotic, anti-apoptotic and ER stress-related gene levels were determined. The effect of boric acid on the colony formation capacity of these cells was evaluated with the colony formation assay.
Results: Boric acid inhibited cell viability in these cell lines as time and dose dependent. As a result of the XTT test, the IC50 doses of boric acid in MIA PaCa-2 and PANC-1 cells were found to be 15707.5 and 14248.8 μM, respectively. Boric acid significantly upregulated BAX, CASP3, CASP8, CYCS and FAS expression, which are the genes associated with apoptosis in both cell lines. CASP9 and FADD gene levels were significantly elevated only in PANC-1 cells. It was observed that boric acid statistically upregulated the expression of ATF4, HSP47 and XBP1 genes associated with ER stress in both cell lines. In addition, boric acid treatment significantly increased ATF6, CHOP and EIF2A expressions only in PANC-1 cells. Boric acid also caused an increase in GRP78 gene expression in MIA PaCa-2 cells. Colony formation test results illustrated that boric acid significantly suppressed co lony formation capacities in both cell lines.
Conclusion: Boric acid reduced cell viability and colony formation in both human pancreatic cancer cells and changed gene levels in apoptosis and ER stress pathways. Findings suggested that boric acid exhibits anticancer activity in human pancreatic cancer cells v ia ER stress and apoptosis.

Aim: Cardiovascular events, including ventricular arrhythmias and sudden cardiac death (SCD), are the primary source of death in hemodialysis (HD) patients. Checking ECG parameters such as QT interval, QT dispersion (QTd), TPe interval, TPe/QT ratio, and cardiac-electrophysiological balance (iCEB = QT/QRS) can be useful for classifying patients with high arrhythmia and SCD risk. Our study aimed to compare the change of electrocardiographic parameters before and after the HD session with the healthy control group.

Methods: A total of 49 HD patients and 50 healthy volunteers were included in the study. The groups were divided into two groups as hemodialysis and control group. ECGs of the hemodialysis group were evaluated before and after dialysis. ECG data were scanned and evaluated on a digital platform. QT, cQT, QTd, TPe, TPe/QT, TPe/cQT, QT/QRS, and cQT/QRS were measured.

Results: While QTd, cQTd, TPe, TPe / QTc, and QRS decreased significantly after hemodialysis compared to pre-HD(p <0.05 for each), HR, iCEB, and iCEBc showed a significant increase after dialysis treatment (p <0.05 for each). Comparing pre-dialysis ECG parameters with the control group, QT, cQT, QTd, cQTd, TPe and iCEBc were significantly higher in pre-HD (p <0.05 for each). Comparing the ECG parameters after dialysis, HR, cQT, QTd, cQTd, iCEB, and iCEBc values were significantly higher than the control group (p <0.05 for each).

Conclusion: By evaluating the electrocardiographic parameters showing ventricular repolarization and depolarization together, the risk of arrhythmia and sudden cardiac death can be predicted in HD patients.

Bleeding can not be absolutely terminated in spite of conventional techniques of hemostasis. In order to investigate the effect of  Ankaferd Blood Stopper^® (ABS) on persisting bleeding after conventional hemostasis, we applied topical ABS spray or plasebo on orthognatic surgery (n=19). Substances were applied to the surgical field after  conventional methods of hemostasis. In orthognatic surgery group, the association of blood loss with the operation type, age, gender, ABS usage, duration of operation and blood pressure   was analyzed. The rates of Hb and Htc decline was % 25 in ABS group and % 19 (Hb), % 20 (Htc) in placebo group. The only significant association was with gender indicating a higher blood loss with being male (p=0,01). In conclusion, this study did not reveal any ABS effect on bleeding from the surgical site persisting after  conventional hemostasis.

Aim: In autologous breast reconstruction, there is pain in the recipient site due to rib cartilage intervention in the postoperative period. In this study, we aimed to reveal the effect of the rib-sparing internal mammarian vessel approach on postoperative pain in breast reconstruction by comparing it with the noncostal-sparing approach.
Patients and Methods: Between 2018 and 2022 twenty five patients underwent surgery were included in the study. Groups were divided according to internal mammary artery(IMA) exposure techniques. Group 1: Patients who underwent rib-sparing surgery(n=9), Group 2: Patients who underwent rib cartilage resection(n=16). Patient Controlled Analgesia(PCA) pump usage time, morphine dose used, and early and late pain scores were noted in both groups in the postoperative period.
Results: The mean age of the patients was 49.8 years. No complications were encountered in the early and late postoperative period. All flap transfers were successful. Mean PCA duration was 24±1.41 hours in group 1 and 26.31±1.62 hours in group 2. The dose of morphine was 9.67±1 mg in group 1 and 23.93±3.02mg in group 2. The early pain score was 2.89±1.16 in group 1 and 5.18±1.22 in group 2. Late pain scores were 2.11±0.98 in group 1 and 2.75±0.77 in group 2.
There was a statistically significant difference between the morphine dose and early pain scores of the groups (p<0.01). There was no significant difference between the duration of PCA use (p=0.3) and late pain scores (p=0.07) (p>0.05).
Conclusion: In conclusion, we think that costal sparing surgery significantly reduces pain in the early period during recipient site preparation in autologous breast r econstruction.

Aim: To compare the vascular densities (VDs) of macular microvascular (MMV) and radial peripapillary
capillaries (RPC) according to Erectile dysfunction (ED) in non-ocular Behçet's (NOB) patients, and to
examine the correlation between the patients' International Index of Erectile Function (IIEF)-15 scores in 5
different sexual function domains and the values measured by OCT -A.
Patients and Method: This cross-sectional study was conducted between April 2019 - March 2020. Of the
94 male Behçet's patients, 23 without eye involvement and who met the inclusion criteria were included in
the study. The control group consisted of 25 age-matched healthy individuals. Values measured by optical
coherence tomography angiography (OCT-A) were compared between patients with and without ED and
controls. The correlation between the patients' scores in 5 different sexual function domains of the IIEF-15
questionnaire and those measured by OCT -A was examined.
Results: Compared to controls, VDs were reduced in the whole area of the deep capillary plexus in both
patients with and without ED. VDs of all vessels of the whole area in the RPC network were also decreased
in EDs compared to controls and non-EDs. In addition, retinal nerve fiber layer (RNFL) thicknesses in the
inferior quadrant were found to be decreased in patients with ED compared to controls and those without ED.
In the correlation analysis between NOB patients' scores in 5 domains of IIEF-15 and OCT-A measurements,
there was a positive correlation between the RNFL thickness values and VDs of all vessels in the whole area
of RPC, and the scores in 4 domains of IIEF-15.
Conclusions: After excluding factors that may cause ED, MMV and RPC VDs and RNFL inferior quadrant
thicknesses were found to be decreased in NOB patients with ED. In addition, a correlation was found between
IIEF-15 scores in sexual function domains and RPC VDs and RNFL thicknesses of NOB patients.

Aim: Gallbladder cancer is an uncommon, but aggressive tumor. Its prognosis is poor and the most cases are incidentally detected in histopathological examinations of cholecystectomies due to benign diseases. With the era of laparoscopic cholecystectomy, the number of cases detected in early stage is increasing. In this study, we aimed to evaluate the rate of cancer encountered and the distribution of non-cancer diagnoses in cholecystectomy materials sent to our department, together with the literature findings.

Materials and Methods: The results of the cholecystectomy materials sent to the pathology laboratory and examined routinely in 2016-2017 were retrospectively evaluated by forming diagnostic groups. Clinical preliminary diagnoses, demographic informations (age, sex), and pathology reports of the patients were reviewed.

Results: We included a total of 1000 cholecystectomy materials into the study. Two of the 7 patients who presented with malignancy were incidentally diagnosed and underwent laparoscopic cholecystectomy with the preliminary diagnosis of cholelithiasis, with the primary focus was gallbladder in one patient, and the other was compatible with colonic adenocarcinoma infiltration. Preoperative and / or perioperative malignancy was detected in the remaining 5 patients. A large proportion (> 90%) of the other cases had chronic or chronic active cholecystitis and low rate of acute cholecystitis included gastric heterotopia found in 2 (0.2%), tubular adenoma in 1 (0.1%), tubulovillous adenoma in 1 (0.1%), adenomyoma / adenomyomatosis in 4 (0.4%), polyp in 6 (0,6%) and dysplasia (Biliary intraepithelial neoplasia, BilIN) in 5 (0.5%) patients.

Objective: The aim of our study is evaluate the association between serum vitB12 levels at time of diagnosis and clinical and laboratory signs in multiple myeloma patients.

Material and Methods: Patients were divided into two groups; those had low and normal levels of vitB12. Groups were analized by using independent simple T, Mann Whitney U and chi-square tests considering by distrubition characteristics of data.

Results: Two hundred-and-twelve patients' records were examined retrospectively. Forty-one (32%) patients had low vitB12 levels. In patients with low vit B12 levels, bone marrow plasma cell ratios were also significantly lower than those found normal vit B12 levels (median %30 vs %50, respectively) (p: 0,024). There was no statistically significant difference between the two groups in terms of age, lytic bone lesion numbers, and serum levels of total protein, lactate dehydrogenase, ß2-microglobulin, calcium, creatinin, albumin. However, 11 patients (%26,8) in low vitB12 group had anemia, while 44 (%50,5) patients in normal vitB12 group had. So, anemia was more often in vitamin B12 normal group patients (p: 0,019). No difference was found in terms of myeloma ISS and R-ISS stages in two patient groups.

Conclusions: Bone marrow median plasma cell ratio was also low in the group with low vit B12 levels. Our data could not show its clinical reflection. Further studies with larger groups are required to evaluate the response to treatment, survival and recurrence rate.

Aim: Thyroid Hormone Receptor Interacting Protein 13 (TRIP13) is a protein involved in spindle-aggregation checkpoint, which plays a role in meiotic recombination. Recent studies have revealed that TRIP13 may be a potential tumor inducer in many cancers, including glioblastoma multiforme (GBM). We aimed to investigate the anticancer activity of DCZ0415, a small molecule inhibitor of TRIP13, in U87 human GBM cells in this study.

Materials and Methods: The possible anticancer effect of DCZ0415 on U87 cells was determined by cytotoxicity, colony formation, and apoptosis assays. In addition, the effects of DCZ0415 on mRNA levels of genes which were involved in apoptosis, invasion and Transforming Growth Factor-Beta (TGF-β) signaling pathway were investigated by qRT-PCR analysis.

Results: DCZ0415 inhibited U87 cell proliferation in a dose and time dependent manner. The IC₅₀ dose of DCZ0415 for 48 hours was determined as 19.77 µM in U87 cells. DCZ0415 treatment at this dose induced apoptosis and suppressed colony forming abilities of U87 cells. In addition, DCZ0415 altered mRNA levels of genes associated with apoptosis, invasion and TGF-β signaling pathway, which could lead to anticancer effects.

Conclusion: DCZ0415, an inhibitor of TRIP13 which has been evaluated as a new oncogenic factor in cancer, has an anticancer effect on GBM cells. In this respect, it is thought that TRIP13 may be an important therapeutic target for GBM and DCZ0415 may be considered as an effective inhibitor that causes anticancer effects in GBM cells.

Abstract:

Objective: Our objective in this study was to present our four years of experience in laparoscopic surgery for urinary system accompanied by literature.

Material and Methods: Between January 2014 and October 2018, laparoscopic surgical intervention was made on urinary system for 97 patients in our clinic. 54 patients had right and 42 patients had left laparoscopic surgical intervention and 1 patient had radical prostatectomy. Patients were retrospectively examined for operation duration, average blood loss, intraoperative and postoperative complications, hospitalization duration and drain installation time after separating into two groups as right and left.

Results.

Average age of the patients was 44(16-67). Male/Female rate was 54/43. Apart from radical prostatectomy, 54 patients had right and 42 patients had left kidney laparoscopic surgical intervention. Average operation duration was 145 (40-210) minutes, average drain removal time was 3.1 (1-10) days, hospitalization duration was 3.4 (1-14) days and bleeding amount was 150(20-500) cc in all interventions. Lengthened urinary drainage was observed from the drain in one patient who had pyelolithotomy and one patient who had radical prostatectomy. When all interventions were considered, the average complication ratio was found 5.1%. No differences were observed in the parameters compared among right and left laparoscopic surgery interventions.

Conclusion: For a surgeon in the first learning phase of laparoscopy, choosing relatively simpler procedures in the beginning but passing to more complex operations without much delay may quickly shorten the learning phase. Through the selection of suitable patients and adequate equipment, laparoscopic surgery can also be applied safely in peripheral centers.

\r\n Aim:  In this study, we aimed to evaluate the effect of pupillary dilatation on intraocular pressure values and corneal biomechanical properties using Ocular response analyzer in eyes with primer open angle glaucoma.

\r\n Patients and Methods:  Goldmann correlated intraocular pressure, corneal corrected intraocular pressure, corneal hysteresis and corneal resistance factor were all respectively evaluated in 28 eyes of 15 patients with primary open angle glaucoma before and 30 minutes after tropicamide 0.5% instillation.

\r\n Results: Their mean age was 57.7±13.2 years (range 45–65 years). The mean corneal hysteresis, corneal resistance factor, Goldmann correlated intraocular pressure and corneal corrected intraocular pressure measurements of the eyes were 9.5±2.2 mmHg, 10.1±2.1 mmHg, 16.2±2.8 mmHg, 17.2±3.6 mmHg before tropicamide instillation, and 9.7±2.2 mmHg, 10.1±2.0 mmHg, 16.9±3.5 mmHg, 18.2±4.0 mmHg after tropicamide instillation, respectively. There was statistically significant difference between pre- and post-tropicamide instillation for Goldmann correlated intraocular pressure and corneal corrected intraocular pressure (p=0.043, p=0.015, respectively; paired t-test) while no statistically significant difference was found for corneal hysteresis and corneal resistance factor (p=0.057 p=0.702, respectively; paired t-test ).  

\r\n Conclusion: Pupillary dilatation with 0.5% tropicamide seems to have a decreasing effect on on intraocular pressure while no effect was noted for corneal biomechanical properties in primer open angle glaucoma patients.

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Aim: Irisin molecule is in the group of myokins, it is released from muscle cells and a messenger between
muscle and fat tissue. It is shown that irisin peptide has an important role in insulin resistance, glucose and
energy metabolism. In our study we aimed to show irisin molecule's relationship with glucose metabolism.
Patients and Methods: The study included 29 newly diagnosed type 2 diabetes mellitus patients, 41
newly diagnosed prediabetes patients and 28 healthy control groups who applied to the Internal Medicine
Outpatient Clinic between April 2017 and September 2017. Serum irisin levels, laboratory findings and
metabolic parameters were measured and recorded.
Results: The mean plasma irisin level of the type 2 diabetes mellitus patient group was statistically
significantly higher than the prediabetic patients and the control group (p=0.015 p<0.001). Although the
mean plasma irisin level of prediabetic patients was higher than the control group, no significant difference
was found. A statistically significant correlation was found between plasma irisin level and plasma fasting
glucose, HbA1c, total cholesterol, LDL, TG in a positive way and HDL in a negative way .
Conclusion: Our study supports that plasma irisin increases in a compensatory response to the increased
insulin resistance in Type 2 DM patients in a way that regulates glucose metabolism. Although in our
study the mean irisin level in prediabetic patients was higher than the control group, no statistically
significant difference was found between the two groups. Even tough irisin is thought to have positive
results on insulin resistance, studies that larger and consider more different variables are needed in order
to understand its ef fect more clearly .

Amaç: Sağlıklı bireylerde yaş ve cinsiyetin ganglion hücre kompleksi ve retina sinir lifi kalınlığı üzerine etkisinin RTVue optik kohorens tomografi ile değerlendirilmesi

Hastalar ve Yöntem: Yaşları 10-84 arasında değişen 393 sağlıklı katılımcıyı bu kesitsel çalışmada değerlendirdik.  Yaşa bağlı değişikler  lineer regresyon  analizi ve Pearson korelasyon analizi ile incelendi. Retina sinir lifi kalınlığı ve ganglion hücre kompleksi arasındaki ilişki pearson korelasyon testi ile değerlendirildi.

Bulgular: Tüm populasyonun ortalama retina sinir lifi kalınlığı 108.94±9.77 µm idi ve  yıllık  0.101 µm  (95% güven aralığında , -0.151, -0.051; lineer regresyon analizi ile, p<0.001) azalmaktaydı. En önemli azalma üst temporal bölümde ve yıllık 0.197 µm  (0.197 µm/yıl, 95% güven aralığı, -0.293, -0.101; lineer regresyon analizi ile, p<0.001) olarak görüldü. Üst kadran hariç retina sinir lifi kalınlığında cinsiyete göre fark bulunamadı. Ortalama ganglion hücre kompleksi kalınlığı 97.45±6.42  µm olarak bulundu ve her yıl  0.043 µm azalmaktaydı (95% güven aralığında, -0.079, -0.007; lineer regresyon analisi ile, p=0.019). Cinsiyetle ganglion hücre kalınlığı arasında bir ilişki bulunmazken retina sinir lifi ile ganglion hücre kompleksi arasında anlamlı korelasyon tespit edilmiştir (p<0.001 ve r=0.630).

Sonuç: Retina sinir lifi kalınlığı ve ganglion hücre kompleksi kalınlığı yaşla birlikte önemli ölçüde azalmaktadır ancak ganglion hücre kalınlığı daha az etkilenmektedir. Ek olarak bu çalışmada ganglion hücre kalınlığı ve retina sinir lifi kalınlığı RTVue veri tabanından yüksek bulunmuştur. Bu fark tanıda gecikmeye neden olabileceğinden dikkate alınmalıdır.

Objective: Feeding gastrostomy is generally needed in the cases of oropharnyngeal dysphagia. The objective of this study is to analyze the use of surgical gastrostomy with mini laparatomy under local anaesthesia in situations where endoscopic procedure is not possible.

Methods: Stamm gastrostomy was performed in 62 patients in whom oral and nasogastric tube feeding could not be given and percutaneous endoscopic gastrostomy could not be performed.

Results: A mean age of 63.7 years and 83.9% of them were ASA IV. The indications for gastrostomy were tumour obstruction, neuromuscular diseases, paralysis and cerebrovascular bleeding, oesophageal injury, metastatic tumours and hypoxic encephalopathy in 51.6, 17.7, and 16.6, 1.6 and 12.9% respectively. The mean operation duration was 34 ± 12.8 minutes. Procedure-dependent hospital morbidity and mortality were low (% 16.2- % 14.5, respectively).

Conclusion: Stamm gastrostomy with mini laparatomy under local anaesthesia is an effective alternative in situations where percutaneous or endoscopic procedures cannot be done. It can be performed in high-risk patients safely due to its short operation time, low morbidity and mortality.

Objectives:

Customer satisfaction surveys are a routine device used to assess performance. Surveys are used in hospitals to check physician and patient satisfaction. Hamad Medical corporation’s (HMC) histopathology laboratory is College of American pathologists (CAP) accredited with highly trained pathologists and technical staff that routinely undertake various educational courses and are involved in research related activities. The lab has state of the art staining and immunohistochemistry service as well. However, it was felt that not all clinicians are very comfortable approaching pathologists and some many times experience problems either contacting lab staff or updating histopathology orders. Hence to narrow down the problems encountered by the clinicians and improve the specimen flow through the lab along with the communication between clinician and pathologist, that we deem vital, we designed this pilot survey.

Methods:

The survey questionnaire was made online with 15 questions in total and the link was electronically mailed to all Consultant and Specialist physicians in Hamad medical corporation (HMC). Around 3500 emails were sent out but only 105 surveys were filled in two months’ time. The survey included questions pertaining to multiple facets of quality of histopathology services and information regarding the participant.

Results:

The overall satisfaction was highest for Multidisciplinary presentations (96%) and lowest (77%) for timeliness of reporting. The satisfaction was above 90% for clarity and format, Diagnostic accuracy and pathologists’ responsiveness to problems. Thirty six percent of the people rated MDT presentations as excellent while 46% of the people thought overall quality of professional interaction was good. The areas of improvement, as per this survey, was timeliness of reporting and notifications of significant abnormal results (overall satisfaction 79%). Majority of the people who took the survey (36%) were from internal medicine and half were members of multidisciplinary meetings (49%). Seventy-one of percent of the participants were from Hamad General hospital (HGH), while rest were from the other hospitals under HMC.

Conclusion:

The response rate for the survey was low, hence another survey with a wider reach, preferably by paper, is required to get more representative data. In general, the clinicians at HGH are satisfied with the services provided by the histopathology laboratory. Areas of improvement include Turnaround time (TAT), avoidance of descriptive reports and better communication with the ordering clinician.

Keywords:

Quality control, quality improvement, survey, histopathology, Laboratory

Aim: This study aimed to determine the demographic and clinical characteristics of patients infected with the VOC 202012/01-B.1.1.7 variant of SARS-CoV-2 and to compare these patients with those infected with other variants of SARS-CoV-2, in order to demonstrate the differences.
Patients and Methods: Records of 671 patients with VOC 202012/01 (B.1.1.7)(VOC+) who tested positive in the PCR (polymerase chain reaction) test, between February 2–11, 2021 in Konya Province, and were found to have the VOC 202012/01 (B.1.1.7), according to variant analysis and 2284 (VOC−) patients who also tested positive in the PCR test between the same dates but did not have the variant (VOC−) were screened in the Public Health Administration System of the Turkish Ministry of Health, on February 24, 2021. Age, gender, hospitalization status, and admission to the intensive care unit (ICU) were recorded from the screening results.
Results: There was no statistically significant difference between hospitalization status, according to the presence/absence of the variant (p= 0.234). Of the patients who were variant-positive and those who were not, 1.9% and 3.9% were admitted to the ICU, respectively. The rate of admission to the ICU was significantly higher for patients who were not positive for the variant as compared to those who were (p=0.013).
Conclusıons: In the light of the findings of this study, it is possible to state that SARS-CoV-2 VOC 202012/01(B.1.1.7) is not more dangerous in terms of hospitalization and admission to the ICU.

Aim: JAK2 V617F mutation is determined in 95% of polycythemia vera (PV) patients. However, this test is a high-cost and time-consuming examination. In this study, a rapid, inexpensive and easily available test that can be used in addition to JAK2 V617F mutation is planned to exclude secondary polycythemia (SP).

Patients and Methods: A total of 39 PV patients and 51 SP patients, who were diagnosed according to 2016 diagnostic criteria of World Health Organization, have been included in this study. Demographics, physical examination findings and laboratory results of patients have been determined. A statistical analysis was performed between these two groups.

Results: In PV group, serum vitamin B12 level, erythrocyte count, leukocyte count, neutrophil count, platelet count and lactate dehydrogenase levels were determined to be statistically significantly higher than SP group. Serum vitamin B12 level above 343 pg/mL has been determined as the threshold value for the differentiation of PV from SP.

Conclusion: High serum vitamin B12 level was determined to be associated with PV. However, there is a need for prospective studies performed with larger patient series supporting the data obtained in this study in order for serum vitamin B12 level to be used in the differential diagnosis of primary and secondary polycythemia.

Aim: The clinical course of COVID-19 cases and the severity of symptoms vary according to the case.
However, it has been seen in the cases examined that it poses a greater risk for those with chronic
diseases and elderly individuals. In order to protect elderly individuals from COVID-19, governments
have introduced some restrictions. It is thought that the wrong evaluation of these restrictions may lead
to attitudes of ageism. This study aimed to determine the relationship between society's fear of COVID-19
and attitudes towards ageism.
Patients and Methods: This work is designed in descriptive type. This study was conducted with
volunteers between the ages of 18-65 683 people. The data of the study were collected using the Fraboni
Scale of Ageism and COVID-19 Fear Scale. Data were collected on 1-20 Jun e 2020.
Results: The mean Fraboni Scale of Ageism and COVID-19 Fear Scale scores were 67.87±6.15 and
18.81±6.16, respectively. The results showed a weak and negative correlation between COVID19 fear
and ageism.
Conclusion: In general, individuals had a positive attitude towards the elderly and had low levels of
COVID-19 fear.

Aim: Mutations in the DCLRE1C gene result in functional impairment of the Artemis protein and T/B cell development is adversely affected. As a result of this mutation, a clinic of severe combined and combined immunodeficiency (CID) generally occurs. In our region where consanguineous marriage is common, CID cases due to this mutation are frequently encountered. Therefore, suspected patients should be evaluated promptly for the relevant gene mutation. It is clear that more complicated and costly methods are used in the detection of mutations and there is a need for cheaper and faster methods. Therefore, in this study, it was aimed to determine the mutations of DCLRE1C gene exon 3 (c.194C>T; p.T65I) and exon 14 (c.1669_1670insA; p.T577Nfs*21) by using Polymerase Chain Reaction-Restriction Fragment Length
Polymorphism (PCR-RFLP) method.
Patients and Methods: The study was carried out between 2017 and 2020 and study included 14 patients followed up with DCLRE1C mutation in our clinic, 2 parents and 10 healthy controls. PCR-RFLP analysis was performed with primers containing mutation sites and approp riate restriction enzymes.
Results: As a result of the analysis, 12 patients were homozygous mutant for DCLRE1C gene exon 3, 2 parents were heterozygous for exon 3, and 2 patients were heterozygous for exon 3 and exon 14 and were found to be compound heterozygous genotype. Mutations were confirmed by Sanger DNA sequencing. Mutations in the relevant region were determined quickly and re liably by the PCR-RFLP method.
Conclusion: The study showed that the PCR-RFLP method is a cheap, safe and fast method that can be used in cases such as family screening, especially for the detection of known mutations in primary immunodeficiencies.

Aim: It was aimed to investigate  the relationship of disease clinical stage between the maximum diameter of primer lesion (LEGÇ), maximum of standardized uptake value (SUVmax), mean of standardized uptake value (SUVmean), tumor volüme (TV) and total lesion glycolysis (TLG) values derived from positron emission tomography/computed tomography (PET/CT) images.

Method: The information of 130 lung cancer patients diagnosed histopathologically between 01.01.2012 and 31.12.2014 in Necmettin Erbakan University Nuclear Medicine Department of Meram Medical Faculty scanned for PET-CT for lung cancer diagnosis and staging,  were included in this study. The values of the maximum diameter of primer lesion, SUVmax, SUVmean, TLG and MTV derived from PET-CT scanning and their histopathological subtypes, other clinical and radyological information of patients were noted. The non-small cell lung cancer patients were graded according to tumor diameter, nodal and involvement metastasis (TNM) staging system using clinical information, PET-CT and other radyological test results if any. On the other hand, the small cell carcinoma diagnosed were categorised as limited or extensive stage.

Findings: In this study, the mean age of 118 men and 12 women,  totally 130 patients, was evaluated  63,46 ±9,96 ( range 40-87 age ). The patients were classified as 106 non-small cell lung Cancer (NSCLC) (81.5%) ve 24 small cell lung cancer (SCLC) (18.5%).  The  histopathologically diagnosed NSCLC patients were consists of  62 squamous cell cancers, 39 adeno cancers, and 5  other types (3 carcinoid tumors, 1 large cell cancer and 1 sarcomatoid tumor). 

Results: In our study, it was observed that there was no significant relationship between the maximum diameter of the lesion, SUVmax, SUVmean, MTV and TLG values among SCLC and NSCLC patients. Additionally, it was also found that there was no correlation between these parameters and the SCLC stage.  The maximum diameter of the lesion, SUVmax, SUVmean, MTV and TLG parameters were related with stage.

Conclusion: Higher SUVmax, SUVmean, TV, and TLG values of the primary tumor were determined to predict the more advanced clinical stage in NSCLC. This relationship between metabolic parameters and the clinical stage suggest that PET / CT may be valuable in terms of providing prognostic information in NSCLC.

Aim: We aimed to determine types and locations of deep-seated soft tissue foreign bodies (FB) and to evaluate the differences between gender and age groups.

Materials and Methods: A total of 310 patients operated due to deep-seated FB penetration between January 2011 and January 2018 were included in the study. Patients were divided into three groups as under 18 years, 18-45 years, and over 45 years. FB were divided into five groups. Locations of the FB were divided into five region in the upper extremities and into six region in the lower extremities. FB type and location were analyzed according to the gender and age groups.

Results: The most common FB was metal piece in men by 48.4%, and needle in women by 77.3% (P<.0001). Needle was the most common FB by 67.4% in men and 94.2% in women who aged under 18 years (P=.12), whereas the most common FB was metal piece by 54.7% in men and needle by 71.4% in women in the aged 18-45 years age group (P=.0007) and metal piece by 61.3% in men and needle by 70.0% in women in the over 45 years age group (P=.0023). The most common location of FB was hand in men by 35.2% and foot in women by 61% (P<.0001). The most common location of FB was foot by 65.1% in men, and foot by 62.9% in women who aged under 18 years (P=.04), whereas the most common location of FB was hand by 38.9% in men aged 18-45 years and foot by 60.3% in women in the same age group (P=<.0001). The most common location of FB was hand by 65.5% in men and foot by 60% in women who aged over 45 years (P<.0001).

Conclusion: Our study is the first in the literature to evaluate the type and location of the deep-seated FB according to the gender and age groups. The most common location and type of FB were found as foot and needle in women of all age groups and in men under 18 years. This result may be related to the reason that needles, which is used for sewing, are often dropped to the floor due to inattention or neglect of persons, and these persons spend more time at home. Whereas, the most common location and type of FB were hand and metal piece in men over 18 years, respectively. This result may be associated with the labor class doing heavy work which is under risk for hand injury and consists of men over 18 years.

Aim: Small cell lung cancer (SCLC) is associated with an aggressive course and short survival. Conventional chemotherapy (CT) is the mainstay of SCLC treatment. However, the majority of information on chemotherapy (CT), as well as information on demographic data of patients, is based on studies from several decades ago. In this study, we aimed to determine the current demographic and clinical characteristics of patients with SCLC and to determine their responses to the treatments.

Patients and methods: This was a retrospective, cross-sectional, cohort study. Definitions of survival were overall survival (TOS) and survival after metastasis (MOS). TOS was calculated as the time from the diagnosis to the date of death or last visit. MOS was calculated as the time from the diagnosis of metastasis to the date of death or last visit.

Results: The data of 161 patients were analyzed. Response rates obtained with 1st line CT, 2nd line CT, and 3rd line CT were 72.2%, 43.3%, and 40.4%, respectively. The median TOS and median MOS were calculated as 15.7 months (0.03-106.97) and 13.79 months (0.03-79.54), respectively. Although they were metastatic, ten patients had never received first-line CT, and the median MOS was 1.88 months and 14.62 months, respectively, in those who did not receive CT and received CT. Twenty-one (18.9%) of the 111 patients who needed second-line treatment did not receive CT, and the median MOS was 8.39 months and 18.45 months, respectively, in those who did not receive CT and received CT. Eighteen of the 65 patients (27.7%) who required the third-line treatment did not receive CT, and the median MOS was found to be 15.36 months and 23.86 months, respectively, in those who did not receive CT and received CT. The presence of metastatic disease at the time of diagnosis and refusal of treatment were statistically significant parameters affecting the median TOS. And, poor performance status and refusal of treatment were statistically significant parameters parameters affecting the median MOS.

Conclusions: In this study, it was confirmed that early diagnosis of SCLC was associated with a survival advantage. It was shown that the patients who received and were able to tolerate the treatment had obtained a survival advantage, regardless of the disease phase.

Abstract

Psoriatic Arthritis (PsA) is a chronic progressive inflammatory disease that affects 10-30% of patients with psoriasis (PsO). The term "PsA sine psoriasis" is used to describe "patients diagnosed with PsA without skin manifestations". In this study, it was aimed to define the demographic and clinical features of “PsA” “sine psoriasis” according to CASPAR criteria.

Patients and Methods

Twenty-nine patients diagnosed with PsA sine psoriasis according to CASPAR criteria between 2016-2022 were included in the study. Patients with rheumatic diseases and any skin involvement were excluded from the study.

Results

All twenty-nine patients included in the study were diagnosed with PsA according to the CASPAR criteria. 16 of the patients were female. The mean (±SD) age of the patients was 45±11 years. The mean (±SD)  PsA duration of the patients was 6.2±3.0 years. A history of psoriasis in the first-degree relatives of patients with PsA was 54.1%; A history of psoriasis in second-degree relatives was found in 45.9%. 39.4% patients had polyarticular, 35.7% had oligoarticular, 24.9% had axial involvement. DIP involvement was present in 19 (65.5%) of all patients. Nail findings were present in 88.9% of the patients. Besides, enthesitis was detected in 17 (58.6%) and dactylitis was in 18 (62%) of patients.

Conclusion

Patients with clinical symptoms and findings suggestive of PsA and a family history of psoriasis can be classified as PsA sine psoriasis. Patients with dactylitis and DIP arthritis, familial psoriasis may represent a subgroup of PsA.

Aim: Another issue that is as important as breast milk and breastfeeding today is the mental health of
postpartum mothers. The aim of the study is to evaluate the effect of postpartum depression and anxiety
levels of puerperant women aged 18-49 on breastfeeding attitude s.
Patients and Methods: This study was conducted with 243 participants over the age of 18, who did
not have any psychiatric disease before or during pregnancy, who applied for puerperal and newborn
vaccination between February 1, 2021 and August 1, 2021, registered to the central family health centers.
Results: It was observed that women's education, necessity of breast milk, breastfeeding knowledge
level and breastfeeding duration affected their breastfeeding attitude levels. When we examined the
breastfeeding attitudes according to the weeks of birth, it was seen that the breastfeeding attitudes of
the participants who gave birth before 32 weeks were at a higher level than those who gave birth at 36
weeks or more (p=0.001).
Conclusion: It is evaluated in terms of the state of the optimizable how it affects the views according to
the results. In the field of education, which receives support in state anxiety and postpartum appearance,
it can be played that the body will affect the mother and baby positively, regarding the communication in
this regard, for better general appearance.

Background

Hypertension (HT) is a controllable and preventable public health problem that is a risk factor for many serious diseases, especially cardiovascular diseases. Hypertension, which can be silent and lethal, can not be diagnosed in many people. HT constitutes a significant part of the daily practice of the primary care physician. Today, the Family Medicine is a medical discipline constitutes the first level of the health system in Turkey.

Aim

In our study, the effectiveness of family medicine practice in the diagnosis of arterial hypertension was investigated.

Material and Method

We retrospectively reviewed the data of the patients aged 18 years and older who had access to their data in our family medicine department between 2017-2018. A total of seven questions, including personal information (age, gender and education level) and disease identification information (how many years were diagnosed with hypertension, baseline symptom, where and how the diagnosis of hypertension was first established) were retrospectively reviewed from the Family Medicine Information System.

Results

A total of 286 patients, 178 female and 108 male were detected. 9% of the participants were illiterate while 94.1% were literate . 59.8% of the illiterate patients were in primary education, 10.5% in high school and 16.8% in graduate education. 7.7% of the participants were diagnosed in the family medicine polyclinic, and the remaining 92.3% were diagnosed in secondary health care facilities and other places except family medicine. According to education level, 7.7% were diagnosed in family medicine and 92.3% were diagnosed in second-level health facilities and elsewhere except family medicine.

Conclusion

In our study; patients with arterial hypertension were diagnosed more frequently in secondary health care institutions regardless of their education level. Although the rate of diagnosis of arterial hypertension was increased from 1.5% to 16.3% in primary care after starting the practice of family medicine in Konya, we believe that the role of family medicine practice on the diagnosis of arterial hypertension should be increased even more.

Objective: To investigage the effect of surgical approaches used in the treatment of degenerative cervical spondylotic myelopathy on cervical alingment and vertebral canal diameter measurements

Material and Methods: 45 patients were operated with degenerative cervical sponylotic myelopathy (CSM) in our clinic between 2016 and 2020. 23 of them including 5 females and 18 males, were operated  with open door laminoplasty; and 22 of them including 4 females and 18 males, were operated with  laminectomy with  lateral mass screw fusion. SVA (Distance between C2 midline and C7 superior end plate midline), Cobb angles (The angle between the lines passing through C2 lower end plate and C7 lower end plate), and VCD (vertebral canal diameter measured from MR images) values of patients ​​were measured.

Results: Collected data of patients in preoperative period and 1 year after operation were evaluated statistically.

Conclusion: Plate and screw systems not causing facet joint damage use in patients with CSM are more effecticve in the cervical alignment protection

Purpose : This study compares the organ doses at risk by using the Eclipse treatment planning system for two common total body irradiation techniques (TBI) at extended source skin distance.

Material and Methods: 3D treatment plans with AP-PA (anteroposterior) technique were created retrospectively for 20 patients treated bilateral TBI. For each patient, the whole body, kidneys, lungs, thyroid and liver were contoured to create (DVH) dose volume histograms and examine 3D dose volume distributions. The mean doses of thyroid, lung, kidney, liver, whole body and treatment volumes and the maximum doses of 2% volumes (D2) were calculated from the dose volume histogram and transferred to the SPSS file. The non-parametric Wilcoxon test was used to compare the dose values for two techniques.

Results: Thyroid gland mean doses were significantly lower in lateral technique (11.98 and 12.64 Gy, p = 0.21). It was observed no statistically dose difference between the two techniques in terms of lung doses. Since, the lungs were protected by lead blocks in both of two techniques. The mean doses of liver and kidney were lower in the lateral TBI technique (p = 0.002 and p = 0.004, respectively). D₂ doses of liver were lower in AP-PA planning technique (p = 0.032). In comparison of the hot points between the two techniques, the lateral position was significantly superior (p <0.0001).

Conclusions: In present study, it was observed that the bilateral position was superior to the AP-PA position in order to prevent the hot spots. In the AP-PA position, it is more difficult to tolerate the body irregularities. Additionally, when comparing the dose distributions of the organs (liver, kidney, thyroid), it was seen that the results were statistically better in the lateral position. The lateral position provides an advantage in terms of more homogenous dose distribution and better quality planning.