Makale Arama

 Celiac disease is the only life-long continuing food intolerance. This intolerance, caused by gluten, endamages the structure of small intestine and prevents the absorption of nutritional elements. Celiac disease is usually related with other auto-immune diseases. Rate of this disease in our country is increasing in time. It can be seen in people of different ages and different clinical findings. In our day, the most efficient way of treatment is removal of gluten from daily diet. Gluten-free diet that step in treatment phase, affects the living of individual in a period in which growth and development is most rapid. By applying the gluten-free diet strictly, the risk of complications like low bone mineral density and intestine malignite related with the disease, can be decreased. However, it is not always easy to apply and keep track of gluten-free diet by family or child. Moreover, gluten-free diet can cause excess of some nutritional elements (saturated fat), gaining high calorie, and poorness of some nutritional elements (fiber, folic acid, vitamin B ₁₂, iron, zinc, magnesium). Particularly, gluten-free products, when compared with their gluten-including equivalents, have less magnesium, fiber, and folic acid, as well as they are far more expensive. It is determined that a lot of patient considered "resistant" to diet treatment are also eating gluten-including food. Therefore, gluten-free diet should be planned and followed well, and family and child should be educated. This editted article is about, celiac disease, diet treatment for celiac disease, principles of the diet treatment, concordance to the diet, and the factors that effects this concordance.

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With the understanding that adipose tissue is not only a passive energy store, but also an endocrine organ, interest in bioactive factors secreted from adipose tissue has increased. Adipose tissue, consisting of pre-adipocytes, macrophages, endothelial cells, fibroblasts and leukocytes, as well as adipocytes, has an important role in systemic metabolic regulation. Chemerin, called tazarotene-induced gene 2 (TIG2) or retinoic acid receptor responder 2 (RARRES2), was first discovered in 1997 in psoriatic skin lesions as a retinoic acid-sensitive gene. It was later determined that chemerin regulates adipogenesis and adipocyte metabolism, with data showing that it alters adipocyte differentiation, expression of important genes in glucose and lipid metabolism, and is classified as a new adipokine. The effects of chemerin in circulating and inflammatory fluids are mediated through receptor G protein-bound receptor chemokine-like receptor 1 (CMKLR1). The increase in the number of clinical trials associated with increased levels of local and / or circulating chemerin in various diseases, from obesity, metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), polycystic ovarian syndrome (PCOS) to inflammatory diseases, supports the important roles of chemerin in the pathogenesis of these diseases. Although it is clear that serum chemerin levels increase in these diseases, the mechanisms regulating the expression of the chemerin are not fully understood. More randomized controlled studies are needed to understand the mechanisms of action of chemerin.

The prevelans of prediabetes is increasing over the world. It is estimated that more than 470 million people will have prediabetes by 2030. Prediabetes is defined as intermediate state between normal and diabetic glycaemic values and high risk categories for DM development. Insulin resistance and beta cell dysfuction start with prediabet before marked glucose changes. In observational studies it has been reported that the relationship was found between prediabetes and chronic renal disease, small fiber neuropathy, retinopathy, serebrovascular and cardiovascular disesase. In this review, it was evaluated that the definition of prediabetes and its microvascular and macrovascular complications.

In this article is compiled the current knowledge about oncogenic retroviruses. Cancer is a disease that affects millions of people around the world. The findings of the researches indicate that viral factors cause cancer. Viral factors associated with cancer leads to uncontrolled and abnormal growth of cells by their oncogenesis mechanisms. Cancer viruses can be found in both the DNA and RNA viruses. All RNA tumor viruses are located in retroviruses family.

Cerebral ischemia is defined as a reduction of cerebral blood flow in brain. Various experimental models of cerebral ischemia in humans has been developed to mimic closely the human ischemia. These experimental models have contributed the understanding of the pathophysiology of ischemic brain injury and may also allow the development of new neuroprotective strategies and new treatments. As a conclusion, the selected model in the experimental studies must be the most appropriate model that best reflect the clinical and laboratory findings in human cerebral ischemia.

With the rapid technological advances, ultrasonography (US) has become an important breast imaging procedure in the last decade. In addition to the complementary role to mammography and magnetic resonance imaging, today it has an important place in interventional situations such as guiding needle aspiration, core needle biopsy and presurgery needle localization. American College of Radiology has developed “The Breast Imaging Reporting and Data System” (BIRADS) lexicon to standardize the terminology in the US reports. This lexicon includes the descriptors from several feature categories, the assessment of findings and the recommendation of the action to be taken. Six morphologic features were described for solid breast masses: shape, orientation, margin, lesion boundary, internal echo pattern and posterior acoustic features. Despite the known overlap between benign and malignant features, typical signs of benignity were oval shape, gently lobulation, homogenous hyperechogenity, parallel orientation; typical signs of malignity were irregular shape, antiparallel orientation, noncircumscribed margin, echogenic halo, decreased sound transmission. The purpose of this article was to discuss reliability of these BIRADS US lexicon descriptors in the differentiation of benign from malignant solid masses of the breast.

The prevalence of type 2 diabetes mellitus is increasing worldwide. Although there are a number of treatments currently avaible to treat diabetes mellitus, glycemic control rates remain poor. Sodium Glucose Co-transporter (SGLT) 2 inhibitors are a novel class antihyperglycemic agent that act independently of insulin actions. The SGLT2 inhibitors increase urinary glucose excretion and lower plasma glucose. There are a lot of SGLT inhibitor molecules in a different phases of clinical trials is currently avaible. Initial clinical trials showed that this class of agents are well tolerated and can effectively control blood sugar levels with reduced weight gain without hypoglycemia. This manuscript reviews the role of the kidney in glucose hemostasis and the effects of inhibition of renal glucose reabsorbtion by SGLT2 inhibitors.

Today, age of childbearing women is increasing because of social and economic conditions. Although gynecological cancers are seen in old age, some of them may occur in reproductive age. With recent advances in the fields of surgery, pathology and chemotherapy, low risk patient group can be identified in gynecological cancers. Fertility sparing surgery appears as a parallel development in current cancer treatment, when considering the emotional condition, physical appearance, sexual function and fertility desire of the patient.

Diabetic nephropathy is one of the important microvascular complications of diabetes mellitus. Diabetic nephropathy develops as major complication of both type 1 and type 2 diabetes mellitus. At the same time, it is currently the leading cause of end-stage renal disease. Two of the main risk factors for diabetic nephropathy are hyperglycemia and arterial hypertension, but the genetic susceptibility in both type 1 and type 2 diabetes is of great importance. Contribute to the development of diabetic nephropathy other risk factors such as hyperglycemia, hypertension, obesity, hereditary diseases, smoking, and advanced age. The progression from normal albuminuria to microalbuminuria is accepted as the initial step in diabetic nephropathy, and then distinctive proteinuria, decreased glomerular filtration rate, and end-stage renal failure develops.

Among bone lesions, bone metastases are the most common lesions leading to malignant destruction. Bone metastases commonly result in severe pain that is hard to handle. Appropriate treatment of pain associated with bone metastases is critical for the improvement of the patients’ quality of life. In this article, current treatment approaches regarding bone metastasis are reviewed.

The prevalence of type 2 diabetes is increasing world wide and it is estimated to rise from 382 million today to 582 million by 2035. Although there are a number of therapies currently avaible to treat diabetes mellitus, glycemic control rates remain poor. Imeglimin, the first in a new-tetrahydrotriazine-containing class of oral antidiabetic agents and it has been shown to decrease hepatic glucose production, increase glucose uptake in skeletal tissue and improve insulin secretion in response to glucose. In this text, the efficacy and safety of imeglimin in the treatment of type 2 diabetes are reviewed.

Since it has first observed in April 2009, the swine origin Influenza A virus infection, spreaded worldwide and cases of dead increased. Untill now the number papers in literature about the radiological signs caused by the desease is extremely low. In this review we aimed to overview the H1N1 and collect the data in literature about radiological signs of the desease.

Gestational diabetes mellitus (GDM) was previously described as any degree of glucose intolerance with first recognition at pregnancy for many years. Currently, pregnant with DM at their initial prenatal visit has been diagnosed as overt diabetes, not gestational diabetes. The remaining pregnant who found not to have DM at initial visit and not known to have DM should undergo oral glucose tolerance screening at 24-28. weeks of gestation and diagnosed as GDM if any value exceeds the threshold values. The prevalence of GDM is reported 1-14% among the different populations. Its diagnose is increasing over the world with new GDM criteria. Recently, ADA has adopted the 2008 International Association of Diabetes and Pregnancy Study Groups (IADPSG) conference criteria based on the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) study. IADPSG criteria for GDM is including; 75 gr glucose tolerance test has been recommended as diagnostic test for GDM and a single abnormal value has been considered to be sufficient for diagnosis in this conference. The threshold values for glucose tolerance test are as following; for fasting glucose; 92 mg/dl (5.1 mmol/L), for 1.hour; 180 mg/dl (10 mmol/L), for 2 hour; 153 mg/dl (8.5 mmol/L). In this review, the modifications on GDM definition and the current diagnostic criteria for GDM were evaluated.

Although it remains relatively stable childhood cancer rates in the last two years, thanks to advances in early diagnosis and treatment there has been a serious decline in the mortality rate. Despite all these developments, it still experienced today that children diagnosed with cancer 75% more than they can not survive more than five years. Before cancer treatment, oral and dental health problems may impair during and after the child’s health and quality of life. Therefore, pediatric dentists, the provision of oral hygiene and dental treatment needs of these patients have a very important place.

Aim: Capsule endoscopy is a revolution at the diagnosis of digestive tract diseases by providing a new non-invasive way. In our manuscript we discuss the use of capsule endoscopy in the diagnosis of digestive tract disease. Main Findings: Capsule endoscopy is a new diagnostic tool especially used for the diagnosis digestive tract disease such as obscure gastrointestinal bleeding, small below tumours, coeliac disease, Crohn’s disease, etc. In these patients, the technique is also helpful for effective decision-making concerning subsequent treatments. Beside it is clearly more sensitive than conventional imaging modalities. Conclusion: The capsule endoscopy is a new tecnique consolidated and as its potential is known, its indications are extended. Larger studies are needed to assess the influence of capsule endoscopy on clinical outcoumes.

Invasive candidiasis is responsible for about 10% of nosocomial sepsis and it continues to be significant cause of serious morbidity and mortality in very low birth weight infants. Alhough the informations about the antifungal drugs which used for Candida species are increasing, studies and conclusions about the efficacy and safety are still insufficient. Most of the studies have focused on the pharmacokinetic and pharmacodynamic evaluations and obtained from adult patients. However, efectiveness of the therapy can not be same in newborns due to the different pathophysiology of neonatal candidiasis in newborn, the inferences can not be considered from adult studies. Until now, amphotericin B deoxycholate, fluconazole and micafungin seems to be effectivev therapy for the treatment of neonatal invasive candidiasis. Herein, the medical literature has been scanned and compiled with the latest information about the use of antifungal agents in newborn.

Hepatocellular carcinoma (HCC) generally develops as a consequence of underlying liver disease, most commonly viral hepatitis. The development of HCC follows an orderly progression from cirrhosis to dysplastic nodules to early cancer development, which can be reliably cured if discovered before the development of vascular invasion (typically occurring at a tumor diameter of approximately 2 cm). If resection is not possible because of poor liver function, vascular invasion and metastasis. To prevent tumor progression while waiting, nonsurgical treatments including percutaneous radiofrequency ablation, and transarterial chemoembolization are employed.

Growth and development of a organism vere re-gulated by growth hormones and growth factors along the axis of hypothalarnus-pituitaıy. It was exp-ressed by lots of researchers that arnang these fac-tors, insulin like growth factors take role in diagnosis and treatment of diseases. fn this review, know-ledges abouf chemical structures and functions of re-ceptors and binding proteins of these factors have been reviewed.

Premature rupture of membranes (PROM) is frequently encountered problems in obstetric practice and PROM is effecting perinatal outcomes. Premature rupture of membranes is associated with 20% to 30% of all preterm births. The prognosis is related primarily to gestational age at presentation and delivery. Appropriate treatment must be applied after patients were evaluated carefully, especially about gestational age and presence of infection. Preterm premature rupture of membranes (PPROM) is a major cause of perinatal morbidity and mortality and the most difficult problem for obstetricians. This reason, diagnosis, treatment and management of PPROM is very important. Diagnosis, treatment and management of PPROM is often discussed, but stil no consensus. In this review, we aimed to discuss how to approach with the support of current literature to problems we faced on PROM management.

To inform the doctors and nurses working in intensive care units about the pain in newborns, its effects on neonatal development, and the use of nonpharmacological methods for effective pain management. Newborns are challenged by several painful stimuli because of diagnostic and therapeutic preoperative invasive procedures, surgical trauma, and postoperative invasive procedures in the neonatal intensive care units. These babies face physiologic, psychological, and metabolic consequences because of pain. Pharmacologic and nonpharmacological methods are regarded as complementary in effective pain management. Studies showed that nonpharmacologic methods themselves are not only effective in management of pain resulting from invasive procedures but they also increase the effectiveness of medical therapy when used in combination.

Burns pose a major problem for the community because of mortality and morbidity they cause. Nursing management of burn patients includes medical care and psychological support of burn patients and their families. Optimal care of burn patients requires a multidisciplinary team approach. Nurses are the coordinator of all the patient care activities. This compilation includes published articles about the importance of nursing process in burn patients and nursing diagnosis samples.

Prostaglandins (PG) are very effective ocular hyper-and hypotensive agents in the mammalian eye, with the direc- tion and magnitude of the intraocular pressure (IOP) change varying by species, PG and dose. İt is generally agreed that these drugs reduce intraocular pressure primarily by increasing uveoscleral outflovv. They may also increase trabecular outflovv facility though available evidence is less convincing. İt has been hypothesized that PGs may increase facility of uveascleral outflow in addition to their other mechanisms, but this has not yet been test- ed. Its potent ocular hypotensive action in primates, including man, Prostaglandin F2 alfa has received substantial study as a potential anti-glaucoma therapeutic agent, but the specific PG receptor(s) involved in ali aspects of the response are unknovvn. In studying prostaglandin and prostaglandin analogs, there are a diverse variety of prostanoid receptor selective agonists. These included DP, EP (EP-ı, EP2 EP3), FP, İP and TP receptor selective compounds.

Medical Education and Informatics Department in Meram Faculty of Medicine is maintaining a well attended and multidisciplinary education since the establishment in 2004-2005 academic years. This article is a brief annual report of the activities of the Medical Education and Informatics Department in 2011-2012.

Aim: The aim of this review is to evaluate recent literature regarding effects of nutrition on fetal development. Main findings: Previous studies show that maternal factors such as age, nutrition, and stress are able to have negative effects on fetal development during pregnancy. The role of maternal nutrition on human pregnancy is still unclear but undoubtedly crucial. The dietary recommendations for pregnant women before and during pregnancy are similar to those for other adults, with a few exceptions. The main recommendation is to keep a healthy and balanced diet; however, there are some specific recommendations related to daily supplementation of minerals and vitamins during pregnancy to reduce the risk of birth defects. Maternal nutritional status during the period of conception is an important determinant of fetal growth and development. The relationship between maternal nutrition and low birth weight, intrauterine growth retardation, and spontaneous abortus are reported in the literature. Furthermore, maternal nutritional factors associated with different kinds of birth defects such as neural tube defects, oral cleft, cardiovascular, central neural, respiratory, and urinary system defects. Result: Therefore, further researchs are need for the effects of maternal nutrition on fetal growth

Obesity incidence is rapidly increasing in Turkey like all over the world. Surgery has become a gold standard treatment for obesity due to the unsatisfactory results of diet and drug therapies. The number of clinics applying bariatric surgery is increasing every day. In this review, preoperative, perioperative and postoperative nursing care strategies were discussed.

Diabetic muscle infarct is a rare complication of type 1 insulin dependent diabetic patient, resenting with focal thigh pain, tenderness, swelling and erythema. These pathologic findings were observed in 72 years old male patient, 5 days after he was accepted to our clinic because of diabetic foot ulcer. The mass was thought that on abscess at first but unixue extensor hallucis muscle infarct was observed by surgical exploration.Necrosed muscle was excised and defect area was reconstructed with split thickness skin graft. V/e have presented a case of extensor hallucis longus muscle infarction in a diabetic patient first in the literatüre.

In the course of infectious diseases in children, hematopoiesis and coagulation systems may be effected as a result of several pathological mechanisms. Some hematological problems may occur especially in infection term or in post infection term as a complication. Selection of an appropriate approach to hematological problems as well as infection treatment may be useful to reduce mortality and morbidity related to infectious diseases in children. In this review, hematologic manifestations of infectious diseases in children were evaluated in detail.

The diagnosis and the early treatment of the thyroid diseases occuring before and during pregnancy are essential for both mother and baby. Increased synthesis of the thyroid hormones, urinary iodine loss, and transfer of iodine to the fetus through the placenta increase the daily iodine requirement in pregnant women. In order to evaluate the thyroid functions in pregnant women, the serum free T4 (fT4), free T3 (fT3), and TSH levels should be determined. Low levels of maternal and fetal thyroxin, lead to irreversible central nervous system development defects, where endemic cretinism and mental retardation are the most significant complications. Therefore, if possible, iodine treatment should be initiated prior to pregnancy. On the other hand hyperthyroidism, can lead to complications such as abortion, premature birth, preeclampsia, and placenta detachment. Thus, thyroid function tests should be monitored carefully during pregnancy

Type 2 diabetes makes up more than 90 percent of diabetes mellitus (DM) being of a quite significant risk factor fort he development of coronary arter disease and most of these patients are required to take oral antidiabetic treatment. Upon considered that the main cause of the deaths in type 2 DM is cardiovascular diseases it is necessary that the effects of the drugs used for thesepatients on cardiovascular system be well-known to have various direct and indirect cardiovascular effects over these influences.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient– physician communication about palliative and end-of-life care is infrequent and often of poor quality. Secondly, the uncertainty in predicting prognosis for patients with COPD makes communication about end-of life care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness. The purpose of the present review is to give knowledge regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning. Improving communication represents an important opportunity for the improvement of the quality of palliative and endof-life care received by these patients.

Allergic diseases are highly prevalent disorders that exact a heavy toll of morbidity. Whereas a fine balance is normally struck between immune effector and tolerogenic mechanisms to ensure effective but self-contained and minimally damaging immune responses, this balance fails in those disorders. Of particular interest is the role in these disorders of regulatory T (Treg) cells, which act to maintain immune homeostasis and ward off exuberant or tissue damaging immune responses. In this review, we explore how chronic allergic inflammation can destabilize Treg cells and promote their acquisition of pathogenic T helper cell phenotypes that aggravate disease. We describe cellular and molecular mechanisms involved in such re-programming of Treg cells and therapeutic opportunities by which reprogramming can be reversed to reestablish enduring tolerance.

House dust mites are found in human housing, particularly in bedding and furniture in many parts of world. İt feeds on epidermal flakes shied from human skin and, some humans become allergic disease. Because of the fact that house dust mites and their dropping are the most important causative of the allergic rhinitis, asthma and atopic dermatitis world wide. Medical and economical importance, taxonomy, biology, description, detection, control of such mites are revievved in the light of recent literatüre.

\r\n Locally advanced rectal cancer is one of the best example that optimal outcomes are achieved with a multidisciplinary approach. The mainstay of curative treatment remains radical surgery; however, combine with radiotherapy is the optimal treatment to control local recurrence and to improve survival. To date, preoperative radiotherapy is shown to be superior than postoperatif radiotherapy. In this review, we aimed to evaluate the application methods, advantages and disadvantages of preoperative radiotherapy.

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Clear evidence could not be obtained until recently for effects of static or pulsed electromagnetic fields which are used for the treatment of several disorders and complications. General consensus and standardized protocols are lacking for different techniques and modalities used in applications of therapeutic magnetic fields in the area of medicine. At high frequencies, heating effect becomes dominant and the effect of magnetic field is suppressed. Thus, particularly low-frequency pulsed electromagnetic fields has been reported to be effective with promising results in a number of diseases and disease models.In thecurrent compilation, in vitro / in vivo various treatment protocols for investigating positive effects of low frequency electromagnetic field and their results are presented, contrasting negative effects of high frequency electromagnetic field often reported in literature.

The recent developments involving the molecular basis, diagnosis and treatment of Alport's syndrome was reviewed. The determination of the nature of type IV collağen and localisation of its genes have provided new insights in the understanding of the different sign and symptoms of Alport's syndorme and helped to reach new approaches in diagnosis and treatment. Immunohistochemical examinations may help to distinguish the X linked and autosomal forms of Alport's syndrome. The genomic investigations may be reçuired in suspected cases. İn this disease with no effective treatment the gene therapy is promising.

The aim of this review is call attention to cognitive impairments in Multiple sclerosis which is seen frequently but not ignored sufficiently because of dominancy of the other symptoms. Cognitive impairements in multiple sclerosis can be seen in all type and period of disease especially in progressive forms. 40-65% of patients are affected, deformation typically occurs in memory, attention, and informationprocessing functions. It is the main cause of disability in multiple sclerosis. Etiopathogenesis is not clear yet and treatment is not so effective. Cognitive impairement in patients with multiple sclerosis is a frequent problem that affects life quality. Studies on this subject which are concetrated at the recent years ,are hopeful for future illuminating ethiopathogenesis and developing suitable treatement .

Pharmacogenetics deals with genetic variations and individual response differences of drugs. The discovery of enzymes responsible for drug metabolism and the research to DNA sequences encoding these enzymes enable the creation of individual treatment strategies. Cytochrome 2B6, cytochrome 2C9, cytochrome C19, cytochrome 2D6, cytochrome 3A4, N-acetyltransferase, dihydropyrimidine dehydrogenase, thiopurine methyltransferase, UDP-glucuronyl transferase and catechol-O-methyltransferase enzymes are mainlyresponsible from drug metabolism and polymorphisms in enzyme activities affect the pharmacokinetic properties of the drug which leads to differences in drug response between individuals. First examples that form of the basis of pharmacogenetic studies are N-acetyltransferase and cytochrome 2D6 polymorphisms. Consideration of enzyme polymorphisms that may result with pharmacokinetic differences during drug choice is important to increase the success of treatment and to prevent adverse/toxic reaction risk. The studies about pharmacogenetics, which was studied about 50 years ago, has become more important nowadays with the development of gene technology. Individual drug choice will be an important parameter by further development of pharmacogenetics in the second 50 years through pharmacogenetic studies that is accelerated due to technological developments.

Vitamin D is a liposoluble prohormon and a secosteroid which is produced in the skin after exposure to sun-shine. It is turned to calsitriol which has an important role in the calcium and phosphate metabolism by different metabolic pathways. Deficiency of vitamin D is related to some factors such as less sunlight exposure, inadequately intake of vitamin D and absorbtion problems. Studies recently done have shown vitamin D deficiency exists in many people. The effects of vitamin D deficiency on numerous diseases and functional disorders such as chronic musculoskeletal pain, Type 1 and Type 2 Diabetes Mellitus (DM), obesity, multiple sclerosis, rheumatoid arthritis, cardiovascular diseases, osteoporosis, microalbuminuria, renal failure involving colon, prostat and breast cancers either are reported in literature.Vitamin D is one of the main structural elements playing an essential role in several metabolic pathways both directly and indirectly providing numerous functions carring vital importance for organism. In spite of causing a lot of functional disorders and diseases, vitamin D replacement therapy in case of deficiency is safe, economic and simple unless neglected. In this review, we aimed to demonstrate the metabolism, functions and effects of vitamin D, increased risks of chronic diseases likely to be encountered in vitamin D deficiency and the importance of vitamin D replacement therapy.

Ultrasound elastography (EUS) is a method to assess the mechanical properties of tissue, by applying stress and detecting tissue displacement using ultrasound. There are several EUS techniques used in clinical practice; strain (compression) EUS is the most common technique that allows real-time visualisation of the tissue. The importance of EUS in evaluation of musculoskeletal system is increasing since it helps out early diagnosis of diseases and guide the theraphy. This review includes the various EUS techniques available for clinical use, presents the published reports on musculoskeletal applications of EUS and discusses the technical limitations and future perspectives of this method in the assessment of the musculoskeletal system.

The identification of the airway anatomy and associated pathological structures are the basic clinical skills for the especially specialists of anesthesiology, intensive care, emergency medicine, chest diseases and ENT. There are a lot of anatomical structures, which affect the airway management and external anatomical landmarks are insufficient for the complete evaluation of these structures, even in the best conditions. Bedside ultrasonography, which is used especially in the vascular interventions and regional anesthesia applications extensively, can also be useful in the visualization of the airway structures. In this paper, these two issues of how the airway structures can be visualized by USG and of how this information can be used in clinics are defined together with the literature.

Tuberculosis (TBC) is an infection that rarely seen in the first year of maximum immunosuppression. Beacuase of its rarity we aimed to present a case of TBC that developed after renal transplantation in our newly established transplantation unit. A live donor renal transplantation was performed on a 45 years old man who was complaining of chronic renal failure for four years and on hemodialysis for two years. There was no signs of TBC in the physical examination, preoperative laboratory investigation and past medical history of the patient. Prednisolone, MMF, FK-506 combination and in the 1st and 4th day Basiliximab were performed as immunosuppressive protocol. In 1 st postoperative month, there was a cavernous lesion in the left upper zone on chest x-ray. Antituberculosis treatment was started according to a positive sputum culture for TBC bacili. After twelve months of antituberculosis treatment there was a clinical and laboratory improvement and the treatment was ceased accordingly. Because of its frequent past history in our country, TBC is aserious disease that should be kept in mind and dealt with carefully in patients undergoing renal transplantation.

Vascular endothelial growth factor (VEGF), one of the most important mediators of angiogenesis, is upregulated during neovascularization. In fact, anti-VEGF agents have efficacy in the treatment of neovascular age-related macular degeneration, diabetic retinopathy, macular edema, neovascular glaucoma, and corneal neovascularization. In this review, which discusses the biochemistry of VEGF and the use of the anti-VEGF agents in eye diseases.

The advantages of laparoscopic surgery are similar for pregnant and nonpregnant women; nevertheless, this procedure was avoided during pregnancy because of concerns that it may be harmful to the fetus. Within the last decade, however, multiple case reports and case series describing the safe performance of laparoscopic procedures in pregnant patients have been published, resulting in a paradigm shift. Appendicitis, gallbladder disease, mesenteric cysts, and adnexal masses/torsion have been successfully managed laparoscopically during pregnancy. More advanced laparoscopic procedures, such as radical nephrectomy, splenectomy, salpingectomy, adrenalectomy, retroperitoneal lymphadenectomy, and ventral hernia repair, have also been reported in gravid patients. This topic will discuss issues specific to laparoscopic surgery during pregnancy. Discussions of laparoscopic surgery in the general population and specific laparoscopic procedures can be found separately.

Sydenham’s Chorea (SC) is a neurological movement disorder that results from antistreptocpccal antibodies cross-reacting with brain tissues, especially basal ganglia and causing to an inflamatory reaction. According to the 1992 modified Jones criteria, acute rheumatic fever is a major criterion and is sufficient evidence on which to base a diagnosis. SC is frequently seen in the 5-15 years of age. It appears approximately 6 months later from the attack of ARF. SC usually continues 4-6 weeks, it may be permanent. Carditis accompanies SC much more frequently than the other signs of ARF. SC is a neuropsychiatric disorder that may present with anxiety, emotional lability, obsessive compulsive symptoms, attention deficit and hyperactivity symptoms or tics. Most of the cases improve spontanously and many treatment are available. Recurence is common. Penisilin prophylaxis should continued to avoid carditis and recurrence. SC is considered to be the most common cause of acquired chorea in devoloping countries. Even though it has been recognized for centuries, it has kept up its importance by periodic exacerbations. SC and ARF are still declining in recent years in our country, together with which is a significant cause of morbidity as a public health problem.

During pregnancy, some structural changes take place in the uterus endometrium These structural changes have been characterized by remodeling and distruption of the extracellular matrix (ECM). Remodelling and distruption of uterine endometrium have importance for a successful implantation and placentation. MMPs are a group of zinc-dependent endopeptidases that degrade a variety of components of ECM and basal membrane. The activity of MMPs occurs as a result of balance between activated MMPs and their inhibitors (TIMPs). Earlier experimental studies indicated that MMPs and TIMPs have essential role in ESM destruction and remodeling while blastocyt implantation and trophoblast invasion during early pregnancy. Therefore, MMPs and TIMPs are crucial to the beginning and continuation of pregnancy.

Aim: Multiple sclerosis (MS) is an immune- mediated disease of the central nervous system. We will emphasize in this article; very different mechanisms, and complex interactions have important role in immunopathology of multiple sclerosis. Main Findings: The pathogenesis of MS is best viewed as a complex interaction between genetically predetermined susceptibility markers and environmental stimuli. MS is charecterized by inflammation, demyelination, apoptosis in oligodendrocytes, remyelination, and axon loss. Immune reaction against different components of the central nervous system (particularly myelin structures) are thought to play an important role in the initiation of the destructive process. The inflammation in MS appears to be caused by an overactive pro-inflammatory TH1 profile in T cells. Demyelination can result as a consequence of direct damage to myelin by inflammatory cells or indirectly because of the enviroment produced by inflammation. Axon loss occurs in MS lesions starting early in the disease. Conclusion: MS occurs with different immünopathological mechanisms.

Renal transplanted patient may encountered any surgical procedures because of improving the survival rates and keeping their normal life. This review aims to summarize the management of renal transplanted patients who undergo any surgery under anesthetic aspect.

Aim: This review sought to determine the relationship between cyanosis and hematological signs and findings. Main finding: Patients with cyanotic congenital heart disease are succeptible to develope hematological side effects. Several findings, including polycytemia, thrombocytopenia, factor deficiencies, iron-deficiency anemia and disseminated intravasculary coagulation have been reported. Decreased arterial oxygen saturation in cyanotic congenital heart disease causes compensatory kurise in hemoglobin and haematocrit levels. Erythrocytosis is an adaptive response to improve oxygen transport in cyanotic congenital heart disease. However, at highly increased haematocrit levels patients may experience hyperviscosity symptoms. Iron-deficiency in cyanotic congenital heart disease patients is often overlooked due to elevated hemoglobin concentrations. The detection of a hemostatic abnormality and its correction by appropriate therapy are likely to minimize the side effects. Results: Children with cyanotic congenital heart disease are prone to both thrombosis and hemorrhage. Hematological management of cyanotic congenital heart disease has received little attention. The lack of practical therapeutic guidelines forced us to consolidate our observations on patients with cyanotic congenital heart disease.

To prevent testicular degeneration caused by the effect of temperature, infertility, the formation of groin hernias, testicular torsion, predisposition to travma and negative effect to children psychologically at the children who had undescended testes are important. The testis doesn’t descend into the scrotum if hemiscrotum doesn’t grow sufficiently. If right or left scrotum appears to be normal, testis ascends or is retractil. Testes at the children who had retractil testes remain in scrotum after drawing into scrotum, the size of the testes are normal and the testes are frequently in scrotum since before. Ectopic testis can be localised at the regions of perineal, femoral, pubisopenil regions or contralateral scrotum. Orchiopexy or laparoscopic orchiopexy is performed after observing the children, who had undescended testis for one year. Surgical procedure should be carried out without waiting for the children who had ectopic testes, but not for the children who had retractile testis.

In pürine pathway, adenosine deaminase is a cytoplasmic enzyme which changes adenosine into inosine and ammoniumi deoxyadenosine into deoxyinosine and ammonium catalyzed irreversibly. Activation of ADA in human fluids is by two enzymes: ADA1 and ADA2. Increased ADA levels in tuberculosis pleural effusion have %81-100 sensivity and %83-100 specivity. ADA in tuberculosis effusions originated from macrophages and monosit is mainly ADA2. ADA level also can be increased in ampiyem, lenfoproliteratif disorders and parapnömonic pleural effusions which have ıymphocyte cell mostly.

Moisturizers are important for regulating epidermal barrier and it’s water contenent. They are also important for maintenance of healthy skin. Moisturizers acts as occlusives and humectans to increase the skin water capacity. There are many preperats enhancing these functions. Choice of moisturizer is depent on many factors. Aplication of moisturizers can save as important adjunctive therapy for patients with various dermatologic disorders.

Esophageal achalasia in childhood especially in whom below one year of age is a rare lesion and difficult to diag- nose. An 11 months age female infant has been treated successfully by pneumatic dilatation, after returning of the esophagus to it’s normal calibre there was no complications seen in the barium study that performed later. After a follow up period of 12 months there was no vomiting or feeding problems or recurrence of the achalasia.

 Postpartum haemorrhage (PPH) which is the first cause of maternal mortality in our country is responsible for about 25% of maternal deaths in the world . While PPH is defined as loss of 500 ml or more of blood from the genital tract within 24 hours of thebirth of a baby, severe PPH is blood loss exceeding 1,000 mL. The most common causes are uterine atony, genital tract injuries and placental retention. Many methods are used such as effective implementation of the uterine fundus massage, the use of agents which myometrium contact, hypogastric and/or uterine artery ligation or embolization in its treatment. Despite this, PPH is the primer cause of maternal death in our country. To reduce maternal mortality rates caused by dependence of PPH,  evidence-based approaches are important in treatment and care. Pharmacological, surgical approaches and various applications for the third stage of labour in the prevention and treatment of PPH are used. But there are no evidence-based studies at adequate levels for all treatment. The clinical data in a large part of the PPH/therapeutic approach are limited. Therefore, it is intended in this article to determine the current approaches related to the prevention of postpartum haemorrhage and to inform health professionals about the adequacy of the initiatives implemented.

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Aim: Respiratory muscle weakness is the inevitable consequence of many neuromuscular disorders. Deterioration in respiratory function contributes to significant morbidity and is responsible for high mortality rates with these diseases. The aim of this review to summarize diagnostic and therapeutic approaches for respiratory problems in patients with neuromuscular disorders. Main Findings: Usually, chronic respiratory failure develops slowly over a period of several years. Initially, it presents with disordered breathing that is apparent only during sleep, followed by continuous progression to severe hypoventilation, cor pulmonale and eventually frank respiratory failure in end-stage disease. Early detection of respiratory compromise and preventive care are likely to improve outcome and quality of life for many patients. This has led to the development of proactive monitoring and treatment programmes that include regular assessment of pulmonary functions, respiratory strength and sleep studies, home mechanical ventilation, chest physiotherapy, early antibiotic treatment and nutritional intervention. In particular, noninvasive positive pressure ventilation is effective in resolving respiratory failure and has dramatically changed the management of these patients. Conclusion: Pulmonary functions and sleep related respiratory problems should be followed up regularly in patients with neuromuscular disorders. Noninvasive mechanical ventilation is the most important therapeutic option for the management of respiratory failure in these patients group.

It is known that different factors, not a single one, play a role in the formation of cancer, which is accepted to develop as a result of a "mutation" in a normal cell. These factors also differ for the tissue or organ in which the cancer develops. Determining the factors that affect the etiology of a cancer requires complex approaches and studies. However, in general, it is possible to group cancer-related factors as those that increase the risk of cancer, those that reduce the risk of cancer, and those that cause cancer. Diet constitutes a "community of factors" associated with all three groups. This review has been prepared to investigate the effect of diet on various organ cancers and to reveal the measures that can be taken in the light of the information obtained.

Colorectal cancer remains a significant health problem today. In parallel to the developments in the field of surgery, improvements in adjuvant and neoadjuvant treatment modalities lead to increase in both local control and overall survival times. The main purpose of this review is to discuss the current treatment options of rectal cancer with literature data. Surgery is an essential treatment option for rectal cancer. Treatment success for rectal cancer has been increasing by the help of neoadjuvant (preoperative) or adjuvant (postoperative) modalities. According to the recent studies, preoperative (chemo) radiation therapy is superior to postoperative treatment in terms of local control and sphincter preservation. However, there is not enough data regarding to the difference between the efficacy of shortterm preoperative radiotherapy and long-term chemoradiotherapy. Today, for the treatment of rectum cancer, preoperative (chemo) radiotherapy is superior to postoperative (chemo) radiotherapy in terms of overall survival and local control. However, new prospective randomized trials should be designed to compare the short term and long term preoperative (chemo) radiotherapy.

Adult onset Still’s disease is a systemic disease of unknovvn etiology. Clinical and laboratory features are not pathognomonic. The diagnosis is difficult and based upon Yamaguchi’s criteria after exclusion of infectious diseases, hematologic process or autoimmune diseases. Treatment is not well codified but steroids represent the most efficient therapy to control fever and systemic manifestations. Search for new treatments and specific markers of adult onset Still’s disease are needed. İn this study, we present the cases of two patients with adult onset Still’s disease and revievv of the literatüre.

The disease was first described by Scheuermann as the dorsal kyphosis of juveniles in 1920. Scheuermann's disease is the most common cause of thoracic hyperkyphosis in adolescence. There are two sub-types: thoracic and thoracolumbar / lumbar. Histologically, when the irregularities in the vertebral end plates are examined, collagen fibrils are seen to decrease or vanish. As a result, end-plate continuity deteriorates and Schmorl nodules appear when the disc material protrudes into the corpus. Deformations cause wedging in the vertebral corpus, resulting in narrow angled kyphotic deformity. In the large series, the prevalence is up to 8%, and the genetic transition and mechanical stress come into prominence in the epidemiology of the disease. Pain can be accompanied by deformity in symptomatic state. Classical radiological features include irregular vertebral endplates and kyphosis more than 45 degrees with 5 degrees of wedging in 3 or more vertebrae. In some cases, minimal scoliosis may accompany to kyphosis. Periodic radiologic follow-up is recommended for patients below 50 degrees of kyphosis. Bracing is appropriate in uncompleted skeletal maturation with kyphosis up to 75 degrees. In cases above 75 degrees, it is appropriate to perform surgical treatment when bracing is unsuccessful in adolescence and presence of exceeding pain despite the conventional methods and obvious deformity in adults. 

To find an evidence based approach in embryo transfer technique by reviewing relevant studies in the literature. Although the embryo transfer technique has an important role for success, there are limited randomised controlled studies about this issue in the literature. When the results of the studies are reviewed; performing the transfer by ultrasound guidance, with ease and with an atraumatic technique and using soft catheters seem to be related with success. Using appropriate techniques in embryo transfer procedure will enable increased pregnancy rates

Mechanical ventilation (MV) is the most important part of contemporary critical care concept and one of the most frequent reasons for intensive care admissions. Currently, there is a tendency to use the mechanical ventilators in the intensive care units by pediatric intensivists. The aim of this review is to summarize the basic principles of mechanical ventilation in order to be applied when required by all physicians. There is an indication for MV when the spontaneous respiration is threatened to sustain life. Currently, the principal criteria to determine the need for MV is the clinical judgement of the physician rather than laboratory results of the patients. Some of terminology should be well- known to initiate the MV. The main difference between the basic ventilator modes ventilator’s ability to detect and and respond to patient’s own spontaneous respiration.

Aim: Multiple Sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Clinical, imaging, and pathological studies in multiple sclerosis have generally emphasized the relative preservation of axons in comparison with myelin. Recent evidence, however, demonstrates that axonal loss is also significant, affects long tracts such as the corticospinal and sensory tracts and relates closely to functional disability. In this article we will consider emerging observations that reflect on the mechanisms of axon loss. Main Findings: There are different mechanisms of axon loss occur. Mechanisms of axon loss: Axonal damage in the inflammation, demyelination- induced axon loss, wallerian degeneration, and final common pathway in the axon loss. Conclusion: Axon loss is irreversible and responsible for long term disability. However therapies are also needed that enhance remyelination or neuroprotective.

The latex allergy has been increasingly recognised in recent years in both adultsand children. After anaphylactic type reactions due to latex has been shown as case reports, latex allergy became an important problem especially in medical practice. The majör risk factors in latex allergy are intense exposure to latex allergens (surgical gloves, catheters, etc.), atopy hand eczema, female gender, history of multiple operations and dental interventions. Some occupational groups such as health-care workers and workers in latex industry are under greater risk due to their possible frequent contact with latex. An association between latex allergy and allergy to various fruits (banana, avocado, pineapple, kiwi, etc) has been reported. Latex allergy is responsible for a wide spectrum of clinical symptoms ranging from a mild dermatitis to severe anaphylaxis in both adults and children. There fore an allergologic investigation for latex allergy should be considered for those from high-risk groups. Then, it will be possible to take precautions in order to prevent life-threatining allergic reactions by exposure to latex

Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the ICU, and it complicates illness course by increasing mortality rate, hospital length of stay, and costs for patients who acquire it. Therefore, the prevention of VAP is a major issue in ICU clinical practice since it may help improve clinical outcome and reduce costs.. There are numerous strategies discussed in literature in relation to the prevention of VAP The numbers of studies targeting many areas of preventative strategies have significantly increased since the turn of this century. On the other hand, these strategies for ventilator-assisted pneumonia remain highly controversial. Preventive measures of VAP are mainly aimed to reduce oropharyngeal or gastric colonization, and to avoid aspiration of contaminated aerodigestive tract secretions. This review aims to summarize the nonpharmacologic and pharmacologic measures for prevention of VAP. We belive that prevention is better than cure.

Today health related quality of life with its ever increasing importance has become an inherent part of treatment and follow up in all departments of medicine including diagnosis and treatment. In neuro-intensive care unit, the severest patients with the most intensive diagnosis and treatment period are followed up. Neurologic disorders with neurointensive care requirement include so many parameters potentially affecting the quality of life in acute and severe stages besides in chronic term. Apart from the effects of these diseases on life quality, there are many other important parameters related to quality of life. It is possible to list chief parameters as malnutrition in intensive care unit, agitation, pain, disruption of skin integrity, musculoskeletal system involvement, cardiovascular and autonomous involvement, side effect of drugs and multidrug interactions. In this review, the relationship between nutrition and health related quality of life in neurointensive care unit will be reviewed.

Colon and rectum cancer, is called for colorectal cancer. Colorectal cancer, is a major health problem especially of developed western countries. The prevalence in U.S., Canada, Britain France, Germany varies between 40-60 per thousand faces. In the United States per year is approximately 150.000, in Europe, 170,000 ,a million new cases are seen all in the world. The prevalence of new cases of cancer in the U.S. in the third place receives 11%, while in European countries after lung cancer is the most common cause of cancer death (1).

Aim: Sitosterolemia -also known as phytosterolemia- is a rare autosomal, recessively inherited disease characterized by elevated plasma and tissue plant sterol concentrations. Sitosterolemia is characterized by tendon and tuberous xanthomas and by a strong propensity toward premature coronary atherosclerosis. In this article information concerning sitosterolemia disease are reviewed. Main Main Findings: In contrast to healthy subjects with total plasma plant sterols less than 1 mg/dl, patients with sitosterolemia have plasma phytosterol levels in the range of 12 to 40 mg/dl. The main plant sterols in patients with phytosterolemia are sitosterol and kampesterol but also elevated levels of stigmasterol, avenasterol, brassikasterol, kampestanol, sitostanol are found. Sitosterolemia has been shown to result from mutations in either of the genes for 2 proteins (ABCG5 or ABCG8). These ABC transporters preferentially pump plant sterols out of intestinal cells into the gut lumen, thereby decreasing sterol absorption. Results: We believe that it is important to measure blood sitosterol levels in suspicious patients in order to get correct diagnosis and treatment the sitosterolemia.

Chronic otitis media and mastoiditis are the result of infection by an organism of low virulence or of acute infection with incomplete resolution. Mastoid inflammation produces thickening of some trabeculae secondary to reactive new bone formation and at the same time mineralization of other trabeculae. A cholesteatoma is an epidermoid cyst that consists histologicaly of an iner layer of stratified squamous epithelium. The lumen of the cyst is filled with desquamated epithelial debris. As the cyst enlarges and comes into contact with contigious bony structures of the middle ear, mastoid and petrous pyramid, erosion of these structures occurs owing to pressure necrosis and enzymatic lysis of bone. Ossicular erosion is seen %70 ratio. Ossicular erosion is seen later and the long crus of incus is eroded the most frequently. But the bigger lesions may make erosion whole ossicles. Cholesteatomas may make tegmen erosion, mastoid cortex irregularity, fasial nevre contour irregularity and semisircular canal defect according to bigness and period. Tympanosclerosis develops in the result of collecting hyalin and calsific deposits in tympanic membran and the submucosa of middle ear. These are tympanosclerotic plugs. It appears in the result of otitis media or trauma.

Annulate lamellae (AL) are found in the cytoplasm and consist of stacks of flattened membrane cisternae perforated by numerous and densely packed pore complexes lacking both chromatin and a lamina. AL are frequently observed in rapidly growing or differentiating cells, such as male and female gametes, tumor ceils, and virally infected cells. Nuclear and annulate lamellae pores appear morphologically indistinguishable in their basic structure when viewed by a number of different electron microscopy techniques. Since AL are relatively easier to observe in germ cells, most of our knowledge concerning this organelle and speculations as to the proposed function of these cytomembranes has arisen from morphological studies of annulate lamellae during the course of germ cell maturations. Most cells have an inherent propensity towards AL formation . Even though annulate lamellae are not a ubiquitous feature of terminally differentiated cells, it is possible to induce the formation of the AL network in cells. The purpose of this review is to acquaint or reacquaint the reader with this inracellular membrane network and to adres a number of basic questions concerning the orgin, function, and fate this rather intriguing cellular organelle.

Diagnosis of acute abdomen in pregnancy is still a difficult situation. Due to physiological and anatomical changes of a pregnant woman during pregnancy, the diagnosis and treatment can be difficult to decide. In addition, some of the procedures used for the diagnosis are avoided because of risk to the fetus. Delay in the diagnosis may cause maternal morbidity, mortality, risk of fetal loss and can cause premature birth. Surgical intervention may be required or surgical intervention may be harmful in some cases. The incidence of acute abdomen in pregnancy has been reported as 1 in 500-635. Among the causes of nonobstetric acute abdomen in pregnancy are: acute appendicitis, intestinal obstruction, acute cholecystitis, cholelithiasis, inflammatory bowel disease, peptic ulcer, acute pancreatitis, hepatic rupture, intestinal obstruction, acute fatty liver of pregnancy and severe preeclampsia. The life of the mother and fetus are important in the diagnosis and treatment. Early diagnosis and treatment are very important for the fetus and the mother.

Aim: Nosocomial pneumonia is the second most frequent nosocomial infection and represents the leading cause of death from infections that are acquired in the hospital. The aim of this review summarize to therapeutic approaches in infection of intensive care unit. Main findings: Pneumonia is the most common nosocomial infection in intensive care unit (ICU). Occurrence ranges from 0.4% in unselected hospitalized patients to 23% in the ICU. ICU patients with any nosocomial infection have 2.5 times the death rate of uninfected patients. Interventions to prevent pneumonia in the ICU should combine multiple measures targeting the invasive devices, microorganisms, and protection of the patient. Once pneumonia develops, the appropriateness of the initial antibiotic regimen is a vital determinant of outcome. Conclusion: Antibiotic therapy should be started immediately and must circumvent pathogen-resistance mechanisms developed after previous antibiotic exposure. Therefore, antibiotic choice should be institution specific and patient oriented.

Phacoemulsification (phaco) surgery is the most commonly surgical intervention performed by ophthalmologists. The injury of corneal endothelial layer with phaco surgery is still important despite recent developments. The specular microscopy analysis of endothelial layer is very important in the preoperative evaluation of the patients with cataract. In addition, the influence of endothelial cell to phaco surgery may be evaluated with specular microscopic analysis techniques. Current phaco surgery is aimed to minimize endothelial damage by endothelial protective surgical techniques. Thus, endothelial cell count does not decrease under the physiological threshold level, and postoperative corneal edema improves with the compensation of residual cells in a short time. However, endothelial cell loss during aging may cause corneal decompensation at advanced age. Therefore, endothelial cell loss should be minimized at each step of phaco surgery. This article aims to review the analysis of corneal endothelial layer and specular microscopy and to evaluate the effect of phaco surgery on corneal endothelium.

Epistaxis, whether spontaneous or otherwise is experienced by up to 60% of people in their lifetime, 6% requiring medical attention. The condition has a bimodal distribution, with incidence peaks at ages younger than 10 years and older than 50 years. Epistaxis appears to occur more often in males than in females. With the evolution of endoscopic technology new treatment strategies combined with the use of stepwise epistaxis management plans can limit patient complications and provide effective treatment possibilities.

Tracheobronchial foreign body aspiration is a common and lifethreatening problem in childhood and adulthood and an important cause of childhood morbidity and mortality. Recurrent respiratory tract infections may be due to foreign body aspiration. Aspirates includes frequently; toys, coins, beans, nuts, peanut, kernel, dried legumes, and sugars in children and; food, awn, turban pins, metallic objects and dental prosthesis in the adults, respectively. If foreign body aspiration may caused to complete or nearly total occlusion, in this time the object have to be removed urgently. Although flexible bronchoscopy can be used to remove of foreign bodies in children and adults, rigid bronchoscopy remains the gold standard all the time.

Daptomycin, is currently the first and only member of a new age antibiotics class labeled as cyclic lipopeptides. The spectrum of its effectiveness is limited with gram positive aerobe and anaerobe bacteria. It is effective against; staphylococci including methicillin resistant S.aureus (MRSA), vancomycin intermediately sensitive S.aureus (VISA), vancomycin resistant S.aureus (VRSA), enterococci including E.faecalis and E.faecium, and penicillin resistance streptococci including S.pneumoniae. Daptomycin, first used in the world in 2003, was licensed in our country in 2009. The clinical indications for daptomycin use are the same with other countries; namely, complicated skin and soft tissues infections, and S.aureus bacteremia and S.aureus right sided endocarditis.

Ventriculo-peritoneal shunt, hydrocephalus, anüs

Aim: Familial Mediterranean fever, is the most common and well known disease in hereditary periodic fever syndromes at the present time. In this review we summarized the disease, which was seen frequently in our country, and newly treatment methods. Main findings: Familial Mediterranean fever was described in a Jewish girl in 1908. Generally it was seen in Armenians, Sefaradian Jew, Arabians and Anatolian Turks. Pathogenesis of the disease was not clear. Characteristic feature of the disease is acute fever attacks accompanied with abdominal pain, chest pain and joint pain. The most important complication is type AA amiloidosis. There is no specific laboratory or radiological finding. Colchicum which is used in the treatment, decreases frequency of attacks and prevents from development of amiloidosis. Result: Aproximately 1/4 patients are resistive to colchicum treatment. There are some studies which shows adding interferon a, selective seratonine reuptake inhibitors and biological agents to the treatment are effective in these patients.

 Today an increasing prevalence of obesity, which is one of major health problems is associated with many chronic diseases such as diabetes, cardiovascular disease, stroke, cancer, asthma obstructive sleep apnea syndrome. Therefore, treatment of obesity contribute to  prevention of many chronic diseases risk. Recent years, it has started to consider on effects on the gastrointestinal system in treatment of obesity as well as adequate and balanced diet, increasing  physical activity and lifestyle changes. Especially it was seen that gut microbiota has been associated with obesity. Many studies showed that gut microbiota may be vary with eating habits and obesity. It is discussed changed microbiota might be associated with obesity and many obesity-related diseases. It is thought that long term-controlled studies in this area   will create a new approach to the treatment of obesity and come into prominence in the fight against obesity. In this review,it was aimed to evaluate the relationship between body weight and the gut microbiota.
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Free radicals derived fi-om molecular oxygen are receiving particular attention irı medicine. Skin as a sit,• of ()Aygen radical production is a target organ for their &imaging properties. In this review the desen-prim'r of radical oxygen species and their ef-fects on skin is presented, antioxidant defence ince-hanisms and possible novel therapeutic antioxidant agents are mentioned.

Retinopathy of prematurity (ROP) is a potentially blinding disease. ROP continues to be a leading cause of blindness of newborn in areas of the world that provide neonatal intensive care services to premature newborns. The aim of this review is to evaluate the new technical improvements and treatment modalities under current data. Increased number of Newborn Intensive Care Units leads to survive of incerased number of immature babies which in turn leads to increased number of premature infants to be screened and eyes to be treated. Although the current gold standart of screening method is examination by an experienced opthalmolog with binocular indirect ophthalmoscopy, a new debate arose that claims digital retinal photographs may be taken and evaluated in the remote reading centers by experienced ophthalmologists. On the other hand intravitreal injection of single dose of anti-VEGF may replace the more destructive cryotherapy and laser at the treatment aspect. Recent technical and medical improvements may induce major changes at the screening and treatment protocols of PR.

Aim: Aging is a major process that results in changes in cardiovascular structure and function in elderly people. The aim of this review to summarize the effect of aging on some aspects of cardiovascular structure and function. Result: Increased arterial stiffness alters afterload and left ventricular shape. Age related deteriorations in left ventricular structure and functions are impaired ejection reserve, increase in diastolic volume and an altered diastolic filling pattern. Reduction in the number of myocytes and deterioration of subcellular structure are also remarkable with advanced age. Significant alterations in cardiovascular function during exercise are also demonstrated in elderly people. Conclusion: Significant changes have been noted in the structure and function of the cardiovascular system in older people that are considered to be the result of aging. These changes can be regarded as either adaptive or early preclinical disease, but they occur in the absence of clinically manifest dysfunction.

In pregnant women, trauma is responsible for nonobstetrik maternal-fetal mortality and morbidity. Approach to trauma in pregnancy is similar to non-pregnant women. Approach to patient with considering physiological changes during pregnancy and timely prevention of possible obstetrical complications is significant keeping in mind that these complications may affect maternal mortality and morbidity.

Neonatal hemochromatosis is a rare disease clinically defined as severe neonatal liver disease in association with extrahepatic siderozis. The etiology of neonatal hemochromatosis is not understood exactly. However, according to a theory neonatal hemochromatosis is accepted to be an alloimmune disorder causing liver injury in fetus. After an effected one in the pregnancy the recurrence rate of neonatal hemochromatosis is ~80%. Hepatocellular failure which occurs in the first days of life with coagulopathy, hypoglycemia, hypoalbuminemia, hypofibrinogenemia, thrombocytopenia, anemia, and direct and indirect hyperbilirubinemia characterizes neonatal hemochromatosis. In order to diagnose neonatal hemochromatosis there are some certain criteria that sould be taken into account such as a positive family history, high serum ferritin levels, high serum alpha-fetoprotein levels and siderozis demonstrated with histology or with magnetic resonance. Since an affective medical treatment has not been found yet, liver transplantation is almost always required. The prognosis of neonatal hemochromatosis is generally poor. This review will discuss neonatal hemochromatosis that leads to liver failure in the fetus or newborn.

Diabetes mellitus (DM) absolute or relative deficiency of endogenous insulin or resulting from peripheral ineffectiveness of chronic hyperglycemia, carbohydrate, protein and fat metabolism disorder, capillary membrane changes, and accelerated atherosclerosis associated with chronic, progressive disease (1). The main cause of vision loss in patients with diabetic macular edema(4). In the treatment of macula edema, laser photocoagulation, VEGF inhibitors and vitrectomy is recommended. Choroid, neuroretina, photoreceptors preserving particularly selective RPE laser damage seems to be the appropriate treatment method (24). It was seen that Fundus was preserved µs pulse duration and consecutive irradiation damage, selective RPE with photoreceptors (26,27). Suffered damage to the planned study of selective RPE treatment in diabetic macular edema, Afyon Kocatepe University School of Medicine, Department of Ophthalmology, Retina Unit, between October 2005 and February 2007 were followed up with a diagnosis of DRP, and triggers as a result of the examination detected the presence of macular edema over the age of 18, 99 eyes of 84 patients separated into 2 groups and administered SRL and grid laser treatment followed 6 months. As a result, SRL, and grid laser photocoagulation was effective in the treatment of DMÖ. 84.9 % increase in SRL-treated patients and stabilization of visual acuities were determined. It was confirmed that in Grid laser group and 6-month follow-up and stabilization as a result of an increase in visual acuity was 89.9%.

Psychiatric disorders and psychological stress has been implicated as a potential trigger in onset and exacerbation of dermatological diseases. Additionally, skin diseases have often been found to be associated with anxiety, depression and impaired quality of life. Therefore, it may be considered that there are a reciprocal influence between psychiatric status and skin diseases. Although significant majority of the cases begin before adulthood, limited data are available about relationship between skin disease and psychiatric morbidity in childhood and adolescence. In this article, psychodermatologic disorders in these age groups and our current scientific knowledge on these disorders will be discussed.

Towards the end of 2019, new coronavirus causing acute respiratory distress syndrome in patients was detected in Wuhan Province, China . This virus was called serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Virus Taxonomy Committee. The disease caused by this new coronavirus was called coronavirus disease-2019 (COVID-19) by the World Health Organization. This virus was found to be in the subclass of Betakoronavirus caused by bats. The role of viral proteins such as envelopes, membranes, nucleocapsids and spike proteins responsible for viral infectivity in immunopathogenesis is being investigated in studies. It has been emphasized in studies in which multiple organ failure develops due to the development of cytokine storm, especially in the advanced stages of the disease. An effective host immune response, including natural and adaptive immunity to SARS-Cov-2, is essential for controlling and treating viral infection. Although there is no effective treatment for the disease today, the benefits of various immunosuppressive and immunomodulatory drugs have been shown in studies. In this article, the immunopathogenesis of SARS-CoV-2 and the treatment models that can be effective on immunopathogenesis are reviewed in the light of current literature.

Asthma is one ofthe commonest diseases in children and adults İn many countries. The prevalence of asthma has dramatically increased in recent years. The development of asthma depend on an interaction between genetic factors, environmental exposure to allergens, and nonspesific adjuvant factors such as tobacco smoke, air pollu- tion, and vira! infections. These factors initiates a series of immunological changes, resulting in airvvay inflamma- tion. The airvvay inflammatory process is characterized by chronic eosinophilic and Th2 type lymphocytic infiltra- tion. Although the knovvledge about asthma pathogenesis has increased, the prevalence of asthma has not decreased. Therefore, the asthma stili is a threat for the society’s health at the beginning of the 21 st century.

Platelet-rich plasma has become increasingly popular in recent years, and it is a plasma component that contains a high concentration of platelets, which is obtained by centrifugation of blood. It was first used in 1987 to reduce the transfusion of homologous blood products following open heart surgery. In recent years, in addition to dermatology, the use of Platelet-rich plasma has been increasing in many medical branches such as orthopedics, physical therapy, plastic surgery, cardiovascular surgery, maxillofacial surgery, urology and ophthalmology. Dermatology are still increasingly being used in many different indications. The results obtained in the studies give hope and indicate a new indication every day. However, in studies, the lack of application stand and the low number of patients are seen as limiting effects. Before determining the exact indications of the Platelet-rich plasma, standardization of applications and controlled studies on large patient populations are needed.

\r\n Autism spectrum disorder is a neuro-developmental disorder characterized by social interaction and communication, and restricted and repetitive behaviors. Autism is seen in nearly one of 68 children. The incidence is reported to increase, and the increase is suggested to arise from increased information, awareness and alterations in diagnostic criteria. However, environmental factors and their relationships to several unknown genetic factors are also considered to contribute to the increase. The assessment of whether environmental factors lead to risks for autism spectrum disorder in perinatal period, especially when children are exposed to these factors in a neurodevelopmentally important and fragile stage, is so important. It is reported that in pregnancy, there is an association between autism spectrum disorder, and exposure to such drugs as valporic acid, terbutaline and Selective Seratonin Reuptake Inhibitors.Exposure to heavy metals and pesticides increases the risk of autism spectrum disorder.Intense smoking, and alcohol consumption and drugsdisrupt neurodevelopmental process, Also, gestational diabetes may elavate the risk of autism spectrum disorder due to autoimmunal disorders, infections and inflammatory pocesse of prolonged fever. Migration, seasons and air pollution exposed in pregnancy are also reported to affect autism spectrum disorder risk. The awareness level between environmental factors and autism spectrum disorder should be increased among prospective mothers, and these mothers should be trained as to the risk factors. Because prospective mothers avoid these factors, or the elimination of these factors should be beneficial for reducing autism spectrum disorder risk, analyzing related studies and enlightening risk factors are especially important. Here, we aimed at revising recent studies related to prenatal factors from a holistic perspective.

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Sustainability is satisfying the needs of present generation by pro tecting presence and quality of resources that future generations will need. A sustainable nutrition system refers to a diet with low environmental impacts which contribute to food and nutrition security for healthy life for present and future generations. Nutrition systems has changed as a result of growing global population, developing the technology, urbanization and industrialization. This situation result in environmental problems as water resources and land uses and increasing greenhouse gases emissions in addition to several health problems notably increasing cronic diseases incidence. Environmental changes and nutrition systems are interrelated. A nutrition model which is containing animal based food enough and plant based can supply sustainability of health and environment.

Some authors reporied that antibacterial effect increases 1.7 to 10.8 times, when antibiotics are used logether with ultrasound in the contaıninated injuries. It has been suggesıed that the ultrasound may increase the antibacierial effect, when the antibacterial drug gets in iade rnore with the microbial cell membrane I'n this review, investigations vere carried out about this subject in the Lastern Mack Countries.

Acute pancreatitis is an important cause of acute abdominal pain in children and requires prompt treatment because it may become life-threatening. The incidence of acute pediatric pancreatitis is increasing. Although epidemiology of acute pancreatitis, clinical manifestations and acute pancreatitis course in children are generally different than in adults, information about etiology, management and results are obtained on the basis of adult studies. In most cases, inflammation may limit itself, but in some cases acute pancreatitis, acute recurrent pancreatitis or chronic pancreatitis may progress. It is necessary to provide optimal management in the acute period of pancreatitis in children, as this may prevent secondary conplications. In this review we summarise the epidemiology of acute pancreatitis, role of imaging and imaging findings in the diagnosis of acute pancreatitis, treatment methods and management and complications of acute pancreatitis.

Sport has been adopted by many people around the world and has been accepted as a way of life. It not only contributes to the consciousness of exercise required for healthy life, but also contributes to the solution of many problems that people face in their daily lives thanks to the principles such as brotherhood, interlocking and justice. The practice of sports medicine has some differences in terms of ethical conflicts compared to other medicine practices. In addition to the classical physician-patient relationship, managing the physician-patient-team relationship, especially sports team physicians, forms the basis of these differences. During the management of this relationship, sports physicians may face some ethical conflicts. The physician must act in an honest and conscientious manner in his approach to the athlete and in his decisions. However, it is another important ethical behavior that the physician provides sufficient information to the athlete and enables the athlete to decide on his own body and act freely. Particularly financial pressures on teams and athletes, as well as the competition and ambition of success that are at the core of sports, can create dilemmas that can affect sports physicians' decision making processes. However, sports physicians are people who are expected to comply with ethical principles without losing their professionalism. If these ethical principles are not followed, malpractice situations may arise and physicians may encounter judicial processes. With the development of technology, many innovations in the field of sports medicine, as in every field, come into practical use. The role of these innovations in the development of sports medicine practices is very important. However, it is important to keep professional information up-to-date in the process of possible ethical problems and optimal decision making that these developments can create. Sports physicians have a great role in dealing with ethical and legally inappropriate situations, especially the use of doping. This review will review possible ethical problems and malpractice situations that sports physicians may encounter.

Cancer is a serious genetic disease caused by a series of disorders in the genome. Development of hightroughput sequencing approaches as well as the publication of large-scale projects have enabled the identification of several non-coding RNA molecules that are differentially expressed in various types of cancer. It has been reported that ncRNA transcripts such as long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) have critical roles in the development and progression of cancer and can be used in the diagnosis/treatment of cancer. In particular, miRNAs are small RNA molecules which control gene expression at the post-transcriptional level and play critical roles in the important hallmark capabilities of cancers such as metastasis, invasion, cell proliferation, differentiation, and angiogenesis. Similarly, lncRNAs have also been identified as RNA transcripts that have important roles in the understanding of the molecular mechanism of cancer. Accordingly, in this comprehensive review, functional ncRNA molecules without protein coding capacity such as miRNAs, lncRNAs, and T-UCRs and the hallmarks of cancer were discussed together with a current perspective. 

In order tü prepare the patients who had developed chronic renal failure to hemodilaysis, latero-lateral arteriovenous fistula application was applied among the localized arteria. In 4 cases in which superficial venis weren't sujficient (arteria brachialis-venae brachialis) was reconstructed among the deep vessels in fossa an-tecubiti. It was observed that there were some en-largements which made the hemodialysis possible on the superficial veins by means of the venous connection between deep and superficial veins in 30 clays

In order tü prepare the patients who had developed chronic renal failure to hemodilaysis, latero-lateral arteriovenous fistula application was applied among the localized arteria. In 4 cases in which superficial venis weren't sujficient (arteria brachialis-venae brachialis) was reconstructed among the deep vessels in fossa an-tecubiti. It was observed that there were some en-largements which made the hemodialysis possible on the superficial veins by means of the venous connection between deep and superficial veins in 30 clays